Community Health Systems swung to a loss in the third quarter. Net operating revenues were $2.757 billion, down 10.7 percent from $3.087 billion a year earlier, the company reported on October 28 in results furnished to the SEC. Net loss attributable to stockholders was $86 million, or $0.63 per share, against net income of $130 million, or $0.96 per share, in the same quarter of 2025. Adjusted EBITDA fell to $280 million, from $376 million, a margin of 10.2 percent of revenues against 12.2 percent.
The reported decline overstates the operating trend and understates the profit problem at the same time. On a same store basis, net operating revenues rose 3.8 percent, so the headline fall reflects a smaller hospital portfolio after divestitures rather than collapsing demand at the hospitals the company still runs. Reported admissions fell 12.3 percent and adjusted admissions 11.9 percent, again a portfolio effect. Yet even adjusting for the shrinkage, earnings fell much faster than revenue, and operating cash flow, while up to $155 million from $70 million in the quarter, is negative $55 million for the nine months against positive $277 million a year earlier.
For the nine months, revenues were $8.547 billion, down 8.9 percent, with same store revenue up 2.9 percent, and adjusted EBITDA was $918 million against $1.131 billion. The company also noted the prior year quarter benefited from $28 million received in a legal settlement, which flatters the comparison in the other direction.
Guidance for 2026 puts net operating revenues at $11.3 billion to $11.5 billion and adjusted EBITDA at $1.225 billion to $1.275 billion, with a diluted net loss per share of $1.60 to $1.70 and interest expense estimated at $820 million to $830 million. That interest line, close to two thirds of guided EBITDA at the midpoint, is the structural story for this operator: the remaining hospitals are growing modestly, and the debt taken on to assemble the portfolio is consuming most of what they earn.