Community Health Systems Q3 2026 EBITDA Falls as Same-Store Volumes Grow

Community Health Systems Inc. (NYSE: CYH) reported lower third-quarter revenue and adjusted EBITDA as consolidated patient volumes declined, even as its same-store hospitals recorded growth across admissions, surgeries and emergency-room visits. The hospital operator also projected a full-year net loss and disclosed a sharp increase in uncompensated care.

Net operating revenue fell 10.7% year over year to $2.76 billion for the three months ended Sept. 30, 2026. Adjusted EBITDA declined 25.5% to $280 million, while the adjusted EBITDA margin narrowed by 200 basis points to 10.2%.

The company posted a net loss attributable to Community Health Systems stockholders of $86 million, compared with net income of $130 million a year earlier. The reported diluted loss was $0.63 per share, versus earnings of $0.96 per share in the prior-year quarter. Excluding specified adjustments, the diluted loss was $0.48 per share, compared with adjusted earnings of $1.27 per share.

Same-store activity remains positive

Consolidated admissions decreased 12.3%, adjusted admissions fell 11.9%, surgeries declined 15.1% and emergency-room visits were down 13.1% from the third quarter of 2025. On a same-store basis, however, admissions increased 2.2%, adjusted admissions rose 3.6%, surgeries grew 2.0% and emergency-room visits advanced 3.6%.

Same-store net operating revenue increased 3.8%, while net revenue per adjusted admission rose 0.2% on a consolidated basis and 1.0% at same-store facilities.

For the first nine months of 2026, net operating revenue decreased 8.9% to $8.55 billion. Adjusted EBITDA fell 18.8% to $918 million, and the adjusted EBITDA margin contracted by 140 basis points to 10.7%. Same-store revenue grew 2.9% over that period, supported by increases of 0.7% in admissions, 1.9% in adjusted admissions and 0.7% in emergency-room visits. Same-store surgeries declined 0.4%.

The nine-month net loss attributable to stockholders was $74 million, compared with net income of $399 million in the prior-year period. Excluding adjustments, the diluted loss was $1.15 per share, versus earnings of $1.20 per share a year earlier.

Uncompensated care increases

Managed care and other payors accounted for 46.1% of third-quarter net revenue, down from 48.5% a year earlier. Medicare managed care increased to 19.0% from 17.2%, while Medicaid represented 16.2%, Medicare 17.0% and self-pay 1.7%.

Total consolidated uncompensated care rose to 32.9% of adjusted net revenue from 25.2% in the third quarter of 2025. The measure includes uncollectible revenue, charity care and administrative self-pay discounts.

Debt declines, operating cash flow remains limited

Community Health Systems ended September with $9.59 billion of total debt, down from $10.40 billion at the end of 2025. All debt was fixed-rate as of Sept. 30. Total assets declined to $12.11 billion from $13.20 billion, while the stockholders’ deficit widened to $1.49 billion from $1.39 billion.

Days revenue outstanding for same-store hospitals, adjusted for receivables tied to state Medicaid supplemental payment programs, increased to 59 days from 54 days at year-end 2025.

Adjusted cash flow from operations totaled $15 million for the first nine months, excluding $70 million of cash taxes paid from divestiture proceeds. Capital expenditures were $239 million, representing 2.8% of net operating revenue, compared with $241 million and 2.6% of revenue in the prior-year period.

2026 outlook

Community Health Systems expects full-year net operating revenue of $11.3 billion to $11.5 billion and adjusted EBITDA of $1.23 billion to $1.28 billion. The company projects a diluted net loss of $1.70 to $1.60 per share, based on approximately 136 million weighted-average diluted shares.

Management also forecasts net cash provided by operating activities of $100 million to $300 million and capital expenditures of $350 million to $400 million. Depreciation and amortization are expected to equal 3.8% to 3.9% of revenue.

The company cautioned that its projections are subject to regulatory, economic and competitive uncertainty. Identified risks include changes to Medicare, Medicaid and Affordable Care Act coverage; reimbursement pressure; labor costs and staffing challenges; collectability of patient receivables; cybersecurity incidents; legal and regulatory proceedings; and the company’s substantial debt and refinancing obligations.