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Supplemental Condensed Consolidating Financial Information and Other Collateral-Related Information - Schedule of Condensed Consolidating Statement of Cash Flows (Detail) - USD ($) $ in Millions | 3 Months Ended | 9 Months Ended
--- | --- | ---
Sep. 30, 2018 | Sep. 30, 2017 | Sep. 30, 2018 | Sep. 30, 2017
Cash flows from operating activities: |  |  |  |
Net income (loss) | $ 896 | $ 530 | $ 3,144 | $ 2,102
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: |  |  |  |
Changes in operating assets and liabilities |  |  | (147) | (289)
Depreciation and amortization | 582 | 539 | 1,697 | 1,581
Income taxes |  |  |  | (9)
Gain on sales of facilities | (6) | (7) | (420) | (10)
Losses on retirement of debt | 9 | 39 | 9 | 39
Amortization of debt issuance costs |  |  | 23 | 23
Share-based compensation |  |  | 204 | 195
Other |  |  | 76 | 60
Net cash provided by (used in) operating activities |  |  | 4,586 | 3,692
Cash flows from investing activities: |  |  |  |
Purchase of property and equipment |  |  | (2,420) | (2,033)
Acquisition of hospitals and health care entities |  |  | (1,056) | (1,142)
Disposition of hospitals and health care entities |  |  | 802 | 24
Change in investments |  |  | 65 | (15)
Other |  |  | (6) | (6)
Net cash used in investing activities |  |  | (2,615) | (3,172)
Cash flows from financing activities: |  |  |  |
Issuance of long-term debt |  |  | 2,000 | 1,502
Net change in revolving credit facilities |  |  | (330) | 650
Repayment of long-term debt |  |  | (1,652) | (700)
Distributions to noncontrolling interests |  |  | (315) | (363)
Payment of debt issuance costs |  |  | (24) | (25)
Payment of cash dividends |  |  | (366) |
Repurchases of common stock |  |  | (1,195) | (1,475)
Other |  |  | (232) | (37)
Net cash (used in) provided by financing activities |  |  | (2,114) | (448)
Effect on exchange rate changes on cash and cash equivalents |  |  | (11) |
Change in cash and cash equivalents |  |  | (154) | 72
Cash and cash equivalents at beginning of period |  |  | 732 | 646
Cash and cash equivalents at end of period | 578 | 718 | 578 | 718
Eliminations [Member] |  |  |  |
Cash flows from operating activities: |  |  |  |
Net income (loss) | (728) | (436) | (2,670) | (1,702)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: |  |  |  |
Equity in earnings of affiliates |  |  | 2,670 | 1,702
HCA Healthcare, Inc. Issuer [Member] |  |  |  |
Cash flows from operating activities: |  |  |  |
Net income (loss) | 759 | 426 | 2,723 | 1,742
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: |  |  |  |
Changes in operating assets and liabilities |  |  | (15) | (15)
Income taxes |  |  |  | (9)
Equity in earnings of affiliates |  |  | (2,670) | (1,702)
Other |  |  | 67 | 58
Net cash provided by (used in) operating activities |  |  | 105 | 74
Cash flows from financing activities: |  |  |  |
Payment of cash dividends |  |  | (366) |
Repurchases of common stock |  |  | (1,195) | (1,475)
Changes in intercompany balances with affiliates, net |  |  | 1,697 | 1,468
Other |  |  | (242) | (66)
Net cash (used in) provided by financing activities |  |  | (106) | (73)
Change in cash and cash equivalents |  |  | (1) | 1
Cash and cash equivalents at beginning of period |  |  | 1 |
Cash and cash equivalents at end of period |  | 1 |  | 1
HCA Inc. Issuer [Member] |  |  |  |
Cash flows from operating activities: |  |  |  |
Net income (loss) | (708) | (524) | (2,016) | (1,463)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: |  |  |  |
Changes in operating assets and liabilities |  |  | (83) | (293)
Losses on retirement of debt | 9 | 39 | 9 | 39
Amortization of debt issuance costs |  |  | 23 | 23
Net cash provided by (used in) operating activities |  |  | (2,067) | (1,694)
Cash flows from financing activities: |  |  |  |
Issuance of long-term debt |  |  | 2,000 | 1,500
Net change in revolving credit facilities |  |  | (330) | 650
Repayment of long-term debt |  |  | (1,566) | (604)
Payment of debt issuance costs |  |  | (24) | (25)
Changes in intercompany balances with affiliates, net |  |  | 1,987 | 173
Net cash (used in) provided by financing activities |  |  | 2,067 | 1,694
Subsidiary Guarantors [Member] |  |  |  |
Cash flows from operating activities: |  |  |  |
Net income (loss) | 1,275 | 928 | 4,151 | 2,843
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: |  |  |  |
Changes in operating assets and liabilities |  |  | (154) | (191)
Depreciation and amortization | 340 | 311 | 992 | 923
Gain on sales of facilities | (6) | (3) | (378) | (6)
Share-based compensation |  |  | 204 | 195
Other |  |  |  | 2
Net cash provided by (used in) operating activities |  |  | 4,815 | 3,766
Cash flows from investing activities: |  |  |  |
Purchase of property and equipment |  |  | (1,425) | (1,161)
Acquisition of hospitals and health care entities |  |  | (894) | (9)
Disposition of hospitals and health care entities |  |  | 770 | 12
Change in investments |  |  | 19 | 1
Other |  |  | (18) | (7)
Net cash used in investing activities |  |  | (1,548) | (1,164)
Cash flows from financing activities: |  |  |  |
Repayment of long-term debt |  |  | (44) | (54)
Distributions to noncontrolling interests |  |  | (63) | (105)
Changes in intercompany balances with affiliates, net |  |  | (3,167) | (2,439)
Other |  |  |  | 1
Net cash (used in) provided by financing activities |  |  | (3,274) | (2,597)
Change in cash and cash equivalents |  |  | (7) | 5
Cash and cash equivalents at beginning of period |  |  | 112 | 114
Cash and cash equivalents at end of period | 105 | 119 | 105 | 119
Subsidiary Non-Guarantors [Member] |  |  |  |
Cash flows from operating activities: |  |  |  |
Net income (loss) | 298 | 136 | 956 | 682
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: |  |  |  |
Changes in operating assets and liabilities |  |  | 105 | 210
Depreciation and amortization | 242 | 228 | 705 | 658
Gain on sales of facilities |  | (4) | (42) | (4)
Other |  |  | 9 |
Net cash provided by (used in) operating activities |  |  | 1,733 | 1,546
Cash flows from investing activities: |  |  |  |
Purchase of property and equipment |  |  | (995) | (872)
Acquisition of hospitals and health care entities |  |  | (162) | (1,133)
Disposition of hospitals and health care entities |  |  | 32 | 12
Change in investments |  |  | 46 | (16)
Other |  |  | 12 | 1
Net cash used in investing activities |  |  | (1,067) | (2,008)
Cash flows from financing activities: |  |  |  |
Issuance of long-term debt |  |  |  | 2
Repayment of long-term debt |  |  | (42) | (42)
Distributions to noncontrolling interests |  |  | (252) | (258)
Changes in intercompany balances with affiliates, net |  |  | (517) | 798
Other |  |  | 10 | 28
Net cash (used in) provided by financing activities |  |  | (801) | 528
Effect on exchange rate changes on cash and cash equivalents |  |  | (11) |
Change in cash and cash equivalents |  |  | (146) | 66
Cash and cash equivalents at beginning of period |  |  | 619 | 532
Cash and cash equivalents at end of period | $ 473 | $ 598 | $ 473 | $ 598

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- Definition The cash outflow associated with the acquisition of or advances to an entity that is related to it but not strictly controlled (for example, an unconsolidated subsidiary, affiliate, and joint venture or equity method investment) or the acquisition of an additional interest in a subsidiary (controlled entity). + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3213-108585 + Details
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