v3.26.3
Segment and Geographic Information
 9 Months Ended
Sep. 30, 2026
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 three geographically organized groups: the National, Atlantic and American Groups. At September 30, 2026, the National Group included 52 hospitals located in Alaska, California, Idaho, Kentucky, Nevada, New Hampshire, North Carolina, Tennessee, Utah and Virginia; the Atlantic Group included 64 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 seven 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 and nine months ended September 30, 2026 and 2025 and assets at September 30, 2026 and December 31, 2025:

 

 

Quarter

 

 

Nine Months

 

 

2026

 

 

National
Group

 

Atlantic
Group

 

American
Group

 

 

National
Group

 

Atlantic
Group

 

American
Group

 

Revenues

$

5,738

 

$

6,421

 

$

6,848

 

 

$

16,310

 

$

20,357

 

$

19,996

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

2,031

 

 

2,347

 

 

2,356

 

 

 

5,962

 

 

6,926

 

 

6,920

 

Supplies

 

779

 

 

916

 

 

1,047

 

 

 

2,315

 

 

2,794

 

 

3,190

 

Other operating expenses

 

1,449

 

 

1,870

 

 

1,907

 

 

 

4,113

 

 

6,085

 

 

5,597

 

Equity in earnings of affiliates

 

(1

)

 

—

 

 

(17

)

 

 

(2

)

 

(2

)

 

(49

)

 

 

4,258

 

 

5,133

 

 

5,293

 

 

 

12,388

 

 

15,803

 

 

15,658

 

Adjusted segment EBITDA

$

1,480

 

$

1,288

 

$

1,555

 

 

$

3,922

 

$

4,554

 

$

4,338

 

 

 

Quarter

 

 

Nine Months

 

 

2025

 

 

National
Group

 

Atlantic
Group

 

American
Group

 

 

National
Group

 

Atlantic
Group

 

American
Group

 

Revenues

$

5,525

 

$

6,142

 

$

6,688

 

 

$

15,790

 

$

18,431

 

$

19,512

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

1,970

 

 

2,288

 

 

2,275

 

 

 

5,848

 

 

6,750

 

 

6,687

 

Supplies

 

742

 

 

889

 

 

1,053

 

 

 

2,238

 

 

2,738

 

 

3,140

 

Other operating expenses

 

1,466

 

 

1,627

 

 

1,796

 

 

 

3,954

 

 

4,793

 

 

5,156

 

Equity in earnings of affiliates

 

(1

)

 

(1

)

 

(16

)

 

 

(1

)

 

(3

)

 

(47

)

 

 

4,177

 

 

4,803

 

 

5,108

 

 

 

12,039

 

 

14,278

 

 

14,936

 

Adjusted segment EBITDA

$

1,348

 

$

1,339

 

$

1,580

 

 

$

3,751

 

$

4,153

 

$

4,576

 

 

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

 

 

 

Quarter

 

 

Nine Months

 

 

 

2026

 

 

2025

 

 

2026

 

 

2025

 

Adjusted segment EBITDA:

 

 

 

 

 

 

 

 

 

 

 

 

National Group

 

$

1,480

 

 

$

1,348

 

 

$

3,922

 

 

$

3,751

 

Atlantic Group

 

 

1,288

 

 

 

1,339

 

 

 

4,554

 

 

 

4,153

 

American Group

 

 

1,555

 

 

 

1,580

 

 

 

4,338

 

 

 

4,576

 

 

 

 

4,323

 

 

 

4,267

 

 

 

12,814

 

 

 

12,480

 

Adjustments to reconcile total adjusted segment
  EBITDA to consolidated income before income taxes:

 

 

 

 

 

 

 

 

 

 

 

 

Corporate and other

 

 

405

 

 

 

397

 

 

 

1,067

 

 

 

1,028

 

Depreciation and amortization

 

 

954

 

 

 

889

 

 

 

2,828

 

 

 

2,612

 

Interest expense

 

 

607

 

 

 

561

 

 

 

1,790

 

 

 

1,676

 

Losses (gains) on sales of facilities

 

 

(13

)

 

 

2

 

 

 

(22

)

 

 

4

 

Income before income taxes

 

$

2,370

 

 

$

2,418

 

 

$

7,151

 

 

$

7,160

 

 

 

 

Quarter

 

 

Nine Months

 

 

2026

 

 

2025

 

 

2026

 

 

2025

 

Revenues:

 

 

 

 

 

 

 

 

 

 

 

 

National Group

 

$

5,738

 

 

$

5,525

 

 

$

16,310

 

 

$

15,790

 

Atlantic Group

 

 

6,421

 

 

 

6,142

 

 

 

20,357

 

 

 

18,431

 

American Group

 

 

6,848

 

 

 

6,688

 

 

 

19,996

 

 

 

19,512

 

Corporate and other

 

 

842

 

 

 

806

 

 

 

2,525

 

 

 

2,354

 

 

$

19,849

 

 

$

19,161

 

 

$

59,188

 

 

$

56,087

 

Depreciation and amortization:

 

 

 

 

 

 

 

 

 

 

 

 

National Group

 

$

239

 

 

$

226

 

 

$

713

 

 

$

675

 

Atlantic Group

 

 

304

 

 

 

281

 

 

 

900

 

 

 

830

 

American Group

 

 

296

 

 

 

283

 

 

 

887

 

 

 

839

 

Corporate and other

 

 

115

 

 

 

99

 

 

 

328

 

 

 

268

 

 

$

954

 

 

$

889

 

 

$

2,828

 

 

$

2,612

 

 

 

 

September 30,
2026

 

 

December 31,
2025

 

Assets:

 

 

 

 

 

 

National Group

 

$

13,950

 

 

$

13,596

 

Atlantic Group

 

 

18,467

 

 

 

17,945

 

American Group

 

 

21,846

 

 

 

21,217

 

Corporate and other

 

 

9,189

 

 

 

7,962

 

 

 

$

63,452

 

 

$

60,720