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Segment Reporting (Tables) | 12 Months Ended
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Dec. 31, 2024
Segment Reporting [Abstract] |
Segment Reporting |
2024 |  | Acute Care Hospital Services |  |  | Behavioral Health Care Services (c) |  |  | Total |
|  | (amounts in thousands) |
Net revenue from reportable segments |  | $ | 8,922,327 |  |  | $ | 6,895,051 |  |  | $ | 15,817,378 |
Reconciliation of Net Revenue |  |  |  |  |  |  |  |  |
Non-segment revenue |  |  |  |  |  |  |  |  | 10,557 |
Total Net Revenue |  |  |  |  |  |  |  | $ | 15,827,935 |
Salaries, wages and benefits |  | $ | 3,511,359 |  |  | $ | 3,603,123 |  |  |  |
Other segment item operating expenses (a) |  |  | 4,202,491 |  |  |  | 1,724,763 |  |  |  |
Depreciation and amortization expense |  |  | 368,096 |  |  |  | 206,362 |  |  |  |
Interest (income) expense, net |  |  | 6,339 |  |  |  | 4,027 |  |  |  |
Other (income) expense, net |  |  | (1,305 | ) |  |  | (3,547 | ) |  |  |
Reportable segment income before income taxes |  | $ | 835,347 |  |  | $ | 1,360,323 |  |  | $ | 2,195,670 |
Reconciliation of non-segment revenue/expenses to consolidated income before income taxes |  |  |  |  |  |  |  |  |
Non-segment revenue |  |  |  |  |  |  |  |  | 10,557 |
Non-segment operating expenses (b) |  |  |  |  |  |  |  |  | 529,927 |
Non-segment interest expense, net |  |  |  |  |  |  |  |  | 175,743 |
Non-segment other (income) expense, net |  |  |  |  |  |  |  |  | 2,621 |
Income before income taxes |  |  |  |  |  |  |  | $ | 1,497,936 |
2023 |  | Acute Care Hospital Services |  |  | Behavioral Health Care Services (c) |  |  | Total |
|  | (amounts in thousands) |
Net revenue from reportable segments |  | $ | 8,081,402 |  |  | $ | 6,190,921 |  |  | $ | 14,272,323 |
Reconciliation of Net Revenue |  |  |  |  |  |  |  |  |
Non-segment revenue |  |  |  |  |  |  |  |  | 9,653 |
Total Net Revenue |  |  |  |  |  |  |  | $ | 14,281,976 |
Salaries, wages and benefits |  | $ | 3,406,060 |  |  | $ | 3,353,008 |  |  |  |
Other segment item operating expenses (a) |  |  | 3,762,066 |  |  |  | 1,564,649 |  |  |  |
Depreciation and amortization expense |  |  | 367,644 |  |  |  | 189,297 |  |  |  |
Interest (income) expense, net |  |  | (2,501 | ) |  |  | 4,558 |  |  |  |
Other (income) expense, net |  |  | 7,788 |  |  |  | (4,271 | ) |  |  |
Reportable segment income before income taxes |  | $ | 540,345 |  |  | $ | 1,083,680 |  |  | $ | 1,624,025 |
Reconciliation of non-segment revenue/expenses to consolidated income before income taxes |  |  |  |  |  |  |  |  |
Non-segment revenue |  |  |  |  |  |  |  |  | 9,653 |
Non-segment operating expenses (b) |  |  |  |  |  |  |  |  | 463,871 |
Non-segment interest expense, net |  |  |  |  |  |  |  |  | 204,617 |
Non-segment other (income) expense, net |  |  |  |  |  |  |  |  | 24,764 |
Income before income taxes |  |  |  |  |  |  |  | $ | 940,426 |
2022 |  | Acute Care Hospital Services (d) |  |  | Behavioral Health Care Services (c) |  |  | Total |
|  | (amounts in thousands) |
Net revenue from reportable segments |  | $ | 7,646,749 |  |  | $ | 5,729,758 |  |  | $ | 13,376,507 |
Reconciliation of Net Revenue |  |  |  |  |  |  |  |  |
Non-segment revenue |  |  |  |  |  |  |  |  | 22,863 |
Total Net Revenue |  |  |  |  |  |  |  | $ | 13,399,370 |
Salaries, wages and benefits |  | $ | 3,332,535 |  |  | $ | 3,107,216 |  |  |  |
Other segment item operating expenses (a) |  |  | 3,497,538 |  |  |  | 1,457,217 |  |  |  |
Depreciation and amortization expense |  |  | 383,115 |  |  |  | 186,555 |  |  |  |
Interest (income) expense, net |  |  | 1,109 |  |  |  | 5,323 |  |  |  |
Other (income) expense, net |  |  | 2,788 |  |  |  | (6,843 | ) |  |  |
Reportable segment income before income taxes |  | $ | 429,664 |  |  | $ | 980,290 |  |  | $ | 1,409,954 |
Reconciliation of non-segment revenue/expenses to consolidated income before income taxes |  |  |  |  |  |  |  |  |
Non-segment revenue |  |  |  |  |  |  |  |  | 22,863 |
Non-segment operating expenses (b) |  |  |  |  |  |  |  |  | 431,639 |
Non-segment interest expense, net |  |  |  |  |  |  |  |  | 120,457 |
Non-segment other (income) expense, net |  |  |  |  |  |  |  |  | 14,461 |
Income before income taxes |  |  |  |  |  |  |  | $ | 866,260 |
(a) Other segment operating expenses for each period includes other operating expenses, supplies expense and lease and rental expense. (b) Non-segment operating expenses for each period includes salaries, wages and benefits, other operating expenses, supplies expense and lease and rental expense. (c) Includes net revenues generated from our behavioral health care facilities located in the U.K. amounting to approximately $880 million in 2024, $761 million in 2023 and $685 million in 2022. (d) Included in our 2022 acute care hospital services reportable segment income before income taxes is a pre-tax $58 million provision for asset impairment charge to reduce the carrying value of real property assets.

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- Definition Tabular disclosure of the profit or loss and total assets for each reportable segment. An entity discloses certain information on each reportable segment if the amounts (a) are included in the measure of segment profit or loss reviewed by the chief operating decision maker or (b) are otherwise regularly provided to the chief operating decision maker, even if not included in that measure of segment profit or loss. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 25 -Publisher FASB -URI https://asc.fasb.org/1943274/2147482810/280-10-50-25 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 22 -Publisher FASB -URI https://asc.fasb.org/1943274/2147482810/280-10-50-22 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 30 -Publisher FASB -URI https://asc.fasb.org/1943274/2147482810/280-10-50-30 + Details
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