falsedesktopTHC2020-09-30000007031820000043{"tbl_sim": "https://q10k.com/tbl-sim", "search": "https://q10k.com/search"}{"q10k_tbl_0": "\t\tPage\nPART I. FINANCIAL INFORMATION\t\t\nItem 1.\tFinancial Statements (Unaudited)\t\n\tCondensed Consolidated Financial Statements\t1\n\tNotes to Condensed Consolidated Financial Statements\t5\nItem 2.\tManagement's Discussion and Analysis of Financial Condition and Results of Operations\t31\nItem 3.\tQuantitative and Qualitative Disclosures About Market Risk\t66\nItem 4.\tControls and Procedures\t66\nPART II. OTHER INFORMATION\t\t\nItem 1.\tLegal Proceedings\t67\nItem 1A.\tRisk Factors\t67\nItem 6.\tExhibits\t69\n", "q10k_tbl_1": "\tSeptember 30\tDecember 31\n\t2020\t2019\nASSETS\t\t\nCurrent assets:\t\t\nCash and cash equivalents\t3300\t262\nAccounts receivable\t2479\t2743\nInventories of supplies at cost\t349\t310\nIncome tax receivable\t2\t10\nAssets held for sale\t386\t387\nOther current assets\t1292\t1369\nTotal current assets\t7808\t5081\nInvestments and other assets\t2445\t2369\nDeferred income taxes\t436\t183\nProperty and equipment at cost less accumulated depreciation and amortization ($5906 at September 30 2020 and $5498 at December 31 2019)\t6618\t6878\nGoodwill\t7302\t7252\nOther intangible assets at cost less accumulated amortization ($1207 at September 30 2020 and $1092 at December 31 2019)\t1578\t1602\nTotal assets\t26187\t23365\nLIABILITIES AND EQUITY\t\t\nCurrent liabilities:\t\t\nCurrent portion of long-term debt\t155\t171\nAccounts payable\t1025\t1204\nAccrued compensation and benefits\t834\t877\nProfessional and general liability reserves\t285\t330\nAccrued interest payable\t218\t245\nLiabilities held for sale\t91\t44\nContract liabilities\t1500\t61\nOther current liabilities\t1735\t1273\nTotal current liabilities\t5843\t4205\nLong-term debt net of current portion\t15561\t14580\nProfessional and general liability reserves\t666\t635\nDefined benefit plan obligations\t525\t560\nDeferred income taxes\t27\t27\nOther long-term liabilities\t1564\t1415\nTotal liabilities\t24186\t21422\nCommitments and contingencies\t\t\nRedeemable noncontrolling interests in equity of consolidated subsidiaries\t1479\t1506\nEquity:\t\t\nShareholders' equity:\t\t\nCommon stock $0.05 par value; authorized 262500000 shares; 153745411 shares issued at September 30 2020 and 152540815 shares issued at December 31 2019\t7\t7\nAdditional paid-in capital\t4826\t4760\nAccumulated other comprehensive loss\t(251)\t(257)\nAccumulated deficit\t(2542)\t(2513)\nCommon stock in treasury at cost 48337999 shares at September 30 2020 and 48344195 shares at December 31 2019\t(2414)\t(2414)\nTotal shareholders' deficit\t(374)\t(417)\nNoncontrolling interests\t896\t854\nTotal equity\t522\t437\nTotal liabilities and equity\t26187\t23365\n", "q10k_tbl_2": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nNet operating revenues\t4557\t4568\t12725\t13673\nGrant income\t(66)\t0\t445\t0\nEquity in earnings of unconsolidated affiliates\t44\t38\t103\t114\nOperating expenses:\t\t\t\t\nSalaries wages and benefits\t2142\t2172\t6193\t6468\nSupplies\t784\t760\t2158\t2254\nOther operating expenses net\t1058\t1036\t3054\t3136\nDepreciation and amortization\t215\t205\t624\t627\nImpairment and restructuring charges and acquisition-related costs\t57\t46\t166\t101\nLitigation and investigation costs\t9\t84\t13\t115\nNet losses (gains) on sales consolidation and deconsolidation of facilities\t(1)\t1\t(4)\t3\nOperating income\t271\t302\t1069\t1083\nInterest expense\t(263)\t(244)\t(761)\t(742)\nOther non-operating income (expense) net\t0\t(3)\t3\t(3)\nLoss from early extinguishment of debt\t(312)\t(180)\t(316)\t(227)\nIncome (loss) from continuing operations before income taxes\t(304)\t(125)\t(5)\t111\nIncome tax benefit (expense)\t197\t(22)\t227\t(75)\nIncome (loss) from continuing operations before discontinued operations\t(107)\t(147)\t222\t36\nDiscontinued operations:\t\t\t\t\nIncome from operations\t1\t1\t0\t13\nIncome tax expense\t0\t0\t0\t(2)\nIncome from discontinued operations\t1\t1\t0\t11\nNet income (loss)\t(106)\t(146)\t222\t47\nLess: Net income available to noncontrolling interests\t90\t80\t237\t259\nNet loss attributable to Tenet Healthcare Corporation common shareholders\t(196)\t(226)\t(15)\t(212)\nAmounts available (attributable) to Tenet Healthcare Corporation common shareholders\t\t\t\t\nLoss from continuing operations net of tax\t(197)\t(227)\t(15)\t(223)\nIncome from discontinued operations net of tax\t1\t1\t0\t11\nNet loss attributable to Tenet Healthcare Corporation common shareholders\t(196)\t(226)\t(15)\t(212)\nEarnings (loss) per share available (attributable) to Tenet Healthcare Corporation common shareholders:\t\t\t\t\nBasic\t\t\t\t\nContinuing operations\t(1.87)\t(2.19)\t(0.14)\t(2.16)\nDiscontinued operations\t0.01\t0.01\t0\t0.11\n\t(1.86)\t(2.18)\t(0.14)\t(2.05)\nDiluted\t\t\t\t\nContinuing operations\t(1.87)\t(2.19)\t(0.14)\t(2.16)\nDiscontinued operations\t0.01\t0.01\t0\t0.11\n\t(1.86)\t(2.18)\t(0.14)\t(2.05)\nWeighted average shares and dilutive securities outstanding (in thousands):\t\t\t\t\nBasic\t105263\t103558\t104803\t103181\nDiluted\t105263\t103558\t104803\t103181\n", "q10k_tbl_3": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nNet income (loss)\t(106)\t(146)\t222\t47\nOther comprehensive income:\t\t\t\t\nAmortization of net actuarial loss included in other non-operating expense net\t2\t3\t6\t9\nUnrealized gains on debt securities held as available-for-sale\t0\t0\t1\t0\nOther comprehensive income before income taxes\t2\t3\t7\t9\nIncome tax benefit (expense) related to items of other comprehensive income\t2\t0\t(1)\t(2)\nTotal other comprehensive income net of tax\t4\t3\t6\t7\nComprehensive net income (loss)\t(102)\t(143)\t228\t54\nLess: Comprehensive income attributable to noncontrolling interests\t90\t80\t237\t259\nComprehensive loss attributable to Tenet Healthcare Corporation common shareholders\t(192)\t(223)\t(9)\t(205)\n", "q10k_tbl_4": "\tNine Months Ended September 30\t\n\t2020\t2019\nNet income\t222\t47\nAdjustments to reconcile net income to net cash provided by operating activities:\t\t\nDepreciation and amortization\t624\t627\nDeferred income tax (benefit) expense\t(246)\t65\nStock-based compensation expense\t38\t34\nImpairment and restructuring charges and acquisition-related costs\t166\t101\nLitigation and investigation costs\t13\t115\nNet losses (gains) on sales consolidation and deconsolidation of facilities\t(4)\t3\nLoss from early extinguishment of debt\t316\t227\nEquity in earnings of unconsolidated affiliates net of distributions received\t(11)\t(6)\nAmortization of debt discount and debt issuance costs\t30\t25\nPre-tax income from discontinued operations\t0\t(13)\nOther items net\t(4)\t(14)\nChanges in cash from operating assets and liabilities:\t\t\nAccounts receivable\t280\t(174)\nInventories and other current assets\t30\t(98)\nIncome taxes\t9\t(4)\nAccounts payable accrued expenses and other current liabilities\t1546\t(67)\nOther long-term liabilities\t205\t(15)\nPayments for restructuring charges acquisition-related costs and litigation costs and settlements\t(252)\t(136)\nNet cash used in operating activities from discontinued operations excluding income taxes\t(1)\t(4)\nNet cash provided by operating activities\t2961\t713\nCash flows from investing activities:\t\t\nPurchases of property and equipment - continuing operations\t(374)\t(492)\nPurchases of businesses or joint venture interests net of cash acquired\t(61)\t(23)\nProceeds from sales of facilities and other assets - continuing operations\t13\t44\nProceeds from sales of facilities and other assets - discontinued operations\t0\t17\nProceeds from sales of marketable securities long-term investments and other assets\t44\t52\nPurchases of marketable securities and equity investments\t(41)\t(25)\nOther long-term assets\t(4)\t1\nOther items net\t17\t0\nNet cash used in investing activities\t(406)\t(426)\nCash flows from financing activities:\t\t\nRepayments of borrowings under credit facility\t(740)\t(1880)\nProceeds from borrowings under credit facility\t740\t2155\nRepayments of other borrowings\t(3244)\t(6084)\nProceeds from other borrowings\t3815\t5718\nDebt issuance costs\t(48)\t(63)\nDistributions paid to noncontrolling interests\t(184)\t(223)\nProceeds from sale of noncontrolling interests\t7\t15\nPurchases of noncontrolling interests\t(34)\t(8)\nProceeds from exercise of stock options and employee stock purchase plan\t13\t4\nOther items net\t158\t(18)\nNet cash provided by (used in) financing activities\t483\t(384)\nNet increase (decrease) in cash and cash equivalents\t3038\t(97)\nCash and cash equivalents at beginning of period\t262\t411\nCash and cash equivalents at end of period\t3300\t314\nSupplemental disclosures:\t\t\nInterest paid net of capitalized interest\t(757)\t(705)\nIncome tax payments net\t(10)\t(18)\n", "q10k_tbl_5": "\tAs Reported\tEffect of Change in Accounting Principle\tAs Adjusted\nAt December 31 2019:\t\t\t\nDeferred income taxes\t169\t14\t183\nProfessional and general liability reserves\t585\t50\t635\nOther long-term liabilities\t1405\t10\t1415\nAccumulated deficit\t(2467)\t(46)\t(2513)\n", "q10k_tbl_6": "\tThree Months Ended September 30 2020\t\t\tNine Months Ended September 30 2020\t\t\n\tPrior to Change in Accounting Principle\tEffect of Change in Accounting Principle\tAs Reported\tPrior to Change in Accounting Principle\tEffect of Change in Accounting Principle\tAs Reported\nSalaries wages and benefits\t2142\t0\t2142\t6200\t(7)\t6193\nOther operating expenses net\t1058\t0\t1058\t3088\t(34)\t3054\nOperating income\t271\t0\t271\t1028\t41\t1069\nIncome tax benefit\t197\t0\t197\t237\t(10)\t227\nNet income (loss)\t(106)\t0\t(106)\t191\t31\t222\nNet loss from continuing operations attributable to Tenet Healthcare Corporation common shareholders\t(197)\t0\t(197)\t(46)\t31\t(15)\nLoss per share attributable to Tenet Healthcare Corporation common shareholders from continuing operations:\t\t\t\t\t\t\nBasic\t(1.87)\t0\t(1.87)\t(0.44)\t0.30\t(0.14)\nDiluted\t(1.87)\t0\t(1.87)\t(0.44)\t0.30\t(0.14)\n", "q10k_tbl_7": "\tThree Months Ended September 30 2019\t\t\tNine Months Ended September 30 2019\t\t\n\tAs Reported\tEffect of Change in Accounting Principle\tAs Adjusted\tAs Reported\tEffect of Change in Accounting Principle\tAs Adjusted\nSalaries wages and benefits\t2174\t(2)\t2172\t6475\t(7)\t6468\nOther operating expenses net\t1042\t(6)\t1036\t3159\t(23)\t3136\nOperating income\t294\t8\t302\t1053\t30\t1083\nIncome tax expense\t(20)\t(2)\t(22)\t(67)\t(8)\t(75)\nNet income (loss)\t(152)\t6\t(146)\t25\t22\t47\nNet loss from continuing operations attributable to Tenet Healthcare Corporation common shareholders\t(233)\t6\t(227)\t(245)\t22\t(223)\nLoss per share attributable to Tenet Healthcare Corporation common shareholders from continuing operations:\t\t\t\t\t\t\nBasic\t(2.25)\t0.06\t(2.19)\t(2.37)\t0.21\t(2.16)\nDiluted\t(2.25)\t0.06\t(2.19)\t(2.37)\t0.21\t(2.16)\n", "q10k_tbl_8": "\tPrior to Change in Accounting Principle\tEffect of Change in Accounting Principle\tAs Reported\nNine Months Ended September 30 2020:\t\t\t\nNet income\t191\t31\t222\nDeferred income tax benefit\t(256)\t10\t(246)\nAccounts payable accrued expenses and other current liabilities\t1587\t(41)\t1546\nNet cash provided by operating activities\t2961\t0\t2961\n", "q10k_tbl_9": "\tAs Reported\tEffect of Change in Accounting Principle\tAs Adjusted\nNine Months Ended September 30 2019:\t\t\t\nNet income\t25\t22\t47\nDeferred income tax expense\t57\t8\t65\nAccounts payable accrued expenses and other current liabilities\t(37)\t(30)\t(67)\nNet cash provided by operating activities\t713\t0\t713\n", "q10k_tbl_10": "\tGross Carrying Amount\tAccumulated Amortization\tNet Book Value\nAt September 30 2020:\t\t\t\nCapitalized software costs\t1696\t(1012)\t684\nTrade names\t102\t0\t102\nContracts\t879\t(107)\t772\nOther\t108\t(88)\t20\nTotal\t2785\t(1207)\t1578\n", "q10k_tbl_11": "\tGross Carrying Amount\tAccumulated Amortization\tNet Book Value\nAt December 31 2019:\t\t\t\nCapitalized software costs\t1616\t(912)\t704\nTrade names\t102\t0\t102\nContracts\t869\t(94)\t775\nOther\t107\t(86)\t21\nTotal\t2694\t(1092)\t1602\n", "q10k_tbl_12": "\t\tThree Months Ending\tYears Ending\t\t\t\tLater Years\n\t\tDecember 31\t\t\t\t\n\tTotal\t2020\t2021\t2022\t2023\t2024\nAmortization of intangible assets\t890\t48\t134\t118\t106\t90\t394\n", "q10k_tbl_13": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nNet operating revenues\t697\t622\t1731\t1809\nNet income\t167\t156\t414\t447\nNet income available to the investees\t101\t97\t253\t290\n", "q10k_tbl_14": "\tSeptember 30 2020\tDecember 31 2019\nContinuing operations:\t\t\nPatient accounts receivable\t2278\t2567\nEstimated future recoveries\t158\t162\nNet cost reports and settlements receivable and valuation allowances\t42\t12\n\t2478\t2741\nDiscontinued operations\t1\t2\nAccounts receivable net\t2479\t2743\n", "q10k_tbl_15": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nEstimated costs for:\t\t\t\t\nUninsured patients\t165\t171\t466\t493\nCharity care patients\t30\t41\t113\t116\nTotal\t195\t212\t579\t609\n", "q10k_tbl_16": "\t\tContract Liability -\n\t\tCurrent\n\tContract Assets\tAdvances from Medicare\nDecember 31 2019\t170\t0\nSeptember 30 2020\t171\t1270\nIncrease\t1\t1270\n", "q10k_tbl_17": "\tContract Liability -\n\tCurrent\n\tAdvances from Medicare\nDecember 31 2019\t0\nSeptember 30 2020\t172\nIncrease\t172\nDecember 31 2018\t0\nSeptember 30 2019\t0\nIncrease\t0\n", "q10k_tbl_18": "\t\t\tContract Liability -\tContract Liability -\n\t\tContract Asset -\tCurrent\tLong-Term\n\tReceivables\tUnbilled Revenue\tDeferred Revenue\tDeferred Revenue\nDecember 31 2019\t26\t11\t61\t18\nSeptember 30 2020\t29\t13\t58\t17\nIncrease/(decrease)\t3\t2\t(3)\t(1)\nDecember 31 2018\t42\t11\t61\t20\nSeptember 30 2019\t86\t11\t72\t19\nIncrease/(decrease)\t44\t0\t11\t(1)\n", "q10k_tbl_19": "Accounts receivable\t85\nOther current assets\t24\nInvestments and other long-term assets\t7\nProperty and equipment\t206\nOther intangible assets\t22\nGoodwill\t42\nContract liabilities\t(49)\nOther current liabilities\t(34)\nLong-term liabilities\t(8)\nNet assets held for sale\t295\n", "q10k_tbl_20": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nSignificant disposals:\t\t\t\t\nIncome (loss) from continuing operations before income taxes\t\t\t\t\nChicago area (includes a $5 million loss and a $6 million loss on sale in the 2020 and 2019 periods respectively)\t2\t0\t0\t(11)\nTotal\t2\t0\t0\t(11)\nSignificant planned divestitures classified as held for sale:\t\t\t\t\nIncome (loss) from continuing operations before income taxes\t\t\t\t\nMemphis area\t(5)\t4\t23\t9\nTotal\t(5)\t4\t23\t9\n", "q10k_tbl_21": "\tSeptember 30 2020\tDecember 31 2019\nSenior unsecured notes:\t\t\n8.125% due 2022\t0\t2800\n6.750% due 2023\t1872\t1872\n7.000% due 2025\t478\t478\n6.125% due 2028\t2500\t0\n6.875% due 2031\t362\t362\nSenior secured first lien notes:\t\t\n4.625% due 2024\t1870\t1870\n4.625% due 2024\t600\t600\n7.500% due 2025\t700\t0\n4.875% due 2026\t2100\t2100\n5.125% due 2027\t1500\t1500\n4.625% due 2028\t600\t0\nSenior secured second lien notes:\t\t\n5.125% due 2025\t1410\t1410\n6.250% due 2027\t1500\t1500\nFinance leases and mortgage notes\t408\t445\nUnamortized issue costs and note discounts\t(184)\t(186)\nTotal long-term debt\t15716\t14751\nLess current portion\t155\t171\nLong-term debt net of current portion\t15561\t14580\n", "q10k_tbl_22": "\tOptions\tWeighted Average Exercise Price Per Share\tAggregate Intrinsic Value\tWeighted Average Remaining Life\n\t\t\t(In Millions)\t\nOutstanding at December 31 2019\t1960992\t20.24\t\t\nExercised\t(472304)\t19.02\t\t\nForfeited/Expired\t(11326)\t20.60\t\t\nOutstanding at September 30 2020\t1477362\t20.63\t7\t5.4 years\nVested and expected to vest at September 30 2020\t1477362\t20.63\t7\t5.4 years\nExercisable at September 30 2020\t797819\t17.98\t5\t3.9 years\n", "q10k_tbl_23": "\tOptions Outstanding\t\t\tOptions Exercisable\t\nRange of Exercise Prices\tNumber of Options\tWeighted Average Remaining Contractual Life\tWeighted Average Exercise Price\tNumber of Options\tWeighted Average Exercise Price\n16.43 to $19.759\t756152\t4.0 years\t17.61\t756152\t17.61\n19.76 to $35.430\t721210\t6.8 years\t23.80\t41667\t24.83\n\t1477362\t5.4 years\t20.63\t797819\t17.98\n", "q10k_tbl_24": "\tRestricted Stock Units\tWeighted Average Grant Date Fair Value Per Unit\nUnvested at December 31 2019\t1463499\t25.08\nGranted\t1720004\t27.61\nVested\t(713627)\t25.57\nForfeited\t(263077)\t32.96\nUnvested at September 30 2020\t2206799\t25.80\n", "q10k_tbl_25": "\tCommon Stock\t\tAdditional Paid-In Capital\tAccumulated Other Comprehensive Loss\tAccumulated Deficit\tTreasury Stock\tNoncontrolling Interests\tTotal Equity\n\tShares Outstanding\tIssued Par Amount\t\t\t\nBalances at December 31 2019\t104197\t7\t4760\t(257)\t(2513)\t(2414)\t854\t437\nNet income\t0\t0\t0\t0\t93\t0\t32\t125\nDistributions paid to noncontrolling interests\t0\t0\t0\t0\t0\t0\t(40)\t(40)\nOther comprehensive income\t0\t0\t0\t1\t0\t0\t0\t1\nAccretion of redeemable noncontrolling interests\t0\t0\t(1)\t0\t0\t0\t0\t(1)\nPurchases (sales) of businesses and noncontrolling interests\t0\t0\t(30)\t0\t0\t0\t15\t(15)\nCumulative effect of accounting change\t0\t0\t0\t0\t(14)\t0\t0\t(14)\nStock-based compensation expense tax benefit and issuance of common stock\t331\t0\t10\t0\t0\t0\t0\t10\nBalances at March 31 2020\t104528\t7\t4739\t(256)\t(2434)\t(2414)\t861\t503\nNet income\t0\t0\t0\t0\t88\t0\t35\t123\nDistributions paid to noncontrolling interests\t0\t0\t0\t0\t0\t0\t(8)\t(8)\nOther comprehensive income\t0\t0\t0\t1\t0\t0\t0\t1\nAccretion of redeemable noncontrolling interests\t0\t0\t(2)\t0\t0\t0\t0\t(2)\nPurchases (sales) of businesses and noncontrolling interests\t0\t0\t(2)\t0\t0\t0\t2\t0\nStock-based compensation expense tax benefit and issuance of common stock\t374\t0\t16\t0\t0\t0\t0\t16\nBalances at June 30 2020\t104902\t7\t4751\t(255)\t(2346)\t(2414)\t890\t633\nNet income (loss)\t0\t0\t0\t0\t(196)\t0\t48\t(148)\nDistributions paid to noncontrolling interests\t0\t0\t0\t0\t0\t0\t(46)\t(46)\nOther comprehensive income\t0\t0\t0\t4\t0\t0\t0\t4\nAccretion of redeemable noncontrolling interests\t0\t0\t(1)\t0\t0\t0\t0\t(1)\nPurchases of businesses and noncontrolling interests\t0\t0\t58\t0\t0\t0\t4\t62\nStock-based compensation expense tax benefit and issuance of common stock\t505\t0\t18\t0\t0\t0\t0\t18\nBalances at September 30 2020\t105407\t7\t4826\t(251)\t(2542)\t(2414)\t896\t522\n", "q10k_tbl_26": "\tCommon Stock\t\tAdditional Paid-In Capital\tAccumulated Other Comprehensive Loss\tAccumulated Deficit\tTreasury Stock\tNoncontrolling Interests\tTotal Equity\n\tShares Outstanding\tIssued Par Amount\t\t\t\nBalances at December 31 2018\t102537\t7\t4747\t(223)\t(2299)\t(2414)\t806\t624\nNet income (loss)\t0\t0\t0\t0\t(12)\t0\t37\t25\nDistributions paid to noncontrolling interests\t0\t0\t0\t0\t0\t0\t(37)\t(37)\nOther comprehensive income\t0\t0\t0\t2\t0\t0\t0\t2\nAccretion of redeemable noncontrolling interests\t0\t0\t(5)\t0\t0\t0\t0\t(5)\nPurchases (sales) of businesses and noncontrolling interests\t0\t0\t(2)\t0\t0\t0\t2\t0\nCumulative effect of accounting change\t0\t0\t0\t0\t1\t0\t0\t1\nStock-based compensation expense tax benefit and issuance of common stock\t543\t0\t8\t0\t0\t0\t0\t8\nBalances at March 31 2019\t103080\t7\t4748\t(221)\t(2310)\t(2414)\t808\t618\nNet income\t0\t0\t0\t0\t26\t0\t47\t73\nDistributions paid to noncontrolling interests\t0\t0\t0\t0\t0\t0\t(35)\t(35)\nOther comprehensive income\t0\t0\t0\t2\t0\t0\t0\t2\nAccretion of redeemable noncontrolling interests\t0\t0\t(4)\t0\t0\t0\t0\t(4)\nPurchases of businesses and noncontrolling interests\t0\t0\t0\t0\t0\t0\t5\t5\nStock-based compensation expense tax benefit and issuance of common stock\t256\t0\t11\t0\t0\t0\t0\t11\nBalances at June 30 2019\t103336\t7\t4755\t(219)\t(2284)\t(2414)\t825\t670\nNet income (loss)\t0\t0\t0\t0\t(226)\t0\t45\t(181)\nDistributions paid to noncontrolling interests\t0\t0\t0\t0\t0\t0\t(46)\t(46)\nOther comprehensive income\t0\t0\t0\t3\t0\t0\t0\t3\nAccretion of redeemable noncontrolling interests\t0\t0\t(4)\t0\t0\t0\t0\t(4)\nPurchases (sales) of businesses and noncontrolling interests\t0\t0\t(5)\t0\t0\t0\t6\t1\nStock-based compensation expense tax benefit and issuance of common stock\t436\t0\t5\t0\t0\t0\t0\t5\nBalances at September 30 2019\t103772\t7\t4751\t(216)\t(2510)\t(2414)\t830\t448\n", "q10k_tbl_27": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nHospital Operations:\t\t\t\t\nNet patient service revenues from hospitals and related outpatient facilities:\t\t\t\t\nMedicare\t662\t697\t1964\t2176\nMedicaid\t251\t284\t791\t914\nManaged care\t2374\t2357\t6519\t7041\nUninsured\t50\t44\t112\t56\nIndemnity and other\t171\t184\t491\t508\nTotal\t3508\t3566\t9877\t10695\nOther revenues(1)\t295\t284\t848\t844\nHospital Operations total prior to inter-segment eliminations\t3803\t3850\t10725\t11539\nAmbulatory Care\t565\t522\t1423\t1526\nConifer\t325\t336\t962\t1040\nInter-segment eliminations\t(136)\t(140)\t(385)\t(432)\nNet operating revenues\t4557\t4568\t12725\t13673\n", "q10k_tbl_28": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nNet patient service revenues\t532\t490\t1345\t1437\nManagement fees\t23\t23\t60\t69\nRevenue from other sources\t10\t9\t18\t20\nNet operating revenues\t565\t522\t1423\t1526\n", "q10k_tbl_29": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nRevenue cycle services - Tenet\t132\t136\t375\t420\nRevenue cycle services - other customers\t170\t175\t518\t542\nOther services - Tenet\t4\t4\t10\t12\nOther services - other customers\t19\t21\t59\t66\nNet operating revenues\t325\t336\t962\t1040\n", "q10k_tbl_30": "\t\tThree Months Ending\tYears Ending\t\t\t\tLater Years\n\t\tDecember 31\t\t\t\t\n\tTotal\t2020\t2021\t2022\t2023\t2024\nPerformance obligations\t6685\t147\t585\t583\t583\t532\t4255\n", "q10k_tbl_31": "\tBalances at Beginning of Period\tLitigation and Investigation Costs\tCash Payments\tBalances at End of Period\nNine Months Ended September 30 2020\t86\t13\t(84)\t15\nNine Months Ended September 30 2019\t8\t115\t(37)\t86\n", "q10k_tbl_32": "\tNine Months Ended September 30\t\n\t2020\t2019\nBalances at beginning of period\t1506\t1420\nNet income\t122\t130\nDistributions paid to noncontrolling interests\t(90)\t(105)\nAccretion of redeemable noncontrolling interests\t4\t13\nPurchases and sales of businesses and noncontrolling interests net\t(63)\t17\nBalances at end of period\t1479\t1475\n", "q10k_tbl_33": "\tSeptember 30 2020\tDecember 31 2019\nHospital Operations\t283\t383\nAmbulatory Care\t805\t777\nConifer\t391\t346\nRedeemable noncontrolling interests\t1479\t1506\n", "q10k_tbl_34": "\tNine Months Ended September 30\t\n\t2020\t2019\nHospital Operations\t(17)\t(26)\nAmbulatory Care\t94\t100\nConifer\t45\t56\nNet income available to redeemable noncontrolling interests\t122\t130\n", "q10k_tbl_35": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nTax expense (benefit) at statutory federal rate of 21%\t(64)\t(26)\t(1)\t24\nState income taxes net of federal income tax benefit\t(6)\t(3)\t9\t6\nTax benefit attributable to noncontrolling interests\t(18)\t(17)\t(48)\t(53)\nNontaxable gains\t0\t0\t3\t(1)\nNondeductible litigation costs\t0\t7\t0\t7\nStock-based compensation\t1\t4\t1\t4\nChange in valuation allowance\t(113)\t53\t(201)\t88\nChange in tax contingency reserves including interest\t0\t(3)\t0\t(3)\nOther items\t3\t7\t10\t3\nIncome tax expense (benefit)\t(197)\t22\t(227)\t75\n", "q10k_tbl_36": "\tNet Loss Attributable to Common Shareholders (Numerator)\tWeighted Average Shares (Denominator)\tPer-Share Amount\nThree Months Ended September 30 2020:\t\t\t\nNet loss attributable to Tenet Healthcare Corporation common shareholders for basic loss per share\t(197)\t105263\t(1.87)\nEffect of dilutive stock options restricted stock units and deferred compensation units\t0\t0\t0\nNet loss attributable to Tenet Healthcare Corporation common shareholders for diluted loss per share\t(197)\t105263\t(1.87)\nThree Months Ended September 30 2019:\t\t\t\nNet loss attributable to Tenet Healthcare Corporation common shareholders for basic loss per share\t(227)\t103558\t(2.19)\nEffect of dilutive stock options restricted stock units and deferred compensation units\t0\t0\t0\nNet loss attributable to Tenet Healthcare Corporation common shareholders for diluted loss per share\t(227)\t103558\t(2.19)\nNine Months Ended September 30 2020:\t\t\t\nNet loss attributable to Tenet Healthcare Corporation common shareholders for basic loss per share\t(15)\t104803\t(0.14)\nEffect of dilutive stock options restricted stock units and deferred compensation units\t0\t0\t0\nNet loss attributable to Tenet Healthcare Corporation common shareholders for diluted loss per share\t(15)\t104803\t(0.14)\nNine Months Ended September 30 2019:\t\t\t\nNet loss attributable to Tenet Healthcare Corporation common shareholders for basic loss per share\t(223)\t103181\t(2.16)\nEffect of dilutive stock options restricted stock units and deferred compensation units\t0\t0\t0\nNet loss attributable to Tenet Healthcare Corporation common shareholders for diluted loss per share\t(223)\t103181\t(2.16)\n", "q10k_tbl_37": "\tNine Months Ended September 30\t\n\t2020\t2019\nCurrent assets\t7\t5\nProperty and equipment\t15\t15\nOther intangible assets\t8\t4\nGoodwill\t78\t34\nOther long-term assets including previously held equity method investments\t6\t6\nCurrent liabilities\t(4)\t(4)\nLong-term liabilities\t(6)\t(10)\nRedeemable noncontrolling interests in equity of consolidated subsidiaries\t(30)\t(16)\nNoncontrolling interests\t(13)\t(6)\nCash paid net of cash acquired\t(61)\t(23)\nGains on consolidations\t0\t5\n", "q10k_tbl_38": "\tSeptember 30 2020\tDecember 31 2019\nAssets:\t\t\nHospital Operations\t18726\t16196\nAmbulatory Care\t6487\t6195\nConifer\t974\t974\nTotal\t26187\t23365\n", "q10k_tbl_39": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nCapital expenditures:\t\t\t\t\nHospital Operations\t71\t135\t328\t423\nAmbulatory Care\t11\t16\t32\t57\nConifer\t4\t5\t14\t12\nTotal\t86\t156\t374\t492\nNet operating revenues:\t\t\t\t\nHospital Operations total prior to inter-segment eliminations\t3803\t3850\t10725\t11539\nAmbulatory Care\t565\t522\t1423\t1526\nConifer\t\t\t\t\nTenet\t136\t140\t385\t432\nOther clients\t189\t196\t577\t608\nTotal Conifer revenues\t325\t336\t962\t1040\nInter-segment eliminations\t(136)\t(140)\t(385)\t(432)\nTotal\t4557\t4568\t12725\t13673\nEquity in earnings of unconsolidated affiliates:\t\t\t\t\nHospital Operations\t3\t1\t1\t12\nAmbulatory Care\t41\t37\t102\t102\nTotal\t44\t38\t103\t114\nAdjusted EBITDA:\t\t\t\t\nHospital Operations\t240\t342\t1074\t1048\nAmbulatory Care\t215\t207\t538\t591\nConifer\t96\t90\t256\t292\nTotal\t551\t639\t1868\t1931\nDepreciation and amortization:\t\t\t\t\nHospital Operations\t184\t175\t536\t539\nAmbulatory Care\t21\t19\t60\t55\nConifer\t10\t11\t28\t33\nTotal\t215\t205\t624\t627\n", "q10k_tbl_40": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nAdjusted EBITDA\t551\t639\t1868\t1931\nLoss from divested and closed businesses (i.e. the Company's health plan businesses)\t0\t(1)\t0\t(2)\nDepreciation and amortization\t(215)\t(205)\t(624)\t(627)\nImpairment and restructuring charges and acquisition-related costs\t(57)\t(46)\t(166)\t(101)\nLitigation and investigation costs\t(9)\t(84)\t(13)\t(115)\nInterest expense\t(263)\t(244)\t(761)\t(742)\nLoss from early extinguishment of debt\t(312)\t(180)\t(316)\t(227)\nOther non-operating income (expense) net\t0\t(3)\t3\t(3)\nNet gains (losses) on sales consolidation and deconsolidation of facilities\t1\t(1)\t4\t(3)\nIncome (loss) from continuing operations before income taxes\t(304)\t(125)\t(5)\t111\n", "q10k_tbl_41": "\tContinuing Operations Three Months Ended September 30\t\t\t\nSelected Operating Statistics\t2020\t2019\tIncrease (Decrease)\t\nHospital Operations - hospitals and related outpatient facilities:\t\t\t\t\nNumber of hospitals (at end of period)\t65\t65\t0\t(1)\nTotal admissions\t150690\t170004\t(11.4)%\t\nAdjusted patient admissions(2)\t257704\t306535\t(15.9)%\t\nPaying admissions (excludes charity and uninsured)\t141300\t159299\t(11.3)%\t\nCharity and uninsured admissions\t9390\t10705\t(12.3)%\t\nAdmissions through emergency department\t112131\t120915\t(7.3)%\t\nEmergency department visits outpatient\t463836\t627055\t(26.0)%\t\nTotal emergency department visits\t575967\t747970\t(23.0)%\t\nTotal surgeries\t94128\t105736\t(11.0)%\t\nPatient days - total\t784013\t782643\t0.2%\t\nAdjusted patient days(2)\t1302605\t1381862\t(5.7)%\t\nAverage length of stay (days)\t5.20\t4.60\t13.0%\t\nAverage licensed beds\t17242\t17208\t0.2%\t\nUtilization of licensed beds(3)\t49.4%\t49.4%\t-%\t(1)\nTotal visits\t1402346\t1673801\t(16.2)%\t\nPaying visits (excludes charity and uninsured)\t1302529\t1562007\t(16.6)%\t\nCharity and uninsured visits\t99817\t111794\t(10.7)%\t\nAmbulatory Care:\t\t\t\t\nTotal consolidated facilities (at end of period)\t244\t237\t7\t(1)\nTotal cases\t544279\t522530\t4.2%\t\n", "q10k_tbl_42": "\tContinuing Operations Three Months Ended September 30\t\t\nRevenues\t2020\t2019\tIncrease (Decrease)\nNet operating revenues:\t\t\t\nHospital Operations prior to inter-segment eliminations\t3803\t3850\t(1.2)%\nAmbulatory Care\t565\t522\t8.2%\nConifer\t325\t336\t(3.3)%\nInter-segment eliminations\t(136)\t(140)\t(2.9)%\nTotal\t4557\t4568\t(0.2)%\n", "q10k_tbl_43": "\tContinuing Operations Three Months Ended September 30\t\t\nSelected Operating Expenses\t2020\t2019\tIncrease (Decrease)\nHospital Operations:\t\t\t\nSalaries wages and benefits\t1818\t1835\t(0.9)%\nSupplies\t656\t650\t0.9%\nOther operating expenses\t899\t885\t1.6%\nTotal\t3373\t3370\t0.1%\nAmbulatory Care:\t\t\t\nSalaries wages and benefits\t157\t157\t-%\nSupplies\t128\t109\t17.4%\nOther operating expenses\t97\t86\t12.8%\nTotal\t382\t352\t8.5%\nConifer:\t\t\t\nSalaries wages and benefits\t167\t180\t(7.2)%\nSupplies\t0\t1\t(100.0)%\nOther operating expenses\t62\t65\t(4.6)%\nTotal\t229\t246\t(6.9)%\nTotal:\t\t\t\nSalaries wages and benefits\t2142\t2172\t(1.4)%\nSupplies\t784\t760\t3.2%\nOther operating expenses\t1058\t1036\t2.1%\nTotal\t3984\t3968\t0.4%\nRent/lease expense(1):\t\t\t\nHospital Operations\t72\t60\t20.0%\nAmbulatory Care\t24\t22\t9.1%\nConifer\t3\t3\t-%\nTotal\t99\t85\t16.5%\n", "q10k_tbl_44": "\tContinuing Operations Three Months Ended September 30\t\t\nSelected Operating Expenses per Adjusted Patient Admission\t2020\t2019\tIncrease (Decrease)\nHospital Operations:\t\t\t\nSalaries wages and benefits per adjusted patient admission(1)\t7054\t5984\t17.9%\nSupplies per adjusted patient admission(1)\t2546\t2119\t20.2%\nOther operating expenses per adjusted patient admission(1)\t3487\t2890\t20.7%\nTotal per adjusted patient admission\t13087\t10993\t19.0%\n", "q10k_tbl_45": "\tThree Months Ended September 30\t\t\tNine Months Ended September 30\t\t\nNet Patient Service Revenues Less Implicit Price Concessions from:\t2020\t2019\tIncrease (Decrease)(1)\t2020\t2019\tIncrease (Decrease)(1)\nMedicare\t18.9%\t19.6%\t(0.7)%\t19.9%\t20.4%\t(0.5)%\nMedicaid\t7.1%\t8.0%\t(0.9)%\t8.0%\t8.6%\t(0.6)%\nManaged care(2)\t67.7%\t66.1%\t1.6%\t66.0%\t65.8%\t0.2%\nUninsured\t1.4%\t1.2%\t0.2%\t1.1%\t0.5%\t0.6%\nIndemnity and other\t4.9%\t5.1%\t(0.2)%\t5.0%\t4.7%\t0.3%\n", "q10k_tbl_46": "\tThree Months Ended September 30\t\t\tNine Months Ended September 30\t\t\nAdmissions from:\t2020\t2019\tIncrease (Decrease)(1)\t2020\t2019\tIncrease (Decrease)(1)\nMedicare\t21.9%\t23.9%\t(2.0)%\t23.0%\t25.0%\t(2.0)%\nMedicaid\t6.4%\t6.4%\t-%\t6.3%\t6.2%\t0.1%\nManaged care(2)\t62.7%\t60.7%\t2.0%\t61.6%\t60.2%\t1.4%\nCharity and uninsured\t6.2%\t6.3%\t(0.1)%\t6.3%\t6.0%\t0.3%\nIndemnity and other\t2.8%\t2.7%\t0.1%\t2.8%\t2.6%\t0.2%\n", "q10k_tbl_47": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\nRevenue Descriptions\t2020\t2019\t2020\t2019\nMedicare severity-adjusted diagnosis-related group - operating\t350\t362\t1052\t1134\nMedicare severity-adjusted diagnosis-related group - capital\t29\t33\t90\t101\nOutliers\t14\t17\t46\t62\nOutpatient\t160\t182\t462\t557\nDisproportionate share\t54\t61\t160\t178\nOther(1)\t55\t42\t154\t144\nTotal Medicare net patient service revenues\t662\t697\t1964\t2176\n", "q10k_tbl_48": "\tNine Months Ended September 30\t\nHospital Location\t2020\t2019\nAlabama\t74\t69\nArizona\t120\t112\nCalifornia\t603\t650\nFlorida\t149\t169\nIllinois\t0\t5\nMassachusetts\t66\t68\nMichigan\t404\t542\nSouth Carolina\t44\t42\nTennessee\t26\t27\nTexas\t287\t304\n\t1773\t1988\n", "q10k_tbl_49": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nEstimated costs for:\t\t\t\t\nUninsured patients\t165\t171\t466\t493\nCharity care patients\t30\t41\t113\t116\nTotal\t195\t212\t579\t609\n", "q10k_tbl_50": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nNet operating revenues:\t\t\t\t\nHospital Operations\t3803\t3850\t10725\t11539\nAmbulatory Care\t565\t522\t1423\t1526\nConifer\t325\t336\t962\t1040\nInter-segment eliminations\t(136)\t(140)\t(385)\t(432)\nNet operating revenues\t4557\t4568\t12725\t13673\nGrant income\t(66)\t0\t445\t0\nEquity in earnings of unconsolidated affiliates\t44\t38\t103\t114\nOperating expenses:\t\t\t\t\nSalaries wages and benefits\t2142\t2172\t6193\t6468\nSupplies\t784\t760\t2158\t2254\nOther operating expenses net\t1058\t1036\t3054\t3136\nDepreciation and amortization\t215\t205\t624\t627\nImpairment and restructuring charges and acquisition-related costs\t57\t46\t166\t101\nLitigation and investigation costs\t9\t84\t13\t115\nNet losses (gains) on sales consolidation and deconsolidation of facilities\t(1)\t1\t(4)\t3\nOperating income\t271\t302\t1069\t1083\n", "q10k_tbl_51": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nNet operating revenues\t100.0%\t100.0%\t100.0%\t100.0%\nGrant income\t(1.4)%\t-%\t3.5%\t-%\nEquity in earnings of unconsolidated affiliates\t1.0%\t0.8%\t0.8%\t0.8%\nOperating expenses:\t\t\t\t\nSalaries wages and benefits\t47.1%\t47.6%\t48.6%\t47.3%\nSupplies\t17.2%\t16.6%\t17.0%\t16.5%\nOther operating expenses net\t23.2%\t22.7%\t24.0%\t22.9%\nDepreciation and amortization\t4.7%\t4.5%\t4.9%\t4.6%\nImpairment and restructuring charges and acquisition-related costs\t1.3%\t1.0%\t1.3%\t0.7%\nLitigation and investigation costs\t0.2%\t1.8%\t0.1%\t0.9%\nNet gains on sales consolidation and deconsolidation of facilities\t-%\t-%\t-%\t-%\nOperating income\t5.9%\t6.6%\t8.4%\t7.9%\n", "q10k_tbl_52": "\tThree Months Ended September 30\t\t\tNine Months Ended September 30\t\t\nSelected Operating Expenses\t2020\t2019\tIncrease (Decrease)\t2020\t2019\tIncrease (Decrease)\nHospital Operations - Same-Hospital:\t\t\t\t\t\t\nSalaries wages and benefits\t1818\t1835\t(0.9)%\t5244\t5433\t(3.5)%\nSupplies\t656\t651\t0.8%\t1837\t1932\t(4.9)%\nOther operating expenses\t898\t884\t1.6%\t2609\t2675\t(2.5)%\nTotal\t3372\t3370\t0.1%\t9690\t10040\t(3.5)%\nAmbulatory Care:\t\t\t\t\t\t\nSalaries wages and benefits\t157\t157\t-%\t438\t467\t(6.2)%\nSupplies\t128\t109\t17.4%\t319\t316\t0.9%\nOther operating expenses\t97\t86\t12.8%\t258\t254\t1.6%\nTotal\t382\t352\t8.5%\t1015\t1037\t(2.1)%\nConifer:\t\t\t\t\t\t\nSalaries wages and benefits\t167\t180\t(7.2)%\t511\t552\t(7.4)%\nSupplies\t0\t1\t(100.0)%\t2\t3\t(33.3)%\nOther operating expenses\t62\t65\t(4.6)%\t193\t193\t-%\nTotal\t229\t246\t(6.9)%\t706\t748\t(5.6)%\nTotal:\t\t\t\t\t\t\nSalaries wages and benefits\t2142\t2172\t(1.4)%\t6193\t6452\t(4.0)%\nSupplies\t784\t761\t3.0%\t2158\t2251\t(4.1)%\nOther operating expenses\t1057\t1035\t2.1%\t3060\t3122\t(2.0)%\nTotal\t3983\t3968\t0.4%\t11411\t11825\t(3.5)%\nRent/lease expense(1):\t\t\t\t\t\t\nHospital Operations\t72\t60\t20.0%\t203\t178\t14.0%\nAmbulatory Care\t24\t22\t9.1%\t67\t63\t6.3%\nConifer\t3\t3\t-%\t9\t9\t-%\nTotal\t99\t85\t16.5%\t279\t250\t11.6%\n", "q10k_tbl_53": "\tSame-Hospital Continuing Operations\t\t\t\tSame-Hospital Continuing Operations\t\t\t\n\tThree Months Ended September 30\t\t\t\tNine Months Ended September 30\t\t\t\nAdmissions Patient Days and Surgeries\t2020\t2019\tIncrease (Decrease)\t\t2020\t2019\tIncrease (Decrease)\t\nNumber of hospitals (at end of period)\t65\t65\t0\t(1)\t65\t65\t0\t(1)\nTotal admissions\t150690\t170004\t(11.4)%\t\t451323\t512826\t(12.0)%\t\nAdjusted patient admissions(2)\t257704\t306535\t(15.9)%\t\t769775\t916472\t(16.0)%\t\nPaying admissions (excludes charity and uninsured)\t141300\t159300\t(11.3)%\t\t422912\t482061\t(12.3)%\t\nCharity and uninsured admissions\t9390\t10704\t(12.3)%\t\t28411\t30765\t(7.7)%\t\nAdmissions through emergency department\t112131\t120915\t(7.3)%\t\t332615\t367231\t(9.4)%\t\nPaying admissions as a percentage of total admissions\t93.8%\t93.7%\t0.1%\t(1)\t93.7%\t94.0%\t(0.3)%\t(1)\nCharity and uninsured admissions as a percentage of total admissions\t6.2%\t6.3%\t(0.1)%\t(1)\t6.3%\t6.0%\t0.3%\t(1)\nEmergency department admissions as a percentage of total admissions\t74.4%\t71.1%\t3.3%\t(1)\t73.7%\t71.6%\t2.1%\t(1)\nSurgeries - inpatient\t39650\t45637\t(13.1)%\t\t116585\t134831\t(13.5)%\t\nSurgeries - outpatient\t54478\t60099\t(9.4)%\t\t146617\t178931\t(18.1)%\t\nTotal surgeries\t94128\t105736\t(11.0)%\t\t263202\t313762\t(16.1)%\t\nPatient days - total\t784013\t782643\t0.2%\t\t2282375\t2385554\t(4.3)%\t\nAdjusted patient days(2)\t1302605\t1381862\t(5.7)%\t\t3782576\t4177844\t(9.5)%\t\nAverage length of stay (days)\t5.20\t4.60\t13.0%\t\t5.06\t4.65\t8.8%\t\nLicensed beds (at end of period)\t17242\t17206\t0.2%\t\t17242\t17206\t0.2%\t\nAverage licensed beds\t17242\t17208\t0.2%\t\t17226\t17217\t0.1%\t\nUtilization of licensed beds(3)\t49.4%\t49.4%\t-%\t(1)\t48.4%\t50.8%\t(2.4)%\t(1)\n", "q10k_tbl_54": "\tSame-Hospital Continuing Operations\t\t\t\tSame-Hospital Continuing Operations\t\t\t\n\tThree Months Ended September 30\t\t\t\tNine Months Ended September 30\t\t\t\nOutpatient Visits\t2020\t2019\tIncrease (Decrease)\t\t2020\t2019\tIncrease (Decrease)\t\nTotal visits\t1402346\t1673801\t(16.2)%\t\t4002194\t5054470\t(20.8)%\t\nPaying visits (excludes charity and uninsured)\t1302562\t1562010\t(16.6)%\t\t3710299\t4721200\t(21.4)%\t\nCharity and uninsured visits\t99784\t111791\t(10.7)%\t\t291895\t333270\t(12.4)%\t\nEmergency department visits\t463836\t627055\t(26.0)%\t\t1493156\t1916014\t(22.1)%\t\nSurgery visits\t54478\t60099\t(9.4)%\t\t146617\t178931\t(18.1)%\t\nPaying visits as a percentage of total visits\t92.9%\t93.3%\t(0.4)%\t(1)\t92.7%\t93.4%\t(0.7)%\t(1)\nCharity and uninsured visits as a percentage of total visits\t7.1%\t6.7%\t0.4%\t(1)\t7.3%\t6.6%\t0.7%\t(1)\n", "q10k_tbl_55": "\tSame-Hospital Continuing Operations\t\t\tSame-Hospital Continuing Operations\t\t\n\tThree Months Ended September 30\t\t\tNine Months Ended September 30\t\t\nRevenues\t2020\t2019\tIncrease (Decrease)\t2020\t2019\tIncrease (Decrease)\nTotal segment net operating revenues(1)\t3661\t3707\t(1.2)%\t10336\t11078\t(6.7)%\nSelected revenue data - hospitals and related outpatient facilities:\t\t\t\t\t\t\nNet patient service revenues(1)(2)\t3502\t3562\t(1.7)%\t9874\t10666\t(7.4)%\nNet patient service revenue per adjusted patient admission(1)(2)\t13589\t11620\t16.9%\t12827\t11638\t10.2%\nNet patient service revenue per adjusted patient day(1)(2)\t2688\t2578\t4.3%\t2610\t2553\t2.2%\n", "q10k_tbl_56": "\tSame-Hospital Continuing Operations\t\t\t\tSame-Hospital Continuing Operations\t\t\t\n\tThree Months Ended September 30\t\t\t\tNine Months Ended September 30\t\t\t\nTotal Segment Selected Operating Expenses\t2020\t2019\tIncrease (Decrease)\t\t2020\t2019\tIncrease (Decrease)\t\nSalaries wages and benefits as a percentage of net operating revenues\t49.7%\t49.5%\t0.2%\t(1)\t50.7%\t49.0%\t1.7%\t(1)\nSupplies as a percentage of net operating revenues\t17.9%\t17.6%\t0.3%\t(1)\t17.8%\t17.4%\t0.4%\t(1)\nOther operating expenses as a percentage of net operating revenues\t24.5%\t23.8%\t0.7%\t(1)\t25.2%\t24.1%\t1.1%\t(1)\n", "q10k_tbl_57": "\tSeptember 30 2020\tDecember 31 2019\nMedicare\t158\t189\nMedicaid\t55\t69\nNet cost report settlements receivable and valuation allowances\t42\t12\nManaged care\t1436\t1618\nSelf-pay uninsured\t16\t25\nSelf-pay balance after insurance\t74\t76\nEstimated future recoveries\t158\t162\nOther payers\t300\t337\nTotal Hospital Operations\t2239\t2488\nAmbulatory Care\t239\t253\nTotal discontinued operations\t1\t2\n\t2479\t2743\n", "q10k_tbl_58": "\tSeptember 30 2020\t\t\t\t\n\tMedicare\tMedicaid\tManaged Care\tIndemnity Self-Pay and Other\tTotal\n0-60 days\t90%\t40%\t57%\t21%\t51%\n61-120 days\t5%\t28%\t15%\t13%\t14%\n121-180 days\t2%\t12%\t6%\t7%\t6%\nOver 180 days\t3%\t20%\t22%\t59%\t29%\nTotal\t100%\t100%\t100%\t100%\t100%\n", "q10k_tbl_59": "\tDecember 31 2019\t\t\t\t\n\tMedicare\tMedicaid\tManaged Care\tIndemnity Self-Pay and Other\tTotal\n0-60 days\t91%\t49%\t56%\t21%\t51%\n61-120 days\t5%\t21%\t16%\t14%\t15%\n121-180 days\t2%\t10%\t10%\t10%\t9%\nOver 180 days\t2%\t20%\t18%\t55%\t25%\nTotal\t100%\t100%\t100%\t100%\t100%\n", "q10k_tbl_60": "\tSeptember 30\tDecember 31\n\t2020\t2019\n0-60 days\t82\t89\n61-120 days\t16\t11\n121-180 days\t5\t4\nOver 180 days\t6\t11\nTotal\t109\t115\n", "q10k_tbl_61": "\tThree Months Ended September 30\t\t\tNine Months Ended September 30\t\t\nAmbulatory Care Results of Operations\t2020\t2019\tIncrease (Decrease)\t2020\t2019\tIncrease (Decrease)\nNet operating revenues\t565\t522\t8.2%\t1423\t1526\t(6.7)%\nGrant income\t(9)\t0\tN/A\t28\t0\tN/A\nEquity in earnings of unconsolidated affiliates\t41\t37\t10.8%\t102\t102\t-%\nSalaries wages and benefits\t157\t157\t-%\t438\t467\t(6.2)%\nSupplies\t128\t109\t17.4%\t319\t316\t0.9%\nOther operating expenses net\t97\t86\t12.8%\t258\t254\t1.6%\n", "q10k_tbl_62": "Ambulatory Care Facility Growth\tThree Months Ended September 30 2020\tNine Months Ended September 30 2020\nNet revenues\t6.5%\t(7.8)%\nCases\t(0.3)%\t(12.9)%\nNet revenue per case\t6.9%\t5.9%\n", "q10k_tbl_63": "Ambulatory Care Facilities\tNine Months Ended September 30 2020\nFacilities:\t\nWith a healthcare system partner\t224\nWithout a healthcare system partner\t128\nTotal facilities operated\t352\nChange from December 31 2019:\t\nAcquisitions\t9\nDe novo\t3\nDispositions/Mergers\t(6)\nTotal increase in number of facilities operated\t6\n", "q10k_tbl_64": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nTax expense (benefit) at statutory federal rate of 21%\t(64)\t(26)\t(1)\t24\nState income taxes net of federal income tax benefit\t(6)\t(3)\t9\t6\nTax benefit attributable to noncontrolling interests\t(18)\t(17)\t(48)\t(53)\nNontaxable gains\t0\t0\t3\t(1)\nNondeductible litigation costs\t0\t7\t0\t7\nStock-based compensation\t1\t4\t1\t4\nChange in valuation allowance\t(113)\t53\t(201)\t88\nChange in tax contingency reserves including interest\t0\t(3)\t0\t(3)\nOther items\t3\t7\t10\t3\nIncome tax expense (benefit)\t(197)\t22\t(227)\t75\n", "q10k_tbl_65": "\tThree Months Ended September 30\t\tNine Months Ended September 30\t\n\t2020\t2019\t2020\t2019\nNet loss attributable to Tenet Healthcare Corporation common shareholders\t(196)\t(226)\t(15)\t(212)\nLess: Net income available to noncontrolling interests\t(90)\t(80)\t(237)\t(259)\nIncome from discontinued operations net of tax\t1\t1\t0\t11\nIncome (loss) from continuing operations\t(107)\t(147)\t222\t36\nIncome tax benefit (expense)\t197\t(22)\t227\t(75)\nLoss from early extinguishment of debt\t(312)\t(180)\t(316)\t(227)\nOther non-operating income (expense) net\t0\t(3)\t3\t(3)\nInterest expense\t(263)\t(244)\t(761)\t(742)\nOperating income\t271\t302\t1069\t1083\nLitigation and investigation costs\t(9)\t(84)\t(13)\t(115)\nNet gains (losses) on sales consolidation and deconsolidation of facilities\t1\t(1)\t4\t(3)\nImpairment and restructuring charges and acquisition-related costs\t(57)\t(46)\t(166)\t(101)\nDepreciation and amortization\t(215)\t(205)\t(624)\t(627)\nLoss from divested and closed businesses\t0\t(1)\t0\t(2)\nAdjusted EBITDA\t551\t639\t1868\t1931\nNet operating revenues\t4557\t4568\t12725\t13673\nLess: Net operating revenues from health plans\t0\t0\t0\t1\nAdjusted net operating revenues\t4557\t4568\t12725\t13672\nNet loss attributable to Tenet Healthcare Corporation common shareholders as a % of net operating revenues\t(4.3)%\t(4.9)%\t(0.1)%\t(1.6)%\nAdjusted EBITDA as % of adjusted net operating revenues (Adjusted EBITDA margin)\t12.1%\t14.0%\t14.7%\t14.1%\n", "q10k_tbl_66": "\tMaturity Date Years Ending December 31\t\t\t\t\t\t\t\n\t2020\t2021\t2022\t2023\t2024\tThereafter\tTotal\tFair Value\n\t(Dollars in Millions)\t\t\t\t\t\t\t\nFixed rate long-term debt\t64\t138\t76\t1912\t2489\t11221\t15900\t16326\nAverage effective interest rates\t5.6%\t4.7%\t5.2%\t7.3%\t4.9%\t6.0%\t5.9%\t\n", "q10k_tbl_67": "(4)\tInstruments Defining the Rights of Security Holders Including Indentures\t\n\t(a)\tThirty-Sixth Supplemental Indenture dated as of September 16 2020 between the Registrant and The Bank of New York Mellon Trust Company N.A. as trustee relating to 6.125% Senior Notes Due 2028 (Incorporated by reference to Exhibit 4.2 to Registrant's Current Report on Form 8-K filed September 16 2020)\n(10)\tMaterial Contracts\t\n\t(a)\tExchange and Registration Rights Agreement dated as of September 16 2020 between the Registrant and Barclays Capital Inc. as representative of the other initial purchasers of the notes named therein (Incorporated by reference to Exhibit 10.1 to Registrant's Current Report on Form 8-K filed September 16 2020)\n(31)\tRule 13a-14(a)/15d-14(a) Certifications\t\n\t(a)\tCertification of Ronald A. Rittenmeyer Executive Chairman and Chief Executive Officer\n\t(b)\tCertification of Daniel J. Cancelmi Executive Vice President and Chief Financial Officer\n(32)\tSection 1350 Certification of Ronald A. Rittenmeyer Executive Chairman and Chief Executive Officer and Daniel J. Cancelmi Executive Vice President and Chief Financial Officer\t\n(101 SCH)\tInline XBRL Taxonomy Extension Schema Document\t\n(101 CAL)\tInline XBRL Taxonomy Extension Calculation Linkbase Document\t\n(101 DEF)\tInline XBRL Taxonomy Extension Definition Linkbase Document\t\n(101 LAB)\tInline XBRL Taxonomy Extension Label Linkbase Document\t\n(101 PRE)\tInline XBRL Taxonomy Extension Presentation Linkbase Document\t\n(101 INS)\tInline XBRL Taxonomy Extension Instance Document - the instance document does not appear in the interactive data file because its XBRL tags are embedded within the inline XBRL document.\t\n(104)\tCover page from the Company's Quarterly Report on Form 10-Q for the quarter ended September 30 2020 formatted in Inline XBRL (included in Exhibit 101)\t\n"}{"bs": "q10k_tbl_1", "is": "q10k_tbl_2", "cf": "q10k_tbl_4"}None
Quarterly report pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 for the quarterly period ended September 30, 2020
OR
☐
Transition report pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 for the transition period from to
Commission File Number 1-7293
_________________________________________
TENET HEALTHCARE CORPORATION
(Exact name of Registrant as specified in its charter)
_________________________________________
Nevada
95-2557091
(State of Incorporation)
(IRS Employer Identification No.)
14201 Dallas Parkway
Dallas, TX75254
(Address of principal executive offices, including zip code)
(469) 893-2200
(Registrant’s telephone number, including area code)
_________________________________________
Securities registered pursuant to Section 12(b) of the Act:
Title of each class
Trading symbol
Name of each exchange on which registered
Common stock,
$0.05 par value
THC
New York Stock Exchange
6.875% Senior Notes due 2031
THC31
New York Stock Exchange
Indicate by check mark whether the Registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months, and (2) has been subject to such filing requirements for the past 90 days. Yesx No ¨
Indicate by check mark whether the Registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months. Yesx No ¨
Indicate by check mark whether the Registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company (each as defined in Exchange Act Rule 12b-2).
Large accelerated filer
x
Accelerated filer
¨
Non-accelerated filer
¨
Smaller reporting company
☐
Emerging growth company
☐
If an emerging growth company, indicate by check mark if the Registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ¨
Indicate by check mark whether the Registrant is a shell company (as defined in Exchange Act Rule 12b-2). Yes ☐No x
At October 28, 2020, there were105,517,046 shares of the Registrant’s common stock outstanding.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
NOTE 1. BASIS OF PRESENTATION
Description of Business and Basis of Presentation
Tenet Healthcare Corporation (together with our subsidiaries, referred to herein as “Tenet,” “we” or “us”) is a diversified healthcare services company headquartered in Dallas, Texas. Through an expansive care network that includes USPI Holding Company, Inc. (“USPI”), at September 30, 2020 we operated 65 hospitals and approximately 520 other healthcare facilities, including surgical hospitals, ambulatory surgery centers, urgent care and imaging centers, and other care sites and clinics. We also operate Conifer Health Solutions, LLC through our Conifer Holdings, Inc. (“Conifer”) subsidiary, which provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other clients.
This quarterly report supplements our Annual Report on Form 10-K for the year ended December 31, 2019 (“Annual Report”). As permitted by the Securities and Exchange Commission for interim reporting, we have omitted certain notes and disclosures that substantially duplicate those in our Annual Report. For further information, refer to the audited Consolidated Financial Statements and notes included in our Annual Report. Unless otherwise indicated, all financial and statistical data included in these notes to our Condensed Consolidated Financial Statements relate to our continuing operations, with dollar amounts expressed in millions (except per-share amounts).
Effective January 1, 2020, we adopted the Financial Accounting Standards Board (“FASB”) Accounting Standards Update (“ASU”) 2016-13, “Financial Instruments—Credit Losses (Topic 326) Measurement of Credit Losses on Financial Instruments” (“ASU 2016-13”) using the modified retrospective transition approach as of the period of adoption. Upon adoption of ASU 2016-13 on January 1, 2020, we recorded a cumulative effect adjustment to increase accumulated deficit by $14 million.
Certain prior-year amounts have been reclassified to conform to the current year presentation. In the accompanying Condensed Consolidated Balance Sheets, contract liabilities, primarily related to Medicare advance payments we received, are now presented separately due to the fact that the balances increased substantially in 2020. In the accompanying Condensed Consolidated Statements of Operations, electronic health record incentives have been reclassified to other operating expenses, net, as they are no longer significant enough to present separately. In the accompanying Condensed Consolidated Statements of Cash Flows, purchases of marketable securities have been reclassified from other items, net within cash flows from investing activities to purchases of marketable securities and equity investments. Additionally, our financial statements and corresponding footnotes for prior periods have been recast to reflect retrospective application of the change in accounting principle discussed in the Professional and General Liability Reserves section of this note.
Although the Condensed Consolidated Financial Statements and related notes within this document are unaudited, we believe all adjustments considered necessary for a fair presentation have been included and are of a normal recurring nature. In preparing our financial statements in conformity with accounting principles generally accepted in the United States (“GAAP”), we are required to make estimates and assumptions that affect the amounts reported in our Condensed Consolidated Financial Statements and these accompanying notes. We regularly evaluate the accounting policies and estimates we use. In general, we base the estimates on historical experience and on assumptions that we believe to be reasonable given the particular circumstances in which we operate. Actual results may vary from those estimates. Financial and statistical information we report to other regulatory agencies may be prepared on a basis other than GAAP or using different assumptions or reporting periods and, therefore, may vary from amounts presented herein. Although we make every effort to ensure that the information we report to those agencies is accurate, complete and consistent with applicable reporting guidelines, we cannot be responsible for the accuracy of the information they make available to the public.
Operating results for the three and nine-month periods ended September 30, 2020 are not necessarily indicative of the results that may be expected for the full year. Reasons for this include, but are not limited to: the impact of the COVID-19 pandemic on our operations, business, financial condition and cash flows; overall revenue and cost trends, particularly the timing and magnitude of price changes; fluctuations in contractual allowances and cost report settlements and valuation allowances; managed care contract negotiations, settlements or terminations and payer consolidations; trends in patient accounts receivable collectability and associated implicit price concessions; fluctuations in interest rates; levels of malpractice insurance expense and settlement trends; impairment of long-lived assets and goodwill; restructuring charges; losses, costs and insurance recoveries related to natural disasters and other weather-related occurrences; litigation and investigation costs; acquisitions and dispositions of facilities and other assets; gains (losses) on sales, consolidation and deconsolidation of facilities; income tax
rates and deferred tax asset valuation allowance activity; changes in estimates of accruals for annual incentive compensation; the timing and amounts of stock option and restricted stock unit grants to employees and directors; gains (losses) from early extinguishment of debt; and changes in occupancy levels and patient volumes. Factors that affect service mix, revenue mix, patient volumes and, thereby, the results of operations at our hospitals and related healthcare facilities include, but are not limited to: changes in federal, state and local healthcare and business regulations, including mandated closures and other operating restrictions; the business environment, economic conditions and demographics of local communities in which we operate; the number of uninsured and underinsured individuals in local communities treated at our hospitals; disease hotspots and seasonal cycles of illness; climate and weather conditions; physician recruitment, satisfaction, retention and attrition; advances in technology and treatments that reduce length of stay; local healthcare competitors; utilization pressure by managed care organizations, as well as managed care contract negotiations or terminations; hospital performance data on quality measures and patient satisfaction, as well as standard charges for services; any unfavorable publicity about us, or our joint venture partners, that impacts our relationships with physicians and patients; and changing consumer behavior, including with respect to the timing of elective procedures. These considerations apply to year-to-year comparisons as well.
Professional and General Liability Reserves
We accrue for estimated professional and general liability claims when they are probable and can be reasonably estimated. The accrual, which includes an estimate for incurred but not reported claims, is updated each quarter based on a model of projected payments using case-specific facts and circumstances and our historical loss reporting, development and settlement patterns. To the extent that subsequent claims information varies from our estimates, the liability is adjusted in the period such information becomes available. Malpractice expense is presented within other operating expenses in the accompanying Condensed Consolidated Statements of Operations.
In the three months ended March 31, 2020, we changed our method of accounting for our estimated professional and general liability claims. Under the new method of accounting, the liabilities are reported on an undiscounted basis whereas, previously, the liabilities were reported on a discounted basis. We believe that the undiscounted presentation is preferable because it simplifies the accounting for the liabilities, thereby increasing understandability of our financial results and financial condition, is consistent with the manner in which management evaluates our business, and results in an accounting method and financial statement presentation that is consistent with our key peers.
Accordingly, our financial statements and corresponding footnotes for the respective prior periods have been recast to reflect retrospective application of the change in accounting principle. We recorded the cumulative effect for the change in accounting principle as an increase of $44 million to accumulated deficit as of January 1, 2017. This change increased our accumulated deficit by $46 million, $41 million and $63 million at December 31, 2019, September 30, 2019 and December 31, 2018, respectively.
The following tables present the effects of the change in accounting principle to our financial statements: