A “challenging macro environment” serving up more uninsured patients and fewer commercial elective procedures dragged Community Health Systems below internal and analyst operating forecasts for the third quarter.

The 59-hospital system reported $2.76 billion in third-quarter net operating revenue, down about 10.7% year over year due to several divestments but up 3.8% on a same-store basis. Net loss was $86 million, -$0.63 per diluted share or -$0.48 after adjustment, compared to the prior year’s $1.27 per share net income.

The consensus estimates for revenue and earnings were $2.78 billion and -$0.22 per diluted share, per Zach’s Investment Research. The company’s shares were trading over 10% below the open late Thursday afternoon.

“While overall financial results fell below our internal forecast, due to the same factors that many peers are experiencing—namely elevated uninsured volumes and temporary softness in commercial elective procedures—we delivered sequential volume gains and solid cash flow performance,” CEO Kevin Hammons summarized Thursday morning on the company’s earnings call. “Importantly, our leading indicators clearly demonstrate that care is being deferred rather than lost to competitors.”

CHS has reduced its 2026 guidance ranges for net operating revenues, adjusted EBITDA and cash ranges.

Same-store admissions rose 2.2% while adjusted admissions increased 3.6% year over year. However, about half of the adjusted admissions growth was among uninsured patients, Chief Financial Officer Jason Johnson explained, and a 2% overall increase in same-store surgeries masked low numbers for commercial electives. These factors held same-store net revenue per adjusted admission to just 0.2% year-over-year growth.

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