TENET HEALTHCARE CORP, 10-K filed on 2/17/2026
Annual Report
v3.25.4
Cover Page - USD ($)
shares in Thousands, $ in Billions
 12 Months Ended
Dec. 31, 2025
Jan. 30, 2026
Jun. 30, 2025
Entity Information [Line Items]      
Document Type 10-K    
Document Annual Report true    
Document Period End Date Dec. 31, 2025    
Current Fiscal Year End Date --12-31    
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 14201 Dallas Parkway    
Entity Address, City or Town Dallas    
Entity Address, State or Province TX    
Entity Address, Postal Zip Code 75254    
City Area Code 469    
Local Phone Number 893-2200    
Entity Well-known Seasoned Issuer Yes    
Entity Voluntary Filers No    
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    
ICFR Auditor Attestation Flag true    
Document Financial Statement Error Correction false    
Entity Shell Company false    
Entity Public Float     $ 12.2
Entity Common Stock, Shares Outstanding   86,963  
Documents Incorporated by Reference
Portions of the Registrant’s definitive proxy statement for the 2026 annual meeting of shareholders are incorporated by reference into Part III of this Form 10-K.
    
Entity Central Index Key 0000070318    
Amendment Flag false    
Document Fiscal Year Focus 2025    
Document Fiscal Period Focus FY    
Common Stock | New York Stock Exchange      
Entity Information [Line Items]      
Title of 12(b) Security Common stock, $0.05 par value    
Trading Symbol THC    
Security Exchange Name NYSE    
6.875% Senior Notes due 2031 | New York Stock Exchange      
Entity Information [Line Items]      
Title of 12(b) Security 6.875% Senior Notes due 2031    
Trading Symbol THC31    
Security Exchange Name NYSE    
v3.25.4
Audit Information
 12 Months Ended
Dec. 31, 2025
Audit Information [Abstract]  
Auditor Name DELOITTE & TOUCHE LLP
Auditor Location Dallas, Texas
Auditor Firm ID 34
v3.25.4
CONSOLIDATED BALANCE SHEETS - USD ($)
$ in Millions
Dec. 31, 2025
Dec. 31, 2024
Current assets:    
Cash and cash equivalents $ 2,883 $ 3,019
Accounts receivable 2,565 2,536
Inventories of supplies, at cost 348 346
Assets held for sale 62 21
Other current assets 1,991 1,760
Total current assets  7,849 7,682
Investments and other assets 2,883 3,037
Deferred income taxes 84 80
Property and equipment, at cost, less accumulated depreciation and amortization ($6,680 at December 31, 2025 and $5,809 at December 31, 2024) 6,315 6,049
Goodwill 11,198 10,691
Other intangible assets, at cost, less accumulated amortization ($1,328 at December 31, 2025 and $1,288 at December 31, 2024) 1,348 1,397
Total assets  29,677 28,936
Current liabilities:    
Current portion of long-term debt 79 92
Accounts payable 1,360 1,294
Accrued compensation and benefits 858 899
Professional and general liability reserves 276 238
Accrued interest payable 81 149
Liabilities held for sale 0 13
Income tax payable 0 18
Other current liabilities 1,809 1,607
Total current liabilities  4,463 4,310
Long-term debt, net of current portion 13,092 13,081
Professional and general liability reserves 951 900
Defined benefit plan obligations 245 298
Deferred income taxes 240 227
Other long-term liabilities 1,713 1,573
Total liabilities  20,704 20,389
Commitments and contingencies
Redeemable noncontrolling interests in equity of consolidated subsidiaries 2,956 2,727
Shareholders’ equity:    
Common stock, $0.05 par value; authorized 262,500 shares; 158,612 shares issued at December 31, 2025 and 158,001 shares issued at December 31, 2024 8 8
Additional paid-in capital 4,914 4,873
Accumulated other comprehensive loss (181) (180)
Retained earnings 4,415 3,008
Common stock in treasury, at cost, 71,660 shares at December 31, 2025 and 62,892 shares at December 31, 2024 (4,936) (3,538)
Total shareholders’ equity 4,220 4,171
Noncontrolling interests  1,797 1,649
Total equity  6,017 5,820
Total liabilities and equity  $ 29,677 $ 28,936
v3.25.4
CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($)
shares in Thousands, $ in Millions
Dec. 31, 2025
Dec. 31, 2024
Statement of Financial Position [Abstract]    
Property and equipment, accumulated depreciation and amortization $ 6,680 $ 5,809
Other intangible assets, accumulated amortization $ 1,328 $ 1,288
Common stock, par value (in dollars per share) $ 0.05 $ 0.05
Common stock, number of shares authorized (in shares) 262,500 262,500
Common stock, number of shares issued (in shares) 158,612 158,001
Common stock, number of shares held in treasury (in shares) 71,660 62,892
v3.25.4
CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($)
shares in Thousands, $ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Income Statement [Abstract]      
Net operating revenues  $ 21,310 $ 20,675 $ 20,564
Equity in earnings of unconsolidated affiliates 264 260 228
Operating expenses:      
Salaries, wages and benefits 8,705 8,801 9,146
Supplies 3,780 3,647 3,590
Other operating expenses, net 4,523 4,492 4,515
Depreciation and amortization 863 818 870
Impairment and restructuring charges, and acquisition-related costs 130 102 137
Litigation and investigation costs 64 35 47
Net losses (gains) on sales, consolidation and deconsolidation of facilities 1 (2,916) (23)
Operating income 3,508 5,956 2,510
Interest expense (821) (826) (901)
Other non-operating income, net 117 126 19
Loss from early extinguishment of debt (4) (8) (11)
Income before income taxes 2,800 5,248 1,617
Income tax expense (433) (1,184) (306)
Net income 2,367 4,064 1,311
Less: Net income available to noncontrolling interests 960 864 700
Net income available to Tenet Healthcare Corporation common shareholders $ 1,407 $ 3,200 $ 611
Earnings available to Tenet Healthcare Corporation common shareholders:      
Basic earnings per share (in dollars per share) $ 15.61 $ 33.02 $ 6.01
Diluted earnings per share (in dollars per share) $ 15.49 $ 32.70 $ 5.71
Weighted average shares and dilutive securities outstanding (in thousands):      
Basic (in shares) 90,150 96,904 101,639
Diluted (in shares) 90,833 97,881 104,800
v3.25.4
CONSOLIDATED STATEMENTS OF OTHER COMPREHENSIVE INCOME (LOSS) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Statement of Comprehensive Income [Abstract]      
Net income $ 2,367 $ 4,064 $ 1,311
Other comprehensive income (loss):      
Adjustments for defined benefit plans (11) (9) (9)
Amortization of net actuarial loss included in other non-operating income, net 8 8 7
Unrealized gain on debt securities held as available-for-sale 1 1 2
Foreign currency translation adjustments and other 0 1 0
Other comprehensive income (loss) before income taxes (2) 1 0
Income tax benefit related to items of other comprehensive income (loss) 1 0 0
Total other comprehensive income (loss), net of tax (1) 1 0
Comprehensive net income 2,366 4,065 1,311
Less: Comprehensive income available to noncontrolling interests 960 864 700
Comprehensive income available to Tenet Healthcare Corporation common shareholders $ 1,406 $ 3,201 $ 611
v3.25.4
CONSOLIDATED STATEMENTS OF CHANGES IN EQUITY - USD ($)
shares in Thousands, $ in Millions
Total
Common Stock
Additional Paid-in Capital
Accumulated Other Comprehensive Loss
Retained Earnings (Accumulated Deficit)
Treasury Stock
Noncontrolling Interests
Beginning balance (in shares) at Dec. 31, 2022   102,247          
Beginning balance at Dec. 31, 2022 $ 2,459 $ 8 $ 4,778 $ (181) $ (803) $ (2,660) $ 1,317
Changes in Shareholders' Equity              
Net income 945       611   334
Distributions paid to noncontrolling interests (289)           (289)
Other comprehensive income (loss) 0            
Purchases of businesses and noncontrolling interests, net 152   5       147
Repurchases of common stock (in shares)   (3,112)          
Repurchases of common stock (201)         (201)  
Stock-based compensation expense, tax benefit and issuance of common stock (in shares)   815          
Stock-based compensation expense, tax benefit and issuance of common stock 51   51        
Ending balance (in shares) at Dec. 31, 2023   99,950          
Ending balance at Dec. 31, 2023 3,117 $ 8 4,834 (181) (192) (2,861) 1,509
Changes in Shareholders' Equity              
Net income 3,591       3,200   391
Distributions paid to noncontrolling interests (312)           (312)
Other comprehensive income (loss) 1     1      
Accretion of redeemable noncontrolling interests (5)   (5)        
Purchases of businesses and noncontrolling interests, net 73   12       61
Repurchases of common stock (in shares)   (5,596)          
Repurchases of common stock (677)         (677)  
Stock-based compensation expense, tax benefit and issuance of common stock (in shares)   755          
Stock-based compensation expense, tax benefit and issuance of common stock 32   32        
Ending balance (in shares) at Dec. 31, 2024   95,109          
Ending balance at Dec. 31, 2024 5,820 $ 8 4,873 (180) 3,008 (3,538) 1,649
Changes in Shareholders' Equity              
Net income 1,833       1,407   426
Distributions paid to noncontrolling interests (372)           (372)
Other comprehensive income (loss) (1)     (1)      
Purchases of businesses and noncontrolling interests, net 79   (15)       94
Repurchases of common stock (in shares)   (8,771)          
Repurchases of common stock (1,398)         (1,398)  
Stock-based compensation expense, tax benefit and issuance of common stock (in shares)   614          
Stock-based compensation expense, tax benefit and issuance of common stock 56   56        
Ending balance (in shares) at Dec. 31, 2025   86,952          
Ending balance at Dec. 31, 2025 $ 6,017 $ 8 $ 4,914 $ (181) $ 4,415 $ (4,936) $ 1,797
v3.25.4
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Statement of Cash Flows [Abstract]      
Net income $ 2,367 $ 4,064 $ 1,311
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 863 818 870
Deferred income tax expense (benefit) 9 (103) 52
Stock-based compensation expense 104 67 66
Impairment and restructuring charges, and acquisition-related costs 130 102 137
Litigation and investigation costs 64 35 47
Net losses (gains) on sales, consolidation and deconsolidation of facilities 1 (2,916) (23)
Loss from early extinguishment of debt 4 8 11
Equity in earnings of unconsolidated affiliates, net of distributions received (34) (29) (13)
Amortization of debt discount and debt issuance costs 23 26 32
Net gains from the sale of investments and long-lived assets (4) (4) (29)
Other items, net (6) (4) (4)
Changes in cash from operating assets and liabilities:      
Accounts receivable 20 245 (29)
Inventories and other current assets (73) (86) (139)
Income taxes (25) 16 10
Accounts payable, accrued expenses and other current liabilities 209 (30) 215
Other long-term liabilities 9 (9) 14
Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements (121) (153) (154)
Net cash provided by operating activities 3,540 2,047 2,374
Cash flows from investing activities:      
Purchases of property and equipment (1,010) (931) (751)
Purchases of businesses or joint venture interests, net of cash acquired (308) (571) (224)
Proceeds from sales of facilities and other assets 38 4,981 71
Proceeds from sales of marketable securities and long-term investments 93 63 50
Purchases of marketable securities and long-term investments (90) (94) (104)
Other items, net 2 (19) (11)
Net cash provided by (used in) investing activities (1,275) 3,429 (969)
Cash flows from financing activities:      
Repayments of borrowings (2,372) (2,243) (1,542)
Proceeds from borrowings 2,276 23 1,370
Repurchases of common stock (1,386) (672) (200)
Debt issuance costs (32) 0 (16)
Distributions paid to noncontrolling interests (809) (681) (594)
Proceeds from the sale of noncontrolling interests 42 23 43
Purchases of noncontrolling interests (92) (200) (167)
Advances from managed care payers 0 342 0
Repayments of advances from managed care payers (32) (310) 0
Taxes paid related to net share settlement, net of proceeds from shares issued under stock-based compensation plans (51) (25) (12)
Other items, net 55 58 83
Net cash used in financing activities (2,401) (3,685) (1,035)
Net increase (decrease) in cash and cash equivalents (136) 1,791 370
Cash and cash equivalents at beginning of period 3,019 1,228 858
Cash and cash equivalents at end of period 2,883 3,019 1,228
Supplemental disclosures:      
Interest paid, net of capitalized interest (865) (851) (882)
Income tax payments, net $ (450) $ (1,271) $ (243)
v3.25.4
SIGNIFICANT ACCOUNTING POLICIES
 12 Months Ended
Dec. 31, 2025
Accounting Policies [Abstract]  
SIGNIFICANT ACCOUNTING POLICIES SIGNIFICANT ACCOUNTING POLICIES
Description of Business
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. Our expansive, nationwide care delivery network consists of our Hospital Operations and Services (“Hospital Operations”) and Ambulatory Care segments. As of December 31, 2025, our Hospital Operations segment was comprised of 50 acute care and specialty hospitals, a network of employed physicians and 132 outpatient facilities, including urgent care centers (each, a “UCC”), imaging centers, off-campus hospital emergency departments and micro‑hospitals. Our Ambulatory Care segment is comprised of the operations of USPI Holding Company, Inc. (together with its subsidiaries, “USPI”), which held ownership interests in 533 ambulatory surgery centers and 26 surgical hospitals at December 31, 2025. USPI held noncontrolling interests in 150 of these facilities, which are recorded using the equity method of accounting. In addition, we operate a Global Business Center (“GBC”) in the Philippines.
Basis of Presentation
Our Consolidated Financial Statements include the accounts of Tenet and its wholly owned and majority‑owned subsidiaries. We eliminate intercompany accounts and transactions in consolidation, and we include the results of operations of businesses that are newly acquired in purchase transactions from their dates of acquisition. We account for significant investments in other affiliated companies using the equity method. We also utilize the equity method when we have the ability to exercise significant influence over the affiliated company, despite not holding a significant percentage of its ownership interest. Unless otherwise indicated, dollar amounts presented in our Consolidated Financial Statements and these accompanying notes are expressed in millions (except per-share amounts), and all share amounts are expressed in thousands.
Certain prior-year amounts have been reclassified to conform to the current-year presentation. Grant income is no longer significant enough to be presented separately and is now included in net operating revenues in the accompanying Consolidated Statements of Operations. In addition, taxes paid in connection with the net share settlement of our stock compensation awards, net of proceeds from the exercise of stock options, are now presented separately in the accompanying Consolidated Statements of Cash Flows to reflect their increased significance.
Use of Estimates
The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America (“GAAP”) requires us to make estimates and assumptions that affect the amounts reported in our 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. Although we believe all adjustments considered necessary for a fair presentation have been included, actual results may vary from those estimates. The 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 the 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.
Translation of Foreign Currencies
Our GBC, which is located in the Philippines, performs certain administrative functions and other support tasks. The GBC’s accounts are measured in its local currency (the Philippine peso) and then translated into U.S. dollars. All assets and liabilities denominated in foreign currency are translated using the current rate of exchange at the balance sheet date. Results of operations denominated in foreign currency are translated using the average rates prevailing throughout the period of operations. Translation gains or losses resulting from changes in exchange rates are accumulated in shareholders’ equity.
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 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 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.
We determine performance obligations based on the nature of the services we provide. We recognize revenues for performance obligations satisfied over time based on actual charges incurred in relation to total expected charges. We believe that this method provides a faithful depiction of the transfer of services over the term of performance obligations based on the inputs needed to satisfy the obligations. Generally, performance obligations satisfied over time relate to patients in our hospitals receiving inpatient acute care services. We measure performance obligations from admission to the point when there are no further services required for the patient, which is generally the time of discharge. We recognize revenues for performance obligations satisfied at a point in time, which generally relate to patients receiving outpatient services, when (1) services are provided, and (2) we do not believe the patient requires additional services.
Because our patient service performance obligations relate to contracts with a duration of less than one year, we have elected to apply the optional exemption provided in the Financial Accounting Standards Board’s (“FASB”) Accounting Standards Codification (“ASC”) 606‑10‑50‑14(a) and, therefore, we are not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. The unsatisfied or partially unsatisfied performance obligations referred to above are primarily related to inpatient acute care services at the end of the reporting period. The performance obligations for these contracts are generally completed when the patients are discharged, which generally occurs within days or weeks of the end of the reporting period.
We determine the transaction price based on gross charges for services provided, reduced by contractual adjustments recognized for third‑party payers, discounts provided to uninsured patients in accordance with our Compact, and estimated implicit price concessions related primarily to uninsured patients. We determine our estimates of contractual adjustments and discounts based on contractual agreements, our discount policies and historical experience. We determine our estimate of implicit price concessions based on our historical collection experience using a portfolio approach as a practical expedient to account for patient contracts as collective groups rather than individually. The financial statement effects of using this practical expedient are not materially different from an individual contract approach.
Gross charges are retail charges. They are not the same as actual pricing, and they generally do not reflect what a hospital is ultimately paid and, therefore, are not displayed in our consolidated statements of operations. Hospitals are typically paid amounts that are negotiated with insurance companies or are set by the government. Gross charges are used to calculate Medicare outlier payments and to determine certain elements of payment under managed care contracts (such as stop‑loss payments). Because Medicare requires that a hospital’s gross charges be the same for all patients (regardless of payer category), gross charges are what hospitals charge all patients prior to the application of discounts and allowances.
Government Programs—The final determination of certain fee‑for‑service (“FFS”) Medicare and Medicaid program payments to our hospitals, such as Indirect Medical Education, Direct Graduate Medical Education, disproportionate share hospital and bad debt expense reimbursement, are retrospectively determined based on our hospitals’ cost reports. The final determination of these payments often takes many years to resolve because of audits by the program representatives, providers’ rights of appeal, and the application of numerous technical reimbursement provisions. We therefore record accruals to reflect the expected final settlements on our cost reports. For filed cost reports, we adjust the accrual for estimated cost report settlements based on those cost reports and subsequent activity, and we consider the necessity of recording a valuation allowance based on historical settlement results. The accrual for estimated cost report settlements for periods for which a cost report is yet to be filed is recorded based on estimates of what we expect to report on the filed cost reports, and a corresponding valuation allowance is recorded, if necessary, based on the method previously described. Cost reports must generally be filed within five months after the end of the annual cost report reporting period. After the cost report is filed, the accrual and corresponding valuation allowance may need to be adjusted.
Settlements with third‑party payers for retroactive revenue adjustments due to audits, reviews or investigations are considered variable consideration and are included in the determination of the estimated transaction price for providing patient care using the most likely outcome method. These settlements are estimated based on the terms of the payment agreement with the payer, correspondence from the payer and our historical settlement activity, including an assessment to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustment is subsequently resolved. Estimated settlements are adjusted in future periods as
adjustments become known (that is, new information becomes available), or as years are settled or are no longer subject to such audits, reviews and investigations. Because the laws, regulations, instructions and rule interpretations governing Medicare and Medicaid reimbursement are complex and change frequently, the estimates we record could change by material amounts.
Private Insurance—Revenues under managed care plans are based primarily on payment terms involving predetermined rates per diagnosis, per‑diem rates, discounted FFS rates and/or other similar contractual arrangements. These revenues are also subject to review and possible audit by the payers, which can take several years before they are completely resolved. The payers are billed for patient services on an individual patient basis. An individual patient’s bill is subject to adjustment on a patient‑by‑patient basis in the ordinary course of business by the payers following their review and adjudication of each particular bill. We estimate the discounts for contractual allowances at the individual hospital level utilizing billing data on an individual patient basis. At the end of each month, on an individual hospital basis, we estimate our expected reimbursement for patients of managed care plans based on the applicable contract terms. Contractual allowance estimates are periodically reviewed for accuracy by taking into consideration known contract terms, as well as payment history. We believe our estimation and review process enables us to identify instances on a timely basis where such estimates need to be revised. We do not believe there were any adjustments to estimates of patient bills that were material to our revenues during the years ended December 31, 2025, 2024 or 2023. In addition, on a corporate‑wide basis, we do not record any general provision for adjustments to estimated contractual allowances for managed care plans. Managed care accounts, net of contractual allowances recorded, are further reduced to their net realizable value through implicit price concessions based on historical collection trends for these payers and other factors that affect the estimation process.
We know of no claims, disputes or unsettled matters with any payer that would materially affect our revenues for which we have not adequately provided in the accompanying Consolidated Financial Statements.
Uninsured Patients—Generally, patients who are covered by third‑party payers are responsible for related co‑pays, co‑insurance and deductibles, which vary in amount. We also provide services to uninsured patients and offer uninsured patients a discount from standard charges. We estimate the transaction price for patients with co‑pays, co‑insurance and deductibles and for those who are uninsured based on historical collection experience and current market conditions. Under our Compact and other uninsured discount programs, the discount offered to certain uninsured patients is recognized as a contractual allowance, which reduces net operating revenues at the time the self‑pay accounts are recorded. The uninsured patient accounts, net of contractual allowances recorded, are further reduced to their net realizable value at the time they are recorded through implicit price concessions based on historical collection trends for self‑pay accounts and other factors that affect the estimation process.
Implicit Price Concessions—We record implicit price concessions, primarily related to uninsured patients and patients with co‑pays, co‑insurance and deductibles. The implicit price concessions included in estimating the transaction price represent the difference between amounts billed to patients and the amounts we expect to collect based on our collection history with similar patients. Although outcomes vary, our policy is to attempt to collect amounts due from patients, including co‑pays, co‑insurance and deductibles due from patients with insurance, at the time of service while complying with all federal and state statutes and regulations, including, but not limited to, the Emergency Medical Treatment and Active Labor Act (“EMTALA”). Generally, as required by EMTALA, patients may not be denied emergency treatment due to inability to pay. Therefore, services, including the legally required medical screening examination and stabilization of the patient, are performed without delaying to obtain insurance information. In non‑emergency circumstances or for elective procedures and services, it is our policy to verify insurance prior to a patient being treated; however, there are various exceptions that can occur. Such exceptions can include, for example, instances where (1) we are unable to obtain verification because the patient’s insurance company was unable to be reached or contacted, (2) a determination is made that a patient may be eligible for benefits under various government programs, such as Medicaid or Victims of Crime, and it takes several days or weeks before qualification for such benefits is confirmed or denied, and (3) under physician orders we provide services to patients that require immediate treatment.
There are various factors that can impact collection trends, such as: changes in the economy, which in turn have an impact on unemployment rates and the number of uninsured and underinsured patients; the volume of patients through our emergency departments; the increased burden of co‑pays, co‑insurance amounts and deductibles to be made by patients with insurance; and business practices related to collection efforts. These factors continuously change and can have an impact on collection trends and our estimation process. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to net patient service revenues in the period of the change.
We also provide charity care to patients who are financially unable to pay for the healthcare services they receive. Most patients who qualify for charity care are charged a per‑diem amount for services received, subject to a cap. Except for the per‑diem amounts, our policy is not to pursue collection of amounts determined to qualify as charity care; therefore, we do not report these amounts in net operating revenues. Patient advocates from our Eligibility and Enrollment Services program screen
patients in the hospital to determine whether those patients meet eligibility requirements for financial assistance programs. They also expedite the process of applying for these government programs.
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. Approximately 91% of our Hospital Operations segment’s contract assets meet the conditions for unconditional right to payment and are reclassified to patient receivables within 90 days.
Revenue Cycle Management and Other Services
Our Hospital Operations segment also provides revenue cycle management and other services to health systems, individual hospitals and physician practices. We recognize revenue from our contracts when the underlying performance obligations are satisfied, which is generally as services are rendered. Revenue is recognized in an amount that reflects the consideration to which we expect to be entitled.
At contract inception, we assess the services specified in our contracts with customers and identify a performance obligation for each distinct contracted service. We generally consider the following distinct services as separate performance obligations:
•revenue cycle management services;
•value‑based care services;
•patient communication and engagement services;
•consulting services; and
•other client‑defined projects.
Our contracts generally consist of fixed‑price, volume‑based or contingency‑based fees. Long‑term contracts typically provide for the delivery of recurring monthly services over a multi‑year period. The contracts are typically priced such that our monthly fee to our customer represents the value obtained by the customer in the month for those services. Such multi‑year service contracts may have upfront fees related to transition or integration work performed by us to set up the delivery for the ongoing services. Such transition or integration work typically does not result in a separately identifiable obligation; thus, the fees and expenses related to such work are deferred and recognized over the life of the related contractual service period. For contracts in which the amortization period of the asset is one year or less, we have elected to apply the practical expedient provided by FASB ASC 340‑40‑25‑4 and expense these costs as incurred.
Revenue for fixed‑priced contracts is typically recognized at the time of billing unless evidence suggests that the revenue is earned or our obligations are fulfilled in a different pattern. Revenue for volume‑based contracts is typically recognized as the services are being performed at the contractually billable rate, which is generally a percentage of collections or a percentage of client net patient revenue.
Contract Assets and Liabilities—Our client contract terms, including payment conditions, are diverse. For non‑fixed‑price arrangements, we may invoice clients before we perform the contracted services, with subsequent adjustments (true‑up) to align with actual fees. In contrast, some contracts require payment after we have performed the contracted services (in arrears). Contracts may also feature performance‑based incentives or penalties, along with other variable consideration. Revenue recognition occurs when services are rendered and the client gains control or benefit of the services, regardless of the invoicing schedule, leading to the recognition of a contract asset for unbilled revenue. Unbilled revenue is recognized as receivables in the month the services are performed. Conversely, advance payments from clients result in the recognition of a contract liability for deferred revenue until the revenue recognition requirements are met.
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 $2.883 billion and $3.019 billion at December 31, 2025 and 2024, respectively. At December 31, 2025 and 2024, our book overdrafts were $161 million and $143 million, respectively, which were classified as accounts payable. At December 31, 2025 and 2024, $108 million and $110 million, respectively, of total cash and cash equivalents in the accompanying Consolidated Balance Sheets were intended for the operations of our insurance‑related subsidiaries.
At December 31, 2025, 2024 and 2023, we had $111 million, $127 million and $154 million, respectively, of property and equipment purchases accrued for items received but not yet paid. Of these amounts, $102 million, $109 million and $141 million, respectively, were included in accounts payable.
Investments in Debt and Equity Securities
We classify investments in debt securities as either available‑for‑sale, held‑to‑maturity or as part of a trading portfolio. Our policy is to classify investments in debt securities that may be needed for cash requirements as “available‑for‑sale.” At December 31, 2025 and 2024, we had no significant investments in debt securities classified as either held‑to‑maturity or trading. We carry debt securities classified as available‑for‑sale at fair value. We report their unrealized gains and losses, net of taxes, as accumulated other comprehensive income (loss). We periodically evaluate available-for-sale securities in unrealized loss positions for credit impairment, using both qualitative and quantitative criteria. In the event a security is deemed to be impaired as the result of a credit loss, we record a loss in our consolidated statements of operations.
We carry equity securities at fair value, and we report their unrealized gains and losses in other non-operating income, net, in our consolidated statements of operations. If the equity security does not have a readily determinable fair value, the carrying value of the security is adjusted only when there is a price change that is observable from a transaction of an identical or similar investment. We include realized gains or losses in our consolidated statements of operations based on the specific identification method.
Investments in Unconsolidated Affiliates
As of December 31, 2025, we controlled 409 of the facilities in our Ambulatory Care segment and, therefore, consolidated their results. We account for many of the facilities in which our Ambulatory Care segment holds ownership interests (150 of 559 at December 31, 2025), as well as additional companies in which our Hospital Operations 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 Consolidated Statements of Operations. Summarized financial information for equity method investees is presented in the following table. For investments acquired during the reported periods, amounts below include 100% of the investee’s results beginning on the date of our acquisition of the investment.
December 31,
 202520242023
Current assets$1,202 $1,255 $1,223 
Noncurrent assets$1,347 $1,358 $1,355 
Current liabilities$(434)$(435)$(456)
Noncurrent liabilities$(870)$(928)$(917)
Noncontrolling interests$(728)$(699)$(670)
 Years Ended December 31,
 202520242023
Net operating revenues$3,902 $3,709 $3,510 
Net income$1,021 $978 $860 
Net income attributable to the investees$551 $483 $484 
The equity method investment that contributed the most to our equity in earnings of unconsolidated affiliates during the years ended December 31, 2025, 2024 and 2023 was Texas Health Ventures Group, LLC (“THVG”), which is operated by USPI. THVG represented $141 million, $130 million and $104 million of total equity in earnings of unconsolidated affiliates of $264 million, $260 million and $228 million in the years ended December 31, 2025, 2024 and 2023, respectively.
Property and Equipment
Additions and improvements to property and equipment exceeding established minimum amounts with a useful life greater than one year are capitalized at cost. Expenditures for maintenance and repairs are charged to expense as incurred. We use the straight‑line method of depreciation for buildings, building improvements and equipment. The estimated useful life for buildings and improvements is primarily 15 to 40 years, and for equipment three to 15 years. Newly constructed hospitals are usually depreciated over 50 years. Interest costs related to construction projects are capitalized. In the years ended December 31, 2025, 2024 and 2023, capitalized interest was $9 million, $8 million and $9 million, respectively.
We evaluate our long‑lived assets for possible impairment annually or whenever events or changes in circumstances indicate that the carrying amount of the asset, or related group of assets, may not be recoverable from estimated future
undiscounted cash flows. If the estimated future undiscounted cash flows are less than the carrying value of the assets, we calculate the amount of an impairment charge only if the carrying value of the long‑lived assets exceeds their fair value. The fair value of the asset is estimated based on third‑party appraisals, established market values of comparable assets or internally developed estimates of future net cash flows expected to result from the use and ultimate disposition of the asset. The estimates of these future cash flows are based on assumptions and projections we believe to be reasonable and supportable. Estimates require our subjective judgments and take into account assumptions about revenue and expense growth rates, operating margins and recoverable disposition values, based on industry and operating factors. These assumptions may vary by type of asset and presume stable, improving or, in some cases, declining results, depending on their circumstances. If the presumed level of performance does not occur as expected, impairment may result.
We report long‑lived assets to be disposed of at the lower of their carrying amounts or fair values less costs to sell. In such circumstances, our estimates of fair value are based on third‑party appraisals, established market prices for comparable assets or internally developed estimates of future net cash flows.
Leases
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 the 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 segment, 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 primarily relate to medical and office equipment and real estate. 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.
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, 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 (1) expired or existing contracts for whether they are or contain a lease, (2) the lease classification of any existing leases or (3) initial indirect costs for existing leases.
Goodwill and Other Intangible Assets
Goodwill represents the excess of costs over the fair value of assets of businesses acquired. Goodwill and other intangible assets acquired in purchase business combinations and determined to have indefinite useful lives are not amortized, but instead are subject to impairment tests performed at least annually. Our reporting segments are the reporting units used to perform our goodwill analysis. If we determine the carrying value of goodwill is impaired, or if the carrying value of a business that is to be sold or otherwise disposed of exceeds its fair value, we reduce the carrying value, including any allocated goodwill, to fair value. Estimates of fair value are based on third‑party appraisals, established market prices for comparable assets or
internally developed estimates of future net cash flows and presume stable, improving or, in some cases, declining results at our hospitals, depending on their circumstances.
Other intangible assets consist of capitalized software costs, which are amortized on a straight‑line basis over the estimated useful life of the software, which ranges from three to 15 years, costs of acquired management and other contract service rights, most of which have indefinite lives, and miscellaneous intangible assets.
Accruals for General and Professional Liability Risks
We accrue for estimated professional and general liability claims, to the extent not covered by insurance, when they are probable and can be reasonably estimated. We maintain reserves, which are based on modeled estimates for the portion of our professional liability risks, including incurred but not reported claims, to the extent we do not have insurance coverage. Our liability consists of estimates established based upon calculations using several factors, including the number of expected claims, estimates of losses for these claims based on recent and historical settlement amounts, estimates of incurred but not reported claims based on historical experience and the timing of historical payments. Our liabilities are adjusted for new claims information in the period such information becomes known. Malpractice expense is recorded within other operating expenses in our consolidated statements of operations.
Income Taxes
We account for income taxes using the asset and liability method. This approach requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of temporary differences between the carrying amounts and the tax bases of assets and liabilities. Income tax receivables and liabilities and deferred tax assets and liabilities are recognized based on the amounts that more likely than not will be sustained upon ultimate settlement with taxing authorities.
Developing our provision for income taxes and analysis of uncertain tax positions requires significant judgment and knowledge of federal and state income tax laws, regulations and strategies, including the determination of deferred tax assets and liabilities and, if necessary, any valuation allowances that may be required for deferred tax assets.
We assess the realization of our deferred tax assets to determine whether an income tax valuation allowance is required. Based on all available evidence, both positive and negative, and the weight of that evidence to the extent such evidence can be objectively verified, we determine whether it is more likely than not that all or a portion of the deferred tax assets will be realized. The main factors that we consider include:
•Cumulative profits/losses in recent years, adjusted for certain nonrecurring items;
•Income/losses expected in future years;
•Unsettled circumstances that, if unfavorably resolved, would adversely affect future operations and profit levels;
•The availability, or lack thereof, of taxable income in prior carryback periods that would limit realization of tax benefits; and
•The carryforward period associated with the deferred tax assets and liabilities.
We consider many factors when evaluating our uncertain tax positions, and such judgments are subject to periodic review. Tax benefits associated with uncertain tax positions are recognized in the period in which one of the following conditions is satisfied: (1) the more likely than not recognition threshold is satisfied; (2) the position is ultimately settled through negotiation or litigation; or (3) the statute of limitations for the taxing authority to examine and challenge the position has expired. Tax benefits associated with an uncertain tax position are derecognized in the period in which the more likely than not recognition threshold is no longer satisfied.
Costs Associated with Exit or Disposal Activities
We recognize costs associated with exit (including restructuring) or disposal activities when they are incurred and can be measured at fair value, rather than at the date of a commitment to an exit or disposal plan. Our restructuring plans typically focus on the alignment of our operations in the most strategic and cost‑effective structure, such as the establishment of support operations at our GBC, among other things. Certain restructuring and acquisition‑related costs are based on estimates. Changes in estimates are recognized as they occur.
v3.25.4
EQUITY
 12 Months Ended
Dec. 31, 2025
Stockholders' Equity Note [Abstract]  
EQUITY EQUITY
Nonredeemable Noncontrolling Interests
The table below presents our nonredeemable noncontrolling interests balances by segment:
December 31,
20252024
Hospital Operations$211 $205 
Ambulatory Care1,586 1,444 
Total nonredeemable noncontrolling interests$1,797 $1,649 
Our net income available to nonredeemable noncontrolling interests by segment are presented in the table below:
Years Ended December 31,
202520242023
Hospital Operations$45 $50 $30 
Ambulatory Care381 341 304 
Total net income available to noncontrolling interests$426 $391 $334 
Share Repurchase Programs
In October 2022, our board of directors authorized the repurchase of up to $1.000 billion of our common stock through a share repurchase program (the “2022 share repurchase program”). This program allowed for share repurchases to be made in open‑market or privately negotiated transactions, at management’s discretion subject to market conditions and other factors, and in a manner consistent with applicable securities laws and regulations. The program did not require us to acquire any particular amount of common stock and could be suspended for periods or discontinued at any time. In July 2024, our board authorized a new share repurchase program (the “2024 share repurchase program”) of up to an additional $1.500 billion of our common stock with no expiration date, under terms substantially similar to the 2022 share repurchase program. We did not make any additional repurchases under the 2022 share repurchase program following the approval of the 2024 share repurchase program, and it expired on December 31, 2024. In July 2025, our board of directors authorized a $1.500 billion increase to the 2024 share repurchase program.
The tables below present repurchase activity under both the 2022 and 2024 share repurchase programs:
PeriodTotal Number of Shares PurchasedAverage Price
Paid per Share		Total Number of Shares Purchased as Part of Publicly Announced ProgramMaximum Dollar Value of Shares That May Yet be Purchased Under the Program
 (In Thousands)(In Thousands)(In Millions)
January 1 through January 31, 2023—$— —$750 
February 1 through February 28, 2023—$— —$750 
March 1 through March 31, 2023906$55.03 906$700 
April 1 through April 30, 2023—$— —$700 
May 1 through May 31, 2023580$69.17 580$660 
June 1 through June 30, 2023—$— —$660 
July 1 through July 31, 2023—$— —$660 
August 1 through August 31, 2023—$— —$660 
September 1 through September 30, 2023—$— —$660 
October 1 through October 31, 2023—$— —$660 
November 1 through November 30, 2023982$67.12 982$594 
December 1 through December 31, 2023644$68.53 644$550 
Year ended December 31, 20233,112$64.27 3,112
PeriodTotal Number of Shares PurchasedAverage Price Paid per ShareTotal Number of Shares Purchased as Part of Publicly Announced ProgramMaximum Dollar Value of Shares That May Yet be Purchased Under the Program
 (In Thousands)(In Thousands)(In Millions)
January 1 through January 31, 2024—$— —$550 
February 1 through February 29, 2024—$— —$550 
March 1 through March 31, 20242,811$98.86 2,811$272 
April 1 through April 30, 2024—$— —$272 
May 1 through May 31, 2024—$— —$272 
June 1 through June 30, 20241,990$135.85 1,990$2 
July 1 through July 31, 2024—$— —$1,500 
August 1 through August 31, 2024—$— —$1,500 
September 1 through September 30, 2024795$155.93 795$1,376 
October 1 through October 31, 2024—$— —$1,376 
November 1 through November 30, 2024—$— —$1,376 
December 1 through December 31, 2024—$— —$1,376 
Year ended December 31, 20245,596$120.07 5,596
January 1 through January 31, 2025—$— —$1,376 
February 1 through February 28, 20251,800$134.98 1,800$1,133 
March 1 through March 31, 2025829$126.67 829$1,028 
April 1 through April 30, 2025—$— —$1,028 
May 1 through May 31, 20252,456$157.57 2,456$641 
June 1 through June 30, 20252,145$167.83 2,145$281 
July 1 through July 31, 2025598$155.43 598$1,688 
August 1 through August 31, 2025—$— —$1,688 
September 1 through September 30, 2025—$— —$1,688 
October 1 through October 31, 2025469$210.92 469$1,589 
November 1 through November 30, 2025474$208.86 474$1,490 
December 1 through December 31, 2025—$— —$1,490 
Year ended December 31, 20258,771$158.00 8,771
v3.25.4
ACCOUNTS RECEIVABLE
 12 Months Ended
Dec. 31, 2025
Accounts Receivable Additional Disclosures [Abstract]  
ACCOUNTS RECEIVABLE ACCOUNTS RECEIVABLE
The principal components of accounts receivable are presented in the table below:
December 31,
 20252024
Patient accounts receivable$2,418 $2,386 
Estimated future recoveries148 144 
Cost reports and settlements receivable (payable), net of valuation allowances(1)6 
Accounts receivable, net 
$2,565 $2,536 
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 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 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. We participate in various provider fee programs, which help reduce the amount of uncompensated care for indigent patients and those covered by Medicaid.
The following table presents the amount and classification of assets and liabilities in the accompanying Consolidated Balance Sheets related to California’s provider fee program:
December 31,
 20252024
Assets:
Other current assets$493 $334 
Investments and other assets$121 $274 
Liabilities:
Other current liabilities$232 $126 
Other long-term liabilities$48 $102 
Uninsured and Charity Patient Costs
The following table presents our estimated costs (based on selected operating expenses, which include salaries, wages and benefits, supplies and other operating expenses) of caring for our uninsured and charity patients:
 Years Ended December 31,
 202520242023
Estimated costs for:   
Uninsured patients$439 $535 $499 
Charity care patients134 82 110 
Total$573 $617 $609 
v3.25.4
CONTRACT BALANCES
 12 Months Ended
Dec. 31, 2025
Revenue from Contract with Customer [Abstract]  
CONTRACT BALANCES CONTRACT BALANCES
Hospital Operations Segment
Our Hospital Operations segment’s contract assets and liabilities primarily derive from: (1) patients receiving ongoing inpatient care from one of our facilities at the end of the reporting period; and (2) timing differences between our performance of revenue cycle management and other contract-based services and the invoicing or receipt of payment for these services. Our Hospital Operations segment’s contract assets were included in other current assets, and its contract liabilities were included in other current liabilities or other long‑term liabilities, depending upon when we expect to recognize the underlying revenue, in the accompanying Consolidated Balance Sheets at December 31, 2025 and 2024.
The opening and closing balances of our Hospital Operations segment’s receivables, contract assets, and current and long‑term contract liabilities were as follows:
ReceivablesContract Assets –
Unbilled Revenue		Contract Liabilities –
Current
Deferred Revenue		Contract Liabilities –
Long-Term
Deferred Revenue
December 31, 2024$28 $190 $80 $13 
December 31, 202526 188 88 13 
Increase (decrease)$(2)$(2)$8 $— 
December 31, 2023$21 $208 $59 $12 
December 31, 202428 190 80 13 
Increase (decrease)$7 $(18)$21 $1 
The differences between the balances of our contract assets at December 31, 2025 and 2024 and the differences between December 31, 2024 and 2023 were both primarily related to patients who were receiving inpatient acute care and specialty hospital services as of each year‑end date, but who were discharged during the following year. In the years ended December 31, 2025 and 2024, we recognized revenue totaling $60 million and $58 million, respectively, from our revenue cycle management services that was included in the opening current deferred revenue liability. This revenue consists primarily
of prepayments for those contract clients who were billed in advance, changes in estimates related to metric‑based services and up‑front integration services that are recognized over the service period.
Contract Costs—We recognized amortization expense related to deferred contract setup costs of $6 million, $3 million and $5 million during the years ended December 31, 2025, 2024 and 2023, respectively. At December 31, 2025 and 2024, unamortized client contract setup costs were $13 million and $19 million, respectively, and were presented as part of investments and other assets in the accompanying Consolidated Balance Sheets.
NET OPERATING REVENUES
Net operating revenues for our Hospital Operations and Ambulatory Care segments primarily consist of net patient service revenues, principally for patients covered by Medicare, Medicaid, and 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 Hospital Operations segment also include revenues from providing revenue cycle management and value‑based care services to hospitals, health systems, physician practices, employers and other clients.
The table below presents our sources of net operating revenues:
Years Ended December 31,
202520242023
Hospital Operations:
Net patient service revenues from hospitals and related outpatient facilities:
Medicare$2,119 $2,132 $2,383 
Medicaid1,524 1,439 1,233 
Managed care9,696 9,809 10,248 
Uninsured52 64 96 
Indemnity and other551 522 590 
Total13,942 13,966 14,550 
Other revenues(1)
2,196 2,175 2,148 
Total Hospital Operations16,138 16,141 16,698 
Ambulatory Care5,172 4,534 3,866 
Net operating revenues$21,310 $20,675 $20,564 
(1)Primarily revenue from physician practices and revenue cycle management.
Adjustments for prior‑year cost reports and related valuation allowances, principally related to Medicare and Medicaid, increased (decreased) revenues in the years ended December 31, 2025, 2024 and 2023 by $23 million, $(4) million and $24 million, respectively. Estimated cost report settlements receivable, net of payables and valuation allowances, were included in accounts receivable in the accompanying Consolidated Balance Sheets (see Note 3). We believe that we have made adequate provision for any adjustments that may result from the final determination of amounts earned under all the above arrangements with Medicare and Medicaid.
The following table presents the composition of net operating revenues for our Ambulatory Care segment:
Years Ended December 31,
202520242023
Net patient service revenues
$4,956 $4,356 $3,713 
Revenue from other sources216 178 152 
Net operating revenues$5,172 $4,534 $3,865 
Performance Obligations
The following table includes revenue from revenue cycle management services that was expected to be recognized in the future related to performance obligations that are unsatisfied, or partially unsatisfied, at December 31, 2025:
  Years Ending December 31,Later Years
 Total20262027202820292030
Performance obligations$5,126 $748 $747 $747 $747 $747 $1,390 
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, variable‑based escalators, performance incentives, penalties or other variable consideration that is considered constrained. As of December 31, 2025, our contract with CommonSpirit Health (“CommonSpirit”), a successor to Catholic Health Initiatives (“CHI”) and the minority interest holder, as of such date, in our Conifer Health Solutions, LLC joint venture (“Conifer”), represented the majority of the fixed‑fee revenue related to our remaining performance obligations; prior to the subsequent event described in Note 25, Conifer’s contract term with CHI was scheduled to end on December 31, 2032.
v3.25.4
DISPOSITION OF ASSETS AND LIABILITIES
 12 Months Ended
Dec. 31, 2025
Discontinued Operations and Disposal Groups [Abstract]  
DISPOSITION OF ASSETS AND LIABILITIES DISPOSITION OF ASSETS AND LIABILITIES
During the year ended December 31, 2025, a building we own in West Palm Beach, Florida met the criteria to be classified as held for sale. As a result, the building was classified as held for sale at December 31, 2025 in the accompanying Consolidated Balance Sheet. At December 31, 2025, assets related to this building totaled $62 million.
We completed the following sales during the year ended December 31, 2024:
•In January 2024, we completed the sale of three hospitals located in South Carolina and certain related operations (the “SC Hospitals”), all of which were held by our Hospital Operations segment, which resulted in the recognition of a pre-tax gain on sale of $1.677 billion in the year ended December 31, 2024.
•In March 2024, we sold four hospitals and certain related operations located in Orange County and Los Angeles County, California, including facilities from both our Hospital Operations and Ambulatory Care segments, which resulted in the recognition of a pre‑tax gain on sale of $527 million in the year ended December 31, 2024.
•Also in March 2024, we completed the sale of two hospitals and certain related operations located in San Luis Obispo County, California, all of which were held by our Hospital Operations segment, resulting in the recognition of a pre‑tax gain on sale of $275 million in the year ended December 31, 2024.
•In September 2024, we sold our majority ownership interests in several entities that owned or leased five hospitals and certain related operations, all located in Alabama (the “AL Hospitals”), including facilities from both our Hospital Operations and Ambulatory Care segments, which resulted in the recognition of a pre‑tax gain on sale of $353 million in the year ended December 31, 2024. Related to this transaction, we subsequently recognized an additional gain of $8 million during the year ended December 31, 2025 attributable to post-closing adjustments.
•During the year ended December 31, 2024, we sold six ambulatory surgery centers held by our Ambulatory Care segment, which resulted in the recognition of a pre‑tax gain of $46 million in the same period.
Gains recognized from the dispositions described above were included in net gains on sales, consolidation and deconsolidation of facilities in the accompanying Consolidated Statement of Operations for the year ended December 31, 2024.
The following table presents amounts included in income before income taxes related to a significant component of our business that was recently disposed of:
 Years Ended December 31,
 202520242023
SC Hospitals (includes a $1.677 billion gain on sale in 2024)
$2 $1,687 $130 
v3.25.4
IMPAIRMENT AND RESTRUCTURING CHARGES, AND ACQUISITION-RELATED COSTS
 12 Months Ended
Dec. 31, 2025
Restructuring Costs and Asset Impairment Charges [Abstract]  
IMPAIRMENT AND RESTRUCTURING CHARGES, AND ACQUISITION-RELATED COSTS IMPAIRMENT AND RESTRUCTURING CHARGES, AND ACQUISITION-RELATED COSTS
We recognized impairment charges on certain assets in 2025, 2024 and 2023 because the fair values of those assets or groups of assets indicated that the carrying amount was not recoverable. The fair value estimates were derived from third‑party appraisals, established market values of comparable assets, or internally developed estimates of future net cash flows. These fair value estimates can change by material amounts in subsequent periods. Many factors and assumptions can impact the estimates, including the future financial results of the facilities, how the facilities are operated in the future, changes in healthcare industry trends and regulations, and the nature of the ultimate disposition of the assets. In certain cases, these fair value estimates assume the highest and best use of facility assets in the future to a marketplace participant is other than as a medical facility. In these cases, the estimates are based on the fair value of the real property and equipment if utilized other than as a medical facility. The impairment recognized does not include the costs of closing the facilities or other future operating costs, which could be substantial. Accordingly, the ultimate net cash realized from the facilities, should we choose to sell them, could be significantly less than their impaired value.
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 negative trends occur that impact our future outlook, future impairments of long-lived assets and goodwill may occur, and we may incur additional restructuring charges, which could be material.
Our reporting segments are the reporting units used to perform our goodwill analysis. At December 31, 2025, our business was organized into two reporting segments: Hospital Operations and Services and Ambulatory Care. We performed our annual goodwill impairment analysis as of October 1, 2025, which did not result in the recognition of an impairment.
We periodically incur costs to implement restructuring efforts for specific operations, which are recorded in our 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, such as the establishment of support operations at our GBC. Certain restructuring and acquisition‑related costs are based on estimates. Changes in estimates are recognized as they occur.
Year Ended December 31, 2025
During the year ended December 31, 2025, we recorded impairment and restructuring charges and acquisition‑related costs of $130 million, consisting of $44 million of restructuring charges, $25 million of acquisition‑related transaction costs and impairment charges totaling $61 million. Restructuring charges during this period included $15 million of contract and lease termination fees, $13 million related to the transition of various administrative functions to our GBC, $8 million of employee severance costs and $8 million of other restructuring costs. Impairment charges recognized during the year ended December 31, 2025 included $48 million from our Ambulatory Care segment and $13 million from our Hospital Operations segment. These charges primarily related to the write-down of our investments in certain unconsolidated affiliates.
Year Ended December 31, 2024
During the year ended December 31, 2024, we recorded impairment and restructuring charges and acquisition‑related costs of $102 million, consisting of $56 million of restructuring charges, $39 million of acquisition‑related transaction costs and $7 million of impairment charges. Restructuring charges consisted of $17 million of legal costs related to the sale of certain businesses, $12 million of contract and lease termination fees, $11 million of employee severance costs, $9 million related to the transition of various administrative functions to our GBC and $7 million of other restructuring costs. During the year ended December 31, 2024, our Hospital Operations and Ambulatory Care segments recognized impairment charges totaling $1 million and $6 million, respectively. Impairment charges recognized during 2024 primarily related to the write-down of certain intangible assets held by our Ambulatory Care segment to their estimated fair value.
Year Ended December 31, 2023
During the year ended December 31, 2023, we recorded impairment and restructuring charges and acquisition-related costs of $137 million, consisting of $79 million of restructuring charges, $43 million of impairment charges and $15 million of acquisition‑related transaction costs. Restructuring charges consisted of $36 million of legal costs related to the sale of certain businesses, $15 million of employee severance costs, $12 million related to the transition of various administrative functions to our GBC, $10 million of contract and lease termination fees, and $6 million of other restructuring costs. Impairment charges for the year ended December 31, 2023 primarily arose from the write‑down of our investment in certain equity method investments held by our Ambulatory Care segment.
v3.25.4
LEASES
 12 Months Ended
Dec. 31, 2025
Leases [Abstract]  
LEASES LEASES
The following table presents the components of our right‑of‑use assets and liabilities related to leases and their classification in our Consolidated Balance Sheets:
December 31,
Component of Lease BalancesClassification in Consolidated Balance Sheets20252024
Assets:  
Operating lease assetsInvestments and other assets$1,134 $1,037 
Finance lease assetsProperty and equipment, at cost, less accumulated depreciation and amortization419 454 
Total leased assets$1,553 $1,491 
Liabilities:
Operating lease liabilities:
CurrentOther current liabilities$214 $204 
Long-termOther long-term liabilities1,043 950 
Total operating lease liabilities1,257 1,154 
Finance lease liabilities:
CurrentCurrent portion of long-term debt45 54 
Long-termLong-term debt, net of current portion407 390 
Total finance lease liabilities452 444 
Total lease liabilities$1,709 $1,598 
The following table presents the components of our lease expense and their classification in our consolidated statements of operations:
Component of Lease ExpenseClassification in Consolidated Statements of OperationsYears Ended December 31,
202520242023
Operating lease expenseOther operating expenses, net$267 $257 $259 
Finance lease expense:
Amortization of leased assetsDepreciation and amortization51 49 55 
Interest on lease liabilitiesInterest expense24 7 8 
Total finance lease expense75 56 63 
Variable and short term-lease expenseOther operating expenses, net143 160 159 
Total lease expense$485 $473 $481 
The weighted‑average lease terms and discount rates for operating and finance leases are presented in the following table:
Years Ended December 31,
202520242023
Weighted-average remaining lease term (years):
Operating leases7.06.87.6
Finance leases24.824.66.0
Weighted-average discount rate:
Operating leases5.2 %5.2 %5.0 %
Finance leases6.4 %6.5 %6.5 %
Cash flow and other information related to leases is presented in the following table:
Years Ended December 31,
202520242023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash outflows from operating leases$259 $252 $258 
Operating cash outflows from finance leases$5 $10 $13 
Financing cash outflows from finance leases$62 $87 $107 
Right-of-use assets obtained in exchange for lease obligations:
Operating leases$360 $292 $168 
Finance leases$59 $363 $55 
Future maturities of lease liabilities at December 31, 2025 are presented in the following table:
Operating LeasesFinance LeasesTotal
2026$271 $53 $324 
2027247 132 379 
2028214 38 252 
2029177 28 205 
2030139 25 164 
Later years479 522 1,001 
Total lease payments1,527 798 2,325 
Less: Imputed interest270 346 616 
Total lease obligations1,257 452 1,709 
Less: Current obligations214 45 259 
Long-term lease obligations$1,043 $407 $1,450 
In May 1997, we entered into a 30‑year lease agreement for a medical campus located in Palm Springs, California. In December 2024, we executed a lease-purchase agreement to establish a new 30‑year lease beginning upon the expiration of the original lease in May 2027. This agreement includes an initial payment of $100 million at the start of the new lease term, followed by 19 annual escalating lease payments. Following our remittance of a final payment of $100 million in May 2057, ownership of certain of the leased facilities and land will transfer to us. During the year ended December 31, 2024, we recognized a $303 million right‑of‑use asset and a long-term finance lease liability in the same amount in connection with the lease-purchase agreement
LEASES LEASES
The following table presents the components of our right‑of‑use assets and liabilities related to leases and their classification in our Consolidated Balance Sheets:
December 31,
Component of Lease BalancesClassification in Consolidated Balance Sheets20252024
Assets:  
Operating lease assetsInvestments and other assets$1,134 $1,037 
Finance lease assetsProperty and equipment, at cost, less accumulated depreciation and amortization419 454 
Total leased assets$1,553 $1,491 
Liabilities:
Operating lease liabilities:
CurrentOther current liabilities$214 $204 
Long-termOther long-term liabilities1,043 950 
Total operating lease liabilities1,257 1,154 
Finance lease liabilities:
CurrentCurrent portion of long-term debt45 54 
Long-termLong-term debt, net of current portion407 390 
Total finance lease liabilities452 444 
Total lease liabilities$1,709 $1,598 
The following table presents the components of our lease expense and their classification in our consolidated statements of operations:
Component of Lease ExpenseClassification in Consolidated Statements of OperationsYears Ended December 31,
202520242023
Operating lease expenseOther operating expenses, net$267 $257 $259 
Finance lease expense:
Amortization of leased assetsDepreciation and amortization51 49 55 
Interest on lease liabilitiesInterest expense24 7 8 
Total finance lease expense75 56 63 
Variable and short term-lease expenseOther operating expenses, net143 160 159 
Total lease expense$485 $473 $481 
The weighted‑average lease terms and discount rates for operating and finance leases are presented in the following table:
Years Ended December 31,
202520242023
Weighted-average remaining lease term (years):
Operating leases7.06.87.6
Finance leases24.824.66.0
Weighted-average discount rate:
Operating leases5.2 %5.2 %5.0 %
Finance leases6.4 %6.5 %6.5 %
Cash flow and other information related to leases is presented in the following table:
Years Ended December 31,
202520242023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash outflows from operating leases$259 $252 $258 
Operating cash outflows from finance leases$5 $10 $13 
Financing cash outflows from finance leases$62 $87 $107 
Right-of-use assets obtained in exchange for lease obligations:
Operating leases$360 $292 $168 
Finance leases$59 $363 $55 
Future maturities of lease liabilities at December 31, 2025 are presented in the following table:
Operating LeasesFinance LeasesTotal
2026$271 $53 $324 
2027247 132 379 
2028214 38 252 
2029177 28 205 
2030139 25 164 
Later years479 522 1,001 
Total lease payments1,527 798 2,325 
Less: Imputed interest270 346 616 
Total lease obligations1,257 452 1,709 
Less: Current obligations214 45 259 
Long-term lease obligations$1,043 $407 $1,450 
In May 1997, we entered into a 30‑year lease agreement for a medical campus located in Palm Springs, California. In December 2024, we executed a lease-purchase agreement to establish a new 30‑year lease beginning upon the expiration of the original lease in May 2027. This agreement includes an initial payment of $100 million at the start of the new lease term, followed by 19 annual escalating lease payments. Following our remittance of a final payment of $100 million in May 2057, ownership of certain of the leased facilities and land will transfer to us. During the year ended December 31, 2024, we recognized a $303 million right‑of‑use asset and a long-term finance lease liability in the same amount in connection with the lease-purchase agreement
v3.25.4
LONG-TERM DEBT
 12 Months Ended
Dec. 31, 2025
Long-Term Debt and Lease Obligation [Abstract]  
LONG-TERM DEBT LONG-TERM DEBT
The table below presents our long‑term debt included in the accompanying Consolidated Balance Sheets:
December 31,
 20252024
Senior unsecured notes:  
6.125% due 2028
$1,750 $2,500 
6.875% due 2031
362 362 
6.000% due 2033
750 — 
Senior secured first lien notes:  
5.125% due 2027
1,500 1,500 
4.625% due 2028
600 600 
4.250% due 2029
1,400 1,400 
4.375% due 2030
1,450 1,450 
6.125% due 2030
2,000 2,000 
6.750% due 2031
1,350 1,350 
5.500% due 2032
1,500 — 
Senior secured second lien notes:
6.250% due 2027
— 1,500 
Finance leases, mortgages and other notes603 605 
Unamortized issue costs and note discounts(94)(94)
Total long-term debt13,171 13,173 
Less: Current portion79 92 
Long-term debt, net of current portion$13,092 $13,081 
Senior Unsecured Notes and Senior Secured Notes
At December 31, 2025, we had senior unsecured notes and senior secured notes with aggregate principal amounts outstanding of $12.662 billion. These notes have fixed interest rates ranging from 4.250% to 6.875% and require semi‑annual interest payments in arrears. A payment of the principal and any accrued but unpaid interest is due upon the maturity date of the respective notes, which dates are staggered from November 2027 through November 2033. We completed the following transactions during the year ended December 31, 2025, all of which occurred in November:
•We issued $1.500 billion aggregate principal amount of our 5.500% senior secured first lien notes due on November 15, 2032 (the “2032 Senior Secured First Lien Notes”). We will pay interest on the 2032 Senior Secured First Lien Notes on May 15 and November 15 of each year, which payments will commence on May 15, 2026.
•In addition, we issued $750 million aggregate principal amount of our 6.000% senior notes due on November 15, 2033 (the “2033 Senior Unsecured Notes”). We will pay interest on the 2033 Senior Unsecured Notes on May 15 and November 15 of each year, which payments will commence on May 15, 2026.
•We used the net proceeds from the issuance of the 2032 Senior Secured First Lien Notes and 2033 Senior Unsecured Notes, together with cash on hand, to finance the redemption of all $1.500 billion aggregate principal amount outstanding of our 6.250% senior secured second lien notes due February 2027 (the “February 2027 Senior Secured Second Lien Notes”) and the redemption of $750 million aggregate principal amount of the then $2.500 billion aggregate principal amount outstanding of our 6.125% senior notes due October 2028 (the “October 2028 Senior Unsecured Notes”), in each case in advance of their maturity dates.
In March 2024, we redeemed all $2.100 billion aggregate principal amount outstanding of our 4.875% senior secured first lien notes due 2026 in advance of their maturity date. We paid $2.100 billion using cash on hand to redeem the notes.
We recorded losses from the early extinguishment of debt of $7 million and $8 million in connection with the aforementioned redemptions during the years ended December 31, 2025 and 2024, respectively. These losses were primarily related to the write-off of associated unamortized issuance costs.
All of our senior secured notes are guaranteed by certain of our wholly owned domestic hospital company subsidiaries and secured by a pledge of the capital stock and other ownership interests of those subsidiaries on a first lien basis. All of our senior secured notes and the related subsidiary guarantees are our and the subsidiary guarantors’ senior secured obligations. All
of our senior secured notes rank equally in right of payment with all of our other senior secured indebtedness. Our senior secured notes rank senior to any subordinated indebtedness that we or such subsidiary guarantors may incur; they are effectively senior to our and such subsidiary guarantors’ existing and future unsecured indebtedness and other liabilities to the extent of the value of the collateral securing the notes and the subsidiary guarantees; they are effectively subordinated to our and such subsidiary guarantors’ obligations under our senior secured revolving credit facility, as discussed below, to the extent of the value of the collateral securing borrowings thereunder; and they are structurally subordinated to all obligations of our non‑guarantor subsidiaries.
The indentures setting forth the terms of our senior secured notes contain provisions governing our ability to redeem the notes and the terms by which we may do so. On or after the call dates specified in the indentures and at our option, we may redeem our senior secured notes, in whole or in part, at the specified redemption prices set forth in the applicable indenture, together with accrued and unpaid interest. In addition, we may be required to purchase for cash all or any part of each series of our senior secured notes upon the occurrence of a change of control (as defined in the applicable indentures) for a cash purchase price of 101% of the aggregate principal amount of the notes, plus accrued and unpaid interest.
All of our senior unsecured notes are general unsecured senior debt obligations that rank equally in right of payment with all of our other unsecured senior indebtedness, but are effectively subordinated to our senior secured notes described above, the obligations of our subsidiaries and any obligations under our senior secured revolving credit facility to the extent of the value of the collateral. We may redeem either series of our senior unsecured notes, in whole or in part, at any time at the specified redemption prices (plus, in the case of one series of notes, a make-whole premium) set forth in the applicable indenture, together with accrued and unpaid interest.
Credit Agreement
In November 2025, we executed a new senior secured revolving credit facility (the “2025 Credit Agreement”) and concurrently terminated our then-existing senior secured revolving credit facility, which we originally entered into in November 2006 (the “2006 Credit Agreement”), prior to its scheduled maturity date. The 2025 Credit Agreement provides for, subject to borrowing availability, revolving loans in an aggregate principal amount of up to $1.900 billion with a $200 million subfacility for standby letters of credit. Our borrowing availability under the 2025 Credit Agreement is calculated by reference to a borrowing base that is determined by specified percentages of eligible accounts receivable, eligible inventory and Medicaid supplemental payments.
Outstanding revolving loans under the 2025 Credit Agreement accrue interest at either (1) a base rate plus an applicable margin ranging from 0.25% to 0.50% per annum or (2) the Term Secured Overnight Financing Rate (“SOFR”), Daily Simple SOFR or the Euro Interbank Offered Rate (“EURIBOR”) (each as defined in the 2025 Credit Agreement) plus an applicable margin ranging from 1.25% to 1.50% per annum, in each case based upon average quarterly available credit. The undrawn portions of the commitments are subject to a commitment fee at a rate equal to 0.25% per annum. Obligations under the 2025 Credit Agreement are guaranteed by certain of our domestic wholly owned subsidiaries (“Subsidiary Guarantors”) and are secured by a first-priority lien on the accounts receivable and inventory owned by us and the Subsidiary Guarantors.
The 2025 Credit Agreement will terminate on the earlier of (1) November 4, 2030 (the “Scheduled Maturity Date”) or (2) 45 business days prior to the maturity date of (a) any series of our senior notes due in 2028 or (b) any series of our senior secured notes due between 2027 and 2030, but solely to the extent that the principal amount of such series exceeds $2.500 billion (each, a “Springing Maturity Date”), unless (i) prior to each Springing Maturity Date, with respect to at least 80% of the aggregate principal amount of the applicable series of notes, the maturity date is extended to a date no earlier than one year after the Scheduled Maturity Date or such amount is repaid, defeased, discharged or refinanced, or (ii) on each such Springing Maturity Date, the Excess Availability Condition (as defined in the 2025 Credit Agreement), determined on a pro forma basis, after giving effect to the full repayment of the applicable series of the notes, is satisfied.
As of December 31, 2025, our borrowing availability under the 2025 Credit Agreement was $1.900 billion. On that date, we had no cash borrowings and less than $1 million of standby letters of credit outstanding under the 2025 Credit Agreement.
Prior to its termination, our 2006 Credit Agreement provided for revolving loans in an aggregate principal amount of up to $1.500 billion with a $200 million subfacility for standby letters of credit and had a scheduled maturity date of March 16, 2027. Outstanding revolving loans accrued interest depending on the type of loan at either (1) a base rate plus an applicable margin ranging from 0.25% to 0.75% per annum or (2) Term SOFR, Daily Simple SOFR or EURIBOR (each, as defined in the 2006 Credit Agreement) plus an applicable margin ranging from 1.25% to 1.75% per annum and (in the case of Term SOFR and Daily Simple SOFR only) a credit spread adjustment of 0.10%, in each case based on available credit. An
unused commitment fee payable on the undrawn portion of the revolving loans ranged from 0.25% to 0.375% per annum based on available credit.
Letter of Credit Facility
We have a letter of credit facility (as amended to date, the “LC Facility”) that provides for the issuance, from time to time, of standby and documentary letters of credit in an aggregate principal amount of up to $200 million. We amended the LC Facility in November 2025 (the “LC Facility Amendment”) to, among other things, extend the scheduled maturity date from March 16, 2027 to November 4, 2030 and revise certain pricing terms under the LC Facility.
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, as defined in the LC Facility, plus a fixed margin stipulated in the LC Facility. The LC Facility Amendment revised the margin applicable to the drawings under these letters of credit from 0.50% per annum to 0.25% per annum. The LC Facility Amendment also reduced the fee on the aggregate outstanding amount of issued but undrawn letters of credit from 1.50% per annum under the prior agreement to 1.25% per annum. An unused commitment fee at a rate of 0.25% per annum is payable with respect to the uncommitted portion of the aggregate principal available, and 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.
The LC Facility is subject to an effective maximum secured debt covenant of 4.25 to 1.00. 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. At December 31, 2025, we had $104 million of standby letters of credit outstanding under the LC Facility.
Covenants
Senior Secured Notes—The indentures governing our senior secured notes contain covenants that, among other things, restrict our ability and the ability of our subsidiaries to incur liens, consummate asset sales, enter into sale and lease‑back transactions or consolidate, merge or sell all or substantially all of our or their assets, other than in certain transactions between one or more of our wholly owned subsidiaries. These restrictions, however, are subject to a number of exceptions and qualifications. In particular, there are no restrictions on our ability or the ability of our subsidiaries to incur additional indebtedness, make restricted payments, pay dividends or make distributions in respect of capital stock, purchase or redeem capital stock, enter into transactions with affiliates or make advances to, or invest in, other entities (including unaffiliated entities). In addition, the indentures governing our senior secured notes contain a covenant that neither we nor any of our subsidiaries will incur secured debt, unless at the time of and after giving effect to the incurrence of such debt, the aggregate amount of all such secured debt (including the aggregate principal amount of senior secured notes outstanding and any outstanding borrowings under our 2025 Credit Agreement at such time) does not exceed the amount that would cause the secured debt ratio (as defined in the indentures) to exceed 4.00 to 1.00.
Senior Unsecured Notes—The indentures governing our senior unsecured notes contain covenants and conditions that have, among other requirements, limitations on (1) liens on “principal properties” and (2) sale and lease‑back transactions with respect to principal properties. A principal property is defined in the senior unsecured notes indentures as a hospital that has an asset value on our books in excess of 5% of our consolidated net tangible assets, as defined in such indentures. The above limitations do not apply, however, to (1) debt that is not secured by principal properties or (2) debt that is secured by principal properties if the aggregate of such secured debt does not exceed 15% of our consolidated net tangible assets, as further described in the indentures. The senior unsecured notes indentures also prohibit the consolidation, merger or sale of all or substantially all assets unless no event of default would result after giving effect to such transaction.
Credit Agreement—Our 2025 Credit Agreement contains customary covenants for an asset‑backed facility, including a minimum fixed charge coverage ratio to be met if the designated excess availability under the revolving credit facility falls below $150 million, as well as limits on debt, asset sales and prepayments of certain other debt. The 2025 Credit Agreement also includes a provision, which we believe is customary in receivables‑backed credit facilities, that gives our lenders the right to require that proceeds of collections of substantially all of our consolidated accounts receivable be applied directly to repay outstanding loans and other amounts that are due and payable under the 2025 Credit Agreement at any time that unused borrowing availability under the revolving credit facility is less than $200 million for three consecutive business days or if an event of default has occurred and is continuing thereunder. In that event, we would seek to re‑borrow under the 2025 Credit Agreement to satisfy our operating cash requirements. Our ability to borrow under the 2025 Credit Agreement is subject to conditions that we believe are customary in revolving credit facilities, including that no events of default then exist.
At December 31, 2025, we were in compliance with all applicable covenants and conditions.
Future Maturities
Future long‑term debt maturities, including finance lease obligations, were as follows as of December 31, 2025:
  Years Ending December 31,Later Years
 Total20262027202820292030
Long-term debt, including finance lease obligations$13,265 $79 $1,628 $2,402 $1,438 $3,465 $4,253 
v3.25.4
GUARANTEES
 12 Months Ended
Dec. 31, 2025
Guarantees [Abstract]  
GUARANTEES GUARANTEES
Consistent with our policy on physician relocation and recruitment, we provide revenue guarantee agreements to certain physicians who agree to relocate to fill a community need in the service area of one of our hospitals and commit to remain in practice in the area for a specified period of time. Under such agreements, we are required to make payments to the physicians in excess of the amounts they earn in their practices up to the amount of the guarantee. The guarantee periods are typically 12 months. If a physician does not fulfill his or her commitment period to the community, which is typically three years subsequent to the guarantee period, we seek recovery of the guarantee payments from the physician on a prorated basis. We also provide guarantees to hospital‑based physician groups providing certain services at our hospitals with terms generally ranging from one to three years. These agreements can be based on meeting a target net income, collections, subsidy or work relative value units depending on the terms of the individual agreements.
At December 31, 2025, 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 $168 million. We had a total liability of $138 million recorded for these guarantees included in other current liabilities in the accompanying Consolidated Balance Sheet at December 31, 2025.
We have also 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 $51 million at December 31, 2025.
v3.25.4
EMPLOYEE BENEFIT PLANS
 12 Months Ended
Dec. 31, 2025
Share-Based Payment Arrangement [Abstract]  
EMPLOYEE BENEFIT PLANS EMPLOYEE BENEFIT PLANS
Share-Based Compensation Plans
We have granted stock options and restricted stock units (“RSUs”) to certain of our employees and directors pursuant to our stock incentive plans. Stock options have an exercise price equal to the fair market value of our shares on the date of grant and generally expire 10 years from the date of grant. An RSU is a contractual right to receive one share of our common stock in the future, and the fair value of the RSU is based on our share price on the grant date. Typically, stock options and time‑based RSUs vest one‑third on each of the first three anniversary dates of the grant; however, certain special retention awards may have different vesting terms. Shares underlying vested RSUs are generally distributed to participants (settled) immediately after the vesting date. We also grant RSUs to our non‑employee directors as part of their annual compensation. Previously, these grants vested immediately and were settled on the third anniversary of the date of grant. Beginning in 2024, annual compensation grants to our non-employee directors vest on the first anniversary of the date of grant. Compensation cost is measured by the fair value of the awards on their grant dates and is recognized over the requisite service period of the awards, whether or not the awards had any intrinsic value during the period.
We also grant performance‑based RSUs that vest subject to the achievement of specified performance goals within a pre‑established time frame. The performance‑based RSUs may contain provisions that increase or decrease the number of RSUs that ultimately vest, depending upon the level of achievement. For certain of our performance‑based awards, the number of RSUs that ultimately vest is also subject to adjustment based on the achievement of a market‑based condition. In aggregate, these adjustments range from 0% to a maximum of 250% of the number of RSUs initially granted for awards made in 2025 and 2024, and from 0% to 225% for awards granted in 2023. The fair value of awards that contain a market‑based condition is estimated using a discrete model to analyze the fair value of the subject shares. The discrete model utilizes multiple stock paths, through the use of a Monte Carlo simulation, which paths are then analyzed to determine the fair value of the subject shares.
Pursuant to the terms of our stock‑based compensation plans, awards granted under the plan vest and may be exercised as determined by the human resources committee of our board of directors. In the event of a change in control, the human resources committee of our board of directors may, at its sole discretion without obtaining shareholder approval, accelerate the vesting or performance periods of the awards.
At December 31, 2025, assuming outstanding performance‑based RSUs for which performance has not yet been determined will achieve target performance, approximately 8,264 thousand shares of common stock were available under our 2019 Stock Incentive Plan for future stock option grants and other equity incentive awards, including RSUs. The accompanying
Consolidated Statements of Operations include pre-tax compensation costs related to our stock‑based compensation arrangements of $104 million, $67 million and $66 million for the years ended December 31, 2025, 2024 and 2023, respectively.
Stock Options
The following table presents information about our stock option activity during the years ended December 31, 2025, 2024 and 2023:
 Number of OptionsWtd. Avg.
Exercise Price
Per Share		Aggregate
Intrinsic Value		Wtd. Avg.
Remaining
Contractual Life
   (In Millions) 
Outstanding at December 31, 2022460,947 $23.33   
Exercised(76,507)$26.07   
Outstanding at December 31, 2023384,440 $22.79   
Exercised(197,943)$21.86   
Outstanding at December 31, 2024186,497 $23.76   
Exercised(41,816)$22.39   
Outstanding at December 31, 2025144,681 $24.16 $25 2.5 years
The stock options exercised during the year ended December 31, 2025, 2024 or 2023 had an aggregate intrinsic values of $7 million, $19 million and $4 million, respectively. We did not grant any stock options during the years ended December 31, 2025, 2024 or 2023, and all outstanding options were vested and exercisable at December 31, 2025.
The following table presents additional information about our outstanding stock options at December 31, 2025:
 Options Outstanding and Exercisable
Range of Exercise Prices Number of
Options		Wtd. Avg.
Remaining
Contractual Life		Wtd. Avg.
Exercise Price
Per Share
$18.99 to $20.609
86,469 2.2 years$20.60 
$20.61 to $35.430
58,212 3.1 years$29.44 
 144,681 2.5 years$24.16 
As of December 31, 2025, 26.0% of all our outstanding options were held by current employees and 74.0% were held by former employees. All of our outstanding options were in‑the‑money, that is, they had exercise price less than the $198.72 market price of our common stock on December 31, 2025.
Restricted Stock Units
The following table presents information about our RSU activity during the years ended December 31, 2025, 2024 and 2023:
 Number of RSUsWtd. Avg. Grant Date Fair
Value Per RSU
Unvested at December 31, 20221,520,418 $66.36 
Granted759,590 $60.88 
Performance-based adjustment185,901 $48.97 
Vested(954,401)$48.75 
Forfeited(90,445)$64.61 
Unvested at December 31, 20231,421,063 $66.46 
Granted573,033 $94.70 
Performance-based adjustment205,075 $66.51 
Vested(684,268)$65.64 
Forfeited(32,904)$80.91 
Unvested at December 31, 20241,481,999 $83.84 
Granted596,913 $138.06 
Performance-based adjustment255,386 $80.85 
Vested(872,894)$81.41 
Forfeited(21,025)$105.02 
Unvested at December 31, 20251,440,379 $111.02 
During the year ended December 31, 2025, we granted 289,780 RSUs that will vest over periods ranging from one to four years. In addition, we granted 307,133 performance-based RSUs, the vesting of which is contingent on our achievement of specified performance goals for the years 2025 to 2027. Provided the goals are achieved, the performance‑based RSUs that could vest will range from 0% to 250% of the 307,133 units granted, depending on our level of achievement with respect to the performance goals. During the same period, we issued an additional 255,386 RSUs that vested immediately as a result of our level of achievement with respect to previously awarded performance-based RSUs.
During the year ended December 31, 2024, we granted 275,694 RSUs that vest over periods ranging from one to three years. In addition, we granted 297,339 performance-based RSUs, the vesting of which is contingent on our achievement of specified performance goals for the years 2024 to 2026. Provided the goals are achieved, the performance‑based RSUs that could vest will range from 0% to 250% of the 297,339 units granted, depending on our level of achievement with respect to the performance goals. During the same period, we issued an additional 205,075 RSUs that vested immediately as a result of our level of achievement with respect to previously awarded performance-based RSUs.
During the year ended December 31, 2023, we granted 429,601 RSUs that vest over periods ranging from one to five years and 20,707 RSUs that vested upon the relocation of one of our executive officers. In addition, we granted 309,282 performance‑based RSUs, the vesting of which is contingent on our achievement of specified performance goals for the years 2023 to 2025. Provided the goals are achieved, the performance‑based RSUs that could vest will range from 0% to 225% of the 297,339 units granted, depending on our level of achievement with respect to the performance goals. During the same period, we issued an additional 185,901 RSUs that vested immediately as a result of our level of achievement with respect to previously awarded performance-based RSUs.
For certain of the performance-based RSU grants, the number of units that will ultimately vest is subject to adjustment based on the achievement of a market-based condition. The fair value of these RSUs is estimated through the use of a Monte Carlo simulation. Significant inputs used in our valuation of these RSUs included the following:
Years Ended December 31,
202520242023
Expected volatility
36.6% - 48.0%
34.9% - 52.1%
53.6% - 65.6%
Risk-free interest rate
4.1% - 4.3%
4.4% - 4.9%
4.2% - 4.8%
USPI Management Equity Plan
USPI maintained a separate restricted stock plan (the “USPI Management Equity Plan”) under which it has granted RSUs representing a contractual right to receive one share of USPI’s non‑voting common stock in the future. The vesting of
RSUs granted under the plan varied based on the terms of the underlying award agreement. The following table presents information about RSU activity under the USPI Management Equity Plan during the years ended December 31, 2024 and 2023.
Number of RSUsWtd. Avg. Grant Date Fair
Value Per RSU
Unvested at December 31, 2022922,840 $34.13 
Vested(303,171)$34.13 
Forfeited(11,685)$34.13 
Unvested at December 31, 2023607,984 $34.13 
Vested(598,846)$34.13 
Forfeited(1,997)$34.13 
Cancelled(7,141)$34.13 
Unvested at December 31, 2024— $34.13 
In October 2024, USPI repurchased all outstanding non-voting shares at their estimated fair value. The accompanying Consolidated Statements of Operations for the years ended December 31, 2024 and 2023 included $6 million and $20 million, respectively, of pre-tax compensation costs related to USPI’s management equity plan. We did not incur any expenses related to the USPI Management Equity Plan during the year ended December 31, 2025
Other Employee Benefit and Retirement Plans
Employee Stock Purchase Plan
We have an employee stock purchase plan under which we are currently authorized to issue up to 4,070 thousand shares of common stock to our eligible employees. As of December 31, 2025, there were approximately 2,444 thousand shares available for issuance under our employee stock purchase plan. Under the terms of the plan, eligible employees may elect to have between 1% and 10% of their base earnings withheld each quarter to purchase shares of our common stock. Shares are purchased at a price equal to 95% of the closing price on the last day of the quarter. The plan requires a one‑year holding period for all shares issued. The holding period does not apply upon termination of employment. Under the plan, no individual may purchase, in any year, shares with a fair market value in excess of $25,000. The plan is currently not considered to be compensatory.
We issued the following numbers of shares under our employee stock purchase plan:
 Years Ended December 31, 
 202520242023
Number of shares (in thousands)25 33 69 
Weighted average price$160.90 $121.76 $65.62 
Defined Contribution Retirement Plans
We maintain various other defined contribution plans for the benefit of our employees. During the years ended December 31, 2025, 2024 and 2023, we incurred total expenses from these plans of $165 million, $128 million and $126 million, respectively, primarily related to our contributions to the plans.
Substantially all of our employees, upon qualification, are eligible to participate in our defined contribution 401(k) plans. Under the plans, employees may contribute a portion of their eligible compensation, which we may match with employer contributions at our discretion. Employer matching contributions will vary depending on which of our subsidiaries employs the participant and whether the employee is covered under a collective bargaining agreement.
Defined Benefit Retirement Plans
We maintain three frozen non‑qualified defined benefit pension plans (“SERPs”) that provide supplemental retirement benefits to certain of our current and former executives. These plans are not funded, and plan obligations for these plans are paid from our working capital. Pension benefits are generally based on years of service and compensation. Upon completing the acquisition of Vanguard Health Systems, Inc. on October 1, 2013, we assumed a frozen qualified defined benefit plan (“DMC Pension Plan”) covering substantially all of the employees of our Detroit market that were hired prior to June 1, 2003. The benefits paid under the DMC Pension Plan are primarily based on years of service and final average earnings. During the year ended December 31, 2021, the Society of Actuaries issued the MP‑2021 mortality improvement scale, which we incorporated into the estimates of our defined benefit plan obligations at December 31, 2025 and 2024.
The following tables summarize the balance sheet impact, as well as the benefit obligations, funded status and rate assumptions associated with the SERPs and the DMC Pension Plan based on actuarial valuations prepared:
 December 31,
 20252024
Reconciliation of funded status of plans and the amounts included in the Consolidated Balance Sheets:  
Projected benefit obligations(1)
  
Beginning obligations$(895)$(951)
Interest cost(49)(49)
Actuarial gain (loss)(18)22 
Benefits paid82 83 
Annuity purchase33 — 
Ending obligations(847)(895)
Fair value of plans assets  
Beginning plan assets573 592 
Gain (loss) on plan assets35 (3)
Employer contribution61 42 
Benefits paid(58)(58)
Annuity purchase(33)— 
Ending plan assets578 573 
Funded status of plans$(269)$(322)
Amounts recognized in the Consolidated Balance Sheets consist of:  
Other current liability$(24)$(24)
Other long-term liability$(245)$(298)
Accumulated other comprehensive loss$228 $225 
SERP Assumptions:  
Discount rate5.50 %5.75 %
Compensation increase rate3.00 %3.00 %
Measurement dateDecember 31, 2025December 31, 2024
DMC Pension Plan Assumptions:  
Discount rate5.42 %5.69 %
Compensation increase rateFrozenFrozen
Measurement dateDecember 31, 2025December 31, 2024
(1)The accumulated benefit obligation at December 31, 2025 and 2024 was approximately $847 million and $895 million, respectively.
The components of net periodic benefit costs and related assumptions are as follows:
 Years Ended December 31,
 202520242023
Interest costs$49 $49 $53 
Expected return on plan assets(29)(29)(36)
Amortization of net actuarial loss8 8 7 
Special termination benefit costs— — 1 
Net periodic benefit cost$28 $28 $25 
SERP Assumptions:   
Discount rate5.75 %5.50 %5.75 %
Compensation increase rate3.00 %3.00 %3.00 %
Measurement dateJanuary 1, 2025January 1, 2024January 1, 2023
Census dateJanuary 1, 2025January 1, 2024January 1, 2023
DMC Pension Plan Assumptions:   
Discount rate5.69 %5.25 %5.51 %
Long-term rate of return on assets5.25 %5.00 %5.75 %
Compensation increase rateFrozenFrozenFrozen
Measurement dateJanuary 1, 2025January 1, 2024January 1, 2023
Census dateJanuary 1, 2025January 1, 2024January 1, 2023
Net periodic benefit costs for the current year are based on assumptions determined at the valuation date of the prior year for the SERPs and the DMC Pension Plan. We recorded loss adjustments of $3 million, $1 million and $2 million in other comprehensive income in the years ended December 31, 2025, 2024 and 2023, respectively, to recognize changes in the funded status of our SERPs and the DMC Pension Plan. Changes in the funded status are recorded as a direct increase or decrease to shareholders’ equity through accumulated other comprehensive loss. Net actuarial losses of $11 million during the year ended December 31, 2025 and $9 million during each of the years ended December 31, 2024 and 2023, and the amortization of net actuarial loss of $8 million during each of the years ended December 31, 2025 and 2024 and $7 million during the year ended December 31, 2023 were recognized in other comprehensive income. Actuarial gains (losses) affecting the benefit obligation during the years ended December 31, 2025 and 2024 were primarily attributable to the return on plan assets for the DMC Pension Plan and changes in the discount rate utilized for the SERP and DMC Pension Plan. Actuarial gains during the year ended December 31, 2023 were primarily attributable to changes in the discount rate utilized for the SERP and DMC Pension Plan. Cumulative net actuarial losses totaled $228 million, $225 million and $224 million as of December 31, 2025, 2024 and 2023, respectively. There were no unrecognized prior service costs at December 31, 2025, 2024 and 2023 that had not yet been recognized as components of net periodic benefit cost.
To develop the expected long‑term rate of return on plan assets assumption, the DMC Pension Plan considers the current level of expected returns on risk‑free investments (primarily government bonds), the historical level of risk premium associated with the other asset classes in which the portfolio is invested and the expectations for future returns on each asset class. The expected return for each asset class is then weighted based on the target asset allocation to develop the expected long‑term rate of return on assets assumption for the portfolio.
The weighted‑average asset allocations by asset category as of December 31, 2025, were as follows:
TargetActual
Cash and cash equivalents— %11 %
Equity securities11 %8 %
Debt securities70 %62 %
Alternative investments19 %19 %
The DMC Pension Plan assets are invested in public commingled vehicles, segregated separately managed accounts, and private commingled vehicles, all of which are managed by professional investment management firms. The objective for all asset categories is to maximize total return without assuming undue risk exposure. The DMC Pension Plan maintains a well‑diversified asset allocation that meets these objectives. The DMC Pension Plan assets are largely comprised of cash and cash equivalents, including but not limited to money market funds and repurchase agreements secured by U.S. Treasury or federal agency obligations, equity securities, including but not limited to the publicly traded shares of U.S. companies with
various market capitalizations in addition to international and convertible securities, debt securities including, but not limited to, domestic and foreign government obligations, corporate bonds, and mortgage‑backed securities, and alternative investments. Alternative investments is a broadly defined asset category with the objective of diversifying the overall portfolio, complementing traditional equity and fixed‑income securities and improving the overall performance consistency of the portfolio. Alternative investments may include, but are not limited to, diversified hedge funds in the form of professionally managed pooled limited partnership investments and investments in private markets via professionally managed pooled limited partnership interests.
In each investment account, the DMC Pension Plan investment managers are responsible for monitoring and reacting to economic indicators, such as gross domestic product, consumer price index and U.S. monetary policy that may affect the performance of their account. The performance of all managers and the aggregate asset allocation are formally reviewed on a quarterly basis. The current asset allocation objective is to maintain a certain percentage within each asset class allowing for deviation within the established range for each asset class. The portfolio is rebalanced on an as‑needed basis to keep these allocations within the accepted ranges.
In general, fair values determined by Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. We consider a security that trades at least weekly to have an active market. Fair values determined by Level 2 inputs utilize data points that are observable, such as quoted prices for similar assets, interest rates and yield curves. Fair values determined by Level 3 inputs utilize unobservable data points for the asset or liability, and include situations where there is little, if any, market activity for the asset or liability.
The following table presents the DMC Pension Plan assets measured at fair value on a recurring basis as of December 31, 2025 and 2024, aggregated by the level in the fair value hierarchy within which those measurements are determined:
TotalLevel 1Level 2Level 3
As of December 31, 2025:
Cash and cash equivalents$64 $64 $— $— 
Equity securities49 49 — — 
Fixed income funds356 356 — — 
Alternative investments:
Private equity securities99 — — 99 
Hedge funds10 — — 10 
 $578 $469 $— $109 
As of December 31, 2024:
Cash and cash equivalents$22 $22 $— $— 
Equity securities66 66 — — 
Fixed income funds376 376 — — 
Alternative investments:
Private equity securities106 — — 106 
Hedge funds3 — — 3 
$573 $464 $— $109 
The following table presents the estimated future benefit payments to be made from the SERPs and the DMC Pension Plan, a portion of which will be funded from plan assets, for the next five years and in the aggregate for the five years thereafter:
  Years Ending December 31, Five Years Thereafter
 Total20262027202820292030
Estimated benefit payments$732 $81 $80 $79 $77 $75 $340 
The SERP and DMC Pension Plan obligations of $269 million at December 31, 2025 are classified in the accompanying Consolidated Balance Sheet as an other current liability of $24 million and defined benefit plan obligations of $245 million based on an estimate of the expected payment patterns. We expect to make total contributions to the plans of approximately $24 million for the year ending December 31, 2026.
v3.25.4
PROPERTY AND EQUIPMENT
 12 Months Ended
Dec. 31, 2025
Property, Plant and Equipment [Abstract]  
PROPERTY AND EQUIPMENT PROPERTY AND EQUIPMENT
The principal components of property and equipment are presented in the table below:
 December 31,
 20252024
Land$534 $539 
Buildings and improvements6,672 6,130 
Construction in progress211 238 
Equipment5,038 4,399 
Finance lease assets540 552 
 12,995 11,858 
Accumulated depreciation and amortization(6,680)(5,809)
Net property and equipment$6,315 $6,049 
Property and equipment is stated at cost, less accumulated depreciation and amortization and impairment write‑downs related to assets held and used. We recognized depreciation expense of $697 million, $646 million and $696 million in the accompanying Consolidated Statements of Operations for the years ended December 31, 2025, 2024 and 2023, respectively.
v3.25.4
GOODWILL AND OTHER INTANGIBLE ASSETS
 12 Months Ended
Dec. 31, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
GOODWILL AND OTHER INTANGIBLE ASSETS GOODWILL AND OTHER INTANGIBLE ASSETS
The following table presents information on changes in the carrying amount of goodwill for each of our segments:
December 31,
 20252024
Hospital Operations  
Goodwill at beginning of period, net of accumulated impairment losses$2,697 $3,119 
Goodwill acquired during the year, including purchase price allocation adjustments— 42 
Goodwill related to assets held for sale and disposed— (464)
Goodwill at end of period, net of accumulated impairment losses$2,697 $2,697 
Ambulatory Care
Goodwill at beginning of period7,994 $7,188 
Goodwill acquired during the year, including purchase price allocation adjustments507 927 
Goodwill related to assets held for sale and disposed or deconsolidated facilities— (121)
Goodwill at end of period8,501 $7,994 
Total Goodwill$11,198 $10,691 
There were $2.430 billion of accumulated impairment losses related to the goodwill of our Hospital Operations segment at both December 31, 2025 and 2024. There were no accumulated goodwill impairment losses related to our Ambulatory Care segment in either period.
The following table presents information regarding other intangible assets, which were included in the accompanying Consolidated Balance Sheets:
 Gross
Carrying
Amount		Accumulated
Amortization		Net Book
Value
At December 31, 2025:   
Other intangible assets with finite useful lives:
Capitalized software costs$1,511 $(1,166)$345 
Contracts241 (148)93 
Other42 (14)28 
Other intangible assets with finite lives1,794 (1,328)466 
Other intangible assets with indefinite useful lives:
Trade names105 — 105 
Contracts773 — 773 
Other4 — 4 
Other intangible assets with indefinite lives882 — 882 
Total other intangible assets, net$2,676 $(1,328)$1,348 
At December 31, 2024:
Other intangible assets with finite useful lives:
Capitalized software costs$1,469 $(1,075)$394 
Contracts241 (135)106 
Other96 (78)18 
Other intangible assets with finite lives1,806 (1,288)518 
Other intangible assets with indefinite useful lives:
Trade names105 — 105 
Contracts769 — 769 
Other5 — 5 
Other intangible assets with indefinite lives879 — 879 
Total other intangible assets, net$2,685 $(1,288)$1,397 
Estimated future amortization of intangible assets with finite useful lives at December 31, 2025 was as follows:
 TotalYears Ending December 31,Later Years
 20262027202820292030
Amortization of intangible assets$466 $106 $114 $82 $58 $43 $63 
We recognized amortization expense of $166 million, $172 million and $174 million during the years ended December 31, 2025, 2024 and 2023, respectively.
v3.25.4
OTHER ASSETS
 12 Months Ended
Dec. 31, 2025
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]  
OTHER ASSETS OTHER ASSETS
The principal components of other current assets in the accompanying Consolidated Balance Sheets are presented below:
December 31,
 20252024
Prepaid expenses$423 $368 
Contract assets188 190 
California provider fee program receivables493 334 
Receivables from other government programs385 326 
Guarantees138 194 
Non-patient receivables224 229 
Other140 119 
Total other current assets$1,991 $1,760 
The principal components of investments and other assets in the accompanying Consolidated Balance Sheets are presented below:
 December 31,
 20252024
Marketable securities$59 $50 
Equity investments in unconsolidated healthcare entities1,383 1,482 
Total investments1,442 1,532 
Cash surrender value of life insurance policies54 48 
Long-term deposits50 51 
California provider fee program receivables121 274 
Operating lease assets1,134 1,037 
Other long-term receivables and other assets82 95 
Total investments and other assets$2,883 $3,037 
v3.25.4
ACCUMULATED OTHER COMPREHENSIVE LOSS
 12 Months Ended
Dec. 31, 2025
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]  
ACCUMULATED OTHER COMPREHENSIVE LOSS ACCUMULATED OTHER COMPREHENSIVE LOSS
The table below presents our accumulated other comprehensive loss by component:
 December 31,
 20252024
Adjustments for defined benefit plans$(183)$(181)
Unrealized gains on investments1 — 
Foreign currency translation adjustments and other1 1 
Accumulated other comprehensive loss$(181)$(180)
The following table presents the income tax benefit from each component of our other comprehensive income (loss):
 December 31,
 20252024
Adjustments for defined benefit plans$(1)$— 
Net income tax benefit related to items of other comprehensive income (loss)$(1)$— 
v3.25.4
NET OPERATING REVENUES
 12 Months Ended
Dec. 31, 2025
Revenue from Contract with Customer [Abstract]  
NET OPERATING REVENUES CONTRACT BALANCES
Hospital Operations Segment
Our Hospital Operations segment’s contract assets and liabilities primarily derive from: (1) patients receiving ongoing inpatient care from one of our facilities at the end of the reporting period; and (2) timing differences between our performance of revenue cycle management and other contract-based services and the invoicing or receipt of payment for these services. Our Hospital Operations segment’s contract assets were included in other current assets, and its contract liabilities were included in other current liabilities or other long‑term liabilities, depending upon when we expect to recognize the underlying revenue, in the accompanying Consolidated Balance Sheets at December 31, 2025 and 2024.
The opening and closing balances of our Hospital Operations segment’s receivables, contract assets, and current and long‑term contract liabilities were as follows:
ReceivablesContract Assets –
Unbilled Revenue		Contract Liabilities –
Current
Deferred Revenue		Contract Liabilities –
Long-Term
Deferred Revenue
December 31, 2024$28 $190 $80 $13 
December 31, 202526 188 88 13 
Increase (decrease)$(2)$(2)$8 $— 
December 31, 2023$21 $208 $59 $12 
December 31, 202428 190 80 13 
Increase (decrease)$7 $(18)$21 $1 
The differences between the balances of our contract assets at December 31, 2025 and 2024 and the differences between December 31, 2024 and 2023 were both primarily related to patients who were receiving inpatient acute care and specialty hospital services as of each year‑end date, but who were discharged during the following year. In the years ended December 31, 2025 and 2024, we recognized revenue totaling $60 million and $58 million, respectively, from our revenue cycle management services that was included in the opening current deferred revenue liability. This revenue consists primarily
of prepayments for those contract clients who were billed in advance, changes in estimates related to metric‑based services and up‑front integration services that are recognized over the service period.
Contract Costs—We recognized amortization expense related to deferred contract setup costs of $6 million, $3 million and $5 million during the years ended December 31, 2025, 2024 and 2023, respectively. At December 31, 2025 and 2024, unamortized client contract setup costs were $13 million and $19 million, respectively, and were presented as part of investments and other assets in the accompanying Consolidated Balance Sheets.
NET OPERATING REVENUES
Net operating revenues for our Hospital Operations and Ambulatory Care segments primarily consist of net patient service revenues, principally for patients covered by Medicare, Medicaid, and 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 Hospital Operations segment also include revenues from providing revenue cycle management and value‑based care services to hospitals, health systems, physician practices, employers and other clients.
The table below presents our sources of net operating revenues:
Years Ended December 31,
202520242023
Hospital Operations:
Net patient service revenues from hospitals and related outpatient facilities:
Medicare$2,119 $2,132 $2,383 
Medicaid1,524 1,439 1,233 
Managed care9,696 9,809 10,248 
Uninsured52 64 96 
Indemnity and other551 522 590 
Total13,942 13,966 14,550 
Other revenues(1)
2,196 2,175 2,148 
Total Hospital Operations16,138 16,141 16,698 
Ambulatory Care5,172 4,534 3,866 
Net operating revenues$21,310 $20,675 $20,564 
(1)Primarily revenue from physician practices and revenue cycle management.
Adjustments for prior‑year cost reports and related valuation allowances, principally related to Medicare and Medicaid, increased (decreased) revenues in the years ended December 31, 2025, 2024 and 2023 by $23 million, $(4) million and $24 million, respectively. Estimated cost report settlements receivable, net of payables and valuation allowances, were included in accounts receivable in the accompanying Consolidated Balance Sheets (see Note 3). We believe that we have made adequate provision for any adjustments that may result from the final determination of amounts earned under all the above arrangements with Medicare and Medicaid.
The following table presents the composition of net operating revenues for our Ambulatory Care segment:
Years Ended December 31,
202520242023
Net patient service revenues
$4,956 $4,356 $3,713 
Revenue from other sources216 178 152 
Net operating revenues$5,172 $4,534 $3,865 
Performance Obligations
The following table includes revenue from revenue cycle management services that was expected to be recognized in the future related to performance obligations that are unsatisfied, or partially unsatisfied, at December 31, 2025:
  Years Ending December 31,Later Years
 Total20262027202820292030
Performance obligations$5,126 $748 $747 $747 $747 $747 $1,390 
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, variable‑based escalators, performance incentives, penalties or other variable consideration that is considered constrained. As of December 31, 2025, our contract with CommonSpirit Health (“CommonSpirit”), a successor to Catholic Health Initiatives (“CHI”) and the minority interest holder, as of such date, in our Conifer Health Solutions, LLC joint venture (“Conifer”), represented the majority of the fixed‑fee revenue related to our remaining performance obligations; prior to the subsequent event described in Note 25, Conifer’s contract term with CHI was scheduled to end on December 31, 2032.
v3.25.4
INSURANCE
 12 Months Ended
Dec. 31, 2025
Property and Professional and General Liablity Insurance [Abstract]  
INSURANCE 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 issued on an occurrence basis. For both the policy periods of April 1, 2024 through March 31, 2025 and April 1, 2025 through March 31, 2026, 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 in California, $200 million for all other earthquakes and a per‑occurrence sub‑limit of $200 million per named windstorm 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 for earthquakes in California and named windstorms, and 2% of insured values for earthquakes in the New Madrid fault zone, each with a maximum deductible per claim of $25 million. All other covered losses are subject to a minimum deductible of $5 million per occurrence.
We also purchase cyber liability insurance from third parties. During the year ended December 31, 2024, we received $3 million of insurance recoveries related to a cybersecurity incident that occurred in 2022, none of which was included in net operating revenues during that period. During the year ended December 31, 2023, we received $41 million of insurance recoveries related to the same cybersecurity incident, $34 million of which was included in net operating revenues during that period.
Professional and General Liability Reserves
We are self‑insured for the majority of our professional and general liability claims, and we purchase insurance from third parties to cover catastrophic claims. At December 31, 2025 and 2024, the aggregate current and long‑term professional and general liability reserves in the accompanying Consolidated Balance Sheets were $1.227 billion and $1.138 billion, respectively. These accruals 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.
Commercial insurance we purchase is subject to per‑claim and policy period aggregate limits. If the policy period aggregate limit of any of our policies is exhausted, in whole or in part, it could deplete or reduce the limits available to pay other material claims applicable to that policy period.
Malpractice expense of $341 million, $309 million and $369 million was included in other operating expenses in the accompanying Consolidated Statements of Operations for the years ended December 31, 2025, 2024 and 2023, respectively, of which $27 million, $24 million and $116 million, respectively, related to adverse claims development for prior years.
v3.25.4
CLAIMS AND LAWSUITS
 12 Months Ended
Dec. 31, 2025
Commitments and Contingencies Disclosure [Abstract]  
CLAIMS AND LAWSUITS CLAIMS AND LAWSUITS
We operate in a highly regulated and litigious industry; as such, we are regularly named in various legal actions in the ordinary course of our business. 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 private litigation (including class action lawsuits) related to, among other things, the care and treatment provided at our hospitals and outpatient facilities; the application of various federal and state labor and privacy laws, rules and regulations; antitrust claims; tax audits; contract disputes (including disagreements with joint venture partners); and other matters. 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; however, we believe that the ultimate resolution of our existing 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.
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. We do not disclose an estimate when we have concluded that a loss is either not reasonably possible or a loss, or a range of loss, is not reasonably estimable, based on available information. Given the inherent uncertainties associated with material legal matters, especially those involving
governmental agencies, and the indeterminate damages sought in some cases, we are unable to predict the ultimate liability we may incur from such 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.
The following table presents reconciliations of the beginning and ending liability balances in connection with legal settlements and related costs:
 Balances at
Beginning
of Period		Litigation and
Investigation
Costs		Cash
Payments		OtherBalances at
End of
Period
Year Ended December 31, 2025$20 $64 $(49)$3 $38 
Year Ended December 31, 2024$40 $35 $(56)$1 $20 
Year Ended December 31, 2023$51 $47 $(59)$1 $40 
v3.25.4
REDEEMABLE NONCONTROLLING INTERESTS IN EQUITY OF CONSOLIDATED SUBSIDIARIES
 12 Months Ended
Dec. 31, 2025
Noncontrolling Interest [Abstract]  
REDEEMABLE NONCONTROLLING INTERESTS IN EQUITY OF CONSOLIDATED SUBSIDIARIES REDEEMABLE NONCONTROLLING INTERESTS IN EQUITY OF CONSOLIDATED SUBSIDIARIES
Certain of our investees’ partnership and operating agreements contain terms that, upon the occurrence of specified events, could obligate us to purchase some or all of the noncontrolling interests related to our consolidated subsidiaries. The noncontrolling interests subject to these provisions, and the income attributable to those interests, are not included as part of our equity and are presented as redeemable noncontrolling interests in the accompanying Consolidated Balance Sheets at December 31, 2025 and December 31, 2024.
The following table presents the changes in redeemable noncontrolling interests in equity of consolidated subsidiaries:
 Years Ended December 31,
 20252024
Balances at beginning of period 
$2,727 $2,391 
Net income534 473 
Distributions paid to noncontrolling interests(437)(369)
Accretion of redeemable noncontrolling interests— 5 
Purchases and sales of businesses and noncontrolling interests, net132 227 
Balances at end of period 
$2,956 $2,727 
The divestiture of the AL Hospitals during the year ended December 31, 2024 resulted in a decrease of $175 million in our redeemable noncontrolling interest balance during the same period.
The following tables present the composition by segment of our redeemable noncontrolling interests balances, as well as our net income available to redeemable noncontrolling interests:
December 31,
 20252024
Hospital Operations$905 $800 
Ambulatory Care2,051 1,927 
Redeemable noncontrolling interests$2,956 $2,727 
 Years Ended December 31,
 202520242023
Hospital Operations$110 $100 $84 
Ambulatory Care424 373 282 
Net income available to redeemable noncontrolling interests$534 $473 $366 
In June 2022, we entered into a share purchase agreement to acquire the 5% ownership interest then-held by Baylor University Medical Center in USPI for $406 million. Under the share purchase agreement, we were obligated to make non‑interest-bearing monthly payments through June 2025. We repaid the outstanding balance under the share purchase agreement in full during the three months ended June 30, 2025. At December 31, 2024, the remaining obligation under the share purchase agreement of $68 million was included in other current liabilities in the accompanying Condensed Consolidated Balance Sheet.
v3.25.4
INCOME TAXES
 12 Months Ended
Dec. 31, 2025
Income Tax Disclosure [Abstract]  
INCOME TAXES INCOME TAXES
Income before income taxes for continuing operations for the years ended December 31, 2025, 2024 and 2023 consisted of the following:
 Years Ended December 31,
 202520242023
Domestic$2,805 $5,251 $1,620 
Foreign(5)(3)(3)
 $2,800 $5,248 $1,617 
The provision for income taxes for the years ended December 31, 2025, 2024 and 2023 consisted of the following:
 Years Ended December 31,
 202520242023
Current tax expense:   
Federal$305 $926 $208 
State119 361 46 
 424 1,287 254 
Deferred tax expense (benefit):   
Federal18 (92)55 
State(9)(11)(3)
 9 (103)52 
Total tax expense$433 $1,184 $306 
A reconciliation between the amount of reported income tax expense and the amount computed by multiplying income before income taxes by the statutory federal tax rate is presented below.
 Years Ended December 31,
 202520242023
AmountPercentAmountPercentAmountPercent
Tax expense at statutory federal rate$588 21.0 %$1,102 21.0 %$340 21.0 %
Domestic federal tax
Nontaxable or nondeductible items:
Tax benefit attributable to noncontrolling interests(202)(7.2)%(181)(3.4)%(147)(9.1)%
Nondeductible goodwill— — %161 3.1 %— — %
Other(2)(0.1)%7 0.1 %7 0.4 %
Stock-based compensation tax benefit(11)(0.4)%(9)(0.2)%(2)(0.1)%
Other(21)(0.7)%(5)(0.1)%4 0.2 %
State and local income taxes, net of federal income tax effect82 2.9 %278 5.3 %11 0.7 %
Changes in valuation allowances(3)(0.1)%(184)(3.5)%68 4.2 %
Changes in prior year unrecognized tax benefits2 0.1 %15 0.3 %25 1.6 %
Income tax expense$433 15.5 %$1,184 22.6 %$306 18.9 %
During the year ended December 31, 2025, state and local income taxes in California, Michigan and Texas comprised the majority of state and local income taxes, net of federal effect category. During 2024, state and local income taxes in California and South Carolina comprised the majority of state and local income taxes, net of federal effect category. During 2023, state and local income taxes in California and Florida comprised the majority of state and local income taxes, net of federal effect category.
Deferred income taxes reflect the tax effects of temporary differences between the carrying amount of assets and liabilities for financial reporting purposes and the amount used for income tax purposes. The following table presents those significant components of our deferred tax assets and liabilities, including any valuation allowance:
 December 31, 2025December 31, 2024
 AssetsLiabilitiesAssetsLiabilities
Depreciation and fixed-asset differences$3 $419 $— $373 
Reserves related to restructuring charges6 — 4 — 
Receivables (doubtful accounts and adjustments)222 1 245 — 
Accruals for retained insurance risks271 — 253 — 
Intangible assets— 512 — 504 
Other long-term liabilities34 — 34 — 
Benefit plans240 — 235 — 
Other accrued liabilities42 — 50 — 
Investments and other assets— 185 — 160 
Interest expense limitation84 — 57 — 
Net operating loss carryforwards126 — 122 — 
Stock-based compensation24 — 13 — 
Right-of-use lease assets and obligations123 109 123 107 
Other items55 — 19 — 
 1,230 1,226 1,155 1,144 
Valuation allowance(160)(158)— 
 $1,070 $1,226 $997 $1,144 
The table below presents a reconciliation of the deferred tax assets and liabilities and the corresponding amounts reported in the accompanying Consolidated Balance Sheets:
 December 31,
 20252024
Deferred income tax assets$84 $80 
Deferred tax liabilities(240)(227)
Net deferred tax liability$(156)$(147)
During the year ended December 31, 2025, the valuation allowance increased by $2 million, including an increase of $11 million due to limitations on the tax deductibility of interest expense, and a decrease of $9 million due to changes in the expected realizability of deferred tax assets. The balance in the valuation allowance as of December 31, 2025 was $160 million. During the year ended December 31, 2024, the valuation allowance decreased by $90 million, including a decrease of $180 million primarily for utilization of interest expense carryforwards due to gains from sales of facilities, an increase of $92 million due to an acquisition, and a decrease of $2 million due to changes in the expected realizability of deferred tax assets. The balance in the valuation allowance as of December 31, 2024 was $158 million. During the year ended December 31, 2023, the valuation allowance increased by $71 million, including an increase of $73 million due to limitations on the tax deductibility of interest expense, and a decrease of $2 million due to changes in the expected realizability of deferred tax assets. The balance in the valuation allowance as of December 31, 2023 was $248 million.
Income taxes paid during the years ended December 31, 2025, 2024 and 2023 consisted of the following:
 Years Ended December 31,
 202520242023
U.S Federal income taxes$324 $943 $194 
U.S. state and local income taxes:
California39 72 — (1)
South Carolina— (1)118 — (1)
Texas— (1)— (1)12 
Other87 138 37 
126 328 49 
Total income taxes paid$450 $1,271 $243 
(1)The amount of income taxes paid during the year does not meet the 5% disaggregation threshold.
We account for uncertain tax positions in accordance with FASB ASC 740-10-25, which prescribes a comprehensive model for the financial statement recognition, measurement, presentation and disclosure of uncertain tax positions taken or expected to be taken in income tax returns. The following table summarizes the total changes in unrecognized tax benefits during the years ended December 31, 2025, 2024 and 2023. The additions and reductions for tax positions include the impact of items for which the ultimate deductibility is highly certain, but for which there is uncertainty about the timing of such deductions. Such amounts include unrecognized tax benefits that have impacted deferred tax assets and liabilities at December 31, 2025, 2024 and 2023.
 Unrecognized
Tax Benefits
Balance at December 31, 2022$34 
Increases due to tax positions taken in prior periods31 
Reductions due to a lapse of statute of limitations(1)
Balance at December 31, 202364 
Increases due to tax positions taken in prior periods10 
Reductions due to settlements with taxing authorities(3)
Balance at December 31, 202471 
Increases due to tax positions taken in prior periods2 
Reductions due to settlements with taxing authorities(4)
Balance at December 31, 2025$69 
The total amount of unrecognized tax benefits as of December 31, 2025 was $69 million, all of which, if recognized, would affect our effective tax rate and income tax benefit. Income tax expense in the year ended December 31, 2025 included a benefit of $1 million attributable to a decrease in our estimated liabilities for uncertain tax positions, net of related deferred tax effects. The total amount of unrecognized tax benefits as of December 31, 2024 was $71 million, of which $69 million, if recognized, would affect our effective tax rate and income tax benefit. Income tax expense in the year ended December 31, 2024 included expense of $9 million attributable to an increase in our estimated liabilities for uncertain tax positions, net of related deferred tax effects. The total amount of unrecognized tax benefits as of December 31, 2023 was $64 million, of which $63 million, if recognized, would affect our effective tax rate and income tax benefit from continuing operations. Income tax expense in the year ended December 31, 2023 included expense of $24 million attributable to an increase in our estimated liabilities for uncertain tax positions, net of related deferred tax effects.
Our practice is to recognize interest and penalties related to income tax matters in income tax expense in our consolidated statements of operations. Approximately $4 million of interest and penalties related to accrued liabilities for uncertain tax positions are included in the accompanying Consolidated Statement of Operations for the year ended December 31, 2025. Total accrued interest and penalties on unrecognized tax benefits as of December 31, 2025 were $10 million.
The IRS has completed audits of our tax returns for all tax years ended on or before December 31, 2007. All disputed issues with respect to these audits have been resolved and all related tax assessments (including interest) have been paid. Our tax returns for years ended after December 31, 2007 and USPI’s tax returns for years ended after December 31, 2021 remain subject to audit by the IRS.
At December 31, 2025, our carryforwards available to offset future taxable income consisted of (1) federal net operating loss (“NOL”) carryforwards of approximately $291 million pre‑tax, $140 million of which expires in 2026 to 2037 and $151 million of which has no expiration date, for which the associated deferred tax benefit net of valuation allowance is $2 million, (2) capital loss carryforwards of $100 million, for which the deferred tax benefit net of valuation allowance is $23 million and (3) state NOL carryforwards of approximately $2.937 billion expiring in 2026 through 2045 for which the associated deferred tax benefit, net of valuation allowance and federal tax impact, is approximately $23 million. Most of the federal net operating loss carryforward is subject to separate return limitation year restrictions under the Internal Revenue Code and may only be utilized to offset taxable income of certain entities. Our ability to utilize NOL carryforwards to reduce future taxable income may be limited under Section 382 of the Internal Revenue Code if certain ownership changes in our company occur during a rolling three‑year period. These ownership changes include purchases of common stock under share repurchase programs, the offering of stock by us, the purchase or sale of our stock by 5% shareholders, as defined in the Treasury regulations, or the issuance or exercise of rights to acquire our stock. If such ownership changes by 5% shareholders result in aggregate increases that exceed 50 percentage points during the three‑year period, then Section 382 imposes an annual limitation on the amount of our taxable income that may be offset by the NOL carryforwards or tax credit carryforwards at the time of ownership change.
v3.25.4
EARNINGS PER COMMON SHARE
 12 Months Ended
Dec. 31, 2025
Earnings Per Share [Abstract]  
EARNINGS PER COMMON SHARE EARNINGS PER COMMON SHARE
The following table reconciles the numerators and denominators of our basic and diluted earnings per common share calculations. Net income available to our common shareholders is expressed in millions and weighted average shares are expressed in thousands.
 Net Income Available to Common Shareholders (Numerator)Wtd. Avg. Shares
(Denominator)		Per-Share
Amount
Year Ended December 31, 2025   
Net income available to Tenet Healthcare Corporation common shareholders for basic earnings per share$1,407 90,150 $15.61 
Effect of dilutive instruments— 683 (0.12)
Net income available to Tenet Healthcare Corporation common shareholders for diluted earnings per share$1,407 90,833 $15.49 
Year Ended December 31, 2024   
Net income available to Tenet Healthcare Corporation common shareholders for basic earnings per share$3,200 96,904 $33.02 
Effect of dilutive instruments1 977 (0.32)
Net income available to Tenet Healthcare Corporation common shareholders for diluted earnings per share$3,201 97,881 $32.70 
Year Ended December 31, 2023   
Net income available to Tenet Healthcare Corporation common shareholders for basic earnings per share$611 101,639 $6.01 
Effect of dilutive instruments(13)3,161 (0.30)
Net income available to Tenet Healthcare Corporation common shareholders for diluted earnings per share$598 104,800 $5.71 
Dilutive instruments during the years ended December 31, 2025, 2024 and 2023 consisted of stock options, RSUs, convertible long‑term incentive awards, deferred compensation units and dividends on subsidiary preferred stock. For portions of these years, our dilutive instruments also included certain convertible instruments, including: RSUs issued under the USPI Management Equity Plan until they were repurchased in October 2024 and an agreement related to the ownership interest in a Hospital Operations segment joint venture during 2023
v3.25.4
FAIR VALUE MEASUREMENTS
 12 Months Ended
Dec. 31, 2025
Fair Value Disclosures [Abstract]  
FAIR VALUE MEASUREMENTS FAIR VALUE MEASUREMENTS
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. 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 utilize
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.
Non-Recurring 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. The following table presents information about assets measured at fair value on a non-recurring basis and indicates the fair value hierarchy of the valuation techniques we utilized to determine such fair values:
 TotalQuoted Prices
in Active
Markets for
Identical Assets
(Level 1)		Significant Other
Observable Inputs
(Level 2)		Significant
Unobservable
Inputs
(Level 3)
December 31, 2025
Long-lived assets held for sale$62 $— $62 $— 
December 31, 2024
Long-lived assets held for sale$21 $— $21 $— 
Financial Instruments
The fair value of our long‑term debt (except for any borrowings under the Credit Agreement) is based on quoted market prices (Level 1). The inputs used to establish the fair value of borrowings outstanding under the Credit Agreement are considered to be Level 2 inputs. At December 31, 2025 and 2024, the estimated fair value of our long‑term debt was approximately 100.9% and 97.8%, respectively, of the carrying value of the debt.
v3.25.4
ACQUISITIONS
 12 Months Ended
Dec. 31, 2025
Business Combination, Asset Acquisition, Transaction between Entities under Common Control, and Joint Venture Formation [Abstract]  
ACQUISITIONS ACQUISITIONS
During the year ended December 31, 2025, we used $308 million of cash for acquisition-related activity, of which $301 million related to acquisitions and consolidations completed during 2025 and $7 million related to measurement‑period adjustments for acquisitions completed during 2024.
We acquired controlling ownership interests in 27 ambulatory surgery centers and a surgical hospital through a series of transactions in 2025. We also acquired controlling ownership interests in nine previously unconsolidated ambulatory surgery centers.
We acquired controlling ownership interests in 52 ambulatory surgery centers and The Hospitals of Providence Rehabilitation Hospital East, located in El Paso, Texas, through a series of transactions during the year ended December 31, 2024. In addition, we acquired controlling ownership interests in seven previously unconsolidated ambulatory surgery centers and 15 previously unconsolidated UCCs, which allowed us to consolidate their financial results. We paid a total of $571 million to acquire all of these ownership interests during the year ended December 31, 2024.
In December 2023, we purchased 55% of the ownership interest held by NextCare, Inc. and certain of its affiliates (“NextCare”) in NextCare Arizona I JV, LLC (“NextCare JV I”), a joint venture established to own and operate 41 UCCs and a telehealth center in Arizona. We paid $75 million from cash on hand on the acquisition date in 2023 and retained an additional $10 million in escrow pending NextCare’s compliance with certain conditions. We subsequently released the funds held in escrow during the year ended December 31, 2024. We recognized goodwill of $133 million from our acquisition of NextCare JV I. This transaction allowed us to expand our existing network in Arizona with UCCs that were already established and operational. NextCare JV I is included in our Hospital Operations segment.
During the year ended December 31, 2023, we also acquired controlling ownership interests in 20 ambulatory surgery centers through a series of transactions. In addition, we acquired controlling ownership interests in 11 previously unconsolidated ambulatory surgery centers. We paid an aggregate of $149 million to acquire all of these ownership interests during 2023.
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 prices allocated over those fair values is recorded as goodwill. The purchase price allocations for certain acquisitions completed in 2025 are preliminary. We are in process of assessing working capital balances and lease and other agreements assumed, as well as obtaining and evaluating valuations of the acquired property and equipment, management contracts and other intangible assets, and noncontrolling
interests. Therefore, those purchase price allocations, including goodwill, recorded in the accompanying consolidated financial statements are subject to adjustment once the assessments and valuation work are completed and evaluated. Such adjustments will be recorded as soon as practical and within the measurement period as defined by the accounting literature. During the year ended December 31, 2025, we adjusted the preliminary purchase price allocations of certain acquisitions completed by our Ambulatory Care segment in 2024 based on the results of completed valuations and post-closing working capital adjustments. These adjustments resulted in a decrease of $37 million in goodwill recognized.
The table below presents the preliminary or final purchase price allocations for acquisitions made during the years ended December 31, 2025, 2024 and 2023.
Years Ended December 31,
 202520242023
Current assets$50 $47 $34 
Property and equipment54 62 28 
Other intangible assets18 162 5 
Goodwill544 951 644 
Long-term operating lease assets97 108 18 
Other long-term assets— 2 14 
Previously held investments in unconsolidated affiliates(93)(25)(99)
Current liabilities(36)(24)(33)
Current portion of long-term lease liabilities(6)(17)(3)
Long-term operating lease liabilities(92)(96)(10)
Other long-term liabilities(14)(55)(27)
Redeemable noncontrolling interests in equity of consolidated subsidiaries(157)(458)(229)
Noncontrolling interests(84)(69)(102)
Cash paid, net of cash acquired(301)(561)(224)
Gains (losses) on consolidations$(20)$27 $16 
The majority of the goodwill generated from our 2025 and 2024 acquisitions will not be deductible for income tax purposes; however, the majority of the goodwill generated from our 2023 transactions will be. The goodwill generated from these transactions can be attributed to the benefits that we expect to realize from operating efficiencies and growth strategies. Approximately $25 million, $39 million and $15 million in transaction costs related to prospective and closed acquisitions were expensed during the years ended December 31, 2025, 2024 and 2023, respectively, and are included in impairment and restructuring charges, and acquisition‑related costs in the accompanying Consolidated Statements of Operations.
We recognized losses totaling $20 million during the year ended December 31, 2025 and gains totaling $27 million and $16 million during the years ended December 31, 2024 and 2023, respectively, in each case, associated with stepping up our ownership interests in previously held equity investments, which we began consolidating after we acquired controlling interests.
v3.25.4
SEGMENT INFORMATION
 12 Months Ended
Dec. 31, 2025
Segment Reporting [Abstract]  
SEGMENT INFORMATION SEGMENT INFORMATION
Our business consists of our Hospital Operations segment and our Ambulatory Care segment. Our approach to segment identification aligns with how management structures the business to make operational decisions, allocates resources and evaluates performance. Central to this approach is the information routinely reviewed by our Chief Operating Decision Maker (“CODM”) group. For both segments, the CODM group focuses primarily on Adjusted EBITDA as the key metric for performance evaluation and resource allocation. The CODM group’s evaluation of Adjusted EBITDA includes budget‑to‑actual analyses and comparisons across current and historical periods. At December 31, 2025, our CODM group included our Chief Executive Officer and our Chief Financial Officer.
Our Hospital Operations segment is comprised of our acute care and specialty hospitals, physician practices and outpatient facilities. At December 31, 2025, our subsidiaries operated 50 hospitals, serving primarily urban and suburban communities in eight states, as well as 132 outpatient facilities, primarily UCCs, imaging centers, off-campus hospital emergency departments and micro-hospitals. Our Hospital Operations segment also provides revenue cycle management and value‑based care services to hospitals, health systems, physician practices, employers and other clients. Our Hospital Operations segment generated 76%, 78% and 81% of our net operating revenues in the years ended December 31, 2025, 2024 and 2023, respectively.
Our Ambulatory Care segment is comprised of the operations of USPI. At December 31, 2025, USPI had ownership interests in 533 ambulatory surgery centers (401 consolidated) and 26 surgical hospitals (eight consolidated) in 37 states.
The following tables present amounts for each of our reportable segments and the reconciling items necessary to agree to amounts reported in the accompanying Consolidated Balance Sheets and Consolidated Statements of Operations, as applicable.
December 31,
 202520242023
Assets:  
Hospital Operations$16,586 $16,722 $17,268 
Ambulatory Care13,091 12,214 11,044 
Total 
$29,677 $28,936 $28,312 
 Years Ended December 31,
 202520242023
Capital expenditures:   
Hospital Operations$886 $845 $671 
Ambulatory Care124 86 80 
Total 
$1,010 $931 $751 
Depreciation and amortization:   
Hospital Operations$711 $684 $750 
Ambulatory Care152 134 120 
Total 
$863 $818 $870 
Year Ended December 31, 2025
 Hospital OperationsAmbulatory CareTotal
Net operating revenues$16,138 $5,172 $21,310 
Equity in earnings of unconsolidated affiliates6 258 264 
Less:
Salaries, wages and benefits7,440 1,265 8,705 
Supplies2,405 1,375 3,780 
Other operating expenses, net3,759 764 4,523 
Adjusted EBITDA$2,540 $2,026 4,566 
Reconciliation of Adjusted EBITDA:
Depreciation and amortization(863)
Impairment and restructuring charges, and acquisition-related costs(130)
Litigation and investigation costs(64)
Interest expense(821)
Loss from early extinguishment of debt(4)
Other non-operating income, net117 
Net losses on sales, consolidation and deconsolidation of facilities(1)
Income before income taxes$2,800 
Year Ended December 31, 2024
 Hospital OperationsAmbulatory CareTotal
Net operating revenues$16,141 $4,534 $20,675 
Equity in earnings of unconsolidated affiliates10 250 260 
Less:
Salaries, wages and benefits7,664 1,137 8,801 
Supplies2,460 1,187 3,647 
Other operating expenses, net3,842 650 4,492 
Adjusted EBITDA$2,185 $1,810 3,995 
Reconciliation of Adjusted EBITDA:
Depreciation and amortization(818)
Impairment and restructuring charges, and acquisition-related costs(102)
Litigation and investigation costs(35)
Interest expense(826)
Loss from early extinguishment of debt(8)
Other non-operating income, net126 
Net gains on sales, consolidation and deconsolidation of facilities2,916 
Income before income taxes$5,248 
Year Ended December 31, 2023
 Hospital OperationsAmbulatory CareTotal
Net operating revenues$16,698 $3,866 $20,564 
Equity in earnings of unconsolidated affiliates10 218 228 
Less:
Salaries, wages and benefits8,182 964 9,146 
Supplies2,545 1,045 3,590 
Other operating expenses, net3,984 531 4,515 
Adjusted EBITDA$1,997 $1,544 3,541 
Reconciliation of Adjusted EBITDA:
Depreciation and amortization(870)
Impairment and restructuring charges, and acquisition-related costs(137)
Litigation and investigation costs(47)
Interest expense(901)
Loss from early extinguishment of debt(11)
Other non-operating income, net19 
Net gains on sales, consolidation and deconsolidation of facilities23 
Income before income taxes$1,617 
Other operating expenses, net consists of various general and administrative expenses that are integral to supporting our operations. These expenses include, but are not limited to, medical fees, malpractice expense, information technology and software expenses, as well as gains or losses incurred from the disposition of long-lived assets.
v3.25.4
RECENT ACCOUNTING STANDARDS
 12 Months Ended
Dec. 31, 2025
Accounting Standards Update and Change in Accounting Principle [Abstract]  
RECENT ACCOUNTING STANDARDS RECENT ACCOUNTING STANDARDS
Recently Issued Accounting Standards
The FASB issued Accounting Standard Update (“ASU”) 2024-03, “Income Statement – Reporting Comprehensive Income – Expense Disaggregation Disclosures (Subtopic 22-40): Disaggregation of Income Statement Expenses” (“ASU 2024-03”) in November 2024. This ASU requires entities to provide enhanced disclosures related to certain expense categories included in income statement captions. The ASU aims to increase transparency and provide investors with more detailed information about the nature of expenses reported on the face of the income statement. The new standard does not change the requirements for the presentation of expenses on the face of the income statement. ASU 2024-03 is effective for annual
reporting periods beginning after December 15, 2026 and interim reporting periods beginning after December 15, 2027. Early adoption is permitted. While the adoption is not expected to have an impact on our financial statements, it is expected to result in incremental disclosures within the footnotes to our consolidated financial statements.
Recently Adopted Accounting Standards
We adopted ASU 2023-05, “Business Combinations – Joint Venture Formations (Subtopic 805-60): Recognition and Initial Measurement” (“ASU 2023-05”) effective January 1, 2025. The amendments in the ASU sought to reduce diversity in practice that has resulted from a lack of authoritative guidance regarding the accounting for the formation of joint ventures in separate financial statements. The amendments also sought to clarify the initial measurement of joint venture net assets, including businesses contributed to a joint venture. The adoption of ASU 2023-05 did not result in a material impact to our consolidated financial statements.
We adopted ASU 2023-09, “Income Taxes (Topic 740): Improvements to Income Tax Disclosures” (“ASU 2023-09”) effective January 1, 2025. This ASU requires the disclosure, on an annual basis, of specific categories in the effective tax rate reconciliation and additional information for reconciling items that meet a quantitative threshold. In addition, ASU 2023-09 requires companies to disclose additional information about income taxes paid. The adoption of ASU 2023-09 did not have a material impact on our consolidated financial statements.
v3.25.4
SUBSEQUENT EVENT
 12 Months Ended
Dec. 31, 2025
Subsequent Events [Abstract]  
SUBSEQUENT EVENT SUBSEQUENT EVENT
As discussed in Note 15, we provide certain revenue cycle management services through the operations of Conifer to certain CHI facilities under an amended and restated master services agreement (the “RCM Agreement”). At December 31, 2025, CommonSpirit owned an interest of approximately 23.8% in Conifer.
On January 27, 2026, we entered into an agreement with CHI relating to Conifer. Subject to the terms of that agreement and other related contracts, the parties have agreed to, among other things: (1) terminate the RCM Agreement effective as of December 31, 2026; (2) CHI’s payment to us of an aggregate amount equal to $1.900 billion in annual installments over the next three years; provided that, of such amount, $540 million was satisfied on January 27, 2026 by offsetting the $540 million due to CHI from Conifer as described in the next clause; and (3) the reduction of our redeemable noncontrolling interest balance, and an increase in our additional paid-in capital balance associated with the redemption by Conifer of CHI’s minority equity interest in Conifer, in exchange for a payment by Conifer of $540 million, which redemption is effective as of January 1, 2026. We do not expect to recognize a gain or loss related to the redemption of CHI’s minority equity interest in Conifer.
This subsequent event did not require adjustment to the Consolidated Financial Statements as of December 31, 2025.
v3.25.4
SCHEDULE II-VALUATION AND QUALIFYING ACCOUNTS
 12 Months Ended
Dec. 31, 2025
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]  
SCHEDULE II-VALUATION AND QUALIFYING ACCOUNTS
SCHEDULE II—VALUATION AND QUALIFYING ACCOUNTS
(In Millions)
 Balance at
Beginning
of Period

Costs and
Expenses(1)
DeductionsOther
Items		Balance at
End of
Period
Valuation allowance for deferred tax assets:
     
Year ended December 31, 2025$158 $11 $— $(9)$160 
Year ended December 31, 2024$248 $(182)$— $92 $158 
Year ended December 31, 2023$177 $71 $— $— $248 
(1)
Includes amounts recorded in discontinued operations.
v3.25.4
Insider Trading Arrangements
 3 Months Ended
Dec. 31, 2025
Trading Arrangements, by Individual  
Rule 10b5-1 Arrangement Adopted false
Non-Rule 10b5-1 Arrangement Adopted false
Rule 10b5-1 Arrangement Terminated false
Non-Rule 10b5-1 Arrangement Terminated false
v3.25.4
Insider Trading Policies and Procedures
 12 Months Ended
Dec. 31, 2025
Insider Trading Policies and Procedures [Line Items]  
Insider Trading Policies and Procedures Adopted true
v3.25.4
Cybersecurity Risk Management and Strategy Disclosure
 12 Months Ended
Dec. 31, 2025
Cybersecurity Risk Management, Strategy, and Governance [Line Items]  
Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]
We identify and assess areas of risk for our company on an ongoing basis, and we have developed, and regularly refine, comprehensive practices to manage and mitigate existing and potential risks to our business. Our board of directors oversees enterprise risk management as an integral and continuous part of its oversight role. Integrated into our overall enterprise risk management framework are processes dedicated to the identification, assessment and management of material risks from cybersecurity threats. Our approach to cybersecurity risk management is both proactive and defensive, and includes the following elements:
•a team dedicated solely to cybersecurity and managed by our chief information security officer (“CISO”), who reports directly to our chief information officer (“CIO”);
•an information technology request review process that includes cybersecurity assessments of third-party products and systems proposed to connect to our information systems environment or access our data; and
•a cybersecurity incident response plan.
Cybersecurity Team and Strategy—Our cybersecurity team, which includes both our employees and those of our managed services provider, is comprised of subgroups focused on distinct functional areas of responsibility. The team maintains a Security Operations Center, staffed 24 hours a day, that delivers day-to-day execution support for our cybersecurity risk management program.
We leverage a multi-layered strategy that is designed to identify, assess, manage and mitigate risks to our systems and data from cybersecurity threats. Proactively, we have implemented numerous threat‑management tools and processes. In addition, we have disaster recovery and business continuity plans that are tested and updated periodically. We strive to stay abreast of cybersecurity threats through threat intelligence subscriptions and other feeds, industry and federal threat notices, and participation in healthcare industry intelligence sharing. Our program leverages best practices and is guided by industry frameworks, including the National Institute of Standards and Technology Cyber Security Framework. We also conduct
table‑top exercises, which serve to simulate cybersecurity incidents to practice response and identify gaps, on a regular basis. Our internal audit team performs random sampling audits of security practices at our facilities, and we routinely perform security risk assessments.
We also require all employees to participate in cybersecurity awareness training annually, and we circulate cybersecurity awareness alerts, safety tips and newsletters to employees across the enterprise regularly. In addition, we routinely run phishing campaigns and perform other tests to increase awareness and reduce the risk of cybersecurity threats.
Third-Party Review Processes—Our business requires interaction of our systems and the sharing of data with third parties, including our service providers and vendors, as well as other healthcare providers and their vendors, that present risks to our systems and data from third-party systems and practices. Incidents and cybersecurity attacks at third parties can impact our operations and our obligations to patients, payers and others. We manage this risk through an information technology review and approval process that considers the anticipated use and implementation of proposed technologies, and includes cybersecurity team assessments of third-party products and systems proposed to connect to our information systems environment or access our data. A subgroup of our cybersecurity team is dedicated to risk-assessment analyses of vendor security practices and protections. In certain circumstances, we enter into information security agreements with service providers to secure their commitment to maintain certain security protections.
Cybersecurity Incident Response Plan—In addition to protecting our assets proactively, our cybersecurity team is tasked with detecting and defending against cybersecurity threats to our systems and data. We maintain a response plan that outlines actions to be taken with respect to cyber incidents and includes procedures, notification processes, and protocols for escalation to senior management and our board of directors. The cybersecurity incident response team is composed of a smaller, core group of our cybersecurity team, as well as a larger, extended group that includes personnel from our operations, legal, compliance, privacy, risk management, communications, incident command center, security, human resources, finance, audit and government relations teams. We also engage third parties, such as forensics consultants, external legal counsel and law enforcement, as needed and as appropriate based on the circumstances. Incidents are escalated to senior management in accordance with our plan and as otherwise appropriate based on the nature of the incident.
Cybersecurity Risk Management Processes Integrated [Flag] true
Cybersecurity Risk Management Processes Integrated [Text Block] We strive to stay abreast of cybersecurity threats through threat intelligence subscriptions and other feeds, industry and federal threat notices, and participation in healthcare industry intelligence sharing.
Cybersecurity Risk Management Third Party Engaged [Flag] true
Cybersecurity Risk Third Party Oversight and Identification Processes [Flag] true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag] true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Text Block] As previously disclosed, in April 2022, we experienced a cybersecurity incident that disrupted a subset of our hospital operations and involved the exfiltration of certain confidential company and patient information. We incurred significant costs to remediate the issues, sustained lost revenues from the associated business interruption and incurred other related expenses. Following this incident, we implemented certain changes to our information systems and processes meant to provide additional protections to our environment, including enhancements to our Security Operations Center, system backups, training practices, detection tools and capabilities, and implementation of new tools and processes, among others.
Cybersecurity Risk Board of Directors Oversight [Text Block]
Board Oversight—Our board of directors has identified the oversight of cybersecurity risks to be one of its priorities, and it receives regular reports from management, including the CIO and the CISO, on various cybersecurity matters, including the security of the company’s information systems, anticipated sources of future material cyber risks and how management is addressing any significant potential vulnerability. The board’s audit committee reviews the company’s cybersecurity program at least annually and receives regular updates on cybersecurity threats and other matters. Cecil D. Haney, a member of the audit committee, brings to the board valuable insights into cybersecurity, systems planning, and crisis and risk management.
Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block] Our board of directors has identified the oversight of cybersecurity risks to be one of its priorities, and it receives regular reports from management, including the CIO and the CISO, on various cybersecurity matters, including the security of the company’s information systems, anticipated sources of future material cyber risks and how management is addressing any significant potential vulnerability. The board’s audit committee reviews the company’s cybersecurity program at least annually and receives regular updates on cybersecurity threats and other matters.
Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block] The board’s audit committee reviews the company’s cybersecurity program at least annually and receives regular updates on cybersecurity threats and other matters.
Cybersecurity Risk Role of Management [Text Block]
Management Oversight—Our CISO, who reports directly to our CIO, oversees and manages our cybersecurity strategy and related programs. As the head of our cybersecurity team, both internal and outsourced, our CISO is primarily responsible for assessing and managing risks from cybersecurity threats. The processes by which he is informed about and monitors the prevention, detection, mitigation and remediation of cybersecurity incidents are described above. He reports information about such risks to the CIO and other members of senior management, who, in turn, report them to our board and audit committee, as appropriate. Our CISO joined the company in August 2022 with over 20 years of risk management, national security and cybersecurity experience garnered at both public and private companies, as well as governmental agencies.
Cybersecurity Risk Management Positions or Committees Responsible [Flag] true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block] Our CISO, who reports directly to our CIO, oversees and manages our cybersecurity strategy and related programs.
Cybersecurity Risk Management Expertise of Management Responsible [Text Block] Our CISO joined the company in August 2022 with over 20 years of risk management, national security and cybersecurity experience garnered at both public and private companies, as well as governmental agencies
Cybersecurity Risk Process for Informing Management or Committees Responsible [Text Block] The processes by which he is informed about and monitors the prevention, detection, mitigation and remediation of cybersecurity incidents are described above.
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag] true
v3.25.4
SIGNIFICANT ACCOUNTING POLICIES (Policies)
 12 Months Ended
Dec. 31, 2025
Accounting Policies [Abstract]  
Basis of Presentation
Our Consolidated Financial Statements include the accounts of Tenet and its wholly owned and majority‑owned subsidiaries. We eliminate intercompany accounts and transactions in consolidation, and we include the results of operations of businesses that are newly acquired in purchase transactions from their dates of acquisition. We account for significant investments in other affiliated companies using the equity method. We also utilize the equity method when we have the ability to exercise significant influence over the affiliated company, despite not holding a significant percentage of its ownership interest. Unless otherwise indicated, dollar amounts presented in our Consolidated Financial Statements and these accompanying notes are expressed in millions (except per-share amounts), and all share amounts are expressed in thousands.
Changes to Prior-Year Presentation
Certain prior-year amounts have been reclassified to conform to the current-year presentation. Grant income is no longer significant enough to be presented separately and is now included in net operating revenues in the accompanying Consolidated Statements of Operations. In addition, taxes paid in connection with the net share settlement of our stock compensation awards, net of proceeds from the exercise of stock options, are now presented separately in the accompanying Consolidated Statements of Cash Flows to reflect their increased significance.
Use of Estimates
The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America (“GAAP”) requires us to make estimates and assumptions that affect the amounts reported in our 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. Although we believe all adjustments considered necessary for a fair presentation have been included, actual results may vary from those estimates. The 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 the 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.
Translation of Foreign Currencies
Our GBC, which is located in the Philippines, performs certain administrative functions and other support tasks. The GBC’s accounts are measured in its local currency (the Philippine peso) and then translated into U.S. dollars. All assets and liabilities denominated in foreign currency are translated using the current rate of exchange at the balance sheet date. Results of operations denominated in foreign currency are translated using the average rates prevailing throughout the period of operations. Translation gains or losses resulting from changes in exchange rates are accumulated in shareholders’ equity.
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 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 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.
We determine performance obligations based on the nature of the services we provide. We recognize revenues for performance obligations satisfied over time based on actual charges incurred in relation to total expected charges. We believe that this method provides a faithful depiction of the transfer of services over the term of performance obligations based on the inputs needed to satisfy the obligations. Generally, performance obligations satisfied over time relate to patients in our hospitals receiving inpatient acute care services. We measure performance obligations from admission to the point when there are no further services required for the patient, which is generally the time of discharge. We recognize revenues for performance obligations satisfied at a point in time, which generally relate to patients receiving outpatient services, when (1) services are provided, and (2) we do not believe the patient requires additional services.
Because our patient service performance obligations relate to contracts with a duration of less than one year, we have elected to apply the optional exemption provided in the Financial Accounting Standards Board’s (“FASB”) Accounting Standards Codification (“ASC”) 606‑10‑50‑14(a) and, therefore, we are not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. The unsatisfied or partially unsatisfied performance obligations referred to above are primarily related to inpatient acute care services at the end of the reporting period. The performance obligations for these contracts are generally completed when the patients are discharged, which generally occurs within days or weeks of the end of the reporting period.
We determine the transaction price based on gross charges for services provided, reduced by contractual adjustments recognized for third‑party payers, discounts provided to uninsured patients in accordance with our Compact, and estimated implicit price concessions related primarily to uninsured patients. We determine our estimates of contractual adjustments and discounts based on contractual agreements, our discount policies and historical experience. We determine our estimate of implicit price concessions based on our historical collection experience using a portfolio approach as a practical expedient to account for patient contracts as collective groups rather than individually. The financial statement effects of using this practical expedient are not materially different from an individual contract approach.
Gross charges are retail charges. They are not the same as actual pricing, and they generally do not reflect what a hospital is ultimately paid and, therefore, are not displayed in our consolidated statements of operations. Hospitals are typically paid amounts that are negotiated with insurance companies or are set by the government. Gross charges are used to calculate Medicare outlier payments and to determine certain elements of payment under managed care contracts (such as stop‑loss payments). Because Medicare requires that a hospital’s gross charges be the same for all patients (regardless of payer category), gross charges are what hospitals charge all patients prior to the application of discounts and allowances.
Government Programs—The final determination of certain fee‑for‑service (“FFS”) Medicare and Medicaid program payments to our hospitals, such as Indirect Medical Education, Direct Graduate Medical Education, disproportionate share hospital and bad debt expense reimbursement, are retrospectively determined based on our hospitals’ cost reports. The final determination of these payments often takes many years to resolve because of audits by the program representatives, providers’ rights of appeal, and the application of numerous technical reimbursement provisions. We therefore record accruals to reflect the expected final settlements on our cost reports. For filed cost reports, we adjust the accrual for estimated cost report settlements based on those cost reports and subsequent activity, and we consider the necessity of recording a valuation allowance based on historical settlement results. The accrual for estimated cost report settlements for periods for which a cost report is yet to be filed is recorded based on estimates of what we expect to report on the filed cost reports, and a corresponding valuation allowance is recorded, if necessary, based on the method previously described. Cost reports must generally be filed within five months after the end of the annual cost report reporting period. After the cost report is filed, the accrual and corresponding valuation allowance may need to be adjusted.
Settlements with third‑party payers for retroactive revenue adjustments due to audits, reviews or investigations are considered variable consideration and are included in the determination of the estimated transaction price for providing patient care using the most likely outcome method. These settlements are estimated based on the terms of the payment agreement with the payer, correspondence from the payer and our historical settlement activity, including an assessment to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustment is subsequently resolved. Estimated settlements are adjusted in future periods as
adjustments become known (that is, new information becomes available), or as years are settled or are no longer subject to such audits, reviews and investigations. Because the laws, regulations, instructions and rule interpretations governing Medicare and Medicaid reimbursement are complex and change frequently, the estimates we record could change by material amounts.
Private Insurance—Revenues under managed care plans are based primarily on payment terms involving predetermined rates per diagnosis, per‑diem rates, discounted FFS rates and/or other similar contractual arrangements. These revenues are also subject to review and possible audit by the payers, which can take several years before they are completely resolved. The payers are billed for patient services on an individual patient basis. An individual patient’s bill is subject to adjustment on a patient‑by‑patient basis in the ordinary course of business by the payers following their review and adjudication of each particular bill. We estimate the discounts for contractual allowances at the individual hospital level utilizing billing data on an individual patient basis. At the end of each month, on an individual hospital basis, we estimate our expected reimbursement for patients of managed care plans based on the applicable contract terms. Contractual allowance estimates are periodically reviewed for accuracy by taking into consideration known contract terms, as well as payment history. We believe our estimation and review process enables us to identify instances on a timely basis where such estimates need to be revised. We do not believe there were any adjustments to estimates of patient bills that were material to our revenues during the years ended December 31, 2025, 2024 or 2023. In addition, on a corporate‑wide basis, we do not record any general provision for adjustments to estimated contractual allowances for managed care plans. Managed care accounts, net of contractual allowances recorded, are further reduced to their net realizable value through implicit price concessions based on historical collection trends for these payers and other factors that affect the estimation process.
We know of no claims, disputes or unsettled matters with any payer that would materially affect our revenues for which we have not adequately provided in the accompanying Consolidated Financial Statements.
Uninsured Patients—Generally, patients who are covered by third‑party payers are responsible for related co‑pays, co‑insurance and deductibles, which vary in amount. We also provide services to uninsured patients and offer uninsured patients a discount from standard charges. We estimate the transaction price for patients with co‑pays, co‑insurance and deductibles and for those who are uninsured based on historical collection experience and current market conditions. Under our Compact and other uninsured discount programs, the discount offered to certain uninsured patients is recognized as a contractual allowance, which reduces net operating revenues at the time the self‑pay accounts are recorded. The uninsured patient accounts, net of contractual allowances recorded, are further reduced to their net realizable value at the time they are recorded through implicit price concessions based on historical collection trends for self‑pay accounts and other factors that affect the estimation process.
Implicit Price Concessions—We record implicit price concessions, primarily related to uninsured patients and patients with co‑pays, co‑insurance and deductibles. The implicit price concessions included in estimating the transaction price represent the difference between amounts billed to patients and the amounts we expect to collect based on our collection history with similar patients. Although outcomes vary, our policy is to attempt to collect amounts due from patients, including co‑pays, co‑insurance and deductibles due from patients with insurance, at the time of service while complying with all federal and state statutes and regulations, including, but not limited to, the Emergency Medical Treatment and Active Labor Act (“EMTALA”). Generally, as required by EMTALA, patients may not be denied emergency treatment due to inability to pay. Therefore, services, including the legally required medical screening examination and stabilization of the patient, are performed without delaying to obtain insurance information. In non‑emergency circumstances or for elective procedures and services, it is our policy to verify insurance prior to a patient being treated; however, there are various exceptions that can occur. Such exceptions can include, for example, instances where (1) we are unable to obtain verification because the patient’s insurance company was unable to be reached or contacted, (2) a determination is made that a patient may be eligible for benefits under various government programs, such as Medicaid or Victims of Crime, and it takes several days or weeks before qualification for such benefits is confirmed or denied, and (3) under physician orders we provide services to patients that require immediate treatment.
There are various factors that can impact collection trends, such as: changes in the economy, which in turn have an impact on unemployment rates and the number of uninsured and underinsured patients; the volume of patients through our emergency departments; the increased burden of co‑pays, co‑insurance amounts and deductibles to be made by patients with insurance; and business practices related to collection efforts. These factors continuously change and can have an impact on collection trends and our estimation process. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to net patient service revenues in the period of the change.
We also provide charity care to patients who are financially unable to pay for the healthcare services they receive. Most patients who qualify for charity care are charged a per‑diem amount for services received, subject to a cap. Except for the per‑diem amounts, our policy is not to pursue collection of amounts determined to qualify as charity care; therefore, we do not report these amounts in net operating revenues. Patient advocates from our Eligibility and Enrollment Services program screen
patients in the hospital to determine whether those patients meet eligibility requirements for financial assistance programs. They also expedite the process of applying for these government programs.
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. Approximately 91% of our Hospital Operations segment’s contract assets meet the conditions for unconditional right to payment and are reclassified to patient receivables within 90 days.
Revenue Cycle Management and Other Services
Our Hospital Operations segment also provides revenue cycle management and other services to health systems, individual hospitals and physician practices. We recognize revenue from our contracts when the underlying performance obligations are satisfied, which is generally as services are rendered. Revenue is recognized in an amount that reflects the consideration to which we expect to be entitled.
At contract inception, we assess the services specified in our contracts with customers and identify a performance obligation for each distinct contracted service. We generally consider the following distinct services as separate performance obligations:
•revenue cycle management services;
•value‑based care services;
•patient communication and engagement services;
•consulting services; and
•other client‑defined projects.
Our contracts generally consist of fixed‑price, volume‑based or contingency‑based fees. Long‑term contracts typically provide for the delivery of recurring monthly services over a multi‑year period. The contracts are typically priced such that our monthly fee to our customer represents the value obtained by the customer in the month for those services. Such multi‑year service contracts may have upfront fees related to transition or integration work performed by us to set up the delivery for the ongoing services. Such transition or integration work typically does not result in a separately identifiable obligation; thus, the fees and expenses related to such work are deferred and recognized over the life of the related contractual service period. For contracts in which the amortization period of the asset is one year or less, we have elected to apply the practical expedient provided by FASB ASC 340‑40‑25‑4 and expense these costs as incurred.
Revenue for fixed‑priced contracts is typically recognized at the time of billing unless evidence suggests that the revenue is earned or our obligations are fulfilled in a different pattern. Revenue for volume‑based contracts is typically recognized as the services are being performed at the contractually billable rate, which is generally a percentage of collections or a percentage of client net patient revenue.
Contract Assets and Liabilities—Our client contract terms, including payment conditions, are diverse. For non‑fixed‑price arrangements, we may invoice clients before we perform the contracted services, with subsequent adjustments (true‑up) to align with actual fees. In contrast, some contracts require payment after we have performed the contracted services (in arrears). Contracts may also feature performance‑based incentives or penalties, along with other variable consideration. Revenue recognition occurs when services are rendered and the client gains control or benefit of the services, regardless of the invoicing schedule, leading to the recognition of a contract asset for unbilled revenue. Unbilled revenue is recognized as receivables in the month the services are performed. Conversely, advance payments from clients result in the recognition of a contract liability for deferred revenue until the revenue recognition requirements are met.
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 $2.883 billion and $3.019 billion at December 31, 2025 and 2024, respectively. At December 31, 2025 and 2024, our book overdrafts were $161 million and $143 million, respectively, which were classified as accounts payable. At December 31, 2025 and 2024, $108 million and $110 million, respectively, of total cash and cash equivalents in the accompanying Consolidated Balance Sheets were intended for the operations of our insurance‑related subsidiaries.
At December 31, 2025, 2024 and 2023, we had $111 million, $127 million and $154 million, respectively, of property and equipment purchases accrued for items received but not yet paid. Of these amounts, $102 million, $109 million and $141 million, respectively, were included in accounts payable.
Investments in Debt and Equity Securities
We classify investments in debt securities as either available‑for‑sale, held‑to‑maturity or as part of a trading portfolio. Our policy is to classify investments in debt securities that may be needed for cash requirements as “available‑for‑sale.” At December 31, 2025 and 2024, we had no significant investments in debt securities classified as either held‑to‑maturity or trading. We carry debt securities classified as available‑for‑sale at fair value. We report their unrealized gains and losses, net of taxes, as accumulated other comprehensive income (loss). We periodically evaluate available-for-sale securities in unrealized loss positions for credit impairment, using both qualitative and quantitative criteria. In the event a security is deemed to be impaired as the result of a credit loss, we record a loss in our consolidated statements of operations.
We carry equity securities at fair value, and we report their unrealized gains and losses in other non-operating income, net, in our consolidated statements of operations. If the equity security does not have a readily determinable fair value, the carrying value of the security is adjusted only when there is a price change that is observable from a transaction of an identical or similar investment. We include realized gains or losses in our consolidated statements of operations based on the specific identification method.
Investments in Unconsolidated Affiliates
As of December 31, 2025, we controlled 409 of the facilities in our Ambulatory Care segment and, therefore, consolidated their results. We account for many of the facilities in which our Ambulatory Care segment holds ownership interests (150 of 559 at December 31, 2025), as well as additional companies in which our Hospital Operations 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 Consolidated Statements of Operations. Summarized financial information for equity method investees is presented in the following table. For investments acquired during the reported periods, amounts below include 100% of the investee’s results beginning on the date of our acquisition of the investment.
December 31,
 202520242023
Current assets$1,202 $1,255 $1,223 
Noncurrent assets$1,347 $1,358 $1,355 
Current liabilities$(434)$(435)$(456)
Noncurrent liabilities$(870)$(928)$(917)
Noncontrolling interests$(728)$(699)$(670)
 Years Ended December 31,
 202520242023
Net operating revenues$3,902 $3,709 $3,510 
Net income$1,021 $978 $860 
Net income attributable to the investees$551 $483 $484 
The equity method investment that contributed the most to our equity in earnings of unconsolidated affiliates during the years ended December 31, 2025, 2024 and 2023 was Texas Health Ventures Group, LLC (“THVG”), which is operated by USPI. THVG represented $141 million, $130 million and $104 million of total equity in earnings of unconsolidated affiliates of $264 million, $260 million and $228 million in the years ended December 31, 2025, 2024 and 2023, respectively.
Property and Equipment
Additions and improvements to property and equipment exceeding established minimum amounts with a useful life greater than one year are capitalized at cost. Expenditures for maintenance and repairs are charged to expense as incurred. We use the straight‑line method of depreciation for buildings, building improvements and equipment. The estimated useful life for buildings and improvements is primarily 15 to 40 years, and for equipment three to 15 years. Newly constructed hospitals are usually depreciated over 50 years. Interest costs related to construction projects are capitalized. In the years ended December 31, 2025, 2024 and 2023, capitalized interest was $9 million, $8 million and $9 million, respectively.
We evaluate our long‑lived assets for possible impairment annually or whenever events or changes in circumstances indicate that the carrying amount of the asset, or related group of assets, may not be recoverable from estimated future
undiscounted cash flows. If the estimated future undiscounted cash flows are less than the carrying value of the assets, we calculate the amount of an impairment charge only if the carrying value of the long‑lived assets exceeds their fair value. The fair value of the asset is estimated based on third‑party appraisals, established market values of comparable assets or internally developed estimates of future net cash flows expected to result from the use and ultimate disposition of the asset. The estimates of these future cash flows are based on assumptions and projections we believe to be reasonable and supportable. Estimates require our subjective judgments and take into account assumptions about revenue and expense growth rates, operating margins and recoverable disposition values, based on industry and operating factors. These assumptions may vary by type of asset and presume stable, improving or, in some cases, declining results, depending on their circumstances. If the presumed level of performance does not occur as expected, impairment may result.
We report long‑lived assets to be disposed of at the lower of their carrying amounts or fair values less costs to sell. In such circumstances, our estimates of fair value are based on third‑party appraisals, established market prices for comparable assets or internally developed estimates of future net cash flows.
Leases
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 the 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 segment, 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 primarily relate to medical and office equipment and real estate. 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.
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, 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 (1) expired or existing contracts for whether they are or contain a lease, (2) the lease classification of any existing leases or (3) initial indirect costs for existing leases.
Goodwill and Other Intangible Assets
Goodwill represents the excess of costs over the fair value of assets of businesses acquired. Goodwill and other intangible assets acquired in purchase business combinations and determined to have indefinite useful lives are not amortized, but instead are subject to impairment tests performed at least annually. Our reporting segments are the reporting units used to perform our goodwill analysis. If we determine the carrying value of goodwill is impaired, or if the carrying value of a business that is to be sold or otherwise disposed of exceeds its fair value, we reduce the carrying value, including any allocated goodwill, to fair value. Estimates of fair value are based on third‑party appraisals, established market prices for comparable assets or
internally developed estimates of future net cash flows and presume stable, improving or, in some cases, declining results at our hospitals, depending on their circumstances.
Other intangible assets consist of capitalized software costs, which are amortized on a straight‑line basis over the estimated useful life of the software, which ranges from three to 15 years, costs of acquired management and other contract service rights, most of which have indefinite lives, and miscellaneous intangible assets.
Accruals for General and Professional Liability Risks
We accrue for estimated professional and general liability claims, to the extent not covered by insurance, when they are probable and can be reasonably estimated. We maintain reserves, which are based on modeled estimates for the portion of our professional liability risks, including incurred but not reported claims, to the extent we do not have insurance coverage. Our liability consists of estimates established based upon calculations using several factors, including the number of expected claims, estimates of losses for these claims based on recent and historical settlement amounts, estimates of incurred but not reported claims based on historical experience and the timing of historical payments. Our liabilities are adjusted for new claims information in the period such information becomes known. Malpractice expense is recorded within other operating expenses in our consolidated statements of operations.
Income Taxes
We account for income taxes using the asset and liability method. This approach requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of temporary differences between the carrying amounts and the tax bases of assets and liabilities. Income tax receivables and liabilities and deferred tax assets and liabilities are recognized based on the amounts that more likely than not will be sustained upon ultimate settlement with taxing authorities.
Developing our provision for income taxes and analysis of uncertain tax positions requires significant judgment and knowledge of federal and state income tax laws, regulations and strategies, including the determination of deferred tax assets and liabilities and, if necessary, any valuation allowances that may be required for deferred tax assets.
We assess the realization of our deferred tax assets to determine whether an income tax valuation allowance is required. Based on all available evidence, both positive and negative, and the weight of that evidence to the extent such evidence can be objectively verified, we determine whether it is more likely than not that all or a portion of the deferred tax assets will be realized. The main factors that we consider include:
•Cumulative profits/losses in recent years, adjusted for certain nonrecurring items;
•Income/losses expected in future years;
•Unsettled circumstances that, if unfavorably resolved, would adversely affect future operations and profit levels;
•The availability, or lack thereof, of taxable income in prior carryback periods that would limit realization of tax benefits; and
•The carryforward period associated with the deferred tax assets and liabilities.
We consider many factors when evaluating our uncertain tax positions, and such judgments are subject to periodic review. Tax benefits associated with uncertain tax positions are recognized in the period in which one of the following conditions is satisfied: (1) the more likely than not recognition threshold is satisfied; (2) the position is ultimately settled through negotiation or litigation; or (3) the statute of limitations for the taxing authority to examine and challenge the position has expired. Tax benefits associated with an uncertain tax position are derecognized in the period in which the more likely than not recognition threshold is no longer satisfied.
Costs Associated with Exit or Disposal Activities
We recognize costs associated with exit (including restructuring) or disposal activities when they are incurred and can be measured at fair value, rather than at the date of a commitment to an exit or disposal plan. Our restructuring plans typically focus on the alignment of our operations in the most strategic and cost‑effective structure, such as the establishment of support operations at our GBC, among other things. Certain restructuring and acquisition‑related costs are based on estimates. Changes in estimates are recognized as they occur.
Recent Accounting Standards
Recently Issued Accounting Standards
The FASB issued Accounting Standard Update (“ASU”) 2024-03, “Income Statement – Reporting Comprehensive Income – Expense Disaggregation Disclosures (Subtopic 22-40): Disaggregation of Income Statement Expenses” (“ASU 2024-03”) in November 2024. This ASU requires entities to provide enhanced disclosures related to certain expense categories included in income statement captions. The ASU aims to increase transparency and provide investors with more detailed information about the nature of expenses reported on the face of the income statement. The new standard does not change the requirements for the presentation of expenses on the face of the income statement. ASU 2024-03 is effective for annual
reporting periods beginning after December 15, 2026 and interim reporting periods beginning after December 15, 2027. Early adoption is permitted. While the adoption is not expected to have an impact on our financial statements, it is expected to result in incremental disclosures within the footnotes to our consolidated financial statements.
Recently Adopted Accounting Standards
We adopted ASU 2023-05, “Business Combinations – Joint Venture Formations (Subtopic 805-60): Recognition and Initial Measurement” (“ASU 2023-05”) effective January 1, 2025. The amendments in the ASU sought to reduce diversity in practice that has resulted from a lack of authoritative guidance regarding the accounting for the formation of joint ventures in separate financial statements. The amendments also sought to clarify the initial measurement of joint venture net assets, including businesses contributed to a joint venture. The adoption of ASU 2023-05 did not result in a material impact to our consolidated financial statements.
We adopted ASU 2023-09, “Income Taxes (Topic 740): Improvements to Income Tax Disclosures” (“ASU 2023-09”) effective January 1, 2025. This ASU requires the disclosure, on an annual basis, of specific categories in the effective tax rate reconciliation and additional information for reconciling items that meet a quantitative threshold. In addition, ASU 2023-09 requires companies to disclose additional information about income taxes paid. The adoption of ASU 2023-09 did not have a material impact on our consolidated financial statements.
v3.25.4
SIGNIFICANT ACCOUNTING POLICIES (Tables)
 12 Months Ended
Dec. 31, 2025
Accounting Policies [Abstract]  
Schedule of Equity Method Investments Summarized financial information for equity method investees is presented in the following table. For investments acquired during the reported periods, amounts below include 100% of the investee’s results beginning on the date of our acquisition of the investment.
December 31,
 202520242023
Current assets$1,202 $1,255 $1,223 
Noncurrent assets$1,347 $1,358 $1,355 
Current liabilities$(434)$(435)$(456)
Noncurrent liabilities$(870)$(928)$(917)
Noncontrolling interests$(728)$(699)$(670)
 Years Ended December 31,
 202520242023
Net operating revenues$3,902 $3,709 $3,510 
Net income$1,021 $978 $860 
Net income attributable to the investees$551 $483 $484 
v3.25.4
EQUITY (Tables)
 12 Months Ended
Dec. 31, 2025
Stockholders' Equity Note [Abstract]  
Schedule of Changes in Redeemable Noncontrolling Interests in Equity of Consolidated Subsidiaries
The table below presents our nonredeemable noncontrolling interests balances by segment:
December 31,
20252024
Hospital Operations$211 $205 
Ambulatory Care1,586 1,444 
Total nonredeemable noncontrolling interests$1,797 $1,649 
Our net income available to nonredeemable noncontrolling interests by segment are presented in the table below:
Years Ended December 31,
202520242023
Hospital Operations$45 $50 $30 
Ambulatory Care381 341 304 
Total net income available to noncontrolling interests$426 $391 $334 
Schedule of Share Repurchase Activity
The tables below present repurchase activity under both the 2022 and 2024 share repurchase programs:
PeriodTotal Number of Shares PurchasedAverage Price
Paid per Share		Total Number of Shares Purchased as Part of Publicly Announced ProgramMaximum Dollar Value of Shares That May Yet be Purchased Under the Program
 (In Thousands)(In Thousands)(In Millions)
January 1 through January 31, 2023—$— —$750 
February 1 through February 28, 2023—$— —$750 
March 1 through March 31, 2023906$55.03 906$700 
April 1 through April 30, 2023—$— —$700 
May 1 through May 31, 2023580$69.17 580$660 
June 1 through June 30, 2023—$— —$660 
July 1 through July 31, 2023—$— —$660 
August 1 through August 31, 2023—$— —$660 
September 1 through September 30, 2023—$— —$660 
October 1 through October 31, 2023—$— —$660 
November 1 through November 30, 2023982$67.12 982$594 
December 1 through December 31, 2023644$68.53 644$550 
Year ended December 31, 20233,112$64.27 3,112
PeriodTotal Number of Shares PurchasedAverage Price Paid per ShareTotal Number of Shares Purchased as Part of Publicly Announced ProgramMaximum Dollar Value of Shares That May Yet be Purchased Under the Program
 (In Thousands)(In Thousands)(In Millions)
January 1 through January 31, 2024—$— —$550 
February 1 through February 29, 2024—$— —$550 
March 1 through March 31, 20242,811$98.86 2,811$272 
April 1 through April 30, 2024—$— —$272 
May 1 through May 31, 2024—$— —$272 
June 1 through June 30, 20241,990$135.85 1,990$2 
July 1 through July 31, 2024—$— —$1,500 
August 1 through August 31, 2024—$— —$1,500 
September 1 through September 30, 2024795$155.93 795$1,376 
October 1 through October 31, 2024—$— —$1,376 
November 1 through November 30, 2024—$— —$1,376 
December 1 through December 31, 2024—$— —$1,376 
Year ended December 31, 20245,596$120.07 5,596
January 1 through January 31, 2025—$— —$1,376 
February 1 through February 28, 20251,800$134.98 1,800$1,133 
March 1 through March 31, 2025829$126.67 829$1,028 
April 1 through April 30, 2025—$— —$1,028 
May 1 through May 31, 20252,456$157.57 2,456$641 
June 1 through June 30, 20252,145$167.83 2,145$281 
July 1 through July 31, 2025598$155.43 598$1,688 
August 1 through August 31, 2025—$— —$1,688 
September 1 through September 30, 2025—$— —$1,688 
October 1 through October 31, 2025469$210.92 469$1,589 
November 1 through November 30, 2025474$208.86 474$1,490 
December 1 through December 31, 2025—$— —$1,490 
Year ended December 31, 20258,771$158.00 8,771
v3.25.4
ACCOUNTS RECEIVABLE (Tables)
 12 Months Ended
Dec. 31, 2025
Accounts Receivable Additional Disclosures [Abstract]  
Schedule of Components of Accounts Receivable
The principal components of accounts receivable are presented in the table below:
December 31,
 20252024
Patient accounts receivable$2,418 $2,386 
Estimated future recoveries148 144 
Cost reports and settlements receivable (payable), net of valuation allowances(1)6 
Accounts receivable, net 
$2,565 $2,536 
Schedule of Location of Assets and Liabilities
The following table presents the amount and classification of assets and liabilities in the accompanying Consolidated Balance Sheets related to California’s provider fee program:
December 31,
 20252024
Assets:
Other current assets$493 $334 
Investments and other assets$121 $274 
Liabilities:
Other current liabilities$232 $126 
Other long-term liabilities$48 $102 
Schedule of Estimated Costs for Charity Care and Self-Pay Patients
The following table presents our estimated costs (based on selected operating expenses, which include salaries, wages and benefits, supplies and other operating expenses) of caring for our uninsured and charity patients:
 Years Ended December 31,
 202520242023
Estimated costs for:   
Uninsured patients$439 $535 $499 
Charity care patients134 82 110 
Total$573 $617 $609 
v3.25.4
CONTRACT BALANCES (Tables)
 12 Months Ended
Dec. 31, 2025
Revenue from Contract with Customer [Abstract]  
Schedule of Opening and Closing Balances of Contracts Assets and Liabilities
The opening and closing balances of our Hospital Operations segment’s receivables, contract assets, and current and long‑term contract liabilities were as follows:
ReceivablesContract Assets –
Unbilled Revenue		Contract Liabilities –
Current
Deferred Revenue		Contract Liabilities –
Long-Term
Deferred Revenue
December 31, 2024$28 $190 $80 $13 
December 31, 202526 188 88 13 
Increase (decrease)$(2)$(2)$8 $— 
December 31, 2023$21 $208 $59 $12 
December 31, 202428 190 80 13 
Increase (decrease)$7 $(18)$21 $1 
v3.25.4
DISPOSITION OF ASSETS AND LIABILITIES (Tables)
 12 Months Ended
Dec. 31, 2025
Discontinued Operations and Disposal Groups [Abstract]  
Schedule of Assets and Liabilities Classified As Held for Sale
The following table presents amounts included in income before income taxes related to a significant component of our business that was recently disposed of:
 Years Ended December 31,
 202520242023
SC Hospitals (includes a $1.677 billion gain on sale in 2024)
$2 $1,687 $130 
v3.25.4
LEASES (Tables)
 12 Months Ended
Dec. 31, 2025
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 Consolidated Balance Sheets:
December 31,
Component of Lease BalancesClassification in Consolidated Balance Sheets20252024
Assets:  
Operating lease assetsInvestments and other assets$1,134 $1,037 
Finance lease assetsProperty and equipment, at cost, less accumulated depreciation and amortization419 454 
Total leased assets$1,553 $1,491 
Liabilities:
Operating lease liabilities:
CurrentOther current liabilities$214 $204 
Long-termOther long-term liabilities1,043 950 
Total operating lease liabilities1,257 1,154 
Finance lease liabilities:
CurrentCurrent portion of long-term debt45 54 
Long-termLong-term debt, net of current portion407 390 
Total finance lease liabilities452 444 
Total lease liabilities$1,709 $1,598 
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 consolidated statements of operations:
Component of Lease ExpenseClassification in Consolidated Statements of OperationsYears Ended December 31,
202520242023
Operating lease expenseOther operating expenses, net$267 $257 $259 
Finance lease expense:
Amortization of leased assetsDepreciation and amortization51 49 55 
Interest on lease liabilitiesInterest expense24 7 8 
Total finance lease expense75 56 63 
Variable and short term-lease expenseOther operating expenses, net143 160 159 
Total lease expense$485 $473 $481 
The weighted‑average lease terms and discount rates for operating and finance leases are presented in the following table:
Years Ended December 31,
202520242023
Weighted-average remaining lease term (years):
Operating leases7.06.87.6
Finance leases24.824.66.0
Weighted-average discount rate:
Operating leases5.2 %5.2 %5.0 %
Finance leases6.4 %6.5 %6.5 %
Cash flow and other information related to leases is presented in the following table:
Years Ended December 31,
202520242023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash outflows from operating leases$259 $252 $258 
Operating cash outflows from finance leases$5 $10 $13 
Financing cash outflows from finance leases$62 $87 $107 
Right-of-use assets obtained in exchange for lease obligations:
Operating leases$360 $292 $168 
Finance leases$59 $363 $55 
Schedule of Operating Lease Liability Maturity
Future maturities of lease liabilities at December 31, 2025 are presented in the following table:
Operating LeasesFinance LeasesTotal
2026$271 $53 $324 
2027247 132 379 
2028214 38 252 
2029177 28 205 
2030139 25 164 
Later years479 522 1,001 
Total lease payments1,527 798 2,325 
Less: Imputed interest270 346 616 
Total lease obligations1,257 452 1,709 
Less: Current obligations214 45 259 
Long-term lease obligations$1,043 $407 $1,450 
Schedule of Finance Lease Liability Maturity
Future maturities of lease liabilities at December 31, 2025 are presented in the following table:
Operating LeasesFinance LeasesTotal
2026$271 $53 $324 
2027247 132 379 
2028214 38 252 
2029177 28 205 
2030139 25 164 
Later years479 522 1,001 
Total lease payments1,527 798 2,325 
Less: Imputed interest270 346 616 
Total lease obligations1,257 452 1,709 
Less: Current obligations214 45 259 
Long-term lease obligations$1,043 $407 $1,450 
v3.25.4
LONG-TERM DEBT (Tables)
 12 Months Ended
Dec. 31, 2025
Long-Term Debt and Lease Obligation [Abstract]  
Schedule of Long-Term Debt
The table below presents our long‑term debt included in the accompanying Consolidated Balance Sheets:
December 31,
 20252024
Senior unsecured notes:  
6.125% due 2028
$1,750 $2,500 
6.875% due 2031
362 362 
6.000% due 2033
750 — 
Senior secured first lien notes:  
5.125% due 2027
1,500 1,500 
4.625% due 2028
600 600 
4.250% due 2029
1,400 1,400 
4.375% due 2030
1,450 1,450 
6.125% due 2030
2,000 2,000 
6.750% due 2031
1,350 1,350 
5.500% due 2032
1,500 — 
Senior secured second lien notes:
6.250% due 2027
— 1,500 
Finance leases, mortgages and other notes603 605 
Unamortized issue costs and note discounts(94)(94)
Total long-term debt13,171 13,173 
Less: Current portion79 92 
Long-term debt, net of current portion$13,092 $13,081 
Schedule of Future Long Term Debt Maturities
Future long‑term debt maturities, including finance lease obligations, were as follows as of December 31, 2025:
  Years Ending December 31,Later Years
 Total20262027202820292030
Long-term debt, including finance lease obligations$13,265 $79 $1,628 $2,402 $1,438 $3,465 $4,253 
v3.25.4
EMPLOYEE BENEFIT PLANS (Tables)
 12 Months Ended
Dec. 31, 2025
Share-Based Payment Arrangement [Abstract]  
Schedule of Stock Option Activity
The following table presents information about our stock option activity during the years ended December 31, 2025, 2024 and 2023:
 Number of OptionsWtd. Avg.
Exercise Price
Per Share		Aggregate
Intrinsic Value		Wtd. Avg.
Remaining
Contractual Life
   (In Millions) 
Outstanding at December 31, 2022460,947 $23.33   
Exercised(76,507)$26.07   
Outstanding at December 31, 2023384,440 $22.79   
Exercised(197,943)$21.86   
Outstanding at December 31, 2024186,497 $23.76   
Exercised(41,816)$22.39   
Outstanding at December 31, 2025144,681 $24.16 $25 2.5 years
Schedule of Information About Stock Options by Range of Exercise Prices
The following table presents additional information about our outstanding stock options at December 31, 2025:
 Options Outstanding and Exercisable
Range of Exercise Prices Number of
Options		Wtd. Avg.
Remaining
Contractual Life		Wtd. Avg.
Exercise Price
Per Share
$18.99 to $20.609
86,469 2.2 years$20.60 
$20.61 to $35.430
58,212 3.1 years$29.44 
 144,681 2.5 years$24.16 
Schedule of Restricted Stock Unit Activity
The following table presents information about our RSU activity during the years ended December 31, 2025, 2024 and 2023:
 Number of RSUsWtd. Avg. Grant Date Fair
Value Per RSU
Unvested at December 31, 20221,520,418 $66.36 
Granted759,590 $60.88 
Performance-based adjustment185,901 $48.97 
Vested(954,401)$48.75 
Forfeited(90,445)$64.61 
Unvested at December 31, 20231,421,063 $66.46 
Granted573,033 $94.70 
Performance-based adjustment205,075 $66.51 
Vested(684,268)$65.64 
Forfeited(32,904)$80.91 
Unvested at December 31, 20241,481,999 $83.84 
Granted596,913 $138.06 
Performance-based adjustment255,386 $80.85 
Vested(872,894)$81.41 
Forfeited(21,025)$105.02 
Unvested at December 31, 20251,440,379 $111.02 
The following table presents information about RSU activity under the USPI Management Equity Plan during the years ended December 31, 2024 and 2023.
Number of RSUsWtd. Avg. Grant Date Fair
Value Per RSU
Unvested at December 31, 2022922,840 $34.13 
Vested(303,171)$34.13 
Forfeited(11,685)$34.13 
Unvested at December 31, 2023607,984 $34.13 
Vested(598,846)$34.13 
Forfeited(1,997)$34.13 
Cancelled(7,141)$34.13 
Unvested at December 31, 2024— $34.13 
Schedule of Share-based Payment Award, Awards Other Than Options, Valuation Assumptions Significant inputs used in our valuation of these RSUs included the following:
Years Ended December 31,
202520242023
Expected volatility
36.6% - 48.0%
34.9% - 52.1%
53.6% - 65.6%
Risk-free interest rate
4.1% - 4.3%
4.4% - 4.9%
4.2% - 4.8%
Schedule of Employee Stock Purchase Plan Activity
We issued the following numbers of shares under our employee stock purchase plan:
 Years Ended December 31, 
 202520242023
Number of shares (in thousands)25 33 69 
Weighted average price$160.90 $121.76 $65.62 
Schedule of Reconciliation of Funded Status of Plans, the Amounts included in the Consolidated Balance Sheets and Assumptions Used for Projected Benefit Obligations
The following tables summarize the balance sheet impact, as well as the benefit obligations, funded status and rate assumptions associated with the SERPs and the DMC Pension Plan based on actuarial valuations prepared:
 December 31,
 20252024
Reconciliation of funded status of plans and the amounts included in the Consolidated Balance Sheets:  
Projected benefit obligations(1)
  
Beginning obligations$(895)$(951)
Interest cost(49)(49)
Actuarial gain (loss)(18)22 
Benefits paid82 83 
Annuity purchase33 — 
Ending obligations(847)(895)
Fair value of plans assets  
Beginning plan assets573 592 
Gain (loss) on plan assets35 (3)
Employer contribution61 42 
Benefits paid(58)(58)
Annuity purchase(33)— 
Ending plan assets578 573 
Funded status of plans$(269)$(322)
Amounts recognized in the Consolidated Balance Sheets consist of:  
Other current liability$(24)$(24)
Other long-term liability$(245)$(298)
Accumulated other comprehensive loss$228 $225 
SERP Assumptions:  
Discount rate5.50 %5.75 %
Compensation increase rate3.00 %3.00 %
Measurement dateDecember 31, 2025December 31, 2024
DMC Pension Plan Assumptions:  
Discount rate5.42 %5.69 %
Compensation increase rateFrozenFrozen
Measurement dateDecember 31, 2025December 31, 2024
(1)The accumulated benefit obligation at December 31, 2025 and 2024 was approximately $847 million and $895 million, respectively.
Schedule of Components of Net Benefit Costs and Assumptions Used for Net Periodic Benefit Costs
The components of net periodic benefit costs and related assumptions are as follows:
 Years Ended December 31,
 202520242023
Interest costs$49 $49 $53 
Expected return on plan assets(29)(29)(36)
Amortization of net actuarial loss8 8 7 
Special termination benefit costs— — 1 
Net periodic benefit cost$28 $28 $25 
SERP Assumptions:   
Discount rate5.75 %5.50 %5.75 %
Compensation increase rate3.00 %3.00 %3.00 %
Measurement dateJanuary 1, 2025January 1, 2024January 1, 2023
Census dateJanuary 1, 2025January 1, 2024January 1, 2023
DMC Pension Plan Assumptions:   
Discount rate5.69 %5.25 %5.51 %
Long-term rate of return on assets5.25 %5.00 %5.75 %
Compensation increase rateFrozenFrozenFrozen
Measurement dateJanuary 1, 2025January 1, 2024January 1, 2023
Census dateJanuary 1, 2025January 1, 2024January 1, 2023
Schedule of Weighted-Average Asset Allocations by Asset Category
The weighted‑average asset allocations by asset category as of December 31, 2025, were as follows:
TargetActual
Cash and cash equivalents— %11 %
Equity securities11 %8 %
Debt securities70 %62 %
Alternative investments19 %19 %
Schedule of DMC Pension Plan Assets Measured at Fair Value on a Recurring Basis Aggregated by the Level in the Fair Value Hierarchy
The following table presents the DMC Pension Plan assets measured at fair value on a recurring basis as of December 31, 2025 and 2024, aggregated by the level in the fair value hierarchy within which those measurements are determined:
TotalLevel 1Level 2Level 3
As of December 31, 2025:
Cash and cash equivalents$64 $64 $— $— 
Equity securities49 49 — — 
Fixed income funds356 356 — — 
Alternative investments:
Private equity securities99 — — 99 
Hedge funds10 — — 10 
 $578 $469 $— $109 
As of December 31, 2024:
Cash and cash equivalents$22 $22 $— $— 
Equity securities66 66 — — 
Fixed income funds376 376 — — 
Alternative investments:
Private equity securities106 — — 106 
Hedge funds3 — — 3 
$573 $464 $— $109 
Schedule of Estimated Future Benefit Payments
The following table presents the estimated future benefit payments to be made from the SERPs and the DMC Pension Plan, a portion of which will be funded from plan assets, for the next five years and in the aggregate for the five years thereafter:
  Years Ending December 31, Five Years Thereafter
 Total20262027202820292030
Estimated benefit payments$732 $81 $80 $79 $77 $75 $340 
v3.25.4
PROPERTY AND EQUIPMENT (Tables)
 12 Months Ended
Dec. 31, 2025
Property, Plant and Equipment [Abstract]  
Schedule of Components of Property and Equipment
The principal components of property and equipment are presented in the table below:
 December 31,
 20252024
Land$534 $539 
Buildings and improvements6,672 6,130 
Construction in progress211 238 
Equipment5,038 4,399 
Finance lease assets540 552 
 12,995 11,858 
Accumulated depreciation and amortization(6,680)(5,809)
Net property and equipment$6,315 $6,049 
v3.25.4
GOODWILL AND OTHER INTANGIBLE ASSETS (Tables)
 12 Months Ended
Dec. 31, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
Schedule of Changes in the Carrying Amount of Goodwill
The following table presents information on changes in the carrying amount of goodwill for each of our segments:
December 31,
 20252024
Hospital Operations  
Goodwill at beginning of period, net of accumulated impairment losses$2,697 $3,119 
Goodwill acquired during the year, including purchase price allocation adjustments— 42 
Goodwill related to assets held for sale and disposed— (464)
Goodwill at end of period, net of accumulated impairment losses$2,697 $2,697 
Ambulatory Care
Goodwill at beginning of period7,994 $7,188 
Goodwill acquired during the year, including purchase price allocation adjustments507 927 
Goodwill related to assets held for sale and disposed or deconsolidated facilities— (121)
Goodwill at end of period8,501 $7,994 
Total Goodwill$11,198 $10,691 
Schedule of Other Intangible Assets
The following table presents information regarding other intangible assets, which were included in the accompanying Consolidated Balance Sheets:
 Gross
Carrying
Amount		Accumulated
Amortization		Net Book
Value
At December 31, 2025:   
Other intangible assets with finite useful lives:
Capitalized software costs$1,511 $(1,166)$345 
Contracts241 (148)93 
Other42 (14)28 
Other intangible assets with finite lives1,794 (1,328)466 
Other intangible assets with indefinite useful lives:
Trade names105 — 105 
Contracts773 — 773 
Other4 — 4 
Other intangible assets with indefinite lives882 — 882 
Total other intangible assets, net$2,676 $(1,328)$1,348 
At December 31, 2024:
Other intangible assets with finite useful lives:
Capitalized software costs$1,469 $(1,075)$394 
Contracts241 (135)106 
Other96 (78)18 
Other intangible assets with finite lives1,806 (1,288)518 
Other intangible assets with indefinite useful lives:
Trade names105 — 105 
Contracts769 — 769 
Other5 — 5 
Other intangible assets with indefinite lives879 — 879 
Total other intangible assets, net$2,685 $(1,288)$1,397 
Schedule of Estimated Future Amortization of Intangibles with Finite Useful Lives
Estimated future amortization of intangible assets with finite useful lives at December 31, 2025 was as follows:
 TotalYears Ending December 31,Later Years
 20262027202820292030
Amortization of intangible assets$466 $106 $114 $82 $58 $43 $63 
v3.25.4
OTHER ASSETS (Tables)
 12 Months Ended
Dec. 31, 2025
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]  
Schedule of Other Current Assets
The principal components of other current assets in the accompanying Consolidated Balance Sheets are presented below:
December 31,
 20252024
Prepaid expenses$423 $368 
Contract assets188 190 
California provider fee program receivables493 334 
Receivables from other government programs385 326 
Guarantees138 194 
Non-patient receivables224 229 
Other140 119 
Total other current assets$1,991 $1,760 
Schedule of Investments and Other Assets
The principal components of investments and other assets in the accompanying Consolidated Balance Sheets are presented below:
 December 31,
 20252024
Marketable securities$59 $50 
Equity investments in unconsolidated healthcare entities1,383 1,482 
Total investments1,442 1,532 
Cash surrender value of life insurance policies54 48 
Long-term deposits50 51 
California provider fee program receivables121 274 
Operating lease assets1,134 1,037 
Other long-term receivables and other assets82 95 
Total investments and other assets$2,883 $3,037 
v3.25.4
ACCUMULATED OTHER COMPREHENSIVE LOSS (Tables)
 12 Months Ended
Dec. 31, 2025
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]  
Schedule of Accumulated Other Comprehensive Loss
The table below presents our accumulated other comprehensive loss by component:
 December 31,
 20252024
Adjustments for defined benefit plans$(183)$(181)
Unrealized gains on investments1 — 
Foreign currency translation adjustments and other1 1 
Accumulated other comprehensive loss$(181)$(180)
The following table presents the income tax benefit from each component of our other comprehensive income (loss):
 December 31,
 20252024
Adjustments for defined benefit plans$(1)$— 
Net income tax benefit related to items of other comprehensive income (loss)$(1)$— 
v3.25.4
NET OPERATING REVENUES (Tables)
 12 Months Ended
Dec. 31, 2025
Revenue from Contract with Customer [Abstract]  
Schedule of Sources of Net Operating Revenues Less Provisions for Doubtful Accounts and Implicit Price Concessions
The table below presents our sources of net operating revenues:
Years Ended December 31,
202520242023
Hospital Operations:
Net patient service revenues from hospitals and related outpatient facilities:
Medicare$2,119 $2,132 $2,383 
Medicaid1,524 1,439 1,233 
Managed care9,696 9,809 10,248 
Uninsured52 64 96 
Indemnity and other551 522 590 
Total13,942 13,966 14,550 
Other revenues(1)
2,196 2,175 2,148 
Total Hospital Operations16,138 16,141 16,698 
Ambulatory Care5,172 4,534 3,866 
Net operating revenues$21,310 $20,675 $20,564 
(1)Primarily revenue from physician practices and revenue cycle management.
The following table presents the composition of net operating revenues for our Ambulatory Care segment:
Years Ended December 31,
202520242023
Net patient service revenues
$4,956 $4,356 $3,713 
Revenue from other sources216 178 152 
Net operating revenues$5,172 $4,534 $3,865 
Schedule of Revenue Expected to be Recognized in the Future Related to Performance Obligations
The following table includes revenue from revenue cycle management services that was expected to be recognized in the future related to performance obligations that are unsatisfied, or partially unsatisfied, at December 31, 2025:
  Years Ending December 31,Later Years
 Total20262027202820292030
Performance obligations$5,126 $748 $747 $747 $747 $747 $1,390 
v3.25.4
CLAIMS AND LAWSUITS (Tables)
 12 Months Ended
Dec. 31, 2025
Commitments and Contingencies Disclosure [Abstract]  
Schedule of Reconciliations of Legal Settlements and Related Costs
The following table presents reconciliations of the beginning and ending liability balances in connection with legal settlements and related costs:
 Balances at
Beginning
of Period		Litigation and
Investigation
Costs		Cash
Payments		OtherBalances at
End of
Period
Year Ended December 31, 2025$20 $64 $(49)$3 $38 
Year Ended December 31, 2024$40 $35 $(56)$1 $20 
Year Ended December 31, 2023$51 $47 $(59)$1 $40 
v3.25.4
REDEEMABLE NONCONTROLLING INTERESTS IN EQUITY OF CONSOLIDATED SUBSIDIARIES (Tables)
 12 Months Ended
Dec. 31, 2025
Noncontrolling Interest [Abstract]  
Schedule of Changes in Redeemable Noncontrolling Interests in Equity of Consolidated Subsidiaries
The following table presents the changes in redeemable noncontrolling interests in equity of consolidated subsidiaries:
 Years Ended December 31,
 20252024
Balances at beginning of period 
$2,727 $2,391 
Net income534 473 
Distributions paid to noncontrolling interests(437)(369)
Accretion of redeemable noncontrolling interests— 5 
Purchases and sales of businesses and noncontrolling interests, net132 227 
Balances at end of period 
$2,956 $2,727 
The following tables present the composition by segment of our redeemable noncontrolling interests balances, as well as our net income available to redeemable noncontrolling interests:
December 31,
 20252024
Hospital Operations$905 $800 
Ambulatory Care2,051 1,927 
Redeemable noncontrolling interests$2,956 $2,727 
 Years Ended December 31,
 202520242023
Hospital Operations$110 $100 $84 
Ambulatory Care424 373 282 
Net income available to redeemable noncontrolling interests$534 $473 $366 
v3.25.4
INCOME TAXES (Tables)
 12 Months Ended
Dec. 31, 2025
Income Tax Disclosure [Abstract]  
Schedule of Income before Income Tax, Domestic and Foreign
Income before income taxes for continuing operations for the years ended December 31, 2025, 2024 and 2023 consisted of the following:
 Years Ended December 31,
 202520242023
Domestic$2,805 $5,251 $1,620 
Foreign(5)(3)(3)
 $2,800 $5,248 $1,617 
Schedule of Provision for Income Taxes For Continuing Operations
The provision for income taxes for the years ended December 31, 2025, 2024 and 2023 consisted of the following:
 Years Ended December 31,
 202520242023
Current tax expense:   
Federal$305 $926 $208 
State119 361 46 
 424 1,287 254 
Deferred tax expense (benefit):   
Federal18 (92)55 
State(9)(11)(3)
 9 (103)52 
Total tax expense$433 $1,184 $306 
Schedule of Reconciliation Between Reported Income Tax Expense (Benefit) and Income Taxes Calculated by the Statutory Federal Income Tax Rate
A reconciliation between the amount of reported income tax expense and the amount computed by multiplying income before income taxes by the statutory federal tax rate is presented below.
 Years Ended December 31,
 202520242023
AmountPercentAmountPercentAmountPercent
Tax expense at statutory federal rate$588 21.0 %$1,102 21.0 %$340 21.0 %
Domestic federal tax
Nontaxable or nondeductible items:
Tax benefit attributable to noncontrolling interests(202)(7.2)%(181)(3.4)%(147)(9.1)%
Nondeductible goodwill— — %161 3.1 %— — %
Other(2)(0.1)%7 0.1 %7 0.4 %
Stock-based compensation tax benefit(11)(0.4)%(9)(0.2)%(2)(0.1)%
Other(21)(0.7)%(5)(0.1)%4 0.2 %
State and local income taxes, net of federal income tax effect82 2.9 %278 5.3 %11 0.7 %
Changes in valuation allowances(3)(0.1)%(184)(3.5)%68 4.2 %
Changes in prior year unrecognized tax benefits2 0.1 %15 0.3 %25 1.6 %
Income tax expense$433 15.5 %$1,184 22.6 %$306 18.9 %
Schedule of Components of Deferred Tax Assets and Liabilities, Including Any Valuation Allowance The following table presents those significant components of our deferred tax assets and liabilities, including any valuation allowance:
 December 31, 2025December 31, 2024
 AssetsLiabilitiesAssetsLiabilities
Depreciation and fixed-asset differences$3 $419 $— $373 
Reserves related to restructuring charges6 — 4 — 
Receivables (doubtful accounts and adjustments)222 1 245 — 
Accruals for retained insurance risks271 — 253 — 
Intangible assets— 512 — 504 
Other long-term liabilities34 — 34 — 
Benefit plans240 — 235 — 
Other accrued liabilities42 — 50 — 
Investments and other assets— 185 — 160 
Interest expense limitation84 — 57 — 
Net operating loss carryforwards126 — 122 — 
Stock-based compensation24 — 13 — 
Right-of-use lease assets and obligations123 109 123 107 
Other items55 — 19 — 
 1,230 1,226 1,155 1,144 
Valuation allowance(160)(158)— 
 $1,070 $1,226 $997 $1,144 
Schedule of Reconciliation of the Deferred Tax Assets and Liabilities and the Corresponding Amounts Reported in the Accompanying Consolidated Balance Sheets
The table below presents a reconciliation of the deferred tax assets and liabilities and the corresponding amounts reported in the accompanying Consolidated Balance Sheets:
 December 31,
 20252024
Deferred income tax assets$84 $80 
Deferred tax liabilities(240)(227)
Net deferred tax liability$(156)$(147)
Schedule of Income Taxes Paid
Income taxes paid during the years ended December 31, 2025, 2024 and 2023 consisted of the following:
 Years Ended December 31,
 202520242023
U.S Federal income taxes$324 $943 $194 
U.S. state and local income taxes:
California39 72 — (1)
South Carolina— (1)118 — (1)
Texas— (1)— (1)12 
Other87 138 37 
126 328 49 
Total income taxes paid$450 $1,271 $243 
(1)The amount of income taxes paid during the year does not meet the 5% disaggregation threshold.
Schedule of Changes in Unrecognized Tax Benefits that have Impacted Deferred Tax Assets and Liabilities The following table summarizes the total changes in unrecognized tax benefits during the years ended December 31, 2025, 2024 and 2023. The additions and reductions for tax positions include the impact of items for which the ultimate deductibility is highly certain, but for which there is uncertainty about the timing of such deductions. Such amounts include unrecognized tax benefits that have impacted deferred tax assets and liabilities at December 31, 2025, 2024 and 2023.
 Unrecognized
Tax Benefits
Balance at December 31, 2022$34 
Increases due to tax positions taken in prior periods31 
Reductions due to a lapse of statute of limitations(1)
Balance at December 31, 202364 
Increases due to tax positions taken in prior periods10 
Reductions due to settlements with taxing authorities(3)
Balance at December 31, 202471 
Increases due to tax positions taken in prior periods2 
Reductions due to settlements with taxing authorities(4)
Balance at December 31, 2025$69 
v3.25.4
EARNINGS PER COMMON SHARE (Tables)
 12 Months Ended
Dec. 31, 2025
Earnings Per Share [Abstract]  
Schedule of Reconciliation of Numerators and Denominators of our Basic and Diluted Earnings Per Common Share
The following table reconciles the numerators and denominators of our basic and diluted earnings per common share calculations. Net income available to our common shareholders is expressed in millions and weighted average shares are expressed in thousands.
 Net Income Available to Common Shareholders (Numerator)Wtd. Avg. Shares
(Denominator)		Per-Share
Amount
Year Ended December 31, 2025   
Net income available to Tenet Healthcare Corporation common shareholders for basic earnings per share$1,407 90,150 $15.61 
Effect of dilutive instruments— 683 (0.12)
Net income available to Tenet Healthcare Corporation common shareholders for diluted earnings per share$1,407 90,833 $15.49 
Year Ended December 31, 2024   
Net income available to Tenet Healthcare Corporation common shareholders for basic earnings per share$3,200 96,904 $33.02 
Effect of dilutive instruments1 977 (0.32)
Net income available to Tenet Healthcare Corporation common shareholders for diluted earnings per share$3,201 97,881 $32.70 
Year Ended December 31, 2023   
Net income available to Tenet Healthcare Corporation common shareholders for basic earnings per share$611 101,639 $6.01 
Effect of dilutive instruments(13)3,161 (0.30)
Net income available to Tenet Healthcare Corporation common shareholders for diluted earnings per share$598 104,800 $5.71 
v3.25.4
FAIR VALUE MEASUREMENTS (Tables)
 12 Months Ended
Dec. 31, 2025
Fair Value Disclosures [Abstract]  
Schedule of Assets and Liabilities Measured at Fair Value on a Non-Recurring Basis The following table presents information about assets measured at fair value on a non-recurring basis and indicates the fair value hierarchy of the valuation techniques we utilized to determine such fair values:
 TotalQuoted Prices
in Active
Markets for
Identical Assets
(Level 1)		Significant Other
Observable Inputs
(Level 2)		Significant
Unobservable
Inputs
(Level 3)
December 31, 2025
Long-lived assets held for sale$62 $— $62 $— 
December 31, 2024
Long-lived assets held for sale$21 $— $21 $— 
v3.25.4
ACQUISITIONS (Tables)
 12 Months Ended
Dec. 31, 2025
Business Combination, Asset Acquisition, Transaction between Entities under Common Control, and Joint Venture Formation [Abstract]  
Schedule of Preliminary Purchase Price Allocation
The table below presents the preliminary or final purchase price allocations for acquisitions made during the years ended December 31, 2025, 2024 and 2023.
Years Ended December 31,
 202520242023
Current assets$50 $47 $34 
Property and equipment54 62 28 
Other intangible assets18 162 5 
Goodwill544 951 644 
Long-term operating lease assets97 108 18 
Other long-term assets— 2 14 
Previously held investments in unconsolidated affiliates(93)(25)(99)
Current liabilities(36)(24)(33)
Current portion of long-term lease liabilities(6)(17)(3)
Long-term operating lease liabilities(92)(96)(10)
Other long-term liabilities(14)(55)(27)
Redeemable noncontrolling interests in equity of consolidated subsidiaries(157)(458)(229)
Noncontrolling interests(84)(69)(102)
Cash paid, net of cash acquired(301)(561)(224)
Gains (losses) on consolidations$(20)$27 $16 
v3.25.4
SEGMENT INFORMATION (Tables)
 12 Months Ended
Dec. 31, 2025
Segment Reporting [Abstract]  
Schedule of Reconciliation of Assets by Reportable Segment to Consolidated Assets
The following tables present amounts for each of our reportable segments and the reconciling items necessary to agree to amounts reported in the accompanying Consolidated Balance Sheets and Consolidated Statements of Operations, as applicable.
December 31,
 202520242023
Assets:  
Hospital Operations$16,586 $16,722 $17,268 
Ambulatory Care13,091 12,214 11,044 
Total 
$29,677 $28,936 $28,312 
Schedule of Reconciliation of Other Significant Reconciling Items From Segments to Consolidated
 Years Ended December 31,
 202520242023
Capital expenditures:   
Hospital Operations$886 $845 $671 
Ambulatory Care124 86 80 
Total 
$1,010 $931 $751 
Depreciation and amortization:   
Hospital Operations$711 $684 $750 
Ambulatory Care152 134 120 
Total 
$863 $818 $870 
Year Ended December 31, 2025
 Hospital OperationsAmbulatory CareTotal
Net operating revenues$16,138 $5,172 $21,310 
Equity in earnings of unconsolidated affiliates6 258 264 
Less:
Salaries, wages and benefits7,440 1,265 8,705 
Supplies2,405 1,375 3,780 
Other operating expenses, net3,759 764 4,523 
Adjusted EBITDA$2,540 $2,026 4,566 
Reconciliation of Adjusted EBITDA:
Depreciation and amortization(863)
Impairment and restructuring charges, and acquisition-related costs(130)
Litigation and investigation costs(64)
Interest expense(821)
Loss from early extinguishment of debt(4)
Other non-operating income, net117 
Net losses on sales, consolidation and deconsolidation of facilities(1)
Income before income taxes$2,800 
Year Ended December 31, 2024
 Hospital OperationsAmbulatory CareTotal
Net operating revenues$16,141 $4,534 $20,675 
Equity in earnings of unconsolidated affiliates10 250 260 
Less:
Salaries, wages and benefits7,664 1,137 8,801 
Supplies2,460 1,187 3,647 
Other operating expenses, net3,842 650 4,492 
Adjusted EBITDA$2,185 $1,810 3,995 
Reconciliation of Adjusted EBITDA:
Depreciation and amortization(818)
Impairment and restructuring charges, and acquisition-related costs(102)
Litigation and investigation costs(35)
Interest expense(826)
Loss from early extinguishment of debt(8)
Other non-operating income, net126 
Net gains on sales, consolidation and deconsolidation of facilities2,916 
Income before income taxes$5,248 
Year Ended December 31, 2023
 Hospital OperationsAmbulatory CareTotal
Net operating revenues$16,698 $3,866 $20,564 
Equity in earnings of unconsolidated affiliates10 218 228 
Less:
Salaries, wages and benefits8,182 964 9,146 
Supplies2,545 1,045 3,590 
Other operating expenses, net3,984 531 4,515 
Adjusted EBITDA$1,997 $1,544 3,541 
Reconciliation of Adjusted EBITDA:
Depreciation and amortization(870)
Impairment and restructuring charges, and acquisition-related costs(137)
Litigation and investigation costs(47)
Interest expense(901)
Loss from early extinguishment of debt(11)
Other non-operating income, net19 
Net gains on sales, consolidation and deconsolidation of facilities23 
Income before income taxes$1,617 
v3.25.4
SIGNIFICANT ACCOUNTING POLICIES - Description of Business (Details)
 12 Months Ended
Dec. 31, 2025
healthcare_facility
hospital
Hospital Operations  
Business Combination [Line Items]  
Number of acute care and specialty hospitals operated | hospital 50
Number of outpatient facilities operated | healthcare_facility 132
Ambulatory Care  
Business Combination [Line Items]  
Number of outpatient centers recorded using equity method | healthcare_facility 150
Ambulatory Care | United Surgical Partners International  
Business Combination [Line Items]  
Number of ambulatory surgery centers | hospital 533
Number of surgical hospitals operated by subsidiaries | hospital 26
Number of outpatient centers recorded using equity method | healthcare_facility 150
v3.25.4
SIGNIFICANT ACCOUNTING POLICIES - Net Operating Revenues (Details)
 12 Months Ended
Dec. 31, 2025
Accounting Policies [Abstract]  
Cost report filing period after end of annual cost reporting period 5 months
Percentage of contract assets that meet the conditions for unconditional right to payment percentage 91.00%
v3.25.4
SIGNIFICANT ACCOUNTING POLICIES - Cash and Cash Equivalents (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Cash and Cash Equivalents      
Cash and cash equivalents $ 2,883 $ 3,019  
Accrued property and equipment purchases for items received but not yet paid 111 127 $ 154
Accrued property and equipment purchases for items received but not yet paid, accounts payable 102 109 $ 141
Captive Insurance Subsidiaries      
Cash and Cash Equivalents      
Cash and cash equivalents 108 110  
Accounts Payable      
Cash and Cash Equivalents      
Book overdrafts classified as accounts payable $ 161 $ 143  
v3.25.4
SIGNIFICANT ACCOUNTING POLICIES - Investments in Unconsolidated Affiliates (Details)
$ in Millions
 12 Months Ended
Dec. 31, 2025
USD ($)
healthcare_facility
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Schedule of Equity Method Investments [Line Items]      
Percentage of investee results reflected on date of acquisition 1    
Current assets $ 7,849 $ 7,682  
Current liabilities (4,463) (4,310)  
Noncontrolling interests (1,797) (1,649)  
Net operating revenues 21,310 20,675 $ 20,564
Net income 2,367 4,064 1,311
Equity in earnings of unconsolidated affiliates 264 260 228
Texas Health Ventures Group, LLC      
Schedule of Equity Method Investments [Line Items]      
Equity in earnings of unconsolidated affiliates 141 130 104
Equity Method Investment, Nonconsolidated Investee or Group of Investees      
Schedule of Equity Method Investments [Line Items]      
Current assets 1,202 1,255 1,223
Noncurrent assets 1,347 1,358 1,355
Current liabilities (434) (435) (456)
Noncurrent liabilities (870) (928) (917)
Noncontrolling interests (728) (699) (670)
Net operating revenues 3,902 3,709 3,510
Net income 1,021 978 860
Net income attributable to the investees $ 551 483 484
Ambulatory Care      
Schedule of Equity Method Investments [Line Items]      
Number of outpatient centers recorded not using equity method | healthcare_facility 409    
Number of outpatient centers recorded using equity method | healthcare_facility 150    
Number of out patient centers, ownership interest | healthcare_facility 559    
Net operating revenues $ 5,172 4,534 3,865
Equity in earnings of unconsolidated affiliates $ 258 $ 250 $ 218
v3.25.4
SIGNIFICANT ACCOUNTING POLICIES - Property and Equipment (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Buildings and improvements | Minimum      
Property and equipment      
Useful life 15 years    
Buildings and improvements | Maximum      
Property and equipment      
Useful life 40 years    
Equipment | Minimum      
Property and equipment      
Useful life 3 years    
Equipment | Maximum      
Property and equipment      
Useful life 15 years    
Newly Constructed Hospitals      
Property and equipment      
Useful life 50 years    
Construction in progress      
Property and equipment      
Interest costs capitalized related to construction projects $ 9 $ 8 $ 9
v3.25.4
SIGNIFICANT ACCOUNTING POLICIES - Leases (Details)
Dec. 31, 2025
renewal_option
Property and equipment  
Number of renewal options 1
Minimum  
Property and equipment  
Operating lease, renewal term 5 years
Maximum  
Property and equipment  
Operating lease, renewal term 10 years
Real Estate | Minimum  
Property and equipment  
Operating lease, term of contract 5 years
Real Estate | Maximum  
Property and equipment  
Operating lease, term of contract 10 years
Equipment  
Property and equipment  
Operating lease, term of contract 3 years
Equipment | Minimum  
Property and equipment  
Useful life 3 years
Equipment | Maximum  
Property and equipment  
Useful life 15 years
Medical Equipment  
Property and equipment  
Operating lease, term of contract 3 years
Medical Equipment | Minimum  
Property and equipment  
Useful life 5 years
Medical Equipment | Maximum  
Property and equipment  
Useful life 7 years
v3.25.4
SIGNIFICANT ACCOUNTING POLICIES - Goodwill and Other Intangible Assets (Details) - Capitalized software costs
Dec. 31, 2025
Minimum  
Goodwill and Other Intangible Assets  
Estimated useful life 3 years
Maximum  
Goodwill and Other Intangible Assets  
Estimated useful life 15 years
v3.25.4
EQUITY - Noncontrolling Interests (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Noncontrolling Interest [Line Items]        
Total nonredeemable noncontrolling interests $ 6,017 $ 5,820 $ 3,117 $ 2,459
Total net income available to noncontrolling interests 1,833 3,591 945  
Noncontrolling Interests        
Noncontrolling Interest [Line Items]        
Total nonredeemable noncontrolling interests 1,797 1,649 1,509 $ 1,317
Total net income available to noncontrolling interests 426 391 334  
Noncontrolling Interests | Hospital Operations        
Noncontrolling Interest [Line Items]        
Total nonredeemable noncontrolling interests 211 205    
Total net income available to noncontrolling interests 45 50 30  
Noncontrolling Interests | Ambulatory Care        
Noncontrolling Interest [Line Items]        
Total nonredeemable noncontrolling interests 1,586 1,444    
Total net income available to noncontrolling interests $ 381 $ 341 $ 304  
v3.25.4
EQUITY - Narrative (Details) - USD ($)
$ in Millions
Jul. 31, 2025
Jul. 31, 2024
Oct. 31, 2022
2022 Share Repurchase Program      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Amount of common stock authorized to be repurchased     $ 1,000
2024 Share Repurchase Program      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Amount of common stock authorized to be repurchased   $ 1,500  
Amount of common stock authorized to be repurchased $ 1,500    
v3.25.4
EQUITY - Share Repurchase Programs (Details) - Share Repurchase Program - USD ($)
$ / shares in Units, shares in Thousands, $ in Millions
 1 Months Ended 12 Months Ended
Dec. 31, 2025
Nov. 30, 2025
Oct. 31, 2025
Sep. 30, 2025
Aug. 31, 2025
Jul. 31, 2025
Jun. 30, 2025
May 31, 2025
Apr. 30, 2025
Mar. 31, 2025
Feb. 28, 2025
Jan. 31, 2025
Dec. 31, 2024
Nov. 30, 2024
Oct. 31, 2024
Sep. 30, 2024
Aug. 31, 2024
Jul. 31, 2024
Jun. 30, 2024
May 31, 2024
Apr. 30, 2024
Mar. 31, 2024
Feb. 29, 2024
Jan. 31, 2024
Dec. 31, 2023
Nov. 30, 2023
Oct. 31, 2023
Sep. 30, 2023
Aug. 31, 2023
Jul. 31, 2023
Jun. 30, 2023
May 31, 2023
Apr. 30, 2023
Mar. 31, 2023
Feb. 28, 2023
Jan. 31, 2023
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Equity, Class of Treasury Stock [Line Items]                                                                              
Total Number of Shares Purchased (in shares) 0 474 469 0 0 598 2,145 2,456 0 829 1,800 0 0 0 0 795 0 0 1,990 0 0 2,811 0 0 644 982 0 0 0 0 0 580 0 906 0 0 8,771 5,596 3,112
Average Price Paid per Share (in dollars per shares) $ 0 $ 208.86 $ 210.92 $ 0 $ 0 $ 155.43 $ 167.83 $ 157.57 $ 0 $ 126.67 $ 134.98 $ 0 $ 0 $ 0 $ 0 $ 155.93 $ 0 $ 0 $ 135.85 $ 0 $ 0 $ 98.86 $ 0 $ 0 $ 68.53 $ 67.12 $ 0 $ 0 $ 0 $ 0 $ 0 $ 69.17 $ 0 $ 55.03 $ 0 $ 0 $ 158.00 $ 120.07 $ 64.27
Maximum Dollar Value of Shares That May Yet be Purchased Under the Program $ 1,490 $ 1,490 $ 1,589 $ 1,688 $ 1,688 $ 1,688 $ 281 $ 641 $ 1,028 $ 1,028 $ 1,133 $ 1,376 $ 1,376 $ 1,376 $ 1,376 $ 1,376 $ 1,500 $ 1,500 $ 2 $ 272 $ 272 $ 272 $ 550 $ 550 $ 550 $ 594 $ 660 $ 660 $ 660 $ 660 $ 660 $ 660 $ 700 $ 700 $ 750 $ 750 $ 1,490 $ 1,376 $ 550
v3.25.4
ACCOUNTS RECEIVABLE - Components of Accounts Receivable (Details) - USD ($)
$ in Millions
Dec. 31, 2025
Dec. 31, 2024
Accounts Receivable Additional Disclosures [Abstract]    
Patient accounts receivable $ 2,418 $ 2,386
Estimated future recoveries 148 144
Cost reports and settlements receivable (payable), net of valuation allowances (1) 6
Accounts receivable, net  $ 2,565 $ 2,536
v3.25.4
ACCOUNTS RECEIVABLE - Location of Assets and Liabilities (Details) - USD ($)
$ in Millions
Dec. 31, 2025
Dec. 31, 2024
Assets:    
Other current assets $ 2,565 $ 2,536
Investments and other assets 121 274
Liabilities:    
Other current liabilities 1,360 1,294
California's Provider Fee Program    
Assets:    
Other current assets 493 334
Investments and other assets 121 274
Liabilities:    
Other current liabilities 232 126
Other long-term liabilities $ 48 $ 102
v3.25.4
ACCOUNTS RECEIVABLE - Estimated Costs for Charity Care and Self-Pay Patients (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Accounts receivable and allowance for doubtful accounts      
Estimated costs of caring $ 573 $ 617 $ 609
Uninsured patients      
Accounts receivable and allowance for doubtful accounts      
Estimated costs of caring 439 535 499
Charity care patients      
Accounts receivable and allowance for doubtful accounts      
Estimated costs of caring $ 134 $ 82 $ 110
v3.25.4
CONTRACT BALANCES - Hospital Operations and Ambulatory Care Segments (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Contract Assets – Unbilled Revenue    
Balance at beginning of period $ 190  
Balance at end of period 188 $ 190
Hospital Operations    
Receivables    
Balance at beginning of period 28 21
Balance at end of period 26 28
Increase (decrease) (2) 7
Contract Assets – Unbilled Revenue    
Balance at beginning of period 190 208
Balance at end of period 188 190
Increase (decrease) (2) (18)
Contract Liabilities – Current Deferred Revenue    
Balance at beginning of period 80 59
Balance at end of period 88 80
Contract Liabilities – Long-Term Deferred Revenue    
Balance at beginning of period 13 12
Balance at end of period 13 13
Hospital Operations | Short-term Contract with Customer    
Contract Liabilities – Current Deferred Revenue    
Increase (decrease) 8 21
Contract Liabilities – Long-Term Deferred Revenue    
Increase (decrease) 8 21
Hospital Operations | Long-term Contract with Customer    
Contract Liabilities – Current Deferred Revenue    
Increase (decrease) 0 1
Contract Liabilities – Long-Term Deferred Revenue    
Increase (decrease) $ 0 $ 1
v3.25.4
CONTRACT BALANCES - Contract Costs (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Disaggregation of Revenue [Line Items]      
Amortized customer contract costs $ 6 $ 3 $ 5
Unamortized contract costs 13 19  
Hospital Operations      
Disaggregation of Revenue [Line Items]      
Contract liabilities advance payments $ 60 $ 58  
v3.25.4
DISPOSITION OF ASSETS AND LIABILITIES - Narrative (Details)
$ in Millions
 1 Months Ended 12 Months Ended
Sep. 30, 2024
hospital
Mar. 31, 2024
hospital
Jan. 31, 2024
hospital
Dec. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
hospital
Current Assets and Liabilities Held for Sale          
Asset held-for-sale       $ 62  
Disposal Group, Disposed of by Sale, Not Discontinued Operations | SC Hospitals          
Current Assets and Liabilities Held for Sale          
Number of hospitals for sale | hospital     3    
Gain on sale of properties         $ 1,677
Disposal Group, Disposed of by Sale, Not Discontinued Operations | AL Hospitals          
Current Assets and Liabilities Held for Sale          
Number of hospitals for sale | hospital 5        
Gain on sale of properties       $ 8 353
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Ambulatory Surgery Centers          
Current Assets and Liabilities Held for Sale          
Gain on sale of properties         $ 46
Number of ambulatory surgery centers for sale | hospital         6
Discontinued Operations, Held-for-sale | OCLA CA Hospitals          
Current Assets and Liabilities Held for Sale          
Number of hospitals for sale | hospital     4    
Gain on sale of properties         $ 527
Discontinued Operations, Held-for-sale | Central CA Hospitals          
Current Assets and Liabilities Held for Sale          
Number of hospitals for sale | hospital   2      
Gain on sale of properties         $ 275
v3.25.4
DISPOSITION OF ASSETS AND LIABILITIES - Significant Components (Details) - SC Hospitals - Disposal Group, Disposed of by Sale, Not Discontinued Operations - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]      
Accumulated other comprehensive loss $ 2 $ 1,687 $ 130
Gain on sale of properties   $ 1,677  
v3.25.4
IMPAIRMENT AND RESTRUCTURING CHARGES, AND ACQUISITION-RELATED COSTS (Details)
$ in Millions
 12 Months Ended
Dec. 31, 2025
USD ($)
segment
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Impaired Long-Lived Assets Held and Used [Line Items]      
Number of reportable segments | segment 2    
Impairment and restructuring charges, and acquisition-related costs $ 130 $ 102 $ 137
Restructuring charges 44 56 79
Acquisition costs 25 39 15
Impairment charges 61 7 43
Restructuring costs   7 6
Ambulatory Care      
Impaired Long-Lived Assets Held and Used [Line Items]      
Impairment charges 48 6  
Hospital Operations      
Impaired Long-Lived Assets Held and Used [Line Items]      
Impairment charges 13 1  
Contract Termination      
Impaired Long-Lived Assets Held and Used [Line Items]      
Restructuring charges 15 12 10
Global Business Center in Republic of Philippines      
Impaired Long-Lived Assets Held and Used [Line Items]      
Restructuring charges 13 9 12
Employee Severance      
Impaired Long-Lived Assets Held and Used [Line Items]      
Restructuring charges $ 8 11 15
Legal Costs Related to the Sale of Certain Facilities      
Impaired Long-Lived Assets Held and Used [Line Items]      
Restructuring charges   $ 17 $ 36
v3.25.4
LEASES - Balance Sheet Components (Details) - USD ($)
$ in Millions
Dec. 31, 2025
Dec. 31, 2024
Assets:    
Operating lease assets $ 1,134 $ 1,037
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List] Investments and other assets Investments and other assets
Finance lease assets $ 419 $ 454
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List] Property, Plant, and Equipment and Finance Lease Right-of-Use Asset, after Accumulated Depreciation and Amortization Property, Plant, and Equipment and Finance Lease Right-of-Use Asset, after Accumulated Depreciation and Amortization
Total leased assets $ 1,553 $ 1,491
Operating lease liabilities:    
Operating lease liabilities, current $ 214 $ 204
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List] Other current liabilities Other current liabilities
Operating lease liabilities, long-term $ 1,043 $ 950
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List] Other long-term liabilities Other long-term liabilities
Total operating lease liabilities $ 1,257 $ 1,154
Finance lease liabilities:    
Finance lease liabilities, current $ 45 $ 54
Finance Lease, Liability, Current, Statement of Financial Position [Extensible List] Current portion of long-term debt Current portion of long-term debt
Finance lease liabilities, long-term $ 407 $ 390
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List] Long-term debt, net of current portion Long-term debt, net of current portion
Total finance lease liabilities $ 452 $ 444
Total lease liabilities $ 1,709 $ 1,598
v3.25.4
LEASES - Lease Costs (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Leases [Abstract]      
Operating lease expense $ 267 $ 257 $ 259
Finance lease expense:      
Amortization of leased assets 51 49 55
Interest on lease liabilities 24 7 8
Total finance lease expense 75 56 63
Variable and short term-lease expense 143 160 159
Total lease expense $ 485 $ 473 $ 481
Weighted-average remaining lease term (years), operating leases 7 years 6 years 9 months 18 days 7 years 7 months 6 days
Weighted-average remaining lease term (years), finance leases 24 years 9 months 18 days 24 years 7 months 6 days 6 years
Weighted-average discount rate, operating leases (percentage) 5.20% 5.20% 5.00%
Weighted-average discount rate, finance leases (percentage) 6.40% 6.50% 6.50%
v3.25.4
LEASES - Supplemental Cash Flow Information (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Cash paid for amounts included in the measurement of lease liabilities:      
Operating cash outflows from operating leases $ 259 $ 252 $ 258
Operating cash outflows from finance leases 5 10 13
Financing cash outflows from finance leases 62 87 107
Right-of-use assets obtained in exchange for lease obligations:      
Operating leases 360 292 168
Finance leases $ 59 $ 363 $ 55
v3.25.4
LEASES - Lease Maturities (Details) - USD ($)
$ in Millions
Dec. 31, 2025
Dec. 31, 2024
Operating Leases    
2026 $ 271  
2027 247  
2028 214  
2029 177  
2030 139  
Later years 479  
Total lease payments 1,527  
Less: Imputed interest 270  
Total operating lease liabilities 1,257 $ 1,154
Less: Current obligations 214 204
Long-term lease obligations 1,043 950
Finance Leases    
2026 53  
2027 132  
2028 38  
2029 28  
2030 25  
Later years 522  
Total lease payments 798  
Less: Imputed interest 346  
Total finance lease liabilities 452 444
Less: Current obligations 45 54
Long-term lease obligations 407 390
Total    
2026 324  
2027 379  
2028 252  
2029 205  
2030 164  
Later years 1,001  
Total lease payments 2,325  
Less: Imputed interest 616  
Total lease liabilities 1,709 $ 1,598
Less: Current obligations 259  
Long-term lease obligations $ 1,450  
v3.25.4
LEASES - Narrative (Details)
$ in Millions
 1 Months Ended
Dec. 31, 2024
USD ($)
leasePayments
Dec. 31, 2025
USD ($)
May 31, 1997
Lessee, Lease, Description [Line Items]      
Finance lease assets $ 454 $ 419  
Total finance lease liabilities $ 444 $ 452  
California      
Lessee, Lease, Description [Line Items]      
Finance lease, term of contract 30 years   30 years
Initial payment $ 100    
Number of annual escalating lease payments | leasePayments 19    
Expected final payment $ 100    
Finance lease assets 303    
Total finance lease liabilities $ 303    
v3.25.4
LONG-TERM DEBT - Debt (Details) - USD ($)
$ in Millions
Dec. 31, 2025
Nov. 30, 2025
Dec. 31, 2024
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Finance leases, mortgages and other notes $ 603   $ 605
Unamortized issue costs and note discounts (94)   (94)
Total long-term debt 13,171   13,173
Less: Current portion 79   92
Long-term debt, net of current portion $ 13,092   13,081
Senior Notes | 6.125% due 2028      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Stated interest rate, percentage 6.125%    
Carrying amount $ 1,750 $ 2,500 2,500
Senior Notes | 6.875% due 2031      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Stated interest rate, percentage 6.875%    
Carrying amount $ 362   362
Senior Notes | 6.000% due 2033      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Stated interest rate, percentage 6.00%    
Carrying amount $ 750   0
Senior Notes | 5.125% due 2027      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Stated interest rate, percentage 5.125%    
Carrying amount $ 1,500   1,500
Senior Notes | 4.625% due 2028      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Stated interest rate, percentage 4.625%    
Carrying amount $ 600   600
Senior Notes | 4.250% due 2029      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Stated interest rate, percentage 4.25%    
Carrying amount $ 1,400   1,400
Senior Notes | 4.375% due 2030      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Stated interest rate, percentage 4.375%    
Carrying amount $ 1,450   1,450
Senior Notes | 6.125% due 2030      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Stated interest rate, percentage 6.125%    
Carrying amount $ 2,000   2,000
Senior Notes | 6.750% due 2031      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Stated interest rate, percentage 6.75%    
Carrying amount $ 1,350   1,350
Senior Notes | 5.500% due 2032      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Stated interest rate, percentage 5.50%    
Carrying amount $ 1,500   0
Senior Notes | 6.250% due 2027      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Stated interest rate, percentage 6.25%    
Carrying amount $ 0   $ 1,500
v3.25.4
LONG-TERM DEBT - Senior Secured Notes and Senior Unsecured Notes (Details) - USD ($)
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Nov. 30, 2025
Mar. 31, 2024
LONG-TERM DEBT AND LEASE OBLIGATIONS          
Loss from early extinguishment of debt $ 4,000,000 $ 8,000,000 $ 11,000,000    
Senior Notes          
LONG-TERM DEBT AND LEASE OBLIGATIONS          
Aggregate principal amount 12,662,000,000        
Loss from early extinguishment of debt $ 7,000,000 8,000,000      
Repurchase obligation due to change of control percentage of principal 101.00%        
Senior Notes | 5.500% due 2032          
LONG-TERM DEBT AND LEASE OBLIGATIONS          
Aggregate principal amount $ 1,500,000,000        
Stated interest rate, percentage 5.50%        
Carrying amount $ 1,500,000,000 0      
Senior Notes | 6.000% due 2033          
LONG-TERM DEBT AND LEASE OBLIGATIONS          
Aggregate principal amount $ 750,000,000        
Stated interest rate, percentage 6.00%        
Carrying amount $ 750,000,000 0      
Senior Notes | 6.250% due 2027          
LONG-TERM DEBT AND LEASE OBLIGATIONS          
Stated interest rate, percentage 6.25%        
Carrying amount $ 0 1,500,000,000      
Senior Notes | 6.125% due 2028          
LONG-TERM DEBT AND LEASE OBLIGATIONS          
Stated interest rate, percentage 6.125%        
Carrying amount $ 1,750,000,000 $ 2,500,000,000   $ 2,500,000,000  
Repurchased face amount $ 750,000,000        
Senior Notes | 4.875% due 2026          
LONG-TERM DEBT AND LEASE OBLIGATIONS          
Stated interest rate, percentage 4.875%        
Repurchased face amount         $ 2,100,000,000
Senior Notes | Minimum          
LONG-TERM DEBT AND LEASE OBLIGATIONS          
Stated interest rate, percentage 4.25%        
Senior Notes | Maximum          
LONG-TERM DEBT AND LEASE OBLIGATIONS          
Stated interest rate, percentage 6.875%        
v3.25.4
LONG-TERM DEBT - Credit Agreement and Letter of Credit Facility (Details) - Credit Agreement
 1 Months Ended 12 Months Ended
Nov. 30, 2025
USD ($)
day
Sep. 30, 2023
Dec. 31, 2025
USD ($)
Credit Agreement      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Expiration period 45 days    
Maximum principal amount of such series $ 2,500,000,000    
Minimum percentage of series of notes 80.00%    
Amount available for borrowing under revolving credit facility     $ 1,900,000,000
Carrying amount     0
Standby letters of credit outstanding     1,000,000
Revolving Credit Facility      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Revolving credit facility, maximum borrowing capacity (up to)     $ 1,500,000,000
Revolving Credit Facility | Secured Overnight Financing Rate (SOFR)      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Basis spread on credit spread     0.10%
Revolving Credit Facility | Minimum | Base rate      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Percentage margin on variable rate     0.25%
Revolving Credit Facility | Minimum | Secured Overnight Financing Rate (SOFR)      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Percentage margin on variable rate     1.25%
Revolving Credit Facility | Maximum | Base rate      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Percentage margin on variable rate     0.75%
Revolving Credit Facility | Maximum | Secured Overnight Financing Rate (SOFR)      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Percentage margin on variable rate     1.75%
Revolving Credit Facility | Credit Agreement      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Revolving credit facility, maximum borrowing capacity (up to) $ 1,900,000,000    
Unused commitment fee percentage 0.25%    
Revolving Credit Facility | Credit Agreement | Minimum      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Unused commitment fee percentage     0.25%
Revolving Credit Facility | Credit Agreement | Minimum | Base rate      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Percentage margin on variable rate 0.25%    
Revolving Credit Facility | Credit Agreement | Minimum | Secured Overnight Financing Rate (SOFR)      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Percentage margin on variable rate 1.25%    
Revolving Credit Facility | Credit Agreement | Maximum      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Unused commitment fee percentage     0.375%
Revolving Credit Facility | Credit Agreement | Maximum | Base rate      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Percentage margin on variable rate 0.50%    
Revolving Credit Facility | Credit Agreement | Maximum | Secured Overnight Financing Rate (SOFR)      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Percentage margin on variable rate 1.50%    
Letter of Credit Facility      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Revolving credit facility, maximum borrowing capacity (up to)     $ 200,000,000
Letter of Credit Facility | Credit Agreement      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Revolving credit facility, maximum borrowing capacity (up to) $ 200,000,000    
Letter of Credit Facility | Letter of Credit Facility      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Revolving credit facility, maximum borrowing capacity (up to)     200,000,000
Percentage margin on variable rate 0.25% 0.50%  
Standby letters of credit outstanding     $ 104,000,000
Interest rate on issued but undrawn letters of credit percentage 1.25% 1.50%  
Issuance fee, based on face amount percentage 0.125%    
Maximum secured debt covenant ratio 4.25    
Letter of Credit Facility | Letter of Credit Facility | Minimum      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Unused commitment fee percentage 0.25%    
Letter of Credit Facility | Letter of Credit Facility | Maximum      
LONG-TERM DEBT AND LEASE OBLIGATIONS      
Number of business days after notice for reimbursement of drawings | day 3    
v3.25.4
LONG-TERM DEBT - Covenants (Details)
 12 Months Ended
Dec. 31, 2025
USD ($)
Credit Agreement | Revolving Credit Facility  
Covenants  
Threshold limit of revolving credit facility $ 200,000,000
Threshold limit of unused borrowing availability under the revolving credit facility, number of consecutive days 3 days
Maximum | Senior Notes  
Covenants  
Secured debt ratio 4.00
Asset value as a percentage of consolidated net tangible assets for properties to be defined as principal property 15.00%
Minimum | Senior Notes  
Covenants  
Asset value as a percentage of consolidated net tangible assets for properties to be defined as principal property 5.00%
v3.25.4
LONG-TERM DEBT - Future Maturities (Details)
$ in Millions
Dec. 31, 2025
USD ($)
Long-term debt, including finance lease obligations  
Total $ 13,265
2026 79
2027 1,628
2028 2,402
2029 1,438
2030 3,465
Later Years $ 4,253
v3.25.4
GUARANTEES (Details)
$ in Millions
 12 Months Ended
Dec. 31, 2025
USD ($)
Income Guarantee  
GUARANTEES  
Guarantee obligation period 12 months
Commitment period 3 years
Guarantee of Business Revenue | Minimum  
GUARANTEES  
Guarantee obligation period 1 year
Guarantee of Business Revenue | Maximum  
GUARANTEES  
Guarantee obligation period 3 years
Income and Revenue Collection Guarantee  
GUARANTEES  
Maximum potential amount of future payments under guarantees $ 168
Income and Revenue Collection Guarantee | Other current liabilities  
GUARANTEES  
Liability for guarantees 138
Guaranteed Investees of Third Parties  
GUARANTEES  
Maximum potential amount of future payments under guarantees $ 51
v3.25.4
EMPLOYEE BENEFIT PLANS - Share-Based Compensation Plans (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Stock-based compensation costs, pretax $ 104 $ 67 $ 66
2019 Stock Incentive Plan      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Shares available for issuance under the plan (in shares) 8,264,000    
Stock Options      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Expiration period from the date of grant 10 years    
Vesting period 3 years    
Vesting percentage 33.33%    
Restricted Stock Units      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Contractual right to receive shares of common stock for a stock based award (in shares) 1    
Vesting period 3 years    
Vesting percentage 33.33%    
Performance Based Restricted Stock Unit | Minimum | Performance Based Vesting, Three Year Period, 0% to 250%      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Vesting percentage 0.00% 0.00%  
Performance Based Restricted Stock Unit | Minimum | Performance Based Vesting, Three Year Period, 0% to 225%      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Vesting percentage     0.00%
Performance Based Restricted Stock Unit | Maximum | Performance Based Vesting, Three Year Period, 0% to 250%      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Vesting percentage 250.00% 250.00%  
Performance Based Restricted Stock Unit | Maximum | Performance Based Vesting, Three Year Period, 0% to 225%      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Vesting percentage     225.00%
v3.25.4
EMPLOYEE BENEFIT PLANS - Stock Options (Details) - Stock Options - USD ($)
$ / shares in Units, $ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Number of Options      
Outstanding at the beginning of the period (in shares) 186,497 384,440 460,947
Exercised (in shares) (41,816) (197,943) (76,507)
Outstanding at the end of the period (in shares) 144,681 186,497 384,440
Wtd. Avg. Exercise Price Per Share      
Outstanding at the beginning of the period (in dollars per share) $ 23.76 $ 22.79 $ 23.33
Exercised (in dollars per share) 22.39 21.86 26.07
Outstanding at the end of the period (in dollars per share) $ 24.16 $ 23.76 $ 22.79
Aggregate Intrinsic Value      
Outstanding at the end of the period $ 25    
Wtd. Avg. Remaining Contractual Life      
Outstanding at the end of the period 2 years 6 months    
Aggregate intrinsic value of awards exercised $ 7 $ 19 $ 4
Granted (in shares) 0 0 0
v3.25.4
EMPLOYEE BENEFIT PLANS - Range of Exercise Prices (Details) - Stock Options
 12 Months Ended
Dec. 31, 2025
$ / shares
shares
Options Outstanding and Exercisable  
Number of options outstanding (in shares) | shares 144,681
Weighted average remaining contractual life 2 years 6 months
Weighted average exercise price (in dollars per share) $ 24.16
$18.99 to $20.609  
Options Outstanding and Exercisable  
Number of options outstanding (in shares) | shares 86,469
Weighted average remaining contractual life 2 years 2 months 12 days
Weighted average exercise price (in dollars per share) $ 20.60
$18.99 to $20.609 | Minimum  
Summary information about outstanding stock options  
Lower range of stock exercise price range (in dollars per share) 18.99
$18.99 to $20.609 | Maximum  
Summary information about outstanding stock options  
Upper range of stock exercise price range (in dollars per share) $ 20.609
$20.61 to $35.430  
Options Outstanding and Exercisable  
Number of options outstanding (in shares) | shares 58,212
Weighted average remaining contractual life 3 years 1 month 6 days
Weighted average exercise price (in dollars per share) $ 29.44
$20.61 to $35.430 | Minimum  
Summary information about outstanding stock options  
Lower range of stock exercise price range (in dollars per share) 20.61
$20.61 to $35.430 | Maximum  
Summary information about outstanding stock options  
Upper range of stock exercise price range (in dollars per share) $ 35.430
v3.25.4
EMPLOYEE BENEFIT PLANS - Employee Options (Details) - Stock Options
 12 Months Ended
Dec. 31, 2025
$ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]  
Share price (in dollars per share) $ 198.72
Current Employees  
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]  
Share based payment award options outstanding percentage 26.00%
Former Employees  
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]  
Share based payment award options outstanding percentage 74.00%
v3.25.4
EMPLOYEE BENEFIT PLANS - Restricted Stock Units (Details) - $ / shares
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Restricted Stock Units      
Number of RSUs      
Unvested at the beginning of the period (in shares) 1,481,999 1,421,063 1,520,418
Granted (in shares) 596,913 573,033 759,590
Vested (in shares) (872,894) (684,268) (954,401)
Forfeited (in shares) (21,025) (32,904) (90,445)
Unvested at the end of the period (in shares) 1,440,379 1,481,999 1,421,063
Wtd. Avg. Grant Date Fair Value Per RSU      
Unvested at the beginning of the period (in dollars per share) $ 83.84 $ 66.46 $ 66.36
Granted (in dollars per share) 138.06 94.70 60.88
Vested (in dollars per share) 81.41 65.64 48.75
Forfeited (in dollars per share) 105.02 80.91 64.61
Unvested at the end of the period (in dollars per share) $ 111.02 $ 83.84 $ 66.46
Performance Based Restricted Stock Unit      
Number of RSUs      
Granted (in shares) 255,386 205,075 185,901
Wtd. Avg. Grant Date Fair Value Per RSU      
Granted (in dollars per share) $ 80.85 $ 66.51 $ 48.97
v3.25.4
EMPLOYEE BENEFIT PLANS - Restricted Stock Units Narrative (Details) - shares
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Time-Based RSUs | Vest Over Period From One To Four Years      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Awards (in shares) 289,780    
Time-Based RSUs | Vest Over Period From One To Four Years | Minimum      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Vesting period 1 year    
Time-Based RSUs | Vest Over Period From One To Four Years | Maximum      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Vesting period 4 years    
Time-Based RSUs | Vest Over Period From One To Three Years      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Awards (in shares)   275,694  
Time-Based RSUs | Vest Over Period From One To Three Years | Minimum      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Vesting period   1 year  
Time-Based RSUs | Vest Over Period From One To Three Years | Maximum      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Vesting period   3 years  
Time-Based RSUs | Vest Over Period From One To Five Years      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Awards (in shares)     429,601
Time-Based RSUs | Vest Over Period From One To Five Years | Minimum      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Vesting period     1 year
Time-Based RSUs | Vest Over Period From One To Five Years | Maximum      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Vesting period     5 years
Time-Based RSUs | Relocation Based Vesting | Executive Officer      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Awards (in shares)     20,707
Performance Based Restricted Stock Unit      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Awards (in shares) 255,386 205,075 185,901
Performance Based Restricted Stock Unit | Performance Based Vesting, Three Year Period, 0% to 250%      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Awards (in shares) 307,133 297,339 309,282
Performance Based Restricted Stock Unit | Performance Based Vesting, Three Year Period, 0% to 250% | Minimum      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Vesting percentage 0.00% 0.00%  
Performance Based Restricted Stock Unit | Performance Based Vesting, Three Year Period, 0% to 250% | Maximum      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Vesting percentage 250.00% 250.00%  
Performance Based Restricted Stock Unit | Vest Immediately      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Awards (in shares) 255,386 205,075 185,901
Performance Based Restricted Stock Unit | Performance Based Vesting, Three Year Period, 0% to 225%      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Awards (in shares)     297,339
Performance Based Restricted Stock Unit | Performance Based Vesting, Three Year Period, 0% to 225% | Minimum      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Vesting percentage     0.00%
Performance Based Restricted Stock Unit | Performance Based Vesting, Three Year Period, 0% to 225% | Maximum      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Vesting percentage     225.00%
v3.25.4
EMPLOYEE BENEFIT PLANS - Valuation of Restricted Stock Units (Details) - Restricted Stock Units
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Expected volatility, minimum 36.60% 34.90% 53.60%
Expected volatility , maximum 48.00% 52.10% 65.60%
Risk-free interest rate, minimum 4.10% 4.40% 4.20%
Risk-free interest rate, maximum 4.30% 4.90% 4.80%
v3.25.4
EMPLOYEE BENEFIT PLANS - USPI Management Equity Plan (Details) - USD ($)
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Wtd. Avg. Grant Date Fair Value Per RSU      
Stock-based compensation costs, pretax $ 104,000,000 $ 67,000,000 $ 66,000,000
Restricted Stock Units      
Employee Stock Ownership Plan (ESOP) Disclosures [Line Items]      
Contractual right to receive shares of common stock for a stock based award (in shares) 1    
Number of RSUs      
Unvested at the beginning of the period (in shares) 1,481,999 1,421,063 1,520,418
Vested (in shares) (872,894) (684,268) (954,401)
Forfeited (in shares) (21,025) (32,904) (90,445)
Unvested at the end of the period (in shares) 1,440,379 1,481,999 1,421,063
Wtd. Avg. Grant Date Fair Value Per RSU      
Unvested at the beginning of the period (in dollars per share) $ 83.84 $ 66.46 $ 66.36
Vested (in dollars per share) 81.41 65.64 48.75
Forfeited (in dollars per share) 105.02 80.91 64.61
Unvested at the end of the period (in dollars per share) $ 111.02 $ 83.84 $ 66.46
USPI Management Equity Plan | Restricted Stock Units      
Employee Stock Ownership Plan (ESOP) Disclosures [Line Items]      
Contractual right to receive shares of common stock for a stock based award (in shares) 1    
Number of RSUs      
Unvested at the beginning of the period (in shares) 0 607,984 922,840
Vested (in shares)   (598,846) (303,171)
Forfeited (in shares)   (1,997) (11,685)
Cancelled (in shares)   (7,141)  
Unvested at the end of the period (in shares)   0 607,984
Wtd. Avg. Grant Date Fair Value Per RSU      
Unvested at the beginning of the period (in dollars per share) $ 34.13 $ 34.13 $ 34.13
Vested (in dollars per share)   34.13 34.13
Forfeited (in dollars per share)   34.13 34.13
Cancelled (in dollars per share)   34.13  
Unvested at the end of the period (in dollars per share)   $ 34.13 $ 34.13
Stock-based compensation costs, pretax $ 0 $ 6,000,000 $ 20,000,000
v3.25.4
EMPLOYEE BENEFIT PLANS - Employee Stock Purchase Plan (Details) - Employee Stock Purchase Plan - USD ($)
$ / shares in Units, shares in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Number of shares authorized to be issued under the plan (in shares) 4,070    
Shares available for issuance under the plan (in shares) 2,444    
Percentage of closing price at which shares are purchased by participant 95.00%    
Requisite holding period for shares issued under the plan 1 year    
Fair market value per employee per year $ 25,000    
Number of shares (in shares) 25 33 69
Weighted average price (in dollars per share) $ 160.90 $ 121.76 $ 65.62
Minimum      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Base earnings elected to be withheld each quarter by eligible employees to purchase shares of the entity's common stock 1.00%    
Maximum      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Base earnings elected to be withheld each quarter by eligible employees to purchase shares of the entity's common stock 10.00%    
v3.25.4
EMPLOYEE BENEFIT PLANS - Other Employee Benefit and Retirement Plans (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Share-Based Payment Arrangement [Abstract]      
Contribution expense $ 165 $ 128 $ 126
v3.25.4
EMPLOYEE BENEFIT PLANS - Employee Retirement Plans (Details)
 12 Months Ended
Dec. 31, 2025
USD ($)
plan
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Projected benefit obligations      
Beginning obligations $ (895,000,000) $ (951,000,000)  
Interest cost $ (49,000,000) $ (49,000,000) $ (53,000,000)
Defined Benefit Plan Net Periodic Benefit Cost Credit Interest Cost Statement Of Income Or Comprehensive Income Extensible List Not Disclosed Flag Interest costs Interest costs Interest costs
Actuarial gain (loss) $ (18,000,000) $ 22,000,000  
Benefits paid 82,000,000 83,000,000  
Annuity purchase 33,000,000 0  
Ending obligations (847,000,000) (895,000,000) $ (951,000,000)
Fair value of plans assets      
Beginning plan assets 573,000,000 592,000,000  
Gain (loss) on plan assets 35,000,000 (3,000,000)  
Employer contribution 61,000,000 42,000,000  
Benefits paid (58,000,000) (58,000,000)  
Annuity purchase (33,000,000) 0  
Ending plan assets 578,000,000 573,000,000 592,000,000
Funded status of plans (269,000,000) (322,000,000)  
Accumulated benefit obligation 847,000,000 895,000,000  
Amounts recognized in the Consolidated Balance Sheets consist of:      
Other current liability (24,000,000) (24,000,000)  
Other long-term liability (245,000,000) (298,000,000)  
Accumulated other comprehensive loss 228,000,000 225,000,000  
Components of net periodic benefit costs      
Interest costs $ 49,000,000 $ 49,000,000 $ 53,000,000
Defined Benefit Plan Net Periodic Benefit Cost Credit Interest Cost Statement Of Income Or Comprehensive Income Extensible List Not Disclosed Flag Interest costs Interest costs Interest costs
Expected return on plan assets $ (29,000,000) $ (29,000,000) $ (36,000,000)
Defined Benefit Plan Net Periodic Benefit Cost Credit Expected Return Loss Statement Of Income Or Comprehensive Income Extensible List Not Disclosed Flag Expected return on plan assets Expected return on plan assets Expected return on plan assets
Amortization of net actuarial loss $ 8,000,000 $ 8,000,000 $ 7,000,000
Special termination benefit costs 0 0 1,000,000
Net periodic benefit cost 28,000,000 28,000,000 25,000,000
Net Periodic Benefit Costs Assumptions:      
Loss adjustments recorded in other comprehensive income 3,000,000 1,000,000 2,000,000
Net actuarial losses 11,000,000 9,000,000 9,000,000
Amortization of net actuarial loss 8,000,000 8,000,000 7,000,000
Cumulative net actuarial losses 228,000,000 225,000,000 224,000,000
Unrecognized prior service costs $ 0 $ 0 $ 0
SERP      
Employee Retirement Plans      
Number of frozen plans | plan 3    
Accumulated Benefit Obligations Assumptions      
Discount rate 5.50% 5.75%  
Compensation increase rate 3.00% 3.00%  
Net Periodic Benefit Costs Assumptions:      
Discount rate 5.75% 5.50% 5.75%
Compensation increase rate 3.00% 3.00% 3.00%
Pension Plan      
Fair value of plans assets      
Beginning plan assets $ 573,000,000    
Ending plan assets $ 578,000,000 $ 573,000,000  
Accumulated Benefit Obligations Assumptions      
Discount rate 5.42% 5.69%  
Net Periodic Benefit Costs Assumptions:      
Discount rate 5.69% 5.25% 5.51%
Long-term rate of return on assets 5.25% 5.00% 5.75%
v3.25.4
EMPLOYEE BENEFIT PLANS - Asset Allocations (Details) - Pension Plan
Dec. 31, 2025
Cash and cash equivalents  
Weighted-average asset allocations by asset category  
Target 0.00%
Actual 11.00%
Equity securities  
Weighted-average asset allocations by asset category  
Target 11.00%
Actual 8.00%
Debt securities  
Weighted-average asset allocations by asset category  
Target 70.00%
Actual 62.00%
Alternative investments  
Weighted-average asset allocations by asset category  
Target 19.00%
Actual 19.00%
v3.25.4
EMPLOYEE BENEFIT PLANS - Fair Value of Assets and Future Benefit Payments (Details) - USD ($)
$ in Millions
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Employee Retirement Plans      
Fair value of DMC Pension Plan assets $ 578 $ 573 $ 592
SERP and DMC Pension Plan      
Total 732    
2026 81    
2027 80    
2028 79    
2029 77    
2030 75    
Five Years Thereafter 340    
Amounts recognized in the Consolidated Balance Sheets consist of:      
Benefit plan obligations (269) (322)  
Other current liability 24 24  
Defined benefit plan obligations 245 298  
Expected contribution to the plan for 2026 24    
Pension Plan      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 578 573  
Pension Plan | Cash and cash equivalents      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 64 22  
Pension Plan | Equity securities      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 49 66  
Pension Plan | Fixed income funds      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 356 376  
Pension Plan | Private equity securities      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 99 106  
Pension Plan | Hedge funds      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 10 3  
Pension Plan | Level 1      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 469 464  
Pension Plan | Level 1 | Cash and cash equivalents      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 64 22  
Pension Plan | Level 1 | Equity securities      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 49 66  
Pension Plan | Level 1 | Fixed income funds      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 356 376  
Pension Plan | Level 1 | Private equity securities      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 0 0  
Pension Plan | Level 1 | Hedge funds      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 0 0  
Pension Plan | Level 2      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 0 0  
Pension Plan | Level 2 | Cash and cash equivalents      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 0 0  
Pension Plan | Level 2 | Equity securities      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 0 0  
Pension Plan | Level 2 | Fixed income funds      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 0 0  
Pension Plan | Level 2 | Private equity securities      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 0 0  
Pension Plan | Level 2 | Hedge funds      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 0 0  
Pension Plan | Level 3      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 109 109  
Pension Plan | Level 3 | Cash and cash equivalents      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 0 0  
Pension Plan | Level 3 | Equity securities      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 0 0  
Pension Plan | Level 3 | Fixed income funds      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 0 0  
Pension Plan | Level 3 | Private equity securities      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets 99 106  
Pension Plan | Level 3 | Hedge funds      
Employee Retirement Plans      
Fair value of DMC Pension Plan assets $ 10 $ 3  
v3.25.4
PROPERTY AND EQUIPMENT (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Components of property and equipment      
Finance lease assets $ 540 $ 552  
Total property, plant and equipment, gross 12,995 11,858  
Accumulated depreciation and amortization (6,680) (5,809)  
Net property and equipment 6,315 6,049  
Depreciation 697 646 $ 696
Land      
Components of property and equipment      
Property plant and equipment gross 534 539  
Buildings and improvements      
Components of property and equipment      
Property plant and equipment gross 6,672 6,130  
Construction in progress      
Components of property and equipment      
Property plant and equipment gross 211 238  
Equipment      
Components of property and equipment      
Property plant and equipment gross $ 5,038 $ 4,399  
v3.25.4
GOODWILL AND OTHER INTANGIBLE ASSETS - Goodwill (Details) - USD ($)
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Changes in the carrying amount of goodwill    
Goodwill at beginning of period, net of accumulated impairment losses $ 10,691,000,000  
Goodwill at end of period, net of accumulated impairment losses 11,198,000,000 $ 10,691,000,000
Hospital Operations    
Changes in the carrying amount of goodwill    
Goodwill at beginning of period, net of accumulated impairment losses 2,697,000,000 3,119,000,000
Goodwill acquired during the year, including purchase price allocation adjustments 0 42,000,000
Goodwill related to assets held for sale and disposed or deconsolidated facilities 0 (464,000,000)
Goodwill at end of period, net of accumulated impairment losses 2,697,000,000 2,697,000,000
Accumulated impairment losses 2,430,000,000 2,430,000,000
Ambulatory Care    
Changes in the carrying amount of goodwill    
Goodwill at beginning of period, net of accumulated impairment losses 7,994,000,000 7,188,000,000
Goodwill acquired during the year, including purchase price allocation adjustments 507,000,000 927,000,000
Goodwill related to assets held for sale and disposed or deconsolidated facilities 0 (121,000,000)
Goodwill at end of period, net of accumulated impairment losses 8,501,000,000 7,994,000,000
Accumulated impairment losses $ 0 $ 0
v3.25.4
GOODWILL AND OTHER INTANGIBLE ASSETS - Other Intangible Assets (Details) - USD ($)
$ in Millions
Dec. 31, 2025
Dec. 31, 2024
Finite-Lived Intangible Assets, Net [Abstract]    
Gross Carrying Amount $ 1,794 $ 1,806
Accumulated Amortization (1,328) (1,288)
Net Book Value 466 518
Other intangible assets with indefinite lives 882 879
Gross Carrying Amount 2,676 2,685
Net Book Value 1,348 1,397
Trade names    
Finite-Lived Intangible Assets, Net [Abstract]    
Other intangible assets with indefinite lives 105 105
Contracts    
Finite-Lived Intangible Assets, Net [Abstract]    
Other intangible assets with indefinite lives 773 769
Other    
Finite-Lived Intangible Assets, Net [Abstract]    
Other intangible assets with indefinite lives 4 5
Capitalized software costs    
Finite-Lived Intangible Assets, Net [Abstract]    
Gross Carrying Amount 1,511 1,469
Accumulated Amortization (1,166) (1,075)
Net Book Value 345 394
Contracts    
Finite-Lived Intangible Assets, Net [Abstract]    
Gross Carrying Amount 241 241
Accumulated Amortization (148) (135)
Net Book Value 93 106
Other    
Finite-Lived Intangible Assets, Net [Abstract]    
Gross Carrying Amount 42 96
Accumulated Amortization (14) (78)
Net Book Value $ 28 $ 18
v3.25.4
GOODWILL AND OTHER INTANGIBLE ASSETS - Amortization (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Estimated future amortization of intangibles with finite useful lives      
Net Book Value $ 466 $ 518  
2026 106    
2027 114    
2028 82    
2029 58    
2030 43    
Later Years 63    
Amortization expense $ 166 $ 172 $ 174
v3.25.4
OTHER ASSETS - Components of Other Current Assets (Details) - USD ($)
$ in Millions
Dec. 31, 2025
Dec. 31, 2024
Accounts receivable and allowance for doubtful accounts    
Prepaid expenses $ 423 $ 368
Contract assets 188 190
California provider fee program receivables 2,565 2,536
Receivables from other government programs 385 326
Guarantees 138 194
Non-patient receivables 224 229
Other 140 119
Total other current assets 1,991 1,760
California's Provider Fee Program    
Accounts receivable and allowance for doubtful accounts    
California provider fee program receivables $ 493 $ 334
v3.25.4
OTHER ASSETS - Investments and Other Assets (Details) - USD ($)
$ in Millions
Dec. 31, 2025
Dec. 31, 2024
Investments and other assets    
Marketable securities $ 59 $ 50
Equity investments in unconsolidated healthcare entities 1,383 1,482
Total investments 1,442 1,532
Cash surrender value of life insurance policies 54 48
Long-term deposits 50 51
California provider fee program receivables 121 274
Operating lease assets 1,134 1,037
Other long-term receivables and other assets 82 95
Total investments and other assets $ 2,883 $ 3,037
v3.25.4
ACCUMULATED OTHER COMPREHENSIVE LOSS - Accumulated Other Comprehensive Loss by Component (Details) - USD ($)
$ in Millions
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Accumulated Other Comprehensive Income (Loss) [Line Items]        
Accumulated other comprehensive loss $ 6,017 $ 5,820 $ 3,117 $ 2,459
Adjustments for defined benefit plans        
Accumulated Other Comprehensive Income (Loss) [Line Items]        
Accumulated other comprehensive loss (183) (181)    
Unrealized gains on investments        
Accumulated Other Comprehensive Income (Loss) [Line Items]        
Accumulated other comprehensive loss 1 0    
Foreign currency translation adjustments and other        
Accumulated Other Comprehensive Income (Loss) [Line Items]        
Accumulated other comprehensive loss 1 1    
Accumulated other comprehensive loss        
Accumulated Other Comprehensive Income (Loss) [Line Items]        
Accumulated other comprehensive loss $ (181) $ (180)    
v3.25.4
ACCUMULATED OTHER COMPREHENSIVE LOSS - Income Tax Benefit (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]      
Adjustments for defined benefit plans $ (1) $ 0  
Net income tax benefit related to items of other comprehensive income (loss) $ (1) $ 0 $ 0
v3.25.4
NET OPERATING REVENUES - Net Operating Revenue By Source (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Disaggregation of Revenue [Line Items]      
Net operating revenues  $ 21,310 $ 20,675 $ 20,564
Ambulatory Care      
Disaggregation of Revenue [Line Items]      
Net operating revenues  5,172 4,534 3,865
Operating Segments      
Disaggregation of Revenue [Line Items]      
Net operating revenues  21,310 20,675 20,564
Operating Segments | Hospital Operations      
Disaggregation of Revenue [Line Items]      
Net operating revenues  16,138 16,141 16,698
Operating Segments | Hospital Operations | Other Revenues      
Disaggregation of Revenue [Line Items]      
Net operating revenues  2,196 2,175 2,148
Operating Segments | Ambulatory Care      
Disaggregation of Revenue [Line Items]      
Net operating revenues  5,172 4,534 3,866
Acute Care Hospitals And Related Outpatient Facilities | Operating Segments | Hospital Operations | Total      
Disaggregation of Revenue [Line Items]      
Net operating revenues  13,942 13,966 14,550
Acute Care Hospitals And Related Outpatient Facilities | Operating Segments | Hospital Operations | Medicare      
Disaggregation of Revenue [Line Items]      
Net operating revenues  2,119 2,132 2,383
Acute Care Hospitals And Related Outpatient Facilities | Operating Segments | Hospital Operations | Medicaid      
Disaggregation of Revenue [Line Items]      
Net operating revenues  1,524 1,439 1,233
Acute Care Hospitals And Related Outpatient Facilities | Operating Segments | Hospital Operations | Managed care      
Disaggregation of Revenue [Line Items]      
Net operating revenues  9,696 9,809 10,248
Acute Care Hospitals And Related Outpatient Facilities | Operating Segments | Hospital Operations | Uninsured      
Disaggregation of Revenue [Line Items]      
Net operating revenues  52 64 96
Acute Care Hospitals And Related Outpatient Facilities | Operating Segments | Hospital Operations | Indemnity and other      
Disaggregation of Revenue [Line Items]      
Net operating revenues  $ 551 $ 522 $ 590
v3.25.4
NET OPERATING REVENUES - Narrative (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Disaggregation of Revenue [Line Items]      
Net operating revenues  $ 21,310 $ 20,675 $ 20,564
Revision of Prior Period, Adjustment      
Disaggregation of Revenue [Line Items]      
Net operating revenues  $ 23 $ (4) $ 24
v3.25.4
NET OPERATING REVENUES - Net Operating Revenue Composition, Ambulatory Segment (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Disaggregation of Revenue [Line Items]      
Net operating revenues  $ 21,310 $ 20,675 $ 20,564
Ambulatory Care      
Disaggregation of Revenue [Line Items]      
Net operating revenues  5,172 4,534 3,865
Net patient service revenues | Ambulatory Care      
Disaggregation of Revenue [Line Items]      
Net operating revenues  4,956 4,356 3,713
Revenue from other sources | Ambulatory Care      
Disaggregation of Revenue [Line Items]      
Net operating revenues  $ 216 $ 178 $ 152
v3.25.4
NET OPERATING REVENUES - Performance Obligation (Details) - Hospital Operations
$ in Millions
Dec. 31, 2025
USD ($)
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]  
Revenue, remaining performance obligation, amount $ 5,126
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2026-01-01  
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]  
Revenue, remaining performance obligation, amount $ 748
Revenue, remaining performance obligation, expected timing of satisfaction, period 1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2027-01-01  
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]  
Revenue, remaining performance obligation, amount $ 747
Revenue, remaining performance obligation, expected timing of satisfaction, period 1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2028-01-01  
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]  
Revenue, remaining performance obligation, amount $ 747
Revenue, remaining performance obligation, expected timing of satisfaction, period 1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2029-01-01  
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]  
Revenue, remaining performance obligation, amount $ 747
Revenue, remaining performance obligation, expected timing of satisfaction, period 1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2030-01-01  
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]  
Revenue, remaining performance obligation, amount $ 747
Revenue, remaining performance obligation, expected timing of satisfaction, period 1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2031-01-01  
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]  
Revenue, remaining performance obligation, amount $ 1,390
Revenue, remaining performance obligation, expected timing of satisfaction, period
v3.25.4
INSURANCE - Property Insurance (Details) - USD ($)
$ in Millions
 12 Months Ended 24 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Mar. 31, 2026
Insurance coverage        
Insurance recoveries   $ 3 $ 41  
Net operating revenues  $ 21,310 20,675 20,564  
Insurance Recoveries        
Insurance coverage        
Net operating revenues    $ 0 $ 34  
Forecast        
Insurance coverage        
Insurance, per occurrence limit       $ 850
Forecast | Floods        
Insurance coverage        
Insurance, annual limit       100
Forecast | Earthquakes | California        
Insurance coverage        
Insurance, annual limit       200
Forecast | Earthquakes | Other Geographic Areas        
Insurance coverage        
Insurance, annual limit       200
Forecast | Windstorms        
Insurance coverage        
Insurance, annual limit       200
Forecast | Fires and Other Perils        
Insurance coverage        
Insurance, annual limit       $ 850
Forecast | California Earthquakes And Named Windstorms        
Insurance coverage        
Insurance deductible as a percent       5.00%
Forecast | New Madrid Fault Earthquakes        
Insurance coverage        
Insurance deductible as a percent       2.00%
Insurance, maximum deductible per incident       $ 25
Forecast | Fires and Certain Other Covered Losses        
Insurance coverage        
Insurance, deductible       $ 5
v3.25.4
INSURANCE - Professional and General Liability Reserves (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Insurance coverage      
Malpractice expense, portion related to adverse developments in prior years $ 27 $ 24 $ 116
Other Operating Expense, Net      
Insurance coverage      
Malpractice expense 341 309 $ 369
Professional and General Liability Reserves      
Insurance coverage      
Self insurance reserve $ 1,227 $ 1,138  
v3.25.4
CLAIMS AND LAWSUITS (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Loss Contingency Accrual [Roll Forward]      
Litigation and Investigation Costs $ 64 $ 35 $ 47
Claims, Lawsuits, and Regulatory Proceedings      
Loss Contingency Accrual [Roll Forward]      
Balances at Beginning of Period 20 40 51
Litigation and Investigation Costs 64 35 47
Cash Payments (49) (56) (59)
Other 3 1 1
Balances at End of Period $ 38 $ 20 $ 40
v3.25.4
REDEEMABLE NONCONTROLLING INTERESTS IN EQUITY OF CONSOLIDATED SUBSIDIARIES - Changes in Redeemable Noncontrolling Interests (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Increase (Decrease) in Temporary Equity [Roll Forward]      
Balances at beginning of period  $ 2,727    
Net income 534 $ 473 $ 366
Distributions paid to noncontrolling interests (372) (312) (289)
Balances at end of period  2,956 2,727  
Redeemable Noncontrolling Interests      
Increase (Decrease) in Temporary Equity [Roll Forward]      
Balances at beginning of period  2,727 2,391  
Net income 534 473  
Distributions paid to noncontrolling interests (437) (369)  
Accretion of redeemable noncontrolling interests 0 5  
Purchases and sales of businesses and noncontrolling interests, net 132 227  
Balances at end of period  $ 2,956 $ 2,727 $ 2,391
v3.25.4
REDEEMABLE NONCONTROLLING INTERESTS IN EQUITY OF CONSOLIDATED SUBSIDIARIES - Narrative (Details) - USD ($)
$ in Millions
 1 Months Ended 12 Months Ended
Jun. 30, 2022
Dec. 31, 2024
Dec. 31, 2025
Interests acquired and other disclosures      
Other current liabilities   $ 1,607 $ 1,809
United Surgical Partners International      
Interests acquired and other disclosures      
Other current liabilities   68  
Baylor University Medical Center | United Surgical Partners International      
Interests acquired and other disclosures      
Share purchase agreement amount of payment $ 406    
Baylor University Medical Center | United Surgical Partners International | Put Option      
Interests acquired and other disclosures      
Joint venture ownership percentage 5.00%    
AL Hospitals      
Interests acquired and other disclosures      
Decrease to redeemable noncontrolling interest from sale   $ 175  
v3.25.4
REDEEMABLE NONCONTROLLING INTERESTS IN EQUITY OF CONSOLIDATED SUBSIDIARIES - Segment Details (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Increase (Decrease) in Temporary Equity [Roll Forward]      
Redeemable noncontrolling interests $ 2,956 $ 2,727  
Net income available to redeemable noncontrolling interests 534 473 $ 366
Hospital Operations      
Increase (Decrease) in Temporary Equity [Roll Forward]      
Redeemable noncontrolling interests 905 800  
Net income available to redeemable noncontrolling interests 110 100 84
Ambulatory Care      
Increase (Decrease) in Temporary Equity [Roll Forward]      
Redeemable noncontrolling interests 2,051 1,927  
Net income available to redeemable noncontrolling interests $ 424 $ 373 $ 282
v3.25.4
INCOME TAXES - Income Before Income Taxes (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Income Tax Disclosure [Abstract]      
Domestic $ 2,805 $ 5,251 $ 1,620
Foreign (5) (3) (3)
Income before income taxes $ 2,800 $ 5,248 $ 1,617
v3.25.4
INCOME TAXES - Provision and Income Taxes (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Current tax expense:      
Federal $ 305 $ 926 $ 208
State 119 361 46
Total 424 1,287 254
Deferred tax expense (benefit):      
Federal 18 (92) 55
State (9) (11) (3)
Total 9 (103) 52
Total tax expense $ 433 $ 1,184 $ 306
v3.25.4
INCOME TAXES - Federal Tax Reconciliation (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Amount      
Tax expense at statutory federal rate $ 588 $ 1,102 $ 340
Tax benefit attributable to noncontrolling interests (202) (181) (147)
Nondeductible goodwill 0 161 0
Other (2) 7 7
Stock-based compensation tax benefit (11) (9) (2)
Other (21) (5) 4
State and local income taxes, net of federal income tax effect 82 278 11
Changes in valuation allowances (3) (184) 68
Changes in prior year unrecognized tax benefits 2 15 25
Total tax expense $ 433 $ 1,184 $ 306
Percent      
Tax expense at statutory federal rate 21.00% 21.00% 21.00%
Tax benefit attributable to noncontrolling interests (7.20%) (3.40%) (9.10%)
Nondeductible goodwill 0.00% 3.10% 0.00%
Other (0.10%) 0.10% 0.40%
Stock-based compensation tax benefit (0.40%) (0.20%) (0.10%)
Other (0.70%) (0.10%) 0.20%
State and local income taxes, net of federal income tax effect 2.90% 5.30% 0.70%
Changes in valuation allowances (0.10%) (3.50%) 4.20%
Changes in prior year unrecognized tax benefits 0.10% 0.30% 1.60%
Income tax expense 15.50% 22.60% 18.90%
v3.25.4
INCOME TAXES - Components of Deferred Tax Assets and Liabilities (Details) - USD ($)
$ in Millions
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Assets      
Depreciation and fixed-asset differences $ 3    
Reserves related to restructuring charges 6 $ 4  
Receivables (doubtful accounts and adjustments) 222 245  
Accruals for retained insurance risks 271 253  
Other long-term liabilities 34 34  
Benefit plans 240 235  
Other accrued liabilities 42 50  
Interest expense limitation 84 57  
Net operating loss carryforwards 126 122  
Stock-based compensation 24 13  
Right-of-use lease assets and obligations 123 123  
Other items 55 19  
Deferred tax assets, gross 1,230 1,155  
Valuation allowance (160) (158) $ (248)
Deferred tax assets, net 1,070 997  
Liabilities      
Depreciation and fixed-asset differences 419 373  
Receivables (doubtful accounts and adjustments) 1    
Intangible assets 512 504  
Investments and other assets 185 160  
Right-of-use lease assets and obligations 109 107  
Deferred tax liabilities, gross, total 1,226 1,144  
Deferred tax liabilities, total 1,226 1,144  
Reconciliation of the deferred tax assets and liabilities      
Deferred income tax assets 84 80  
Deferred tax liabilities (240) (227)  
Net deferred tax liability $ (156) $ (147)  
v3.25.4
INCOME TAXES - Narrative (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Operating loss carryforwards        
Increase (decrease) in valuation allowance against deferred tax assets $ 2 $ (90) $ 71  
Increase (decrease) in valuation allowance due to changes in expected realizability of deferred tax assets (9) (2) 2  
Valuation allowance 160 158 248  
Increase (decrease) in valuation allowance due to limitations on deductions of interest expense   (180) 73  
Unrecognized tax benefits 69 71 64 $ 34
Unrecognized tax benefits, period increase (decrease) (1) 9 24  
Unrecognized tax benefits which, if recognized, would impact effective tax rate   69 $ 63  
Taxes payable 4      
Total accrued interest and penalties on unrecognized tax benefits 10      
Deferred tax benefit, net of valuation allowance and federal tax impact, associated with NOL carryforwards 126 122    
Federal        
Operating loss carryforwards        
Net operating loss carryforwards 291      
Operating loss carryforwards, subject to expiration 140      
Operating loss carryforwards, not subject to expiration 151      
Deferred tax benefit, net of valuation allowance and federal tax impact, associated with NOL carryforwards not subject to expiration 2      
Capital loss carryforward 100      
Deferred tax benefit, net of valuation allowance and federal tax impact, associated with NOL carryforwards 23      
State        
Operating loss carryforwards        
Net operating loss carryforwards 2,937      
Deferred tax benefit, net of valuation allowance and federal tax impact, associated with NOL carryforwards 23      
Interest Expense Carryforward Utilization        
Operating loss carryforwards        
Increase (decrease) in valuation allowance against deferred tax assets $ 11      
Acquisition        
Operating loss carryforwards        
Increase (decrease) in valuation allowance against deferred tax assets   $ 92    
v3.25.4
INCOME TAXES - Income Taxes Paid (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Income Tax Paid, by Individual Jurisdiction [Line Items]      
U.S Federal income taxes $ 324 $ 943 $ 194
U.S. state and local income taxes:      
U.S. state and local income taxes 126 328 49
Total income taxes paid 450 1,271 243
California      
U.S. state and local income taxes:      
U.S. state and local income taxes 39 72 0
South Carolina      
U.S. state and local income taxes:      
U.S. state and local income taxes 0 118 0
Texas      
U.S. state and local income taxes:      
U.S. state and local income taxes 0 0 12
Other      
U.S. state and local income taxes:      
U.S. state and local income taxes $ 87 $ 138 $ 37
v3.25.4
INCOME TAXES - Valuation Allowances and Unrecognized Tax Benefits (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Changes in unrecognized tax benefits      
Beginning balance $ 71 $ 64 $ 34
Increases due to tax positions taken in prior periods 2 10 31
Reductions due to a lapse of statute of limitations     (1)
Reductions due to settlements with taxing authorities (4) (3)  
Ending balance $ 69 $ 71 $ 64
v3.25.4
EARNINGS PER COMMON SHARE (Details) - USD ($)
$ / shares in Units, shares in Thousands, $ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Net Income Available to Common Shareholders (Numerator)      
Net income available to Tenet Healthcare Corporation common shareholders for basic earnings per share $ 1,407 $ 3,200 $ 611
Effect of dilutive instruments 0 1 (13)
Net income available to Tenet Healthcare Corporation common shareholders for diluted earnings per share $ 1,407 $ 3,201 $ 598
Wtd. Avg. Shares (Denominator)      
Net income available to Tenet Healthcare Corporation common shareholders for basic earnings per share (in shares) 90,150 96,904 101,639
Effect of dilutive instruments (in shares) 683 977 3,161
Net income available to Tenet Healthcare Corporation common shareholders for diluted earnings per share (in shares) 90,833 97,881 104,800
Per-Share Amount      
Net income available to Tenet Healthcare Corporation common shareholders for basic earnings per share (in dollars per share) $ 15.61 $ 33.02 $ 6.01
Effect of dilutive instruments (in dollars per share) (0.12) (0.32) (0.30)
Net income available to Tenet Healthcare Corporation common shareholders for diluted earnings per share (in dollars per share) $ 15.49 $ 32.70 $ 5.71
v3.25.4
FAIR VALUE MEASUREMENTS (Details) - USD ($)
$ in Millions
Dec. 31, 2025
Dec. 31, 2024
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Long-lived assets held for sale $ 62 $ 21
Quoted Prices in Active Markets for Identical Assets (Level 1)    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Long-lived assets held for sale 0 0
Significant Other Observable Inputs (Level 2)    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Long-lived assets held for sale $ 62 $ 21
Estimated fair value of the long-term debt instrument as a percentage of carrying value 100.90% 97.80%
Significant Unobservable Inputs (Level 3)    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Long-lived assets held for sale $ 0 $ 0
v3.25.4
ACQUISITIONS - Narrative (Details)
$ in Millions
 1 Months Ended 12 Months Ended
Dec. 31, 2023
USD ($)
healthcare_facility
Dec. 31, 2025
USD ($)
surgery_center
Dec. 31, 2024
USD ($)
care_center
surgery_center
Dec. 31, 2023
USD ($)
surgery_center
Business Combination [Line Items]        
Cash paid, net of cash acquired   $ 308 $ 571 $ 224
Consideration adjustment   7    
Goodwill   11,198 10,691  
Decrease in goodwill   (37)    
Ambulatory Care        
Business Combination [Line Items]        
Goodwill $ 7,188 8,501 7,994 7,188
Series of Individual Business Acquisitions        
Business Combination [Line Items]        
Cash paid to acquire businesses   308    
Cash paid, net of cash acquired   301 561 224
Goodwill 644 544 951 644
Acquisition-related transaction costs   25 39 15
Gains (losses) on consolidations   $ (20) $ 27 $ 16
2025 Acquisition | Ambulatory Care        
Business Combination [Line Items]        
Number of surgical centers acquired | surgery_center   27    
Number of ambulatory surgery centers noncontrolling interests | surgery_center   9    
2024 Acquisition | Ambulatory Care        
Business Combination [Line Items]        
Number of surgical centers acquired | surgery_center     52  
Number of ambulatory surgery centers noncontrolling interests | surgery_center     7  
Number of urgent care centers recorded using equity method | care_center     15  
Consideration conveyed in the acquisition     $ 571  
NextCare Arizona I JC, LLC        
Business Combination [Line Items]        
Cash paid to acquire businesses $ 75      
Business acquisition, percentage of voting interests acquired 55.00%     55.00%
Number of operational urgent care centers acquired | healthcare_facility 41      
Business combination, contingent consideration, liability $ 10     $ 10
Goodwill $ 133     $ 133
2023 Acquisition | Ambulatory Care        
Business Combination [Line Items]        
Number of surgical centers acquired | surgery_center       20
Number of ambulatory surgery centers noncontrolling interests | surgery_center       11
Consideration conveyed in the acquisition       $ 149
v3.25.4
ACQUISITIONS - Purchase Price Allocation (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Final purchase price allocations      
Goodwill $ 11,198 $ 10,691  
Cash paid, net of cash acquired $ (308) (571) $ (224)
Business Combination Achieved In Stages Preacquisition Equity Interest In Acquiree Remeasurement Gain (Loss) Statement Of Income Or Comprehensive Income Extensible Enumeration Not Disclosed Flag Gains (losses) on consolidations    
Series of Individual Business Acquisitions      
Final purchase price allocations      
Current assets $ 50 47 34
Property and equipment 54 62 28
Other intangible assets 18 162 5
Goodwill 544 951 644
Long-term operating lease assets 97 108 18
Other long-term assets 0 2 14
Previously held investments in unconsolidated affiliates (93) (25) (99)
Current liabilities (36) (24) (33)
Current portion of long-term lease liabilities (6) (17) (3)
Long-term operating lease liabilities (92) (96) (10)
Other long-term liabilities (14) (55) (27)
Redeemable noncontrolling interests in equity of consolidated subsidiaries (157) (458) (229)
Noncontrolling interests (84) (69) (102)
Cash paid, net of cash acquired (301) (561) (224)
Gains (losses) on consolidations $ (20) $ 27 $ 16
v3.25.4
SEGMENT INFORMATION - Narrative (Details)
 12 Months Ended
Dec. 31, 2025
state
healthcare_facility
hospital
surgery_center
Dec. 31, 2024
Dec. 31, 2023
Concentration Risk [Line Items]      
Revenue generated by general hospitals 76.00% 78.00% 81.00%
Hospital Operations      
Concentration Risk [Line Items]      
Number of hospitals owned by subsidiaries 50    
Number of states in which entity operates | state 8    
Number of outpatient facilities operated | healthcare_facility 132    
Ambulatory Care | United Surgical Partners International      
Concentration Risk [Line Items]      
Number of states in which entity operates | state 37    
Number of ambulatory surgery centers 533    
Number of ambulatory surgery centers consolidated | surgery_center 401    
Number of surgical hospitals operated by subsidiaries 26    
Number of surgical hospitals consolidated 8    
v3.25.4
SEGMENT INFORMATION - Reconciling Items (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Segment Reporting Information [Line Items]      
Assets $ 29,677 $ 28,936 $ 28,312
Capital expenditures 1,010 931 751
Depreciation and amortization 863 818 870
Net operating revenues  21,310 20,675 20,564
Equity in earnings of unconsolidated affiliates 264 260 228
Salaries, wages and benefits 8,705 8,801 9,146
Supplies 3,780 3,647 3,590
Other operating expenses, net 4,523 4,492 4,515
Adjusted EBITDA 4,566 3,995 3,541
Reconciliation of Adjusted EBITDA:      
Depreciation and amortization (863) (818) (870)
Impairment and restructuring charges, and acquisition-related costs (130) (102) (137)
Litigation and investigation costs (64) (35) (47)
Interest expense (821) (826) (901)
Loss from early extinguishment of debt (4) (8) (11)
Other non-operating income, net 117 126 19
Net gains (losses) on sales, consolidation and deconsolidation of facilities (1) 2,916 23
Income before income taxes 2,800 5,248 1,617
Operating segments      
Segment Reporting Information [Line Items]      
Net operating revenues  21,310 20,675 20,564
Hospital Operations      
Segment Reporting Information [Line Items]      
Assets 16,586 16,722 17,268
Capital expenditures 886 845 671
Depreciation and amortization 711 684 750
Equity in earnings of unconsolidated affiliates 6 10 10
Salaries, wages and benefits 7,440 7,664 8,182
Supplies 2,405 2,460 2,545
Other operating expenses, net 3,759 3,842 3,984
Adjusted EBITDA 2,540 2,185 1,997
Reconciliation of Adjusted EBITDA:      
Depreciation and amortization (711) (684) (750)
Hospital Operations | Operating segments      
Segment Reporting Information [Line Items]      
Net operating revenues  16,138 16,141 16,698
Ambulatory Care      
Segment Reporting Information [Line Items]      
Assets 13,091 12,214 11,044
Capital expenditures 124 86 80
Depreciation and amortization 152 134 120
Net operating revenues  5,172 4,534 3,865
Equity in earnings of unconsolidated affiliates 258 250 218
Salaries, wages and benefits 1,265 1,137 964
Supplies 1,375 1,187 1,045
Other operating expenses, net 764 650 531
Adjusted EBITDA 2,026 1,810 1,544
Reconciliation of Adjusted EBITDA:      
Depreciation and amortization (152) (134) (120)
Ambulatory Care | Operating segments      
Segment Reporting Information [Line Items]      
Net operating revenues  $ 5,172 $ 4,534 $ 3,866
v3.25.4
SUBSEQUENT EVENT (Details) - Conifer Health Solutions, LLC - USD ($)
$ in Millions
Jan. 27, 2026
Dec. 31, 2025
Catholic Health Initiatives | Subsequent Event    
Subsequent events    
Revenue cycle management services agreement amount to be received $ 1,900  
Revenue cycle management services agreement period for early termination payments 3 years  
Revenue cycle management services agreement termination amount $ 540  
Payments for redemption $ 540  
CommonSpirit    
Subsequent events    
Ownership percentage of subsidiary   23.80%
v3.25.4
SCHEDULE II-VALUATION AND QUALIFYING ACCOUNTS (Details) - Valuation Allowance for Deferred Tax Assets - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Movement in valuation and qualifying accounts      
Balance at Beginning of Period $ 158 $ 248 $ 177
Costs and Expenses 11 (182) 71
Deductions 0 0 0
Other Items (9) 92 0
Balance at End of Period $ 160 $ 158 $ 248