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Supplemental Condensed Consolidating Financial Information And Other Collateral-related Information (Tables) | 12 Months Ended
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Dec. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract] |
Schedule of Condensed Consolidating Comprehensive Income Statement | HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2019 (Dollars in millions)
|  | HCA Healthcare, Inc. Issuer |  |  | HCA Inc. Issuer |  |  | Subsidiary Guarantors |  |  | Subsidiary Non- Guarantors |  |  | Eliminations |  |  | Condensed Consolidated |
Revenues |  | $ | — |  |  | $ | — |  |  | $ | 29,220 |  |  | $ | 22,116 |  |  | $ | — |  |  | $ | 51,336 |
Salaries and benefits |  |  | — |  |  |  | — |  |  |  | 12,898 |  |  |  | 10,662 |  |  |  | — |  |  |  | 23,560 |
Supplies |  |  | — |  |  |  | — |  |  |  | 4,802 |  |  |  | 3,679 |  |  |  | — |  |  |  | 8,481 |
Other operating expenses |  |  | 7 |  |  |  | — |  |  |  | 4,643 |  |  |  | 4,831 |  |  |  | — |  |  |  | 9,481 |
Equity in earnings of affiliates |  |  | (3,597 | ) |  |  | — |  |  |  | (6 | ) |  |  | (37 | ) |  |  | 3,597 |  |  |  | (43 | )
Depreciation and amortization |  |  | — |  |  |  | — |  |  |  | 1,447 |  |  |  | 1,149 |  |  |  | — |  |  |  | 2,596 |
Interest expense (income) |  |  | 64 |  |  |  | 4,025 |  |  |  | (2,001 | ) |  |  | (264 | ) |  |  | — |  |  |  | 1,824 |
Gains on sales of facilities |  |  | — |  |  |  | — |  |  |  | (14 | ) |  |  | (4 | ) |  |  | — |  |  |  | (18 | )
Losses on retirement of debt |  |  | — |  |  |  | 211 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 211 |
Management fees |  |  | — |  |  |  | — |  |  |  | (768 | ) |  |  | 768 |  |  |  | — |  |  |  | — |
|  |  | (3,526 | ) |  |  | 4,236 |  |  |  | 21,001 |  |  |  | 20,784 |  |  |  | 3,597 |  |  |  | 46,092 |
Income (loss) before income taxes |  |  | 3,526 |  |  |  | (4,236 | ) |  |  | 8,219 |  |  |  | 1,332 |  |  |  | (3,597 | ) |  |  | 5,244 |
Provision (benefit) for income taxes |  |  | 21 |  |  |  | (976 | ) |  |  | 1,874 |  |  |  | 180 |  |  |  | — |  |  |  | 1,099 |
Net income (loss) |  |  | 3,505 |  |  |  | (3,260 | ) |  |  | 6,345 |  |  |  | 1,152 |  |  |  | (3,597 | ) |  |  | 4,145 |
Net income attributable to noncontrolling interests |  |  | — |  |  |  | — |  |  |  | 91 |  |  |  | 549 |  |  |  | — |  |  |  | 640 |
Net income (loss) attributable to HCA Healthcare, Inc. |  | $ | 3,505 |  |  | $ | (3,260 | ) |  | $ | 6,254 |  |  | $ | 603 |  |  | $ | (3,597 | ) |  | $ | 3,505 |
Comprehensive income (loss) attributable to HCA Healthcare, Inc. |  | $ | 3,426 |  |  | $ | (3,311 | ) |  | $ | 6,215 |  |  | $ | 614 |  |  | $ | (3,518 | ) |  | $ | 3,426 |
HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2018 (Dollars in millions)
|  | HCA Healthcare, Inc. Issuer |  |  | HCA Inc. Issuer |  |  | Subsidiary Guarantors |  |  | Subsidiary Non- Guarantors |  |  | Eliminations |  |  | Condensed Consolidated |
Revenues |  | $ | — |  |  | $ | — |  |  | $ | 27,482 |  |  | $ | 19,195 |  |  | $ | — |  |  | $ | 46,677 |
Salaries and benefits |  |  | — |  |  |  | — |  |  |  | 12,287 |  |  |  | 9,138 |  |  |  | — |  |  |  | 21,425 |
Supplies |  |  | — |  |  |  | — |  |  |  | 4,560 |  |  |  | 3,164 |  |  |  | — |  |  |  | 7,724 |
Other operating expenses |  |  | 8 |  |  |  | — |  |  |  | 4,463 |  |  |  | 4,137 |  |  |  | — |  |  |  | 8,608 |
Equity in earnings of affiliates |  |  | (3,688 | ) |  |  | — |  |  |  | (7 | ) |  |  | (22 | ) |  |  | 3,688 |  |  |  | (29 | )
Depreciation and amortization |  |  | — |  |  |  | — |  |  |  | 1,335 |  |  |  | 943 |  |  |  | — |  |  |  | 2,278 |
Interest expense (income) |  |  | 64 |  |  |  | 3,580 |  |  |  | (1,635 | ) |  |  | (254 | ) |  |  | — |  |  |  | 1,755 |
Gains on sales of facilities |  |  | — |  |  |  | — |  |  |  | (357 | ) |  |  | (71 | ) |  |  | — |  |  |  | (428 | )
Losses on retirement of debt |  |  | — |  |  |  | 9 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 9 |
Management fees |  |  | — |  |  |  | — |  |  |  | (639 | ) |  |  | 639 |  |  |  | — |  |  |  | — |
|  |  | (3,616 | ) |  |  | 3,589 |  |  |  | 20,007 |  |  |  | 17,674 |  |  |  | 3,688 |  |  |  | 41,342 |
Income (loss) before income taxes |  |  | 3,616 |  |  |  | (3,589 | ) |  |  | 7,475 |  |  |  | 1,521 |  |  |  | (3,688 | ) |  |  | 5,335 |
Provision (benefit) for income taxes |  |  | (171 | ) |  |  | (834 | ) |  |  | 1,714 |  |  |  | 237 |  |  |  | — |  |  |  | 946 |
Net income (loss) |  |  | 3,787 |  |  |  | (2,755 | ) |  |  | 5,761 |  |  |  | 1,284 |  |  |  | (3,688 | ) |  |  | 4,389 |
Net income attributable to noncontrolling interests |  |  | — |  |  |  | — |  |  |  | 99 |  |  |  | 503 |  |  |  | — |  |  |  | 602 |
Net income (loss) attributable to HCA Healthcare, Inc. |  | $ | 3,787 |  |  | $ | (2,755 | ) |  | $ | 5,662 |  |  | $ | 781 |  |  | $ | (3,688 | ) |  | $ | 3,787 |
Comprehensive income (loss) attributable to HCA Healthcare, Inc. |  | $ | 3,779 |  |  | $ | (2,745 | ) |  | $ | 5,712 |  |  | $ | 713 |  |  | $ | (3,680 | ) |  | $ | 3,779 |
HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2017 (Dollars in millions)
|  | HCA Healthcare, Inc. Issuer |  |  | HCA Inc. Issuer |  |  | Subsidiary Guarantors |  |  | Subsidiary Non- Guarantors |  |  | Eliminations |  |  | Condensed Consolidated |
Revenues |  | $ | — |  |  | $ | — |  |  | $ | 25,774 |  |  | $ | 17,840 |  |  | $ | — |  |  | $ | 43,614 |
Salaries and benefits |  |  | — |  |  |  | — |  |  |  | 11,619 |  |  |  | 8,440 |  |  |  | — |  |  |  | 20,059 |
Supplies |  |  | — |  |  |  | — |  |  |  | 4,286 |  |  |  | 3,030 |  |  |  | — |  |  |  | 7,316 |
Other operating expenses |  |  | 6 |  |  |  | — |  |  |  | 4,249 |  |  |  | 3,796 |  |  |  | — |  |  |  | 8,051 |
Equity in earnings of affiliates |  |  | (2,476 | ) |  |  | — |  |  |  | (6 | ) |  |  | (39 | ) |  |  | 2,476 |  |  |  | (45 | )
Depreciation and amortization |  |  | — |  |  |  | — |  |  |  | 1,237 |  |  |  | 894 |  |  |  | — |  |  |  | 2,131 |
Interest expense (income) |  |  | 64 |  |  |  | 3,088 |  |  |  | (1,309 | ) |  |  | (153 | ) |  |  | — |  |  |  | 1,690 |
Gains on sales of facilities |  |  | — |  |  |  | — |  |  |  | (2 | ) |  |  | (6 | ) |  |  | — |  |  |  | (8 | )
Losses on retirement of debt |  |  | — |  |  |  | 39 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 39 |
Management fees |  |  | — |  |  |  | — |  |  |  | (621 | ) |  |  | 621 |  |  |  | — |  |  |  | — |
|  |  | (2,406 | ) |  |  | 3,127 |  |  |  | 19,453 |  |  |  | 16,583 |  |  |  | 2,476 |  |  |  | 39,233 |
Income (loss) before income taxes |  |  | 2,406 |  |  |  | (3,127 | ) |  |  | 6,321 |  |  |  | 1,257 |  |  |  | (2,476 | ) |  |  | 4,381 |
Provision (benefit) for income taxes |  |  | 190 |  |  |  | (1,154 | ) |  |  | 2,293 |  |  |  | 309 |  |  |  | — |  |  |  | 1,638 |
Net income (loss) |  |  | 2,216 |  |  |  | (1,973 | ) |  |  | 4,028 |  |  |  | 948 |  |  |  | (2,476 | ) |  |  | 2,743 |
Net income attributable to noncontrolling interests |  |  | — |  |  |  | — |  |  |  | 108 |  |  |  | 419 |  |  |  | — |  |  |  | 527 |
Net income (loss) attributable to HCA Healthcare, Inc. |  | $ | 2,216 |  |  | $ | (1,973 | ) |  | $ | 3,920 |  |  | $ | 529 |  |  | $ | (2,476 | ) |  | $ | 2,216 |
Comprehensive income (loss) attributable to HCA Healthcare, Inc. |  | $ | 2,276 |  |  | $ | (1,953 | ) |  | $ | 3,898 |  |  | $ | 591 |  |  | $ | (2,536 | ) |  | $ | 2,276 |
Schedule of Condensed Consolidating Balance Sheet | HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET DECEMBER 31, 2019 (Dollars in millions)
|  | HCA Healthcare, Inc. Issuer |  |  | HCA Inc. Issuer |  |  | Subsidiary Guarantors |  |  | Subsidiary Non- Guarantors |  |  | Eliminations |  |  | Condensed Consolidated |
ASSETS |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Current assets: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Cash and cash equivalents |  | $ | — |  |  | $ | — |  |  | $ | 118 |  |  | $ | 503 |  |  | $ | — |  |  | $ | 621 |
Accounts receivable, net |  |  | — |  |  |  | — |  |  |  | 4,037 |  |  |  | 3,343 |  |  |  | — |  |  |  | 7,380 |
Inventories |  |  | — |  |  |  | — |  |  |  | 1,208 |  |  |  | 641 |  |  |  | — |  |  |  | 1,849 |
Other |  |  | — |  |  |  | — |  |  |  | 727 |  |  |  | 619 |  |  |  | — |  |  |  | 1,346 |
|  |  | — |  |  |  | — |  |  |  | 6,090 |  |  |  | 5,106 |  |  |  | — |  |  |  | 11,196 |
Property and equipment, net |  |  | — |  |  |  | — |  |  |  | 13,418 |  |  |  | 9,297 |  |  |  | — |  |  |  | 22,715 |
Investments of insurance subsidiaries |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 315 |  |  |  | — |  |  |  | 315 |
Investments in and advances to affiliates |  |  | 36,684 |  |  |  | — |  |  |  | 29 |  |  |  | 220 |  |  |  | (36,684 | ) |  |  | 249 |
Goodwill and other intangible assets |  |  | — |  |  |  | — |  |  |  | 5,743 |  |  |  | 2,526 |  |  |  | — |  |  |  | 8,269 |
Right-of-use operating lease assets |  |  | — |  |  |  | — |  |  |  | 455 |  |  |  | 1,379 |  |  |  | — |  |  |  | 1,834 |
Other |  |  | 300 |  |  |  | 3 |  |  |  | 29 |  |  |  | 148 |  |  |  | — |  |  |  | 480 |
|  | $ | 36,984 |  |  | $ | 3 |  |  | $ | 25,764 |  |  | $ | 18,991 |  |  | $ | (36,684 | ) |  | $ | 45,058 |
LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Current liabilities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Accounts payable |  | $ | — |  |  | $ | — |  |  | $ | 1,903 |  |  | $ | 1,002 |  |  | $ | — |  |  | $ | 2,905 |
Accrued salaries |  |  | — |  |  |  | — |  |  |  | 1,070 |  |  |  | 705 |  |  |  | — |  |  |  | 1,775 |
Other accrued expenses |  |  | 85 |  |  |  | 341 |  |  |  | 1,001 |  |  |  | 1,505 |  |  |  | — |  |  |  | 2,932 |
Long-term debt due within one year |  |  | — |  |  |  | 54 |  |  |  | 50 |  |  |  | 41 |  |  |  | — |  |  |  | 145 |
|  |  | 85 |  |  |  | 395 |  |  |  | 4,024 |  |  |  | 3,253 |  |  |  | — |  |  |  | 7,757 |
Long-term debt, net |  |  | 998 |  |  |  | 32,016 |  |  |  | 213 |  |  |  | 350 |  |  |  | — |  |  |  | 33,577 |
Intercompany balances |  |  | 38,089 |  |  |  | (4,314 | ) |  |  | (33,828 | ) |  |  | 53 |  |  |  | — |  |  |  | — |
Professional liability risks |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 1,370 |  |  |  | — |  |  |  | 1,370 |
Right-of-use operating lease obligations |  |  | — |  |  |  | — |  |  |  | 345 |  |  |  | 1,154 |  |  |  | — |  |  |  | 1,499 |
Income taxes and other liabilities |  |  | 620 |  |  |  | 7 |  |  |  | 252 |  |  |  | 541 |  |  |  | — |  |  |  | 1,420 |
|  |  | 39,792 |  |  |  | 28,104 |  |  |  | (28,994 | ) |  |  | 6,721 |  |  |  | — |  |  |  | 45,623 |
Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. |  |  | (2,808 | ) |  |  | (28,101 | ) |  |  | 54,652 |  |  |  | 10,133 |  |  |  | (36,684 | ) |  |  | (2,808 | )
Noncontrolling interests |  |  | — |  |  |  | — |  |  |  | 106 |  |  |  | 2,137 |  |  |  | — |  |  |  | 2,243 |
|  |  | (2,808 | ) |  |  | (28,101 | ) |  |  | 54,758 |  |  |  | 12,270 |  |  |  | (36,684 | ) |  |  | (565 | )
|  | $ | 36,984 |  |  | $ | 3 |  |  | $ | 25,764 |  |  | $ | 18,991 |  |  | $ | (36,684 | ) |  | $ | 45,058 |
HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET DECEMBER 31, 2018 (Dollars in millions)
|  | HCA Healthcare, Inc. Issuer |  |  | HCA Inc. Issuer |  |  | Subsidiary Guarantors |  |  | Subsidiary Non- Guarantors |  |  | Eliminations |  |  | Condensed Consolidated |
ASSETS |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Current assets: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Cash and cash equivalents |  | $ | — |  |  | $ | — |  |  | $ | 174 |  |  | $ | 328 |  |  | $ | — |  |  | $ | 502 |
Accounts receivable, net |  |  | — |  |  |  | — |  |  |  | 3,964 |  |  |  | 2,825 |  |  |  | — |  |  |  | 6,789 |
Inventories |  |  | — |  |  |  | — |  |  |  | 1,178 |  |  |  | 554 |  |  |  | — |  |  |  | 1,732 |
Other |  |  | — |  |  |  | — |  |  |  | 669 |  |  |  | 521 |  |  |  | — |  |  |  | 1,190 |
|  |  | — |  |  |  | — |  |  |  | 5,985 |  |  |  | 4,228 |  |  |  | — |  |  |  | 10,213 |
Property and equipment, net |  |  | — |  |  |  | — |  |  |  | 12,450 |  |  |  | 7,307 |  |  |  | — |  |  |  | 19,757 |
Investments of insurance subsidiaries |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 362 |  |  |  | — |  |  |  | 362 |
Investments in and advances to affiliates |  |  | 33,166 |  |  |  | — |  |  |  | 29 |  |  |  | 203 |  |  |  | (33,166 | ) |  |  | 232 |
Goodwill and other intangible assets |  |  | — |  |  |  | — |  |  |  | 5,724 |  |  |  | 2,229 |  |  |  | — |  |  |  | 7,953 |
Other |  |  | 478 |  |  |  | 64 |  |  |  | 35 |  |  |  | 113 |  |  |  | — |  |  |  | 690 |
|  | $ | 33,644 |  |  | $ | 64 |  |  | $ | 24,223 |  |  | $ | 14,442 |  |  | $ | (33,166 | ) |  | $ | 39,207 |
LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Current liabilities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Accounts payable |  | $ | — |  |  | $ | — |  |  | $ | 1,721 |  |  | $ | 856 |  |  | $ | — |  |  | $ | 2,577 |
Accrued salaries |  |  | — |  |  |  | — |  |  |  | 998 |  |  |  | 582 |  |  |  | — |  |  |  | 1,580 |
Other accrued expenses |  |  | 142 |  |  |  | 403 |  |  |  | 905 |  |  |  | 1,174 |  |  |  | — |  |  |  | 2,624 |
Long-term debt due within one year |  |  | — |  |  |  | 696 |  |  |  | 55 |  |  |  | 37 |  |  |  | — |  |  |  | 788 |
|  |  | 142 |  |  |  | 1,099 |  |  |  | 3,679 |  |  |  | 2,649 |  |  |  | — |  |  |  | 7,569 |
Long-term debt, net |  |  | 996 |  |  |  | 30,544 |  |  |  | 212 |  |  |  | 281 |  |  |  | — |  |  |  | 32,033 |
Intercompany balances |  |  | 36,951 |  |  |  | (6,789 | ) |  |  | (28,415 | ) |  |  | (1,747 | ) |  |  | — |  |  |  | — |
Professional liability risks |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 1,275 |  |  |  | — |  |  |  | 1,275 |
Income taxes and other liabilities |  |  | 505 |  |  |  | — |  |  |  | 223 |  |  |  | 520 |  |  |  | — |  |  |  | 1,248 |
|  |  | 38,594 |  |  |  | 24,854 |  |  |  | (24,301 | ) |  |  | 2,978 |  |  |  | — |  |  |  | 42,125 |
Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. |  |  | (4,950 | ) |  |  | (24,790 | ) |  |  | 48,437 |  |  |  | 9,519 |  |  |  | (33,166 | ) |  |  | (4,950 | )
Noncontrolling interests |  |  | — |  |  |  | — |  |  |  | 87 |  |  |  | 1,945 |  |  |  | — |  |  |  | 2,032 |
|  |  | (4,950 | ) |  |  | (24,790 | ) |  |  | 48,524 |  |  |  | 11,464 |  |  |  | (33,166 | ) |  |  | (2,918 | )
|  | $ | 33,644 |  |  | $ | 64 |  |  | $ | 24,223 |  |  | $ | 14,442 |  |  | $ | (33,166 | ) |  | $ | 39,207 |
Schedule of Condensed Consolidating Statement of Cash Flows | HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE YEAR ENDED DECEMBER 31, 2019 (Dollars in millions)
|  | HCA Healthcare, Inc. Issuer |  |  | HCA Inc. Issuer |  |  | Subsidiary Guarantors |  |  | Subsidiary Non- Guarantors |  |  | Eliminations |  |  | Condensed Consolidated |
Cash flows from operating activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net income (loss) |  | $ | 3,505 |  |  | $ | (3,260 | ) |  | $ | 6,345 |  |  | $ | 1,152 |  |  | $ | (3,597 | ) |  | $ | 4,145 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Change in operating assets and liabilities |  |  | — |  |  |  | (62 | ) |  |  | 17 |  |  |  | (43 | ) |  |  | — |  |  |  | (88 | )
Depreciation and amortization |  |  | — |  |  |  | — |  |  |  | 1,447 |  |  |  | 1,149 |  |  |  | — |  |  |  | 2,596 |
Income taxes |  |  | 250 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 250 |
Gains on sales of facilities |  |  | — |  |  |  | — |  |  |  | (14 | ) |  |  | (4 | ) |  |  | — |  |  |  | (18 | )
Losses on retirement of debt |  |  | — |  |  |  | 211 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 211 |
Amortization of debt issuance costs |  |  | — |  |  |  | 30 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 30 |
Share-based compensation |  |  | — |  |  |  | — |  |  |  | 347 |  |  |  | — |  |  |  | — |  |  |  | 347 |
Equity in earnings of affiliates |  |  | (3,597 | ) |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 3,597 |  |  |  | — |
Other |  |  | 109 |  |  |  | — |  |  |  | 23 |  |  |  | (3 | ) |  |  | — |  |  |  | 129 |
Net cash provided by (used in) operating activities |  |  | 267 |  |  |  | (3,081 | ) |  |  | 8,165 |  |  |  | 2,251 |  |  |  | — |  |  |  | 7,602 |
Cash flows from investing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Purchase of property and equipment |  |  | — |  |  |  | — |  |  |  | (2,342 | ) |  |  | (1,816 | ) |  |  | — |  |  |  | (4,158 | )
Acquisition of hospitals and health care entities |  |  | — |  |  |  | — |  |  |  | (43 | ) |  |  | (1,639 | ) |  |  | — |  |  |  | (1,682 | )
Sales of hospitals and health care entities |  |  | — |  |  |  | — |  |  |  | 42 |  |  |  | 19 |  |  |  | — |  |  |  | 61 |
Change in investments |  |  | — |  |  |  | — |  |  |  | 6 |  |  |  | 19 |  |  |  | — |  |  |  | 25 |
Other |  |  | — |  |  |  | — |  |  |  | (7 | ) |  |  | 41 |  |  |  | — |  |  |  | 34 |
Net cash used in investing activities |  |  | — |  |  |  | — |  |  |  | (2,344 | ) |  |  | (3,376 | ) |  |  | — |  |  |  | (5,720 | )
Cash flows from financing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Issuance of long-term debt |  |  | — |  |  |  | 6,451 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 6,451 |
Net change in revolving bank credit facilities |  |  | — |  |  |  | (560 | ) |  |  | — |  |  |  | — |  |  |  | — |  |  |  | (560 | )
Repayment of long-term debt |  |  | — |  |  |  | (5,227 | ) |  |  | (59 | ) |  |  | (38 | ) |  |  | — |  |  |  | (5,324 | )
Distributions to noncontrolling interests |  |  | — |  |  |  | — |  |  |  | (104 | ) |  |  | (438 | ) |  |  | — |  |  |  | (542 | )
Payment of debt issuance costs |  |  | — |  |  |  | (73 | ) |  |  | — |  |  |  | — |  |  |  | — |  |  |  | (73 | )
Payment of dividends |  |  | (550 | ) |  |  | — |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | (550 | )
Repurchases of common stock |  |  | (1,031 | ) |  |  | — |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | (1,031 | )
Changes in intercompany balances with affiliates, net |  |  | 1,457 |  |  |  | 2,490 |  |  |  | (5,714 | ) |  |  | 1,767 |  |  |  | — |  |  |  | — |
Other |  |  | (143 | ) |  |  | — |  |  |  | — |  |  |  | 1 |  |  |  | — |  |  |  | (142 | )
Net cash (used in) provided by financing activities |  |  | (267 | ) |  |  | 3,081 |  |  |  | (5,877 | ) |  |  | 1,292 |  |  |  | — |  |  |  | (1,771 | )
Effect of exchange rate changes on cash and cash equivalents |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 8 |  |  |  | — |  |  |  | 8 |
Change in cash and cash equivalents |  |  | — |  |  |  | — |  |  |  | (56 | ) |  |  | 175 |  |  |  | — |  |  |  | 119 |
Cash and cash equivalents at beginning of period |  |  | — |  |  |  | — |  |  |  | 174 |  |  |  | 328 |  |  |  | — |  |  |  | 502 |
Cash and cash equivalents at end of period |  | $ | — |  |  | $ | — |  |  | $ | 118 |  |  | $ | 503 |  |  | $ | — |  |  | $ | 621 |
HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE YEAR ENDED DECEMBER 31, 2018 (Dollars in millions)
|  | HCA Healthcare, Inc. Issuer |  |  | HCA Inc. Issuer |  |  | Subsidiary Guarantors |  |  | Subsidiary Non- Guarantors |  |  | Eliminations |  |  | Condensed Consolidated |
Cash flows from operating activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net income (loss) |  | $ | 3,787 |  |  | $ | (2,755 | ) |  | $ | 5,761 |  |  | $ | 1,284 |  |  | $ | (3,688 | ) |  | $ | 4,389 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Change in operating assets and liabilities |  |  | — |  |  |  | 23 |  |  |  | (178 | ) |  |  | 188 |  |  |  | — |  |  |  | 33 |
Depreciation and amortization |  |  | — |  |  |  | — |  |  |  | 1,335 |  |  |  | 943 |  |  |  | — |  |  |  | 2,278 |
Income taxes |  |  | 74 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 74 |
Gains on sales of facilities |  |  | — |  |  |  | — |  |  |  | (357 | ) |  |  | (71 | ) |  |  | — |  |  |  | (428 | )
Losses on retirement of debt |  |  | — |  |  |  | 9 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 9 |
Amortization of debt issuance costs |  |  | — |  |  |  | 31 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 31 |
Share-based compensation |  |  | — |  |  |  | — |  |  |  | 268 |  |  |  | — |  |  |  | — |  |  |  | 268 |
Equity in earnings of affiliates |  |  | (3,688 | ) |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 3,688 |  |  |  | — |
Other |  |  | 91 |  |  |  | — |  |  |  | 25 |  |  |  | (9 | ) |  |  | — |  |  |  | 107 |
Net cash provided by (used in) operating activities |  |  | 264 |  |  |  | (2,692 | ) |  |  | 6,854 |  |  |  | 2,335 |  |  |  | — |  |  |  | 6,761 |
Cash flows from investing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Purchase of property and equipment |  |  | — |  |  |  | — |  |  |  | (2,008 | ) |  |  | (1,565 | ) |  |  | — |  |  |  | (3,573 | )
Acquisition of hospitals and health care entities |  |  | — |  |  |  | — |  |  |  | (897 | ) |  |  | (356 | ) |  |  | — |  |  |  | (1,253 | )
Sales of hospitals and health care entities |  |  | — |  |  |  | — |  |  |  | 770 |  |  |  | 38 |  |  |  | — |  |  |  | 808 |
Change in investments |  |  | — |  |  |  | — |  |  |  | 12 |  |  |  | 45 |  |  |  | — |  |  |  | 57 |
Other |  |  | — |  |  |  | — |  |  |  | (9 | ) |  |  | 69 |  |  |  | — |  |  |  | 60 |
Net cash used in investing activities |  |  | — |  |  |  | — |  |  |  | (2,132 | ) |  |  | (1,769 | ) |  |  | — |  |  |  | (3,901 | )
Cash flows from financing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Issuance of long-term debt |  |  | — |  |  |  | 2,000 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 2,000 |
Net change in revolving bank credit facilities |  |  | — |  |  |  | (640 | ) |  |  | — |  |  |  | — |  |  |  | — |  |  |  | (640 | )
Repayment of long-term debt |  |  | — |  |  |  | (1,590 | ) |  |  | (72 | ) |  |  | (42 | ) |  |  | — |  |  |  | (1,704 | )
Distributions to noncontrolling interests |  |  | — |  |  |  | — |  |  |  | (83 | ) |  |  | (358 | ) |  |  | — |  |  |  | (441 | )
Payment of debt issuance costs |  |  | — |  |  |  | (25 | ) |  |  | — |  |  |  | — |  |  |  | — |  |  |  | (25 | )
Payment of dividends |  |  | (487 | ) |  |  | — |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | (487 | )
Repurchases of common stock |  |  | (1,530 | ) |  |  | — |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | (1,530 | )
Changes in intercompany balances with affiliates, net |  |  | 2,004 |  |  |  | 2,947 |  |  |  | (4,505 | ) |  |  | (446 | ) |  |  | — |  |  |  | — |
Other |  |  | (252 | ) |  |  | — |  |  |  | — |  |  |  | 4 |  |  |  | — |  |  |  | (248 | )
Net cash (used in) provided by financing activities |  |  | (265 | ) |  |  | 2,692 |  |  |  | (4,660 | ) |  |  | (842 | ) |  |  | — |  |  |  | (3,075 | )
Effect of exchange rate changes on cash and cash equivalents |  |  | — |  |  |  | — |  |  |  | — |  |  |  | (15 | ) |  |  | — |  |  |  | (15 | )
Change in cash and cash equivalents |  |  | (1 | ) |  |  | — |  |  |  | 62 |  |  |  | (291 | ) |  |  | — |  |  |  | (230 | )
Cash and cash equivalents at beginning of period |  |  | 1 |  |  |  | — |  |  |  | 112 |  |  |  | 619 |  |  |  | — |  |  |  | 732 |
Cash and cash equivalents at end of period |  | $ | — |  |  | $ | — |  |  | $ | 174 |  |  | $ | 328 |  |  | $ | — |  |  | $ | 502 |
HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE YEAR ENDED DECEMBER 31, 2017 (Dollars in millions)
|  | HCA Healthcare, Inc. Issuer |  |  | HCA Inc. Issuer |  |  | Subsidiary Guarantors |  |  | Subsidiary Non- Guarantors |  |  | Eliminations |  |  | Condensed Consolidated |
Cash flows from operating activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net income (loss) |  | $ | 2,216 |  |  | $ | (1,973 | ) |  | $ | 4,028 |  |  | $ | 948 |  |  | $ | (2,476 | ) |  | $ | 2,743 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Change in operating assets and liabilities |  |  | — |  |  |  | (193 | ) |  |  | (219 | ) |  |  | 116 |  |  |  | — |  |  |  | (296 | )
Depreciation and amortization |  |  | — |  |  |  | — |  |  |  | 1,237 |  |  |  | 894 |  |  |  | — |  |  |  | 2,131 |
Income taxes |  |  | 433 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 433 |
Gains on sales of facilities |  |  | — |  |  |  | — |  |  |  | (2 | ) |  |  | (6 | ) |  |  | — |  |  |  | (8 | )
Losses on retirement of debt |  |  | — |  |  |  | 39 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 39 |
Amortization of debt issuance costs |  |  | — |  |  |  | 31 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 31 |
Share-based compensation |  |  | — |  |  |  | — |  |  |  | 270 |  |  |  | — |  |  |  | — |  |  |  | 270 |
Equity in earnings of affiliates |  |  | (2,476 | ) |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 2,476 |  |  |  | — |
Other |  |  | 78 |  |  |  | — |  |  |  | — |  |  |  | 5 |  |  |  | — |  |  |  | 83 |
Net cash provided by (used in) operating activities |  |  | 251 |  |  |  | (2,096 | ) |  |  | 5,314 |  |  |  | 1,957 |  |  |  | — |  |  |  | 5,426 |
Cash flows from investing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Purchase of property and equipment |  |  | — |  |  |  | — |  |  |  | (1,681 | ) |  |  | (1,334 | ) |  |  | — |  |  |  | (3,015 | )
Acquisition of hospitals and health care entities |  |  | — |  |  |  | — |  |  |  | (26 | ) |  |  | (1,186 | ) |  |  | — |  |  |  | (1,212 | )
Sales of hospitals and health care entities |  |  | — |  |  |  | — |  |  |  | 14 |  |  |  | 11 |  |  |  | — |  |  |  | 25 |
Change in investments |  |  | — |  |  |  | — |  |  |  | (1 | ) |  |  | (72 | ) |  |  | — |  |  |  | (73 | )
Other |  |  | — |  |  |  | — |  |  |  | — |  |  |  | (4 | ) |  |  | — |  |  |  | (4 | )
Net cash used in investing activities |  |  | — |  |  |  | — |  |  |  | (1,694 | ) |  |  | (2,585 | ) |  |  | — |  |  |  | (4,279 | )
Cash flows from financing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Issuance of long-term debt |  |  | — |  |  |  | 1,500 |  |  |  | — |  |  |  | 2 |  |  |  | — |  |  |  | 1,502 |
Net change in revolving bank credit facilities |  |  | — |  |  |  | 760 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 760 |
Repayment of long-term debt |  |  | — |  |  |  | (628 | ) |  |  | (77 | ) |  |  | (48 | ) |  |  | — |  |  |  | (753 | )
Distributions to noncontrolling interests |  |  | — |  |  |  | — |  |  |  | (140 | ) |  |  | (308 | ) |  |  | — |  |  |  | (448 | )
Payment of debt issuance costs |  |  | — |  |  |  | (26 | ) |  |  | — |  |  |  | — |  |  |  | — |  |  |  | (26 | )
Repurchases of common stock |  |  | (2,051 | ) |  |  | — |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | (2,051 | )
Changes in intercompany balances with affiliates, net |  |  | 1,867 |  |  |  | 490 |  |  |  | (3,404 | ) |  |  | 1,047 |  |  |  | — |  |  |  | — |
Other |  |  | (66 | ) |  |  | — |  |  |  | — |  |  |  | 21 |  |  |  | — |  |  |  | (45 | )
Net cash (used in) provided by financing activities |  |  | (250 | ) |  |  | 2,096 |  |  |  | (3,621 | ) |  |  | 714 |  |  |  | — |  |  |  | (1,061 | )
Change in cash and cash equivalents |  |  | 1 |  |  |  | — |  |  |  | (1 | ) |  |  | 86 |  |  |  | — |  |  |  | 86 |
Cash and cash equivalents at beginning of period |  |  | — |  |  |  | — |  |  |  | 113 |  |  |  | 533 |  |  |  | — |  |  |  | 646 |
Cash and cash equivalents at end of period |  | $ | 1 |  |  | $ | — |  |  | $ | 112 |  |  | $ | 619 |  |  | $ | — |  |  | $ | 732 |
Reconciliations of Consolidated Statements of Stockholder's Deficit and Consolidated Statement of Cash Flows | The Hospital Company Consolidated Statements of Stockholder’s Deficitpresentations for the years ended December 31, are as follows (dollars in millions):
|  | 2019 |  |  | 2018 |  |  | 2017 |
Presentation in HCA Healthcare, Inc. Consolidated Statements of Stockholders’ Deficit: |  |  |  |  |  |  |  |  |  |  |  |
Repurchases of common stock |  | $ | (1,031 | ) |  | $ | (1,530 | ) |  | $ | (2,051 | )
Share-based benefit plans |  |  | 313 |  |  |  | 115 |  |  |  | 281 |
Cash dividends declared ($1.60 per share — 2019 and $1.40 per share — 2018) |  |  | (555 | ) |  |  | (496 | ) |  |  | — |
Other |  |  | (11 | ) |  |  | (12 | ) |  |  | (10 | )
Presentation in Healthtrust, Inc. — The Hospital Company Consolidated Statements of Stockholder’s Deficit: |  |  |  |  |  |  |  |  |  |  |  |
Distributions to HCA Healthcare, Inc., net of contributions from HCA Healthcare, Inc. |  | $ | (1,284 | ) |  | $ | (1,923 | ) |  | $ | (1,780 | )
Presentation in HCA Healthcare, Inc. Consolidated Statements of Cash Flows (cash flows from financing activities): |  |  |  |  |  |  |  |  |  |  |  |
Repurchases of common stock |  | $ | (1,031 | ) |  | $ | (1,530 | ) |  | $ | (2,051 | )
Payment of dividends |  |  | (550 | ) |  |  | (487 | ) |  |  | — |
Presentation in Healthtrust, Inc. — The Hospital Company Consolidated Statements of Cash Flows (cash flows from financing activities): |  |  |  |  |  |  |  |  |  |  |  |
Cash distributions to HCA Healthcare, Inc. |  | $ | (1,581 | ) |  | $ | (2,017 | ) |  | $ | (2,051 | )
Schedule of Quarterly Consolidated Financial Information |
|  | 2019 |
|  | First |  |  | Second |  |  | Third |  |  | Fourth |
Revenues |  | $ | 12,517 |  |  | $ | 12,602 |  |  | $ | 12,694 |  |  | $ | 13,523 |
Net income |  | $ | 1,181 | (a) |  | $ | 927 | (b) |  | $ | 764 | (c) |  | $ | 1,273 |
Net income attributable to HCA Healthcare, Inc. |  | $ | 1,039 | (a) |  | $ | 783 | (b) |  | $ | 612 | (c) |  | $ | 1,071 |
Basic earnings per share |  | $ | 3.03 |  |  | $ | 2.29 |  |  | $ | 1.80 |  |  | $ | 3.16 |
Diluted earnings per share |  | $ | 2.97 |  |  | $ | 2.25 |  |  | $ | 1.76 |  |  | $ | 3.09 |
|  | 2018 |
|  | First |  |  | Second |  |  | Third |  |  | Fourth |
Revenues |  | $ | 11,423 |  |  | $ | 11,529 |  |  | $ | 11,451 |  |  | $ | 12,274 |
Net income |  | $ | 1,282 | ( d ) |  | $ | 966 | ( e ) |  | $ | 896 | ( f ) |  | $ | 1,245 | ( g )
Net income attributable to HCA Healthcare, Inc. |  | $ | 1,144 | ( d ) |  | $ | 820 | ( e ) |  | $ | 759 | ( f ) |  | $ | 1,064 | ( g )
Basic earnings per share |  | $ | 3.26 |  |  | $ | 2.35 |  |  | $ | 2.20 |  |  | $ | 3.09 |
Diluted earnings per share |  | $ | 3.18 |  |  | $ | 2.31 |  |  | $ | 2.15 |  |  | $ | 3.01 |
(a) | First quarter results include $1 million of losses on sales of facilities (See Note 3 of the notes to consolidated financial statements).
(b) | Second quarter results include $14 million of gains on sales of facilities (See Note 3 of the notes to consolidated financial statements).
(c) | Third quarter results include $ 162 million of losses on retirement of debt (See Note 9 of the notes to consolidated financial statements).
(d) | F irst quarter results include $305 million of gains on sales of facilities (See Note 3 of the notes to consolidated financial statements).
( e ) | Second quarter results include $8 million of gains on sales of facilities (See Note 3 of the notes to consolidated financial statements).
( f ) | Third quarter results include $ 5 million of gains on sales of facilities (See Note 3 of the notes to consolidated financial statements) and $7 million of losses on retirement of debt (See Note 9 of the notes to consolidated financial statements).
( g ) | Fourth quarter results include $6 million of gains on sales of facilities (See Note 3 of the notes to consolidated financial statements).

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