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SEGMENT INFORMATION
 9 Months Ended
Sep. 30, 2023
Segment Reporting [Abstract]  
SEGMENT INFORMATION SEGMENT INFORMATION
Our business consists of our Hospital Operations segment, our Ambulatory Care segment and our Conifer segment. The factors for determining the reportable segments include the manner in which management evaluates operating performance combined with the nature of the individual business activities.
Our Hospital Operations segment is comprised of our acute care and specialty hospitals, a network of employed physicians and ancillary outpatient facilities. At September 30, 2023, our subsidiaries operated 61 hospitals serving primarily urban and suburban communities in nine states, including the new acute care hospital we opened in September 2022 in South Carolina. Also at September 30, 2023, our Hospital Operations segment included 107 outpatient facilities, primarily imaging centers, ancillary emergency facilities and micro‑hospitals. Our Ambulatory Care segment is comprised of the operations of USPI. At September 30, 2023, USPI had ownership interests in 457 ambulatory surgery centers (316 consolidated) and 24 surgical hospitals (eight consolidated) in 35 states. Effective June 30, 2022, we purchased all of the shares in USPI that Baylor held on that date for $406 million, which increased our ownership interest in USPI’s voting shares from 95% to 100% (see Note 13 for additional information about this transaction). Our Conifer segment provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other clients. At September 30, 2023, Conifer provided services to approximately 670 Tenet and non‑Tenet hospitals and other clients nationwide. Conifer provides revenue management, administrative support and various other services to Tenet hospitals. We believe the pricing terms for these services are commercially reasonable and consistent with estimated third‑party terms. At September 30, 2023, we owned approximately 76% of Conifer Health Solutions, LLC, which is Conifer’s principal subsidiary.
The following tables include amounts for each of our reportable segments and the items necessary to reconcile them to the amounts reported in the accompanying Condensed Consolidated Balance Sheets and Condensed Consolidated Statements of Operations, as applicable:
September 30, 2023December 31, 2022
Assets:  
Hospital Operations$15,795 $15,682 
Ambulatory Care10,919 10,557 
Conifer876 917 
Total $27,590 $27,156 
Three Months Ended
September 30,		Nine Months Ended
September 30,
2023202220232022
Capital expenditures:    
Hospital Operations$153 $143 $477 $405 
Ambulatory Care20 18 58 58 
Conifer3 4 8 9 
Total $176 $165 $543 $472 
Net operating revenues:
Hospital Operations total prior to inter-segment eliminations$3,919 $3,778 $11,740 $11,221 
Ambulatory Care941 806 2,788 2,315 
Conifer
Tenet109 116 321 342 
Other clients206 217 641 648 
Total Conifer revenues315 333 962 990 
Inter-segment eliminations(109)(116)(321)(342)
Total $5,066 $4,801 $15,169 $14,184 
Three Months Ended
September 30,		Nine Months Ended
September 30,
2023202220232022
Equity in earnings of unconsolidated affiliates:
Hospital Operations$1 $2 $6 $8 
Ambulatory Care50 49 149 143 
Total $51 $51 $155 $151 
Adjusted EBITDA:
Hospital Operations$401 $432 $1,194 $1,377 
Ambulatory Care370 319 1,080 920 
Conifer83 90 255 275 
Total $854 $841 $2,529 $2,572 
Depreciation and amortization:
Hospital Operations$183 $172 $540 $518 
Ambulatory Care32 28 86 83 
Conifer9 9 28 27 
Total$224 $209 $654 $628 
Adjusted EBITDA$854 $841 $2,529 $2,572 
Depreciation and amortization(224)(209)(654)(628)
Impairment and restructuring charges, and acquisition-related costs(47)(24)(84)(97)
Litigation and investigation costs(14)(12)(28)(50)
Interest expense(227)(222)(674)(671)
Loss from early extinguishment of debt— — (11)(109)
Other non-operating income, net4 6 8 6 
Net gains (losses) on sales, consolidation and deconsolidation of facilities(1)— 12 — 
Income from continuing operations, before income taxes$345 $380 $1,098 $1,023