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Segment and Geographic Information | 9 Months Ended
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Sep. 30, 2022
Segment Reporting [Abstract] |
Segment and Geographic Information | NOTE 10 — 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, Georgia, Idaho, Indiana, northern Kentucky, Nevada, New Hampshire, North Carolina, South Carolina, Utah and Virginia, and the American Group includes 79 hospitals located in Colorado, Kansas, southern Kentucky, Louisiana, Missouri, Tennessee and Texas. We also operate seven 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, gains and losses 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 nine months ended September 30, 2022 and 2021 are summarized in the following table (dollars in millions):
|  | Quarter |  |  | Nine Months |
|  | 2022 |  |  | 2021 |  |  | 2022 |  |  | 2021 |
Revenues: |  |  |  |  |  |  |  |  |  |  |  |
National Group |  | $ | 7,635 |  |  | $ | 7,787 |  |  | $ | 22,490 |  |  | $ | 22,143 |
American Group |  |  | 6,599 |  |  |  | 6,767 |  |  |  | 19,872 |  |  |  | 19,562 |
Corporate and other |  |  | 737 |  |  |  | 722 |  |  |  | 2,374 |  |  |  | 1,983 |
|  | $ | 14,971 |  |  | $ | 15,276 |  |  | $ | 44,736 |  |  | $ | 43,688 |
Losses (equity) in earnings of affiliates: |  |  |  |  |  |  |  |  |  |  |  |
National Group |  | $ | (1 | ) |  | $ | (14 | ) |  | $ | (3 | ) |  | $ | (30 | )
American Group |  |  | (13 | ) |  |  | (14 | ) |  |  | (31 | ) |  |  | (38 | )
Corporate and other |  |  | 4 |  |  |  | (7 | ) |  |  | 5 |  |  |  | (10 | )
|  | $ | (10 | ) |  | $ | (35 | ) |  | $ | (29 | ) |  | $ | (78 | )
Adjusted segment EBITDA: |  |  |  |  |  |  |  |  |  |  |  |
National Group |  | $ | 1,550 |  |  | $ | 1,780 |  |  | $ | 4,656 |  |  | $ | 5,330 |
American Group |  |  | 1,389 |  |  |  | 1,604 |  |  |  | 4,417 |  |  |  | 4,698 |
Corporate and other |  |  | (37 | ) |  |  | (160 | ) |  |  | (185 | ) |  |  | (533 | )
|  | $ | 2,902 |  |  | $ | 3,224 |  |  | $ | 8,888 |  |  | $ | 9,495 |
Depreciation and amortization: |  |  |  |  |  |  |  |  |  |  |  |
National Group |  | $ | 369 |  |  | $ | 343 |  |  | $ | 1,088 |  |  | $ | 1,005 |
American Group |  |  | 309 |  |  |  | 295 |  |  |  | 914 |  |  |  | 884 |
Corporate and other |  |  | 71 |  |  |  | 78 |  |  |  | 217 |  |  |  | 236 |
|  | $ | 749 |  |  | $ | 716 |  |  | $ | 2,219 |  |  | $ | 2,125 |
Adjusted segment EBITDA |  | $ | 2,902 |  |  | $ | 3,224 |  |  | $ | 8,888 |  |  | $ | 9,495 |
Depreciation and amortization |  |  | 749 |  |  |  | 716 |  |  |  | 2,219 |  |  |  | 2,125 |
Interest expense |  |  | 446 |  |  |  | 398 |  |  |  | 1,288 |  |  |  | 1,168 |
Losses (gains) on sales of facilities |  |  | 3 |  |  |  | (1,047 | ) |  |  | 25 |  |  |  | (1,057 | )
Losses on retirement of debt |  |  | — |  |  |  | — |  |  |  | 78 |  |  |  | 12 |
Income before income taxes |  | $ | 1,704 |  |  | $ | 3,157 |  |  | $ | 5,278 |  |  | $ | 7,247 |

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- Definition The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 31 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8924-108599 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 34 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8981-108599 Reference 3: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 21 -Subparagraph (a) -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8721-108599 Reference 4: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 40 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9031-108599 Reference 5: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 32 -Subparagraph (f) -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599 Reference 6: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 32 -Subparagraph (e) -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599 Reference 7: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 26 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8844-108599 Reference 8: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 41 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9038-108599 Reference 9: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 32 -Subparagraph (d) -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599 Reference 10: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 22 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8736-108599 Reference 11: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 42 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9054-108599 Reference 12: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 15 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8657-108599 Reference 13: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 21 -Subparagraph (b) -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8721-108599 Reference 14: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -URI https://asc.fasb.org/topic&trid=2134510 + Details
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