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Segment and Geographic Information
 6 Months Ended
Jun. 30, 2020
Segment Reporting [Abstract]  
Segment and Geographic Information
NOTE 11 — SEGMENT AND GEOGRAPHIC INFORMATION
We operate in one line of business, which is operating hospitals and related health care entities. We operate in two geographically organized groups: the National and American Groups. The National Group includes 96 hospitals located in Alaska, California, Florida, southern Georgia, Idaho, Indiana, northern Kentucky, Nevada, New Hampshire, North Carolina, South Carolina, Utah and Virginia, and the American Group includes 84 hospitals located in Colorado, northern Georgia, Kansas, southern Kentucky, Louisiana, Mississippi, Missouri, Tennessee and Texas. We also operate six hospitals in England, and these facilities are included in the Corporate and other group.
 
Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, losses (gains) on sales of facilities, losses on retirement of debt, income taxes and net income attributable to noncontrolling interests. We use adjusted segment EBITDA as an analytical indicator for purposes of allocating resources to geographic areas and assessing their performance. Adjusted segment EBITDA is commonly used as an analytical indicator within the health care industry, and also serves as a measure of leverage capacity and debt service ability. Adjusted segment EBITDA should not be considered as a measure of financial performance under generally accepted accounting principles, and the items excluded from adjusted segment EBITDA are significant components in understanding and assessing financial performance. Because adjusted segment EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, adjusted segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. The geographic distributions of our revenues, equity in earnings of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters and six months ended June 30, 2020 and 2019 are summarized in the following table (dollars in millions):
 
 
  
Quarter
 
  
Six Months
 
 
  
2020
 
  
2019
 
  
2020
 
  
2019
 
Revenues:
  
  
  
  
National Group
  
$
5,546
 
  
$
6,444
 
  
$
12,020
 
  
$
12,761
 
American Group
  
 
5,103
 
  
 
5,626
 
  
 
10,847
 
  
 
11,221
 
Corporate and other
  
 
419
 
  
 
532
 
  
 
1,062
 
  
 
1,137
 
  
 
 
     
 
 
     
 
 
     
 
 
  
  
$
11,068
 
  
$
12,602
 
  
$
23,929
 
  
$
25,119
 
  
 
 
     
 
 
     
 
 
     
 
 
  
Equity in earnings of affiliates:
  
  
  
  
National Group
  
$
(4
) 
  
$
(3
) 
  
$
(3
) 
  
$
(5
) 
American Group
  
 
(2
) 
  
 
(11
) 
  
 
(11
) 
  
 
(22
) 
Corporate and other
  
 
5
 
  
 
6
 
  
 
6
 
  
 
8
 
  
 
 
     
 
 
     
 
 
     
 
 
  
  
$
(1
) 
  
$
(8
) 
  
$
(8
) 
  
$
(19
) 
  
 
 
     
 
 
     
 
 
     
 
 
  
Adjusted segment EBITDA:
  
  
  
  
National Group
  
$
1,485
 
  
$
1,364
 
  
$
2,700
 
  
$
2,818
 
American Group
  
 
1,408
 
  
 
1,117
 
  
 
2,523
 
  
 
2,258
 
Corporate and other
  
 
(227
) 
  
 
(188
) 
  
 
(357
) 
  
 
(242
) 
  
 
 
     
 
 
     
 
 
     
 
 
  
  
$
2,666
 
  
$
2,293
 
  
$
4,866
 
  
$
4,834
 
  
 
 
     
 
 
     
 
 
     
 
 
  
Depreciation and amortization:
  
  
  
  
National Group
  
$
312
 
  
$
283
 
  
$
618
 
  
$
548
 
American Group
  
 
295
 
  
 
270
 
  
 
582
 
  
 
551
 
Corporate and other
  
 
84
 
  
 
83
 
  
 
165
 
  
 
156
 
  
 
 
     
 
 
     
 
 
     
 
 
  
  
$
691
 
  
$
636
 
  
$
1,365
 
  
$
1,255
 
  
 
 
     
 
 
     
 
 
     
 
 
  
Adjusted segment EBITDA
  
$
2,666
 
  
$
2,293
 
  
$
4,866
 
  
$
4,834
 
Depreciation and amortization
  
 
691
 
  
 
636
 
  
 
1,365
 
  
 
1,255
 
Interest expense
  
 
388
 
  
 
477
 
  
 
816
 
  
 
938
 
Losses (gains) on sales of facilities
  
 
27
 
  
 
(18
) 
  
 
20
 
  
 
(17
) 
Losses on retirement of debt
  
 
—
 
  
 
—
 
  
 
295
 
  
 
—
 
  
 
 
     
 
 
     
 
 
     
 
 
  
Income before income taxes
  
$
1,560
 
  
$
1,198
 
  
$
2,370
 
  
$
2,658