UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

Form 10-Q

(Mark One)

☒ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended September 30, 2023

Or

☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from to

Commission file number 1-11239

HCA Healthcare, Inc.

(Exact name of registrant as specified in its charter)

Delaware	27-3865930
(State or other jurisdiction of incorporation or organization)	(I.R.S. Employer Identification No.)
One Park Plaza Nashville, Tennessee	37203
(Address of principal executive offices)	(Zip Code)

(615) 344-9551

(Registrant’s telephone number, including area code)

Not Applicable

(Former name, former address and former fiscal year, if changed since last report)

Securities registered pursuant to Section 12(b) of the Act:

Title of each class	Trading Symbol(s)	Name of each exchange on which registered
Voting common stock, $.01 par value	HCA	New York Stock Exchange

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§ 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes ☒ No ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

Large accelerated filer	☒	Accelerated filer	☐
Non-accelerated filer	☐	Smaller reporting company	☐
Emerging growth company	☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No ☒

Indicate the number of shares outstanding of each of the issuer’s classes of common stock as of the latest practicable date.

Class of Common Stock	Outstanding at October 23, 2023
Voting common stock, $.01 par value	267,660,800 shares

HCA HEALTHCARE, INC.

Form 10-Q

September 30, 2023

		Page of Form 10-Q
Part I.	Financial Information
Item 1.	Financial Statements (Unaudited):
	Condensed Consolidated Income Statements — for the quarters and nine months ended September 30, 2023 and 2022	3
	Condensed Consolidated Comprehensive Income Statements — for the quarters and nine months ended September 30, 2023 and 2022	4
	Condensed Consolidated Balance Sheets — September 30, 2023 and December 31, 2022	5
	Condensed Consolidated Statements of Stockholders’ Equity (Deficit) — for the quarters and nine months ended September 30, 2023 and 2022	6
	Condensed Consolidated Statements of Cash Flows — for the nine months ended September 30, 2023 and 2022	7
	Notes to Condensed Consolidated Financial Statements	8
Item 2.	Management’s Discussion and Analysis of Financial Condition and Results of Operations	16
Item 3.	Quantitative and Qualitative Disclosures About Market Risk	28
Item 4.	Controls and Procedures	28
Part II.	Other Information
Item 1.	Legal Proceedings	28
Item 1A.	Risk Factors	28
Item 2.	Unregistered Sales of Equity Securities and Use of Proceeds	28
Item 5.	OOther Information	29
Item 6.	Exhibits	29
Signatures		30

2

HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED INCOME STATEMENTS

FOR THE QUARTERS AND NINE MONTHS ENDED SEPTEMBER 30, 2023 AND 2022

Unaudited

(Dollars in millions, except per share amounts)

	Quarter						Nine Months
	2023			2022			2023		2022
Revenues	$	16,213		$	14,971		$	47,665	$	44,736
Salaries and benefits		7,556			6,899			21,917		20,630
Supplies		2,417			2,320			7,318		6,942
Other operating expenses		3,379			2,860			9,316		8,305
Equity in (earnings) losses of affiliates		(19	)		(10	)		6		(29	)
Depreciation and amortization		769			749			2,288		2,219
Interest expense		483			446			1,447		1,288
Losses (gains) on sales of facilities		(2	)		3			12		25
Losses on retirement of debt		—			—			—		78
		14,583			13,267			42,304		39,458
Income before income taxes		1,630			1,704			5,361		5,278
Provision for income taxes		355			360			1,131		1,090
Net income		1,275			1,344			4,230		4,188
Net income attributable to noncontrolling interests		196			210			595		626
Net income attributable to HCA Healthcare, Inc.	$	1,079		$	1,134		$	3,635	$	3,562
Per share data:
Basic earnings	$	3.98		$	3.97		$	13.26	$	12.13
Diluted earnings	$	3.91		$	3.91		$	13.07	$	11.97
Shares used in earnings per share calculations (in millions):
Basic		271.173			285.958			274.171		293.583
Diluted		275.424			289.852			278.173		297.702

The accompanying notes are an integral part of the condensed consolidated financial statements.

3

HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED COMPREHENSIVE INCOME STATEMENTS

FOR THE QUARTERS AND NINE MONTHS ENDED SEPTEMBER 30, 2023 AND 2022

Unaudited

(Dollars in millions)

	Quarter						Nine Months
	2023			2022			2023			2022
Net income	$	1,275		$	1,344		$	4,230		$	4,188
Other comprehensive loss before taxes:
Foreign currency translation		(35	)		(76	)		3			(181	)
Unrealized losses on available-for-sale securities		(7	)		(16	)		(5	)		(58	)
Losses included in other operating expenses		—			—			—			1
		(7	)		(16	)		(5	)		(57	)
Defined benefit plans		—			—			—			—
Pension costs included in salaries and benefits		1			2			1			7
		1			2			1			7
Change in fair value of derivative financial instruments		—			1			—			6
Interest costs included in interest expense		—			—			—			4
		—			1			—			10
Other comprehensive loss before taxes		(41	)		(89	)		(1	)		(221	)
Income tax benefits related to other comprehensive loss items		(6	)		(12	)		—			(33	)
Other comprehensive loss		(35	)		(77	)		(1	)		(188	)
Comprehensive income		1,240			1,267			4,229			4,000
Comprehensive income attributable to noncontrolling interests		196			210			595			626
Comprehensive income attributable to HCA Healthcare, Inc.	$	1,044		$	1,057		$	3,634		$	3,374

The accompanying notes are an integral part of the condensed consolidated financial statements.

4

HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS

Unaudited

(Dollars in millions)

	September 30, 2023			December 31, 2022
ASSETS
Current assets:
Cash and cash equivalents	$	891		$	908
Accounts receivable		9,182			8,891
Inventories		2,030			2,068
Other		2,191			1,776
		14,294			13,643
Property and equipment, at cost		57,772			54,757
Accumulated depreciation		(30,655	)		(29,182	)
		27,117			25,575
Investments of insurance subsidiaries		382			381
Investments in and advances to affiliates		739			823
Goodwill and other intangible assets		9,778			9,653
Right-of-use operating lease assets		2,079			2,065
Other		200			298
	$	54,589		$	52,438
LIABILITIES AND STOCKHOLDERS’ EQUITY (DEFICIT)
Current liabilities:
Accounts payable	$	4,139		$	4,239
Accrued salaries		1,912			1,712
Other accrued expenses		3,803			3,581
Long-term debt due within one year		2,553			370
		12,407			9,902
Long-term debt, less debt issuance costs and discounts of $341 and $301		36,793			37,714
Professional liability risks		1,590			1,528
Right-of-use operating lease obligations		1,776			1,752
Income taxes and other liabilities		1,666			1,615
Stockholders’ equity (deficit):
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 268,967,300 shares — 2023 and 277,378,300 shares — 2022		3			3
Accumulated other comprehensive loss		(491	)		(490	)
Retained deficit		(1,989	)		(2,280	)
Stockholders’ deficit attributable to HCA Healthcare, Inc.		(2,477	)		(2,767	)
Noncontrolling interests		2,834			2,694
		357			(73	)
	$	54,589		$	52,438

The accompanying notes are an integral part of the condensed consolidated financial statements.

5

HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY (DEFICIT)

FOR THE QUARTERS AND NINE MONTHS ENDED SEPTEMBER 30, 2023 AND 2022

Unaudited

(Dollars in millions)

	Equity (Deficit) Attributable to HCA Healthcare, Inc.
						Capital			Accumulated						Equity
	Common Stock					in Excess			Other						Attributable to
	Shares			Par		of Par			Comprehensive			Retained			Noncontrolling
	(in millions)			Value		Value			Loss			Deficit			Interests			Total
Balances, December 31, 2021		305.477		$	3	$	—		$	(404	)	$	(532	)	$	2,422		$	1,489
Comprehensive income (loss)										(43	)		1,273			192			1,422
Repurchase of common stock		(8.375	)										(2,101	)					(2,101	)
Share-based benefit plans		1.879											(57	)					(57	)
Cash dividends declared    ($0.56 per share)													(171	)					(171	)
Distributions																(171	)		(171	)
Other													(1	)		4			3
Balances, March 31, 2022		298.981			3		—			(447	)		(1,589	)		2,447			414
Comprehensive income (loss)										(68	)		1,155			224			1,311
Repurchase of common stock		(12.230	)				(111	)					(2,571	)					(2,682	)
Share-based benefit plans		0.253					118												118
Cash dividends declared    ($0.56 per share)													(163	)					(163	)
Distributions																(162	)		(162	)
Other							(7	)								29			22
Balances, June 30, 2022		287.004			3		—			(515	)		(3,168	)		2,538			(1,142	)
Comprehensive income (loss)										(77	)		1,134			210			1,267
Repurchase of common stock		(3.361	)				(113	)					(585	)					(698	)
Share-based benefit plans		0.261					116												116
Cash dividends declared    ($0.56 per share)													(162	)					(162	)
Distributions																(217	)		(217	)
Other							(3	)								61			58
Balances, September 30, 2022		283.904			3		—			(592	)		(2,781	)		2,592			(778	)
Comprehensive income										102			2,081			565			2,748
Repurchase of common stock		(6.781	)				(40	)					(1,479	)					(1,519	)
Share-based benefit plans		0.255					48					57							105
Cash dividends declared    ($0.56 per share)													(159	)					(159	)
Distributions																(475	)		(475	)
Other							(8	)					1			12			5
Balances, December 31, 2022		277.378			3		—			(490	)		(2,280	)		2,694			(73	)
Comprehensive income										20			1,363			180			1,563
Repurchase of common stock		(3.340	)										(849	)					(849	)
Share-based benefit plans		1.902											(87	)					(87	)
Cash dividends declared    ($0.60 per share)													(