0001564590-23-006841 | 10-Q | XBRL Viewer | Community Health Systems INC

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Document and Entity Information - shares	3 Months Ended
Document and Entity Information - shares	Mar. 31, 2023	Apr. 25, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Mar. 31, 2023
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q1
Current Fiscal Year End Date	--12-31
Entity File Number	001-15925
Entity Registrant Name	COMMUNITY HEALTH SYSTEMS, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	13-3893191
Entity Address, Address Line One	4000 Meridian Boulevard
Entity Address, City or Town	Franklin
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37067
City Area Code	615
Local Phone Number	465-7000
Title of 12(b) Security	Common Stock, $.01 par value
Trading Symbol	CYH
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		136,742,427
Entity Central Index Key	0001108109
Amendment Flag	false

Condensed Consolidated Statements of Loss - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Income Statement [Abstract]
Net operating revenues	$ 3,108	$ 3,111
Operating costs and expenses:
Salaries and benefits	1,365	1,325
Supplies	507	499
Other operating expenses	835	853
Lease cost and rent	81	77
Pandemic relief funds		(47)
Depreciation and amortization	132	128
Impairment and (gain) loss on sale of businesses, net	(22)	6
Total operating costs and expenses	2,898	2,841
Income from operations	210	270
Interest expense, net	207	217
Loss from early extinguishment of debt		5
Equity in earnings of unconsolidated affiliates	(3)	(5)
Income before income taxes	6	53
Provision for income taxes	26	23
Net (loss) income	(20)	30
Less: Net income attributable to noncontrolling interests	31	31
Net loss attributable to Community Health Systems, Inc. stockholders	$ (51)	$ (1)
Loss per share attributable to Community Health Systems, Inc. stockholders:
Basic	$ (0.40)	$ (0.01)
Diluted	$ (0.40)	$ (0.01)
Weighted-average number of shares outstanding:
Basic	129,688,917	127,818,209
Diluted	129,688,917	127,818,209

Condensed Consolidated Statements of Comprehensive (Loss) Income - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Statement Of Income And Comprehensive Income [Abstract]
Net (loss) income	$ (20)	$ 30
Other comprehensive income (loss), net of income taxes:
Net change in fair value of available-for-sale debt securities, net of tax	3	(8)
Other comprehensive income (loss)	3	(8)
Comprehensive (loss) income	(17)	22
Less: Comprehensive income attributable to noncontrolling interests	31	31
Comprehensive loss attributable to Community Health Systems, Inc. stockholders	$ (48)	$ (9)

- 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	Mar. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 144	$ 118
Patient accounts receivable	2,043	2,040
Supplies	345	353
Prepaid income taxes	79	99
Prepaid expenses and taxes	276	237
Other current assets	227	235
Total current assets	3,114	3,082
Property and equipment	9,560	9,639
Less accumulated depreciation and amortization	(4,305)	(4,274)
Property and equipment, net	5,255	5,365
Goodwill	4,051	4,166
Deferred income taxes	49	49
Other assets, net	2,154	2,007
Total assets	14,623	14,669
Current liabilities:
Current maturities of long-term debt	39	21
Current operating lease liabilities	138	148
Accounts payable	712	773
Accrued liabilities:
Employee compensation	596	637
Accrued interest	184	189
Other	463	418
Total current liabilities	2,132	2,186
Long-term debt	11,696	11,614
Deferred income taxes	351	354
Long-term operating lease liabilities	588	605
Other long-term liabilities	647	644
Total liabilities	15,414	15,403
Redeemable noncontrolling interests in equity of consolidated subsidiaries	561	541
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; 136,749,427 shares issued and outstanding at March 31, 2023, and 134,703,717 shares issued and outstanding at December 31, 2022	1	1
Additional paid-in capital	2,054	2,084
Accumulated other comprehensive loss	(18)	(21)
Accumulated deficit	(3,482)	(3,431)
Total Community Health Systems, Inc. stockholders’ deficit	(1,445)	(1,367)
Noncontrolling interests in equity of consolidated subsidiaries	93	92
Total stockholders’ deficit	(1,352)	(1,275)
Total liabilities and stockholders’ deficit	$ 14,623	$ 14,669

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2023	Dec. 31, 2022
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	136,749,427	134,703,717
Common stock, shares outstanding	136,749,427	134,703,717

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Cash flows from operating activities:
Net (loss) income	$ (20)	$ 30
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization	132	128
Deferred income taxes	7	22
Stock-based compensation expense	6	5
Impairment and (gain) loss on sale of businesses, net	(22)	6
Loss from early extinguishment of debt		5
Other non-cash expenses, net	42	45
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures:
Patient accounts receivable	(2)	(17)
Supplies, prepaid expenses and other current assets	(50)	(40)
Accounts payable, accrued liabilities and income taxes	(32)	(23)
Other	(56)	(60)
Net cash provided by operating activities	5	101
Cash flows from investing activities:
Acquisitions of facilities and other related businesses	(8)	(1)
Purchases of property and equipment	(122)	(97)
Proceeds from disposition of hospitals and other ancillary operations	92	2
Proceeds from sale of property and equipment	5
Purchases of available-for-sale debt securities and equity securities	(26)	(31)
Proceeds from sales of available-for-sale debt securities and equity securities	61	24
Purchases of investments in unconsolidated affiliates	(5)	(4)
Increase in other investments	(16)	(14)
Net cash used in investing activities	(19)	(121)
Cash flows from financing activities:
Repurchase of restricted stock shares for payroll tax withholding requirements	(4)	(8)
Deferred financing costs and other debt-related costs		(73)
Proceeds from noncontrolling investors in joint ventures	2	1
Redemption of noncontrolling investments in joint ventures	(1)
Distributions to noncontrolling investors in joint ventures	(44)	(29)
Other borrowings	29	27
Issuance of long-term debt		1,535
Proceeds from ABL Facility	815
Repayments of long-term indebtedness	(757)	(1,480)
Net cash provided by (used in) financing activities	40	(27)
Net change in cash and cash equivalents	26	(47)
Cash and cash equivalents at beginning of period	118	507
Cash and cash equivalents at end of period	144	460
Supplemental disclosure of cash flow information:
Interest payments	$ (197)	(242)
Income tax payments, net		$ (2)

Basis of Presentation and Significant Accounting Policies

3 Months Ended

Mar. 31, 2023

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 March 31, 2023 and December 31, 2022 and for the three-month periods ended March 31, 2023 and 2022, have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”). In the opinion of management, such information contains all adjustments, consisting only of normal recurring adjustments, necessary for a fair presentation of the results for such periods. All intercompany transactions and balances have been eliminated. The results of operations for the three months ended March 31, 2023, are not necessarily indicative of the results to be expected for the full fiscal year ending December 31, 2023. The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements. Actual results could differ from these estimates under different assumptions or conditions.

Certain information and disclosures normally included in the notes to the consolidated financial statements have been condensed or omitted as permitted by the rules and regulations of the Securities and Exchange Commission (the “SEC”). The Company believes the disclosures are adequate to make the information presented not misleading. The accompanying unaudited condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto for the year ended December 31, 2022, contained in the Company’s Annual Report on Form 10-K filed with the SEC on February 17, 2023 (“2022 Form 10-K”).

Noncontrolling interests in less-than-wholly-owned consolidated subsidiaries of the Parent are presented as a component of total equity in 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 in 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 $61 million and $63 million for the three months ended March 31, 2023 and 2022, 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, and management services provided, 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 month periods ended March 31, 2023 and 2022, 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 months ended March 31, 2023 and 2022 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
	March 31,
	2023		2022
Medicare	$	649	$	668
Medicare Managed Care		543		513
Medicaid		423		467
Managed Care and other third-party payors		1,469		1,420
Self-pay		24		43
Total	$	3,108	$	3,111

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, Medicare Managed Care, 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 operating revenues 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 macroeconomic conditions 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 $120 million and $101 million as of March 31, 2023 and December 31, 2022, respectively, and these amounts are included in accrued liabilities-other in the accompanying condensed consolidated balance sheets. Amounts due from third-party payors were $103 million and $97 million as of March 31, 2023 and December 31, 2022, 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 2018.

Charity Care

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

These charity care services are estimated to be $326 million and $363 million for the three months ended March 31, 2023 and 2022, 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 $38 million and $41 million during the three months ended March 31, 2023 and 2022, 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 three months ended March 31, 2023, the Company recorded a net gain of approximately $22 million, comprised of a gain of $25 million related to the sale of a hospital on January 1,

2023, offset by an approximate $3 million impairment charge recorded to reduce the carrying value of several assets that were idled, disposed of or held-for-sale.

During the three months ended March 31, 2022, the Company recorded an impairment charge of approximately $6 million related to a hospital that had been classified as held-for-sale based on the difference between the carrying value of the hospital disposal group compared to the estimated fair value less costs to sell.

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.

Accounting for Stock-Based Compensation

3 Months Ended

Mar. 31, 2023

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”). In addition, at the annual meeting of stockholders to be held on May 9, 2023 (the “2023 Annual Meeting”), the Company’s stockholders will be voting on whether or not to approve the further amendment and restatement of the 2009 Plan (the “Amended 2009 Plan”), which was approved by the board of directors on March 22, 2023.

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 (“RSUs”), performance-based shares or units and other share awards. Persons eligible to receive grants under the 2009 Plan include the Company’s directors, officers, employees and consultants. To date, all options granted under the 2009 Plan have been “nonqualified” stock options for tax purposes. Generally, these options vest in one-third increments on each of the first three anniversaries of the option grant date and expire on the tenth anniversary of the option grant date. 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. As of March 31, 2023, 1,560,708 shares of unissued common stock were reserved for future grants under the 2009 Plan. In addition, if the Amended 2009 Plan is approved by the Company’s stockholders at the 2023 Annual Meeting, then 7,500,000 additional shares of unissued common stock will be reserved for future grants under the Amended 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
	March 31,
	2023			2022
Effect on income before income taxes	$	(6	)	$	(5	)
Effect on net loss	$	(5	)	$	(4	)

At March 31, 2023, $49 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 26 months. Of that amount, $8 million relates to outstanding unvested stock options expected to be recognized over a weighted-average period of 26 months and $41 million relates to outstanding unvested restricted stock and restricted stock units expected to be recognized over a weighted-average period of 26 months. There were no modifications to awards during the three months ended March 31, 2023 and 2022.

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 months ended March 31, 2023 and 2022:

	Three Months Ended March 31,
	2023	2022
Expected volatility	87.3%	84.3% - 87.5%
Expected dividends	—	—
Expected term	6 years	3 - 6 years
Risk-free interest rate	4.2%	1.5% - 1.6%

In determining the expected term, the Company examined concentrations of option holdings and historical patterns of option exercises and forfeitures, as well as forward-looking factors, in an effort to determine if there were any discernable employee populations. From this analysis, in determining the expected term for the three months ended March 31, 2023, the Company identified one population, consisting of persons receiving grants of stock options. Additionally, in determining the expected term for the three months ended March 31, 2022, two populations were identified, one consisting of certain senior executives who have since retired, 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 March 31, 2023, and changes during the three-month period following December 31, 2022, was as follows (in millions, except share and per share data):

						Weighted-	Aggregate
				Weighted-		Average	Intrinsic
				Average		Remaining	Value as of
				Exercise		Contractual	March 31,
	Shares			Price		Term	2023
Outstanding at December 31, 2022		2,831,751		$	7.32
Granted		814,000			6.15
Exercised		(8,334	)		4.97
Forfeited and cancelled		—			—
Outstanding at March 31, 2023		3,637,417		$	7.06	8.1 years	$	—
Exercisable at March 31, 2023		2,078,661		$	6.46	7.2 years	$	—

The weighted-average grant date fair value of stock options granted during the three months ended March 31, 2023 and 2022 was $4.61 and $7.25, respectively. The aggregate intrinsic value (calculated as the number of in-the-money stock options multiplied by the difference between the Company’s closing stock price on the last trading day of the reporting period ($4.90) 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 March 31, 2023. 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 three months ended March 31, 2023 and 2022. 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, disability, change in control of the Company or, other than for performance-based awards, termination of employment by the Company for any reason other than for cause of the holder of the restricted stock. On March 1, 2023, restricted stock awards subject to performance objectives granted on March 1, 2020 vested at 100% of the shares originally granted based on the Company’s cumulative performance compared to objectives for the 2020 through 2022 performance period. Restricted stock awards subject to performance objectives that have not yet been satisfied are not considered outstanding for purposes of determining diluted 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 March 31, 2023, and changes during the three-month period following December 31, 2022, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2022		5,541,065		$	8.53
Granted		2,651,000			6.14
Vested		(2,076,569	)		6.77
Forfeited		(10,001	)		9.31
Unvested at March 31, 2023		6,105,495			8.09

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 29,268 RSUs and 17,682 RSUs with a grant date of March 1, 2023 and 2022, respectively. Both the March 2023 and 2022 grants had a grant date fair value of approximately $180,000. In addition to the grants set forth above, on March 1, 2023, the non-employee Chairman of the Board of Directors was awarded an additional RSU grant of 43,089 RSUs with a grant date fair value of approximately $265,000 as additional compensation for serving as chairman of the Board of Directors. 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 four directors elected to defer the receipt of RSUs granted on March 1, 2023 to a future date and a total of three directors elected to defer the receipt of RSUs granted on March 1, 2022 to a future date.

RSUs outstanding under the 2009 Plan as of March 31, 2023, and changes during the three-month period following December 31, 2022, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2022		512,360		$	7.54
Granted		365,037			6.15
Vested		(95,577	)		7.92
Forfeited		—			—
Unvested at March 31, 2023		781,820			6.84

Acquisitions and Divestitures

3 Months Ended

Mar. 31, 2023

Acquisitions And Divestitures [Abstract]

ACQUISITIONS AND DIVESTITURES

3. ACQUISITIONS AND DIVESTITURES

Acquisitions

The Company accounts for all transactions that represent business combinations using the acquisition method of accounting, where the identifiable assets acquired, the liabilities assumed and any noncontrolling interest in the acquired entity are recognized and measured at their fair values on the date the Company obtains control in the acquiree. Such fair values that are not finalized for

reporting periods following the acquisition date are estimated and recorded as provisional amounts. Adjustments to these provisional amounts during the measurement period (defined as the date through which all information required to identify and measure the consideration transferred, the assets acquired, the liabilities assumed and any noncontrolling interests has been obtained, limited to one year from the acquisition date) are recorded when identified. Goodwill is determined as the excess of the fair value of the consideration conveyed in the acquisition over the fair value of the net assets acquired.

During the three months ended March 31, 2023, one or more subsidiaries of the Company paid approximately $8 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. In connection with these acquisitions, the Company allocated the purchase price to property and equipment, working capital and goodwill.

Divestitures

The following table provides a summary of hospitals that the Company divested during the three months ended March 31, 2023 and the year ended December 31, 2022:

			Licensed
Hospital	Buyer	City, State	Beds	Effective Date
2023 Divestiture:
Greenbrier Valley Medical Center	Vandalia Health, Inc.	Ronceverte, WV	122	January 1, 2023

2022 Divestiture:
AllianceHealth Seminole	SSM HealthCare of Oklahoma, Inc.	Seminole, OK	32	July 1, 2022

On December 30, 2022, the Company entered into a definitive agreement for the sale of substantially all of the assets of Plateau Medical Center (25 licensed beds) in Oak Hill, West Virginia, to a subsidiary of Vandalia Health, Inc. This hospital was classified as held-for-sale as of March 31, 2023. This disposition was completed on April 1, 2023, as further described in Note 13.

On February 28, 2023, the Company entered into a definitive agreement for the sale of substantially all of the assets of Lake Norman Regional Medical Center (123 licensed beds) in Mooresville, North Carolina, and Davis Regional Medical Center (144 licensed beds) in Statesville, North Carolina, to Novant Health, Inc. These hospitals were classified as held-for-sale as of March 31, 2023.

On March 2, 2023, the Company entered into a contribution and membership purchase agreement for the sale of a majority interest in Lutheran Rehabilitation Hospital (36 licensed beds) in Fort Wayne, Indiana, to Select Medical Corporation. This hospital was classified as held-for-sale as of March 31, 2023.

The following table discloses amounts included in the condensed consolidated balance sheets for the hospitals classified as held-for-sale as of March 31, 2023 and December 31, 2022 (in millions). Other assets, net, primarily includes the net property and equipment and goodwill for the hospitals held-for-sale. No divestitures or potential divestitures meet the criteria for reporting as a discontinued operation as of March 31, 2023 or December 31, 2022.

	March 31, 2023			December 31, 2022
Other current assets	$	9		$	6
Other assets, net		312			132
Accrued liabilities		(18	)		(4	)

Goodwill and Other Intangible Assets

3 Months Ended

Mar. 31, 2023

Goodwill And Intangible Assets Disclosure [Abstract]

GOODWILL

4. GOODWILL

The changes in the carrying amount of goodwill for the three months ended March 31, 2023 are as follows (in millions):

Balance, as of December 31, 2022
Goodwill	$	6,980
Accumulated impairment losses		(2,814	)
		4,166
Goodwill acquired as part of acquisitions during current year		6
Goodwill allocated to hospitals divested or held-for-sale		(121	)
Balance, as of March 31, 2023
Goodwill		6,865
Accumulated impairment losses		(2,814	)
	$	4,051

Goodwill is allocated to each identified reporting unit, which is defined as an operating segment or one level below the operating segment (referred to as a component of the entity). Management has determined that the Company’s operating segment meets the criteria to be classified as a reporting unit. At March 31, 2023, after giving effect to the 2023 acquisition and divestiture activity, the Company had approximately $4.1 billion of goodwill recorded.

Goodwill is evaluated for impairment annually and when an event occurs or circumstances change that, more likely than not, reduce the fair value of the reporting unit below its carrying value. The Company performed its last annual goodwill impairment evaluation during the fourth quarter of 2022 using an October 31, 2022 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, the Company’s recent financial results, estimates of future revenue and expense growth, estimated market multiples, expected capital expenditures, income tax rates, costs of invested capital and a discount rate.

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 as a result of any decline in the Company’s stock price and the fair value of its long-term debt, an increase in the volatility of the Company’s stock price and the fair value of its long-term debt, lower-than-expected hospital volumes and/or net operating revenues, higher market interest rates, increased operating costs or other adverse impacts on the Company’s financial results. Such changes impacting the calculation of fair value could result in a material impairment charge in the future.

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

Income Taxes

3 Months Ended

Mar. 31, 2023

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 $11 million at March 31, 2023. A total of less than $1 million of interest and penalties is included in the amount of the liability for uncertain tax positions at March 31, 2023. It is the Company’s policy to recognize interest and penalties related to unrecognized benefits in its condensed consolidated statements of loss as income tax expense.

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

The Company’s income tax return for the 2014, 2015 and 2018 tax years remain 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 Community Health Systems, Inc. for the tax period ended December 31, 2018.

The Company’s provision for income taxes was $26 million and $23 million for the three months ended March 31, 2023 and 2022, respectively. The Company’s effective tax rates were 433.3% and 43.4% for the three months ended March 31, 2023 and 2022, respectively. The increase in the provision for income taxes for the three months ended March 31, 2023, compared to the same period in 2022 was primarily due to an increase in non-deductible interest for 2023 compared to 2022. The difference in the Company’s effective tax rate for the three months ended March 31, 2023, compared to the same period in 2022 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 less than $1 million and approximately $2 million during the three months ended March 31, 2023 and 2022, 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)
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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
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-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
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-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
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-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

3 Months Ended

Mar. 31, 2023

Long Term Debt And Capital Lease Obligations [Abstract]

LONG-TERM DEBT

6. LONG-TERM DEBT

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

	March 31,			December 31,
	2023			2022
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			756
6% Senior Secured Notes due 2029		900			900
5¼% Senior Secured Notes due 2030		1,535			1,535
4¾% Senior Secured Notes due 2031		1,058			1,058
6⅞% Junior-Priority Secured Notes due 2029		1,386			1,386
6⅛% Junior-Priority Secured Notes due 2030		1,232			1,232
ABL Facility		125			53
Finance lease and financing obligations		377			380
Other		53			36
Less: Unamortized deferred debt issuance costs and note premium		(388	)		(402	)
Total debt		11,735			11,635
Less: Current maturities		(39	)		(21	)
Total long-term debt	$	11,696		$	11,614

Pursuant to the asset-based loan (ABL) credit agreement, the lenders have extended to CHS/Community Health Systems, Inc. (“CHS”) a revolving asset-based loan facility (the “ABL Facility”). The maximum aggregate principal amount under the ABL Facility is $1.0 billion, subject to borrowing base capacity. At March 31, 2023, the Company had outstanding borrowings of $125 million and approximately $792 million of additional borrowing capacity (after taking into consideration the $83 million of outstanding letters of credit) under the ABL Facility. The issued letters of credit were primarily in support of potential insurance-related claims and certain bonds.

The ABL Facility contains customary representations and warranties, subject to limitations and exceptions, and customary covenants restricting the Company’s ability, subject to certain exceptions, to, among other things (1) declare dividends, make distributions or redeem or repurchase capital stock, (2) prepay, redeem or repurchase other debt, (3) incur liens or grant negative pledges, (4) make loans and investments and enter into acquisitions and joint ventures, (5) incur additional indebtedness or provide certain guarantees, (6) engage in mergers, acquisitions and asset sales, (7) conduct transactions with affiliates, (8) alter the nature of the Company’s, CHS’ or the guarantors’ businesses, (9) grant certain guarantees with respect to physician practices, (10) engage in sale and leaseback transactions or (11) change the Company’s fiscal year. The Company is also required to comply with a consolidated fixed coverage ratio, upon certain triggering events described below, and various affirmative covenants. The consolidated

fixed 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 March 31, 2023, the Company is not subject to the consolidated fixed charge coverage ratio as such triggering event had not occurred during the twelve months ended March 31, 2023.

The Company paid interest of $197 million and $242 million on borrowings during the three months ended March 31, 2023 and 2022, respectively.

Fair Value of Financial Instruments

3 Months Ended

Mar. 31, 2023

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 March 31, 2023 and December 31, 2022, 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):

	March 31, 2023				December 31, 2022
	Carrying		Estimated Fair		Carrying		Estimated Fair
	Amount		Value		Amount		Value
Assets:
Cash and cash equivalents	$	144	$	144	$	118	$	118
Investments in equity securities		78		78		107		107
Available-for-sale debt securities		180		180		179		179
Trading securities		5		5		5		5
Liabilities:
8% Senior Secured Notes due 2026		2,084		2,032		2,083		1,917
8% Senior Secured Notes due 2027		694		678		693		631
5⅝% Senior Secured Notes due 2027		1,836		1,672		1,833		1,633
6⅞% Senior Notes due 2028		749		474		749		389
6% Senior Secured Notes due 2029		866		759		865		751
5¼% Senior Secured Notes due 2030		1,450		1,200		1,448		1,166
4¾% Senior Secured Notes due 2031		1,054		787		1,053		766
6⅞% Junior-Priority Secured Notes due 2029		1,285		864		1,282		720
6⅛% Junior-Priority Secured Notes due 2030		1,165		750		1,164		615
ABL Facility and other debt		174		174		85		85

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

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

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

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

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

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

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

- 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

3 Months Ended

Mar. 31, 2023

Fair Value Disclosures [Abstract]

FAIR VALUE

8. FAIR VALUE

Fair Value Hierarchy

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

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

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

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

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

In instances where the determination of the fair value hierarchy measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input that is significant to the fair value measurement in its entirety. The Company’s assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment of factors specific to the asset or liability. Transfers between levels within the fair value hierarchy are recognized by the Company on the date of the change in circumstances that requires such transfer. There were no transfers between levels during the three-month periods ended March 31, 2023 or 2022.

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 March 31, 2023 and December 31, 2022 (in millions):

	March 31, 2023		Level 1		Level 2		Level 3
Investments in equity securities	$	78	$	78	$	—	$	—
Available-for-sale debt securities		180		—		180		—
Trading securities		5		—		5		—
Total assets	$	263	$	78	$	185	$	—

	December 31, 2022		Level 1		Level 2		Level 3
Investments in equity securities	$	107	$	107	$	—	$	—
Available-for-sale debt securities		179		—		179		—
Trading securities		5		—		5		—
Total assets	$	291	$	107	$	184	$	—

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

3 Months Ended

Mar. 31, 2023

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 months ended March 31, 2023 and 2022 are as follows (in millions):

	Three Months Ended March 31,
Lease Cost	2023			2022
Operating lease cost:
Operating lease cost	$	55		$	51
Short-term rent expense		22			23
Variable lease cost		5			4
Sublease income		(1	)		(1	)
Total operating lease cost	$	81		$	77
Finance lease cost:
Amortization of right-of-use assets	$	3		$	3
Interest on finance lease liabilities		3			4
Total finance lease cost	$	6		$	7

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

	Balance Sheet Classification	March 31, 2023			December 31, 2022
Operating Leases:
Operating lease right-of-use assets	Other assets, net	$	712		$	738

Finance Leases:
Finance lease right-of-use assets	Property and equipment
	Land and improvements	$	—		$	—
	Buildings and improvements		261			261
	Equipment and fixtures		11			12
	Property and equipment		272			273
	Less accumulated depreciation and amortization		(58	)		(56	)
	Property and equipment, net	$	214		$	217

Current finance lease liabilities	Current maturities of long-term debt	$	2		$	3
Long-term finance lease liabilities	Long-term debt		219			220

Supplemental cash flow information related to leases for the three months ended March 31, 2023 and 2022 is as follows (in millions):

	Three Months Ended March 31,
Cash flow information	2023		2022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases ⁽¹⁾	$	52	$	50
Operating cash flows from finance leases		3		4
Financing cash flows from finance leases		1		6
Right-of-use assets obtained in exchange for new finance lease liabilities		—		31
Right-of-use assets obtained in exchange for new operating lease liabilities		24		69

_______________________________

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

Stockholders' Deficit

3 Months Ended

Mar. 31, 2023

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 March 31, 2023, 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 March 31, 2023, 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 March 31, 2023, and during the three-month period following December 31, 2022 (in millions):

				Community Health Systems, Inc. Stockholders
	Redeemable Noncontrolling Interest			Common Stock		Additional Paid-In Capital			Accumulated Other Comprehensive Loss (Income)			Accumulated Deficit			Noncontrolling Interest			Total Stockholders’ Deficit
Balance, December 31, 2022	$	541		$	1	$	2,084		$	(21	)	$	(3,431	)	$	92		$	(1,275	)
Comprehensive income (loss)		21			—		—			3			(51	)		11			(37	)
Distributions to noncontrolling interests		(33	)		—		—			—			—			(11	)		(11	)
Purchases of subsidiary shares from noncontrolling interests		(1	)		—		—			—			—			—			—
Contributions from noncontrolling interests		1			—		—			—			—			1			1
Adjustment to redemption value of redeemable noncontrolling interests		32			—		(32	)		—			—			—			(32	)
Cancellation of restricted stock for tax withholdings on vested shares		—			—		(4	)		—			—			—			(4	)
Share-based compensation		—			—		6			—			—			—			6
Balance, March 31, 2023	$	561		$	1	$	2,054		$	(18	)	$	(3,482	)	$	93		$	(1,352	)

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 March 31, 2022, and during the three-month period 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)			Accumulated Deficit			Noncontrolling Interest			Total Stockholders’ Deficit
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	)

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
	March 31,
	2023			2022
Net loss attributable to Community Health Systems, Inc. stockholders	$	(51	)	$	(1	)
Transfers to the noncontrolling interests:
Net increase (decrease) in Community Health Systems, Inc. paid-in-capital for purchase of subsidiary partnership interests		—			(1	)
Net transfers to the noncontrolling interests		—			(1	)
Change to Community Health Systems, Inc. stockholders' deficit from net loss attributable to Community Health Systems, Inc. stockholders and transfers to noncontrolling interests	$	(51	)	$	(2	)

- Definition

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

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 13
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496158-112644

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (c)
-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496171-112644

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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-Paragraph 14
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-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496171-112644

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.3-04)
-URI https://asc.fasb.org/extlink&oid=120397183&loc=d3e187085-122770

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
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-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496189-112644

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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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-Topic 505
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-Publisher FASB
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Earnings Per Share

3 Months Ended

Mar. 31, 2023

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 attributable to Community Health Systems, Inc. stockholders:

	Three Months Ended
	March 31,
	2023		2022
Weighted-average number of shares outstanding — basic		129,688,917		127,818,209
Effect of dilutive securities:
Restricted stock awards		—		—
Employee stock options		—		—
Other equity-based awards		—		—
Weighted-average number of shares outstanding — diluted		129,688,917		127,818,209

The Company generated a loss attributable to Community Health Systems, Inc. stockholders for both of the three-month periods ended March 31, 2023 and 2022, so the effect of dilutive securities is not considered because their effect would be antidilutive. If the Company had generated income during both of the three months ended March 31, 2023 and 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 468,193 shares and 2,198,436 shares, respectively.

	Three Months Ended
	March 31,
	2023		2022
Dilutive securities outstanding not included in the computation of earnings per share because their effect is antidilutive:
Employee stock options and restricted stock awards		5,889,077		1,367,000

Contingencies

3 Months Ended

Mar. 31, 2023

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

Caleb Padilla, individually and on behalf of all others similarly situated v Community Health Systems, Inc., Wayne T. Smith, Larry Cash, and Thomas J. Aaron. This purported federal securities class action was filed in the United States District Court for the Middle District of Tennessee on May 30, 2019. It seeks class certification on behalf of purchasers of the Company’s common stock between February 20, 2017 and February 27, 2018 and alleges misleading statements resulted in artificially inflated prices for the Company's common stock. On November 20, 2019, the District Court appointed Arun Bhattacharya and Michael Gaviria as lead plaintiffs in the case. The lead plaintiffs filed a consolidated class complaint on January 21, 2020. The Company filed a motion to dismiss the consolidated class complaint on March 23, 2020, and the District Court denied that motion on August 17, 2022. The Company has reached a tentative settlement of this matter, which is subject to the Court’s approval. The hearing to determine the Court’s preliminary approval of the settlement has not yet been set.

The table below presents a reconciliation of the beginning and ending liability balances (in millions) during the three months ended March 31, 2023, with respect to the Company’s determination of the contingencies of the Company in respect of which an accrual has been recorded.

Summary of Recorded Amounts

	Probable
	Contingencies
Balance as of December 31, 2022	$	11
Expense		9
Reserve for insured claim		4
Cash payments		—
Balance as of March 31, 2023	$	24

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 in the condensed consolidated balance sheets 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 in the condensed consolidated balance sheets.

Subsequent Events

3 Months Ended

Mar. 31, 2023

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.

On April 1, 2023, the Company completed the sale of substantially all of the assets of Plateau Medical Center (25 licensed beds) in Oak Hill, West Virginia, to a subsidiary of Vandalia Health, Inc. pursuant to the terms of a definitive agreement which was entered into on December 30, 2022, as amended. The net proceeds from this sale of approximately $92 million were received at a preliminary closing on March 31, 2023.

On April 3, 2023, the Company entered into a definitive agreement for the sale of substantially all of the assets of Medical Center of South Arkansas (166 licensed beds) in El Dorado, Arkansas to affiliates of SARH Holdings, Inc.

Basis of Presentation and Significant Accounting Policies (Policies)

3 Months Ended

Mar. 31, 2023

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Basis of Accounting

Consolidation

Revenue Recognition

Revenue Recognition.

Net Operating Revenues

	Three Months Ended
	March 31,
	2023		2022
Medicare	$	649	$	668
Medicare Managed Care		543		513
Medicaid		423		467
Managed Care and other third-party payors		1,469		1,420
Self-pay		24		43
Total	$	3,108	$	3,111

Patient Accounts Receivable

Charity Care

Accounting for the Impairment or Disposal of Long-Lived Assets

2023, offset by an approximate $3 million impairment charge recorded to reduce the carrying value of several assets that were idled, disposed of or held-for-sale.

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)

3 Months Ended

Mar. 31, 2023

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Schedule of Net Operating Revenues

	Three Months Ended
	March 31,
	2023		2022
Medicare	$	649	$	668
Medicare Managed Care		543		513
Medicaid		423		467
Managed Care and other third-party payors		1,469		1,420
Self-pay		24		43
Total	$	3,108	$	3,111

Accounting for Stock-Based Compensation (Tables)

3 Months Ended

Mar. 31, 2023

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
	March 31,
	2023			2022
Effect on income before income taxes	$	(6	)	$	(5	)
Effect on net loss	$	(5	)	$	(4	)

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

	Three Months Ended March 31,
	2023	2022
Expected volatility	87.3%	84.3% - 87.5%
Expected dividends	—	—
Expected term	6 years	3 - 6 years
Risk-free interest rate	4.2%	1.5% - 1.6%

Schedule of Share-based Compensation, Stock Options, Activity

						Weighted-	Aggregate
				Weighted-		Average	Intrinsic
				Average		Remaining	Value as of
				Exercise		Contractual	March 31,
	Shares			Price		Term	2023
Outstanding at December 31, 2022		2,831,751		$	7.32
Granted		814,000			6.15
Exercised		(8,334	)		4.97
Forfeited and cancelled		—			—
Outstanding at March 31, 2023		3,637,417		$	7.06	8.1 years	$	—
Exercisable at March 31, 2023		2,078,661		$	6.46	7.2 years	$	—

Schedule of Share-based Compensation, Restricted Stock, Activity

Restricted stock outstanding under the 2009 Plan as of March 31, 2023, and changes during the three-month period following December 31, 2022, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2022		5,541,065		$	8.53
Granted		2,651,000			6.14
Vested		(2,076,569	)		6.77
Forfeited		(10,001	)		9.31
Unvested at March 31, 2023		6,105,495			8.09

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

RSUs outstanding under the 2009 Plan as of March 31, 2023, and changes during the three-month period following December 31, 2022, was as follows:

				Weighted-
				Average Grant
	Shares			Date Fair Value
Unvested at December 31, 2022		512,360		$	7.54
Granted		365,037			6.15
Vested		(95,577	)		7.92
Forfeited		—			—
Unvested at March 31, 2023		781,820			6.84

Acquisitions and Divestitures (Tables)

3 Months Ended

Mar. 31, 2023

Acquisitions And Divestitures [Abstract]

Schedule of Divestitures

The following table provides a summary of hospitals that the Company divested during the three months ended March 31, 2023 and the year ended December 31, 2022:

			Licensed
Hospital	Buyer	City, State	Beds	Effective Date
2023 Divestiture:
Greenbrier Valley Medical Center	Vandalia Health, Inc.	Ronceverte, WV	122	January 1, 2023

2022 Divestiture:
AllianceHealth Seminole	SSM HealthCare of Oklahoma, Inc.	Seminole, OK	32	July 1, 2022

Schedule of Balance Sheet Items Classified as Held for Sale

	March 31, 2023			December 31, 2022
Other current assets	$	9		$	6
Other assets, net		312			132
Accrued liabilities		(18	)		(4	)

- 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)

3 Months Ended

Mar. 31, 2023

Goodwill And Intangible Assets Disclosure [Abstract]

Schedule of Goodwill

The changes in the carrying amount of goodwill for the three months ended March 31, 2023 are as follows (in millions):

Balance, as of December 31, 2022
Goodwill	$	6,980
Accumulated impairment losses		(2,814	)
		4,166
Goodwill acquired as part of acquisitions during current year		6
Goodwill allocated to hospitals divested or held-for-sale		(121	)
Balance, as of March 31, 2023
Goodwill		6,865
Accumulated impairment losses		(2,814	)
	$	4,051

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
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-Name Accounting Standards Codification
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+ Details

Long-Term Debt (Tables)

3 Months Ended

Mar. 31, 2023

Long Term Debt And Capital Lease Obligations [Abstract]

Schedule of Debt

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

	March 31,			December 31,
	2023			2022
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			756
6% Senior Secured Notes due 2029		900			900
5¼% Senior Secured Notes due 2030		1,535			1,535
4¾% Senior Secured Notes due 2031		1,058			1,058
6⅞% Junior-Priority Secured Notes due 2029		1,386			1,386
6⅛% Junior-Priority Secured Notes due 2030		1,232			1,232
ABL Facility		125			53
Finance lease and financing obligations		377			380
Other		53			36
Less: Unamortized deferred debt issuance costs and note premium		(388	)		(402	)
Total debt		11,735			11,635
Less: Current maturities		(39	)		(21	)
Total long-term debt	$	11,696		$	11,614

Fair Value of Financial Instruments (Tables)

3 Months Ended

Mar. 31, 2023

Fair Value Disclosures [Abstract]

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

	March 31, 2023				December 31, 2022
	Carrying		Estimated Fair		Carrying		Estimated Fair
	Amount		Value		Amount		Value
Assets:
Cash and cash equivalents	$	144	$	144	$	118	$	118
Investments in equity securities		78		78		107		107
Available-for-sale debt securities		180		180		179		179
Trading securities		5		5		5		5
Liabilities:
8% Senior Secured Notes due 2026		2,084		2,032		2,083		1,917
8% Senior Secured Notes due 2027		694		678		693		631
5⅝% Senior Secured Notes due 2027		1,836		1,672		1,833		1,633
6⅞% Senior Notes due 2028		749		474		749		389
6% Senior Secured Notes due 2029		866		759		865		751
5¼% Senior Secured Notes due 2030		1,450		1,200		1,448		1,166
4¾% Senior Secured Notes due 2031		1,054		787		1,053		766
6⅞% Junior-Priority Secured Notes due 2029		1,285		864		1,282		720
6⅛% Junior-Priority Secured Notes due 2030		1,165		750		1,164		615
ABL Facility and other debt		174		174		85		85

Fair Value (Tables)

3 Months Ended

Mar. 31, 2023

Fair Value Disclosures [Abstract]

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

	March 31, 2023		Level 1		Level 2		Level 3
Investments in equity securities	$	78	$	78	$	—	$	—
Available-for-sale debt securities		180		—		180		—
Trading securities		5		—		5		—
Total assets	$	263	$	78	$	185	$	—

	December 31, 2022		Level 1		Level 2		Level 3
Investments in equity securities	$	107	$	107	$	—	$	—
Available-for-sale debt securities		179		—		179		—
Trading securities		5		—		5		—
Total assets	$	291	$	107	$	184	$	—

Leases (Tables)

3 Months Ended

Mar. 31, 2023

Leases [Abstract]

Components of Lease Cost and Rent Expense

The components of lease cost and rent expense for the three months ended March 31, 2023 and 2022 are as follows (in millions):

	Three Months Ended March 31,
Lease Cost	2023			2022
Operating lease cost:
Operating lease cost	$	55		$	51
Short-term rent expense		22			23
Variable lease cost		5			4
Sublease income		(1	)		(1	)
Total operating lease cost	$	81		$	77
Finance lease cost:
Amortization of right-of-use assets	$	3		$	3
Interest on finance lease liabilities		3			4
Total finance lease cost	$	6		$	7

Supplemental Balance Sheet Information Related to Leases

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

	Balance Sheet Classification	March 31, 2023			December 31, 2022
Operating Leases:
Operating lease right-of-use assets	Other assets, net	$	712		$	738

Finance Leases:
Finance lease right-of-use assets	Property and equipment
	Land and improvements	$	—		$	—
	Buildings and improvements		261			261
	Equipment and fixtures		11			12
	Property and equipment		272			273
	Less accumulated depreciation and amortization		(58	)		(56	)
	Property and equipment, net	$	214		$	217

Current finance lease liabilities	Current maturities of long-term debt	$	2		$	3
Long-term finance lease liabilities	Long-term debt		219			220

Supplemental Cash Flow and Other Information Related to Leases

Supplemental cash flow information related to leases for the three months ended March 31, 2023 and 2022 is as follows (in millions):

	Three Months Ended March 31,
Cash flow information	2023		2022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases ⁽¹⁾	$	52	$	50
Operating cash flows from finance leases		3		4
Financing cash flows from finance leases		1		6
Right-of-use assets obtained in exchange for new finance lease liabilities		—		31
Right-of-use assets obtained in exchange for new operating lease liabilities		24		69

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

Stockholders' Deficit (Tables)

3 Months Ended

Mar. 31, 2023

Equity [Abstract]

Schedule of Stockholders' Deficit

				Community Health Systems, Inc. Stockholders
	Redeemable Noncontrolling Interest			Common Stock		Additional Paid-In Capital			Accumulated Other Comprehensive Loss (Income)			Accumulated Deficit			Noncontrolling Interest			Total Stockholders’ Deficit
Balance, December 31, 2022	$	541		$	1	$	2,084		$	(21	)	$	(3,431	)	$	92		$	(1,275	)
Comprehensive income (loss)		21			—		—			3			(51	)		11			(37	)
Distributions to noncontrolling interests		(33	)		—		—			—			—			(11	)		(11	)
Purchases of subsidiary shares from noncontrolling interests		(1	)		—		—			—			—			—			—
Contributions from noncontrolling interests		1			—		—			—			—			1			1
Adjustment to redemption value of redeemable noncontrolling interests		32			—		(32	)		—			—			—			(32	)
Cancellation of restricted stock for tax withholdings on vested shares		—			—		(4	)		—			—			—			(4	)
Share-based compensation		—			—		6			—			—			—			6
Balance, March 31, 2023	$	561		$	1	$	2,054		$	(18	)	$	(3,482	)	$	93		$	(1,352	)

				Community Health Systems, Inc. Stockholders
	Redeemable Noncontrolling Interest			Common Stock		Additional Paid-In Capital			Accumulated Other Comprehensive Loss (Income)			Accumulated Deficit			Noncontrolling Interest			Total Stockholders’ Deficit
Balance, December 31, 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	)

Schedule of Impact of Noncontrolling Interest to Stockholders' Deficit

	Three Months Ended
	March 31,
	2023			2022
Net loss attributable to Community Health Systems, Inc. stockholders	$	(51	)	$	(1	)
Transfers to the noncontrolling interests:
Net increase (decrease) in Community Health Systems, Inc. paid-in-capital for purchase of subsidiary partnership interests		—			(1	)
Net transfers to the noncontrolling interests		—			(1	)
Change to Community Health Systems, Inc. stockholders' deficit from net loss attributable to Community Health Systems, Inc. stockholders and transfers to noncontrolling interests	$	(51	)	$	(2	)

Earnings Per Share (Tables)

3 Months Ended

Mar. 31, 2023

Earnings Per Share [Abstract]

Schedule of Components of Denominator for Computation of Basic and Diluted 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 attributable to Community Health Systems, Inc. stockholders:

	Three Months Ended
	March 31,
	2023		2022
Weighted-average number of shares outstanding — basic		129,688,917		127,818,209
Effect of dilutive securities:
Restricted stock awards		—		—
Employee stock options		—		—
Other equity-based awards		—		—
Weighted-average number of shares outstanding — diluted		129,688,917		127,818,209

Schedule of Antidilutive Securities

	Three Months Ended
	March 31,
	2023		2022
Dilutive securities outstanding not included in the computation of earnings per share because their effect is antidilutive:
Employee stock options and restricted stock awards		5,889,077		1,367,000

Contingencies (Tables)

3 Months Ended

Mar. 31, 2023

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, 2022	$	11
Expense		9
Reserve for insured claim		4
Cash payments		—
Balance as of March 31, 2023	$	24

Basis of Presentation and Significant Accounting Policies - Additional Information (Details) - USD ($) $ in Millions		3 Months Ended
	Jan. 01, 2023	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Cost of Revenue, Policy [Abstract]
Corporate office costs		$ 61	$ 63
Third Party Reimbursement [Abstract]
Amounts due to third party payors		120		$ 101
Amounts due from third party payors		103		$ 97
Net Operating Revenues, Policy [Abstract]
Charity care services charges excluded from net operating revenues		326	363
Value of charity care services at the Company's standard charges included in contractual allowances		38	41
Hospitals Sold or Deemed Held for Sale
Accounting for the Impairment or Disposal of Long-Lived Assets
Gain (loss) on disposition of business	$ 25	22
Impairment of amount related to several assets idled disposed or held for sale		$ 3
Impairment of long-lived assets held for sale			$ 6

Basis of Presentation and Significant Accounting Policies - Schedule of Net Operating Revenues (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	$ 3,108	$ 3,111
Medicare
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	649	668
Medicare Managed Care
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	543	513
Medicaid
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	423	467
Managed Care and Other Third Party Payors
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	1,469	1,420
Self-Pay
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	$ 24	$ 43

- 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

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-Name Accounting Standards Codification
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-Paragraph 3
-Subparagraph (c)
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (f)
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-Name Accounting Standards Codification
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-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
	Mar. 01, 2023 USD ($) Director shares	Mar. 01, 2022 USD ($) Director shares	Mar. 31, 2023 USD ($) Item $ / shares shares	Mar. 31, 2022 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 \| $			$ 49,000,000
Employee service share-based compensation total compensation cost not yet recognized, period for recognition			26 months
Employee service share-based compensation, nonvested awards, modifications to awards \| Item			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			26 months
Employee service share-based compensation, unrecognized compensation costs on nonvested stock options \| $			$ 8,000,000
Granted, Shares			814,000
Weighted-average grant date fair value of stock options \| $ / shares			$ 4,610,000	$ 7,250,000
Share Price \| $ / shares			$ 4.90
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			26 months
Employee service share-based compensation, unrecognized compensation costs on nonvested awards other than options \| $			$ 41,000,000
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			2,651,000
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			365,037
Number of directors elected to defer the receipt of RSUs granted \| Director	4	3
Amended 2009 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Additional shares of unissued common stock reserved for future grants			7,500,000
Plan 2009
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unissued common stock reserved for grants			1,560,708
Share-based compensation arrangement award vesting rights			one-third increments on each of the first three anniversaries of the option grant 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	29,268	17,682
Fair value of units granted \| $	$ 180,000	$ 180,000
Plan 2009 \| Restricted Stock Units (RSUs) \| Non-employee Chairman of the Board of Directors
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, number of grants	43,089
Fair value of units granted \| $	$ 265,000
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	100.00%

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation Expense (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Effect on income before income taxes	$ (6)	$ (5)
Effect on net loss	$ (5)	$ (4)

Accounting for Stock-Based Compensation - Schedule of Share-based Payment Awards, Stock Options, Valuation Assumptions (Details) - Employee Stock Option	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility	87.30%
Expected volatility, minimum		84.30%
Expected volatility, maximum		87.50%
Expected term	6 years
Risk-free interest rate	4.20%
Risk-free interest rate, minimum		1.50%
Risk-free interest rate, maximum		1.60%
Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term		3 years
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term		6 years

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation, Stock Options, Activity (Details) - Employee Stock Option	3 Months Ended
	Mar. 31, 2023 $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Shares \| shares	2,831,751
Granted, Shares \| shares	814,000
Exercised, Shares \| shares	(8,334)
Forfeited and cancelled, Shares \| shares	0
Ending Balance, Shares \| shares	3,637,417
Exercisable, Shares \| shares	2,078,661
Beginning of Period, Weighted Average Exercise Price \| $ / shares	$ 7.32
Granted, Weighted Average Exercise Price \| $ / shares	6.15
Exercised, Weighted Average Exercise Price \| $ / shares	4.97
Forfeited and Cancelled, Weighted Average Exercise Price \| $ / shares	0
End of Period, Weighted Average Exercise Price \| $ / shares	7.06
Exercisable, Weighted Average Exercise Price \| $ / shares	$ 6.46
Weighted Average Remaining Contractual Term	8 years 1 month 6 days
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	3 Months Ended
	Mar. 31, 2023 $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Unvested Shares \| shares	5,541,065
Granted, Shares \| shares	2,651,000
Vested, Shares \| shares	(2,076,569)
Forfeited, Shares \| shares	(10,001)
Ending Balance, Unvested Shares \| shares	6,105,495
Beginning of Period, Weighted Average Grant Date Fair Value \| $ / shares	$ 8.53
Granted, Weighted Average Grant Date Fair Value \| $ / shares	6.14
Vested, Weighted Average Grant Date Fair Value \| $ / shares	6.77
Forfeited, Weighted Average Grant Date Fair Value \| $ / shares	9.31
End of Period, Weighted Average Grant Date Fair Value \| $ / shares	$ 8.09

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation, Restricted Stock Units, Activity (Details) - Restricted Stock Units (RSUs)	3 Months Ended
	Mar. 31, 2023 $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Unvested Shares \| shares	512,360
Granted, Shares \| shares	365,037
Vested, Shares \| shares	(95,577)
Ending Balance, Unvested Shares \| shares	781,820
Beginning of Period, Weighted Average Grant Date Fair Value \| $ / shares	$ 7.54
Granted, Weighted Average Grant Date Fair Value \| $ / shares	6.15
Vested, Weighted Average Grant Date Fair Value \| $ / shares	7.92
End of Period, Weighted Average Grant Date Fair Value \| $ / shares	$ 6.84

Acquisitions and Divestitures - Acquisitions - Additional Information (Details) $ in Millions	3 Months Ended
	Mar. 31, 2023 USD ($)	Mar. 02, 2023 Item
Lutheran Rehabilitation Hospital \| Fort Wayne, Indiana
Acquisitions and Divestitures [Line Items]
Number of licensed beds \| Item		36
Physician Practices Clinics and Other Ancillary Businesses
Acquisitions and Divestitures [Line Items]
Business acquisition, cost of acquired entity, purchase price \| $	$ 8

Acquisitions and Divestitures - Schedule of Divestitures (Details) - Item	3 Months Ended	12 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Greenbrier Valley Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	122
Effective Date	Jan. 01, 2023
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

Acquisitions and Divestitures - Divestitures - Additional Information (Details) - Item	Feb. 28, 2023	Dec. 30, 2022
Plateau Medical Center \| Oak Hill West Virginia
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		25
Greenbrier Valley Medical Center \| Mooresville, North Carolina
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	123
Davis Regional Medical Center \| Statesville, North Carolina
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	144

Acquisitions and Divestitures - Schedule of Balance Sheet Items Classified as Held for Sale (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Acquisitions Divestitures And Closures [Abstract]
Other current assets	$ 9	$ 6
Other assets, net	312	132
Accrued liabilities	$ (18)	$ (4)

Goodwill - Schedule of Goodwill (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Goodwill Roll Forward
Goodwill	$ 6,865	$ 6,980
Accumulated impairment losses	(2,814)	(2,814)
Goodwill	4,051	$ 4,166
Goodwill acquired as part of acquisitions during current year	6
Goodwill allocated to hospitals divested or held-for-sale	$ (121)

- 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) - USD ($)	12 Months Ended
Goodwill - Additional Information (Details) - USD ($)	Dec. 31, 2022	Mar. 31, 2023
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill	$ 4,166,000,000	$ 4,051,000,000
Impairment of goodwill	$ 0

- Definition

+ References + Details

Income Taxes - Additional Information (Details) - USD ($)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Income Taxes [Line Items]
Provision for income taxes	$ 26,000,000	$ 23,000,000
Effective income tax rate	433.30%	43.40%
Income tax refunds (payments), net		$ (2,000,000)
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	$ 11,000,000
Amount of interest and penalties included in liabilities for uncertain tax positions	1,000,000
Income tax refunds (payments), net	$ (1,000,000)

Long-Term Debt - Schedule of Debt (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Debt and lease obligations	$ 11,735	$ 11,635
Less: Unamortized deferred debt issuance costs and note premium	(388)	(402)
Less: Current maturities	(39)	(21)
Total long-term debt	11,696	11,614
Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Debt Instrument [Line Items]
Debt and lease obligations	2,101	2,101
Senior Secured Notes \| Senior Secured Notes at 8%, Due 2027
Debt Instrument [Line Items]
Debt and lease obligations	700	700
Senior Secured Notes \| Senior Secured Notes at 5.625% due 2027
Debt Instrument [Line Items]
Debt and lease obligations	1,900	1,900
Senior Secured Notes \| Senior Secured Notes at 6%, Due 2029
Debt Instrument [Line Items]
Debt and lease obligations	900	900
Senior Secured Notes \| Senior Secured Notes at 5.250%, Due 2030
Debt Instrument [Line Items]
Debt and lease obligations	1,535	1,535
Senior Secured Notes \| Senior Secured Notes at 4.75%, Due 2031
Debt Instrument [Line Items]
Debt and lease obligations	1,058	1,058
Senior Notes \| Senior Notes at 6.875%, Due 2028
Debt Instrument [Line Items]
Debt and lease obligations	756	756
Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.875%, Due 2029
Debt Instrument [Line Items]
Debt and lease obligations	1,386	1,386
Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.125%, Due 2030
Debt Instrument [Line Items]
Debt and lease obligations	1,232	1,232
Asset Based Loan Facility
Debt Instrument [Line Items]
Debt and lease obligations	125	53
Finance Lease and Financing Obligations
Debt Instrument [Line Items]
Debt and lease obligations	377	380
Other
Debt Instrument [Line Items]
Debt and lease obligations	$ 53	$ 36

Long-Term Debt - Schedule of Debt (Parenthetical) (Details)	3 Months Ended
	Mar. 31, 2023
Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	8.00%
Debt instrument, maturity year	2026
Senior Secured Notes \| Senior Secured Notes at 8%, Due 2027
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	8.00%
Debt instrument, maturity year	2027
Senior Secured Notes \| Senior Secured Notes at 5.625% due 2027
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	5.625%
Debt instrument, maturity year	2027
Senior Secured Notes \| Senior Secured Notes at 5.250%, Due 2030
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	5.25%
Debt instrument, maturity year	2030
Senior Secured Notes \| Senior Secured Notes at 4.75%, Due 2031
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	4.75%
Debt instrument, maturity year	2031
Senior Secured Notes \| Senior Secured Notes at 6%, Due 2029
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	6.00%
Debt instrument, maturity year	2029
Senior Notes \| Senior Notes at 6.875%, Due 2028
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	6.875%
Debt instrument, maturity year	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%
Debt instrument, maturity year	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%
Debt instrument, maturity year	2030

Long-Term Debt - Additional Information (Details) - USD ($)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Apr. 03, 2018
Debt Instrument [Line Items]
Interest paid on borrowings	$ 197,000,000	$ 242,000,000
Asset Based Loan Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity			$ 1,000,000,000.0
Line of credit facility, excess availability	792,000,000
Line of credit outstanding amount	125,000,000
Asset Based Loan Facility \| ABL Facility Customary Covenants
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	$ 95,000,000
Debt instrument variable interest rate	10.00%
Asset Based Loan Facility \| Letter of Credit
Debt Instrument [Line Items]
Line of credit outstanding amount	$ 83,000,000

- Definition

The carrying value as of the balance sheet date of the current and noncurrent portions of long-term obligations drawn from a line of credit, which is a bank's commitment to make loans up to a specific amount. Examples of items that might be included in the application of this element may consist of letters of credit, standby letters of credit, and revolving credit arrangements, under which borrowings can be made up to a maximum amount as of any point in time conditional on satisfaction of specified terms before, as of and after the date of drawdowns on the line. Includes short-term obligations that would normally be classified as current liabilities but for which (a) postbalance sheet date issuance of a long term obligation to refinance the short term obligation on a long term basis, or (b) the enterprise has entered into a financing agreement that clearly permits the enterprise to refinance the short-term obligation on a long term basis and the following conditions are met (1) the agreement does not expire within 1 year and is not cancelable by the lender except for violation of an objectively determinable provision, (2) no violation exists at the BS date, and (3) the lender has entered into the financing agreement is expected to be financially capable of honoring the agreement.

+ References + Details

Fair Value of Financial Instruments - Schedule of Estimated Fair Value of Financial Instruments, by Balance Sheet Grouping (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Carrying Amount
Assets:
Cash and cash equivalents	$ 144	$ 118
Investments in equity securities	78	107
Available-for-sale debt securities	180	179
Trading securities	5	5
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Liabilities:
Notes payable, fair value disclosure	2,084	2,083
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 8%, Due 2027
Liabilities:
Notes payable, fair value disclosure	694	693
Carrying Amount \| Senior Secured Notes \| Senior Notes at 6% Due 2029
Liabilities:
Notes payable, fair value disclosure	866	865
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes 5.25%, Due 2030
Liabilities:
Notes payable, fair value disclosure	1,450	1,448
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 4.750% due 2031
Liabilities:
Notes payable, fair value disclosure	1,054	1,053
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 5.625% due 2027
Liabilities:
Notes payable, fair value disclosure	1,836	1,833
Carrying Amount \| Senior Notes \| Senior Notes at 6.875% Due 2028
Liabilities:
Notes payable, fair value disclosure	749	749
Carrying Amount \| Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.875% Due 2029
Liabilities:
Notes payable, fair value disclosure	1,285	1,282
Carrying Amount \| Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.125% Due 2030
Liabilities:
Notes payable, fair value disclosure	1,165	1,164
Carrying Amount \| ABL Facility and Other Debt
Liabilities:
Notes payable, fair value disclosure	174	85
Estimated Fair Value
Assets:
Cash and cash equivalents	144	118
Investments in equity securities	78	107
Available-for-sale debt securities	180	179
Trading securities	5	5
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Liabilities:
Notes payable, fair value disclosure	2,032	1,917
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 8%, Due 2027
Liabilities:
Notes payable, fair value disclosure	678	631
Estimated Fair Value \| Senior Secured Notes \| Senior Notes at 6% Due 2029
Liabilities:
Notes payable, fair value disclosure	759	751
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes 5.25%, Due 2030
Liabilities:
Notes payable, fair value disclosure	1,200	1,166
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 4.750% due 2031
Liabilities:
Notes payable, fair value disclosure	787	766
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 5.625% due 2027
Liabilities:
Notes payable, fair value disclosure	1,672	1,633
Estimated Fair Value \| Senior Notes \| Senior Notes at 6.875% Due 2028
Liabilities:
Notes payable, fair value disclosure	474	389
Estimated Fair Value \| Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.875% Due 2029
Liabilities:
Notes payable, fair value disclosure	864	720
Estimated Fair Value \| Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.125% Due 2030
Liabilities:
Notes payable, fair value disclosure	750	615
Estimated Fair Value \| ABL Facility and Other Debt
Liabilities:
Notes payable, fair value disclosure	$ 174	$ 85

Fair Value - Additional Information (Details) - USD ($)	Mar. 31, 2023	Mar. 31, 2022
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	Mar. 31, 2023	Dec. 31, 2022
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investments in equity securities	$ 78	$ 107
Available-for-sale debt securities	180	179
Trading securities	5	5
Total assets	263	291
Fair Value, Inputs, Level 1
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investments in equity securities	78	107
Total assets	78	107
Fair Value, Inputs, Level 2
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Available-for-sale debt securities	180	179
Trading securities	5	5
Total assets	$ 185	$ 184

Leases - Components of Lease Cost and Rent Expense (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Leases [Abstract]
Operating lease cost	$ 55	$ 51
Short-term rent expense	22	23
Variable lease cost	5	4
Sublease income	(1)	(1)
Total operating lease cost	81	77
Finance lease cost:
Amortization of right-of-use assets	3	3
Interest on finance lease liabilities	3	4
Total finance lease cost	$ 6	$ 7

Leases - Supplemental Balance Sheet Information Related to Leases (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Operating Leases:
Operating lease right-of-use assets	$ 712	$ 738
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Other assets, net	Other assets, net
Finance Leases:
Property and equipment	$ 9,560	$ 9,639
Less accumulated depreciation and amortization	(4,305)	(4,274)
Property and equipment, net	5,255	5,365
Current finance lease liabilities	$ 2	$ 3
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	$ 219	$ 220
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List]	Long-term debt	Long-term debt
Finance Lease ROU Assets
Finance Leases:
Property and equipment	$ 272	$ 273
Less accumulated depreciation and amortization	(58)	(56)
Property and equipment, net	214	217
Finance Lease ROU Assets \| Building and Improvements
Finance Leases:
Property and equipment	261	261
Finance Lease ROU Assets \| Equipment and Fixtures
Finance Leases:
Property and equipment	$ 11	$ 12

Leases - Supplemental Cash Flow and Other Information Related to Leases (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Leases [Abstract]
Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases	$ 52	$ 50
Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from finance leases	3	4
Cash paid for amounts included in the measurement of lease liabilities: Financing cash flows from finance leases	1	6
Right-of-use assets obtained in exchange for new finance lease liabilities		31
Right-of-use assets obtained in exchange for new operating lease liabilities	$ 24	$ 69

Stockholders' Deficit - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	Mar. 31, 2023	Dec. 31, 2022
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
	Mar. 31, 2023	Mar. 31, 2022
Equity, beginning balance	$ (1,275)	$ (1,290)
Redeemable Noncontrolling Interests, beginning balance	541
Comprehensive income (loss)	(37)	6
Distributions to noncontrolling interests	(11)	(17)
Purchases of subsidiary shares from noncontrolling interests		(1)
Contributions from noncontrolling interests	1
Adjustment to redemption value of redeemable noncontrolling interests	(32)	(7)
Cancellation of restricted stock for tax withholdings on vested shares	(4)	(8)
Share-based compensation	6	5
Equity, ending balance	(1,352)	(1,312)
Redeemable Noncontrolling Interests, ending balance	561
Redeemable Noncontrolling Interests (Non- Equity)
Redeemable Noncontrolling Interests, beginning balance	541	480
Comprehensive income (loss) attributable to redeemable noncontrolling interest	21	16
Distributions to redeemable noncontrolling interests	(33)	(12)
Purchases of subsidiary shares from noncontrolling interests	(1)	1
Contributions from noncontrolling interests	1	1
Adjustment to redemption value of redeemable noncontrolling interests	32	7
Redeemable Noncontrolling Interests, ending balance	561	493
Common Stock
Equity, beginning balance	1	1
Equity, ending balance	1	1
Additional Paid-in Capital
Equity, beginning balance	2,084	2,118
Purchases of subsidiary shares from noncontrolling interests		(1)
Adjustment to redemption value of redeemable noncontrolling interests	(32)	(7)
Cancellation of restricted stock for tax withholdings on vested shares	(4)	(8)
Share-based compensation	6	5
Equity, ending balance	2,054	2,107
Accumulated Other Comprehensive (Loss) Income
Equity, beginning balance	(21)	(14)
Comprehensive income (loss)	3	(8)
Equity, ending balance	(18)	(22)
Accumulated Deficit
Equity, beginning balance	(3,431)	(3,477)
Comprehensive income (loss)	(51)	(1)
Equity, ending balance	(3,482)	(3,478)
Noncontrolling Interest
Equity, beginning balance	92	82
Comprehensive income (loss)	11	15
Distributions to noncontrolling interests	(11)	(17)
Contributions from noncontrolling interests	1
Equity, ending balance	$ 93	$ 80

Stockholders' Deficit - Schedule of Impact of Noncontrolling Interest to Stockholders' Deficit (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Equity [Abstract]
Net loss attributable to Community Health Systems, Inc. stockholders	$ (51)	$ (1)
Net increase (decrease) in Community Health Systems, Inc. paid-in-capital for purchase of subsidiary partnership interests		(1)
Net transfers to the noncontrolling interests		(1)
Change to Community Health Systems, Inc. stockholders' deficit from net loss attributable to Community Health Systems, Inc. stockholders and transfers to noncontrolling interests	$ (51)	$ (2)

- 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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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Earnings Per Share - Schedule of Components of Denominator for Computation of Basic and Diluted Earnings Per Share (Details) - shares	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Effect of dilutive securities:
Weighted-average number of shares outstanding — basic	129,688,917	127,818,209
Weighted-average number of shares outstanding — diluted	129,688,917	127,818,209

Earnings Per Share - Additional Information (Details) - shares	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Earnings Per Share [Abstract]
Increase in number of shares to diluted shares calculation if income would have been generated	468,193	2,198,436

Earnings Per Share - Schedule of Antidilutive Securities (Details) - shares	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Earnings Per Share [Abstract]
Employee stock options and restricted stock awards excluded from computation of earnings per share amount	5,889,077	1,367,000

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	3 Months Ended
	Mar. 31, 2023 USD ($)
Loss Contingency Accrual [Roll Forward]
Beginning Balance	$ 11
Expense	9
Reserve for insured claim	4
Ending Balance	$ 24

Subsequent Events - Additional Information (Details) - Subsequent Event $ in Millions	Apr. 01, 2023 USD ($) Bed	Apr. 03, 2023 Bed
Plateau Medical Center
Subsequent Event [Line Items]
Number of licensed beds \| Bed	25	166
Medical Center of South Arkansas
Subsequent Event [Line Items]
Proceeds from sale of afiliates assets \| $	$ 92