A regional healthcare operator managing a robust network of ambulatory surgical centers and hospitals with consistent revenue growth despite recent volatility in net income.
The company has successfully navigated a period of significant debt reduction while stabilizing its top-line revenue at approximately $12.5B annually; the recent recovery in net profit to $676M suggests improved profitability or one-time gains that may stabilize earnings per share for long-term investors.
Investors should be wary of the negative shareholders' equity of -$837M and the massive cash outflow from financing activities, which signals potential liquidity stress; the substantial goodwill of $3.32B poses an impairment risk if operating performance declines or if the healthcare regulatory environment worsens.
Community Health Systems Inc. is a leading provider of ambulatory surgical centers (ASCs) and acute care hospitals serving the midwestern United States, delivering critical healthcare services including surgery, emergency care, and primary care.
While revenue remained resilient at $12.48B in 2025, mirroring the previous year's $12.63B figure, net income experienced a dramatic swing from a $362M loss in 2024 to a $676M profit in 2025; this turnaround was partially offset by massive debt repayments of $6.52B and negative financing cash flows, indicating a capital restructuring strategy rather than pure operational expansion.
The ambulatory surgery center industry is characterized by high volume, specialized procedures, and increasing consolidation as operators seek to achieve economies of scale; Community Health Systems competes against larger national chains and regional hospital systems for physician contracts and patient referrals.
| Metric | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|
| Revenue | $12.21B | $12.49B | $12.63B | $12.48B |
| Cost of Revenue | $1.98B | $1.99B | $1.95B | $1.86B |
| Gross Profit | $10.24B | $10.50B | $10.69B | $10.62B |
| Operating Expenses | $9.41B | $9.54B | $10.15B | $9.13B |
| Operating Income | $821.0M | $957.0M | $542.0M | $1.49B |
| Stock-Based Comp | $20.0M | $22.0M | $17.0M | $11.0M |
| D&A | $534.0M | $505.0M | $486.0M | $426.0M |
| Non-Operating Income | $-472.0M | $-750.0M | $-825.0M | $-764.0M |
| Interest Income | $2.0M | $2.0M | $3.0M | $2.0M |
| Pre-Tax Income | $349.0M | $207.0M | $-283.0M | $724.0M |
| Income Tax | $170.0M | $191.0M | $79.0M | $48.0M |
| Continuing Ops | $179.0M | $16.0M | $-362.0M | $676.0M |
| Discontinued Ops | $0 | $0 | $0 | $0 |
| Net Income | $179.0M | $16.0M | $-362.0M | $676.0M |
| Minority Interest | $133.0M | $149.0M | $154.0M | $167.0M |
| Net to Common | $46.0M | $-133.0M | $-516.0M | $509.0M |
| Metric | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|
| Current Assets | $3.08B | $3.21B | $3.30B | $3.23B |
| Cash & Equivalents | $118.0M | $38.0M | $37.0M | $260.0M |
| Accounts Receivable | $2.04B | $2.23B | $2.29B | $2.08B |
| Other Current Assets | $924.0M | $939.0M | $978.0M | $897.0M |
| Long-Term Assets | $11.59B | $11.25B | $10.75B | $9.97B |
| PP&E (Net) | $5.37B | $5.21B | $4.78B | $4.50B |
| Goodwill | $4.17B | $3.96B | $3.79B | $3.32B |
| Operating Leases | $738.0M | $665.0M | $623.0M | $617.0M |
| Other LT Assets | $1.16B | $1.25B | $1.41B | $1.40B |
| Total Assets | $14.67B | $14.46B | $14.05B | $13.20B |
| Current Liabilities | $2.19B | $2.14B | $2.35B | $2.21B |
| Accounts Payable | $773.0M | $912.0M | $913.0M | $842.0M |
| Current Leases | $148.0M | $124.0M | $115.0M | $110.0M |
| Other Current Liab | $1.26B | $1.11B | $1.32B | $1.26B |
| Long-Term Liabilities | $13.22B | $13.14B | $13.03B | $11.83B |
| Long-Term Debt | $11.61B | $11.47B | $11.43B | $10.38B |
| LT Operating Leases | $605.0M | $563.0M | $535.0M | $537.0M |
| Other LT Liab | $998.0M | $1.11B | $1.06B | $916.0M |
| Total Liabilities | $15.40B | $15.28B | $15.37B | $14.04B |
| Shareholders' Equity | $-734.0M | $-824.0M | $-1.32B | $-837.0M |
| Retained Earnings | $-3.43B | $-3.56B | $-4.08B | $-3.57B |
| AOCI | $-21.0M | $-14.0M | $-10.0M | $-9.0M |
| Total L&E | $14.67B | $14.46B | $14.05B | $13.20B |
| Metric | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|
| Net Income (CFO) | $179.0M | $16.0M | $-362.0M | $676.0M |
| Non-Cash Adjustments | $-72.0M | $-64.0M | $771.0M | $-138.0M |
| Working Capital Changes | $193.0M | $258.0M | $71.0M | $5.0M |
| Cash from Operations | $300.0M | $210.0M | $480.0M | $543.0M |
| Capital Expenditures | $415.0M | $467.0M | $360.0M | $335.0M |
| Cash from Investing | $-259.0M | $-26.0M | $-275.0M | $847.0M |
| Debt Repayments | $2.36B | $4.32B | $5.06B | $6.52B |
| Cash from Financing | $-430.0M | $-264.0M | $-206.0M | $-1.17B |
| FX Effect | $0 | $0 | $0 | $0 |
| Net Change in Cash | $-389.0M | $-80.0M | $-1.0M | $223.0M |
| Beginning Cash | $507.0M | $118.0M | $38.0M | $37.0M |
| Ending Cash | $118.0M | $38.0M | $37.0M | $260.0M |
The company derives its primary revenue from patient services across its extensive portfolio of ambulatory surgical centers (ASCs) and acute care hospitals, supplemented by pharmacy, laboratory, and diagnostic imaging services that support core clinical operations.
Significant leverage is evident with long-term debt of $10.38B against total liabilities exceeding assets, creating substantial refinancing and interest rate risks; healthcare regulatory changes and reimbursement rate adjustments could materially impact margins; the company recently reported a large non-operating loss of $764M that distorts underlying operational performance.
Community Health Systems maintains a dense network of facilities in key midwestern markets, providing significant geographic reach and operational scale; the company benefits from strong physician relationships and specialized expertise in high-volume surgical procedures.
Not financial advice. All content is for informational purposes only. Data may contain errors. Consult a qualified financial advisor before making investment decisions.