Cover Page - shares	9 Months Ended
Cover Page - shares	Sep. 30, 2019	Oct. 31, 2019
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Entity File Number	1-7293
Entity Registrant Name	TENET HEALTHCARE CORP
Entity Incorporation, State or Country Code	NV
Entity Tax Identification Number	95-2557091
Entity Address, Address Line One	1445 Ross Avenue, Suite 1400
Entity Address, City or Town	Dallas
Entity Address, State or Province	TX
Entity Address, Postal Zip Code	75202
City Area Code	469
Local Phone Number	893-2200
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		103,895,190
Entity Central Index Key	0000070318
Current Fiscal Year End Date	--12-31
Document Period End Date	Sep. 30, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus (i.e. Q1,Q2,Q3,FY)	Q3
Amendment Flag	false
Common stock \| New York Stock Exchange
Title of 12(b) Security	Common stock
Trading Symbol	THC
Security Exchange Name	NYSE
6.875% Senior Notes due 2031 \| New York Stock Exchange
Title of 12(b) Security	6.875% Senior Notes due 2031
Trading Symbol	THC31
Security Exchange Name	NYSE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Current assets:
Cash and cash equivalents	$ 314	$ 411
Accounts receivable	2,768	2,595
Inventories of supplies, at cost	311	305
Income tax receivable	18	21
Assets held for sale	0	107
Other current assets	1,378	1,197
Total current assets	4,789	4,636
Investments and other assets	2,380	1,456
Deferred income taxes	252	312
Property and equipment, at cost, less accumulated depreciation and amortization ($5,645 at September 30, 2019 and $5,221 at December 31, 2018)	7,001	6,993
Goodwill	7,315	7,281
Other intangible assets, at cost, less accumulated amortization ($1,098 at September 30, 2019 and $1,013 at December 31, 2018)	1,620	1,731
Total assets	23,357	22,409
Current liabilities:
Current portion of long-term debt	165	182
Accounts payable	1,125	1,207
Accrued compensation and benefits	842	838
Professional and general liability reserves	230	216
Accrued interest payable	252	240
Liabilities held for sale	0	43
Other current liabilities	1,314	1,131
Total current liabilities	3,928	3,857
Long-term debt, net of current portion	14,858	14,644
Professional and general liability reserves	671	666
Defined benefit plan obligations	495	521
Deferred income taxes	36	36
Other long-term liabilities	1,405	578
Total liabilities	21,393	20,302
Commitments and contingencies
Redeemable noncontrolling interests in equity of consolidated subsidiaries	1,475	1,420
Shareholders’ equity:
Common stock, $0.05 par value; authorized 262,500,000 shares; 152,118,277 shares issued at September 30, 2019 and 150,897,143 shares issued at December 31, 2018	7	7
Additional paid-in capital	4,751	4,747
Accumulated other comprehensive loss	(216)	(223)
Accumulated deficit	(2,469)	(2,236)
Common stock in treasury, at cost, 48,346,277 shares at September 30, 2019 and 48,359,705 shares at December 31, 2018	(2,414)	(2,414)
Total shareholders’ deficit	(341)	(119)
Noncontrolling interests	830	806
Total equity	489	687
Total liabilities and equity	$ 23,357	$ 22,409

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Property and equipment, accumulated depreciation and amortization	$ 5,645	$ 5,221
Other intangible assets, accumulated amortization	$ 1,098	$ 1,013
Common stock, par value (in dollars per share)	$ 0.05	$ 0.05
Common stock, authorized shares (in shares)	262,500,000	262,500,000
Common stock, shares issued (in shares)	152,118,277	150,897,143
Common stock in treasury (in shares)	48,346,277	48,359,705

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Income Statement [Abstract]
Net operating revenues	$ 4,568	$ 4,489	$ 13,673	$ 13,694
Equity in earnings of unconsolidated affiliates	38	33	114	97
Operating expenses:
Salaries, wages and benefits	2,174	2,116	6,475	6,478
Supplies	760	726	2,254	2,248
Other operating expenses, net	1,042	1,094	3,160	3,181
Electronic health record incentives	0	0	(1)	(1)
Depreciation and amortization	205	204	627	602
Impairment and restructuring charges, and acquisition-related costs	46	46	101	123
Litigation and investigation costs	84	9	115	28
Net losses (gains) on sales, consolidation and deconsolidation of facilities	1	7	3	(111)
Operating income	294	320	1,053	1,243
Interest expense	(244)	(249)	(742)	(758)
Other non-operating expense, net	(3)	0	(3)	(2)
Loss from early extinguishment of debt	(180)	0	(227)	(2)
Income (loss) from continuing operations, before income taxes	(133)	71	81	481
Income tax expense	(20)	(6)	(67)	(120)
Income (loss) from continuing operations, before discontinued operations	(153)	65	14	361
Discontinued operations:
Income from operations	1	0	13	3
Income tax expense	0	0	(2)	0
Income from discontinued operations	1	0	11	3
Net income (loss)	(152)	65	25	364
Less: Net income available to noncontrolling interests	80	74	259	248
Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders	(232)	(9)	(234)	116
Amounts available (attributable) to Tenet Healthcare Corporation common shareholders
Income (loss) from continuing operations, net of tax	(233)	(9)	(245)	113
Income from discontinued operations, net of tax	1	0	11	3
Net income available (loss attributable) to Tenet Healthcare Corporation common shareholders	$ (232)	$ (9)	$ (234)	$ 116
Basic
Continuing operations (in dollars per share)	$ (2.25)	$ (0.09)	$ (2.37)	$ 1.11
Discontinued operations (in dollars per share)	0.01	0	0.11	0.03
Total loss per share, Basic (in dollars per share)	(2.24)	(0.09)	(2.26)	1.14
Diluted
Continuing operations (in dollars per share)	(2.25)	(0.09)	(2.37)	1.09
Discontinued operations (in dollars per share)	0.01	0	0.11	0.03
Total loss per share, Diluted (in dollars per share)	$ (2.24)	$ (0.09)	$ (2.26)	$ 1.12
Weighted average shares and dilutive securities outstanding (in thousands):
Basic (in shares)	103,558	102,402	103,181	101,980
Diluted (in shares)	103,558	102,402	103,181	103,802

CONDENSED CONSOLIDATED STATEMENTS OF OTHER COMPREHENSIVE INCOME - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Statement of Comprehensive Income [Abstract]
Net income (loss)	$ (152)	$ 65	$ 25	$ 364
Other comprehensive income (loss):
Amortization of net actuarial loss included in other non-operating expense, net	3	3	9	11
Sale of foreign subsidiary	0	37	0	37
Foreign currency translation adjustments	0	0	0	(3)
Other comprehensive income before income taxes	3	40	9	45
Income tax benefit (expense) related to items of other comprehensive income (loss)	0	1	(2)	0
Total other comprehensive income, net of tax	3	41	7	45
Comprehensive net income (loss)	(149)	106	32	409
Less: Comprehensive income available to noncontrolling interests	80	74	259	248
Comprehensive income available (loss attributable) to Tenet Healthcare Corporation common shareholders	$ (229)	$ 32	$ (227)	$ 161

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Statement of Cash Flows [Abstract]
Net income (loss)	$ 25	$ 364
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	627	602
Deferred income tax expense	57	110
Stock-based compensation expense	34	34
Impairment and restructuring charges, and acquisition-related costs	101	123
Litigation and investigation costs	115	28
Net losses (gains) on sales, consolidation and deconsolidation of facilities	3	(111)
Loss from early extinguishment of debt	227	2
Equity in earnings of unconsolidated affiliates, net of distributions received	(6)	9
Amortization of debt discount and debt issuance costs	25	33
Pre-tax income from discontinued operations	(13)	(3)
Other items, net	(14)	(22)
Changes in cash from operating assets and liabilities:
Accounts receivable	(174)	(36)
Inventories and other current assets	(98)	73
Income taxes	(4)	(14)
Accounts payable, accrued expenses and other current liabilities	(37)	(194)
Other long-term liabilities	(15)	(82)
Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements	(136)	(113)
Net cash used in operating activities from discontinued operations, excluding income taxes	(4)	(4)
Net cash provided by operating activities	713	799
Cash flows from investing activities:
Purchases of property and equipment — continuing operations	(492)	(404)
Purchases of businesses or joint venture interests, net of cash acquired	(23)	(97)
Proceeds from sales of facilities and other assets — continuing operations	44	498
Proceeds from sales of facilities and other assets — discontinued operations	17	0
Proceeds from sales of marketable securities, long-term investments and other assets	52	165
Purchases of equity investments	(14)	(43)
Other long-term assets	1	5
Other items, net	(11)	(4)
Net cash provided by (used in) investing activities	(426)	120
Cash flows from financing activities:
Repayments of borrowings under credit facility	(1,880)	(505)
Proceeds from borrowings under credit facility	2,155	505
Repayments of other borrowings	(6,084)	(238)
Proceeds from other borrowings	5,718	15
Debt issuance costs	(63)	0
Distributions paid to noncontrolling interests	(223)	(217)
Proceeds from sales of noncontrolling interests	15	14
Purchases of noncontrolling interests	(8)	(643)
Proceeds from exercise of stock options and employee stock purchase plan	4	15
Other items, net	(18)	24
Net cash used in financing activities	(384)	(1,030)
Net decrease in cash and cash equivalents	(97)	(111)
Cash and cash equivalents at beginning of period	411	611
Cash and cash equivalents at end of period	314	500
Supplemental disclosures:
Interest paid, net of capitalized interest	(705)	(652)
Income tax payments, net	$ (18)	$ (24)

BASIS OF PRESENTATION

9 Months Ended

Sep. 30, 2019

Organization, Consolidation and Presentation of Financial Statements [Abstract]

BASIS OF PRESENTATION

Description of Business and Basis of Presentation

Tenet Healthcare Corporation (together with our subsidiaries, referred to herein as “Tenet,” “we” or “us”) is a diversified healthcare services company headquartered in Dallas, Texas. Through an expansive care network that includes USPI Holding Company, Inc. (“USPI”), at September 30, 2019, we operated 65 hospitals and approximately 500 other healthcare facilities, including surgical hospitals, ambulatory surgery centers, urgent care and imaging centers, and other care sites and clinics. We also operate Conifer Health Solutions, through our Conifer Holdings, Inc. (“Conifer”) subsidiary, which provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other customers.

This quarterly report supplements our Annual Report on Form 10-K for the year ended December 31, 2018 (“Annual Report”). As permitted by the Securities and Exchange Commission for interim reporting, we have omitted certain notes and disclosures that substantially duplicate those in our Annual Report. For further information, refer to the audited Consolidated Financial Statements and notes included in our Annual Report. Unless otherwise indicated, all financial and statistical data included in these notes to our Condensed Consolidated Financial Statements relate to our continuing operations, with dollar amounts expressed in millions (except per-share amounts).

Effective January 1, 2019, we adopted the Financial Accounting Standards Board (“FASB”) Accounting Standards Update (“ASU”) 2016-02, “Leases (Topic 842)” (“ASU 2016-02”) using the modified retrospective transition approach as of the period of adoption. Our financial statements for periods prior to January 1, 2019 were not modified for the application of the new lease accounting standard. The main difference between the guidance in ASU 2016-02 and previous accounting principles generally accepted in the United States of America (“GAAP”) is the recognition of lease assets and lease liabilities on the balance sheet by lessees for those leases classified as operating leases under previous GAAP. Upon adoption of ASU 2016-02, we recorded $822 million of right-of-use assets, net of deferred rent, associated with operating leases in investments and other assets in our condensed consolidated balance sheet, $147 million of current liabilities associated with operating leases in other current liabilities in our condensed consolidated balance sheet and $715 million of long-term liabilities associated with operating leases in other long-term liabilities in our condensed consolidated balance sheet. We also recognized $1 million of cumulative effect adjustment that decreased accumulated deficit at January 1, 2019.

Although the Condensed Consolidated Financial Statements and related notes within this document are unaudited, we believe all adjustments considered necessary for a fair presentation have been included and are of a normal recurring nature. In preparing our financial statements in conformity with GAAP, we are required to make estimates and assumptions that affect the amounts reported in our Condensed Consolidated Financial Statements and these accompanying notes. We regularly evaluate the accounting policies and estimates we use. In general, we base the estimates on historical experience and on assumptions that we believe to be reasonable given the particular circumstances in which we operate. Actual results may vary from those estimates. Financial and statistical information we report to other regulatory agencies may be prepared on a basis other than GAAP or using different assumptions or reporting periods and, therefore, may vary from amounts presented herein. Although we make every effort to ensure that the information we report to those agencies is accurate, complete and consistent with applicable reporting guidelines, we cannot be responsible for the accuracy of the information they make available to the public.

Operating results for the three and nine month periods ended September 30, 2019 are not necessarily indicative of the results that may be expected for the full year. Reasons for this include, but are not limited to: overall revenue and cost trends, particularly the timing and magnitude of price changes; fluctuations in contractual allowances and cost report settlements and valuation allowances; managed care contract negotiations, settlements or terminations and payer consolidations; trends in patient accounts receivable collectability and associated implicit price concessions; fluctuations in interest rates; levels of malpractice insurance expense and settlement trends; impairment of long-lived assets and goodwill; restructuring charges; losses, costs and insurance recoveries related to natural disasters and other weather-related occurrences; litigation and investigation costs; acquisitions and dispositions of facilities and other assets; gains (losses) on sales, consolidation and deconsolidation of facilities; income tax rates and deferred tax asset valuation allowance activity; changes in estimates of accruals for annual incentive compensation; the timing and amounts of stock option and restricted stock unit grants to employees and directors; gains (losses) from early extinguishment of debt; and changes in occupancy levels and patient volumes. Factors that affect service mix, revenue mix, patient volumes and, thereby, the results of operations at our hospitals and related healthcare facilities include, but are not limited to: changes in federal and state healthcare regulations; the business environment, economic conditions and demographics of local communities in which we operate; the number of uninsured and

underinsured individuals in local communities treated at our hospitals; seasonal cycles of illness; climate and weather conditions; physician recruitment, satisfaction, retention and attrition; advances in technology and treatments that reduce length of stay; local healthcare competitors; managed care contract negotiations or terminations; the number of patients with high-deductible health insurance plans; hospital performance data on quality measures and patient satisfaction, as well as standard charges for services; any unfavorable publicity about us, or our joint venture partners, that impacts our relationships with physicians and patients; and the timing of elective procedures. These considerations apply to year-to-year comparisons as well.

Net Operating Revenues

We recognize net operating revenues in the period in which we satisfy our performance obligations under contracts by transferring services to our customers. Net operating revenues are recognized in the amounts we expect to be entitled to, which are the transaction prices allocated for the distinct services. Net operating revenues for our Hospital Operations and other and Ambulatory Care segments primarily consist of net patient service revenues, principally for patients covered by Medicare, Medicaid, managed care and other health plans, as well as certain uninsured patients under our Compact with Uninsured Patients (“Compact”) and other uninsured discount and charity programs. Net operating revenues for our Conifer segment primarily consist of revenues from providing revenue cycle management services to healthcare systems, as well as individual hospitals, physician practices, self-insured organizations, health plans and other entities.

Net Patient Service Revenues—We report net patient service revenues at the amounts that reflect the consideration we expect to be entitled to in exchange for providing patient care. These amounts are due from patients, third-party payers (including managed care payers and government programs) and others, and they include variable consideration for retroactive revenue adjustments due to settlement of audits, reviews and investigations. Generally, we bill our patients and third-party payers several days after the services are performed or shortly after discharge. Revenues are recognized as performance obligations are satisfied.

Conifer Revenues—Our Conifer segment recognizes revenue from its contracts when Conifer’s performance obligations are satisfied, which is generally as services are rendered. Revenue is recognized in an amount that reflects the consideration to which Conifer expects to be entitled.

Cash and Cash Equivalents

We treat highly liquid investments with original maturities of three months or less as cash equivalents. Cash and cash equivalents were $314 million and $411 million at September 30, 2019 and December 31, 2018, respectively. At September 30, 2019 and December 31, 2018, our book overdrafts were $287 million and $288 million, respectively, which were classified as accounts payable.

At September 30, 2019 and December 31, 2018, $204 million and $177 million, respectively, of total cash and cash equivalents in the accompanying Condensed Consolidated Balance Sheets were intended for the operations of our captive insurance subsidiaries, and $2 million and $8 million, respectively, of total cash and cash equivalents in the accompanying Condensed Consolidated Balance Sheets were intended for the operations of our health plan-related businesses.

Also at September 30, 2019 and December 31, 2018, we had $69 million and $135 million, respectively, of property and equipment purchases accrued for items received but not yet paid. Of these amounts, $50 million and $114 million, respectively, were included in accounts payable.

During the nine months ended September 30, 2019 and 2018, we entered into non-cancellable capital (finance) leases of $91 million and $94 million, respectively.

Other Intangible Assets

The following tables provide information regarding other intangible assets, which are included in the accompanying Condensed Consolidated Balance Sheets at September 30, 2019 and December 31, 2018:



	Gross Carrying Amount		Accumulated Amortization			Net Book Value
At September 30, 2019:
Capitalized software costs	$	1,637	$	(927	)	$	710
Trade names	102		—			102
Contracts	875		(90		)	785
Other	104		(81		)	23
Total	$	2,718	$	(1,098	)	$	1,620



	Gross Carrying Amount		Accumulated Amortization			Net Book Value
At December 31, 2018:
Capitalized software costs	$	1,667	$	(858	)	$	809
Trade names	102		—			102
Contracts	871		(76		)	795
Other	104		(79		)	25
Total	$	2,744	$	(1,013	)	$	1,731

Estimated future amortization of intangibles with finite useful lives at September 30, 2019 is as follows:



			Three Months Ending		Years Ending								Later Years
			December 31,
	Total		2019		2020		2021		2022		2023
Amortization of intangible assets	$	938	$	45	$	132	$	117	$	104	$	95	$	445

We recognized amortization expense of $138 million and $134 million in the accompanying Condensed Consolidated Statements of Operations for the nine months ended September 30, 2019 and 2018, respectively.

Investments in Unconsolidated Affiliates

We control 237 of the facilities within our Ambulatory Care segment and, therefore, consolidate their results. We account for many of the facilities our Ambulatory Care segment operates (111 of 348 at September 30, 2019), as well as additional companies in which our Hospital Operations and other segment holds ownership interests, under the equity method as investments in unconsolidated affiliates and report only our share of net income as equity in earnings of unconsolidated affiliates in the accompanying Condensed Consolidated Statements of Operations. Summarized financial information for these equity method investees is included in the following table; among the equity method investees are four North Texas hospitals in which we held minority interests that were operated by our Hospital Operations and other segment through the divestiture of these investments effective March 1, 2018. For investments acquired during the reporting periods, amounts reflect 100% of the investee’s results beginning on the date of our acquisition of the investment.



	Three Months Ended September 30,				Nine Months Ended September 30,
	2019		2018		2019		2018
Net operating revenues	$	622	$	546	$	1,809	$	1,667
Net income	$	156	$	126	$	447	$	374
Net income available to the investees	$	97	$	80	$	290	$	240

ACCOUNTS RECEIVABLE

9 Months Ended

Sep. 30, 2019

Accounts Receivable Additional Disclosures [Abstract]

ACCOUNTS RECEIVABLE

The principal components of accounts receivable are shown in the table below:



	September 30, 2019		December 31, 2018
Continuing operations:
Patient accounts receivable	$	2,559	$	2,427
Estimated future recoveries	169		148
Net cost reports and settlements receivable and valuation allowances	38		18
	2,766		2,593
Discontinued operations	2		2
Accounts receivable, net	$	2,768	$	2,595

Accounts that are pursued for collection through Conifer’s business offices are maintained on our hospitals’ books and reflected in patient accounts receivable. Patient accounts receivable, including billed accounts and certain unbilled accounts, as well as estimated amounts due from third-party payers for retroactive adjustments, are receivables if our right to consideration is unconditional and only the passage of time is required before payment of that consideration is due. Estimated uncollectable amounts are generally considered implicit price concessions that are a direct reduction to patient accounts receivable rather than allowance for doubtful accounts.

We had $274 million and $218 million of receivables recorded in other current assets and investments and other assets, respectively, and $70 million and $50 million of payables recorded in other current liabilities and other long-term liabilities, respectively, in the accompanying Condensed Consolidated Balance Sheet at September 30, 2019 related to California’s provider fee program. We had $278 million and $231 million of receivables recorded in other current assets and investments and other assets, respectively, and $100 million and $42 million of payables recorded in other current liabilities and other long-term liabilities, respectively, in the accompanying Condensed Consolidated Balance Sheet at December 31, 2018 related to California’s provider fee program.

We also provide financial assistance through our charity and uninsured discount programs to uninsured patients who are unable to pay for the healthcare services they receive. Our policy is not to pursue collection of amounts determined to qualify for financial assistance; therefore, we do not report these amounts in net operating revenues. Most states include an estimate of the cost of charity care in the determination of a hospital’s eligibility for Medicaid disproportionate share hospital (“DSH”) payments. These payments are intended to mitigate our cost of uncompensated care. Some states have also developed provider fee or other supplemental payment programs to mitigate the shortfall of Medicaid reimbursement compared to the cost of caring for Medicaid patients.

The following table shows our estimated costs (based on selected operating expenses, which include salaries, wages and benefits, supplies and other operating expenses and which exclude the costs of our health plan businesses) of caring for our uninsured and charity patients in the three and nine months ended September 30, 2019 and 2018:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2019		2018		2019		2018
Estimated costs for:
Uninsured patients	$	171	$	172	$	493	$	477
Charity care patients	41		28		116		91
Total	$	212	$	200	$	609	$	568

CONTRACT BALANCES

9 Months Ended

Sep. 30, 2019

Revenue from Contract with Customer [Abstract]

CONTRACT BALANCES

Hospital Operations and Other Segment

Amounts related to services provided to patients for which we have not billed and that do not meet the conditions of unconditional right to payment at the end of the reporting period are contract assets. For our Hospital Operations and other segment, our contract assets consist primarily of services that we have provided to patients who are still receiving inpatient care in our facilities at the end of the reporting period. Our Hospital Operations and other segment’s contract assets are included in other current assets in the accompanying Condensed Consolidated Balance Sheet at September 30, 2019. The opening and closing balances of contract assets for our Hospital Operations and other segment are as follows:



December 31, 2018	$	169
September 30, 2019	163
Increase/(decrease)	$	(6	)



January 1, 2018	$	171
September 30, 2018	152
Increase/(decrease)	$	(19	)

Approximately 89% of our Hospital Operations and other segment’s contract assets meet the conditions for unconditional right to payment and are reclassified to patient receivables within 90 days.

Conifer Segment

Conifer enters into contracts with customers to sell revenue cycle management and other services, such as value-based care, consulting and project services. The payment terms and conditions in our customer contracts vary. In some cases, customers are invoiced in advance and (for other than fixed-price fee arrangements) a true-up to the actual fee is included on a subsequent invoice. In other cases, payment is due in arrears. In addition, some contracts contain performance incentives, penalties and other forms of variable consideration. When the timing of Conifer’s delivery of services is different from the timing of payments made by the customers, Conifer recognizes either unbilled revenue (performance precedes contractual right to invoice the customer) or deferred revenue (customer payment precedes Conifer service performance). In the following table, customers that prepay prior to obtaining control/benefit of the service are represented by deferred contract revenue until the performance obligations are satisfied. Unbilled revenue represents arrangements in which Conifer has provided services to and the customer has obtained control/benefit of services prior to the contractual invoice date. Contracts with payment in arrears are recognized as receivables in the month the service is performed.

The opening and closing balances of Conifer’s receivables, contract asset, and current and long-term contract liabilities are as follows:



					Contract Liability-			Contract Liability-
			Contract Asset-		Current			Long-Term
	Receivables		Unbilled Revenue		Deferred Revenue			Deferred Revenue
December 31, 2018	$	42	$	11	$	61		$	20
September 30, 2019	86		11		72			19
Increase/(decrease)	$	44	$	—	$	11		$	(1	)

January 1, 2018	$	89	$	10	$	80		$	21
September 30, 2018	89		11		74			21
Increase/(decrease)	$	—	$	1	$	(6	)	$	—

The difference between the opening and closing balances of Conifer’s contract assets and contract liabilities are primarily related to prepayments for those customers who are billed in advance, changes in estimates related to metric-based services, and up-front integration services that are typically not distinct and are, therefore, recognized over the performance obligation period to which they relate. Our Conifer segment’s receivables and contract assets are reported as part of other current assets in our accompanying Condensed Consolidated Balance Sheets, and our Conifer segment’s current and long-term contract liabilities are reported as part of other current liabilities and other long-term liabilities, respectively, in our accompanying Condensed Consolidated Balance Sheets.

The amount of revenue Conifer recognized in the nine months ended September 30, 2019 and 2018 that was included in the opening current deferred revenue liability was $57 million and $68 million, respectively. This revenue consists primarily of prepayments for those customers who are billed in advance, changes in estimates related to metric-based services, and up-front integration services that are recognized over the services period.

Contract Costs

We have elected to apply the practical expedient provided by FASB Accounting Standards Codification 340-40-25-4 and expense as incurred the incremental customer contract acquisition costs for contracts in which the amortization period of the asset is one year or less. However, incremental costs incurred to obtain and fulfill customer contracts for which the amortization period of the asset is longer than one year, which consist primarily of Conifer deferred contract setup costs, are capitalized and amortized on a straight-line basis over the lesser of their estimated useful lives or the term of the related contract. During the three months ended September 30, 2019 and 2018, we recognized amortization expense of $2 million and $3 million, respectively. During the nine months ended September 30, 2019 and 2018, we recognized amortization expense of $4 million and $9 million, respectively. At September 30, 2019 and December 31, 2018, the unamortized customer contract costs were $26 million and $28 million, respectively, and are presented as part of investments and other assets in the accompanying Condensed Consolidated Balance Sheets.NET OPERATING REVENUES

Net operating revenues for our Hospital Operations and other and Ambulatory Care segments primarily consist of net patient service revenues, principally for patients covered by Medicare, Medicaid, managed care and other health plans, as well as certain uninsured patients under our Compact and other uninsured discount and charity programs. Net operating revenues for our Conifer segment primarily consist of revenues from providing revenue cycle management services to healthcare systems, as well as individual hospitals, physician practices, self-insured organizations, health plans and other entities.

The table below shows our sources of net operating revenues from continuing operations:



	Three Months Ended September 30,						Nine Months Ended September 30,
	2019			2018			2019			2018
Hospital Operations and other:
Net patient service revenues from hospitals and related outpatient facilities
Medicare	$	697		$	681		$	2,176		$	2,164
Medicaid	284			336			914			971
Managed care	2,357			2,228			7,041			6,869
Uninsured	44			33			56			78
Indemnity and other	184			156			508			438
Total	3,566			3,434			10,695			10,520
Other revenues(1)	284			328			844			922
Hospital Operations and other total prior to inter-segment eliminations	3,850			3,762			11,539			11,442
Ambulatory Care	522			502			1,526			1,531
Conifer	336			371			1,040			1,161
Inter-segment eliminations	(140		)	(146		)	(432		)	(440		)
Net operating revenues	$	4,568		$	4,489		$	13,673		$	13,694




(1)	Primarily physician practices revenues.

Adjustments for prior-year cost reports and related valuation allowances, principally related to Medicare and Medicaid, increased revenues in the nine months ended September 30, 2019 and 2018 by $24 million and $11 million, respectively. Estimated cost report settlements and valuation allowances are included in accounts receivable in the accompanying Condensed Consolidated Balance Sheets (see Note 2). We believe that we have made adequate provision for any adjustments that may result from final determination of amounts earned under all the above arrangements with Medicare and Medicaid.

The table below shows the composition of net operating revenues for our Ambulatory Care segment:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2019		2018		2019		2018
Net patient service revenues	$	490	$	471	$	1,437	$	1,440
Management fees	23		22		69		68
Revenue from other sources	9		9		20		23
Net operating revenues	$	522	$	502	$	1,526	$	1,531

The table below shows the composition of net operating revenues for our Conifer segment:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2019		2018		2019		2018
Revenue cycle services – Tenet	$	136	$	141	$	420	$	424
Revenue cycle services – other customers	175		203		542		655
Other services – Tenet	4		5		12		16
Other services – other customers	21		22		66		66
Net operating revenues	$	336	$	371	$	1,040	$	1,161

Other services represent approximately 8% of Conifer’s revenue and include value-based care services, consulting services and other client-defined projects.

Performance Obligations

The following table includes Conifer’s revenue that is expected to be recognized in the future related to performance obligations that are unsatisfied, or partially unsatisfied, at the end of the reporting period. The amounts in the table primarily consist of revenue cycle management fixed fees, which are typically recognized ratably as the performance obligation is satisfied. The estimated revenue does not include volume or contingency based contracts, performance incentives, penalties or

other variable consideration that is considered constrained. Conifer’s contract with Common Spirit, a minority interest owner of Conifer Health Solutions, LLC, represents the majority of the fixed-fee revenue related to remaining performance obligations. Conifer’s contract term with Common Spirit ends December 31, 2032.



			Three Months Ending		Years Ending								Later Years
			December 31,
	Total		2019		2020		2021		2022		2023
Performance obligations	$	7,440	$	149	$	598	$	594	$	594	$	594	$	4,911

ASSETS AND LIABILITIES HELD FOR SALE

9 Months Ended

Sep. 30, 2019

Discontinued Operation, Additional Disclosures [Abstract]

ASSETS AND LIABILITIES HELD FOR SALE

There were no assets or liabilities classified as held for sale at September 30, 2019. In the three months ended December 31, 2017, three of our hospitals in the Chicago-area, as well as other operations affiliated with the hospitals, met the criteria to be classified as held for sale. As a result, we have classified these assets totaling $107 million as “assets held for sale” in current assets and the related liabilities of $43 million as “liabilities held for sale” in current liabilities in the accompanying Condensed Consolidated Balance Sheet at December 31, 2018. These assets and liabilities, which were in our Hospital Operations and other segment until their divestiture on January 28, 2019, were recorded at the lower of their carrying amount or their fair value less estimated costs to sell. We recorded impairment charges of $17 million in the three months ended March 31, 2018 for the write-down of the assets held for sale to their estimated fair value, less estimated costs to sell, as a result of the planned divestiture of these assets.

The following table provides information on significant components of our business that have been disposed of since January 1, 2018:



	Three Months Ended September 30,						Nine Months Ended September 30,
	2019			2018			2019			2018
Significant disposals:
Income (loss) from continuing operations, before income taxes
Chicago-area (includes a $6 million loss on sale in the 2019 year-to-date period and $17 million of impairment charges in the 2018 year-to-date period)	$	—		$	(10	)	$	(11	)	$	(25	)
Philadelphia (includes a $2 million loss on sale in the 2018 year-to-date period)	—			1			1			(10		)
MacNeal (includes a $88 million gain on sale in the 2018 year-to-date period)	(1		)	(7		)	1			90
Aspen (includes $9 million of impairment charges in the 2018 year-to-date period)	—			(6		)	—			(6		)
Total	$	(1	)	$	(22	)	$	(9	)	$	49

IMPAIRMENT AND RESTRUCTURING CHARGES, AND ACQUISITION-RELATED COSTS	9 Months Ended
	Sep. 30, 2019
Restructuring Costs and Asset Impairment Charges [Abstract]
IMPAIRMENT AND RESTRUCTURING CHARGES, AND ACQUISITION-RELATED COSTS	IMPAIRMENT AND RESTRUCTURING CHARGES, AND ACQUISITION-RELATED COSTS During the nine months ended September 30, 2019, we recorded impairment and restructuring charges and acquisition-related costs of $101 million, consisting of $7 million of impairment charges, $90 million of restructuring charges and $4 million of acquisition-related costs. Restructuring charges consisted of $38 million of employee severance costs, $3 million of contract and lease termination fees, and $49 million of other restructuring costs. Acquisition-related costs consisted of $4 million of transaction costs. Our impairment charges for the nine months ended September 30, 2019 were comprised of $4 million from our Hospital Operations and other segment and $3 million from our Ambulatory Care segment. During the nine months ended September 30, 2018, we recorded impairment and restructuring charges and acquisition-related costs of $123 million, consisting of $29 million of impairment charges, $82 million of restructuring charges and $12 million of acquisition-related costs. Impairment charges consisted primarily of $17 million of charges to write-down assets held for sale to their estimated fair value, less estimated costs to sell, for certain Chicago-area facilities, $9 million of charges to write-down assets held for sale to their estimated fair value, less estimated costs to sell, for Aspen and $3 million of other impairment charges. Restructuring charges consisted of $47 million of employee severance costs, $10 million of contract and lease termination fees, and $25 million of other restructuring costs. Acquisition-related costs consisted of $8 million of transaction costs and $4 million of acquisition integration charges. Our impairment charges for the nine months ended September 30, 2018 were comprised of $20 million from our Hospital Operations and other segment and $9 million from our Ambulatory Care segment. Our impairment tests presume stable, improving or, in some cases, declining operating results in our facilities, which are based on programs and initiatives being implemented that are designed to achieve each facility’s most recent projections. If these projections are not met, or if in the future negative trends occur that impact our future outlook, impairments of long-lived assets and goodwill may occur, and we may incur additional restructuring charges, which could be material. At September 30, 2019, our continuing operations consisted of three reportable segments, Hospital Operations and other, Ambulatory Care and Conifer. Our segments are reporting units used to perform our goodwill impairment analysis. We periodically incur costs to implement restructuring efforts for specific operations, which are recorded in our consolidated statement of operations as they are incurred. Our restructuring plans focus on various aspects of operations, including aligning our operations in the most strategic and cost-effective structure. Certain restructuring and acquisition-related costs are based on estimates. Changes in estimates are recognized as they occur.

LEASES (Notes)

9 Months Ended

Sep. 30, 2019

Leases [Abstract]

LEASES

The following table presents the components of our right-of-use assets and liabilities related to leases and their classification in our Condensed Consolidated Balance Sheet at September 30, 2019:



Component of Lease Balances	Classification in Condensed Consolidated Balance Sheet	September 30, 2019
Assets:
Operating lease assets	Investments and other assets	$	913
Finance lease assets	Property and equipment, at cost, less accumulated depreciation and amortization	435
Total leased assets		$	1,348

Liabilities:
Operating lease liabilities:
Current	Other current liabilities	$	160
Long-term	Other long-term liabilities	854
Total operating lease liabilities		1,014
Finance lease liabilities:
Current	Current portion of long-term debt	139
Long-term	Long-term debt, net of current portion	201
Total finance lease liabilities		340
Total lease liabilities		$	1,354

We determine if an arrangement is a lease at inception of the contract. Our right-of-use assets represent our right to use the underlying assets for the lease term and our lease liabilities represent our obligation to make lease payments arising from the leases. Right-of-use assets and lease liabilities are recognized at commencement date based on the present value of lease payments over the lease term. We use our estimated incremental borrowing rate, which is derived from information available at the lease commencement date, in determining the present value of lease payments. For our Hospital Operations and other and Conifer segments, we estimate our incremental borrowing rates for our portfolio of leases using documented rates included in our recent equipment finance leases or, if applicable, recent secured debt issuances that correspond to various lease terms. We also give consideration to information obtained from our bankers, our secured debt fair value and publicly available data for instruments with similar characteristics. For our Ambulatory Care segment, we estimate an incremental borrowing rate for each center by utilizing historical and projected financial data, estimating a hypothetical credit rating using publicly available market data and adjusting the market data to reflect the effects of collateralization.

Our operating leases are primarily for real estate, including off-campus outpatient facilities, medical office buildings, and corporate and other administrative offices, as well as medical and office equipment. Our finance leases are primarily for medical equipment and information technology and telecommunications assets. Our real estate lease agreements typically have initial terms of five to 10 years, and our equipment lease agreements typically have initial terms of three years. We do not record leases with an initial term of 12 months or less (“short-term leases”) in our consolidated balance sheets.

Our real estate leases may include one or more options to renew, with renewals that can extend the lease term from five to 10 years. The exercise of lease renewal options is at our sole discretion. In general, we do not consider renewal options

to be reasonably likely to be exercised, therefore, renewal options are generally not recognized as part of our right-of-use assets and lease liabilities. Certain leases also include options to purchase the leased property. The useful life of assets and leasehold improvements are limited by the expected lease term, unless there is a transfer of title or purchase option reasonably certain of exercise. The majority of our medical equipment leases have terms of three years with a bargain purchase option that is reasonably certain of exercise, so these assets are depreciated over their useful life, typically ranging from five to seven years. Similarly, some of our leases of information technology and telecommunications assets include a transfer of title and, therefore, have useful lives of 15 years.

Certain of our lease agreements for real estate include payments based on actual common area maintenance expenses and others include rental payments adjusted periodically for inflation. These variable lease payments are recognized in other operating expenses, net, but are not included in the right-of-use asset or liability balances. Our lease agreements do not contain any material residual value guarantees, restrictions or covenants.

We have elected the practical expedient that allows lessees to choose to not separate lease and non-lease components by class of underlying asset and are applying this expedient to all relevant asset classes. We have also elected the practical expedient package to not reassess at adoption (i) expired or existing contracts for whether they are or contain a lease, (ii) the lease classification of any existing leases or (iii) initial indirect costs for existing leases.

The following table presents the components of our lease expense and their classification in our Condensed Consolidated Statement of Operations for the three and nine months ended September 30, 2019:



	Classification on Condensed Consolidated	Three Months Ended		Nine Months Ended
Component of Lease Expense	Statements of Operations	September 30, 2019		September 30, 2019
Operating lease expense	Other operating expenses, net	$	54	$	156
Finance lease expense:
Amortization of leased assets	Depreciation and amortization	22		63
Interest on lease liabilities	Interest expense	4		12
Total finance lease expense		26		75
Variable and short term-lease expense	Other operating expenses, net	33		100
Total lease expense		$	113	$	331

The weighted-average lease terms and discount rates for operating and finance leases are presented in the following table:



	September 30, 2019
Weighted-average remaining lease term (years)
Operating leases	7.7
Finance leases	6.0

Weighted-average discount rate
Operating leases	5.5	%
Finance leases	5.6	%

Cash flow and other information related to leases is included in the following table:



	Nine Months Ended
	September 30, 2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash outflows from operating leases	$	146
Operating cash outflows from finance leases	$	15
Financing cash outflows from finance leases	$	112

Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	208
Finance leases	$	91

Future maturities of lease liabilities at September 30, 2019 are presented in the following table:



	Operating Leases		Finance Leases		Total
2019	$	160	$	139	$	299
2020	189		137		326
2021	177		80		257
2022	157		24		181
2023	133		13		146
Later years	420		124		544
Total lease payments	1,236		517		1,753
Less: Imputed interest	222		177		399
Total lease obligations	1,014		340		1,354
Less: Current obligations	160		139		299
Long-term lease obligations	$	854	$	201	$	1,055

Future maturities of lease liabilities at December 31, 2018, prior to our adoption of ASU 2016-02, are presented in the following table:



			Years Ending December 31,										Later Years
	Total		2019		2020		2021		2022		2023		Later Years
Capital lease obligations	$	425	$	140	$	95	$	57	$	37	$	21	$	75
Long-term non-cancelable operating leases	$	932	$	171	$	151	$	133	$	113	$	92	$	272

LEASES

The following table presents the components of our right-of-use assets and liabilities related to leases and their classification in our Condensed Consolidated Balance Sheet at September 30, 2019:



Component of Lease Balances	Classification in Condensed Consolidated Balance Sheet	September 30, 2019
Assets:
Operating lease assets	Investments and other assets	$	913
Finance lease assets	Property and equipment, at cost, less accumulated depreciation and amortization	435
Total leased assets		$	1,348

Liabilities:
Operating lease liabilities:
Current	Other current liabilities	$	160
Long-term	Other long-term liabilities	854
Total operating lease liabilities		1,014
Finance lease liabilities:
Current	Current portion of long-term debt	139
Long-term	Long-term debt, net of current portion	201
Total finance lease liabilities		340
Total lease liabilities		$	1,354

We determine if an arrangement is a lease at inception of the contract. Our right-of-use assets represent our right to use the underlying assets for the lease term and our lease liabilities represent our obligation to make lease payments arising from the leases. Right-of-use assets and lease liabilities are recognized at commencement date based on the present value of lease payments over the lease term. We use our estimated incremental borrowing rate, which is derived from information available at the lease commencement date, in determining the present value of lease payments. For our Hospital Operations and other and Conifer segments, we estimate our incremental borrowing rates for our portfolio of leases using documented rates included in our recent equipment finance leases or, if applicable, recent secured debt issuances that correspond to various lease terms. We also give consideration to information obtained from our bankers, our secured debt fair value and publicly available data for instruments with similar characteristics. For our Ambulatory Care segment, we estimate an incremental borrowing rate for each center by utilizing historical and projected financial data, estimating a hypothetical credit rating using publicly available market data and adjusting the market data to reflect the effects of collateralization.

Our operating leases are primarily for real estate, including off-campus outpatient facilities, medical office buildings, and corporate and other administrative offices, as well as medical and office equipment. Our finance leases are primarily for medical equipment and information technology and telecommunications assets. Our real estate lease agreements typically have initial terms of five to 10 years, and our equipment lease agreements typically have initial terms of three years. We do not record leases with an initial term of 12 months or less (“short-term leases”) in our consolidated balance sheets.

Our real estate leases may include one or more options to renew, with renewals that can extend the lease term from five to 10 years. The exercise of lease renewal options is at our sole discretion. In general, we do not consider renewal options

to be reasonably likely to be exercised, therefore, renewal options are generally not recognized as part of our right-of-use assets and lease liabilities. Certain leases also include options to purchase the leased property. The useful life of assets and leasehold improvements are limited by the expected lease term, unless there is a transfer of title or purchase option reasonably certain of exercise. The majority of our medical equipment leases have terms of three years with a bargain purchase option that is reasonably certain of exercise, so these assets are depreciated over their useful life, typically ranging from five to seven years. Similarly, some of our leases of information technology and telecommunications assets include a transfer of title and, therefore, have useful lives of 15 years.

Certain of our lease agreements for real estate include payments based on actual common area maintenance expenses and others include rental payments adjusted periodically for inflation. These variable lease payments are recognized in other operating expenses, net, but are not included in the right-of-use asset or liability balances. Our lease agreements do not contain any material residual value guarantees, restrictions or covenants.

We have elected the practical expedient that allows lessees to choose to not separate lease and non-lease components by class of underlying asset and are applying this expedient to all relevant asset classes. We have also elected the practical expedient package to not reassess at adoption (i) expired or existing contracts for whether they are or contain a lease, (ii) the lease classification of any existing leases or (iii) initial indirect costs for existing leases.

The following table presents the components of our lease expense and their classification in our Condensed Consolidated Statement of Operations for the three and nine months ended September 30, 2019:



	Classification on Condensed Consolidated	Three Months Ended		Nine Months Ended
Component of Lease Expense	Statements of Operations	September 30, 2019		September 30, 2019
Operating lease expense	Other operating expenses, net	$	54	$	156
Finance lease expense:
Amortization of leased assets	Depreciation and amortization	22		63
Interest on lease liabilities	Interest expense	4		12
Total finance lease expense		26		75
Variable and short term-lease expense	Other operating expenses, net	33		100
Total lease expense		$	113	$	331

The weighted-average lease terms and discount rates for operating and finance leases are presented in the following table:



	September 30, 2019
Weighted-average remaining lease term (years)
Operating leases	7.7
Finance leases	6.0

Weighted-average discount rate
Operating leases	5.5	%
Finance leases	5.6	%

Cash flow and other information related to leases is included in the following table:



	Nine Months Ended
	September 30, 2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash outflows from operating leases	$	146
Operating cash outflows from finance leases	$	15
Financing cash outflows from finance leases	$	112

Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	208
Finance leases	$	91

Future maturities of lease liabilities at September 30, 2019 are presented in the following table:



	Operating Leases		Finance Leases		Total
2019	$	160	$	139	$	299
2020	189		137		326
2021	177		80		257
2022	157		24		181
2023	133		13		146
Later years	420		124		544
Total lease payments	1,236		517		1,753
Less: Imputed interest	222		177		399
Total lease obligations	1,014		340		1,354
Less: Current obligations	160		139		299
Long-term lease obligations	$	854	$	201	$	1,055

Future maturities of lease liabilities at December 31, 2018, prior to our adoption of ASU 2016-02, are presented in the following table:



			Years Ending December 31,										Later Years
	Total		2019		2020		2021		2022		2023		Later Years
Capital lease obligations	$	425	$	140	$	95	$	57	$	37	$	21	$	75
Long-term non-cancelable operating leases	$	932	$	171	$	151	$	133	$	113	$	92	$	272

LONG-TERM DEBT

9 Months Ended

Sep. 30, 2019

Long-term Debt and Lease Obligation [Abstract]

LONG-TERM DEBT

The table below shows our long-term debt at September 30, 2019 and December 31, 2018:



	September 30, 2019			December 31, 2018
Senior unsecured notes:
5.500% due 2019	$	—		$	468
6.750% due 2020	—			300
8.125% due 2022	2,800			2,800
6.750% due 2023	1,872			1,872
7.000% due 2025	478			478
6.875% due 2031	362			362
Senior secured first lien notes:
4.750% due 2020	—			500
6.000% due 2020	—			1,800
4.500% due 2021	—			850
4.375% due 2021	—			1,050
4.625% due 2024	1,870			1,870
4.625% due 2024	600			—
4.875% due 2026	2,100			—
5.125% due 2027	1,500			—
Senior secured second lien notes:
7.500% due 2022	—			750
5.125% due 2025	1,410			1,410
6.250% due 2027	1,500			—
Senior secured credit facility due 2024	275			—
Finance leases and mortgage notes	452			500
Unamortized issue costs and note discounts	(196		)	(184		)
Total long-term debt	15,023			14,826
Less current portion	165			182
Long-term debt, net of current portion	$	14,858		$	14,644

Senior Secured and Senior Unsecured Notes

On August 26, 2019, we sold $600 million aggregate principal amount of 4.625% senior secured first lien notes, which will mature on September 1, 2024 (the “2024 Senior Secured First Lien Notes”), $2.1 billion aggregate principal amount of 4.875% senior secured first lien notes, which will mature on January 1, 2026 (the “2026 Senior Secured First Lien Notes”) and $1.5 billion aggregate principal amount of 5.125% senior secured first lien notes, which will mature on November 1, 2027 (the “2027 Senior Secured First Lien Notes”). We will pay interest on the 2024 Senior Secured First Lien Notes semi-annually in arrears on March 1 and September 1 of each year, which payments will commence on March 1, 2020. We will pay interest on the 2026 Senior Secured First Lien Notes semi-annually in arrears on January 1 and July 1 of each year, which payments will commence on January 1, 2020. We will pay interest on the 2027 Senior Secured First Lien Notes semi-annually in arrears on May 1 and November 1 of each year, which payments will commence on May 1, 2020. The proceeds from the sales of these notes were used, after payment of fees and expenses, together with cash on hand and borrowings under our senior secured revolving credit facility, to fund the redemptions of all $500 million aggregate principal amount of our outstanding 4.750% senior secured first lien notes due 2020, all $1.8 billion aggregate principal amount of our outstanding 6.000% senior secured first lien notes due 2020, all $850 million aggregate principal amount of our outstanding 4.500% senior secured first lien notes due 2021 and all $1.05 billion aggregate principal amount of our outstanding 4.375% senior secured first lien notes due 2021. In connection with the redemptions, we recorded a loss from early extinguishment of debt of approximately $180 million in the three months ended September 30, 2019, primarily related to the difference between the redemption prices and the par values of the notes, as well as the write-off of the associated unamortized issuance costs.

On February 5, 2019, we sold $1.5 billion aggregate principal amount of 6.250% senior secured second lien notes, which will mature on February 1, 2027 (the “2027 Senior Secured Second Lien Notes”). We will pay interest on the 2027 Senior Secured Second Lien Notes semi-annually in arrears on February 1 and August 1 of each year, which payments commenced on August 1, 2019. The proceeds from the sale of the 2027 Senior Secured Second Lien Notes were used, after payment of fees and expenses, together with cash on hand and borrowings under our senior secured revolving credit facility, to fund the redemption of all $300 million aggregate principal amount of our outstanding 6.750% senior notes due 2020 and all $750 million aggregate principal amount of our outstanding 7.500% senior secured second lien notes due 2022, as well as the repayment upon maturity of all $468 million aggregate principal amount of our outstanding 5.500% senior unsecured notes due March 1, 2019. In connection with the redemptions, we recorded a loss from early extinguishment of debt of approximately $47 million in the three months ended March 31, 2019, primarily related to the difference between the redemption prices and the par values of the notes, as well as the write-off of the associated unamortized issuance costs.

Credit Agreement

We amended our senior secured revolving credit facility in September 2019 (as amended, the “Credit Agreement”) to provide, subject to borrowing availability, for revolving loans in an aggregate principal amount of up to $1.5 billion (from a previous limit of $1.0 billion), with a $200 million subfacility for standby letters of credit. Obligations under the Credit Agreement, which now has a scheduled maturity date of September 12, 2024, are guaranteed by substantially all of our domestic wholly owned hospital subsidiaries and are secured by a first-priority lien on the eligible inventory and accounts receivable owned by us and the subsidiary guarantors, including receivables for Medicaid supplemental payments as of the most recent amendment. Outstanding revolving loans accrue interest at a base rate plus a margin ranging from 0.25% to 0.75% per annum or the London Interbank Offered Rate plus a margin ranging from 1.25% to 1.75% per annum, in each case based on available credit. An unused commitment fee payable on the undrawn portion of the revolving loans ranges from 0.25% to 0.375% per annum based on available credit. Our borrowing availability is based on a specified percentage of eligible inventory and accounts receivable, including self-pay accounts. At September 30, 2019, we had $275 million of cash borrowings outstanding under the Credit Agreement subject to a weighted average interest rate of 3.45%, and we had $1 million of standby letters of credit outstanding. Based on our eligible receivables, $1.2 billion was available for borrowing under the Credit Agreement at September 30, 2019.

Letter of Credit Facility

We have a letter of credit facility (as amended, the “LC Facility”) that provides for the issuance of standby and documentary letters of credit, from time to time, in an aggregate principal amount of up to $180 million (subject to increase to up to $200 million). The maturity date of the LC Facility is March 7, 2021. Obligations under the LC Facility are guaranteed and secured by a first-priority pledge of the capital stock and other ownership interests of certain of our wholly owned domestic hospital subsidiaries on an equal ranking basis with our senior secured first lien notes.

Drawings under any letter of credit issued under the LC Facility that we have not reimbursed within three business days after notice thereof accrue interest at a base rate plus a margin equal to 0.50% per annum. An unused commitment fee is

payable at an initial rate of 0.25% per annum with a step up to 0.375% per annum should our secured-debt-to-EBITDA ratio equal or exceed 3.00 to 1.00 at the end of any fiscal quarter. A fee on the aggregate outstanding amount of issued but undrawn letters of credit accrues at a rate of 1.50% per annum. An issuance fee equal to 0.125% per annum of the aggregate face amount of each outstanding letter of credit is payable to the account of the issuer of the related letter of credit. At September 30, 2019, we had $92 million of standby letters of credit outstanding under the LC Facility.

GUARANTEES	9 Months Ended
GUARANTEES	Sep. 30, 2019
Guarantees [Abstract]
GUARANTEES	GUARANTEES At September 30, 2019, the maximum potential amount of future payments under our income guarantees to certain physicians who agree to relocate and revenue collection guarantees to hospital-based physician groups providing certain services at our hospitals was $143 million. We had a total liability of $122 million recorded for these guarantees included in other current liabilities at September 30, 2019. At September 30, 2019, we also had issued guarantees of the indebtedness and other obligations of our investees to third parties, the maximum potential amount of future payments under which was approximately $25 million. Of the total, $8 million relates to the obligations of consolidated subsidiaries, which obligations are recorded in the accompanying Condensed Consolidated Balance Sheet at September 30, 2019.

EMPLOYEE BENEFIT PLANS

9 Months Ended

Sep. 30, 2019

Defined Benefit Plan [Abstract]

EMPLOYEE BENEFIT PLANS

Share-Based Compensation Plans

In recent years, we have granted options and restricted stock units to certain of our employees and directors pursuant to our stock incentive plans. Options have an exercise price equal to the fair market value of the shares on the date of grant and generally expire 10 years from the date of grant. A restricted stock unit is a contractual right to receive one share of our common stock in the future. Typically, options and time-based restricted stock units vest one-third on each of the first three anniversary dates of the grant; however, certain special retention awards may have different vesting terms. In addition, we grant performance-based options and performance-based restricted stock units that vest subject to the achievement of specified performance goals within a specified time frame. At September 30, 2019, assuming outstanding performance-based restricted stock units and options for which performance has not yet been determined will achieve target performance, approximately 8.0 million shares of common stock were available under our 2019 Stock Incentive Plan for future stock option grants and other equity incentive awards, including restricted stock units (approximately 7.9 million shares remain available if we assume maximum performance for outstanding performance-based restricted stock units and options for which performance has not yet been determined).

The accompanying Condensed Consolidated Statements of Operations for both the nine months ended September 30, 2019 and 2018 include $34 million of pre-tax compensation costs related to our stock-based compensation arrangements.

Stock Options

The following table summarizes stock option activity during the nine months ended September 30, 2019:



	Options		Weighted Average Exercise Price Per Share		Aggregate Intrinsic Value		Weighted Average Remaining Life
					(In Millions)
Outstanding at December 31, 2018	2,262,743		$	19.12
Granted	230,713		28.28
Exercised	(76,159	)	4.56
Forfeited/Expired	(203,256	)	19.66
Outstanding at September 30, 2019	2,214,041		$	20.53	$	6	6.0 years
Vested and expected to vest at September 30, 2019	2,214,041		$	20.53	$	6	6.0 years
Exercisable at September 30, 2019	684,628		$	19.03	$	2	2.8 years

There were 76,159 and 612,074 stock options exercised during the nine months ended September 30, 2019 and 2018, respectively, with aggregate intrinsic values of approximately $1 million and $4 million, respectively.

At September 30, 2019, there were $5 million of total unrecognized compensation costs related to stock options. These costs are expected to be recognized over a weighted average period of 1.7 years.

On March 29, 2019, we granted an aggregate of 7,862 performance-based stock options to a new senior officer. The options will all vest on the third anniversary of the grant date, subject to the achievement of a closing stock price of at least $36.05 (a 25% premium above the March 29, 2019 grant-date closing stock price of $28.84) for at least 20 consecutive trading days within three years of the grant date, and will expire on the tenth anniversary of the grant date. On February 27, 2019, we granted to certain of our senior officers an aggregate of 222,851 performance-based stock options. The options will all vest on the third anniversary of the grant date, subject to the achievement of a closing stock price of at least $35.33 (a 25% premium above the February 27, 2019 grant-date closing stock price of $28.26) for at least 20 consecutive trading days within three years of the grant date, and will expire on the tenth anniversary of the grant date.

In the three months ended June 30, 2018, we granted new senior officers 31,184 performance-based stock options. The options will all vest on the third anniversary of the grant date, subject to achieving a closing stock price of at least $44.29 (a 25% premium above the May 31, 2018 grant-date closing stock price of $35.43) for at least 20 consecutive trading days within three years of the grant date, and will expire on the tenth anniversary of the grant date. In the three months ended March 31, 2018, we granted to certain of our senior officers an aggregate of 604,012 performance-based stock options. The stock options will all vest on the third anniversary of the grant date because, in the three months ended June 30, 2018, the requirement that our stock close at a price of at least $25.75 (a 25% premium above the February 28, 2018 grant-date closing stock price of $20.60) for at least 20 consecutive trading days within three years of the grant date was met; these options will expire on the tenth anniversary of the grant date.

The weighted average estimated fair value of stock options we granted in the nine months ended September 30, 2019 and 2018 was $12.50 and $9.16 per share, respectively. These fair values were calculated based on each grant date, using a Monte Carlo simulation with the following assumptions:



	February 27, 2019	February 28, 2018
Expected volatility	48%	46%
Expected dividend yield	0%	0%
Expected life	6.2 years	6.2 years
Expected forfeiture rate	0%	0%
Risk-free interest rate	2.53%	2.72%

The expected volatility used for the 2019 and 2018 Monte Carlo simulations incorporates historical volatility based on an analysis of historical prices of our stock. The expected volatility reflects the historical volatility for a duration consistent with the expected life of the options; it does not consider the implied volatility from open-market exchanged options due to the limited trading activity and the transient nature of factors impacting our stock price volatility. The historical share-price volatility for 2019 and 2018 excludes the movements in our stock price for the period from August 15, 2017 through November 30, 2017 due to impact that the announcement of the departure of certain board members and officers, as well as reports that we were exploring a potential sale of the company, had on our stock price during that time. The risk-free interest rates are based on zero-coupon United States Treasury yields in effect at the date of grant consistent with the expected exercise time frames.

The following table summarizes information about our outstanding stock options at September 30, 2019:



	Options Outstanding				Options Exercisable
Range of Exercise Prices	Number of Options	Weighted Average Remaining Contractual Life	Weighted Average Exercise Price		Number of Options	Weighted Average Exercise Price
$16.43 to $19.759	1,229,723	5.4 years	$	18.14	413,960	$	16.46
$19.76 to $35.430	984,318	6.7 years	23.51		270,668	22.94
	2,214,041	6.0 years	$	20.53	684,628	$	19.03

Restricted Stock Units

The following table summarizes restricted stock unit activity during the nine months ended September 30, 2019:



	Restricted Stock Units		Weighted Average Grant Date Fair Value Per Unit
Unvested at December 31, 2018	1,884,130		$	32.25
Granted	1,460,753		27.85
Vested	(1,425,660	)	37.49
Forfeited	(329,926	)	24.71
Unvested at September 30, 2019	1,589,297		$	25.07

In the nine months ended September 30, 2019, we granted an aggregate of 1,460,753 restricted stock units. Of these, 337,848 will vest and be settled ratably over a three-year period from the grant date, 566,172 will vest and be settled ratably over a 27 month period from the grant date, and 340,931 will vest and be settled on the third anniversary of the grant date. In addition, in May 2019, we made an annual grant of 100,444 restricted stock units to our non-employee directors for the 2019-2020 board service year, which units vested immediately and will settle in shares of our common stock on the third anniversary of the date of the grant. Because the board of directors appointed one new member in August 2019, we made an initial grant totaling 3,003 restricted stock units to the director, as well as a prorated annual grant totaling 7,978 restricted stock units. Both the initial grant and the annual grant vested immediately, however, the initial grant settles upon separation from the board, while the annual grant settles on the third anniversary of the grant date. We also granted 7,427 additional restricted stock units that vested and settled immediately as a result of our level of achievement with respect to a performance goal on a 2013 grant and 96,950 additional restricted stock units as a result of our level of achievement with respect to a performance goal on a 2014 grant.

In the nine months ended September 30, 2018, we granted an aggregate of 734,091 restricted stock units. Of these, 288,325 will vest and be settled ratably over a three-year period from the grant date, 339,806 will vest and be settled ratably over a two-year period from the grant date, and 29,870 will vest and be settled on the third anniversary of the grant date. In addition, in May 2018, we made an annual grant of 54,198 restricted stock units to our non-employee directors for the 2018-2019 board service year, which units vested immediately and will settle in shares of our common stock on the third anniversary of the date of the grant. Because the board of directors appointed two new members in May 2018, we made initial grants totaling 3,670 restricted stock units to these directors, as well as prorated annual grants totaling 12,154 restricted stock units. Both the initial grants and the annual grants vested immediately, however, the initial grants will not settle until the directors’ separation from the board, while the annual grants settle on the third anniversary of the grant date. In addition, we granted 6,068 performance-based restricted stock units to certain of our senior officers; the vesting of these restricted stock units is contingent on our achievement of specified performance goals for the years 2018 to 2020. Provided the goals are achieved, the performance-based restricted stock units will vest and settle on the third anniversary of the grant date. The actual number of performance-based restricted stock units that could vest will range from 0% to 200% of the 6,068 units granted, depending on our level of achievement with respect to the performance goals.

At September 30, 2019, there were $30 million of total unrecognized compensation costs related to restricted stock units. These costs are expected to be recognized over a weighted average period of 1.8 years.

Employee Retirement Plans

In the nine months ended September 30, 2019 and 2018, we recognized (i) service cost related to one of our frozen nonqualified defined benefit pension plans of less than $1 million and approximately $2 million, respectively, in salaries, wages and benefits expense, and (ii) other components of net periodic pension cost and net periodic postretirement benefit cost related to our frozen qualified and nonqualified defined benefit plans of $16 million and $12 million, respectively, in other non-operating expense, net, in the accompanying Condensed Consolidated Statements of Operations.

EQUITY

9 Months Ended

Sep. 30, 2019

Stockholders' Equity Note [Abstract]

EQUITY

Changes in Shareholders’ Equity

The following tables show the changes in consolidated equity during the nine months ended September 30, 2019 and 2018 (dollars in millions, share amounts in thousands):



	Common Stock			Additional Paid-In Capital			Accumulated Other Comprehensive Loss			Accumulated Deficit			Treasury Stock			Noncontrolling Interests			Total Equity
	Shares Outstanding	Issued Par Amount		Additional Paid-In Capital			Accumulated Other Comprehensive Loss			Accumulated Deficit			Treasury Stock			Noncontrolling Interests			Total Equity
Balances at December 31, 2018	102,537	$	7	$	4,747		$	(223	)	$	(2,236	)	$	(2,414	)	$	806		$	687
Net income (loss)	—	—		—			—			(19		)	—			37			18
Distributions paid to noncontrolling interests	—	—		—			—			—			—			(37		)	(37		)
Other comprehensive income	—	—		—			2			—			—			—			2
Accretion of redeemable noncontrolling interests	—	—		(5		)	—			—			—			—			(5		)
Purchases (sales) of businesses and noncontrolling interests	—	—		(2		)	—			—			—			2			—
Cumulative effect of accounting change	—	—		—			—			1			—			—			1
Stock-based compensation expense, tax benefit and issuance of common stock	543	—		8			—			—			—			—			8
Balances at March 31, 2019	103,080	$	7	$	4,748		$	(221	)	$	(2,254	)	$	(2,414	)	$	808		$	674
Net income	—	—		—			—			17			—			47			64
Distributions paid to noncontrolling interests	—	—		—			—			—			—			(35		)	(35		)
Other comprehensive income	—	—		—			2			—			—			—			2
Accretion of redeemable noncontrolling interests	—	—		(4		)	—			—			—			—			(4		)
Purchases of businesses and noncontrolling interests	—	—		—			—			—			—			5			5
Stock-based compensation expense, tax benefit and issuance of common stock	256	—		11			—			—			—			—			11
Balances at June 30, 2019	103,336	$	7	$	4,755		$	(219	)	$	(2,237	)	$	(2,414	)	$	825		$	717
Net income (loss)	—	—		—			—			(232		)	—			45			(187		)
Distributions paid to noncontrolling interests	—	—		—			—			—			—			(46		)	(46		)
Other comprehensive income	—	—		—			3			—			—			—			3
Accretion of redeemable noncontrolling interests	—	—		(4		)	—			—			—			—			(4		)
Purchases (sales) of businesses and noncontrolling interests	—	—		(5		)	—			—			—			6			1
Stock-based compensation expense, tax benefit and issuance of common stock	436	—		5			—			—			—			—			5
Balances at September 30, 2019	103,772	$	7	$	4,751		$	(216	)	$	(2,469	)	$	(2,414	)	$	830		$	489



	Common Stock			Additional Paid-In Capital			Accumulated Other Comprehensive Loss			Accumulated Deficit			Treasury Stock			Noncontrolling Interests			Total Equity
	Shares Outstanding	Issued Par Amount		Additional Paid-In Capital			Accumulated Other Comprehensive Loss			Accumulated Deficit			Treasury Stock			Noncontrolling Interests			Total Equity
Balances at December 31, 2017	100,972	$	7	$	4,859		$	(204	)	$	(2,390	)	$	(2,419	)	$	686		$	539
Net income	—	—		—			—			99			—			31			130
Distributions paid to noncontrolling interests	—	—		—			—			—			—			(34		)	(34		)
Other comprehensive income	—	—		—			8			—			—			—			8
Accretion of redeemable noncontrolling interests	—	—		(37		)	—			—			—			—			(37		)
Sales of businesses and noncontrolling interests	—	—		(4		)	—			—			—			(2		)	(6		)
Cumulative effect of accounting change	—	—		—			(43		)	43			—			—			—
Stock-based compensation expense, tax benefit and issuance of common stock	1,017	—		15			—			—			1			—			16
Balances at March 31, 2018	101,989	$	7	$	4,833		$	(239	)	$	(2,248	)	$	(2,418	)	$	681		$	616
Net income	—	—		—			—			26			—			42			68
Distributions paid to noncontrolling interests	—	—		—			—			—			—			(38		)	(38		)
Other comprehensive loss	—	—		—			(4		)	—			—			—			(4		)
Accretion of redeemable noncontrolling interests	—	—		(123		)	—			—			—			—			(123		)
Purchases (sales) of businesses and noncontrolling interests	—	—		(2		)	—			—			—			45			43
Stock-based compensation expense, tax benefit and issuance of common stock	312	—		14			—			—			—			—			14
Balances at June 30, 2018	102,301	$	7	$	4,722		$	(243	)	$	(2,222	)	$	(2,418	)	$	730		$	576
Net income (loss)	—	—		—			—			(9		)	—			40			31
Distributions paid to noncontrolling interests	—	—		—			—			—			—			(40		)	(40		)
Other comprehensive income	—	—		—			41			—			—			—			41
Accretion of redeemable noncontrolling interests	—	—		(6		)	—			—			—			—			(6		)
Purchases of businesses and noncontrolling interests	—	—		3			—			—			—			36			39
Stock-based compensation expense, tax benefit and issuance of common stock	146	—		14			—			—			3			—			17
Balances at September 30, 2018	102,447	$	7	$	4,733		$	(202	)	$	(2,231	)	$	(2,415	)	$	766		$	658

Our noncontrolling interests balances at September 30, 2019 and December 31, 2018 were comprised of $114 million and $112 million, respectively, from our Hospital Operations and other segment, and $716 million and $694 million, respectively, from our Ambulatory Care segment. Our net income available to noncontrolling interests for the nine months ended September 30, 2019 and 2018 in the table above were comprised of $10 million and $6 million, respectively, from our Hospital Operations and other segment, and $119 million and $107 million, respectively, from our Ambulatory Care segment.

NET OPERATING REVENUES

9 Months Ended

Sep. 30, 2019

Revenue from Contract with Customer [Abstract]

NET OPERATING REVENUES

CONTRACT BALANCES

Hospital Operations and Other Segment

Amounts related to services provided to patients for which we have not billed and that do not meet the conditions of unconditional right to payment at the end of the reporting period are contract assets. For our Hospital Operations and other segment, our contract assets consist primarily of services that we have provided to patients who are still receiving inpatient care in our facilities at the end of the reporting period. Our Hospital Operations and other segment’s contract assets are included in other current assets in the accompanying Condensed Consolidated Balance Sheet at September 30, 2019. The opening and closing balances of contract assets for our Hospital Operations and other segment are as follows:



December 31, 2018	$	169
September 30, 2019	163
Increase/(decrease)	$	(6	)



January 1, 2018	$	171
September 30, 2018	152
Increase/(decrease)	$	(19	)

Approximately 89% of our Hospital Operations and other segment’s contract assets meet the conditions for unconditional right to payment and are reclassified to patient receivables within 90 days.

Conifer Segment

Conifer enters into contracts with customers to sell revenue cycle management and other services, such as value-based care, consulting and project services. The payment terms and conditions in our customer contracts vary. In some cases, customers are invoiced in advance and (for other than fixed-price fee arrangements) a true-up to the actual fee is included on a subsequent invoice. In other cases, payment is due in arrears. In addition, some contracts contain performance incentives, penalties and other forms of variable consideration. When the timing of Conifer’s delivery of services is different from the timing of payments made by the customers, Conifer recognizes either unbilled revenue (performance precedes contractual right to invoice the customer) or deferred revenue (customer payment precedes Conifer service performance). In the following table, customers that prepay prior to obtaining control/benefit of the service are represented by deferred contract revenue until the performance obligations are satisfied. Unbilled revenue represents arrangements in which Conifer has provided services to and the customer has obtained control/benefit of services prior to the contractual invoice date. Contracts with payment in arrears are recognized as receivables in the month the service is performed.

The opening and closing balances of Conifer’s receivables, contract asset, and current and long-term contract liabilities are as follows:



					Contract Liability-			Contract Liability-
			Contract Asset-		Current			Long-Term
	Receivables		Unbilled Revenue		Deferred Revenue			Deferred Revenue
December 31, 2018	$	42	$	11	$	61		$	20
September 30, 2019	86		11		72			19
Increase/(decrease)	$	44	$	—	$	11		$	(1	)

January 1, 2018	$	89	$	10	$	80		$	21
September 30, 2018	89		11		74			21
Increase/(decrease)	$	—	$	1	$	(6	)	$	—

The difference between the opening and closing balances of Conifer’s contract assets and contract liabilities are primarily related to prepayments for those customers who are billed in advance, changes in estimates related to metric-based services, and up-front integration services that are typically not distinct and are, therefore, recognized over the performance obligation period to which they relate. Our Conifer segment’s receivables and contract assets are reported as part of other current assets in our accompanying Condensed Consolidated Balance Sheets, and our Conifer segment’s current and long-term contract liabilities are reported as part of other current liabilities and other long-term liabilities, respectively, in our accompanying Condensed Consolidated Balance Sheets.

The amount of revenue Conifer recognized in the nine months ended September 30, 2019 and 2018 that was included in the opening current deferred revenue liability was $57 million and $68 million, respectively. This revenue consists primarily of prepayments for those customers who are billed in advance, changes in estimates related to metric-based services, and up-front integration services that are recognized over the services period.

Contract Costs

We have elected to apply the practical expedient provided by FASB Accounting Standards Codification 340-40-25-4 and expense as incurred the incremental customer contract acquisition costs for contracts in which the amortization period of the asset is one year or less. However, incremental costs incurred to obtain and fulfill customer contracts for which the amortization period of the asset is longer than one year, which consist primarily of Conifer deferred contract setup costs, are capitalized and amortized on a straight-line basis over the lesser of their estimated useful lives or the term of the related contract. During the three months ended September 30, 2019 and 2018, we recognized amortization expense of $2 million and $3 million, respectively. During the nine months ended September 30, 2019 and 2018, we recognized amortization expense of $4 million and $9 million, respectively. At September 30, 2019 and December 31, 2018, the unamortized customer contract costs were $26 million and $28 million, respectively, and are presented as part of investments and other assets in the accompanying Condensed Consolidated Balance Sheets.NET OPERATING REVENUES

Net operating revenues for our Hospital Operations and other and Ambulatory Care segments primarily consist of net patient service revenues, principally for patients covered by Medicare, Medicaid, managed care and other health plans, as well as certain uninsured patients under our Compact and other uninsured discount and charity programs. Net operating revenues for our Conifer segment primarily consist of revenues from providing revenue cycle management services to healthcare systems, as well as individual hospitals, physician practices, self-insured organizations, health plans and other entities.

The table below shows our sources of net operating revenues from continuing operations:



	Three Months Ended September 30,						Nine Months Ended September 30,
	2019			2018			2019			2018
Hospital Operations and other:
Net patient service revenues from hospitals and related outpatient facilities
Medicare	$	697		$	681		$	2,176		$	2,164
Medicaid	284			336			914			971
Managed care	2,357			2,228			7,041			6,869
Uninsured	44			33			56			78
Indemnity and other	184			156			508			438
Total	3,566			3,434			10,695			10,520
Other revenues(1)	284			328			844			922
Hospital Operations and other total prior to inter-segment eliminations	3,850			3,762			11,539			11,442
Ambulatory Care	522			502			1,526			1,531
Conifer	336			371			1,040			1,161
Inter-segment eliminations	(140		)	(146		)	(432		)	(440		)
Net operating revenues	$	4,568		$	4,489		$	13,673		$	13,694




(1)	Primarily physician practices revenues.

Adjustments for prior-year cost reports and related valuation allowances, principally related to Medicare and Medicaid, increased revenues in the nine months ended September 30, 2019 and 2018 by $24 million and $11 million, respectively. Estimated cost report settlements and valuation allowances are included in accounts receivable in the accompanying Condensed Consolidated Balance Sheets (see Note 2). We believe that we have made adequate provision for any adjustments that may result from final determination of amounts earned under all the above arrangements with Medicare and Medicaid.

The table below shows the composition of net operating revenues for our Ambulatory Care segment:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2019		2018		2019		2018
Net patient service revenues	$	490	$	471	$	1,437	$	1,440
Management fees	23		22		69		68
Revenue from other sources	9		9		20		23
Net operating revenues	$	522	$	502	$	1,526	$	1,531

The table below shows the composition of net operating revenues for our Conifer segment:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2019		2018		2019		2018
Revenue cycle services – Tenet	$	136	$	141	$	420	$	424
Revenue cycle services – other customers	175		203		542		655
Other services – Tenet	4		5		12		16
Other services – other customers	21		22		66		66
Net operating revenues	$	336	$	371	$	1,040	$	1,161

Other services represent approximately 8% of Conifer’s revenue and include value-based care services, consulting services and other client-defined projects.

Performance Obligations

The following table includes Conifer’s revenue that is expected to be recognized in the future related to performance obligations that are unsatisfied, or partially unsatisfied, at the end of the reporting period. The amounts in the table primarily consist of revenue cycle management fixed fees, which are typically recognized ratably as the performance obligation is satisfied. The estimated revenue does not include volume or contingency based contracts, performance incentives, penalties or

other variable consideration that is considered constrained. Conifer’s contract with Common Spirit, a minority interest owner of Conifer Health Solutions, LLC, represents the majority of the fixed-fee revenue related to remaining performance obligations. Conifer’s contract term with Common Spirit ends December 31, 2032.



			Three Months Ending		Years Ending								Later Years
			December 31,
	Total		2019		2020		2021		2022		2023
Performance obligations	$	7,440	$	149	$	598	$	594	$	594	$	594	$	4,911

PROPERTY AND PROFESSIONAL AND GENERAL LIABILITY INSURANCE	9 Months Ended
	Sep. 30, 2019
Property and Professional and General Liablity Insurance [Abstract]
PROPERTY AND PROFESSIONAL AND GENERAL LIABILITY INSURANCE	PROPERTY AND PROFESSIONAL AND GENERAL LIABILITY INSURANCE Property Insurance We have property, business interruption and related insurance coverage to mitigate the financial impact of catastrophic events or perils that is subject to deductible provisions based on the terms of the policies. These policies are on an occurrence basis. For the policy period April 1, 2019 through March 31, 2020, we have coverage totaling $850 million per occurrence, after deductibles and exclusions, with annual aggregate sub-limits of $100 million for floods, $200 million for earthquakes and a per-occurrence sub-limit of $200 million for named windstorms with no annual aggregate. With respect to fires and other perils, excluding floods, earthquakes and named windstorms, the total $850 million limit of coverage per occurrence applies. Deductibles are 5% of insured values up to a maximum of $40 million for California earthquakes, $25 million for floods and named windstorms, and 2% of insured values for New Madrid fault earthquakes, with a maximum per claim deductible of $25 million. Floods and certain other covered losses, including fires and other perils, have a minimum deductible of $1 million. Professional and General Liability Reserves We are self-insured for the majority of our professional and general liability claims and purchase insurance from third-parties to cover catastrophic claims. At September 30, 2019 and December 31, 2018, the aggregate current and long-term professional and general liability reserves in the accompanying Condensed Consolidated Balance Sheets were $901 million and $882 million, respectively. These reserves include the reserves recorded by our captive insurance subsidiaries and our self-insured retention reserves recorded based on modeled estimates for the portion of our professional and general liability risks, including incurred but not reported claims, for which we do not have insurance coverage. We estimated the reserves for losses and related expenses using expected loss-reporting patterns discounted to their present value under a risk-free rate approach using a Federal Reserve seven-year maturity rate of 1.62% at September 30, 2019 and 2.59% at December 31, 2018. If the aggregate limit of any of our professional and general liability policies is exhausted, in whole or in part, it could deplete or reduce the limits available to pay any other material claims applicable to that policy period. Included in other operating expenses, net, in the accompanying Condensed Consolidated Statements of Operations is malpractice expense of $295 million and $267 million for the nine months ended September 30, 2019 and 2018, respectively.

CLAIMS AND LAWSUITS

9 Months Ended

Sep. 30, 2019

Commitments and Contingencies Disclosure [Abstract]

CLAIMS AND LAWSUITS

We operate in a highly regulated and litigious industry. Healthcare companies are subject to numerous investigations by various governmental agencies. Further, private parties have the right to bring qui tam or “whistleblower” lawsuits against companies that allegedly submit false claims for payments to, or improperly retain overpayments from, the government and, in some states, private payers. We and our subsidiaries have received inquiries in recent years from government agencies, and we may receive similar inquiries in future periods. We are also subject to class action lawsuits, employment-related claims and other legal actions in the ordinary course of business. Some of these actions may involve large demands, as well as substantial defense costs. We cannot predict the outcome of current or future legal actions against us or the effect that judgments or settlements in such matters may have on us.

We are also subject to a non-prosecution agreement (“NPA”), as described in our Annual Report. If we fail to comply with this agreement, we could be subject to criminal prosecution, substantial penalties and exclusion from participation in federal healthcare programs, any of which could adversely impact our business, financial condition, results of operations or cash flows.

We record accruals for estimated losses relating to claims and lawsuits when available information indicates that a loss is probable and we can reasonably estimate the amount of the loss or a range of loss. Significant judgment is required in both the determination of the probability of a loss and the determination as to whether a loss is reasonably estimable. These determinations are updated at least quarterly and are adjusted to reflect the effects of negotiations, settlements, rulings, advice of legal counsel and technical experts, and other information and events pertaining to a particular matter, but are subject to significant uncertainty regarding numerous factors that could affect the ultimate loss levels. If a loss on a material matter is reasonably possible and estimable, we disclose an estimate of the loss or a range of loss. In cases where we have not disclosed an estimate, we have concluded that the loss is either not reasonably possible or the loss, or a range of loss, is not reasonably estimable, based on available information. Given the inherent uncertainties involved in these matters, especially those involving governmental agencies, and the indeterminate damages sought in some of these matters, there is significant uncertainty as to the ultimate liability we may incur from these matters, and an adverse outcome in one or more of these matters could be material to our results of operations or cash flows for any particular reporting period.

Shareholder Derivative Litigation

In January 2017, the Dallas County District Court consolidated two previously disclosed shareholder derivative lawsuits filed on behalf of the Company by purported shareholders of the Company’s common stock against current and former officers and directors into a single matter captioned In re Tenet Healthcare Corporation Shareholder Derivative Litigation. The plaintiffs filed a consolidated shareholder derivative petition in February 2017. The consolidated shareholder derivative petition alleged that false or misleading statements or omissions concerning the Company’s financial performance and compliance policies, specifically with respect to the previously disclosed civil qui tam litigation and parallel criminal investigation of the Company and certain of its subsidiaries (together, the “Clinica de la Mama matters”), caused the price of the Company’s common stock to be artificially inflated. In addition, the plaintiffs alleged that the defendants violated GAAP by failing to disclose an estimate of the possible loss or a range of loss related to the Clinica de la Mama matters. The plaintiffs claimed that they did not make demand on the Company’s board of directors to bring the lawsuit because such a demand would have been futile. In May 2018, the judge in the consolidated shareholder derivative litigation entered an order lifting the previous year-long stay of the matter and, in July 2018, the defendants filed pleadings seeking dismissal of the lawsuit. In October 2018, the judge granted defendants’ motion to dismiss, but also agreed to give the plaintiffs 30 days to replead their complaint. In January 2019, the court issued a final judgment and order of dismissal after the plaintiffs elected not to replead. In February 2019, the plaintiffs filed an appeal of the court’s ruling that dismissal was appropriate because the plaintiffs failed to adequately plead that a pre-suit demand on the Company’s board of directors, a precondition to their action, should be excused as futile. The parties’ appellate briefs have been filed, and we expect oral arguments to be held before the end of 2019 or early in 2020. The defendants intend to continue to vigorously contest the plaintiffs’ allegations in this matter.

Antitrust Class Action Lawsuit Filed by Registered Nurses in San Antonio

In Maderazo, et al. v. VHS San Antonio Partners, L.P. d/b/a Baptist Health Systems, et al., filed in June 2006 in the U.S. District Court for the Western District of Texas, a purported class of registered nurses employed by three unaffiliated San Antonio-area hospital systems alleged those hospital systems, including our Baptist Health System, and other unidentified San Antonio regional hospitals violated Section §1 of the federal Sherman Act by conspiring to depress nurses’ compensation and exchanging compensation-related information among themselves in a manner that reduced competition and suppressed the wages paid to such nurses. The suit sought unspecified damages (subject to trebling under federal law), interest, costs and attorneys’ fees. In January 2019, the district court issued an opinion denying the plaintiffs’ motion for class certification. The plaintiffs’ subsequent appeal of the district court’s decision to the U.S. Court of Appeals for the Fifth Circuit was denied in March 2019. In April 2019, the appellate court denied the plaintiffs’ request for additional review of the district court’s ruling, and we learned in August 2019 that the plaintiffs did not request further review by the U.S. Supreme Court. The plaintiffs are now proceeding on behalf of the three named individuals. We will continue to vigorously defend against the plaintiffs’ allegations.

Government Investigation of Detroit Medical Center

Detroit Medical Center (“DMC”) is subject to an ongoing investigation by the U.S. Attorney’s Office for the Eastern District of Michigan and the U.S. Department of Justice (“DOJ”) for potential violations of the Stark law, the Medicare and Medicaid anti-kickback and anti-fraud and abuse amendments codified under Section 1128B(b) of the Social Security Act (the “Anti-kickback Statute”), and the federal False Claims Act (“FCA”) related to DMC’s employment of nurse practitioners and physician assistants (“Mid-Level Practitioners”) from 2006 through 2017. As previously disclosed, a media report was published in August 2017 alleging that 14 Mid-Level Practitioners were terminated by DMC earlier in 2017 due to compliance concerns. We are cooperating with the investigation and continue to produce documents on a schedule agreed upon with the

DOJ. Because the government’s review is in its preliminary stages, we are unable to determine the potential exposure, if any, at this time.

Oklahoma Surgical Hospital Qui Tam Action

In May 2016, a relator filed a qui tam lawsuit under seal in the Western District of Oklahoma against, among other parties, (i) Oklahoma Center for Orthopaedic & Multispecialty Surgery (“OCOM”), a surgical hospital jointly owned by USPI, a healthcare system partner and physicians, (ii) Southwest Orthopaedic Specialists, an independent physician practice group, (iii) Tenet, and (iv) other related entities and individuals. The complaint alleges various violations of the FCA, the Anti-kickback Statute, the Stark law and the Oklahoma Medicaid False Claims Act. In May 2018, Tenet and its affiliates learned that they were parties to the suit when the court unsealed the complaint and the DOJ declined to intervene with respect to the issues involving Tenet, USPI, OCOM and individually named employees. In June 2018, the relator filed an amended complaint more fully describing the claims and adding additional defendants. Tenet, USPI, OCOM and individually named employees filed motions to dismiss the case in October 2018, but the court has not yet ruled on the motions. The litigation is currently stayed until December 2019 while the parties work to finalize the resolution described below.

Pursuant to the obligations under our NPA, we reported the unsealed qui tam action to the DOJ and began investigating the claims contained in the amended complaint and cooperating fully with the DOJ. We began discussing potential resolution of these matters with the DOJ and the Office of Inspector General of the U.S. Department of Health and Human Services (“OIG”) during the three months ended September 30, 2019.

In October 2019, we reached an agreement in principle with the DOJ to resolve the qui tam lawsuit and related investigations for approximately $66 million, subject to further approvals by the DOJ and other government agencies. In the three months ended September 30, 2019, we established a reserve of $68 million for this matter, which includes an estimate of the relator’s attorney’s fees and certain other costs to be paid by us. Any final resolution remains subject to negotiation and final approval of a settlement agreement with the DOJ and any other definitive documentation required by OIG or other government agencies. We believe this could be completed as early as the first quarter of 2020, at which time the monetary component of the resolution would be paid.

Other Matters

On July 1, 2019, certain of the entities that purchased the operations of Hahnemann University Hospital and St. Christopher’s Hospital for Children in Philadelphia from us commenced Chapter 11 bankruptcy proceedings. As previously disclosed in our Form 8-K filed September 1, 2017, the purchasers assumed our funding obligations under the Pension Fund for Hospital and Health Care Employees of Philadelphia and Vicinity (the “Fund”), a pension plan related to the operations at Hahnemann University Hospital and, pursuant to rules under the Employee Retirement Income Security Act of 1974, as amended, under certain circumstances we could become liable for withdrawal liability in the event a withdrawal is triggered with respect to the Fund. In July 2019, the Fund notified us of a withdrawal liability assessment of approximately $63 million. We dispute and intend to contest this assessment in accordance with applicable law.

We are also subject to claims and lawsuits arising in the ordinary course of business, including potential claims related to, among other things, the care and treatment provided at our hospitals and outpatient facilities, the application of various federal and state labor laws, tax audits and other matters. Although the results of these claims and lawsuits cannot be predicted with certainty, we believe that the ultimate resolution of these ordinary course claims and lawsuits will not have a material effect on our business or financial condition.

New claims or inquiries may be initiated against us from time to time. These matters could (1) require us to pay substantial damages or amounts in judgments or settlements, which, individually or in the aggregate, could exceed amounts, if any, that may be recovered under our insurance policies where coverage applies and is available, (2) cause us to incur substantial expenses, (3) require significant time and attention from our management, and (4) cause us to close or sell hospitals or otherwise modify the way we conduct business.

The table below presents reconciliations of the beginning and ending liability balances in connection with legal settlements and related costs recorded in continuing operations during the nine months ended September 30, 2019 and 2018. No amounts were recorded in discontinued operations in those periods.



	Balances at Beginning of Period		Litigation and Investigation Costs		Cash Payments			Balances at End of Period

Nine Months Ended September 30, 2019	$	8	$	115	$	(37	)	$	86
Nine Months Ended September 30, 2018	$	12	$	28	$	(24	)	$	16

For the nine months ended September 30, 2019 and 2018, we recorded costs of $115 million and $28 million, respectively, in continuing operations in connection with significant legal proceedings and governmental investigations.

REDEEMABLE NONCONTROLLING INTERESTS IN EQUITY OF CONSOLIDATED SUBSIDIARIES

9 Months Ended

Sep. 30, 2019

Noncontrolling Interest [Abstract]

REDEEMABLE NONCONTROLLING INTERESTS IN EQUITY OF CONSOLIDATED SUBSIDIARIES

The following table shows the changes in redeemable noncontrolling interests in equity of consolidated subsidiaries during the nine months ended September 30, 2019 and 2018:



	Nine Months Ended September 30,
	2019			2018
Balances at beginning of period	$	1,420		$	1,866
Net income	130			135
Distributions paid to noncontrolling interests	(105		)	(107		)
Accretion of redeemable noncontrolling interests	13			166
Purchases and sales of businesses and noncontrolling interests, net	17			(616		)
Balances at end of period	$	1,475		$	1,444

The following tables show the composition by segment of our redeemable noncontrolling interests balances at September 30, 2019 and December 31, 2018, as well as our net income available to redeemable noncontrolling interests for the nine months ended September 30, 2019 and 2018:



	September 30, 2019		December 31, 2018
Hospital Operations and other	$	400	$	431
Ambulatory Care	743		713
Conifer	332		276
Redeemable noncontrolling interests	$	1,475	$	1,420



	Nine Months Ended September 30,
	2019			2018
Hospital Operations and other	$	(26	)	$	(17	)
Ambulatory Care	100			102
Conifer	56			50
Net income available to redeemable noncontrolling interests	$	130		$	135

INCOME TAXES

9 Months Ended

Sep. 30, 2019

Income Tax Disclosure [Abstract]

INCOME TAXES

During the three months ended September 30, 2019, we recorded income tax expense of $20 million in continuing operations on pre-tax loss of $133 million compared to income tax expense of $6 million on pre-tax income of $71 million during the three months ended September 30, 2018. During the nine months ended September 30, 2019, we recorded income tax expense of $67 million in continuing operations on pre-tax income of $81 million compared to income tax expense of $120 million on pre-tax income of $481 million during the nine months ended September 30, 2018. Our provision for income taxes during interim reporting periods is calculated by applying an estimate of the annual effective tax rate for the full year to “ordinary” income or loss (pre-tax income or loss excluding unusual or infrequently occurring discrete items) for the reporting period. In calculating “ordinary” income, non-taxable income or loss attributable to noncontrolling interests has been deducted from pre-tax income or loss in the determination of the annualized effective tax rate used to calculate income taxes for the quarter. The reconciliation between the amount of recorded income tax expense and the amount calculated at the statutory federal tax rate is shown in the following table:



	Three Months Ended September 30,						Nine Months Ended September 30,
	2019			2018			2019			2018
Tax expense (benefit) at statutory federal rate of 21%	$	(28	)	$	15		$	17		$	101
State income taxes, net of federal income tax benefit	(3		)	3			6			20
Tax attributable to noncontrolling interests	(17		)	(15		)	(53		)	(49		)
Nondeductible goodwill	—			—			—			7
Tax benefit related to loss on Aspen sale	—			(18		)	—			(18		)
Nontaxable gains	—			—			(1		)	—
Nondeductible litigation costs	7			—			7			—
Stock-based compensation	4			—			4			4
Change in valuation allowance	53			24			88			54
Change in tax contingency reserves, including interest	(3		)	—			(3		)	—
Other items	7			(3		)	2			1
Income tax expense	$	20		$	6		$	67		$	120

During the nine months ended September 30, 2019, we decreased our estimated liabilities for uncertain tax positions by $3 million, net of related deferred tax effects. The total amount of unrecognized tax benefits at September 30, 2019 was $41 million, of which $39 million, if recognized, would impact our effective tax rate and income tax expense (benefit) from continuing operations.

Our practice is to recognize interest and penalties related to income tax matters in income tax expense in our consolidated statements of operations. Total accrued interest and penalties on unrecognized tax benefits at September 30, 2019 were $3 million, all of which related to continuing operations.

At September 30, 2019, approximately $7 million of unrecognized federal and state tax benefits, as well as reserves for interest and penalties, may decrease in the next 12 months as a result of the settlement of audits, the filing of amended tax returns or the expiration of statutes of limitations.

EARNINGS (LOSS) PER COMMON SHARE

9 Months Ended

Sep. 30, 2019

Earnings Per Share [Abstract]

EARNINGS (LOSS) PER COMMON SHARE

The following table is a reconciliation of the numerators and denominators of our basic and diluted earnings (loss) per common share calculations for our continuing operations for three and nine months ended September 30, 2019 and 2018. Net income available (loss attributable) to our common shareholders is expressed in millions and weighted average shares are expressed in thousands.



	Net Income Available (Loss Attributable) to Common Shareholders (Numerator)			Weighted Average Shares (Denominator)	Per-Share Amount
Three Months Ended September 30, 2019
Net loss attributable to Tenet Healthcare Corporation common shareholders for basic loss per share	$	(233	)	103,558	$	(2.25	)
Effect of dilutive stock options, restricted stock units and deferred compensation units	—			—	—
Net loss attributable to Tenet Healthcare Corporation common shareholders for diluted loss per share	$	(233	)	103,558	$	(2.25	)

Three Months Ended September 30, 2018
Net loss attributable to Tenet Healthcare Corporation common shareholders for basic loss per share	$	(9	)	102,402	$	(0.09	)
Effect of dilutive stock options, restricted stock units and deferred compensation units	—			—	—
Net loss attributable to Tenet Healthcare Corporation common shareholders for diluted loss per share	$	(9	)	102,402	$	(0.09	)



	Net Income Available (Loss Attributable) to Common Shareholders (Numerator)			Weighted Average Shares (Denominator)	Per-Share Amount
Nine Months Ended September 30, 2019
Net loss attributable to Tenet Healthcare Corporation common shareholders for basic loss per share	$	(245	)	103,181	$	(2.37	)
Effect of dilutive stock options, restricted stock units and deferred compensation units	—			—	—
Net loss attributable to Tenet Healthcare Corporation common shareholders for diluted loss per share	$	(245	)	103,181	$	(2.37	)

Nine Months Ended September 30, 2018
Net income available to Tenet Healthcare Corporation common shareholders for basic earnings per share	$	113		101,980	$	1.11
Effect of dilutive stock options, restricted stock units and deferred compensation units	—			1,822	(0.02		)
Net income available to Tenet Healthcare Corporation common shareholders for diluted earnings per share	$	113		103,802	$	1.09

All potentially dilutive securities were excluded from the calculation of diluted loss per share for the three and nine months ended September 30, 2019 and the three months ended September 30, 2018 because we did not report income from continuing operations available to common shareholders in those periods. In circumstances where we do not have income from continuing operations available to common shareholders, the effect of stock options and other potentially dilutive securities is anti-dilutive, that is, a loss from continuing operations attributable to common shareholders has the effect of making the diluted loss per share less than the basic loss per share. Had we generated income from continuing operations available to common shareholders in the three and nine months ended September 30, 2019 and the three months ended September 30, 2018, the effect (in thousands) of employee stock options, restricted stock units and deferred compensation units on the diluted shares calculation would have been an increase in shares of 1,024 and 2,173 for the three months ended September 30, 2019 and 2018, respectively, and 1,403 for the nine months ended September 30, 2019.

FAIR VALUE MEASUREMENTS

9 Months Ended

Sep. 30, 2019

Fair Value Disclosures [Abstract]

FAIR VALUE MEASUREMENTS

Our non-financial assets and liabilities not permitted or required to be measured at fair value on a recurring basis typically relate to long-lived assets held and used, long-lived assets held for sale and goodwill. We are required to provide additional disclosures about fair value measurements as part of our financial statements for each major category of assets and liabilities measured at fair value on a non-recurring basis. The following table presents this information and indicates the fair value hierarchy of the valuation techniques we utilized to determine such fair values. In general, fair values determined by Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities, which generally are not applicable to non-financial assets and liabilities. Fair values determined by Level 2 inputs utilize data points that are observable, such as definitive sales agreements, appraisals or established market values of comparable assets. Fair values determined by Level 3 inputs are unobservable data points for the asset or liability and include situations where there is little, if any, market activity for the asset or liability, such as internal estimates of future cash flows.



	December 31, 2018		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
Long-lived assets held for sale	$	39	$	—	$	39	$	—
Long-lived assets held and used	130		—		130		—

The fair value of our long-term debt (except for borrowings under the Credit Agreement) is based on quoted market prices (Level 1). The inputs used to establish the fair value of the borrowings outstanding under the Credit Agreement are considered to be Level 2 inputs, which include inputs other than quoted prices included in Level 1 that are observable, either directly or indirectly. At September 30, 2019 and December 31, 2018, the estimated fair value of our long-term debt was approximately 103.9% and 97.3%, respectively, of the carrying value of the debt.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

ACQUISITIONS

9 Months Ended

Sep. 30, 2019

Business Combinations [Abstract]

ACQUISITIONS

Preliminary purchase price allocations (representing the fair value of the consideration conveyed) for all acquisitions made during the nine months ended September 30, 2019 and 2018 are as follows:



	Nine Months Ended September 30,
	2019			2018
Current assets	$	5		$	5
Property and equipment	15			12
Other intangible assets	4			7
Goodwill	34			211
Other long-term assets, including previously held equity method investments	6			(18		)
Current liabilities	(4		)	1
Long-term liabilities	(10		)	(16		)
Redeemable noncontrolling interests in equity of consolidated subsidiaries	(16		)	(18		)
Noncontrolling interests	(6		)	(85		)
Cash paid, net of cash acquired	(23		)	(97		)
Gains on consolidations	$	5		$	2

The goodwill generated from these transactions, the majority of which will be not deductible for income tax purposes, can be attributed to the benefits that we expect to realize from operating efficiencies and growth strategies. The goodwill total of $34 million from acquisitions completed during the nine months ended September 30, 2019 was recorded in our Ambulatory Care segment. Approximately $4 million and $8 million in transaction costs related to prospective and closed acquisitions were expensed during the nine month periods ended September 30, 2019 and 2018, respectively, and are included in impairment and restructuring charges, and acquisition-related costs in the accompanying Condensed Consolidated Statements of Operations.

We are required to allocate the purchase prices of acquired businesses to assets acquired or liabilities assumed and, if applicable, noncontrolling interests based on their fair values. The excess of the purchase price allocation over those fair values is recorded as goodwill. We are in process of finalizing the purchase price allocations, including valuations of the acquired property and equipment, other intangible assets and noncontrolling interests for some of our 2019 and 2018 acquisitions; therefore, those purchase price allocations are subject to adjustment once the valuations are completed.

During the nine months ended September 30, 2019 and 2018, we recognized gains totaling $5 million and $2 million, respectively, associated with stepping up our ownership interests in previously held equity method investments, which we began consolidating after we acquired controlling interests.

SEGMENT INFORMATION

9 Months Ended

Sep. 30, 2019

Segment Reporting [Abstract]

SEGMENT INFORMATION

Our business consists of our Hospital Operations and other segment, our Ambulatory Care segment and our Conifer segment. The factors for determining the reportable segments include the manner in which management evaluates operating performance combined with the nature of the individual business activities.

Our Hospital Operations and other segment is comprised of our acute care and specialty hospitals, ancillary outpatient facilities, urgent care centers, microhospitals and physician practices. At September 30, 2019, our subsidiaries operated 65 hospitals serving primarily urban and suburban communities in nine states.

Our Ambulatory Care segment is comprised of the operations of USPI and included nine Aspen facilities in the United Kingdom until their divestiture effective August 17, 2018. At September 30, 2019, USPI had interests in 264 ambulatory surgery centers, 38 urgent care centers operated under the CareSpot brand, 23 imaging centers and 23 surgical hospitals in 27 states. At September 30, 2019, we owned 95% of USPI.

Our Conifer segment provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other customers. At September 30, 2019, Conifer provided services to approximately 670 Tenet and non-Tenet hospitals and other clients nationwide. In 2012, we entered into agreements documenting the terms and conditions of various services Conifer provides to Tenet hospitals, as well as certain administrative services our Hospital Operations and other segment provides to Conifer. The pricing terms for the services provided by each party to the other under these contracts were based on estimated third-party pricing terms in effect at the time the agreements were signed. At

September 30, 2019, we owned 76% of Conifer Health Solutions, LLC, which is the principal subsidiary of Conifer Holdings, Inc.

The following tables include amounts for each of our reportable segments and the reconciling items necessary to agree to amounts reported in the accompanying Condensed Consolidated Balance Sheets and in the Condensed Consolidated Statements of Operations, as applicable:



	September 30, 2019		December 31, 2018
Assets:
Hospital Operations and other	$	16,202	$	15,684
Ambulatory Care	6,100		5,711
Conifer	1,055		1,014
Total	$	23,357	$	22,409



	Three Months Ended September 30,						Nine Months Ended September 30,
	2019			2018			2019			2018
Capital expenditures:
Hospital Operations and other	$	135		$	115		$	423		$	343
Ambulatory Care	16			18			57			46
Conifer	5			3			12			15
Total	$	156		$	136		$	492		$	404

Net operating revenues:
Hospital Operations and other total prior to inter-segment eliminations(1)	$	3,850		$	3,762		$	11,539		$	11,442
Ambulatory Care	522			502			1,526			1,531
Conifer
Tenet	140			146			432			440
Other customers	196			225			608			721
Total Conifer revenues	336			371			1,040			1,161
Inter-segment eliminations	(140		)	(146		)	(432		)	(440		)
Total	$	4,568		$	4,489		$	13,673		$	13,694

Equity in earnings of unconsolidated affiliates:
Hospital Operations and other	$	1		$	2		$	12		$	6
Ambulatory Care	37			31			102			91
Total	$	38		$	33		$	114		$	97

Adjusted EBITDA(2):
Hospital Operations and other(2)	$	334		$	312		$	1,018		$	1,059
Ambulatory Care	207			184			591			547
Conifer	90			81			292			270
Total	$	631		$	577		$	1,901		$	1,876

Depreciation and amortization:
Hospital Operations and other	$	175		$	175		$	539		$	514
Ambulatory Care	19			17			55			51
Conifer	11			12			33			37
Total	$	205		$	204		$	627		$	602



	Three Months Ended September 30,						Nine Months Ended September 30,
	2019			2018			2019			2018
Adjusted EBITDA(2)	$	631		$	577		$	1,901		$	1,876
Income (loss) from divested and closed businesses (i.e., the Company’s health plan businesses)	(1		)	9			(2		)	9
Depreciation and amortization	(205		)	(204		)	(627		)	(602		)
Impairment and restructuring charges, and acquisition-related costs	(46		)	(46		)	(101		)	(123		)
Litigation and investigation costs	(84		)	(9		)	(115		)	(28		)
Interest expense	(244		)	(249		)	(742		)	(758		)
Loss from early extinguishment of debt	(180		)	—			(227		)	(2		)
Other non-operating expense, net	(3		)	—			(3		)	(2		)
Net gains (losses) on sales, consolidation and deconsolidation of facilities	(1		)	(7		)	(3		)	111
Income (loss) from continuing operations, before income taxes	$	(133	)	$	71		$	81		$	481


(1)	Hospital Operations and other revenues includes health plan revenues of less than $1 million and approximately $1 million for the three and nine months ended September 30, 2019, respectively, and $8 million and $14 million for the three and nine months ended September 30, 2018, respectively.

(2)

Hospital Operations and other Adjusted EBITDA excludes health plan EBITDA of $(1) million and $(2) million for the three and nine months ended September 30, 2019, respectively, and $9 million for both of the three and nine months ended September 30, 2018.

BASIS OF PRESENTATION (Policies)	9 Months Ended
BASIS OF PRESENTATION (Policies)	Sep. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Description of Business and Basis of Presentation	Description of Business and Basis of Presentation Tenet Healthcare Corporation (together with our subsidiaries, referred to herein as “Tenet,” “we” or “us”) is a diversified healthcare services company headquartered in Dallas, Texas. Through an expansive care network that includes USPI Holding Company, Inc. (“USPI”), at September 30, 2019, we operated 65 hospitals and approximately 500 other healthcare facilities, including surgical hospitals, ambulatory surgery centers, urgent care and imaging centers, and other care sites and clinics. We also operate Conifer Health Solutions, through our Conifer Holdings, Inc. (“Conifer”) subsidiary, which provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other customers. This quarterly report supplements our Annual Report on Form 10-K for the year ended December 31, 2018 (“Annual Report”). As permitted by the Securities and Exchange Commission for interim reporting, we have omitted certain notes and disclosures that substantially duplicate those in our Annual Report. For further information, refer to the audited Consolidated Financial Statements and notes included in our Annual Report. Unless otherwise indicated, all financial and statistical data included in these notes to our Condensed Consolidated Financial Statements relate to our continuing operations, with dollar amounts expressed in millions (except per-share amounts). Effective January 1, 2019, we adopted the Financial Accounting Standards Board (“FASB”) Accounting Standards Update (“ASU”) 2016-02, “Leases (Topic 842)” (“ASU 2016-02”) using the modified retrospective transition approach as of the period of adoption. Our financial statements for periods prior to January 1, 2019 were not modified for the application of the new lease accounting standard. The main difference between the guidance in ASU 2016-02 and previous accounting principles generally accepted in the United States of America (“GAAP”) is the recognition of lease assets and lease liabilities on the balance sheet by lessees for those leases classified as operating leases under previous GAAP. Upon adoption of ASU 2016-02, we recorded $822 million of right-of-use assets, net of deferred rent, associated with operating leases in investments and other assets in our condensed consolidated balance sheet, $147 million of current liabilities associated with operating leases in other current liabilities in our condensed consolidated balance sheet and $715 million of long-term liabilities associated with operating leases in other long-term liabilities in our condensed consolidated balance sheet. We also recognized $1 million of cumulative effect adjustment that decreased accumulated deficit at January 1, 2019. Although the Condensed Consolidated Financial Statements and related notes within this document are unaudited, we believe all adjustments considered necessary for a fair presentation have been included and are of a normal recurring nature. In preparing our financial statements in conformity with GAAP, we are required to make estimates and assumptions that affect the amounts reported in our Condensed Consolidated Financial Statements and these accompanying notes. We regularly evaluate the accounting policies and estimates we use. In general, we base the estimates on historical experience and on assumptions that we believe to be reasonable given the particular circumstances in which we operate. Actual results may vary from those estimates. Financial and statistical information we report to other regulatory agencies may be prepared on a basis other than GAAP or using different assumptions or reporting periods and, therefore, may vary from amounts presented herein. Although we make every effort to ensure that the information we report to those agencies is accurate, complete and consistent with applicable reporting guidelines, we cannot be responsible for the accuracy of the information they make available to the public. Operating results for the three and nine month periods ended September 30, 2019 are not necessarily indicative of the results that may be expected for the full year. Reasons for this include, but are not limited to: overall revenue and cost trends, particularly the timing and magnitude of price changes; fluctuations in contractual allowances and cost report settlements and valuation allowances; managed care contract negotiations, settlements or terminations and payer consolidations; trends in patient accounts receivable collectability and associated implicit price concessions; fluctuations in interest rates; levels of malpractice insurance expense and settlement trends; impairment of long-lived assets and goodwill; restructuring charges; losses, costs and insurance recoveries related to natural disasters and other weather-related occurrences; litigation and investigation costs; acquisitions and dispositions of facilities and other assets; gains (losses) on sales, consolidation and deconsolidation of facilities; income tax rates and deferred tax asset valuation allowance activity; changes in estimates of accruals for annual incentive compensation; the timing and amounts of stock option and restricted stock unit grants to employees and directors; gains (losses) from early extinguishment of debt; and changes in occupancy levels and patient volumes. Factors that affect service mix, revenue mix, patient volumes and, thereby, the results of operations at our hospitals and related healthcare facilities include, but are not limited to: changes in federal and state healthcare regulations; the business environment, economic conditions and demographics of local communities in which we operate; the number of uninsured and underinsured individuals in local communities treated at our hospitals; seasonal cycles of illness; climate and weather conditions; physician recruitment, satisfaction, retention and attrition; advances in technology and treatments that reduce length of stay; local healthcare competitors; managed care contract negotiations or terminations; the number of patients with high-deductible health insurance plans; hospital performance data on quality measures and patient satisfaction, as well as standard charges for services; any unfavorable publicity about us, or our joint venture partners, that impacts our relationships with physicians and patients; and the timing of elective procedures. These considerations apply to year-to-year comparisons as well.
Net Operating Revenues	Net Operating Revenues We recognize net operating revenues in the period in which we satisfy our performance obligations under contracts by transferring services to our customers. Net operating revenues are recognized in the amounts we expect to be entitled to, which are the transaction prices allocated for the distinct services. Net operating revenues for our Hospital Operations and other and Ambulatory Care segments primarily consist of net patient service revenues, principally for patients covered by Medicare, Medicaid, managed care and other health plans, as well as certain uninsured patients under our Compact with Uninsured Patients (“Compact”) and other uninsured discount and charity programs. Net operating revenues for our Conifer segment primarily consist of revenues from providing revenue cycle management services to healthcare systems, as well as individual hospitals, physician practices, self-insured organizations, health plans and other entities. Net Patient Service Revenues—We report net patient service revenues at the amounts that reflect the consideration we expect to be entitled to in exchange for providing patient care. These amounts are due from patients, third-party payers (including managed care payers and government programs) and others, and they include variable consideration for retroactive revenue adjustments due to settlement of audits, reviews and investigations. Generally, we bill our patients and third-party payers several days after the services are performed or shortly after discharge. Revenues are recognized as performance obligations are satisfied. Conifer Revenues—Our Conifer segment recognizes revenue from its contracts when Conifer’s performance obligations are satisfied, which is generally as services are rendered. Revenue is recognized in an amount that reflects the consideration to which Conifer expects to be entitled.
Cash and Cash Equivalents	Cash and Cash Equivalents We treat highly liquid investments with original maturities of three months or less as cash equivalents. Cash and cash equivalents were $314 million and $411 million at September 30, 2019 and December 31, 2018, respectively. At September 30, 2019 and December 31, 2018, our book overdrafts were $287 million and $288 million, respectively, which were classified as accounts payable. At September 30, 2019 and December 31, 2018, $204 million and $177 million, respectively, of total cash and cash equivalents in the accompanying Condensed Consolidated Balance Sheets were intended for the operations of our captive insurance subsidiaries, and $2 million and $8 million, respectively, of total cash and cash equivalents in the accompanying Condensed Consolidated Balance Sheets were intended for the operations of our health plan-related businesses. Also at September 30, 2019 and December 31, 2018, we had $69 million and $135 million, respectively, of property and equipment purchases accrued for items received but not yet paid. Of these amounts, $50 million and $114 million, respectively, were included in accounts payable. During the nine months ended September 30, 2019 and 2018, we entered into non-cancellable capital (finance) leases of $91 million and $94 million, respectively.
Investments in Unconsolidated Affiliates	Investments in Unconsolidated Affiliates We control 237 of the facilities within our Ambulatory Care segment and, therefore, consolidate their results. We account for many of the facilities our Ambulatory Care segment operates (111 of 348 at September 30, 2019), as well as additional companies in which our Hospital Operations and other segment holds ownership interests, under the equity method as investments in unconsolidated affiliates and report only our share of net income as equity in earnings of unconsolidated affiliates in the accompanying Condensed Consolidated Statements of Operations.

BASIS OF PRESENTATION (Tables)

9 Months Ended

Sep. 30, 2019

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of other intangible assets

The following tables provide information regarding other intangible assets, which are included in the accompanying Condensed Consolidated Balance Sheets at September 30, 2019 and December 31, 2018:



	Gross Carrying Amount		Accumulated Amortization			Net Book Value
At September 30, 2019:
Capitalized software costs	$	1,637	$	(927	)	$	710
Trade names	102		—			102
Contracts	875		(90		)	785
Other	104		(81		)	23
Total	$	2,718	$	(1,098	)	$	1,620



	Gross Carrying Amount		Accumulated Amortization			Net Book Value
At December 31, 2018:
Capitalized software costs	$	1,667	$	(858	)	$	809
Trade names	102		—			102
Contracts	871		(76		)	795
Other	104		(79		)	25
Total	$	2,744	$	(1,013	)	$	1,731

Schedule of estimated future amortization of intangibles with finite useful lives

Estimated future amortization of intangibles with finite useful lives at September 30, 2019 is as follows:



			Three Months Ending		Years Ending								Later Years
			December 31,
	Total		2019		2020		2021		2022		2023
Amortization of intangible assets	$	938	$	45	$	132	$	117	$	104	$	95	$	445

Schedule of equity method investments

Summarized financial information for these equity method investees is included in the following table; among the equity method investees are four North Texas hospitals in which we held minority interests that were operated by our Hospital Operations and other segment through the divestiture of these investments effective March 1, 2018. For investments acquired during the reporting periods, amounts reflect 100% of the investee’s results beginning on the date of our acquisition of the investment.



	Three Months Ended September 30,				Nine Months Ended September 30,
	2019		2018		2019		2018
Net operating revenues	$	622	$	546	$	1,809	$	1,667
Net income	$	156	$	126	$	447	$	374
Net income available to the investees	$	97	$	80	$	290	$	240

ACCOUNTS RECEIVABLE (Tables)

9 Months Ended

Sep. 30, 2019

Accounts Receivable Additional Disclosures [Abstract]

Schedule of components of accounts receivable

The principal components of accounts receivable are shown in the table below:



	September 30, 2019		December 31, 2018
Continuing operations:
Patient accounts receivable	$	2,559	$	2,427
Estimated future recoveries	169		148
Net cost reports and settlements receivable and valuation allowances	38		18
	2,766		2,593
Discontinued operations	2		2
Accounts receivable, net	$	2,768	$	2,595

Schedule of estimated costs for charity care and self-pay patients

The following table shows our estimated costs (based on selected operating expenses, which include salaries, wages and benefits, supplies and other operating expenses and which exclude the costs of our health plan businesses) of caring for our uninsured and charity patients in the three and nine months ended September 30, 2019 and 2018:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2019		2018		2019		2018
Estimated costs for:
Uninsured patients	$	171	$	172	$	493	$	477
Charity care patients	41		28		116		91
Total	$	212	$	200	$	609	$	568

CONTRACT BALANCES (Tables)

9 Months Ended

Sep. 30, 2019

Revenue from Contract with Customer [Abstract]

Schedule of opening and closing balances of Company's contract assets

The opening and closing balances of contract assets for our Hospital Operations and other segment are as follows:



December 31, 2018	$	169
September 30, 2019	163
Increase/(decrease)	$	(6	)



January 1, 2018	$	171
September 30, 2018	152
Increase/(decrease)	$	(19	)

The opening and closing balances of Conifer’s receivables, contract asset, and current and long-term contract liabilities are as follows:



					Contract Liability-			Contract Liability-
			Contract Asset-		Current			Long-Term
	Receivables		Unbilled Revenue		Deferred Revenue			Deferred Revenue
December 31, 2018	$	42	$	11	$	61		$	20
September 30, 2019	86		11		72			19
Increase/(decrease)	$	44	$	—	$	11		$	(1	)

January 1, 2018	$	89	$	10	$	80		$	21
September 30, 2018	89		11		74			21
Increase/(decrease)	$	—	$	1	$	(6	)	$	—

ASSETS AND LIABILITIES HELD FOR SALE (Tables)

9 Months Ended

Sep. 30, 2019

Discontinued Operation, Additional Disclosures [Abstract]

Assets and liabilities classified as held for sale

The following table provides information on significant components of our business that have been disposed of since January 1, 2018:



	Three Months Ended September 30,						Nine Months Ended September 30,
	2019			2018			2019			2018
Significant disposals:
Income (loss) from continuing operations, before income taxes
Chicago-area (includes a $6 million loss on sale in the 2019 year-to-date period and $17 million of impairment charges in the 2018 year-to-date period)	$	—		$	(10	)	$	(11	)	$	(25	)
Philadelphia (includes a $2 million loss on sale in the 2018 year-to-date period)	—			1			1			(10		)
MacNeal (includes a $88 million gain on sale in the 2018 year-to-date period)	(1		)	(7		)	1			90
Aspen (includes $9 million of impairment charges in the 2018 year-to-date period)	—			(6		)	—			(6		)
Total	$	(1	)	$	(22	)	$	(9	)	$	49

- Definition

Tabular disclosure of information related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

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+ Details

LEASES (Tables)

9 Months Ended

Sep. 30, 2019

Leases [Abstract]

Schedule Of Supplemental Balance Sheet Information Related To Leases

The following table presents the components of our right-of-use assets and liabilities related to leases and their classification in our Condensed Consolidated Balance Sheet at September 30, 2019:



Component of Lease Balances	Classification in Condensed Consolidated Balance Sheet	September 30, 2019
Assets:
Operating lease assets	Investments and other assets	$	913
Finance lease assets	Property and equipment, at cost, less accumulated depreciation and amortization	435
Total leased assets		$	1,348

Liabilities:
Operating lease liabilities:
Current	Other current liabilities	$	160
Long-term	Other long-term liabilities	854
Total operating lease liabilities		1,014
Finance lease liabilities:
Current	Current portion of long-term debt	139
Long-term	Long-term debt, net of current portion	201
Total finance lease liabilities		340
Total lease liabilities		$	1,354

Schedule of Additional Information Related to Lease Expense, Terms and Discount Rates, and Cash Flow Information

The following table presents the components of our lease expense and their classification in our Condensed Consolidated Statement of Operations for the three and nine months ended September 30, 2019:



	Classification on Condensed Consolidated	Three Months Ended		Nine Months Ended
Component of Lease Expense	Statements of Operations	September 30, 2019		September 30, 2019
Operating lease expense	Other operating expenses, net	$	54	$	156
Finance lease expense:
Amortization of leased assets	Depreciation and amortization	22		63
Interest on lease liabilities	Interest expense	4		12
Total finance lease expense		26		75
Variable and short term-lease expense	Other operating expenses, net	33		100
Total lease expense		$	113	$	331

The weighted-average lease terms and discount rates for operating and finance leases are presented in the following table:



	September 30, 2019
Weighted-average remaining lease term (years)
Operating leases	7.7
Finance leases	6.0

Weighted-average discount rate
Operating leases	5.5	%
Finance leases	5.6	%

Cash flow and other information related to leases is included in the following table:



	Nine Months Ended
	September 30, 2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash outflows from operating leases	$	146
Operating cash outflows from finance leases	$	15
Financing cash outflows from finance leases	$	112

Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	208
Finance leases	$	91

Operating Lease Liability Maturity Schedule

Future maturities of lease liabilities at September 30, 2019 are presented in the following table:



	Operating Leases		Finance Leases		Total
2019	$	160	$	139	$	299
2020	189		137		326
2021	177		80		257
2022	157		24		181
2023	133		13		146
Later years	420		124		544
Total lease payments	1,236		517		1,753
Less: Imputed interest	222		177		399
Total lease obligations	1,014		340		1,354
Less: Current obligations	160		139		299
Long-term lease obligations	$	854	$	201	$	1,055

Finance Lease Liability Maturity Schedule

Future maturities of lease liabilities at September 30, 2019 are presented in the following table:



	Operating Leases		Finance Leases		Total
2019	$	160	$	139	$	299
2020	189		137		326
2021	177		80		257
2022	157		24		181
2023	133		13		146
Later years	420		124		544
Total lease payments	1,236		517		1,753
Less: Imputed interest	222		177		399
Total lease obligations	1,014		340		1,354
Less: Current obligations	160		139		299
Long-term lease obligations	$	854	$	201	$	1,055

Schedule of Future Minimum Lease Payments for Capital Leases (prior to adoption of ASU 2016-02)

Future maturities of lease liabilities at December 31, 2018, prior to our adoption of ASU 2016-02, are presented in the following table:



			Years Ending December 31,										Later Years
	Total		2019		2020		2021		2022		2023		Later Years
Capital lease obligations	$	425	$	140	$	95	$	57	$	37	$	21	$	75
Long-term non-cancelable operating leases	$	932	$	171	$	151	$	133	$	113	$	92	$	272

Schedule of Future Minimum Rental Payments for Operating Leases (prior to adoption of ASU 2016-02)

Future maturities of lease liabilities at December 31, 2018, prior to our adoption of ASU 2016-02, are presented in the following table:



			Years Ending December 31,										Later Years
	Total		2019		2020		2021		2022		2023		Later Years
Capital lease obligations	$	425	$	140	$	95	$	57	$	37	$	21	$	75
Long-term non-cancelable operating leases	$	932	$	171	$	151	$	133	$	113	$	92	$	272

LONG-TERM DEBT (Tables)

9 Months Ended

Sep. 30, 2019

Long-term Debt and Lease Obligation [Abstract]

Summary of long-term debt

The table below shows our long-term debt at September 30, 2019 and December 31, 2018:



	September 30, 2019			December 31, 2018
Senior unsecured notes:
5.500% due 2019	$	—		$	468
6.750% due 2020	—			300
8.125% due 2022	2,800			2,800
6.750% due 2023	1,872			1,872
7.000% due 2025	478			478
6.875% due 2031	362			362
Senior secured first lien notes:
4.750% due 2020	—			500
6.000% due 2020	—			1,800
4.500% due 2021	—			850
4.375% due 2021	—			1,050
4.625% due 2024	1,870			1,870
4.625% due 2024	600			—
4.875% due 2026	2,100			—
5.125% due 2027	1,500			—
Senior secured second lien notes:
7.500% due 2022	—			750
5.125% due 2025	1,410			1,410
6.250% due 2027	1,500			—
Senior secured credit facility due 2024	275			—
Finance leases and mortgage notes	452			500
Unamortized issue costs and note discounts	(196		)	(184		)
Total long-term debt	15,023			14,826
Less current portion	165			182
Long-term debt, net of current portion	$	14,858		$	14,644

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

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+ Details

EMPLOYEE BENEFIT PLANS (Tables)

9 Months Ended

Sep. 30, 2019

Defined Benefit Plan [Abstract]

Summary of stock option activity

The following table summarizes stock option activity during the nine months ended September 30, 2019:



	Options		Weighted Average Exercise Price Per Share		Aggregate Intrinsic Value		Weighted Average Remaining Life
					(In Millions)
Outstanding at December 31, 2018	2,262,743		$	19.12
Granted	230,713		28.28
Exercised	(76,159	)	4.56
Forfeited/Expired	(203,256	)	19.66
Outstanding at September 30, 2019	2,214,041		$	20.53	$	6	6.0 years
Vested and expected to vest at September 30, 2019	2,214,041		$	20.53	$	6	6.0 years
Exercisable at September 30, 2019	684,628		$	19.03	$	2	2.8 years

Schedule of assumptions used to determine fair value of stock options

These fair values were calculated based on each grant date, using a Monte Carlo simulation with the following assumptions:



	February 27, 2019	February 28, 2018
Expected volatility	48%	46%
Expected dividend yield	0%	0%
Expected life	6.2 years	6.2 years
Expected forfeiture rate	0%	0%
Risk-free interest rate	2.53%	2.72%

Summary of information about stock options by range of exercise prices

The following table summarizes information about our outstanding stock options at September 30, 2019:



	Options Outstanding				Options Exercisable
Range of Exercise Prices	Number of Options	Weighted Average Remaining Contractual Life	Weighted Average Exercise Price		Number of Options	Weighted Average Exercise Price
$16.43 to $19.759	1,229,723	5.4 years	$	18.14	413,960	$	16.46
$19.76 to $35.430	984,318	6.7 years	23.51		270,668	22.94
	2,214,041	6.0 years	$	20.53	684,628	$	19.03

Summary of restricted stock unit activity

The following table summarizes restricted stock unit activity during the nine months ended September 30, 2019:



	Restricted Stock Units		Weighted Average Grant Date Fair Value Per Unit
Unvested at December 31, 2018	1,884,130		$	32.25
Granted	1,460,753		27.85
Vested	(1,425,660	)	37.49
Forfeited	(329,926	)	24.71
Unvested at September 30, 2019	1,589,297		$	25.07

EQUITY (Tables)

9 Months Ended

Sep. 30, 2019

Stockholders' Equity Note [Abstract]

Schedule of changes in consolidated equity

The following tables show the changes in consolidated equity during the nine months ended September 30, 2019 and 2018 (dollars in millions, share amounts in thousands):



	Common Stock			Additional Paid-In Capital			Accumulated Other Comprehensive Loss			Accumulated Deficit			Treasury Stock			Noncontrolling Interests			Total Equity
	Shares Outstanding	Issued Par Amount		Additional Paid-In Capital			Accumulated Other Comprehensive Loss			Accumulated Deficit			Treasury Stock			Noncontrolling Interests			Total Equity
Balances at December 31, 2018	102,537	$	7	$	4,747		$	(223	)	$	(2,236	)	$	(2,414	)	$	806		$	687
Net income (loss)	—	—		—			—			(19		)	—			37			18
Distributions paid to noncontrolling interests	—	—		—			—			—			—			(37		)	(37		)
Other comprehensive income	—	—		—			2			—			—			—			2
Accretion of redeemable noncontrolling interests	—	—		(5		)	—			—			—			—			(5		)
Purchases (sales) of businesses and noncontrolling interests	—	—		(2		)	—			—			—			2			—
Cumulative effect of accounting change	—	—		—			—			1			—			—			1
Stock-based compensation expense, tax benefit and issuance of common stock	543	—		8			—			—			—			—			8
Balances at March 31, 2019	103,080	$	7	$	4,748		$	(221	)	$	(2,254	)	$	(2,414	)	$	808		$	674
Net income	—	—		—			—			17			—			47			64
Distributions paid to noncontrolling interests	—	—		—			—			—			—			(35		)	(35		)
Other comprehensive income	—	—		—			2			—			—			—			2
Accretion of redeemable noncontrolling interests	—	—		(4		)	—			—			—			—			(4		)
Purchases of businesses and noncontrolling interests	—	—		—			—			—			—			5			5
Stock-based compensation expense, tax benefit and issuance of common stock	256	—		11			—			—			—			—			11
Balances at June 30, 2019	103,336	$	7	$	4,755		$	(219	)	$	(2,237	)	$	(2,414	)	$	825		$	717
Net income (loss)	—	—		—			—			(232		)	—			45			(187		)
Distributions paid to noncontrolling interests	—	—		—			—			—			—			(46		)	(46		)
Other comprehensive income	—	—		—			3			—			—			—			3
Accretion of redeemable noncontrolling interests	—	—		(4		)	—			—			—			—			(4		)
Purchases (sales) of businesses and noncontrolling interests	—	—		(5		)	—			—			—			6			1
Stock-based compensation expense, tax benefit and issuance of common stock	436	—		5			—			—			—			—			5
Balances at September 30, 2019	103,772	$	7	$	4,751		$	(216	)	$	(2,469	)	$	(2,414	)	$	830		$	489



	Common Stock			Additional Paid-In Capital			Accumulated Other Comprehensive Loss			Accumulated Deficit			Treasury Stock			Noncontrolling Interests			Total Equity
	Shares Outstanding	Issued Par Amount		Additional Paid-In Capital			Accumulated Other Comprehensive Loss			Accumulated Deficit			Treasury Stock			Noncontrolling Interests			Total Equity
Balances at December 31, 2017	100,972	$	7	$	4,859		$	(204	)	$	(2,390	)	$	(2,419	)	$	686		$	539
Net income	—	—		—			—			99			—			31			130
Distributions paid to noncontrolling interests	—	—		—			—			—			—			(34		)	(34		)
Other comprehensive income	—	—		—			8			—			—			—			8
Accretion of redeemable noncontrolling interests	—	—		(37		)	—			—			—			—			(37		)
Sales of businesses and noncontrolling interests	—	—		(4		)	—			—			—			(2		)	(6		)
Cumulative effect of accounting change	—	—		—			(43		)	43			—			—			—
Stock-based compensation expense, tax benefit and issuance of common stock	1,017	—		15			—			—			1			—			16
Balances at March 31, 2018	101,989	$	7	$	4,833		$	(239	)	$	(2,248	)	$	(2,418	)	$	681		$	616
Net income	—	—		—			—			26			—			42			68
Distributions paid to noncontrolling interests	—	—		—			—			—			—			(38		)	(38		)
Other comprehensive loss	—	—		—			(4		)	—			—			—			(4		)
Accretion of redeemable noncontrolling interests	—	—		(123		)	—			—			—			—			(123		)
Purchases (sales) of businesses and noncontrolling interests	—	—		(2		)	—			—			—			45			43
Stock-based compensation expense, tax benefit and issuance of common stock	312	—		14			—			—			—			—			14
Balances at June 30, 2018	102,301	$	7	$	4,722		$	(243	)	$	(2,222	)	$	(2,418	)	$	730		$	576
Net income (loss)	—	—		—			—			(9		)	—			40			31
Distributions paid to noncontrolling interests	—	—		—			—			—			—			(40		)	(40		)
Other comprehensive income	—	—		—			41			—			—			—			41
Accretion of redeemable noncontrolling interests	—	—		(6		)	—			—			—			—			(6		)
Purchases of businesses and noncontrolling interests	—	—		3			—			—			—			36			39
Stock-based compensation expense, tax benefit and issuance of common stock	146	—		14			—			—			3			—			17
Balances at September 30, 2018	102,447	$	7	$	4,733		$	(202	)	$	(2,231	)	$	(2,415	)	$	766		$	658

NET OPERATING REVENUES (Tables)

9 Months Ended

Sep. 30, 2019

Revenue from Contract with Customer [Abstract]

Disaggregation of operating revenues less provision for doubtful accounts and implicit price concessions

The table below shows our sources of net operating revenues from continuing operations:



	Three Months Ended September 30,						Nine Months Ended September 30,
	2019			2018			2019			2018
Hospital Operations and other:
Net patient service revenues from hospitals and related outpatient facilities
Medicare	$	697		$	681		$	2,176		$	2,164
Medicaid	284			336			914			971
Managed care	2,357			2,228			7,041			6,869
Uninsured	44			33			56			78
Indemnity and other	184			156			508			438
Total	3,566			3,434			10,695			10,520
Other revenues(1)	284			328			844			922
Hospital Operations and other total prior to inter-segment eliminations	3,850			3,762			11,539			11,442
Ambulatory Care	522			502			1,526			1,531
Conifer	336			371			1,040			1,161
Inter-segment eliminations	(140		)	(146		)	(432		)	(440		)
Net operating revenues	$	4,568		$	4,489		$	13,673		$	13,694




(1)	Primarily physician practices revenues.

The table below shows the composition of net operating revenues for our Ambulatory Care segment:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2019		2018		2019		2018
Net patient service revenues	$	490	$	471	$	1,437	$	1,440
Management fees	23		22		69		68
Revenue from other sources	9		9		20		23
Net operating revenues	$	522	$	502	$	1,526	$	1,531

The table below shows the composition of net operating revenues for our Conifer segment:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2019		2018		2019		2018
Revenue cycle services – Tenet	$	136	$	141	$	420	$	424
Revenue cycle services – other customers	175		203		542		655
Other services – Tenet	4		5		12		16
Other services – other customers	21		22		66		66
Net operating revenues	$	336	$	371	$	1,040	$	1,161

Performance obligation, expected timing of satisfaction

The following table includes Conifer’s revenue that is expected to be recognized in the future related to performance obligations that are unsatisfied, or partially unsatisfied, at the end of the reporting period. The amounts in the table primarily consist of revenue cycle management fixed fees, which are typically recognized ratably as the performance obligation is satisfied. The estimated revenue does not include volume or contingency based contracts, performance incentives, penalties or

other variable consideration that is considered constrained. Conifer’s contract with Common Spirit, a minority interest owner of Conifer Health Solutions, LLC, represents the majority of the fixed-fee revenue related to remaining performance obligations. Conifer’s contract term with Common Spirit ends December 31, 2032.



			Three Months Ending		Years Ending								Later Years
			December 31,
	Total		2019		2020		2021		2022		2023
Performance obligations	$	7,440	$	149	$	598	$	594	$	594	$	594	$	4,911

CLAIMS AND LAWSUITS (Tables)

9 Months Ended

Sep. 30, 2019

Commitments and Contingencies Disclosure [Abstract]

Reconciliations of legal settlements and related costs

The table below presents reconciliations of the beginning and ending liability balances in connection with legal settlements and related costs recorded in continuing operations during the nine months ended September 30, 2019 and 2018. No amounts were recorded in discontinued operations in those periods.



	Balances at Beginning of Period		Litigation and Investigation Costs		Cash Payments			Balances at End of Period

Nine Months Ended September 30, 2019	$	8	$	115	$	(37	)	$	86
Nine Months Ended September 30, 2018	$	12	$	28	$	(24	)	$	16

- Definition

Tabular disclosure of the loss contingencies that were reported in the period or disclosed as of the balance sheet date.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 450
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Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
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-URI http://asc.fasb.org/extlink&oid=118942415&loc=d3e14615-108349

Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 460
-SubTopic 10
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-URI http://asc.fasb.org/extlink&oid=118943654&loc=d3e12021-110248

Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 460
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-URI http://asc.fasb.org/extlink&oid=118943654&loc=d3e12053-110248

+ Details

REDEEMABLE NONCONTROLLING INTERESTS IN EQUITY OF CONSOLIDATED SUBSIDIARIES (Tables)

9 Months Ended

Sep. 30, 2019

Noncontrolling Interest [Abstract]

Schedule of changes in redeemable noncontrolling interests in equity of consolidated subsidiaries

The following table shows the changes in redeemable noncontrolling interests in equity of consolidated subsidiaries during the nine months ended September 30, 2019 and 2018:



	Nine Months Ended September 30,
	2019			2018
Balances at beginning of period	$	1,420		$	1,866
Net income	130			135
Distributions paid to noncontrolling interests	(105		)	(107		)
Accretion of redeemable noncontrolling interests	13			166
Purchases and sales of businesses and noncontrolling interests, net	17			(616		)
Balances at end of period	$	1,475		$	1,444

The following tables show the composition by segment of our redeemable noncontrolling interests balances at September 30, 2019 and December 31, 2018, as well as our net income available to redeemable noncontrolling interests for the nine months ended September 30, 2019 and 2018:



	September 30, 2019		December 31, 2018
Hospital Operations and other	$	400	$	431
Ambulatory Care	743		713
Conifer	332		276
Redeemable noncontrolling interests	$	1,475	$	1,420



	Nine Months Ended September 30,
	2019			2018
Hospital Operations and other	$	(26	)	$	(17	)
Ambulatory Care	100			102
Conifer	56			50
Net income available to redeemable noncontrolling interests	$	130		$	135

INCOME TAXES (Tables)

9 Months Ended

Sep. 30, 2019

Income Tax Disclosure [Abstract]

Schedule of reconciliation between reported income tax expense (benefit) and income taxes calculated by the statutory federal income tax rate

The reconciliation between the amount of recorded income tax expense and the amount calculated at the statutory federal tax rate is shown in the following table:



	Three Months Ended September 30,						Nine Months Ended September 30,
	2019			2018			2019			2018
Tax expense (benefit) at statutory federal rate of 21%	$	(28	)	$	15		$	17		$	101
State income taxes, net of federal income tax benefit	(3		)	3			6			20
Tax attributable to noncontrolling interests	(17		)	(15		)	(53		)	(49		)
Nondeductible goodwill	—			—			—			7
Tax benefit related to loss on Aspen sale	—			(18		)	—			(18		)
Nontaxable gains	—			—			(1		)	—
Nondeductible litigation costs	7			—			7			—
Stock-based compensation	4			—			4			4
Change in valuation allowance	53			24			88			54
Change in tax contingency reserves, including interest	(3		)	—			(3		)	—
Other items	7			(3		)	2			1
Income tax expense	$	20		$	6		$	67		$	120

EARNINGS (LOSS) PER COMMON SHARE (Tables)

9 Months Ended

Sep. 30, 2019

Earnings Per Share [Abstract]

Schedule of reconciliation of numerators and denominators of our basic and diluted loss per common share

The following table is a reconciliation of the numerators and denominators of our basic and diluted earnings (loss) per common share calculations for our continuing operations for three and nine months ended September 30, 2019 and 2018. Net income available (loss attributable) to our common shareholders is expressed in millions and weighted average shares are expressed in thousands.



	Net Income Available (Loss Attributable) to Common Shareholders (Numerator)			Weighted Average Shares (Denominator)	Per-Share Amount
Three Months Ended September 30, 2019
Net loss attributable to Tenet Healthcare Corporation common shareholders for basic loss per share	$	(233	)	103,558	$	(2.25	)
Effect of dilutive stock options, restricted stock units and deferred compensation units	—			—	—
Net loss attributable to Tenet Healthcare Corporation common shareholders for diluted loss per share	$	(233	)	103,558	$	(2.25	)

Three Months Ended September 30, 2018
Net loss attributable to Tenet Healthcare Corporation common shareholders for basic loss per share	$	(9	)	102,402	$	(0.09	)
Effect of dilutive stock options, restricted stock units and deferred compensation units	—			—	—
Net loss attributable to Tenet Healthcare Corporation common shareholders for diluted loss per share	$	(9	)	102,402	$	(0.09	)



	Net Income Available (Loss Attributable) to Common Shareholders (Numerator)			Weighted Average Shares (Denominator)	Per-Share Amount
Nine Months Ended September 30, 2019
Net loss attributable to Tenet Healthcare Corporation common shareholders for basic loss per share	$	(245	)	103,181	$	(2.37	)
Effect of dilutive stock options, restricted stock units and deferred compensation units	—			—	—
Net loss attributable to Tenet Healthcare Corporation common shareholders for diluted loss per share	$	(245	)	103,181	$	(2.37	)

Nine Months Ended September 30, 2018
Net income available to Tenet Healthcare Corporation common shareholders for basic earnings per share	$	113		101,980	$	1.11
Effect of dilutive stock options, restricted stock units and deferred compensation units	—			1,822	(0.02		)
Net income available to Tenet Healthcare Corporation common shareholders for diluted earnings per share	$	113		103,802	$	1.09

FAIR VALUE MEASUREMENTS (Tables)

9 Months Ended

Sep. 30, 2019

Fair Value Disclosures [Abstract]

Schedule of assets and liabilities measured at fair value on a recurring basis

The following table presents this information and indicates the fair value hierarchy of the valuation techniques we utilized to determine such fair values. In general, fair values determined by Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities, which generally are not applicable to non-financial assets and liabilities. Fair values determined by Level 2 inputs utilize data points that are observable, such as definitive sales agreements, appraisals or established market values of comparable assets. Fair values determined by Level 3 inputs are unobservable data points for the asset or liability and include situations where there is little, if any, market activity for the asset or liability, such as internal estimates of future cash flows.



	December 31, 2018		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
Long-lived assets held for sale	$	39	$	—	$	39	$	—
Long-lived assets held and used	130		—		130		—

ACQUISITIONS (Tables)

9 Months Ended

Sep. 30, 2019

Business Combinations [Abstract]

Schedule of preliminary purchase price allocation

Preliminary purchase price allocations (representing the fair value of the consideration conveyed) for all acquisitions made during the nine months ended September 30, 2019 and 2018 are as follows:



	Nine Months Ended September 30,
	2019			2018
Current assets	$	5		$	5
Property and equipment	15			12
Other intangible assets	4			7
Goodwill	34			211
Other long-term assets, including previously held equity method investments	6			(18		)
Current liabilities	(4		)	1
Long-term liabilities	(10		)	(16		)
Redeemable noncontrolling interests in equity of consolidated subsidiaries	(16		)	(18		)
Noncontrolling interests	(6		)	(85		)
Cash paid, net of cash acquired	(23		)	(97		)
Gains on consolidations	$	5		$	2

SEGMENT INFORMATION (Tables)

9 Months Ended

Sep. 30, 2019

Segment Reporting [Abstract]

Reconciliation of assets by reportable segment to consolidated assets

The following tables include amounts for each of our reportable segments and the reconciling items necessary to agree to amounts reported in the accompanying Condensed Consolidated Balance Sheets and in the Condensed Consolidated Statements of Operations, as applicable:



	September 30, 2019		December 31, 2018
Assets:
Hospital Operations and other	$	16,202	$	15,684
Ambulatory Care	6,100		5,711
Conifer	1,055		1,014
Total	$	23,357	$	22,409

Reconciliation of other significant reconciling items from segments to consolidated



	Three Months Ended September 30,						Nine Months Ended September 30,
	2019			2018			2019			2018
Capital expenditures:
Hospital Operations and other	$	135		$	115		$	423		$	343
Ambulatory Care	16			18			57			46
Conifer	5			3			12			15
Total	$	156		$	136		$	492		$	404

Net operating revenues:
Hospital Operations and other total prior to inter-segment eliminations(1)	$	3,850		$	3,762		$	11,539		$	11,442
Ambulatory Care	522			502			1,526			1,531
Conifer
Tenet	140			146			432			440
Other customers	196			225			608			721
Total Conifer revenues	336			371			1,040			1,161
Inter-segment eliminations	(140		)	(146		)	(432		)	(440		)
Total	$	4,568		$	4,489		$	13,673		$	13,694

Equity in earnings of unconsolidated affiliates:
Hospital Operations and other	$	1		$	2		$	12		$	6
Ambulatory Care	37			31			102			91
Total	$	38		$	33		$	114		$	97

Adjusted EBITDA(2):
Hospital Operations and other(2)	$	334		$	312		$	1,018		$	1,059
Ambulatory Care	207			184			591			547
Conifer	90			81			292			270
Total	$	631		$	577		$	1,901		$	1,876

Depreciation and amortization:
Hospital Operations and other	$	175		$	175		$	539		$	514
Ambulatory Care	19			17			55			51
Conifer	11			12			33			37
Total	$	205		$	204		$	627		$	602



	Three Months Ended September 30,						Nine Months Ended September 30,
	2019			2018			2019			2018
Adjusted EBITDA(2)	$	631		$	577		$	1,901		$	1,876
Income (loss) from divested and closed businesses (i.e., the Company’s health plan businesses)	(1		)	9			(2		)	9
Depreciation and amortization	(205		)	(204		)	(627		)	(602		)
Impairment and restructuring charges, and acquisition-related costs	(46		)	(46		)	(101		)	(123		)
Litigation and investigation costs	(84		)	(9		)	(115		)	(28		)
Interest expense	(244		)	(249		)	(742		)	(758		)
Loss from early extinguishment of debt	(180		)	—			(227		)	(2		)
Other non-operating expense, net	(3		)	—			(3		)	(2		)
Net gains (losses) on sales, consolidation and deconsolidation of facilities	(1		)	(7		)	(3		)	111
Income (loss) from continuing operations, before income taxes	$	(133	)	$	71		$	81		$	481


(1)	Hospital Operations and other revenues includes health plan revenues of less than $1 million and approximately $1 million for the three and nine months ended September 30, 2019, respectively, and $8 million and $14 million for the three and nine months ended September 30, 2018, respectively.

(2)

Hospital Operations and other Adjusted EBITDA excludes health plan EBITDA of $(1) million and $(2) million for the three and nine months ended September 30, 2019, respectively, and $9 million for both of the three and nine months ended September 30, 2018.

BASIS OF PRESENTATION (Details) $ in Millions	9 Months Ended
BASIS OF PRESENTATION (Details) $ in Millions	Sep. 30, 2019 USD ($) facility hospital	Jan. 01, 2019 USD ($)	Jan. 01, 2018 USD ($)
Business Acquisition
Number of hospitals operated by subsidiaries \| hospital	65
Number of healthcare facilities \| facility	500
Operating lease, right-of-use assets	$ 913	$ 822
Operating lease liability, current	160	147
Operating lease liabilities, long-term	$ 854	715
Cumulative effect of accounting change		1	$ 0
Accounting Standards Update 2016-02
Business Acquisition
Cumulative effect of accounting change		$ 1

BASIS OF PRESENTATION - Cash and Cash Equivalents (Details) - USD ($) $ in Millions	9 Months Ended		12 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Cash and Cash Equivalents
Cash and cash equivalents	$ 314		$ 411
Accrued property and equipment purchases for items received but not yet paid	69		135
Non-cancellable capital (finance leases) entered into	91	$ 94
Captive insurance subsidiaries
Cash and Cash Equivalents
Cash and cash equivalents	204		177
Health plan-related businesses
Cash and Cash Equivalents
Cash and cash equivalents	2		8
Accounts payable
Cash and Cash Equivalents
Book overdrafts classified as accounts payable	287		288
Accrued property and equipment purchases for items received but not yet paid	$ 50		$ 114

BASIS OF PRESENTATION - Other Intangible Assets (Details) - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Other intangible assets
Gross Carrying Amount	$ 2,718	$ 2,744
Accumulated Amortization	(1,098)	(1,013)
Net Book Value	1,620	1,731
Capitalized software costs
Other intangible assets
Gross Carrying Amount	1,637	1,667
Accumulated Amortization	(927)	(858)
Net Book Value	710	809
Trade names
Other intangible assets
Gross Carrying Amount	102	102
Accumulated Amortization	0	0
Net Book Value	102	102
Contracts
Other intangible assets
Gross Carrying Amount	875	871
Accumulated Amortization	(90)	(76)
Net Book Value	785	795
Other
Other intangible assets
Gross Carrying Amount	104	104
Accumulated Amortization	(81)	(79)
Net Book Value	$ 23	$ 25

BASIS OF PRESENTATION - Amortization of Intangible Assets (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Amortization of intangible assets
Total	$ 938
Six months ending 2019	45
Year Ending 2020	132
Year Ending 2021	117
Year Ending 2022	104
Year Ending 2023	95
Later Years	445
Amortization expense	$ 138	$ 134

BASIS OF PRESENTATION - Investments in Unconsolidated Affiliates (Details) $ in Millions		3 Months Ended		9 Months Ended
	Mar. 01, 2018 hospital	Sep. 30, 2019 USD ($)	Sep. 30, 2018 USD ($)	Sep. 30, 2019 USD ($) hospital	Sep. 30, 2018 USD ($)
Schedule of Equity Method Investments [Line Items]
Investee results reflected				1
Net operating revenues \| $		$ 622	$ 546	$ 1,809	$ 1,667
Net income \| $		156	126	447	374
Net income available to the investees \| $		$ 97	$ 80	$ 290	$ 240
Ambulatory Care
Schedule of Equity Method Investments [Line Items]
Number of outpatient centers recorded not using equity method				237
Number of outpatient centers recorded using equity method				111
Number of outpatient centers				348
Hospital Operations and other
Schedule of Equity Method Investments [Line Items]
Number of hospitals recorded using equity method	4

ACCOUNTS RECEIVABLE - Components (Details) - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Accounts receivable and allowance for doubtful accounts
Accounts receivable, net	$ 2,768	$ 2,595
Continuing Operations
Accounts receivable and allowance for doubtful accounts
Patient accounts receivable	2,559	2,427
Estimated future recoveries	169	148
Net cost reports and settlements receivable and valuation allowances	38	18
Accounts receivable, net	2,766	2,593
Discontinued operations
Accounts receivable and allowance for doubtful accounts
Accounts receivable, net	$ 2	$ 2

ACCOUNTS RECEIVABLE - Narrative (Details) - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Accounts receivable and allowance for doubtful accounts
Receivables	$ 2,768	$ 2,595
Payables	1,125	1,207
California's Provider Fee Program \| Other current assets
Accounts receivable and allowance for doubtful accounts
Receivables	274	278
California's Provider Fee Program \| Other assets
Accounts receivable and allowance for doubtful accounts
Receivables, noncurrent	218	231
California's Provider Fee Program \| Other current liabilities
Accounts receivable and allowance for doubtful accounts
Payables	70	100
California's Provider Fee Program \| Other long-term liabilities
Accounts receivable and allowance for doubtful accounts
Liabilities, noncurrent	$ 50	$ 42

ACCOUNTS RECEIVABLE - Allowance (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Accounts receivable and allowance for doubtful accounts
Estimated costs of caring	$ 212	$ 200	$ 609	$ 568
Uninsured patients
Accounts receivable and allowance for doubtful accounts
Estimated costs of caring	171	172	493	477
Charity care patients
Accounts receivable and allowance for doubtful accounts
Estimated costs of caring	$ 41	$ 28	$ 116	$ 91

CONTRACT BALANCES - Hospital Operations and Other Segment (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Receivables
Percentage of contract assets that meet the conditions for unconditional right to payment (percentage)	89.00%
Hospital Operations And Other Total Prior To Inter-Segment Eliminations
Receivables
Balance at beginning of period	$ 169	$ 171
Balance at end of period	163	152
Increase/(decrease)	$ (6)	$ (19)

CONTRACT BALANCES - Conifer Segment (Details) - Conifer - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Receivables
Beginning balance	$ 42	$ 89
Ending balance	86	89
Increase/(decrease)	44	0
Contract Asset-Unbilled Revenue
Beginning balance	11	10
Ending balance	11	11
Increase/(decrease)	0	1
Contract Liability-Current Deferred Revenue
Balance at beginning of period	61	80
Balance at end of period	72	74
Contract Liability-Long-term Deferred Revenue
Balance at beginning of period	20	21
Balance at end of period	19	21
Amount of revenue recognized included in current deferred revenue liability	57	68
Long-term Contract with Customer
Contract Liability-Current Deferred Revenue
Increase/(decrease)	(1)	0
Contract Liability-Long-term Deferred Revenue
Increase/(decrease)	(1)	0
Short-term Contract with Customer
Contract Liability-Current Deferred Revenue
Increase/(decrease)	11	(6)
Contract Liability-Long-term Deferred Revenue
Increase/(decrease)	$ 11	$ (6)

CONTRACT BALANCES - Contract Costs (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Revenue from Contract with Customer [Abstract]
Amortization expense	$ 2	$ 3	$ 4	$ 9
Unamortized customer contract costs	$ 26		$ 26		$ 28

ASSETS AND LIABILITIES HELD FOR SALE (Details)	3 Months Ended		9 Months Ended
ASSETS AND LIABILITIES HELD FOR SALE (Details)	Mar. 31, 2018 USD ($)	Dec. 31, 2017 hospital	Sep. 30, 2019 USD ($)	Sep. 30, 2018 USD ($)	Dec. 31, 2018 USD ($)
Current Assets and Liabilities Held for Sale
Assets held for sale			$ 0
Liabilities held for sale			0
Impairment charges			$ 7,000,000	$ 29,000,000
Chicago-area
Current Assets and Liabilities Held for Sale
Assets held for sale					$ 107,000,000
Liabilities held for sale					$ 43,000,000
Impairment charges	$ 17,000,000
Chicago-area \| Disposal Group, Held-for-sale, Not Discontinued Operations
Current Assets and Liabilities Held for Sale
Number of hospitals \| hospital		3

ASSETS AND LIABILITIES HELD FOR SALE - Significant Disposals (Details) - USD ($) $ in Millions	3 Months Ended			9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Sep. 30, 2018
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment charges				$ 7	$ 29
Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Income (loss) from continuing operations, before income taxes	$ (1)	$ (22)		(9)	49
Chicago-area
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment charges			$ 17
Chicago-area \| Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Income (loss) from continuing operations, before income taxes	0	(10)		(11)	(25)
Gain (loss) on disposition of business				(6)
Impairment charges					17
Philadelphia
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain (loss) on disposition of business					(2)
Philadelphia \| Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Income (loss) from continuing operations, before income taxes	0	1		1	(10)
MacNeal \| Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Income (loss) from continuing operations, before income taxes	(1)	(7)		1	90
Gain (loss) on disposition of business					88
Aspen \| Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Income (loss) from continuing operations, before income taxes	$ 0	$ (6)		$ 0	(6)
Impairment charges					$ 9

IMPAIRMENT AND RESTRUCTURING CHARGES, AND ACQUISITION-RELATED COSTS (Details) $ in Millions	3 Months Ended			9 Months Ended
	Sep. 30, 2019 USD ($)	Sep. 30, 2018 USD ($)	Mar. 31, 2018 USD ($)	Sep. 30, 2019 USD ($) segment	Sep. 30, 2018 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment and restructuring charges, and acquisition-related costs	$ 46	$ 46		$ 101	$ 123
Impairment charges				7	29
Restructuring charges				90	82
Acquisition costs				4	12
Employee severance costs				38	47
Contract and lease termination costs				3	10
Other restructuring costs				49	25
Acquisition-related transaction costs				$ 4	8
Other impairment charges					3
Acquisition integration charges					4
Number of operating segments \| segment				3
Chicago-area
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment charges			$ 17
Charges to write-down assets held for sale to their estimated fair value					17
Aspen Facilities
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Charges to write-down assets held for sale to their estimated fair value					9
Hospital Operations And Other
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment charges				$ 4	20
Ambulatory Care Segment
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment charges				$ 3	$ 9

LEASES - Balance Sheet Components (Details) - USD ($) $ in Millions	Sep. 30, 2019	Jan. 01, 2019
Leases [Abstract]
Operating lease assets	$ 913	$ 822
Finance lease assets	435
Total leased assets	1,348
Operating lease liability, current	160	147
Operating lease liabilities, long-term	854	$ 715
Total operating lease liabilities	1,014
Finance lease liabilities, current	139
Finance lease liabilities, long-term	201
Total finance lease liabilities	340
Total lease obligations	$ 1,354

LEASES - Narrative (Details)	9 Months Ended
LEASES - Narrative (Details)	Sep. 30, 2019
Lessee, Lease, Description [Line Items]
Finite-lived intangible asset, useful life	15 years
Minimum
Lessee, Lease, Description [Line Items]
Finance lease renewal term	5 years
Maximum
Lessee, Lease, Description [Line Items]
Finance lease renewal term	10 years
Real Estate \| Minimum
Lessee, Lease, Description [Line Items]
Operating lease, term of contract	5 years
Real Estate \| Maximum
Lessee, Lease, Description [Line Items]
Operating lease, term of contract	10 years
Equipment
Lessee, Lease, Description [Line Items]
Operating lease renewal term	3 years
Medical Equipment
Lessee, Lease, Description [Line Items]
Finance lease, term of contract	3 years
Useful life	5 years
Medical Equipment \| Maximum
Lessee, Lease, Description [Line Items]
Useful life	7 years

LEASES - Lease Costs (Details) $ in Millions	3 Months Ended	9 Months Ended
LEASES - Lease Costs (Details) $ in Millions	Sep. 30, 2019 USD ($)	Sep. 30, 2019 USD ($)
Right-of-use assets obtained in exchange for lease obligations:
Operating lease expense	$ 54	$ 156
Finance lease expense:
Amortization of leased assets	22	63
Interest on lease liabilities	4	12
Total finance lease expense	26	75
Variable and short term-lease expense	33	100
Total lease expense	$ 113	$ 331
Weighted-average remaining lease term (years), operating leases	7 years 8 months 12 days	7 years 8 months 12 days
Weighted-average remaining lease term (years), finance leases	6 years	6 years
Weighted-average discount rate, operating leases (percentage)	5.50%	5.50%
Weighted-average discount rate, finance leases (percentage)	5.60%	5.60%

LEASES - Supplemental Cash Flow Information (Details) $ in Millions	9 Months Ended
	Sep. 30, 2019 USD ($)
Cash Paid For Amounts Included In The Measurement Of Lease Liabilities [Abstract]
Operating cash outflows from operating leases	$ 146
Operating cash outflows from finance leases	15
Financing cash outflows from finance leases	112
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	208
Finance leases	$ 91

LEASES - Schedule of Lease Maturities (Details) - USD ($) $ in Millions	Sep. 30, 2019	Jan. 01, 2019
Operating Leases
2019	$ 160
2020	189
2021	177
2022	157
2023	133
Later years	420
Total lease payments	1,236
Less: Imputed interest	222
Total operating lease liabilities	1,014
Less: Current obligations	160	$ 147
Long-term lease obligations	854	$ 715
Finance Leases
2019	139
2020	137
2021	80
2022	24
2023	13
Later years	124
Total lease payments	517
Less: Imputed interest	177
Total finance lease liabilities	340
Less: Current obligations	139
Long-term lease obligations	201
Total
2019	299
2020	326
2021	257
2022	181
2023	146
Later years	544
Total lease payments	1,753
Less: Imputed interest	399
Total lease obligations	1,354
Less: Current obligations	299
Long-term lease obligations	$ 1,055

LEASES - Lease Obligations Prior to Adoption of ASU 2016-02 (Details) $ in Millions	Dec. 31, 2018 USD ($)
Capital lease obligations
Total	$ 425
2019	140
2020	95
2021	57
2022	37
2023	21
Later Years	75
Long-term non-cancelable operating leases
Total	932
2019	171
2020	151
2021	133
2022	113
2023	92
Later Years	$ 272

LONG-TERM DEBT - Schedule of Debt (Details) - USD ($) $ in Millions	Sep. 30, 2019	Aug. 26, 2019	Feb. 05, 2019	Dec. 31, 2018
LONG-TERM DEBT AND LEASE OBLIGATIONS
Finance leases and mortgage notes	$ 452			$ 500
Unamortized issue costs and note discounts	(196)			(184)
Total long-term debt	15,023			14,826
Less current portion	165			182
Long-term debt, net of current portion	14,858			14,644
5.500% due 2019
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage			5.50%
4.875% due 2026
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage		4.875%
5.125% due 2027
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage		5.125%
7.500% due 2022
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage			7.50%
6.250% due 2027
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage			6.25%
Senior Notes \| 5.500% due 2019
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 0			468
Stated interest rate, percentage	5.50%
Senior Notes \| 6.750% due 2020
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 0			300
Stated interest rate, percentage	6.75%		6.75%
Senior Notes \| 8.125% due 2022
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 2,800			2,800
Stated interest rate, percentage	8.125%
Senior Notes \| 6.750% due 2023
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 1,872			1,872
Stated interest rate, percentage	6.75%
Senior Notes \| 7.000% due 2025
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 478			478
Stated interest rate, percentage	7.00%
Senior Notes \| 6.875% due 2031
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 362			362
Stated interest rate, percentage	6.875%
Senior Notes \| 4.750% due 2020
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 0			500
Stated interest rate, percentage	4.75%	4.75%
Senior Notes \| 6.000% due 2020
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 0			1,800
Stated interest rate, percentage	6.00%	6.00%
Senior Notes \| 4.500% due 2021
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 0			850
Stated interest rate, percentage	4.50%	4.50%
Senior Notes \| 4.375% due 2021
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 0			1,050
Stated interest rate, percentage	4.375%	4.375%
Senior Notes \| 4.625% due 2024
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 1,870			1,870
Stated interest rate, percentage	4.625%
Senior Notes \| 4.625% due 2024
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 600			0
Stated interest rate, percentage	4.625%	4.625%
Senior Notes \| 4.875% due 2026
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 2,100			0
Stated interest rate, percentage	4.875%
Senior Notes \| 5.125% due 2027
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 1,500			0
Stated interest rate, percentage	5.125%
Senior Notes \| 7.500% due 2022
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 0			750
Stated interest rate, percentage	7.50%
Senior Notes \| 5.125% due 2025
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 1,410			1,410
Stated interest rate, percentage	5.125%
Senior Notes \| 6.250% due 2027
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 1,500			0
Stated interest rate, percentage	6.25%
Letter of Credit Facility
LONG-TERM DEBT AND LEASE OBLIGATIONS
Carrying amount	$ 275			$ 0

LONG-TERM DEBT - Senior Secured and Senior Secured Notes (Details) - USD ($)	3 Months Ended			9 Months Ended
	Sep. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Aug. 26, 2019	Feb. 05, 2019
LONG-TERM DEBT AND LEASE OBLIGATIONS
Loss from early extinguishment of debt	$ 180,000,000	$ 47,000,000	$ 0	$ 227,000,000	$ 2,000,000
4.875% due 2026
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage						4.875%
5.125% due 2027
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage						5.125%
6.250% due 2027
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage							6.25%
7.500% due 2022
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage							7.50%
5.500% due 2019
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage							5.50%
Senior Notes \| 4.625% due 2024
LONG-TERM DEBT AND LEASE OBLIGATIONS
Long term debt, face amount						$ 600,000,000
Stated interest rate, percentage	4.625%			4.625%		4.625%
Senior Notes \| 4.875% due 2026
LONG-TERM DEBT AND LEASE OBLIGATIONS
Long term debt, face amount						$ 2,100,000,000
Stated interest rate, percentage	4.875%			4.875%
Senior Notes \| 5.125% due 2027
LONG-TERM DEBT AND LEASE OBLIGATIONS
Long term debt, face amount						$ 1,500,000,000
Stated interest rate, percentage	5.125%			5.125%
Senior Notes \| 4.750% due 2020
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage	4.75%			4.75%		4.75%
Repurchased face amount						$ 500,000,000
Senior Notes \| 6.000% due 2020
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage	6.00%			6.00%		6.00%
Repurchased face amount						$ 1,800,000,000
Senior Notes \| 4.500% due 2021
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage	4.50%			4.50%		4.50%
Repurchased face amount						$ 850,000,000
Senior Notes \| 4.375% due 2021
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage	4.375%			4.375%		4.375%
Repurchased face amount						$ 1,050,000,000.00
Senior Notes \| 6.250% due 2027
LONG-TERM DEBT AND LEASE OBLIGATIONS
Long term debt, face amount							$ 1,500,000,000
Stated interest rate, percentage	6.25%			6.25%
Senior Notes \| 6.750% due 2020
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage	6.75%			6.75%			6.75%
Repurchased face amount							$ 300,000,000
Senior Notes \| 7.500% due 2022
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage	7.50%			7.50%
Repurchased face amount							750,000,000
Senior Notes \| 5.500% due 2019
LONG-TERM DEBT AND LEASE OBLIGATIONS
Stated interest rate, percentage	5.50%			5.50%
Repurchased face amount							$ 468,000,000

LONG-TERM DEBT - Credit Agreement and Letter of Credit Facility (Details) - USD ($)	9 Months Ended
	Sep. 30, 2019	Aug. 31, 2019	Dec. 31, 2018
Credit Agreement
LONG-TERM DEBT AND LEASE OBLIGATIONS
Revolving credit facility, maximum borrowing capacity (up to)	$ 1,500,000,000	$ 1,000,000,000.0
Line of credit facility, subfacility maximum available capacity	$ 200,000,000
Interest rate on cash borrowings outstanding under the Credit Agreement (percentage)	3.45%
Standby letters of credit outstanding	$ 1,000,000
Amount available for borrowing under revolving credit facility	$ 1,200,000,000
Credit Agreement \| Minimum
LONG-TERM DEBT AND LEASE OBLIGATIONS
Unused commitment fee (percentage)	0.25%
Credit Agreement \| Maximum
LONG-TERM DEBT AND LEASE OBLIGATIONS
Unused commitment fee (percentage)	0.375%
Credit Agreement \| Base rate \| Minimum
LONG-TERM DEBT AND LEASE OBLIGATIONS
Margin on variable rate (percentage)	0.25%
Credit Agreement \| Base rate \| Maximum
LONG-TERM DEBT AND LEASE OBLIGATIONS
Margin on variable rate (percentage)	0.75%
Credit Agreement \| LIBOR \| Minimum
LONG-TERM DEBT AND LEASE OBLIGATIONS
Margin on variable rate (percentage)	1.25%
Credit Agreement \| LIBOR \| Maximum
LONG-TERM DEBT AND LEASE OBLIGATIONS
Margin on variable rate (percentage)	1.75%
Letter of Credit Facility
LONG-TERM DEBT AND LEASE OBLIGATIONS
Revolving credit facility, maximum borrowing capacity (up to)	$ 180,000,000
Carrying amount	275,000,000		$ 0
Standby letters of credit outstanding	92,000,000
Borrowing capacity after increase subject to certain conditions (up to)	$ 200,000,000
Unused commitment fee after step down (up to) (percentage)	0.50%
Secured debt to EBITDA ratio	3.00
Issuance fee (percentage)	1.50%
Issuance fee, based on face amount (percentage)	0.125%
Letter of Credit Facility \| Maximum
LONG-TERM DEBT AND LEASE OBLIGATIONS
Number of business days after notice, for reimbursement of amount drawn	3 days

GUARANTEES (Details) $ in Millions	Sep. 30, 2019 USD ($)
Income and Revenue Collection Guarantee
GUARANTEES
Maximum potential amount of future payments under guarantees	$ 143
Income and Revenue Collection Guarantee \| Other current liabilities
GUARANTEES
Liability for the fair value of guarantees	122
Guaranteed Investees Of Third Parties
GUARANTEES
Liability for the fair value of guarantees	25
Guaranteed Investees Of Third Parties \| Other current liabilities
GUARANTEES
Guarantee obligations for consolidated subsidiaries	$ 8

EMPLOYEE BENEFIT PLANS (Details) - USD ($) $ in Millions	9 Months Ended
EMPLOYEE BENEFIT PLANS (Details) - USD ($) $ in Millions	Sep. 30, 2019	Sep. 30, 2018
EMPLOYEE BENEFIT PLANS
Shares available for issuance under the plan (in shares)	8,000,000.0
Shares available assuming maximum performance (in shares)	7,900,000
Stock-based compensation costs, pretax	$ 34	$ 34
Stock Options
EMPLOYEE BENEFIT PLANS
Expiration period from the date of grant	10 years
Vesting period	3 years
Portion of awards vesting on each of the first three anniversary dates of the grant	33.33%
Restricted Stock Units
EMPLOYEE BENEFIT PLANS
Contractual right to receive shares of common stock for a stock based award (in shares)	1
Vesting period	3 years
Portion of awards vesting on each of the first three anniversary dates of the grant	33.33%

EMPLOYEE BENEFIT PLANS - Stock Options (Details) - USD ($) $ / shares in Units, $ in Millions					3 Months Ended		9 Months Ended
	Mar. 29, 2019	Feb. 27, 2019	May 31, 2018	Feb. 28, 2018	Sep. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Sep. 30, 2018
Weighted Average Remaining Life
Weighted average estimated fair value of awards granted (in dollars per share)							$ 12.50	$ 9.16
Stock Options
Options
Outstanding at the beginning of the period (in shares)							2,262,743
Granted (in shares)							230,713
Exercised (in shares)							(76,159)	(612,074)
Forfeited/Expired (in shares)							(203,256)
Outstanding at the end of the period (in shares)							2,214,041
Vested and expected to vest at the end of the period (in shares)							2,214,041
Exercisable at the end of the period (in shares)							684,628
Weighted Average Exercise Price Per Share
Outstanding at the beginning of the period (in dollars per share)							$ 19.12
Granted (in dollars per share)							28.28
Exercised (in dollars per share)							4.56
Forfeited/Expired (in dollars per share)							19.66
Outstanding at the end of the period (in dollars per share)							20.53
Vested and expected to vest at the end of the period (in dollars per share)							20.53
Exercisable at the end of the period (in dollars per share)							$ 19.03
Aggregate Intrinsic Value
Outstanding at the end of the period							$ 6
Vested and expected to vest at the end of the period							6
Exercisable at the end of the period							$ 2
Weighted Average Remaining Life
Outstanding at the end of the period							6 years
Vested and expected to vest at the end of the period							6 years
Exercisable at the end of the period							2 years 9 months 18 days
Exercised (in shares)							76,159	612,074
Aggregate Intrinsic value of awards exercised							$ 1	$ 4
Unrecognized compensation costs							$ 5
Period for recognition of unrecognized compensation costs							1 year 8 months 12 days
Assumptions used to calculate fair value of awards granted to top eleven employees
Expected volatility		48.00%		46.00%
Expected dividend yield		0.00%		0.00%
Expected life		6 years 2 months 12 days		6 years 2 months 12 days
Expected forfeiture rate		0.00%		0.00%
Risk-free interest rate		2.53%		2.72%
Performance-based Stock Options \| Senior Officers
Options
Granted (in shares)	7,862				31,184	604,012
Weighted Average Remaining Life
Target closing stock price (in dollars per share)	$ 36.05				$ 44.29			$ 44.29
Stock price premium	25.00%		25.00%
Share price (in dollars per share)	$ 28.84		$ 35.43
Vesting date of grant anniversary subject to specific conditions	3 years				3 years
Number of consecutive trading days (at least)	20 days	20 days			20 days
Non-Performance Employee Stock Option \| Senior Officers
Options
Granted (in shares)		222,851
Weighted Average Remaining Life
Target closing stock price (in dollars per share)		$ 35.33			$ 25.75			$ 25.75
Stock price premium		25.00%		25.00%
Share price (in dollars per share)		$ 28.26		$ 20.60
Vesting date of grant anniversary subject to specific conditions		3 years			3 years
Number of consecutive trading days (at least)					20 days

EMPLOYEE BENEFIT PLANS - Range of Exercise Prices (Details) - Stock Options	9 Months Ended
	Sep. 30, 2019 $ / shares shares
Options Outstanding
Number of Options Outstanding (in shares) \| shares	2,214,041
Weighted Average Remaining Contractual Life	6 years
Weighted Average Exercise Price (in dollars per share)	$ 20.53
Options Exercisable
Number of Options Exercisable (in shares) \| shares	684,628
Weighted Average Exercise Price (in dollars per share)	$ 19.03
$16.43 to $19.759
Options Outstanding
Number of Options Outstanding (in shares) \| shares	1,229,723
Weighted Average Remaining Contractual Life	5 years 4 months 24 days
Weighted Average Exercise Price (in dollars per share)	$ 18.14
Options Exercisable
Number of Options Exercisable (in shares) \| shares	413,960
Weighted Average Exercise Price (in dollars per share)	$ 16.46
$19.76 to $35.430
Options Outstanding
Number of Options Outstanding (in shares) \| shares	984,318
Weighted Average Remaining Contractual Life	6 years 8 months 12 days
Weighted Average Exercise Price (in dollars per share)	$ 23.51
Options Exercisable
Number of Options Exercisable (in shares) \| shares	270,668
Weighted Average Exercise Price (in dollars per share)	$ 22.94
Minimum \| $16.43 to $19.759
Summary information about outstanding stock options
Exercise price per share, low end of the range (in dollars per share)	16.43
Minimum \| $19.76 to $35.430
Summary information about outstanding stock options
Exercise price per share, low end of the range (in dollars per share)	19.76
Maximum \| $16.43 to $19.759
Summary information about outstanding stock options
Exercise price per share, high end of the range (in dollars per share)	19.759
Maximum \| $19.76 to $35.430
Summary information about outstanding stock options
Exercise price per share, high end of the range (in dollars per share)	$ 35.430

EMPLOYEE BENEFIT PLANS - Restricted Stock Units (Details) $ / shares in Units, $ in Millions	1 Months Ended			9 Months Ended
	Aug. 31, 2019 member shares	May 31, 2019 shares	May 31, 2018 member shares	Sep. 30, 2019 USD ($) $ / shares shares	Sep. 30, 2018 shares
Weighted Average Grant Date Fair Value Per Unit
Number of new members appointed to the board of directors \| member	1		2
Restricted Stock Units
Restricted Stock Units
Unvested at the beginning of the period (in shares)				1,884,130
Granted (in shares)		100,444	54,198	1,460,753	734,091
Vested (in shares)				(1,425,660)
Forfeited (in shares)				(329,926)
Unvested at the end of the period (in shares)				1,589,297
Weighted Average Grant Date Fair Value Per Unit
Unvested at the beginning of the period (in dollars per share) \| $ / shares				$ 32.25
Granted (in dollars per share) \| $ / shares				27.85
Vested (in dollars per share) \| $ / shares				37.49
Forfeited (in dollars per share) \| $ / shares				24.71
Unvested at the end of the period (in dollars per share) \| $ / shares				$ 25.07
Vesting period				3 years
Percentage of restricted stock units, which will vest three years from the grant date				33.33%
Unrecognized compensation costs \| $				$ 30
Period for recognition of unrecognized compensation costs				1 year 9 months 18 days
Restricted Stock Units \| Time based vesting, three year period from grant date
Restricted Stock Units
Granted (in shares)				337,848	288,325
Restricted Stock Units \| Twenty-seven month vesting
Restricted Stock Units
Granted (in shares)				566,172
Weighted Average Grant Date Fair Value Per Unit
Vesting period				27 months
Restricted Stock Units \| Vesting and settled ratably over a three-year period from the grant date
Weighted Average Grant Date Fair Value Per Unit
Vesting date of grant anniversary subject to specific conditions				3 years	3 years
Number of restricted stock units vested on third anniversary of grant date (in shares)				340,931	29,870
Restricted Stock Units \| Time Based Vesting Two Years
Restricted Stock Units
Granted (in shares)					339,806
Weighted Average Grant Date Fair Value Per Unit
Vesting period					2 years
Restricted Stock Units \| Time Based Vesting \| Director
Restricted Stock Units
Granted (in shares)	7,978		12,154
Restricted Stock Units \| Performance Based Vesting \| Minimum
Weighted Average Grant Date Fair Value Per Unit
Percentage of restricted stock units, which will vest three years from the grant date					0.00%
Restricted Stock Units \| Performance Based Vesting \| Maximum
Weighted Average Grant Date Fair Value Per Unit
Percentage of restricted stock units, which will vest three years from the grant date					200.00%
Restricted Stock Units \| Performance Based Vesting \| Officer
Restricted Stock Units
Granted (in shares)					6,068
Additional Prorated Restricted Stock Units \| Time Based Vesting \| Director
Restricted Stock Units
Granted (in shares)	3,003		3,670
2013 Grant \| Restricted Stock Units
Restricted Stock Units
Granted (in shares)				7,427
2014 Grant \| Restricted Stock Units
Restricted Stock Units
Granted (in shares)				96,950

EMPLOYEE BENEFIT PLANS - Employee Retirement Plans (Details) $ in Millions	9 Months Ended
	Sep. 30, 2019 USD ($) plan	Sep. 30, 2018 USD ($)
Employee Retirement Plans
Number of frozen plans \| plan	1
Salaries, wages and benefits expense
Employee Retirement Plans
Service costs (less than in current year)	$ 1	$ 2
Other non-operating income (expense), net
Employee Retirement Plans
Other components	$ 16	$ 12

EQUITY - Changes in Shareholders' Equity (Details) - USD ($) shares in Thousands, $ in Millions	3 Months Ended						9 Months Ended
	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Sep. 30, 2018	Jan. 01, 2019	Jan. 01, 2018
Changes in Shareholders' Equity
Balances, beginning of period	$ 717	$ 674	$ 687	$ 576	$ 616	$ 539	$ 687	$ 539
Net income (loss)	(187)	64	18	31	68	130
Distributions paid to noncontrolling interests	(46)	(35)	(37)	(40)	(38)	(34)
Other comprehensive income (loss)	3	2	2	41	(4)	8	7	45
Accretion of redeemable noncontrolling interests	(4)	(4)	(5)	(6)	(123)	(37)
Purchases (sales) of businesses and noncontrolling interests	1	5	0	39	43	(6)
Cumulative effect of accounting change									$ 1	$ 0
Stock-based compensation expense, tax benefit and issuance of common stock	5	11	8	17	14	16
Balances, end of period	$ 489	$ 717	$ 674	$ 658	$ 576	$ 616	$ 489	$ 658
Common Stock
Changes in Shareholders' Equity
Balances, beginning of period (in shares)	103,336	103,080	102,537	102,301	101,989	100,972	102,537	100,972
Balances, beginning of period	$ 7	$ 7	$ 7	$ 7	$ 7	$ 7	$ 7	$ 7
Stock-based compensation expense, tax benefit and issuance of common stock (in shares)	436	256	543	146	312	1,017
Balances, end of period (in shares)	103,772	103,336	103,080	102,447	102,301	101,989	103,772	102,447
Balances, end of period	$ 7	$ 7	$ 7	$ 7	$ 7	$ 7	$ 7	$ 7
Additional Paid-In Capital
Changes in Shareholders' Equity
Balances, beginning of period	4,755	4,748	4,747	4,722	4,833	4,859	4,747	4,859
Accretion of redeemable noncontrolling interests	(4)	(4)	(5)	(6)	(123)	(37)
Purchases (sales) of businesses and noncontrolling interests	(5)		(2)	3	(2)	(4)
Stock-based compensation expense, tax benefit and issuance of common stock	5	11	8	14	14	15
Balances, end of period	4,751	4,755	4,748	4,733	4,722	4,833	4,751	4,733
Accumulated Other Comprehensive Loss
Changes in Shareholders' Equity
Balances, beginning of period	(219)	(221)	(223)	(243)	(239)	(204)	(223)	(204)
Other comprehensive income (loss)	3	2	2	41	(4)	8
Cumulative effect of accounting change										(43)
Balances, end of period	(216)	(219)	(221)	(202)	(243)	(239)	(216)	(202)
Accumulated Deficit
Changes in Shareholders' Equity
Balances, beginning of period	(2,237)	(2,254)	(2,236)	(2,222)	(2,248)	(2,390)	(2,236)	(2,390)
Net income (loss)	(232)	17	(19)	(9)	26	99
Cumulative effect of accounting change									$ 1	$ 43
Balances, end of period	(2,469)	(2,237)	(2,254)	(2,231)	(2,222)	(2,248)	(2,469)	(2,231)
Treasury Stock
Changes in Shareholders' Equity
Balances, beginning of period	(2,414)	(2,414)	(2,414)	(2,418)	(2,418)	(2,419)	(2,414)	(2,419)
Stock-based compensation expense, tax benefit and issuance of common stock				3	0	1
Balances, end of period	(2,414)	(2,414)	(2,414)	(2,415)	(2,418)	(2,418)	(2,414)	(2,415)
Noncontrolling Interests
Changes in Shareholders' Equity
Balances, beginning of period	825	808	806	730	681	686	806	686
Net income (loss)	45	47	37	40	42	31
Distributions paid to noncontrolling interests	(46)	(35)	(37)	(40)	(38)	(34)
Purchases (sales) of businesses and noncontrolling interests	6	5	2	36	45	(2)
Balances, end of period	$ 830	$ 825	$ 808	$ 766	$ 730	$ 681	$ 830	$ 766

EQUITY - Changes in Shareholders' Equity - Noncontrolling interests (Details) - USD ($) $ in Millions	3 Months Ended						9 Months Ended
	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018	Dec. 31, 2017
Accumulated Other Comprehensive Income (Loss) [Line Items]
Stockholders equity balance	$ 489	$ 717	$ 674	$ 658	$ 576	$ 616	$ 489	$ 658	$ 687	$ 539
Net income	(187)	64	18	31	68	130
Noncontrolling Interests
Accumulated Other Comprehensive Income (Loss) [Line Items]
Stockholders equity balance	830	825	808	766	730	681	830	766	806	$ 686
Net income	45	$ 47	$ 37	$ 40	$ 42	$ 31
Noncontrolling Interests \| Hospital Operations and other
Accumulated Other Comprehensive Income (Loss) [Line Items]
Stockholders equity balance	114						114		112
Net income							10	6
Noncontrolling Interests \| Ambulatory Care
Accumulated Other Comprehensive Income (Loss) [Line Items]
Stockholders equity balance	$ 716						716		$ 694
Net income							$ 119	$ 107

NET OPERATING REVENUES (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
NET OPERATING REVENUES (Details) - USD ($) $ in Millions	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Disaggregation of Revenue [Line Items]
Net operating revenues	$ 4,568	$ 4,489	$ 13,673	$ 13,694
Adjustments
Disaggregation of Revenue [Line Items]
Net operating revenues			24	11
Hospital Operations and other
Disaggregation of Revenue [Line Items]
Net operating revenues	522	502	1,526	1,531
Conifer
Disaggregation of Revenue [Line Items]
Net operating revenues	336	371	1,040	1,161
Operating segments \| Hospital Operations and other
Disaggregation of Revenue [Line Items]
Net operating revenues	3,850	3,762	11,539	11,442
Operating segments \| Ambulatory Care
Disaggregation of Revenue [Line Items]
Net operating revenues	522	502	1,526	1,531
Operating segments \| Conifer
Disaggregation of Revenue [Line Items]
Net operating revenues	336	371	1,040	1,161
Inter-segment eliminations
Disaggregation of Revenue [Line Items]
Net operating revenues	(140)	(146)	(432)	(440)
Continuing Operations
Disaggregation of Revenue [Line Items]
Net operating revenues	4,568	4,489	13,673	13,694
Continuing Operations \| Operating segments \| Hospital Operations and other
Disaggregation of Revenue [Line Items]
Net operating revenues	3,850	3,762	11,539	11,442
Continuing Operations \| Operating segments \| Hospital Operations and other \| Other Revenues
Disaggregation of Revenue [Line Items]
Net operating revenues	284	328	844	922
Continuing Operations \| Operating segments \| Ambulatory Care
Disaggregation of Revenue [Line Items]
Net operating revenues	522	502	1,526	1,531
Continuing Operations \| Operating segments \| Conifer
Disaggregation of Revenue [Line Items]
Net operating revenues	336	371	1,040	1,161
Continuing Operations \| Inter-segment eliminations
Disaggregation of Revenue [Line Items]
Net operating revenues	(140)	(146)	(432)	(440)
Acute Care Hospitals and Related Outpatient Facilities \| Continuing Operations \| Operating segments \| Hospital Operations and other \| Medicare
Disaggregation of Revenue [Line Items]
Net operating revenues	697	681	2,176	2,164
Acute Care Hospitals and Related Outpatient Facilities \| Continuing Operations \| Operating segments \| Hospital Operations and other \| Medicaid
Disaggregation of Revenue [Line Items]
Net operating revenues	284	336	914	971
Acute Care Hospitals and Related Outpatient Facilities \| Continuing Operations \| Operating segments \| Hospital Operations and other \| Managed care
Disaggregation of Revenue [Line Items]
Net operating revenues	2,357	2,228	7,041	6,869
Acute Care Hospitals and Related Outpatient Facilities \| Continuing Operations \| Operating segments \| Hospital Operations and other \| Uninsured
Disaggregation of Revenue [Line Items]
Net operating revenues	44	33	56	78
Acute Care Hospitals and Related Outpatient Facilities \| Continuing Operations \| Operating segments \| Hospital Operations and other \| Indemnity and other
Disaggregation of Revenue [Line Items]
Net operating revenues	184	156	508	438
Acute Care Hospitals and Related Outpatient Facilities \| Continuing Operations \| Operating segments \| Hospital Operations and other \| Total
Disaggregation of Revenue [Line Items]
Net operating revenues	$ 3,566	$ 3,434	$ 10,695	$ 10,520

NET OPERATING REVENUES - Ambulatory Care (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Disaggregation of Revenue [Line Items]
Net operating revenues	$ 4,568	$ 4,489	$ 13,673	$ 13,694
Hospital Operations and other
Disaggregation of Revenue [Line Items]
Net operating revenues	522	502	1,526	1,531
Hospital Operations and other \| Net patient service revenues
Disaggregation of Revenue [Line Items]
Net operating revenues	490	471	1,437	1,440
Hospital Operations and other \| Management fees
Disaggregation of Revenue [Line Items]
Net operating revenues	23	22	69	68
Hospital Operations and other \| Revenue from other sources
Disaggregation of Revenue [Line Items]
Net operating revenues	$ 9	$ 9	$ 20	$ 23

NET OPERATING REVENUES - Conifer (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Disaggregation of Revenue [Line Items]
Net operating revenues	$ 4,568	$ 4,489	$ 13,673	$ 13,694
Conifer
Disaggregation of Revenue [Line Items]
Net operating revenues	336	371	$ 1,040	1,161
Conifer \| Revenue from other sources
Disaggregation of Revenue [Line Items]
Net operating revenues, percentage of total			8.00%
Conifer \| Revenue cycle services \| Tenet
Disaggregation of Revenue [Line Items]
Net operating revenues	136	141	$ 420	424
Conifer \| Revenue cycle services \| Non-Tenet
Disaggregation of Revenue [Line Items]
Net operating revenues	175	203	542	655
Conifer \| Other services \| Tenet
Disaggregation of Revenue [Line Items]
Net operating revenues	4	5	12	16
Conifer \| Other services \| Non-Tenet
Disaggregation of Revenue [Line Items]
Net operating revenues	$ 21	$ 22	$ 66	$ 66

NET OPERATING REVENUES - Performance Obligations (Details) - Conifer $ in Millions	Sep. 30, 2019 USD ($)
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Performance obligations	$ 7,440
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2019-10-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Performance obligations	149
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2020-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Performance obligations	598
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2021-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Performance obligations	594
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2022-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Performance obligations	594
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2023-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Performance obligations	594
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2024-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Performance obligations	$ 4,911

NET OPERATING REVENUES NET OPERATING REVENUES - Performance Obligation, conifer (Details) $ in Millions	Sep. 30, 2019 USD ($)
Conifer
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Performance obligations	$ 7,440

NET OPERATING REVENUES NET OPERATING REVENUES - Performance Obligations, Timing of Satisfaction (Details)	Sep. 30, 2019
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2019-10-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Revenue, remaining performance obligation, expected timing of satisfaction, period	3 months
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2020-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Revenue, remaining performance obligation, expected timing of satisfaction, period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2021-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Revenue, remaining performance obligation, expected timing of satisfaction, period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2022-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Revenue, remaining performance obligation, expected timing of satisfaction, period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2023-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Revenue, remaining performance obligation, expected timing of satisfaction, period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2024-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Revenue, remaining performance obligation, expected timing of satisfaction, period

PROPERTY AND PROFESSIONAL AND GENERAL LIABILITY INSURANCE (Details) - Scenario, Forecast $ in Millions	12 Months Ended
	Mar. 31, 2020 USD ($)
Insurance coverage
Insurance, maximum coverage per incident	$ 850
Floods
Insurance coverage
Insurance, maximum coverage per incident	100
Earthquake
Insurance coverage
Insurance, maximum coverage per incident	200
Insurance deductible	40
Windstorms
Insurance coverage
Insurance, maximum coverage per incident	200
Fire and other perils
Insurance coverage
Insurance, maximum coverage per incident	$ 850
Flood, earthquake and windstorm
Insurance coverage
Insurance deductible as a percent	5.00%
Insurance deductible	$ 25
New Madrid Fault Earthquakes
Insurance coverage
Insurance deductible as a percent	2.00%
Insurance deductible	$ 25
Other Catastrophic Events
Insurance coverage
Insurance deductible	$ 1

PROPERTY AND PROFESSIONAL AND GENERAL LIABILITY INSURANCE - Professional and General Liability Reserves (Details) - USD ($) $ in Millions	9 Months Ended		12 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Other operating expense, net
Insurance coverage
Malpractice expense	$ 295	$ 267
Professional and General Liability Reserves
Insurance coverage
Self insurance reserve	$ 901		$ 882
Loss contingency discount rate, maturity rate period	7 years
Risk-free discount rate, percentage	1.62%		2.59%

CLAIMS AND LAWSUITS (Details) $ in Millions	1 Months Ended		3 Months Ended		9 Months Ended
CLAIMS AND LAWSUITS (Details) $ in Millions	Oct. 31, 2019 USD ($)	Jun. 30, 2006 hospital	Sep. 30, 2019 USD ($)	Sep. 30, 2018 USD ($)	Sep. 30, 2019 USD ($) individual	Sep. 30, 2018 USD ($)	Jul. 31, 2019 USD ($)	Jan. 31, 2017 lawsuit
Loss Contingencies
Number of individuals plaintiff proceeding on behalf of \| individual					3
Settlement			$ 84	$ 9	$ 115	$ 28
Shareholder Derivative Litigation
Loss Contingencies
Consolidated lawsuits \| lawsuit								2
Maderazo V. VHS San Antonio Partners, L.P. D/B/A Baptist Health Systems
Loss Contingencies
Number of hospital systems alleging violation \| hospital		3
Maximum
Loss Contingencies
Estimate of possible liability							$ 63
Subsequent event \| Oklahoma Surgical Hospital Qui Tam Action
Loss Contingencies
Estimated litigation liability	$ 66
Settlement	$ 68

CLAIMS AND LAWSUITS - Reconciliations (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Loss Contingency Accrual [Roll Forward]
Litigation and investigation costs	$ 84	$ 9	$ 115	$ 28
Claims, lawsuits, and regulatory proceedings \| Continuing Operations
Loss Contingency Accrual [Roll Forward]
Litigation reserve, balance at beginning of period			8	12
Litigation and investigation costs			115	28
Cash Payments			(37)	(24)
Litigation reserve, balance at end of period	$ 86	$ 16	$ 86	$ 16

REDEEMABLE NONCONTROLLING INTERESTS IN EQUITY OF CONSOLIDATED SUBSIDIARIES - Changes in Redeemable Noncontrolling Interests (Details) - USD ($) $ in Millions	3 Months Ended						9 Months Ended
	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Sep. 30, 2018
Changes in redeemable noncontrolling interests in equity of consolidated subsidiaries
Net income							$ 130	$ 135
Distributions paid to noncontrolling interests	$ (46)	$ (35)	$ (37)	$ (40)	$ (38)	$ (34)
Redeemable noncontrolling interests
Changes in redeemable noncontrolling interests in equity of consolidated subsidiaries
Balances at beginning of period			$ 1,420			$ 1,866	1,420	1,866
Net income							130	135
Distributions paid to noncontrolling interests							(105)	(107)
Accretion of redeemable noncontrolling interests							13	166
Purchases and sales of businesses and noncontrolling interests, net							17	(616)
Balances at end of period	$ 1,475			$ 1,444			$ 1,475	$ 1,444

REDEEMABLE NONCONTROLLING INTERESTS IN EQUITY OF CONSOLIDATED SUBSIDIARIES - Segment Details (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018	Dec. 31, 2017
REDEEMABLE NONCONTROLLING INTEREST
Net income available to redeemable noncontrolling interests	$ 130	$ 135
Redeemable noncontrolling interests
REDEEMABLE NONCONTROLLING INTEREST
Redeemable noncontrolling interests	1,475	1,444	$ 1,420	$ 1,866
Net income available to redeemable noncontrolling interests	130	135
Redeemable noncontrolling interests \| Hospital Operations and other
REDEEMABLE NONCONTROLLING INTEREST
Redeemable noncontrolling interests	400		431
Net income available to redeemable noncontrolling interests	(26)	(17)
Redeemable noncontrolling interests \| Ambulatory Care
REDEEMABLE NONCONTROLLING INTEREST
Redeemable noncontrolling interests	743		713
Net income available to redeemable noncontrolling interests	100	102
Redeemable noncontrolling interests \| Conifer
REDEEMABLE NONCONTROLLING INTEREST
Redeemable noncontrolling interests	332		$ 276
Net income available to redeemable noncontrolling interests	$ 56	$ 50

INCOME TAXES (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
INCOME TAXES (Details) - USD ($) $ in Millions	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Income Taxes
Income tax expense	$ (20)	$ (6)	$ (67)	$ (120)
Continued operations pre-tax earnings	(133)	71	81	481
Decrease in estimated liabilities for uncertain tax positions, net of related deferred tax effects			3
Unrecognized tax benefits	41		41
Unrecognized tax benefits which, if recognized, would impact effective tax rate	39		39
Interest and penalties related to accrued liabilities for uncertain tax positions, recognized	3		3
Unrecognized federal and state tax benefits and reserves for interest and penalties, which may decrease in the next 12 months	7		7
Continuing Operations
Income Taxes
Income tax expense	$ (20)	$ (6)	$ (67)	$ (120)

INCOME TAXES - Federal Tax Reconciliation (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Reconciliation between reported income tax expense (benefit) and income taxes calculated by the statutory federal income tax rate
Tax expense (benefit) at statutory federal rate of 21%	$ (28)	$ 15	$ 17	$ 101
State income taxes, net of federal income tax benefit	(3)	3	6	20
Tax attributable to noncontrolling interests	(17)	(15)	(53)	(49)
Nondeductible goodwill	0	0	0	7
Tax benefit related to loss on Aspen sale	0	(18)	0	(18)
Nontaxable gains	0	0	(1)	0
Stock-based compensation	7	0	7	0
Stock-based compensation	4	0	4	4
Change in valuation allowance	53	24	88	54
Change in tax contingency reserves, including interest	(3)	0	(3)	0
Other items	7	(3)	2	1
Income tax expense	$ 20	$ 6	$ 67	$ 120

EARNINGS (LOSS) PER COMMON SHARE (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Net Income Available (Loss Attributable) to Common Shareholders (Numerator)
Net income (loss) available to Tenet Healthcare Corporation common shareholders for basic earnings (loss) per share	$ (233)	$ (9)	$ (245)	$ 113
Net income (loss) available to Tenet Healthcare Corporation common shareholders for diluted earnings (loss) per share	$ (233)	$ (9)	$ (245)	$ 113
Weighted Average Shares (Denominator)
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders for basic earnings (loss) per share (in shares)	103,558	102,402	103,181	101,980
Effect of dilutive stock options, restricted stock units and deferred compensation units (in shares)	0	0	0	1,822
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders for diluted earnings (loss) per share (in shares)	103,558	102,402	103,181	103,802
Per-Share Amount
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders for basic earnings (loss) per share (in dollars per share)	$ (2.25)	$ (0.09)	$ (2.37)	$ 1.11
Effect of dilutive stock options, restricted stock units and deferred compensation units (in dollars per share)	0	0	0	(0.02)
Net income (loss) attributable to Tenet Healthcare Corporation common shareholders for diluted earnings (loss) per share (in dollars per share)	$ (2.25)	$ (0.09)	$ (2.37)	$ 1.09

EARNINGS (LOSS) PER COMMON SHARE - Antidilutive securities (Details) - shares shares in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019
Employee stock options, restricted stock units and deferred compensation units
Antidilutive securities
Anti-dilutive securities excluded from computation of earnings per share (in shares)	1,024	2,173	1,403

FAIR VALUE MEASUREMENTS (Details) - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Fair value of assets and liabilities measured on recurring basis
Long-lived assets held and used		$ 130
Quoted Prices in Active Markets for Identical Assets (Level 1)
Fair value of assets and liabilities measured on recurring basis
Long-lived assets held and used		0
Significant Other Observable Inputs (Level 2)
Fair value of assets and liabilities measured on recurring basis
Long-lived assets held and used		130
Significant Unobservable Inputs (Level 3)
Fair value of assets and liabilities measured on recurring basis
Long-lived assets held and used		0
Nonrecurring
Fair value of assets and liabilities measured on recurring basis
Long-lived assets held for sale		39
Nonrecurring \| Quoted Prices in Active Markets for Identical Assets (Level 1)
Fair value of assets and liabilities measured on recurring basis
Long-lived assets held for sale		0
Nonrecurring \| Significant Other Observable Inputs (Level 2)
Fair value of assets and liabilities measured on recurring basis
Long-lived assets held for sale		39
Nonrecurring \| Significant Unobservable Inputs (Level 3)
Fair value of assets and liabilities measured on recurring basis
Long-lived assets held for sale		$ 0
Recurring \| Quoted Prices in Active Markets for Identical Assets (Level 1)
Fair value of assets and liabilities measured on recurring basis
Estimated fair value of the long-term debt instrument as a percentage of carrying value (percentage)	103.90%	97.30%

ACQUISITIONS (Details) - USD ($) $ in Millions	9 Months Ended
ACQUISITIONS (Details) - USD ($) $ in Millions	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Final purchase price allocations
Goodwill	$ 7,315		$ 7,281
Gains on consolidations	5	$ 2
Transaction costs related to prospective and closed acquisitions	4	8
Series of individual business acquisitions
Final purchase price allocations
Current assets	5	5
Property and equipment	15	12
Other intangible assets	4	7
Goodwill	34	211
Other long-term assets, including previously held equity method investments	6	(18)
Current liabilities	(4)	1
Long-term liabilities	(10)	(16)
Redeemable noncontrolling interests in equity of consolidated subsidiaries	(16)	(18)
Noncontrolling interests	(6)	(85)
Cash paid, net of cash acquired	(23)	(97)
Gains on consolidations	5	2
Transaction costs related to prospective and closed acquisitions	$ 4	$ 8

SEGMENT INFORMATION - General Information and Customer Concentration (Details)		9 Months Ended
	Aug. 17, 2018 hospital	Sep. 30, 2019 hospital state
Segment Reporting Information [Line Items]
Number of hospitals operated by subsidiaries		65
Conifer Health Solutions, LLC
Segment Reporting Information [Line Items]
Ownership percentage by parent		76.00%
United Surgical Partners International
Segment Reporting Information [Line Items]
Number of states where operations occur \| state		27
Number of ambulatory surgery centers		264
Number of urgent care centers		38
Number of diagnostic imaging centers		23
Number of surgical hospitals		23
European Surgical Partners Ltd \| United Surgical Partners International
Segment Reporting Information [Line Items]
Number of facilities owned by subsidiaries	9
Hospital Operations and other
Segment Reporting Information [Line Items]
Number of states where operations occur \| state		9
Conifer \| Minimum
Segment Reporting Information [Line Items]
Number of hospitals to which segment of the entity provides revenue cycle services		670
United Surgical Partners International \| Ambulatory Care \| United Surgical Partners International
Segment Reporting Information [Line Items]
Ownership percentage by parent		95.00%

SEGMENT INFORMATION - Reconciling Items (Details) - USD ($) $ in Millions	3 Months Ended			9 Months Ended
	Sep. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Segment Reporting Information [Line Items]
Assets:	$ 23,357			$ 23,357		$ 22,409
Capital expenditures:	156		$ 136	492	$ 404
Net operating revenues:	4,568		4,489	13,673	13,694
Equity in earnings of unconsolidated affiliates:	38		33	114	97
Adjusted EBITDA	631		577	1,901	1,876
Depreciation and amortization:	205		204	627	602
Adjusted EBITDA and Other Reconciling Items
Adjusted EBITDA	631		577	1,901	1,876
Income (loss) from divested and closed businesses (i.e., the Company’s health plan businesses)	(1)		9	(2)	9
Depreciation and amortization	(205)		(204)	(627)	(602)
Impairment and restructuring charges, and acquisition-related costs	(46)		(46)	(101)	(123)
Litigation and investigation costs	(84)		(9)	(115)	(28)
Interest expense	(244)		(249)	(742)	(758)
Loss from early extinguishment of debt	(180)	$ (47)	0	(227)	(2)
Other non-operating expense, net	(3)		0	(3)	(2)
Net gains (losses) on sales, consolidation and deconsolidation of facilities	(1)		(7)	(3)	111
Income (loss) from continuing operations, before income taxes	(133)		71	81	481
Adjusted EBITDA attributable to health plans	(1)		9	(2)	9
Inter-segment eliminations
Segment Reporting Information [Line Items]
Net operating revenues:	(140)		(146)	(432)	(440)
Hospital Operations and other
Segment Reporting Information [Line Items]
Assets:	16,202			16,202		15,684
Net operating revenues:	522		502	1,526	1,531
Adjusted EBITDA and Other Reconciling Items
Health plan revenues	1		8	1	14
Hospital Operations and other \| Operating segments
Segment Reporting Information [Line Items]
Capital expenditures:	135		115	423	343
Net operating revenues:	3,850		3,762	11,539	11,442
Equity in earnings of unconsolidated affiliates:	1		2	12	6
Adjusted EBITDA	334		312	1,018	1,059
Depreciation and amortization:	175		175	539	514
Adjusted EBITDA and Other Reconciling Items
Adjusted EBITDA	334		312	1,018	1,059
Depreciation and amortization	(175)		(175)	(539)	(514)
Ambulatory Care
Segment Reporting Information [Line Items]
Assets:	6,100			6,100		5,711
Ambulatory Care \| Operating segments
Segment Reporting Information [Line Items]
Capital expenditures:	16		18	57	46
Net operating revenues:	522		502	1,526	1,531
Equity in earnings of unconsolidated affiliates:	37		31	102	91
Adjusted EBITDA	207		184	591	547
Depreciation and amortization:	19		17	55	51
Adjusted EBITDA and Other Reconciling Items
Adjusted EBITDA	207		184	591	547
Depreciation and amortization	(19)		(17)	(55)	(51)
Conifer
Segment Reporting Information [Line Items]
Assets:	1,055			1,055		$ 1,014
Net operating revenues:	336		371	1,040	1,161
Conifer \| Operating segments
Segment Reporting Information [Line Items]
Capital expenditures:	5		3	12	15
Net operating revenues:	336		371	1,040	1,161
Adjusted EBITDA	90		81	292	270
Depreciation and amortization:	11		12	33	37
Adjusted EBITDA and Other Reconciling Items
Adjusted EBITDA	90		81	292	270
Depreciation and amortization	(11)		(12)	(33)	(37)
Tenet \| Conifer
Segment Reporting Information [Line Items]
Net operating revenues:	140		146	432	440
Other customers \| Conifer
Segment Reporting Information [Line Items]
Net operating revenues:	$ 196		$ 225	$ 608	$ 721