Community Health Systems (CYH) 10-Q26 Oct 232023 Q3 Quarterly reportFinancial data

Company Profile

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
Document and Entity Information - shares	Sep. 30, 2023	Oct. 20, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Sep. 30, 2023
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q3
Current Fiscal Year End Date	--12-31
Entity File Number	001-15925
Entity Registrant Name	COMMUNITY HEALTH SYSTEMS, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	13-3893191
Entity Address, Address Line One	4000 Meridian Boulevard
Entity Address, City or Town	Franklin
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37067
City Area Code	615
Local Phone Number	465-7000
Title of 12(b) Security	Common Stock, $.01 par value
Trading Symbol	CYH
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		136,800,913
Entity Central Index Key	0001108109
Amendment Flag	false

Condensed Consolidated Statemen

Condensed Consolidated Statements of Loss - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Statement [Abstract]
Net operating revenues	$ 3,086	$ 3,025	$ 9,308	$ 9,069
Operating costs and expenses:
Salaries and benefits	1,338	1,352	4,040	3,972
Supplies	489	492	1,499	1,477
Other operating expenses	853	828	2,524	2,511
Lease cost and rent	79	80	240	236
Pandemic relief funds		(115)		(171)
Depreciation and amortization	128	137	384	398
Impairment and (gain) loss on sale of businesses, net	26	47	(9)	54
Total operating costs and expenses	2,913	2,821	8,678	8,477
Income from operations	173	204	630	592
Interest expense, net	208	217	621	652
Loss (gain) from early extinguishment of debt		(78)		(73)
Equity in earnings of unconsolidated affiliates	(2)	(5)	(5)	(11)
(Loss) income before income taxes	(33)	70	14	24
Provision for income taxes	19	70	84	291
Net (loss) income	(52)		(70)	(267)
Less: Net income attributable to noncontrolling interests	39	42	110	102
Net loss attributable to Community Health Systems, Inc. stockholders	$ (91)	$ (42)	$ (180)	$ (369)
Loss per share attributable to Community Health Systems, Inc. stockholders:
Basic	$ (0.69)	$ (0.32)	$ (1.38)	$ (2.86)
Diluted	$ (0.69)	$ (0.32)	$ (1.38)	$ (2.86)
Weighted-average number of shares outstanding:
Basic	130,698,907	129,141,673	130,352,865	128,689,999
Diluted	130,698,907	129,141,673	130,352,865	128,689,999

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Loss - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Statement of Comprehensive Income [Abstract]
Net (loss) income	$ (52)		$ (70)	$ (267)
Other comprehensive (loss) income, net of income taxes:
Net change in fair value of available-for-sale debt securities, net of tax	(3)	$ (6)	(1)	(20)
Amortization and recognition of unrecognized pension cost components, net of tax				1
Other comprehensive loss	(3)	(6)	(1)	(19)
Comprehensive loss	(55)	(6)	(71)	(286)
Less: Comprehensive income attributable to noncontrolling interests	39	42	110	102
Comprehensive loss attributable to Community Health Systems, Inc. stockholders	$ (94)	$ (48)	$ (181)	$ (388)

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 91	$ 118
Patient accounts receivable	2,160	2,040
Supplies	325	353
Prepaid income taxes	98	99
Prepaid expenses and taxes	249	237
Other current assets	325	235
Total current assets	3,248	3,082
Property and equipment	9,367	9,639
Less accumulated depreciation and amortization	(4,207)	(4,274)
Property and equipment, net	5,160	5,365
Goodwill	3,943	4,166
Deferred income taxes	49	49
Other assets, net	2,274	2,007
Total assets	14,674	14,669
Current liabilities:
Current maturities of long-term debt	22	21
Current operating lease liabilities	121	148
Accounts payable	837	773
Accrued liabilities:
Employee compensation	513	637
Accrued interest	184	189
Other	472	418
Total current liabilities	2,149	2,186
Long-term debt	11,820	11,614
Deferred income taxes	344	354
Long-term operating lease liabilities	560	605
Other long-term liabilities	694	644
Total liabilities	15,567	15,403
Redeemable noncontrolling interests in equity of consolidated subsidiaries	329	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; 136,772,094 shares issued and outstanding at September 30, 2023, and 134,703,717 shares issued and outstanding at December 31, 2022	1	1
Additional paid-in capital	2,170	2,084
Accumulated other comprehensive loss	(23)	(21)
Accumulated deficit	(3,611)	(3,431)
Total Community Health Systems, Inc. stockholders’ deficit	(1,463)	(1,367)
Noncontrolling interests in equity of consolidated subsidiaries	241	92
Total stockholders’ deficit	(1,222)	(1,275)
Total liabilities and stockholders’ deficit	$ 14,674	$ 14,669

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 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	136,772,094	134,703,717
Common stock, shares outstanding	136,772,094	134,703,717

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Cash flows from operating activities:
Net loss	$ (70)	$ (267)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization	384	398
Deferred income taxes	22	290
Stock-based compensation expense	16	14
Impairment and (gain) loss on sale of businesses, net	(9)	54
Loss (gain) from early extinguishment of debt		(73)
Other non-cash expenses, net	132	140
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures:
Patient accounts receivable	(119)	93
Supplies, prepaid expenses and other current assets	(100)	(94)
Accounts payable, accrued liabilities and income taxes	(69)	(90)
Other	(67)	(174)
Net cash provided by operating activities	120	291
Cash flows from investing activities:
Acquisitions of facilities and other related businesses	(35)	(9)
Purchases of property and equipment	(357)	(284)
Proceeds from disposition of hospitals and other ancillary operations	123	3
Proceeds from sale of property and equipment	27	30
Purchases of available-for-sale debt securities and equity securities	(126)	(73)
Proceeds from sales of available-for-sale debt securities and equity securities	221	62
Distribution of CoreTrust proceeds		121
Purchases of investments in unconsolidated affiliates	(8)	(18)
Increase in other investments	(51)	(39)
Net cash used in investing activities	(206)	(207)
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	4	10
Redemption of noncontrolling investments in joint ventures	(1)	(2)
Distributions to noncontrolling investors in joint ventures	(108)	(105)
Other borrowings	30	35
Issuance of long-term debt		1,535
Proceeds from ABL Facility	2,290
Repayments of long-term indebtedness	(2,152)	(1,683)
Net cash provided by (used in) financing activities	59	(291)
Net change in cash and cash equivalents	(27)	(207)
Cash and cash equivalents at beginning of period	118	507
Cash and cash equivalents at end of period	91	300
Supplemental disclosure of cash flow information:
Interest payments	(583)	(614)
Income tax payments, net	$ (61)	$ (6)

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Millions	3 Months Ended		9 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Millions	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Pay vs Performance Disclosure
Net Income (Loss)	$ (91)	$ (42)	$ (180)	$ (369)

Insider Trading Arrangements

Insider Trading Arrangements	9 Months Ended
Insider Trading Arrangements	Sep. 30, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies	9 Months Ended
Basis of Presentation and Significant Accounting Policies	Sep. 30, 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 September 30, 2023 and December 31, 2022 and for the three-month and nine-month periods ended September 30, 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 and nine months ended September 30, 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 $ 60 million for the three months ended September 30, 2023 and 2022 , respectively, and $ 187 million and $ 179 million for the nine months ended September 30, 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 and nine-month periods ended September 30, 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 and nine months ended September 30, 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 Nine Months Ended September 30, September 30, 2023 2022 2023 2022 Medicare $ 608 $ 644 $ 1,884 $ 1,928 Medicare Managed Care 498 479 1,563 1,471 Medicaid 456 449 1,328 1,362 Managed Care and other third-party payors 1,479 1,446 4,441 4,248 Self-pay 45 7 92 60 Total $ 3,086 $ 3,025 $ 9,308 $ 9,069 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 $ 119 million and $ 101 million as of September 30, 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 $ 121 million and $ 97 million as of September 30, 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 $ 355 million and $ 285 million for the three months ended September 30, 2023 and 2022, respectively, and $ 1.0 billion and $ 1.1 billion for the nine months ended September 30, 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 $ 39 million and $ 33 million during the three months ended September 30, 2023 and 2022, respectively, and $ 111 million and $ 121 million for the nine months ended September 30, 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 nine months ended September 30, 2023 , the Company recorded a net gain of approximately $ 9 million, comprised of a gain of $ 63 million related to the sale of three hospitals, offset by (i) an approximate $ 21 million impairment charge to adjust the carrying value of long-lived assets at a hospital that was sold at a sales price below carrying value, (ii) an approximate $ 25 million impairment charge recorded to reduce the carrying value of two hospitals that were deemed held-for-sale based on the difference between the carrying value of the disposal group compared to the estimated fair value less costs to sell, and (iii) an approximate $ 8 million impairment charge recorded to reduce the carrying value of several assets that were idled, disposed of or held-for-sale. During the nine months ended September 30, 2023 , approximately $ 84 million of goodwill was allocated from the hospital operations reporting unit associated with the disposal groups for which impairment charges or a gain on sale was recorded during the period. During the nine months ended September 30, 2022 , the Company recorded an impairment charge of approximately $ 54 million, which consists of $ 6 million to adjust the carrying value of long-lived assets at a hospital that was subsequently sold at a sales price below carrying value and $ 48 million primarily related to the closure of Shorepoint Health Venice in Venice, Florida, and near-complete closure of First Hospital Wyoming Valley (psychiatric hospital) in Wilkes-Barre, Pennsylvania, during the three months ended September 30, 2022. 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 Comp

Accounting for Stock-Based Compensation	9 Months Ended
Accounting for Stock-Based Compensation	Sep. 30, 2023
Share-Based Payment Arrangement [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 most recently amended and restated as of March 22, 2023 and most recently approved by the Company’s stockholders at the annual meeting of stockholders held on May 9, 2023 (the “2009 Plan”). The 2009 Plan provides for the grant of incentive stock options intended to qualify under Section 422 of the Internal Revenue Code (“IRC”) and for the grant of stock options which do not so qualify, stock appreciation rights, restricted stock, restricted stock units (“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 September 30, 2023 , 9,029,110 shares of unissued common stock were reserved for future grants under the 2009 Plan. The following table reflects the impact of total compensation expense related to stock-based equity plans on the reported operating results for the respective periods (in millions): Three Months Ended Nine Months Ended September 30, September 30, 2023 2022 2023 2022 Effect on (loss) income before income taxes $ ( 6 ) $ ( 6 ) $ ( 16 ) $ ( 14 ) Effect on net (loss) income $ ( 5 ) $ ( 5 ) $ ( 13 ) $ ( 11 ) At September 30, 2023 , $ 34 million of unrecognized stock-based compensation expense related to outstanding unvested stock options, restricted stock and restricted stock units (the terms of which are summarized below) was expected to be recognized over a weighted-average period of 22 months. Of that amount, $ 6 million relates to outstanding unvested stock options expected to be recognized over a weighted-average period of 22 months and $ 28 million relates to outstanding unvested restricted stock and restricted stock units expected to be recognized over a weighted-average period of 22 months. There were no modifications to awards during the nine months ended September 30, 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 and nine months ended September 30, 2023 and 2022: Three Months Ended Nine Months Ended 2023 2022 2023 2022 Expected volatility N/A N/A 87.3 % 84.3 % - 87.5 % Expected dividends N/A N/A — — Expected term N/A N/A 6 years 3 - 6 years Risk-free interest rate N/A N/A 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 discernible employee populations. From this analysis, in determining the expected term for the nine months ended September 30, 2023, the Company identified one population, consisting of persons receiving grants of stock options. Additionally, in determining the expected term for the nine months ended September 30, 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 September 30, 2023, and changes during each of the three-month periods 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 September 30, 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 Granted — — Exercised ( 6,667 ) 4.93 Forfeited and cancelled — — Outstanding at June 30, 2023 3,630,750 7.07 Granted — — Exercised — — Forfeited and cancelled — — Outstanding at September 30, 2023 3,630,750 $ 7.07 7.6 years $ — Exercisable at September 30, 2023 2,071,994 $ 6.46 6.7 years $ — No stock options were granted during the three months ended September 30, 2023 and 2022. The weighted-average grant date fair value of stock options granted during the nine months ended September 30, 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 ($ 2.90 ) 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 September 30, 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 nine-month periods ended September 30, 2023 and 2022. No options were exercised during the three months ended September 30, 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 September 30, 2023, and changes during each of the three-month periods 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 Granted 59,000 3.34 Vested ( 56,668 ) 8.79 Forfeited ( 12,001 ) 9.32 Unvested at June 30, 2023 6,095,826 8.03 Granted — — Vested ( 4,001 ) 9.72 Forfeited ( 20,668 ) 7.23 Unvested at September 30, 2023 6,071,157 8.03 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 September 30, 2023, and changes during each of the three-month periods 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 Granted — — Vested ( 5,894 ) 5.00 Forfeited — — Unvested at June 30, 2023 775,926 6.86 Granted — — Vested — — Forfeited — — Unvested at September 30, 2023 775,926 6.86

Acquisitions and Divestitures

Acquisitions and Divestitures	9 Months Ended
Acquisitions and Divestitures	Sep. 30, 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. The Company accounts for asset acquisitions pursuant to a cost accumulation model. Direct transaction costs are recognized as part of the cost of an acquisition. The Company also evaluates which elements of a transaction should be accounted for as part of an asset acquisition and which should be accounted for separately. The cost of an asset acquisition, including transaction costs, is allocated to identifiable assets acquired and liabilities assumed based on a relative fair value basis. Goodwill is not recognized in an asset acquisition. During the nine months ended September 30, 2023, one or more subsidiaries of the Company paid approximately $ 35 million to acquire the operating assets and related businesses of certain physician practices, clinics, ambulatory surgery centers and other ancillary businesses that operate within the communities served by the Company’s affiliated hospitals. The majority of this amount relates to the Company's purchase of certain assets from American Physician Partners ("APP") for approximately $ 20 million. This transaction, which resulted in the Company recording a definite-lived intangible asset for the acquisition of an assembled workforce, was accounted for as an asset acquisition. In connection with these acquisitions, inclusive of APP, the Company allocated the purchase price to property and equipment, working capital, intangible assets, noncontrolling interests and goodwill. Divestitures The following table provides a summary of hospitals that the Company divested (or, in the case of Lutheran Rehabilitation Hospital, in which the Company sold a majority interest) during the nine months ended September 30, 2023 and the year ended December 31, 2022: Licensed Hospital Buyer City, State Beds Effective Date 2023 Divestitures: Greenbrier Valley Medical Center Vandalia Health, Inc. Ronceverte, WV 122 January 1, 2023 Plateau Medical Center Vandalia Health, Inc. Oak Hill, WV 25 April 1, 2023 Medical Center of South Arkansas SARH Holdings, Inc. El Dorado, AR 166 July 1, 2023 Lutheran Rehabilitation Hospital Select Medical Corporation Fort Wayne, IN 36 September 1, 2023 2022 Divestiture: AllianceHealth Seminole SSM HealthCare of Oklahoma, Inc. Seminole, OK 32 July 1, 2022 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 September 30, 2023. On July 24, 2023, subsidiaries of the Company entered into a definitive agreement for the sale of substantially all of the assets of Bravera Health Brooksville ( 120 licensed beds) in Brooksville, Florida, Bravera Health Seven Rivers ( 128 licensed beds) in Crystal River, Florida, and Bravera Health Spring Hill ( 124 licensed beds) in Spring Hill, Florida, to Florida Health Sciences Center, Inc., and certain of its affiliates. These hospitals were classified as held-for-sale as of September 30, 2023. On August 4, 2023, subsidiaries of the Company entered into a definitive agreement for the sale of AllianceHealth Ponca City ( 140 licensed beds) in Ponca City, Oklahoma, and AllianceHealth Woodward ( 87 licensed beds) in Woodward, Oklahoma, to INTEGRIS Health, Inc. During the three months ended December 31, 2022, the Company notified the lessor of AllianceHealth Woodward that it will not renew the lease that expires effective December 1, 2023. The lessor has subsequently selected INTEGRIS Health, Inc. as the new leaseholder and operator. These hospitals were classified as held-for-sale as of September 30, 2023. The following table discloses amounts included in the condensed consolidated balance sheets for the hospitals classified as held-for-sale as of September 30, 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 September 30, 2023 or December 31, 2022. September 30, December 31, Other current assets $ 23 $ 6 Other assets, net 469 132 Accrued liabilities ( 33 ) ( 4 )

Goodwill and Other Intangible A

Goodwill and Other Intangible Assets	9 Months Ended
Goodwill and Other Intangible Assets	Sep. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
GOODWILL	4. GOODWILL The changes in the carrying amount of goodwill for the nine months ended September 30, 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 17 Goodwill allocated to hospitals divested or held-for-sale ( 240 ) Balance, as of September 30, 2023 Goodwill 6,757 Accumulated impairment losses ( 2,814 ) $ 3,943 Goodwill is allocated to each identified reporting unit, which is defined as an operating segment or one level below the operating segment (referred to as a component of the entity). Management has determined that the Company’s operating segment meets the criteria to be classified as a reporting unit. Goodwill is evaluated for impairment annually and when an event occurs or circumstances change that, more likely than not, reduce the fair value of the reporting unit below its carrying value. The Company performed its last annual goodwill impairment evaluation during the fourth quarter of 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

Income Taxes	9 Months Ended
Income Taxes	Sep. 30, 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 $ 32 million at September 30, 2023. A total of $ 2 million of interest and penalties is included in the amount of the liability for uncertain tax positions at September 30, 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 June 30, 2024 for Community Health Systems, Inc. for the tax period ended December 31, 2018. The Company’s provision for income taxes was $ 19 million and $ 70 million for the three months ended September 30, 2023 and 2022 , respectively, and $ 84 million and $ 291 million for the nine months ended September 30, 2023 and 2022 , respectively. The Company’s effective tax rates were ( 57.6 )% and 100.0 % for the three months ended September 30, 2023 and 2022 , respectively, and 600.0 % and 1,212.5 % for the nine months ended September 30, 2023 and 2022, respectively. The decrease in the provision for income taxes for the three and nine months ended September 30, 2023, compared to the same period in 2022 was primarily due to a decrease in non-deductible interest for 2023 compared to 2022. The difference in the Company’s effective tax rate for the three and nine months ended September 30, 2023, compared to the same period in 2022 is due to the decrease in the provision for income taxes and the decrease in (loss) income before taxes. Cash paid for income taxes, net of refunds received, resulted in a net payment of $ 24 million and approximately less than $ 1 million during the three months ended September 30, 2023 and 2022 , respectively, and $ 61 million and $ 6 million during the nine months ended September 30, 2023 and 2022 , respectively.

Long-Term Debt

Long-Term Debt	9 Months Ended
Long-Term Debt	Sep. 30, 2023
Long-Term Debt and Lease Obligation [Abstract]
LONG-TERM DEBT	6. LONG-TERM DEBT Long-term debt, net of unamortized debt issuance costs and discounts or premiums, consists of the following (in millions): September 30, December 31, 2023 2022 8 % Senior Secured Notes due 2026 $ 2,101 $ 2,101 8 % Senior Secured Notes due 2027 700 700 5 ⅝% Senior Secured Notes due 2027 1,900 1,900 6 ⅞% Senior Notes due 2028 756 756 6 % Senior Secured Notes due 2029 900 900 5 ¼% Senior Secured Notes due 2030 1,535 1,535 4 ¾% Senior Secured Notes due 2031 1,058 1,058 6 ⅞% Junior-Priority Secured Notes due 2029 1,386 1,386 6 ⅛% Junior-Priority Secured Notes due 2030 1,232 1,232 ABL Facility 230 53 Finance lease and financing obligations 371 380 Other 32 36 Less: Unamortized deferred debt issuance costs and note premium ( 359 ) ( 402 ) Total debt 11,842 11,635 Less: Current maturities ( 22 ) ( 21 ) Total long-term debt $ 11,820 $ 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 September 30, 2023, the Company had outstanding borrowings of $ 230 million and approximately $ 679 million of additional borrowing capacity (after taking into consideration the $ 82 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 September 30, 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 September 30, 2023. The Company paid interest of $ 198 million and $ 204 million on borrowings during the three months ended September 30, 2023 and 2022, respectively, and $ 583 million and $ 614 million on borrowings during the nine months ended September 30, 2023 and 2022 , respectively.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	9 Months Ended
Fair Value of Financial Instruments	Sep. 30, 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 September 30, 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): September 30, 2023 December 31, 2022 Carrying Estimated Carrying Estimated Amount Value Amount Value Assets: Cash and cash equivalents $ 91 $ 91 $ 118 $ 118 Investments in equity securities 63 63 107 107 Available-for-sale debt securities 173 173 179 179 Trading securities 4 4 5 5 Liabilities: 8% Senior Secured Notes due 2026 2,087 2,005 2,083 1,917 8% Senior Secured Notes due 2027 694 651 693 631 5⅝% Senior Secured Notes due 2027 1,843 1,635 1,833 1,633 6⅞% Senior Notes due 2028 750 406 749 389 6% Senior Secured Notes due 2029 868 729 865 751 5¼% Senior Secured Notes due 2030 1,455 1,171 1,448 1,166 4¾% Senior Secured Notes due 2031 1,054 751 1,053 766 6⅞% Junior-Priority Secured Notes due 2029 1,291 746 1,282 720 6⅛% Junior-Priority Secured Notes due 2030 1,169 635 1,164 615 ABL Facility and other debt 259 259 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.

Fair Value

Fair Value	9 Months Ended
Fair Value	Sep. 30, 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 nine months ended September 30, 2023 and 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 September 30, 2023 and December 31, 2022 (in millions): September 30, Level 1 Level 2 Level 3 Investments in equity securities $ 63 $ 63 $ — $ — Available-for-sale debt securities 173 — 173 — Trading securities 4 — 4 — Total assets $ 240 $ 63 $ 177 $ — December 31, 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

Leases	9 Months Ended
Leases	Sep. 30, 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 and nine months ended September 30, 2023 and 2022 are as follows (in millions): Three Months Ended Nine Months Ended Lease Cost 2023 2022 2023 2022 Operating lease cost: Operating lease cost $ 52 $ 53 $ 160 $ 157 Short-term rent expense 22 21 66 66 Variable lease cost 6 7 18 16 Sublease income ( 1 ) ( 1 ) ( 4 ) ( 3 ) Total operating lease cost $ 79 $ 80 $ 240 $ 236 Finance lease cost: Amortization of right-of-use assets $ 4 $ 3 $ 10 $ 10 Interest on finance lease liabilities 3 4 10 12 Total finance lease cost $ 7 $ 7 $ 20 $ 22 Supplemental balance sheet information related to leases is as follows (in millions): Balance Sheet Classification September 30, 2023 December 31, 2022 Operating Leases: Operating lease right-of-use assets Other assets, net $ 664 $ 738 Finance Leases: Finance lease right-of-use assets Property and equipment Land and improvements $ — $ — Buildings and improvements 246 261 Equipment and fixtures 7 12 Property and equipment 253 273 Less accumulated depreciation and amortization ( 61 ) ( 56 ) Property and equipment, net $ 192 $ 217 Current finance lease liabilities Current maturities of long-term debt $ 2 $ 3 Long-term finance lease liabilities Long-term debt 217 220 Supplemental cash flow information related to leases for the nine months ended September 30, 2023 and 2022 is as follows (in millions): Nine Months Ended Cash flow information 2023 2022 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases (1) $ 153 $ 152 Operating cash flows from finance leases 10 12 Financing cash flows from finance leases 3 9 Right-of-use assets obtained in exchange for new finance lease liabilities — 42 Right-of-use assets obtained in exchange for new operating lease liabilities 64 105 _______________________________ (1) Included in the change in other operating assets and liabilities in the condensed consolidated statements of cash flows.

Stockholders' Deficit

Stockholders' Deficit	9 Months Ended
Stockholders' Deficit	Sep. 30, 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 September 30, 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 September 30, 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 schedule below presents the reconciliation of the carrying amount of total equity, equity attributable to the Company’s stockholders, and equity attributable to noncontrolling interests as of September 30, 2023, and during each of the three-month periods following December 31, 2022 (in millions). Other reclassifications of noncontrolling interests reflects reclassification of amounts from redeemable noncontrolling interests to noncontrolling interests due to the expiration of redemption features. Community Health Systems, Inc. Stockholders Redeemable Common Additional Accumulated Accumulated Noncontrolling Total 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 ( 1 ) — — — — — — Contributions from noncontrolling interests 1 — — — — 1 1 Adjustment to redemption value of redeemable 32 — ( 32 ) — — — ( 32 ) Cancellation of restricted stock for tax — — ( 4 ) — — — ( 4 ) Share-based compensation — — 6 — — — 6 Balance, March 31, 2023 561 1 2,054 ( 18 ) ( 3,482 ) 93 ( 1,352 ) Comprehensive income (loss) 28 — — ( 1 ) ( 38 ) 11 ( 28 ) Distributions to noncontrolling interests ( 21 ) — — — — ( 19 ) ( 19 ) Contributions from noncontrolling interests — — — — — 1 1 Purchases of subsidiary shares from noncontrolling ( 6 ) — 5 — — — 5 Noncontrolling interest in acquired entity 7 — — — — — — Adjustment to redemption value of redeemable 14 — ( 14 ) — — — ( 14 ) Share-based compensation — — 4 — — — 4 Balance, June 30, 2023 583 1 2,049 ( 19 ) ( 3,520 ) 86 ( 1,403 ) Comprehensive income (loss) 12 — — ( 3 ) ( 91 ) 27 ( 67 ) Distributions to noncontrolling interests ( 8 ) — — — — ( 17 ) ( 17 ) Other reclassifications of noncontrolling interests ( 265 ) — 122 ( 1 ) — 145 266 Adjustment to redemption value of redeemable 7 — ( 7 ) — — — ( 7 ) Share-based compensation — — 6 — — — 6 Balance, September 30, 2023 $ 329 $ 1 $ 2,170 $ ( 23 ) $ ( 3,611 ) $ 241 $ ( 1,222 ) The following schedule presents the reconciliation of the carrying amount of total equity, equity attributable to the Company’s stockholders, and equity attributable to the noncontrolling interests as of September 30, 2022, and during each of the three-month periods following December 31, 2021 (in millions): Community Health Systems, Inc. Stockholders Redeemable Common Additional Accumulated Accumulated Noncontrolling Total 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 1 — ( 1 ) — — — ( 1 ) Contributions from noncontrolling interests 1 — — — — — — Adjustment to redemption value of redeemable 7 — ( 7 ) — — — ( 7 ) Cancellation of restricted stock for tax — — ( 8 ) — — — ( 8 ) Share-based compensation — — 5 — — — 5 Balance, March 31, 2022 493 1 2,107 ( 22 ) ( 3,478 ) 80 ( 1,312 ) Comprehensive income (loss) 21 — — ( 6 ) ( 326 ) 7 ( 324 ) Distributions to noncontrolling interests ( 39 ) — — — — ( 5 ) ( 5 ) Noncontrolling interest in acquired entity 3 — — — — 2 2 Adjustment to redemption value of redeemable 20 — ( 20 ) — — — ( 20 ) Share-based compensation — — 3 — — — 3 Balance, June 30, 2022 498 1 2,090 ( 27 ) ( 3,804 ) 84 ( 1,656 ) Comprehensive income (loss) 30 — — ( 6 ) ( 41 ) 12 ( 35 ) Contributions from noncontrolling interests 1 — — — — 8 8 Distributions to noncontrolling interests ( 20 ) — — — — ( 12 ) ( 12 ) Purchases of subsidiary shares from noncontrolling ( 1 ) — ( 1 ) — — — ( 1 ) Adjustment to redemption value of redeemable 4 — ( 4 ) — — — ( 4 ) Noncontrolling interest in acquired entity 4 — — — — — — Share-based compensation — — 6 — — — 6 Balance, September 30, 2022 $ 516 $ 1 $ 2,091 $ ( 33 ) $ ( 3,845 ) $ 92 $ ( 1,694 ) _______________________________ (1) Totals may not add due to rounding. The following schedule discloses the effects of changes in the Company’s ownership interest in its less-than-wholly-owned subsidiaries on Community Health Systems, Inc. stockholders’ deficit (in millions): Three Months Ended Nine Months Ended September 30, September 30, 2023 2022 2023 2022 Net loss attributable to Community Health Systems, $ ( 91 ) $ ( 42 ) $ ( 180 ) $ ( 369 ) Transfers to the noncontrolling interests: Net increase (decrease) in Community Health Systems, — ( 1 ) 5 ( 2 ) Net transfers to the noncontrolling interests — ( 1 ) 5 ( 2 ) Change to Community Health Systems, Inc. stockholders' $ ( 91 ) $ ( 43 ) $ ( 175 ) $ ( 371 )

Earnings Per Share

Earnings Per Share	9 Months Ended
Earnings Per Share	Sep. 30, 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 Nine Months Ended September 30, September 30, 2023 2022 2023 2022 Weighted-average number of shares outstanding — basic 130,698,907 129,141,673 130,352,865 128,689,999 Effect of dilutive securities: Restricted stock awards — — — — Employee stock options — — — — Other equity-based awards — — — — Weighted-average number of shares outstanding — diluted 130,698,907 129,141,673 130,352,865 128,689,999 The Company generated a loss attributable to Community Health Systems, Inc. stockholders for each of the three-month and nine-month periods ended September 30, 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 the three months ended September 30, 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 224,178 shares and 565,641 shares, respectively. If the Company had generated income during the nine months ended September 30, 2023 and 2022 , the effect of the restricted stock awards, employee stock options, and other equity-based awards on the diluted shares calculation would have been an increase of 298,184 shares and 1,305,604 shares, respectively. Three Months Ended Nine Months Ended September 30, September 30, 2023 2022 2023 2022 Dilutive securities outstanding not included in the computation Employee stock options and restricted stock awards 5,894,797 5,764,161 6,325,261 3,826,769

Contingencies

Contingencies	9 Months Ended
Contingencies	Sep. 30, 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 was preliminarily approved by the District Court on May 31, 2023. The Court granted final approval of the settlement on October 13, 2023. Thomas Mason, MD, Steven Folstad, MD and Mid-Atlantic Emergency Medical Associates, PA v. Health Management Associates, LLC f/k/a Health Management Associates, Inc., Mooresville Hospital Management Associates d/b/a Lake Norman Regional Medical Center, Statesville HMA, LLC d/b/a Davis Regional Medical Center, Envision Healthcare Corporation f/k/a Emergency Medical Services Corporation, Emcare Holdings, Inc., and Emergency Medical Services, LP . This alleged wrongful retaliation case is filed in the United States District Court for the Western District of North Carolina. The plaintiffs allege their agreements with the defendants were terminated in retaliation for plaintiffs’ alleged refusal to admit patients unnecessarily to the defendant hospitals or otherwise perform unnecessary diagnostic testing. The allegations of the complaint relate to time periods prior to the hospitals’ affiliation with the Company. The plaintiffs filed a third amended complaint on April 26, 2019. The defendants filed motions to dismiss, which were granted in part and denied in part on September 5, 2019. A jury trial in this matter is set to begin on February 5, 2024. The Company continues to vigorously defend this case. The table below presents a reconciliation of the beginning and ending liability balances (in millions) during the nine months ended September 30, 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 34 Reserve for insured claim 4 Cash payments ( 6 ) Balance as of September 30, 2023 $ 43 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.

Basis of Presentation and Sig_2

Basis of Presentation and Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Accounting	The unaudited condensed consolidated financial statements of Community Health Systems, Inc. (the “Parent” or “Parent Company”) and its subsidiaries (the “Company”) as of September 30, 2023 and December 31, 2022 and for the three-month and nine-month periods ended September 30, 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 and nine months ended September 30, 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”).
Consolidation	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 $ 60 million for the three months ended September 30, 2023 and 2022 , respectively, and $ 187 million and $ 179 million for the nine months ended September 30, 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	Revenue Recognition. Net Operating Revenues Net operating revenues are recorded at the transaction price estimated by the Company to reflect the total consideration due from patients and third-party payors in exchange for providing goods and services in patient care. These services are considered to be a single performance obligation and have a duration of less than one year. Revenues are recorded as these goods and services are provided. The transaction price, which involves significant estimates, is determined based on the Company’s standard charges for the goods and services provided, with a reduction recorded for price concessions related to third party contractual arrangements as well as patient discounts and other patient price concessions. During each of the three and nine-month periods ended September 30, 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 and nine months ended September 30, 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 Nine Months Ended September 30, September 30, 2023 2022 2023 2022 Medicare $ 608 $ 644 $ 1,884 $ 1,928 Medicare Managed Care 498 479 1,563 1,471 Medicaid 456 449 1,328 1,362 Managed Care and other third-party payors 1,479 1,446 4,441 4,248 Self-pay 45 7 92 60 Total $ 3,086 $ 3,025 $ 9,308 $ 9,069
Patient Accounts Receivable	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 $ 119 million and $ 101 million as of September 30, 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 $ 121 million and $ 97 million as of September 30, 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	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 $ 355 million and $ 285 million for the three months ended September 30, 2023 and 2022, respectively, and $ 1.0 billion and $ 1.1 billion for the nine months ended September 30, 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 $ 39 million and $ 33 million during the three months ended September 30, 2023 and 2022, respectively, and $ 111 million and $ 121 million for the nine months ended September 30, 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	Accounting for the Impairment or Disposal of Long-Lived Assets. During the nine months ended September 30, 2023 , the Company recorded a net gain of approximately $ 9 million, comprised of a gain of $ 63 million related to the sale of three hospitals, offset by (i) an approximate $ 21 million impairment charge to adjust the carrying value of long-lived assets at a hospital that was sold at a sales price below carrying value, (ii) an approximate $ 25 million impairment charge recorded to reduce the carrying value of two hospitals that were deemed held-for-sale based on the difference between the carrying value of the disposal group compared to the estimated fair value less costs to sell, and (iii) an approximate $ 8 million impairment charge recorded to reduce the carrying value of several assets that were idled, disposed of or held-for-sale. During the nine months ended September 30, 2023 , approximately $ 84 million of goodwill was allocated from the hospital operations reporting unit associated with the disposal groups for which impairment charges or a gain on sale was recorded during the period. During the nine months ended September 30, 2022 , the Company recorded an impairment charge of approximately $ 54 million, which consists of $ 6 million to adjust the carrying value of long-lived assets at a hospital that was subsequently sold at a sales price below carrying value and $ 48 million primarily related to the closure of Shorepoint Health Venice in Venice, Florida, and near-complete closure of First Hospital Wyoming Valley (psychiatric hospital) in Wilkes-Barre, Pennsylvania, during the three months ended September 30, 2022. 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.
Fair Value of Financial Instruments	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.

Basis of Presentation and Sig_3

Basis of Presentation and Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Net Operating Revenues	The Company’s net operating revenues during the three and nine months ended September 30, 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 Nine Months Ended September 30, September 30, 2023 2022 2023 2022 Medicare $ 608 $ 644 $ 1,884 $ 1,928 Medicare Managed Care 498 479 1,563 1,471 Medicaid 456 449 1,328 1,362 Managed Care and other third-party payors 1,479 1,446 4,441 4,248 Self-pay 45 7 92 60 Total $ 3,086 $ 3,025 $ 9,308 $ 9,069

Accounting for Stock-Based Co_2

Accounting for Stock-Based Compensation (Tables)	9 Months Ended
Accounting for Stock-Based Compensation (Tables)	Sep. 30, 2023
Share-Based Payment Arrangement [Abstract]
Schedule of Share-based Compensation Expense	The following table reflects the impact of total compensation expense related to stock-based equity plans on the reported operating results for the respective periods (in millions): Three Months Ended Nine Months Ended September 30, September 30, 2023 2022 2023 2022 Effect on (loss) income before income taxes $ ( 6 ) $ ( 6 ) $ ( 16 ) $ ( 14 ) Effect on net (loss) income $ ( 5 ) $ ( 5 ) $ ( 13 ) $ ( 11 )
Schedule of Share-based Payment Awards, Stock Options, Valuation Assumptions	The fair value of stock options was estimated using the Black Scholes option pricing model with the following assumptions and weighted-average fair values during the three and nine months ended September 30, 2023 and 2022: Three Months Ended Nine Months Ended 2023 2022 2023 2022 Expected volatility N/A N/A 87.3 % 84.3 % - 87.5 % Expected dividends N/A N/A — — Expected term N/A N/A 6 years 3 - 6 years Risk-free interest rate N/A N/A 4.2 % 1.5 % - 1.6 %
Schedule of Share-based Compensation, Stock Options, Activity	Options outstanding and exercisable under the 2009 Plan as of September 30, 2023, and changes during each of the three-month periods 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 September 30, 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 Granted — — Exercised ( 6,667 ) 4.93 Forfeited and cancelled — — Outstanding at June 30, 2023 3,630,750 7.07 Granted — — Exercised — — Forfeited and cancelled — — Outstanding at September 30, 2023 3,630,750 $ 7.07 7.6 years $ — Exercisable at September 30, 2023 2,071,994 $ 6.46 6.7 years $ —
Schedule of Share-based Compensation, Restricted Stock, Activity	Restricted stock outstanding under the 2009 Plan as of September 30, 2023, and changes during each of the three-month periods 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 Granted 59,000 3.34 Vested ( 56,668 ) 8.79 Forfeited ( 12,001 ) 9.32 Unvested at June 30, 2023 6,095,826 8.03 Granted — — Vested ( 4,001 ) 9.72 Forfeited ( 20,668 ) 7.23 Unvested at September 30, 2023 6,071,157 8.03
Schedule of Share-based Compensation, Restricted Stock Units, Activity	RSUs outstanding under the 2009 Plan as of September 30, 2023, and changes during each of the three-month periods 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 Granted — — Vested ( 5,894 ) 5.00 Forfeited — — Unvested at June 30, 2023 775,926 6.86 Granted — — Vested — — Forfeited — — Unvested at September 30, 2023 775,926 6.86

Acquisitions and Divestitures (

Acquisitions and Divestitures (Tables)	9 Months Ended
Acquisitions and Divestitures (Tables)	Sep. 30, 2023
Acquisitions And Divestitures [Abstract]
Schedule of Divestitures	The following table provides a summary of hospitals that the Company divested (or, in the case of Lutheran Rehabilitation Hospital, in which the Company sold a majority interest) during the nine months ended September 30, 2023 and the year ended December 31, 2022: Licensed Hospital Buyer City, State Beds Effective Date 2023 Divestitures: Greenbrier Valley Medical Center Vandalia Health, Inc. Ronceverte, WV 122 January 1, 2023 Plateau Medical Center Vandalia Health, Inc. Oak Hill, WV 25 April 1, 2023 Medical Center of South Arkansas SARH Holdings, Inc. El Dorado, AR 166 July 1, 2023 Lutheran Rehabilitation Hospital Select Medical Corporation Fort Wayne, IN 36 September 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	The following table discloses amounts included in the condensed consolidated balance sheets for the hospitals classified as held-for-sale as of September 30, 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 September 30, 2023 or December 31, 2022. September 30, December 31, Other current assets $ 23 $ 6 Other assets, net 469 132 Accrued liabilities ( 33 ) ( 4 )

Goodwill (Tables)

Goodwill (Tables)	9 Months Ended
Goodwill (Tables)	Sep. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	The changes in the carrying amount of goodwill for the nine months ended September 30, 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 17 Goodwill allocated to hospitals divested or held-for-sale ( 240 ) Balance, as of September 30, 2023 Goodwill 6,757 Accumulated impairment losses ( 2,814 ) $ 3,943

Long-Term Debt (Tables)

Long-Term Debt (Tables)	9 Months Ended
Long-Term Debt (Tables)	Sep. 30, 2023
Long-Term Debt and Lease Obligation [Abstract]
Schedule of Debt	Long-term debt, net of unamortized debt issuance costs and discounts or premiums, consists of the following (in millions): September 30, December 31, 2023 2022 8 % Senior Secured Notes due 2026 $ 2,101 $ 2,101 8 % Senior Secured Notes due 2027 700 700 5 ⅝% Senior Secured Notes due 2027 1,900 1,900 6 ⅞% Senior Notes due 2028 756 756 6 % Senior Secured Notes due 2029 900 900 5 ¼% Senior Secured Notes due 2030 1,535 1,535 4 ¾% Senior Secured Notes due 2031 1,058 1,058 6 ⅞% Junior-Priority Secured Notes due 2029 1,386 1,386 6 ⅛% Junior-Priority Secured Notes due 2030 1,232 1,232 ABL Facility 230 53 Finance lease and financing obligations 371 380 Other 32 36 Less: Unamortized deferred debt issuance costs and note premium ( 359 ) ( 402 ) Total debt 11,842 11,635 Less: Current maturities ( 22 ) ( 21 ) Total long-term debt $ 11,820 $ 11,614

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	9 Months Ended
Fair Value of Financial Instruments (Tables)	Sep. 30, 2023
Fair Value Disclosures [Abstract]
Schedule of Estimated Fair Value of Financial Instruments, by Balance Sheet Grouping	The fair value of financial instruments has been estimated by the Company using available market information as of September 30, 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): September 30, 2023 December 31, 2022 Carrying Estimated Carrying Estimated Amount Value Amount Value Assets: Cash and cash equivalents $ 91 $ 91 $ 118 $ 118 Investments in equity securities 63 63 107 107 Available-for-sale debt securities 173 173 179 179 Trading securities 4 4 5 5 Liabilities: 8% Senior Secured Notes due 2026 2,087 2,005 2,083 1,917 8% Senior Secured Notes due 2027 694 651 693 631 5⅝% Senior Secured Notes due 2027 1,843 1,635 1,833 1,633 6⅞% Senior Notes due 2028 750 406 749 389 6% Senior Secured Notes due 2029 868 729 865 751 5¼% Senior Secured Notes due 2030 1,455 1,171 1,448 1,166 4¾% Senior Secured Notes due 2031 1,054 751 1,053 766 6⅞% Junior-Priority Secured Notes due 2029 1,291 746 1,282 720 6⅛% Junior-Priority Secured Notes due 2030 1,169 635 1,164 615 ABL Facility and other debt 259 259 85 85

Fair Value (Tables)

Fair Value (Tables)	9 Months Ended
Fair Value (Tables)	Sep. 30, 2023
Fair Value Disclosures [Abstract]
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis	The following table sets forth, by level within the fair value hierarchy, the financial assets and liabilities recorded at fair value on a recurring basis as of September 30, 2023 and December 31, 2022 (in millions): September 30, Level 1 Level 2 Level 3 Investments in equity securities $ 63 $ 63 $ — $ — Available-for-sale debt securities 173 — 173 — Trading securities 4 — 4 — Total assets $ 240 $ 63 $ 177 $ — December 31, 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)

Leases (Tables)	9 Months Ended
Leases (Tables)	Sep. 30, 2023
Leases [Abstract]
Components of Lease Cost and Rent Expense	The components of lease cost and rent expense for the three and nine months ended September 30, 2023 and 2022 are as follows (in millions): Three Months Ended Nine Months Ended Lease Cost 2023 2022 2023 2022 Operating lease cost: Operating lease cost $ 52 $ 53 $ 160 $ 157 Short-term rent expense 22 21 66 66 Variable lease cost 6 7 18 16 Sublease income ( 1 ) ( 1 ) ( 4 ) ( 3 ) Total operating lease cost $ 79 $ 80 $ 240 $ 236 Finance lease cost: Amortization of right-of-use assets $ 4 $ 3 $ 10 $ 10 Interest on finance lease liabilities 3 4 10 12 Total finance lease cost $ 7 $ 7 $ 20 $ 22
Supplemental Balance Sheet Information Related to Leases	Supplemental balance sheet information related to leases is as follows (in millions): Balance Sheet Classification September 30, 2023 December 31, 2022 Operating Leases: Operating lease right-of-use assets Other assets, net $ 664 $ 738 Finance Leases: Finance lease right-of-use assets Property and equipment Land and improvements $ — $ — Buildings and improvements 246 261 Equipment and fixtures 7 12 Property and equipment 253 273 Less accumulated depreciation and amortization ( 61 ) ( 56 ) Property and equipment, net $ 192 $ 217 Current finance lease liabilities Current maturities of long-term debt $ 2 $ 3 Long-term finance lease liabilities Long-term debt 217 220
Supplemental Cash Flow and Other Information Related to Leases	Supplemental cash flow information related to leases for the nine months ended September 30, 2023 and 2022 is as follows (in millions): Nine Months Ended Cash flow information 2023 2022 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases (1) $ 153 $ 152 Operating cash flows from finance leases 10 12 Financing cash flows from finance leases 3 9 Right-of-use assets obtained in exchange for new finance lease liabilities — 42 Right-of-use assets obtained in exchange for new operating lease liabilities 64 105 Included in the change in other operating assets and liabilities in the condensed consolidated statements of cash flows.

Stockholders' Deficit (Tables)

Stockholders' Deficit (Tables)	9 Months Ended
Stockholders' Deficit (Tables)	Sep. 30, 2023
Equity [Abstract]
Schedule of Stockholders' Deficit	The schedule below presents the reconciliation of the carrying amount of total equity, equity attributable to the Company’s stockholders, and equity attributable to noncontrolling interests as of September 30, 2023, and during each of the three-month periods following December 31, 2022 (in millions). Other reclassifications of noncontrolling interests reflects reclassification of amounts from redeemable noncontrolling interests to noncontrolling interests due to the expiration of redemption features. Community Health Systems, Inc. Stockholders Redeemable Common Additional Accumulated Accumulated Noncontrolling Total 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 ( 1 ) — — — — — — Contributions from noncontrolling interests 1 — — — — 1 1 Adjustment to redemption value of redeemable 32 — ( 32 ) — — — ( 32 ) Cancellation of restricted stock for tax — — ( 4 ) — — — ( 4 ) Share-based compensation — — 6 — — — 6 Balance, March 31, 2023 561 1 2,054 ( 18 ) ( 3,482 ) 93 ( 1,352 ) Comprehensive income (loss) 28 — — ( 1 ) ( 38 ) 11 ( 28 ) Distributions to noncontrolling interests ( 21 ) — — — — ( 19 ) ( 19 ) Contributions from noncontrolling interests — — — — — 1 1 Purchases of subsidiary shares from noncontrolling ( 6 ) — 5 — — — 5 Noncontrolling interest in acquired entity 7 — — — — — — Adjustment to redemption value of redeemable 14 — ( 14 ) — — — ( 14 ) Share-based compensation — — 4 — — — 4 Balance, June 30, 2023 583 1 2,049 ( 19 ) ( 3,520 ) 86 ( 1,403 ) Comprehensive income (loss) 12 — — ( 3 ) ( 91 ) 27 ( 67 ) Distributions to noncontrolling interests ( 8 ) — — — — ( 17 ) ( 17 ) Other reclassifications of noncontrolling interests ( 265 ) — 122 ( 1 ) — 145 266 Adjustment to redemption value of redeemable 7 — ( 7 ) — — — ( 7 ) Share-based compensation — — 6 — — — 6 Balance, September 30, 2023 $ 329 $ 1 $ 2,170 $ ( 23 ) $ ( 3,611 ) $ 241 $ ( 1,222 ) The following schedule presents the reconciliation of the carrying amount of total equity, equity attributable to the Company’s stockholders, and equity attributable to the noncontrolling interests as of September 30, 2022, and during each of the three-month periods following December 31, 2021 (in millions): Community Health Systems, Inc. Stockholders Redeemable Common Additional Accumulated Accumulated Noncontrolling Total 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 1 — ( 1 ) — — — ( 1 ) Contributions from noncontrolling interests 1 — — — — — — Adjustment to redemption value of redeemable 7 — ( 7 ) — — — ( 7 ) Cancellation of restricted stock for tax — — ( 8 ) — — — ( 8 ) Share-based compensation — — 5 — — — 5 Balance, March 31, 2022 493 1 2,107 ( 22 ) ( 3,478 ) 80 ( 1,312 ) Comprehensive income (loss) 21 — — ( 6 ) ( 326 ) 7 ( 324 ) Distributions to noncontrolling interests ( 39 ) — — — — ( 5 ) ( 5 ) Noncontrolling interest in acquired entity 3 — — — — 2 2 Adjustment to redemption value of redeemable 20 — ( 20 ) — — — ( 20 ) Share-based compensation — — 3 — — — 3 Balance, June 30, 2022 498 1 2,090 ( 27 ) ( 3,804 ) 84 ( 1,656 ) Comprehensive income (loss) 30 — — ( 6 ) ( 41 ) 12 ( 35 ) Contributions from noncontrolling interests 1 — — — — 8 8 Distributions to noncontrolling interests ( 20 ) — — — — ( 12 ) ( 12 ) Purchases of subsidiary shares from noncontrolling ( 1 ) — ( 1 ) — — — ( 1 ) Adjustment to redemption value of redeemable 4 — ( 4 ) — — — ( 4 ) Noncontrolling interest in acquired entity 4 — — — — — — Share-based compensation — — 6 — — — 6 Balance, September 30, 2022 $ 516 $ 1 $ 2,091 $ ( 33 ) $ ( 3,845 ) $ 92 $ ( 1,694 ) _______________________________ (1) Totals may not add due to rounding.
Schedule of Impact of Noncontrolling Interest to Stockholders' Deficit	The following schedule discloses the effects of changes in the Company’s ownership interest in its less-than-wholly-owned subsidiaries on Community Health Systems, Inc. stockholders’ deficit (in millions): Three Months Ended Nine Months Ended September 30, September 30, 2023 2022 2023 2022 Net loss attributable to Community Health Systems, $ ( 91 ) $ ( 42 ) $ ( 180 ) $ ( 369 ) Transfers to the noncontrolling interests: Net increase (decrease) in Community Health Systems, — ( 1 ) 5 ( 2 ) Net transfers to the noncontrolling interests — ( 1 ) 5 ( 2 ) Change to Community Health Systems, Inc. stockholders' $ ( 91 ) $ ( 43 ) $ ( 175 ) $ ( 371 )

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
Earnings Per Share (Tables)	Sep. 30, 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 Nine Months Ended September 30, September 30, 2023 2022 2023 2022 Weighted-average number of shares outstanding — basic 130,698,907 129,141,673 130,352,865 128,689,999 Effect of dilutive securities: Restricted stock awards — — — — Employee stock options — — — — Other equity-based awards — — — — Weighted-average number of shares outstanding — diluted 130,698,907 129,141,673 130,352,865 128,689,999
Schedule of Antidilutive Securities	Three Months Ended Nine Months Ended September 30, September 30, 2023 2022 2023 2022 Dilutive securities outstanding not included in the computation Employee stock options and restricted stock awards 5,894,797 5,764,161 6,325,261 3,826,769

Contingencies (Tables)

Contingencies (Tables)	9 Months Ended
Contingencies (Tables)	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Schedule of Reconciliation of the Beginning and Ending Liability Balances in Connection with Probable Contingencies	The table below presents a reconciliation of the beginning and ending liability balances (in millions) during the nine months ended September 30, 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 34 Reserve for insured claim 4 Cash payments ( 6 ) Balance as of September 30, 2023 $ 43

Basis of Presentation and Sig_4

Basis of Presentation and Significant Accounting Policies - Additional Information (Details) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023 USD ($)	Sep. 30, 2022 USD ($)	Sep. 30, 2023 USD ($) Hospital	Sep. 30, 2022 USD ($)	Dec. 31, 2022 USD ($)
Cost of Revenue, Policy [Abstract]
Corporate office costs	$ 61	$ 60	$ 187	$ 179
Third Party Reimbursement [Abstract]
Amounts due to third party payors	119		119		$ 101
Amounts due from third party payors	121		121		$ 97
Net Operating Revenues, Policy [Abstract]
Charity care services charges excluded from net operating revenues	355	285	1,000	1,100
Value of charity care services at the Company's standard charges included in contractual allowances	$ 39	33	$ 111	121
Accounting for the Impairment or Disposal of Long-Lived Assets
Number of hospitals sold \| Hospital			3
Impairment of long-lived assets held for sale				54
Hospitals Sold or Deemed Held for Sale
Accounting for the Impairment or Disposal of Long-Lived Assets
Net gain (loss) on disposition of business			$ 9
Gain (loss) on disposition of business			63
Impairment of amount related to several assets idled disposed or held for sale			8
Impairment of long-lived assets held for sale			25
Adjustment for Carrying Value of Other Long-Lived Assets at Underperforming Hospitals
Accounting for the Impairment or Disposal of Long-Lived Assets
Impairment of long-lived assets held for sale			21	$ 6
Hospital Closures of Shorepoint Health Venice in Venice, Florida and Near-complete Closure of First Hospital Wyoming Valley (Psychiatric Hospital) in Wilkes-Barre, Pennsylvania
Accounting for the Impairment or Disposal of Long-Lived Assets
Impairment of long-lived assets held for sale		$ 48
Shared Service Center
Accounting for the Impairment or Disposal of Long-Lived Assets
Net gain (loss) on disposition of business			$ 84

Basis of Presentation and Sig_5

Basis of Presentation and Significant Accounting Policies - Schedule of Net Operating Revenues (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	$ 3,086	$ 3,025	$ 9,308	$ 9,069
Medicare
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	608	644	1,884	1,928
Medicare Managed Care
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	498	479	1,563	1,471
Medicaid
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	456	449	1,328	1,362
Managed Care and Other Third Party Payors
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	1,479	1,446	4,441	4,248
Self-Pay
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Net operating revenues	$ 45	$ 7	$ 92	$ 60

Accounting for Stock-Based Co_3

Accounting for Stock-Based Compensation - Additional Information (Details)			3 Months Ended				9 Months Ended
	Mar. 01, 2023 USD ($) Director shares	Mar. 01, 2022 USD ($) Director shares	Sep. 30, 2023 USD ($) $ / shares shares	Jun. 30, 2023 shares	Mar. 31, 2023 shares	Sep. 30, 2022 USD ($) shares	Sep. 30, 2023 USD ($) Item $ / shares shares	Sep. 30, 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			$ 34,000,000				$ 34,000,000
Employee service share-based compensation total compensation cost not yet recognized, period for recognition							22 months
Employee service share-based compensation, nonvested awards, modifications to awards \| Item							0	0
Aggregate intrinsic value of options exercised			0			$ 0
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate intrinsic value of options exercised							$ 1,000,000	$ 1,000,000
Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Employee service share-based compensation total compensation cost not yet recognized, period for recognition							22 months
Employee service share-based compensation, unrecognized compensation costs on nonvested stock options			$ 6,000,000				$ 6,000,000
Granted, Shares \| shares			0	0	814,000	0
Weighted-average grant date fair value of stock options \| $ / shares							$ 4,610,000	$ 7.25
Share Price \| $ / shares			$ 2.9				$ 2.9
Restricted Stock and Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Employee service share-based compensation total compensation cost not yet recognized, period for recognition							22 months
Employee service share-based compensation, unrecognized compensation costs on nonvested awards other than options			$ 28,000,000				$ 28,000,000
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 \| shares				59,000	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 \| shares					365,037
Number of directors elected to defer the receipt of RSUs granted \| Director	4	3
Plan 2009
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unissued common stock reserved for grants \| shares			9,029,110				9,029,110
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 \| shares	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 \| shares	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%

Accounting for Stock-Based Co_4

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation Expense (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Share-Based Payment Arrangement [Abstract]
Effect on (loss) income before income taxes	$ (6)	$ (6)	$ (16)	$ (14)
Effect on net (loss) income	$ (5)	$ (5)	$ (13)	$ (11)

Accounting for Stock-Based Co_5

Accounting for Stock-Based Compensation - Schedule of Share-based Payment Awards, Stock Options, Valuation Assumptions (Details) - Employee Stock Option	9 Months Ended
	Sep. 30, 2023	Sep. 30, 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 Co_6

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation, Stock Options, Activity (Details) - Employee Stock Option - $ / shares	3 Months Ended				9 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Sep. 30, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Shares	3,630,750	3,637,417	2,831,751		2,831,751
Granted, Shares	0	0	814,000	0
Exercised, Shares		(6,667)	(8,334)
Forfeited and cancelled, Shares		0	0
Ending Balance, Shares	3,630,750	3,630,750	3,637,417		3,630,750
Exercisable, Shares	2,071,994				2,071,994
Beginning of Period, Weighted Average Exercise Price	$ 7.07	$ 7.06	$ 7.32		$ 7.32
Granted, Weighted Average Exercise Price		0	6.15
Exercised, Weighted Average Exercise Price		4.93	4.97
Forfeited and Cancelled, Weighted Average Exercise Price		0	0
End of Period, Weighted Average Exercise Price	7.07	$ 7.07	$ 7.06		7.07
Exercisable, Weighted Average Exercise Price	$ 6.46				$ 6.46
Weighted Average Remaining Contractual Term					7 years 7 months 6 days
Exercisable, Weighted Average Remaining Contractual Term					6 years 8 months 12 days

Accounting for Stock-Based Co_7

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation, Restricted Stock, Activity (Details) - Restricted Stock - $ / shares	3 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Unvested Shares	6,095,826	6,105,495	5,541,065
Granted, Shares		59,000	2,651,000
Vested, Shares	(4,001)	(56,668)	(2,076,569)
Forfeited, Shares	(20,668)	(12,001)	(10,001)
Ending Balance, Unvested Shares	6,071,157	6,095,826	6,105,495
Beginning of Period, Weighted Average Grant Date Fair Value	$ 8.03	$ 8.09	$ 8.53
Granted, Weighted Average Grant Date Fair Value		3.34	6.14
Vested, Weighted Average Grant Date Fair Value	9.72	8.79	6.77
Forfeited, Weighted Average Grant Date Fair Value	7.23	9.32	9.31
End of Period, Weighted Average Grant Date Fair Value	$ 8.03	$ 8.03	$ 8.09

Accounting for Stock-Based Co_8

Accounting for Stock-Based Compensation - Schedule of Share-based Compensation, Restricted Stock Units, Activity (Details) - Restricted Stock Units (RSUs) - $ / shares	3 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Unvested Shares	775,926	781,820	512,360
Granted, Shares			365,037
Vested, Shares		(5,894)	(95,577)
Ending Balance, Unvested Shares	775,926	775,926	781,820
Beginning of Period, Weighted Average Grant Date Fair Value	$ 6.86	$ 6.84	$ 7.54
Granted, Weighted Average Grant Date Fair Value			6.15
Vested, Weighted Average Grant Date Fair Value		5	7.92
End of Period, Weighted Average Grant Date Fair Value	$ 6.86	$ 6.86	$ 6.84

Acquisitions and Divestitures -

Acquisitions and Divestitures - Acquisitions - Additional Information (Details) $ in Millions	9 Months Ended
	Sep. 30, 2023 USD ($)
Physician Practices Clinics and Other Ancillary Businesses
Acquisitions and Divestitures [Line Items]
Business acquisition, cost of acquired entity, purchase price	$ 35
American Physician Partners ("APP")
Acquisitions and Divestitures [Line Items]
Business acquisition, cost of acquired entity, purchase price	$ 20

Acquisitions and Divestitures_2

Acquisitions and Divestitures - Schedule of Divestitures (Details) - Item	9 Months Ended	12 Months Ended
	Sep. 30, 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
Plateau Medical Center
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	25
Effective Date	Apr. 01, 2023
Medical Center of South Arkansas
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	166
Effective Date	Jul. 01, 2023
Lutheran Rehabilitation Hospital
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds	36
Effective Date	Sep. 01, 2023

Acquisitions and Divestitures_3

Acquisitions and Divestitures - Divestitures - Additional Information (Details) - Item	Sep. 30, 2023	Aug. 04, 2023	Jul. 24, 2023	Feb. 28, 2023
Plateau Medical Center
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
Bravera Health Brooksville \| Brooksville, Florida
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds			120
Bravera Health Seven Rivers \| Crystal River, Florida
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds			128
Bravera Health Spring Hill \| Spring Hill, Florida
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds			124
AllianceHealth Ponca City \| Ponca City, Oklahoma
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		140
AllianceHealth Woodward \| Woodward, Oklahoma
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of licensed beds		87

Acquisitions and Divestitures_4

Acquisitions and Divestitures - Schedule of Balance Sheet Items Classified as Held for Sale (Details) - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Acquisitions Divestitures And Closures [Abstract]
Other current assets	$ 23	$ 6
Other assets, net	469	132
Accrued liabilities	$ (33)	$ (4)

Goodwill - Schedule of Goodwill

Goodwill - Schedule of Goodwill (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2023	Dec. 31, 2022
Goodwill [Roll Forward]
Goodwill	$ 6,757	$ 6,980
Accumulated impairment losses	(2,814)	(2,814)
Goodwill	3,943	$ 4,166
Goodwill acquired as part of acquisitions during current year	17
Goodwill allocated to hospitals divested or held-for-sale	$ (240)

Goodwill - Additional Informati

Goodwill - Additional Information (Details)	12 Months Ended
Goodwill - Additional Information (Details)	Dec. 31, 2022 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Impairment of goodwill	$ 0

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($)	3 Months Ended		9 Months Ended
Income Taxes - Additional Information (Details) - USD ($)	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Taxes [Line Items]
Amount of interest and penalties included in liabilities for uncertain tax positions	$ 2,000,000		$ 2,000,000
Provision for income taxes	$ 19,000,000	$ 70,000,000	$ 84,000,000	$ 291,000,000
Effective income tax rate	(57.60%)	100%	600%	1,212.50%
Income tax refunds (payments), net	$ (24,000,000)		$ (61,000,000)	$ (6,000,000)
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	$ 32,000,000		$ 32,000,000
Income tax refunds (payments), net		$ (1,000,000)

Long-Term Debt - Schedule of De

Long-Term Debt - Schedule of Debt (Details) - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Debt and lease obligations	$ 11,842	$ 11,635
Less: Unamortized deferred debt issuance costs and note premium	(359)	(402)
Less: Current maturities	(22)	(21)
Total long-term debt	11,820	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	230	53
Finance Lease and Financing Obligations
Debt Instrument [Line Items]
Debt and lease obligations	371	380
Other
Debt Instrument [Line Items]
Debt and lease obligations	$ 32	$ 36

Long-Term Debt - Schedule of _2

Long-Term Debt - Schedule of Debt (Parenthetical) (Details)	9 Months Ended
Long-Term Debt - Schedule of Debt (Parenthetical) (Details)	Sep. 30, 2023
Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage	8%
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%
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%
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 Inf

Long-Term Debt - Additional Information (Details) - USD ($)	3 Months Ended		9 Months Ended
Long-Term Debt - Additional Information (Details) - USD ($)	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Apr. 03, 2018
Debt Instrument [Line Items]
Interest paid on borrowings	$ 198,000,000	$ 204,000,000	$ 583,000,000	$ 614,000,000
Asset Based Loan Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity					$ 1,000,000,000
Line of credit facility, excess availability	679,000,000		679,000,000
Line of credit outstanding amount	230,000,000		230,000,000
Asset Based Loan Facility \| ABL Facility Customary Covenants
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	95,000,000		$ 95,000,000
Debt instrument variable interest rate			10%
Asset Based Loan Facility \| Letter of Credit
Debt Instrument [Line Items]
Line of credit outstanding amount	$ 82,000,000		$ 82,000,000

Fair Value of Financial Instr_3

Fair Value of Financial Instruments - Schedule of Estimated Fair Value of Financial Instruments, by Balance Sheet Grouping (Details) - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Carrying Amount
Assets:
Cash and cash equivalents	$ 91	$ 118
Investments in equity securities	63	107
Available-for-sale debt securities	173	179
Trading securities	4	5
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Liabilities:
Notes payable, fair value disclosure	2,087	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	868	865
Carrying Amount \| Senior Secured Notes \| Senior Secured Notes 5.25%, Due 2030
Liabilities:
Notes payable, fair value disclosure	1,455	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	1,843	1,833
Carrying Amount \| Senior Notes \| Senior Notes at 6.875% Due 2028
Liabilities:
Notes payable, fair value disclosure	750	749
Carrying Amount \| Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.875% Due 2029
Liabilities:
Notes payable, fair value disclosure	1,291	1,282
Carrying Amount \| Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.125% Due 2030
Liabilities:
Notes payable, fair value disclosure	1,169	1,164
Carrying Amount \| ABL Facility and Other Debt
Liabilities:
Notes payable, fair value disclosure	259	85
Estimated Fair Value
Assets:
Cash and cash equivalents	91	118
Investments in equity securities	63	107
Available-for-sale debt securities	173	179
Trading securities	4	5
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 8%, Due 2026
Liabilities:
Notes payable, fair value disclosure	2,005	1,917
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 8%, Due 2027
Liabilities:
Notes payable, fair value disclosure	651	631
Estimated Fair Value \| Senior Secured Notes \| Senior Notes at 6% Due 2029
Liabilities:
Notes payable, fair value disclosure	729	751
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes 5.25%, Due 2030
Liabilities:
Notes payable, fair value disclosure	1,171	1,166
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 4.750% due 2031
Liabilities:
Notes payable, fair value disclosure	751	766
Estimated Fair Value \| Senior Secured Notes \| Senior Secured Notes at 5.625% due 2027
Liabilities:
Notes payable, fair value disclosure	1,635	1,633
Estimated Fair Value \| Senior Notes \| Senior Notes at 6.875% Due 2028
Liabilities:
Notes payable, fair value disclosure	406	389
Estimated Fair Value \| Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.875% Due 2029
Liabilities:
Notes payable, fair value disclosure	746	720
Estimated Fair Value \| Junior Priority Secured Notes \| Junior-Priority Secured Notes at 6.125% Due 2030
Liabilities:
Notes payable, fair value disclosure	635	615
Estimated Fair Value \| ABL Facility and Other Debt
Liabilities:
Notes payable, fair value disclosure	$ 259	$ 85

Fair Value - Additional Informa

Fair Value - Additional Information (Details) - USD ($)	Sep. 30, 2023	Sep. 30, 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 V

Fair Value - Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investments in equity securities	$ 63	$ 107
Available-for-sale debt securities	173	179
Trading securities	4	5
Total assets	240	291
Fair Value, Inputs, Level 1
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investments in equity securities	63	107
Total assets	63	107
Fair Value, Inputs, Level 2
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Available-for-sale debt securities	173	179
Trading securities	4	5
Total assets	$ 177	$ 184

Leases - Components of Lease Co

Leases - Components of Lease Cost and Rent Expense (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Leases [Abstract]
Operating lease cost	$ 52	$ 53	$ 160	$ 157
Short-term rent expense	22	21	66	66
Variable lease cost	6	7	18	16
Sublease income	(1)	(1)	(4)	(3)
Total operating lease cost	79	80	240	236
Finance lease cost:
Amortization of right-of-use assets	4	3	10	10
Interest on finance lease liabilities	3	4	10	12
Total finance lease cost	$ 7	$ 7	$ 20	$ 22

Leases - Supplemental Balance S

Leases - Supplemental Balance Sheet Information Related to Leases (Details) - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Operating Leases:
Operating lease right-of-use assets	$ 664	$ 738
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Other assets, net	Other assets, net
Finance Leases:
Property and equipment	$ 9,367	$ 9,639
Less accumulated depreciation and amortization	(4,207)	(4,274)
Property and equipment, net	5,160	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	$ 217	$ 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	$ 253	$ 273
Less accumulated depreciation and amortization	(61)	(56)
Property and equipment, net	192	217
Finance Lease ROU Assets \| Building and Improvements
Finance Leases:
Property and equipment	246	261
Finance Lease ROU Assets \| Equipment and Fixtures
Finance Leases:
Property and equipment	$ 7	$ 12

Leases - Supplemental Cash Flow

Leases - Supplemental Cash Flow and Other Information Related to Leases (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Leases [Abstract]
Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases	$ 153	$ 152
Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from finance leases	10	12
Cash paid for amounts included in the measurement of lease liabilities: Financing cash flows from finance leases	3	9
Right-of-use assets obtained in exchange for new finance lease liabilities		42
Right-of-use assets obtained in exchange for new operating lease liabilities	$ 64	$ 105

Stockholders' Deficit - Additio

Stockholders' Deficit - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	Sep. 30, 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 - Schedul

Stockholders' Deficit - Schedule of Stockholders' Deficit (Details) - USD ($) $ in Millions	3 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022
Equity, beginning balance	$ (1,403)	$ (1,352)	$ (1,275)	$ (1,656)	$ (1,312)	$ (1,290)
Redeemable Noncontrolling Interests, beginning balance			541
Comprehensive income (loss)	(67)	(28)	(37)	(35)	(324)	6
Distributions to noncontrolling interests	(17)	(19)	(11)	(12)	(5)	(17)
Purchases of subsidiary shares from noncontrolling interests		5		(1)		(1)
Contributions from noncontrolling interests		1	1	8
Other reclassifications of noncontrolling interests	266
Noncontrolling interest in acquired entity					2
Adjustment to redemption value of redeemable noncontrolling interests	(7)	(14)	(32)	(4)	(20)	(7)
Cancellation of restricted stock for tax withholdings on vested shares			(4)			(8)
Share-based compensation	6	4	6	6	3	5
Equity, ending balance	(1,222)	(1,403)	(1,352)	(1,694)	(1,656)	(1,312)
Redeemable Noncontrolling Interests, ending balance	329
Redeemable Noncontrolling Interests (Non- Equity)
Redeemable Noncontrolling Interests, beginning balance	583	561	541	498	493	480
Comprehensive income (loss)	12	28		30	21
Comprehensive income (loss) attributable to redeemable noncontrolling interest			21			16
Distributions to noncontrolling interests	(8)	(21)		(20)	(39)
Distributions to redeemable noncontrolling interests			(33)			(12)
Purchases of subsidiary shares from noncontrolling interests		(6)	(1)	(1)		1
Contributions from noncontrolling interests			1	1		1
Other reclassifications of redeemable noncontrolling interests	(265)
Noncontrolling interest in acquired entity		7		4	3
Adjustment to redemption value of redeemable noncontrolling interests	7	14	32	4	20	7
Redeemable Noncontrolling Interests, ending balance	329	583	561	516	498	493
Common Stock
Equity, beginning balance	1	1	1	1	1	1
Equity, ending balance	1	1	1	1	1	1
Additional Paid-in Capital
Equity, beginning balance	2,049	2,054	2,084	2,090	2,107	2,118
Purchases of subsidiary shares from noncontrolling interests		5		(1)		(1)
Other reclassifications of noncontrolling interests	122
Adjustment to redemption value of redeemable noncontrolling interests	(7)	(14)	(32)	(4)	(20)	(7)
Cancellation of restricted stock for tax withholdings on vested shares			(4)			(8)
Share-based compensation	6	4	6	6	3	5
Equity, ending balance	2,170	2,049	2,054	2,091	2,090	2,107
Accumulated Other Comprehensive Loss (Income)
Equity, beginning balance	(19)	(18)	(21)	(27)	(22)	(14)
Comprehensive income (loss)	(3)	(1)	3	(6)	(6)	(8)
Other reclassifications of noncontrolling interests	(1)
Equity, ending balance	(23)	(19)	(18)	(33)	(27)	(22)
Accumulated Deficit
Equity, beginning balance	(3,520)	(3,482)	(3,431)	(3,804)	(3,478)	(3,477)
Comprehensive income (loss)	(91)	(38)	(51)	(41)	(326)	(1)
Equity, ending balance	(3,611)	(3,520)	(3,482)	(3,845)	(3,804)	(3,478)
Noncontrolling Interest
Equity, beginning balance	86	93	92	84	80	82
Comprehensive income (loss)	27	11	11	12	7	15
Distributions to noncontrolling interests	(17)	(19)	(11)	(12)	(5)	(17)
Contributions from noncontrolling interests		1	1	8
Other reclassifications of noncontrolling interests	145
Noncontrolling interest in acquired entity					2
Equity, ending balance	$ 241	$ 86	$ 93	$ 92	$ 84	$ 80

Stockholders' Deficit - Sched_2

Stockholders' Deficit - Schedule of Impact of Noncontrolling Interest to Stockholders' Deficit (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Equity [Abstract]
Net loss attributable to Community Health Systems, Inc. stockholders	$ (91)	$ (42)	$ (180)	$ (369)
Net increase (decrease) in Community Health Systems, Inc. paid-in-capital for purchase of subsidiary partnership interests		(1)		(2)
Net transfers to the noncontrolling interests		(1)		(2)
Change to Community Health Systems, Inc. stockholders' deficit from net loss attributable to Community Health Systems, Inc. stockholders and transfers to noncontrolling interests	$ (91)	$ (43)	$ (175)	$ (371)

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Components of Denominator for Computation of Basic and Diluted Earnings Per Share (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Effect of dilutive securities:
Weighted-average number of shares outstanding — basic	130,698,907	129,141,673	130,352,865	128,689,999
Weighted-average number of shares outstanding — diluted	130,698,907	129,141,673	130,352,865	128,689,999

Earnings Per Share - Additional

Earnings Per Share - Additional Information (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Earnings Per Share [Abstract]
Increase in number of shares to diluted shares calculation if income would have been generated	224,178	565,641	298,184	1,305,604

Earnings Per Share - Schedule_2

Earnings Per Share - Schedule of Antidilutive Securities (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Earnings Per Share [Abstract]
Employee stock options and restricted stock awards excluded from computation of earnings per share amount	5,894,797	5,764,161	6,325,261	3,826,769

Contingencies - Schedule of Rec

Contingencies - Schedule of Reconciliation of the Beginning and Ending Liability Balances in Connection with Probable Contingencies (Details) - Pending Litigation [Member] - Other Probable Contingencies [Member] $ in Millions	9 Months Ended
	Sep. 30, 2023 USD ($)
Loss Contingency Accrual [Roll Forward]
Beginning Balance	$ 11
Expense	34
Reserve for insured claim	4
Cash payments	(6)
Ending Balance	$ 43