Segment and Geographic Information (Tables)

3 Months Ended

Mar. 31, 2025

Segment Reporting [Abstract]

Schedule of Geographic Distributions of Revenues, Equity in Earnings or Losses of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization

The geographic distributions of our revenues, salaries and benefits, supplies, other operating expenses, equity in earnings of affiliates, adjusted segment EBITDA, depreciation and amortization and assets that are provided to the Chief Operating Decision Maker, which is the Chief Executive Officer, are summarized in the following tables (dollars in millions) and represent the operating segments for the quarters ended March 31, 2025 and 2024 and assets at March 31, 2025 and December 31, 2024:

	2025
	National Group		Atlantic Group			American Group
Revenues	$	5,065	$	6,167		$	6,331
Salaries and benefits		1,959		2,216			2,196
Supplies		741		914			1,020
Other operating expenses		1,233		1,576			1,711
Equity in earnings of affiliates		-		(1	)		(14	)
		3,933		4,705			4,913
Adjusted segment EBITDA	$	1,132	$	1,462		$	1,418

	2024
	National Group			Atlantic Group			American Group
Revenues	$	4,835		$	5,810		$	5,984
Salaries and benefits		1,890			2,161			2,119
Supplies		705			909			980
Other operating expenses		1,194			1,482			1,580
Equity in earnings of affiliates		(1	)		(1	)		(13	)
		3,788			4,551			4,666
Adjusted segment EBITDA	$	1,047		$	1,259		$	1,318

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

	2025			2024
Adjusted segment EBITDA:
National Group	$	1,132		$	1,047
Atlantic Group		1,462			1,259
American Group		1,418			1,318
		4,012			3,624
Adjustments to reconcile Total Adjusted segment   EBITDA to consolidated Income before income taxes:
Corporate and Other		279			271
Depreciation and amortization		860			795
Interest expense		547			512
Gains on sales of facilities		(1	)		(201	)
Income before income taxes	$	2,327		$	2,247

	2025		2024
Revenues:
National Group	$	5,065	$	4,835
Atlantic Group		6,167		5,810
American Group		6,331		5,984
Corporate and other		758		710
	$	18,321	$	17,339
Depreciation and amortization:
National Group	$	226	$	212
Atlantic Group		274		258
American Group		279		255
Corporate and other		81		70
	$	860	$	795

	March 31, 2025		December 31, 2024
Assets:
National Group	$	13,407	$	12,855
Atlantic Group		17,654		17,168
American Group		20,614		20,714
Corporate and other		8,123		8,776
	$	59,798	$	59,513