NOTE 13 — SEGMENT AND GEOGRAPHIC INFORMATION

We operate in one line of business, which is operating hospitals and related health care entities. We operate in three geographically organized groups: the National, Atlantic and American Groups. At December 31, 2025, the National Group included 53 hospitals located in Alaska, California, Idaho, Kentucky, Nevada, New Hampshire, North Carolina, Tennessee, Utah and Virginia; the Atlantic Group included 63 hospitals located in Florida, Georgia, Northern Kansas, Missouri and South Carolina; and the American Group included 66 hospitals located in Colorado, Central Kansas, Louisiana and Texas. The eight hospitals we operate in England are included in the Corporate and other group.

NOTE 13 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, losses and gains on sales of facilities, losses on retirement of debt, income taxes and net income attributable to noncontrolling interests. We use adjusted segment EBITDA as an analytical indicator for purposes of allocating resources to geographic areas and assessing their performance. Adjusted segment EBITDA is commonly used as an analytical indicator within the health care industry, and also serves as a measure of leverage capacity and debt service ability. Adjusted segment EBITDA should not be considered as a measure of financial performance under generally accepted accounting principles, and the items excluded from adjusted segment EBITDA are significant components in understanding and assessing financial performance. Because adjusted segment EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, adjusted segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. The geographic distributions of our revenues, salaries and benefits, supplies, other operating expenses, equity in earnings or losses of affiliates, adjusted segment EBITDA, depreciation and amortization, assets and goodwill and other intangible assets that are provided to the Chief Operating Decision Maker, which is the Chief Executive Officer, are summarized in the following tables (dollars in millions) and represent the operating segments at December 31, 2025:

 

 

 

For the Year Ended December 31, 2025

 

 

 

National
Group

 

 

Atlantic
Group

 

 

American
Group

 

Revenues

 

$

21,278

 

 

$

24,709

 

 

$

26,445

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

 

7,812

 

 

 

9,023

 

 

 

8,992

 

Supplies

 

 

3,043

 

 

 

3,689

 

 

 

4,263

 

Other operating expenses

 

 

5,321

 

 

 

6,358

 

 

 

6,962

 

Equity in (earnings) losses of affiliates

 

 

(1

)

 

 

(3

)

 

 

(68

)

 

 

 

16,175

 

 

 

19,067

 

 

 

20,149

 

Adjusted segment EBITDA

 

$

5,103

 

 

$

5,642

 

 

$

6,296

 

 

 

 

For the Year Ended December 31, 2024

 

 

 

National
Group

 

 

Atlantic
Group

 

 

American
Group

 

Revenues

 

$

19,656

 

 

$

23,380

 

 

$

24,668

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

 

7,542

 

 

 

8,686

 

 

 

8,599

 

Supplies

 

 

2,812

 

 

 

3,553

 

 

 

4,035

 

Other operating expenses

 

 

4,908

 

 

 

6,206

 

 

 

6,367

 

Equity in (earnings) losses of affiliates

 

 

2

 

 

 

(3

)

 

 

(62

)

 

 

 

15,264

 

 

 

18,442

 

 

 

18,939

 

Adjusted segment EBITDA

 

$

4,392

 

 

$

4,938

 

 

$

5,729

 

 

NOTE 13 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

 

 

 

For the Year Ended December 31, 2023

 

 

 

National
Group

 

 

Atlantic
Group

 

 

American
Group

 

Revenues

 

$

18,105

 

 

$

21,167

 

 

$

22,318

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

 

7,196

 

 

 

8,058

 

 

 

8,080

 

Supplies

 

 

2,658

 

 

 

3,331

 

 

 

3,616

 

Other operating expenses

 

 

4,253

 

 

 

5,289

 

 

 

5,473

 

Equity in (earnings) losses of affiliates

 

 

(2

)

 

 

(3

)

 

 

(59

)

 

 

 

14,105

 

 

 

16,675

 

 

 

17,110

 

Adjusted segment EBITDA

 

$

4,000

 

 

$

4,492

 

 

$

5,208

 

 

 

 

For the Year Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Adjusted segment EBITDA:

 

 

 

 

 

 

 

 

 

National Group

 

$

5,103

 

 

$

4,392

 

 

$

4,000

 

Atlantic Group

 

 

5,642

 

 

 

4,938

 

 

 

4,492

 

American Group

 

 

6,296

 

 

 

5,729

 

 

 

5,208

 

 

 

 

17,041

 

 

 

15,059

 

 

 

13,700

 

Adjustments to reconcile Total Adjusted segment
  EBITDA to consolidated Income before income taxes:

 

 

 

 

 

 

 

 

 

Corporate and Other

 

 

1,475

 

 

 

1,177

 

 

 

974

 

Depreciation and amortization

 

 

3,523

 

 

 

3,312

 

 

 

3,077

 

Interest expense

 

 

2,248

 

 

 

2,061

 

 

 

1,938

 

Losses (gains) on sales of facilities

 

 

(37

)

 

 

(14

)

 

 

5

 

Income before income taxes

 

$

9,832

 

 

$

8,523

 

 

$

7,706

 

 

 

 

For the Year Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Revenues:

 

 

 

 

 

 

 

 

 

National Group

 

$

21,278

 

 

$

19,656

 

 

$

18,105

 

Atlantic Group

 

 

24,709

 

 

 

23,380

 

 

 

21,167

 

American Group

 

 

26,445

 

 

 

24,668

 

 

 

22,318

 

Corporate and other

 

 

3,168

 

 

 

2,899

 

 

 

3,378

 

 

 

$

75,600

 

 

$

70,603

 

 

$

64,968

 

 

 

 

 

 

 

 

 

 

 

Depreciation and amortization:

 

 

 

 

 

 

 

 

 

National Group

 

$

905

 

 

$

857

 

 

$

834

 

Atlantic Group

 

 

1,122

 

 

 

1,061

 

 

 

989

 

American Group

 

 

1,131

 

 

 

1,083

 

 

 

971

 

Corporate and other

 

 

365

 

 

 

311

 

 

 

283

 

 

 

$

3,523

 

 

$

3,312

 

 

$

3,077

 

 

NOTE 13 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

 

 

 

December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Assets:

 

 

 

 

 

 

 

 

 

National Group

 

$

13,596

 

 

$

12,855

 

 

$

12,487

 

Atlantic Group

 

 

17,945

 

 

 

17,168

 

 

 

16,098

 

American Group

 

 

21,217

 

 

 

20,714

 

 

 

19,786

 

Corporate and other

 

 

7,962

 

 

 

8,776

 

 

 

7,840

 

 

 

$

60,720

 

 

$

59,513

 

 

$

56,211

 

 

 

 

National
Group

 

 

Atlantic
Group

 

 

American
Group

 

 

Corporate
and Other

 

 

Total

 

Goodwill and other intangible assets:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Balance at December 31, 2022

 

$

1,244

 

 

$

2,057

 

 

$

5,152

 

 

$

1,200

 

 

$

9,653

 

Acquisitions

 

 

 

 

 

8

 

 

 

326

 

 

 

28

 

 

 

362

 

Foreign currency translation, amortization and other

 

 

(3

)

 

 

(1

)

 

 

 

 

 

(66

)

 

 

(70

)

Balance at December 31, 2023

 

 

1,241

 

 

 

2,064

 

 

 

5,478

 

 

 

1,162

 

 

 

9,945

 

Acquisitions

 

 

 

 

 

61

 

 

 

105

 

 

 

4

 

 

 

170

 

Foreign currency translation, amortization and other

 

 

(4

)

 

 

(1

)

 

 

3

 

 

 

(20

)

 

 

(22

)

Balance at December 31, 2024

 

 

1,237

 

 

 

2,124

 

 

 

5,586

 

 

 

1,146

 

 

 

10,093

 

Acquisitions

 

 

21

 

 

 

90

 

 

 

101

 

 

 

6

 

 

 

218

 

Foreign currency translation, amortization and other

 

 

(24

)

 

 

 

 

 

1

 

 

 

5

 

 

 

(18

)

Balance at December 31, 2025

 

$

1,234

 

 

$

2,214

 

 

$

5,688

 

 

$

1,157

 

 

$

10,293

 

Historical Timeline

Fiscal YearFiled
2025Feb 10, 2026Showing above
2024Feb 14, 2025
2023Feb 16, 2024
2022Feb 17, 2023
2021Feb 18, 2022
2020Feb 19, 2021
2019Feb 20, 2020
2018Feb 21, 2019
2017Feb 23, 2018
2016Feb 22, 2017
2015Feb 26, 2016

About Segments Disclosures

Segment disclosures break a company into its reportable operating units, revealing revenue, profit, and asset allocation that consolidated financial statements obscure. Under ASC 280, segments must match how the chief operating decision maker views the business, providing a window into internal management structure and resource allocation priorities.

Key signals: compare segment margins to identify which units drive profitability and which destroy value. Watch for changes in the number of reportable segments — segment aggregation or disaggregation often coincides with strategic shifts or attempts to obscure declining performance. Intersegment elimination patterns reveal internal pricing practices. The reconciliation between segment totals and consolidated figures exposes corporate overhead allocation and unallocated items. Geographic revenue concentration highlights regulatory and currency exposure. Compare segment-level capital expenditure against segment revenue to assess where management is investing for future growth versus harvesting existing assets.