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Segment and Geographic Information
 3 Months Ended
Mar. 31, 2025
Segment Reporting [Abstract]  
Segment and Geographic Information

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION

Effective January 1, 2024, we adopted Accounting Standards Update 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures. We operate in one line of business, which is operating hospitals and related health care entities. We operate in three geographically organized groups: the National, Atlantic and American Groups. At March 31, 2025, the National Group included 55 hospitals located in Alaska, California, Idaho, Indiana, Kentucky, Nevada, New Hampshire, North Carolina, Tennessee, Utah and Virginia, the Atlantic Group included 63 hospitals located in Florida, Georgia, Northern Kansas, Missouri and South Carolina, and the American Group included 66 hospitals located in Colorado, Central Kansas, Louisiana and Texas. The eight hospitals we operate in England are included in the Corporate and other group.

 

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, losses and 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, salaries and benefits, supplies, other operating expenses, equity in earnings of affiliates, adjusted segment EBITDA, depreciation and amortization and assets that are provided to the Chief Operating Decision Maker, which is the Chief Executive Officer, are summarized in the following tables (dollars in millions) and represent the operating segments for the quarters ended March 31, 2025 and 2024 and assets at March 31, 2025 and December 31, 2024:

 

 

2025

 

 

 

National
Group

 

 

Atlantic
Group

 

 

American
Group

 

Revenues

 

$

5,065

 

 

$

6,167

 

 

$

6,331

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

 

1,959

 

 

 

2,216

 

 

 

2,196

 

Supplies

 

 

741

 

 

 

914

 

 

 

1,020

 

Other operating expenses

 

 

1,233

 

 

 

1,576

 

 

 

1,711

 

Equity in earnings of affiliates

 

 

-

 

 

 

(1

)

 

 

(14

)

 

 

 

3,933

 

 

 

4,705

 

 

 

4,913

 

Adjusted segment EBITDA

 

$

1,132

 

 

$

1,462

 

 

$

1,418

 

 

 

 

2024

 

 

 

National
Group

 

 

Atlantic
Group

 

 

American
Group

 

Revenues

 

$

4,835

 

 

$

5,810

 

 

$

5,984

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

 

1,890

 

 

 

2,161

 

 

 

2,119

 

Supplies

 

 

705

 

 

 

909

 

 

 

980

 

Other operating expenses

 

 

1,194

 

 

 

1,482

 

 

 

1,580

 

Equity in earnings of affiliates

 

 

(1

)

 

 

(1

)

 

 

(13

)

 

 

 

3,788

 

 

 

4,551

 

 

 

4,666

 

Adjusted segment EBITDA

 

$

1,047

 

 

$

1,259

 

 

$

1,318

 

 

 

 

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

 

 

2025

 

 

2024

 

Adjusted segment EBITDA:

 

 

 

 

 

 

National Group

 

$

1,132

 

 

$

1,047

 

Atlantic Group

 

 

1,462

 

 

 

1,259

 

American Group

 

 

1,418

 

 

 

1,318

 

 

 

 

4,012

 

 

 

3,624

 

Adjustments to reconcile Total Adjusted segment
  EBITDA to consolidated Income before income taxes:

 

 

 

 

 

 

Corporate and Other

 

 

279

 

 

 

271

 

Depreciation and amortization

 

 

860

 

 

 

795

 

Interest expense

 

 

547

 

 

 

512

 

Gains on sales of facilities

 

 

(1

)

 

 

(201

)

Income before income taxes

 

$

2,327

 

 

$

2,247

 

 

 

2025

 

 

2024

 

 

Revenues:

 

 

 

 

 

 

 

National Group

 

$

5,065

 

 

$

4,835

 

 

Atlantic Group

 

 

6,167

 

 

 

5,810

 

 

American Group

 

 

6,331

 

 

 

5,984

 

 

Corporate and other

 

 

758

 

 

 

710

 

 

 

$

18,321

 

 

$

17,339

 

 

Depreciation and amortization:

 

 

 

 

 

 

 

National Group

 

$

226

 

 

$

212

 

 

Atlantic Group

 

 

274

 

 

 

258

 

 

American Group

 

 

279

 

 

 

255

 

 

Corporate and other

 

 

81

 

 

 

70

 

 

 

$

860

 

 

$

795

 

 

 

 

 

 

March 31,
2025

 

 

December 31,
2024

 

Assets:

 

 

 

 

 

 

National Group

 

$

13,407

 

 

$

12,855

 

Atlantic Group

 

 

17,654

 

 

 

17,168

 

American Group

 

 

20,614

 

 

 

20,714

 

Corporate and other

 

 

8,123

 

 

 

8,776

 

 

 

$

59,798

 

 

$

59,513