10-Q

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 March 31, 2021

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 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 April 26, 2021
Voting common stock, $.01 par value	330,655,500 shares

HCA HEALTHCARE, INC.

Form 10-Q

March 31, 2021

		Page of Form 10-Q
Part I.	Financial Information
Item 1.	Financial Statements (Unaudited):
	Condensed Consolidated Income Statements — for the quarters ended March 31, 2021 and 2020		2
	Condensed Consolidated Comprehensive Income Statements — for the quarters ended March 31, 2021 and 2020		3
	Condensed Consolidated Balance Sheets — March 31, 2021 and December 31, 2020		4
	Condensed Consolidated Statements of Stockholders’ Equity (Deficit) — for the quarters ended March 31, 2021 and 2020		5
	Condensed Consolidated Statements of Cash Flows — for the quarters ended March 31, 2021 and 2020		6
	Notes to Condensed Consolidated Financial Statements		7
Item 2.	Management’s Discussion and Analysis of Financial Condition and Results of Operations		18
Item 3.	Quantitative and Qualitative Disclosures About Market Risk		33
Item 4.	Controls and Procedures		33
Part II.	Other Information
Item 1.	Legal Proceedings		33
Item 1A.	Risk Factors		33
Item 2.	Unregistered Sales of Equity Securities and Use of Proceeds		33
Item 6.	Exhibits		35
Signatures			36

1

HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED INCOME STATEMENTS

FOR THE QUARTERS ENDED MARCH 31, 2021 AND 2020

Unaudited

(Dollars in millions, except per share amounts)

	2021			2020
Revenues	$	13,977		$	12,861
Salaries and benefits		6,301			6,118
Supplies		2,224			2,123
Other operating expenses		2,421			2,427
Equity in earnings of affiliates		(21	)		(7	)
Depreciation and amortization		697			674
Interest expense		384			428
Gains on sales of facilities		(2	)		(7	)
Losses on retirement of debt		—			295
	12,004			12,051
Income before income taxes		1,973			810
Provision for income taxes		393			112
Net income		1,580			698
Net income attributable to noncontrolling interests		157			117
Net income attributable to HCA Healthcare, Inc.	$	1,423		$	581
Per share data:
Basic earnings	$	4.21		$	1.72
Diluted earnings	$	4.14		$	1.69
Shares used in earnings per share calculations (in millions):
Basic		338.123			338.242
Diluted		343.321			344.096

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

2

HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED COMPREHENSIVE INCOME STATEMENTS

FOR THE QUARTERS ENDED MARCH 31, 2021 AND 2020

Unaudited

(Dollars in millions)

	2021			2020
Net income	$	1,580		$	698
Other comprehensive income (loss) before taxes:
Foreign currency translation		8			(73	)
Unrealized losses on available-for-sale securities		(11	)		(5	)
Defined benefit plans		—			—
Pension costs included in salaries and benefits		7			4
	7			4
Change in fair value of derivative financial instruments		1			(60	)
Interest expense (benefits) included in interest expense		9			(1	)
		10			(61	)
Other comprehensive income (loss) before taxes		14			(135	)
Income taxes (benefits) related to other comprehensive income items		3			(24	)
Other comprehensive income (loss)		11			(111	)
Comprehensive income		1,591			587
Comprehensive income attributable to noncontrolling interests		157			117
Comprehensive income attributable to HCA Healthcare, Inc.	$	1,434		$	470

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

3

HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS

Unaudited

(Dollars in millions)

	March 31, 2021			December 31, 2020
ASSETS
Current assets:
Cash and cash equivalents	$	1,030		$	1,793
Accounts receivable		7,424			7,051
Inventories		2,068			2,025
Other		1,514			1,464
		12,036			12,333
Property and equipment, at cost		49,877			49,317
Accumulated depreciation		(26,689	)		(26,118	)
		23,188			23,199
Investments of insurance subsidiaries		393			388
Investments in and advances to affiliates		427			422
Goodwill and other intangible assets		8,575			8,578
Right-of-use operating lease assets		2,083			2,024
Other		575			546
	$	47,277		$	47,490
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Accounts payable	$	3,524		$	3,535
Accrued salaries		1,767			1,720
Other accrued expenses		3,117			3,240
Long-term debt due within one year		234			209
		8,642			8,704
Long-term debt, less debt issuance costs and discounts of $229 and $236		30,838			30,795
Professional liability risks		1,553			1,486
Right-of-use operating lease obligations		1,730			1,673
Income taxes and other liabilities		2,032			1,940
Stockholders’ equity:
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 333,714,500 shares — 2021 and  339,425,600 shares — 2020		3			3
Capital in excess of par value		—			294
Accumulated other comprehensive loss		(491	)		(502	)
Retained earnings		735			777
Stockholders’ equity attributable to HCA Healthcare, Inc.		247			572
Noncontrolling interests		2,235			2,320
		2,482			2,892
	$	47,277		$	47,490

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

4

HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY (DEFICIT)

FOR THE QUARTERS ENDED MARCH 31, 2021 AND 2020

Unaudited

(Dollars in millions)

	Equity (Deficit) Attributable to HCA Healthcare, Inc.														Equity Attributable to Noncontrolling Interests			Total
	Common Stock					Capital in Excess of Par Value			Accumulated Other Comprehensive Loss			Retained Earnings (Deficit)
	Shares (in millions)			Par Value
Balances, December 31, 2019		338.446		$	3	$	—		$	(460	)	$	(2,351	)	$	2,243		$	(565	)
Comprehensive income										(111	)		581			117			587
Repurchase of common stock		(3.287	)										(441	)					(441	)
Share-based benefit plans		2.449					2						(35	)					(33	)
Cash dividends declared ($0.43 per share)													(148	)					(148	)
Distributions																(154	)		(154	)
Other							(2	)								53			51
Balances, March 31, 2020		337.608			3		—			(571	)		(2,394	)		2,259			(703	)
Comprehensive income										9			1,079			137			1,225
Share-based benefit plans		0.352					93												93
Distributions																(45	)		(45	)
Other							(5	)								3			(2	)
Balances, June 30, 2020		337.960			3		88			(562	)		(1,315	)		2,354			568
Comprehensive income										47			668			111			826
Share-based benefit plans		0.410					97												97
Distributions																(194	)		(194	)
Other																2			2
Balances, September 30, 2020		338.370			3		185			(515	)		(647	)		2,273			1,299
Comprehensive income										13			1,426			268			1,707
Share-based benefit plans		1.056					108												108
Cash dividends declared ($0.43 per share)													(2	)					(2	)
Distributions																(233	)		(233	)
Other							1									12			13
Balances, December 31, 2020		339.426			3		294			(502	)		777			2,320			2,892
Comprehensive income										11			1,423			157			1,591
Repurchase of common stock		(8.477	)				(225	)					(1,302	)					(1,527	)
Share-based benefit plans		2.765					(75	)											(75	)
Cash dividends declared ($0.48 per share)													(163	)					(163	)
Distributions																(234	)		(234	)
Other							6									(8	)		(2	)
Balances, March 31, 2021		333.714		$	3	$	—		$	(491	)	$	735		$	2,235		$	2,482

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

5

HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

FOR THE QUARTERS ENDED MARCH 31, 2021 AND 2020

Unaudited

(Dollars in millions)

	2021			2020
Cash flows from operating activities:
Net income	$	1,580		$	698
Adjustments to reconcile net income to net cash provided by operating activities:
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable		(371	)		464
Inventories and other assets		(85	)		(196	)
Accounts payable and accrued expenses		(371	)		(784	)
Depreciation and amortization		697			674
Income taxes		406			121
Gains on sales of facilities		(2	)		(7	)
Losses on retirement of debt		—			295
Amortization of debt issuance costs and discounts		8			7
Share-based compensation		97			82
Other		29			21
Net cash provided by operating activities		1,988			1,375
Cash flows from investing activities:
Purchase of property and equipment		(654	)		(853	)
Acquisition of hospitals and health care entities		(22	)		(328	)
Sales of hospitals and health care entities		20			35
Change in investments		(2	)		(1	)
Other		9			2
Net cash used in investing activities		(649	)		(1,145	)
Cash flows from financing activities:
Issuances of long-term debt		—			2,700
Net change in revolving credit facilities		80			1,440
Repayment of long-term debt		(47	)		(3,327	)
Distributions to noncontrolling interests		(234	)		(154	)
Payment of debt issuance costs		—			(34	)
Payment of dividends		(169	)		(152	)
Repurchase of common stock		(1,527	)		(441	)
Other		(207	)		(141	)
Net cash used in financing activities		(2,104	)		(109	)
Effect of exchange rate changes on cash and cash equivalents		2			(11	)
Change in cash and cash equivalents		(763	)		110
Cash and cash equivalents at beginning of period		1,793			621
Cash and cash equivalents at end of period	$	1,030		$	731
Interest payments	$	375		$	468
Income tax refunds, net	$	(13	)	$	(9	)

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

6

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES

Reporting Entity

HCA Healthcare, Inc. is a holding company whose affiliates own and operate hospitals and related health care entities. The term “affiliates” includes direct and indirect subsidiaries of HCA Healthcare, Inc. and partnerships and joint ventures in which such subsidiaries are partners. At March 31, 2021, these affiliates owned and operated 186 hospitals, 121 freestanding surgery centers, 21 freestanding endoscopy centers and provided extensive outpatient and ancillary services. HCA Healthcare, Inc.’s facilities are located in 20 states and England. The terms “Company,” “HCA,” “we,” “our” or “us,” as used herein and unless otherwise stated or indicated by context, refer to HCA Healthcare, Inc. and its affiliates. The terms “facilities” or “hospitals” refer to entities owned and operated by affiliates of HCA and the term “employees” refers to employees of affiliates of HCA.

Basis of Presentation

The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all the information and footnotes required by generally accepted accounting principles for complete consolidated financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation have been included and are of a normal and recurring nature.

The majority of our expenses are “costs of revenues” items. Costs that could be classified as general and administrative would include our corporate office costs, which were $87 million and $96 million for the quarters ended March 31, 2021 and 2020, respectively. Operating results for the quarter ended March 31, 2021 are not necessarily indicative of the results that may be expected for the year ending December 31, 2021. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K for the year ended December 31, 2020.

COVID-19 Pandemic

On March 11, 2020, the World Health Organization designated COVID-19 as a global pandemic. Patient volumes and the related revenues for most of our services were significantly impacted during the latter portion of the first quarter and the first half of the second quarter of 2020 and have continued to be impacted as various policies were implemented by federal, state and local governments in response to the COVID-19 pandemic, and the public remains wary of real or perceived opportunities for exposure to the virus. We believe the extent of the COVID-19 pandemic’s impact on our operating results and financial condition has been and will continue to be driven by many factors, most of which are beyond our control and ability to forecast. Because of these uncertainties, we cannot estimate how long or to what extent the pandemic will impact our operations.

Revenues

Our revenues generally relate to contracts with patients in which our performance obligations are to provide health care services to the patients. Revenues are recorded during the period our obligations to provide health care services are satisfied. Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days, and revenues are recognized based on charges incurred in relation to total expected charges. Our performance obligations for outpatient services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered

7

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES (continued)

Revenues (continued)

through the health insurance exchanges) and the transaction prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges. Medicare generally pays for inpatient and outpatient services at prospectively determined rates based on clinical, diagnostic and other factors. Services provided to patients having Medicaid coverage are generally paid at prospectively determined rates per discharge, per identified service or per covered member. Agreements with commercial insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates. Our revenues for the quarter ended March 31, 2020 include $55 million related to the settlement of Medicare outlier calculations for prior periods. Management continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals.

Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual adjustments under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record these revenues at the estimated amounts we expect to collect. Patients treated at our hospitals for non-elective care, who have income at or below 400% of the federal poverty level, are eligible for charity care. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues. Our revenues by primary third-party payer classification and other (including uninsured patients) for the quarters ended March 31, 2021 and 2020 are summarized in the following table (dollars in millions):

	2021		Ratio			2020		Ratio
Medicare	$	2,559		18.3	%	$	2,743		21.3	%
Managed Medicare		2,053		14.7			1,826		14.2
Medicaid		527		3.8			414		3.2
Managed Medicaid		725		5.2			666		5.2
Managed care and insurers		6,885		49.1			6,645		51.6
International (managed care and insurers)		333		2.4			292		2.3
Other		895		6.5			275		2.2
Revenues	$	13,977		100.0	%	$	12,861		100.0	%

8

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES (continued)

Revenues (continued)

To quantify the total impact of the trends related to uninsured patient accounts, we believe it is beneficial to view total uncompensated care, which is comprised of charity care, uninsured discounts and implicit price concessions. A summary of the estimated cost of total uncompensated care for the quarters ended March 31, 2021 and 2020 follows (dollars in millions):

	2021			2020
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)	$	11,643		$	11,342
Cost-to-charges ratio (patient care costs as percentage of gross patient charges)		11.4	%		11.9	%
Total uncompensated care	$	6,821		$	7,873
Multiply by the cost-to-charges ratio		11.4	%		11.9	%
Estimated cost of total uncompensated care	$	778		$	937

The total uncompensated care amounts include charity care of $2.942 billion and $3.735 billion, respectively, and the related estimated costs of charity care were $335 million and $444 million, respectively, for the quarters ended March 31, 2021 and 2020.

Reclassifications

Certain prior year amounts have been reclassified to conform to the current year presentation.

NOTE 2 — ACQUISITIONS AND DISPOSITIONS

During the quarter ended March 31, 2021, we paid $22 million to acquire nonhospital health care entities. Purchase price amounts have been allocated to the related assets acquired and liabilities assumed based upon their respective fair values. During the quarter ended March 31, 2020, we paid  $328 million to acquire a hospital in New Hampshire and nonhospital health care entities. The consolidated financial statements include the accounts and operations of the acquired entities subsequent to the respective acquisition dates. The pro forma effects of these acquired entities on our results of operations for periods prior to the respective acquisition dates were not significant. 

During the quarter ended March 31, 2021, we received proceeds of $20 million and recognized a pretax gain of $2 million related to sales of real estate and other investments. During the quarter ended March 31, 2020, we received proceeds of $35 million and recognized a pretax gain of $7 million related to sales of real estate and other investments.

NOTE 3 — INCOME TAXES

Our provisions for income taxes for the quarters ended March 31, 2021 and 2020 were $393 million and $112 million, respectively, and the effective tax rates were 21.7% and 16.2%, respectively. Our provision for income taxes included tax benefits related to settlements of employee equity awards of  $74 million and $53 million for the quarters ended March 31, 2021 and 2020, respectively.

Our liability for unrecognized tax benefits was $596 million, including accrued interest of $88 million, as of March 31, 2021 ($508 million and $73 million, respectively, as of December 31, 2020). Unrecognized tax benefits of $179 million ($157 million as of December 31, 2020) would affect the effective rate, if recognized.

9

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 3 — INCOME TAXES (continued)

The Internal Revenue Service was conducting an examination of the Company’s 2016, 2017 and 2018 federal income tax returns at March 31, 2021. We are also subject to examination by state and foreign taxing authorities. Depending on the resolution of any federal, state and foreign tax disputes, the completion of examinations by federal, state or foreign taxing authorities, or the expiration of statutes of limitation for specific taxing jurisdictions, we believe it is reasonably possible that our liability for unrecognized tax benefits may significantly increase or decrease within the next 12 months. However, we are currently unable to estimate the range of any possible change.

NOTE 4 — EARNINGS PER SHARE

We compute basic earnings per share using the weighted average number of common shares outstanding. We compute diluted earnings per share using the weighted average number of common shares outstanding, plus the dilutive effect of outstanding equity awards, computed using the treasury stock method.

The following table sets forth the computation of basic and diluted earnings per share for the quarters ended March 31, 2021 and 2020 (dollars and shares in millions, except per share amounts):

	2021		2020
Net income attributable to HCA Healthcare, Inc.	$	1,423	$	581
Weighted average common shares outstanding		338.123		338.242
Effect of dilutive incremental shares		5.198		5.854
Shares used for diluted earnings per share		343.321		344.096
Earnings per share:
Basic earnings	$	4.21	$	1.72
Diluted earnings	$	4.14	$	1.69

NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES

A summary of our insurance subsidiaries’ investments at March 31, 2021 and December 31, 2020 follows (dollars in millions):

	March 31, 2021
	Amortized Cost		Unrealized Amounts					Fair Value
			Gains		Losses
Debt securities	$	376	$	22	$	(1	)	$	397
Money market funds and other		104		—		—			104
	$	480	$	22	$	(1	)		501
Amounts classified as current assets									(108	)
Investment carrying value								$	393

10

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES (continued)

	December 31, 2020
	Amortized Cost		Unrealized Amounts				Fair Value
			Gains		Losses
Debt securities	$	384	$	32	$	—	$	416
Money market funds and other		88		—		—		88
	$	472	$	32	$	—		504
Amounts classified as current assets								(116	)
Investment carrying value							$	388

At March 31, 2021 and December 31, 2020, the investments in debt securities of our insurance subsidiaries were classified as “available-for-sale.” Changes in unrealized gains and losses that are not credit-related are recorded as adjustments to other comprehensive income (loss).

Scheduled maturities of investments in debt securities at March 31, 2021 were as follows (dollars in millions):

	Amortized Cost		Fair Value
Due in one year or less	$	4	$	4
Due after one year through five years		144		152
Due after five years through ten years		157		167
Due after ten years		71		74
	$	376	$	397

The average expected maturity of the investments in debt securities at March 31, 2021 was 5.0 years, compared to the average scheduled maturity of 9.2 years. Expected and scheduled maturities may differ because the issuers of certain securities have the right to call, prepay or otherwise redeem such obligations prior to their scheduled maturity date.

NOTE 6 — FINANCIAL INSTRUMENTS

Interest Rate Swap Agreements

We have entered into interest rate swap agreements to manage our exposure to fluctuations in interest rates. These swap agreements involve the exchange of fixed and variable rate interest payments between us and our counterparties based on common notional principal amounts and maturity dates. Pay-fixed interest rate swaps effectively convert variable rate obligations to fixed interest rate obligations. The interest payments under these agreements are settled on a net basis. The net interest payments, based on the notional amounts in these agreements, generally match the timing of the related liabilities for the interest rate swap agreements which have been designated as cash flow hedges. The notional amounts of the swap agreements represent amounts used to calculate the exchange of cash flows and are not our assets or liabilities. Our credit risk related to these agreements is considered low because the swap agreements are with creditworthy financial institutions.

11

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 6 — FINANCIAL INSTRUMENTS (continued)

Interest Rate Swap Agreements (continued)

The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at March 31, 2021 (dollars in millions):

	Notional Amount		Maturity Date		Fair Value
Pay-fixed interest rate swaps	$	2,000		December 2021	$	(20	)
Pay-fixed interest rate swaps		500		December 2022		(16	)

During the next 12 months, we estimate $30 million will be reclassified from other comprehensive income (“OCI”) and will be included in interest expense.

Derivatives — Results of Operations

The following table presents the effect of our interest rate swaps on our results of operations for the quarter ended March 31, 2021 (dollars in millions):

Derivatives in Cash Flow Hedging Relationships	Amount of Gain Recognized in OCI on Derivatives, Net of Tax		Location of Loss Reclassified from Accumulated OCI into Operations		Amount of Loss Reclassified from Accumulated OCI into Operations
Interest rate swaps	$	1		Interest expense	$	9

Credit-risk-related Contingent Features

We have agreements with each of our derivative counterparties that contain a provision where we could be declared in default on our derivative obligations if repayment of the underlying indebtedness is accelerated by the lender due to our default on the indebtedness. As of March 31, 2021, we have not been required to post any collateral related to these agreements. If we had breached these provisions at March 31, 2021, we would have been required to settle our obligations under the agreements at their aggregate, estimated termination value of $37 million.

NOTE 7 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE

Accounting Standards Codification 820, Fair Value Measurements and Disclosures (“ASC 820”), emphasizes fair value is a market-based measurement, and fair value measurements should be determined based on the assumptions market participants would use in pricing assets or liabilities. ASC 820 utilizes a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs classified within Levels 1 and 2 of the hierarchy) and the reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy).

Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates, and yield curves observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market

12

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 7 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE (continued)

activity. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input significant to the fair value measurement in its entirety. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment.

Cash Traded Investments

Our cash traded investments are generally classified within Level 1 or Level 2 of the fair value hierarchy because they are valued using quoted market prices, broker or dealer quotations, or alternative pricing sources with reasonable levels of price transparency.

Derivative Financial Instruments

We have entered into interest rate swap agreements to manage our exposure to fluctuations in interest rates. The valuation of these instruments is determined using widely accepted valuation techniques, including discounted cash flow analysis on the expected cash flows of each derivative. This analysis reflects the contractual terms of the derivatives, including the period to maturity, and uses observable market-based inputs, including interest rate curves and implied volatilities. We incorporate credit valuation adjustments to reflect both our own nonperformance risk and the respective counterparty’s nonperformance risk in the fair value measurements of these instruments. 

The following tables summarize our assets and liabilities measured at fair value on a recurring basis as of March 31, 2021 and December 31, 2020, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions):

	March 31, 2021
				Fair Value Measurements Using
	Fair Value			Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1)			Significant Other Observable Inputs (Level 2)			Significant Unobservable Inputs (Level 3)
Assets:
Investments of insurance subsidiaries:
Debt securities	$	397		$	—		$	397		$	—
Money market funds and other		104			104			—			—
Investments of insurance subsidiaries		501			104			397			—
Less amounts classified as current assets		(108	)		(101	)		(7	)		—
	$	393		$	3		$	390		$	—
Liabilities:
Interest rate swaps (Income taxes and other liabilities)	$	36		$	—		$	36		$	—

13

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 7 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE (continued)

Derivative Financial Instruments (continued)

	December 31, 2020
				Fair Value Measurements Using
	Fair Value			Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1)			Significant Other Observable Inputs (Level 2)			Significant Unobservable Inputs (Level 3)
Assets:
Investments of insurance subsidiaries:
Debt securities	$	416		$	—		$	416		$	—
Money market funds and other		88			88			—			—
Investments of insurance subsidiaries		504			88			416			—
Less amounts classified as current assets		(116	)		(87	)		(29	)		—
	$	388		$	1		$	387		$	—
Liabilities:
Interest rate swaps (Income taxes and other liabilities)	$	46		$	—		$	46		$	—

The estimated fair value of our long-term debt was $34.872 billion and $35.814 billion at March 31, 2021 and December 31, 2020, respectively, compared to carrying amounts, excluding debt issuance costs and discounts, aggregating $31.301 billion and $31.240 billion, respectively. The estimates of fair value are generally based upon the quoted market prices or quoted market prices for similar issues of long-term debt with the same maturities.

NOTE 8 — LONG-TERM DEBT

A summary of long-term debt at March 31, 2021 and December 31, 2020, including related interest rates at March 31, 2021, follows (dollars in millions):

	March 31, 2021			December 31, 2020
Senior secured asset-based revolving credit facility (effective interest rate of 1.4%)	$	80		$	—
Senior secured revolving credit facility		—			—
Senior secured term loan facilities (effective interest rate of 2.8%)		3,657			3,671
Senior secured notes (effective interest rate of 5.1%)		13,850			13,850
Other senior secured debt (effective interest rate of 4.6%)		762			767
Senior secured debt		18,349			18,288
Senior unsecured notes (effective interest rate of 5.5%)		12,952			12,952
Debt issuance costs and discounts		(229	)		(236	)
Total debt (average life of 8.6 years, rates averaging 5.0%)		31,072			31,004
Less amounts due within one year		234			209
	$	30,838		$	30,795

14

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 9 — CONTINGENCIES

We operate in a highly regulated and litigious industry. As a result, various lawsuits, claims and legal and regulatory proceedings have been and can be expected to be instituted or asserted against us. We are also subject to claims and suits arising in the ordinary course of business, including claims for personal injuries or wrongful restriction of, or interference with, physicians’ staff privileges. In certain of these actions the claimants may seek punitive damages against us which may not be covered by insurance. We are also subject to claims by various taxing authorities for additional taxes and related interest and penalties. The resolution of any such lawsuits, claims or legal and regulatory proceedings could have a material, adverse effect on our results of operations, financial position or liquidity.

Health care companies are routinely subject to investigations by various governmental agencies. Under the federal False Claims Act (“FCA”), private parties have the right to bring qui tam, or “whistleblower,” suits against companies that submit false claims for payments to, or improperly retain overpayments from, the government. Some states have adopted similar state whistleblower and false claims provisions. Certain of our individual facilities have received, and from time to time, other facilities may receive, government inquiries from, and may be subject to investigation by, federal and state agencies. Depending on whether the underlying conduct in these or future inquiries or investigations could be considered systemic, their resolution could have a material, adverse effect on our results of operations, financial position or liquidity.

Texas operates a state Medicaid program pursuant to a waiver from the Centers for Medicare & Medicaid Services under Section 1115 of the Social Security Act (“Program”). The Program includes uncompensated-care pools; payments from these pools are intended to defray the uncompensated costs of services provided by our and other hospitals to Medicaid eligible or uninsured individuals. Separately, we and other hospitals provide charity care services in several communities in the state. In 2018, the Civil Division of the U.S. Department of Justice and the U.S. Attorney’s Office for the Southern District of Texas requested information about whether the Program, as operated in Harris County, complied with the laws and regulations applicable to provider related donations, and the Company cooperated with that request. On May 21, 2019, a qui tam lawsuit asserting violations of the FCA and the Texas Medicaid Fraud Prevention Act related to the Program, as operated in Harris County, was unsealed by the U.S. District Court for the Southern District of Texas. Both the federal and state governments declined to intervene in the qui tam lawsuit. The Company believes that our participation is and has been consistent with the requirements of the Program and is vigorously defending against the lawsuit being pursued by the relator. We cannot predict what effect, if any, the qui tam lawsuit could have on the Company.

NOTE 10 — SHARE REPURCHASE TRANSACTIONS AND OTHER COMPREHENSIVE LOSS

During January 2020 and 2019, our Board of Directors authorized share repurchase programs for up to $4 billion ($2 billion for each authorization) of our outstanding common stock. During February 2021, our Board of Directors authorized an additional $6 billion for repurchases of our outstanding common stock. During the quarter ended March 31, 2021, we repurchased 8.477 million shares of our common stock at an average price of $180.11 per share through market purchases pursuant to the $2.0 billion share repurchase program authorized during January 2019 (which was completed during the first quarter of 2021) and the January 2020 authorization. At March 31, 2021, we had $7.274 billion of repurchase authorization available under the January 2020 and February 2021 authorizations.

15

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 10 — SHARE REPURCHASE TRANSACTIONS AND OTHER COMPREHENSIVE LOSS (continued)

The components of accumulated other comprehensive loss are as follows (dollars in millions):

	Unrealized Gains on Available- for-Sale Securities			Foreign Currency Translation Adjustments			Defined Benefit Plans			Change in Fair Value of Derivative Instruments			Total
Balances at December 31, 2020	$	25		$	(271	)	$	(220	)	$	(36	)	$	(502	)
Unrealized losses on available-for-sale securities, net of $2 income tax benefit		(9	)											(9	)
Foreign currency translation adjustments, net of $1 of income tax					7									7
Change in fair value of derivative instruments											1			1
Expense reclassified into operations from other comprehensive income, net of $2 and $2 income tax benefits, respectively								5			7			12
Balances at March 31, 2021	$	16		$	(264	)	$	(215	)	$	(28	)	$	(491	)

NOTE 11 — SEGMENT AND GEOGRAPHIC INFORMATION

We operate in one line of business, which is operating hospitals and related health care entities. We operate in two geographically organized groups: the National and American Groups. The National Group includes 97 hospitals located in Alaska, California, Florida, southern Georgia, Idaho, Indiana, northern Kentucky, Nevada, New Hampshire, North Carolina, South Carolina, Utah and Virginia, and the American Group includes 82 hospitals located in Colorado, northern Georgia, Kansas, southern Kentucky, Louisiana, Missouri, Tennessee and Texas. We also operate seven hospitals in England, and these facilities are included in the Corporate and other group.  

Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, gains on sales of facilities, losses on retirement of debt, income taxes and net income attributable to noncontrolling interests. We use adjusted segment EBITDA as an analytical indicator for purposes of allocating resources to geographic areas and assessing their performance. Adjusted segment EBITDA is commonly used as an analytical indicator within the health care industry, and also serves as a measure of leverage capacity and debt service ability. Adjusted segment EBITDA should not be considered as a measure of financial performance under generally accepted accounting principles, and the items excluded from adjusted segment EBITDA are significant components in understanding and assessing financial performance. Because adjusted segment EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, adjusted segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. The geographic distributions of our revenues, equity in earnings of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters ended March 31, 2021 and 2020 are summarized in the following table (dollars in millions): 

	2021		2020
Revenues:
National Group	$	7,056	$	6,474
American Group		6,291		5,744
Corporate and other		630		643
	$	13,977	$	12,861

16

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 11 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)  

		2021			2020
Equity in earnings of affiliates:
National Group	$	(7	)	$	1
American Group		(12	)		(9	)
Corporate and other		(2	)		1
	$	(21	)	$	(7	)
Adjusted segment EBITDA:
National Group	$	1,705		$	1,215
American Group		1,501			1,115
Corporate and other		(154	)		(130	)
	$	3,052		$	2,200
Depreciation and amortization:
National Group	$	323		$	306
American Group		293			287
Corporate and other		81			81
	$	697		$	674
Adjusted segment EBITDA	$	3,052		$	2,200
Depreciation and amortization		697			674
Interest expense		384			428
Gains on sales of facilities		(2	)		(7	)
Losses on retirement of debt		—			295
Income before income taxes	$	1,973		$	810

17

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS

Forward-Looking Statements

This quarterly report on Form 10-Q includes certain disclosures which contain “forward-looking statements” within the meaning of the federal securities laws, which involve risks and uncertainties. Forward-looking statements include statements regarding expected share-based compensation expense, expected capital expenditures and expected net claim payments and all other statements that do not relate solely to historical or current facts, and can be identified by the use of words like “may,” “believe,” “will,” “expect,” “project,” “estimate,” “anticipate,” “plan,” “initiative” or “continue.” These forward-looking statements are based on our current plans and expectations and are subject to a number of known and unknown uncertainties and risks, many of which are beyond our control, which could significantly affect current plans and expectations and our future financial position and results of operations. These factors include, but are not limited to, (1) developments related to COVID-19, including, without limitation, the length and severity of the pandemic and the spread of virus strains with new epidemiological characteristics; the volume of canceled or rescheduled procedures and the volume of COVID-19 patients cared for across our health systems; measures we are taking to respond to the COVID-19 pandemic; the impact and terms of government and administrative regulation and stimulus (including the Families First Coronavirus Response Act, the Coronavirus Aid, Relief and Economic Security (“CARES”) Act, the Paycheck Protection Program and Health Care Enhancement Act, the Consolidated Appropriations Act, 2021, the American Rescue Plan Act of 2021 and other enacted and potential future legislation); changes in revenues due to declining patient volumes, changes in payer mix and deteriorating macroeconomic conditions (including increases in uninsured and underinsured patients); potential increased expenses related to labor, supply chain or other expenditures; workforce disruptions; supply shortages and disruptions; and the timing, availability and adoption of effective medical treatments and vaccines, (2) the impact of our substantial indebtedness and the ability to refinance such indebtedness on acceptable terms, as well as risks associated with disruptions in the financial markets and the business of financial institutions as the result of the COVID-19 pandemic which could impact us from a financial perspective, (3) the impact of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, the “Affordable Care Act”), including the effects of court challenges to, any repeal of, or changes to, the Affordable Care Act or additional changes to its implementation, the possible enactment of additional federal or state health care reforms and possible changes to other federal, state or local laws or regulations affecting the health care industry, including proposals to expand coverage of federally-funded insurance programs as an alternative to private insurance or establish a single-payer system (such reforms often referred to as “Medicare for All”), and also including any such laws or governmental regulations which are adopted in response to the COVID-19 pandemic, (4) the effects related to the implementation of sequestration spending reductions required under the Budget Control Act of 2011, related legislation extending these reductions, and those required under the Pay-As-You-Go Act of 2010 (“PAYGO Act”) as a result of the federal budget deficit impact of the American Rescue Plan Act of 2021, and the potential for future deficit reduction legislation that may alter these spending reductions, which include cuts to Medicare payments, or create additional spending reductions, (5) increases in the amount and risk of collectability of uninsured accounts and deductibles and copayment amounts for insured accounts, (6) the ability to achieve operating and financial targets, and attain expected levels of patient volumes and control the costs of providing services, (7) possible changes in Medicare, Medicaid and other state programs, including Medicaid supplemental payment programs or Medicaid waiver programs, that may impact reimbursements to health care providers and insurers and the size of the uninsured or underinsured population, (8) the highly competitive nature of the health care business, (9) changes in service mix, revenue mix and surgical volumes, including potential declines in the population covered under third-party payer agreements, the ability to enter into and renew third-party payer provider agreements on acceptable terms and the impact of consumer-driven health plans and physician utilization trends and practices, (10) the efforts of health insurers, health care providers, large employer groups and others to contain health care costs, (11) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (12) increases in wages and the ability to attract and retain qualified management and personnel, including affiliated physicians, nurses and medical and technical support personnel, (13) the availability and terms of capital to fund the expansion of our business and improvements to our existing

18

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Forward-Looking Statements (continued)

facilities, (14) changes in accounting practices, (15) changes in general economic conditions nationally and regionally in our markets, including economic and business conditions (and the impact thereof on the economy, financial markets and banking industry) resulting from the COVID-19 pandemic, (16) the emergence of and effects related to other pandemics, epidemics and infectious diseases, (17) future divestitures which may result in charges and possible impairments of long-lived assets, (18) changes in business strategy or development plans, (19) delays in receiving payments for services provided, (20) the outcome of pending and any future tax audits, disputes and litigation associated with our tax positions, (21) potential adverse impact of known and unknown government investigations, litigation and other claims that may be made against us, (22) the impact of potential cybersecurity incidents or security breaches, (23) our ongoing ability to demonstrate meaningful use of certified electronic health record (“EHR”) technology and the impact of interoperability requirements, (24) the impact of natural disasters, such as hurricanes and floods, or similar events beyond our control, (25) changes in the U.S. federal, state, or foreign tax laws including interpretive guidance that may be issued by taxing authorities or other standard setting bodies, and (26) other risk factors described in our annual report on Form 10-K for the year ended December 31, 2020 and our other filings with the Securities and Exchange Commission. As a consequence, current plans, anticipated actions and future financial position and results of operations may differ from those expressed in any forward-looking statements made by or on behalf of HCA. You are cautioned not to unduly rely on such forward-looking statements when evaluating the information presented in this report, which forward-looking statements reflect management’s views only as of the date of this report. We undertake no obligation to revise or update any forward-looking statements, whether as a result of new information, future events or otherwise.

COVID-19 Pandemic

On March 11, 2020, the World Health Organization designated COVID-19 as a global pandemic. Patient volumes and the related revenues for most of our services were significantly impacted during the latter portion of the first quarter and the first half of the second quarter of 2020 and have continued to be impacted as various policies were implemented by federal, state and local governments in response to the COVID-19 pandemic, and the public remains wary of real or perceived opportunities for exposure to the virus. We believe the extent of the COVID-19 pandemic’s impact on our operating results and financial condition has been and will continue to be driven by many factors, most of which are beyond our control and ability to forecast. Because of these uncertainties, we cannot estimate how long or to what extent the pandemic will impact our operations.

First Quarter 2021 Operations Summary

Revenues increased to $13.977 billion in the first quarter of 2021 from $12.861 billion in the first quarter of 2020. Net income attributable to HCA Healthcare, Inc. totaled $1.423 billion, or $4.14 per diluted share, for the quarter ended March 31, 2021, compared to $581 million, or $1.69 per diluted share, for the quarter ended March 31, 2020. First quarter results for 2020 include losses on retirement of debt of $295 million, or $0.66 per diluted share, and gains on sales of facilities of $7 million, or $0.02 per diluted share. Our revenues for the quarter ended March 31, 2020 include $55 million, or $0.12 per diluted share, related to the settlement of Medicare outlier calculations for prior periods. Our provisions for income taxes for the first quarters of 2021 and 2020 included tax benefits of $74 million, or $0.22 per diluted share, and $53 million, or $0.15 per diluted share, respectively, related to employee equity award settlements. All “per diluted share” disclosures are based upon amounts net of the applicable income taxes.

Revenues increased 8.7% on a consolidated basis and 9.0% on a same facility basis for the quarter ended March 31, 2021, compared to the quarter ended March 31, 2020. The increase in consolidated revenues can be primarily attributed to the net impact of a 16.1% increase in revenue per equivalent admission offset by a 6.4% decline in equivalent admissions. The same facility revenues increase primarily resulted from the net impact of a

19

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

First Quarter 2021 Operations Summary (continued)

16.6% increase in same facility revenue per equivalent admission offset by a 6.5% decline in same facility equivalent admissions.

During the quarter ended March 31, 2021, consolidated admissions and same facility admissions declined 4.1% and 4.2%, respectively, compared to the quarter ended March 31, 2020. Surgeries declined 0.7% on a consolidated basis and declined 0.6% on a same facility basis during the quarter ended March 31, 2021, compared to the quarter ended March 31, 2020. Emergency department visits declined 18.7% and 18.4% on a consolidated basis and on a same facility basis, respectively, during the quarter ended March 31, 2021, compared to the quarter ended March 31, 2020. Consolidated and same facility uninsured admissions declined 15.8% and 15.7%, respectively, for the quarter ended March 31, 2021, compared to the quarter ended March 31, 2020.

Cash flows from operating activities increased $613 million, from $1.375 billion for the first quarter of 2020 to $1.988 billion for the first quarter of 2021. The increase in cash provided by operating activities was primarily related to the net effect of an increase in net income, excluding gains on sales of facilities and losses on retirement of debt, of $659 million and an increase related to income taxes of $218 million, offset by negative changes in working capital of $311 million, primarily related to an increase in accounts receivable.

Results of Operations

Revenue/Volume Trends

Our revenues generally relate to contracts with patients in which our performance obligations are to provide health care services to the patients. Revenues are recorded during the period our obligations to provide health care services are satisfied. Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days, and revenues are recognized based on charges incurred in relation to total expected charges. Our performance obligations for outpatient services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered through the health insurance exchanges) and the transaction prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges. Medicare generally pays for inpatient and outpatient services at prospectively determined rates based on clinical, diagnostic and other factors. Services provided to patients having Medicaid coverage are generally paid at prospectively determined rates per discharge, per identified service or per covered member. Agreements with commercial insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates. Management continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals.

Revenues increased 8.7% from $12.861 billion in the first quarter of 2020 to $13.977 billion in the first quarter of 2021. Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual adjustments under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record self-pay revenues at the estimated amounts we expect to collect. Patients treated at our hospitals for non-elective care, who have income at or below 400% of the federal poverty level, are eligible for charity care.

20

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Results of Operations (continued)

Revenue/Volume Trends (continued)

Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues. Our revenues by primary third-party payer classification and other (including uninsured patients) for the quarters ended March 31, 2021 and 2020 are summarized in the following table (dollars in millions):

	2021		Ratio			2020		Ratio
Medicare	$	2,559		18.3	%	$	2,743		21.3	%
Managed Medicare		2,053		14.7			1,826		14.2
Medicaid		527		3.8			414		3.2
Managed Medicaid		725		5.2			666		5.2
Managed care and insurers		6,885		49.1			6,645		51.6
International (managed care and insurers)		333		2.4			292		2.3
Other		895		6.5			275		2.2
Revenues	$	13,977		100.0	%	$	12,861		100.0	%

Consolidated and same facility revenue per equivalent admission increased 16.1% and 16.6%, respectively, in the first quarter of 2021, compared to the first quarter of 2020. Consolidated and same facility equivalent admissions declined 6.4% and 6.5%, respectively, in the first quarter of 2021, compared to the first quarter of 2020. Consolidated and same facility outpatient surgeries increased 2.2% and 2.3%, respectively, in the first quarter of 2021, compared to the first quarter of 2020. Consolidated and same facility inpatient surgeries declined 5.6% and 5.4%, respectively, in the first quarter of 2021, compared to the first quarter of 2020. Consolidated and same facility emergency department visits declined 18.7% and 18.4%, respectively, in the first quarter of 2021, compared to the first quarter of 2020. Our revenues increased, although our patient volumes declined, during the first quarter of 2021 compared to the first quarter of 2020 due to favorable changes in payer mix and higher acuity levels for patients treated during the first quarter of 2021, which resulted in an increase in revenue per equivalent admission. We believe these trends have been impacted by the effect of the pandemic on our operations, including the patients diagnosed with COVID-19.

To quantify the total impact of the trends related to uninsured patient accounts, we believe it is beneficial to view total uncompensated care, which is comprised of charity care, uninsured discounts and implicit price concessions. A summary of the estimated cost of total uncompensated care for the quarters ended March 31, 2021 and 2020 follows (dollars in millions):

	2021			2020
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)	$	11,643		$	11,342
Cost-to-charges ratio (patient care costs as percentage of gross patient charges)		11.4	%		11.9	%
Total uncompensated care	$	6,821		$	7,873
Multiply by the cost-to-charges ratio		11.4	%		11.9	%
Estimated cost of total uncompensated care	$	778		$	937

Same facility uninsured admissions declined by 6,564 admissions, or 15.7%, in the first quarter of 2021 compared to the first quarter of 2020. Same facility uninsured admissions in 2020, compared to 2019, declined 9.1% in the fourth quarter, declined 14.2% in the third quarter, declined 10.0% in the second quarter, and increased 7.1% in the first quarter. The declines in the first quarter of 2021, compared to the first quarter of 2020, and the last three quarters of 2020, compared to the last three quarters of 2019, were primarily due to the reimbursement received, as

21

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Results of Operations (continued)

Revenue/Volume Trends (continued)

provided for under the Families First Coronavirus Response Act and subsequent legislation, for uninsured patients diagnosed with COVID-19 and the resulting classification of those patients as an insured admission, as well as general declines in patient volumes resulting from the pandemic’s impact on our operations.

The approximate percentages of our admissions related to Medicare, managed Medicare, Medicaid, managed Medicaid, managed care and insurers and the uninsured for the quarters ended March 31, 2021 and 2020 are set forth in the following table.

	2021			2020
Medicare		24	%		27	%
Managed Medicare		22			20
Medicaid		5			5
Managed Medicaid		12			12
Managed care and insurers		30			28
Uninsured		7			8
		100	%		100	%

The approximate percentages of our inpatient revenues related to Medicare, managed Medicare, Medicaid, managed Medicaid, managed care and insurers for the quarters ended March 31, 2021 and 2020 are set forth in the following table.

	2021			2020
Medicare		24	%		29	%
Managed Medicare		17			16
Medicaid		5			4
Managed Medicaid		6			5
Managed care and insurers		48			46
		100	%		100	%

At March 31, 2021, we had 92 hospitals in the states of Texas and Florida. During the quarter ended March 31, 2021, 56% of our admissions and 49% of our revenues were generated by these hospitals. Uninsured admissions in Texas and Florida represented 73% of our uninsured admissions during the quarter ended March 31, 2021.

We receive a significant portion of our revenues from government health programs, principally Medicare and Medicaid, which are highly regulated and subject to frequent and substantial changes. In December 2017, the Centers for Medicare & Medicaid Services (“CMS”) announced that it will phase out federal matching funds for Designated State Health Programs under waivers granted under Section 1115 of the Social Security Act. Texas currently operates its Healthcare Transformation and Quality Improvement Program pursuant to a Medicaid waiver. In December 2017, CMS approved an extension of this waiver through September 30, 2022, but indicated that it will phase out some of the federal funding. Our Texas Medicaid revenues included Medicaid supplemental payments of $138 million and $115 million during the first quarters of 2021 and 2020, respectively.

In addition, we receive supplemental payments in several other states. We are aware these supplemental payment programs are currently being reviewed by certain state agencies and some states have made requests to CMS to replace their existing supplemental payment programs. It is possible these reviews and requests will result in the restructuring of such supplemental payment programs and could result in the payment programs

22

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Results of Operations (continued)

Revenue/Volume Trends (continued)

being reduced or eliminated. Because deliberations about these programs are ongoing, we are unable to estimate the financial impact the program structure modifications, if any, may have on our results of operations.

Key Performance Indicators

We present certain metrics and statistical information that management uses when assessing our results of operations. We believe this information is useful to investors as it provides insight to how management evaluates operational performance and trends between reporting periods. Information on how these metrics and statistical information are defined is provided in the following tables summarizing operating results and operating data.

Operating Results Summary

The following is a comparative summary of results of operations for the quarters ended March 31, 2021 and 2020 (dollars in millions):

	2021						2020
	Amount			Ratio			Amount			Ratio
Revenues	$	13,977			100.0		$	12,861			100.0
Salaries and benefits		6,301			45.1			6,118			47.6
Supplies		2,224			15.9			2,123			16.5
Other operating expenses		2,421			17.4			2,427			18.9
Equity in earnings of affiliates		(21	)		(0.2	)		(7	)		(0.1	)
Depreciation and amortization		697			5.0			674			5.3
Interest expense		384			2.7			428			3.3
Gains on sales of facilities		(2	)		—			(7	)		(0.1	)
Losses on retirement of debt		—			—			295			2.3
		12,004			85.9			12,051			93.7
Income before income taxes		1,973			14.1			810			6.3
Provision for income taxes		393			2.8			112			0.9
Net income		1,580			11.3			698			5.4
Net income attributable to noncontrolling interests		157			1.1			117			0.9
Net income attributable to HCA Healthcare, Inc.	$	1,423			10.2		$	581			4.5
% changes from prior year:
Revenues		8.7	%					2.7	%
Income before income taxes		143.6						(44.5	)
Net income attributable to HCA Healthcare, Inc.		145.0						(44.1	)
Admissions(a)		(4.1	)					1.0
Equivalent admissions(b)		(6.4	)					(0.1	)
Revenue per equivalent admission		16.1						2.9
Same facility % changes from prior year(c):
Revenues		9.0						1.2
Admissions(a)		(4.2	)					0.6
Equivalent admissions(b)		(6.5	)					(0.4	)
Revenue per equivalent admission		16.6						1.6

(a) Represents the total number of patients admitted to our hospitals and is used by management and certain investors as a general measure of inpatient volume.

23

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Results of Operations (continued)

Operating Results Summary (continued)

(b) Equivalent admissions are used by management and certain investors as a general measure of combined inpatient and outpatient volume. Equivalent admissions are computed by multiplying admissions (inpatient volume) by the sum of gross inpatient revenues and gross outpatient revenues and then dividing the resulting amount by gross inpatient revenues. The equivalent admissions computation “equates” outpatient revenues to the volume measure (admissions) used to measure inpatient volume, resulting in a general measure of combined inpatient and outpatient volume.

(c) Same facility information excludes the operations of hospitals and their related facilities which were either acquired or divested during the current and prior period.

Quarters Ended March 31, 2021 and 2020

Revenues increased to $13.977 billion in the first quarter of 2021 from $12.861 billion in the first quarter of 2020. Net income attributable to HCA Healthcare, Inc. totaled $1.423 billion, or $4.14 per diluted share, for the quarter ended March 31, 2021, compared to $581 million, or $1.69 per diluted share, for the quarter ended March 31, 2020. First quarter results for 2020 include losses on retirement of debt of $295 million, or $0.66 per diluted share, and gains on sales of facilities of $7 million, or $0.02 per diluted share. Our revenues for the quarter ended March 31, 2020 include $55 million, or $0.12 per diluted share, related to the settlement of Medicare outlier calculations for prior periods. Our provisions for income taxes for the first quarters of 2021 and 2020 included tax benefits of $74 million, or $0.22 per diluted share, and $53 million, or $0.15 per diluted share, respectively, related to employee equity award settlements. All “per diluted share” disclosures are based upon amounts net of the applicable income taxes.

Revenues increased 8.7% on a consolidated basis and 9.0% on a same facility basis for the quarter ended March 31, 2021, compared to the quarter ended March 31, 2020. The increase in consolidated revenues can be primarily attributed to the net impact of a 16.1% increase in revenue per equivalent admission offset by a 6.4% decline in equivalent admissions. The same facility revenues increase primarily resulted from the net impact of a 16.6% increase in same facility revenue per equivalent admission offset by a 6.5% decline in same facility equivalent admissions.

Salaries and benefits, as a percentage of revenues, were 45.1% in the first quarter of 2021 and 47.6% in the first quarter of 2020. Salaries and benefits per equivalent admission increased 10.0% in the first quarter of 2021 compared to the first quarter of 2020. Same facility labor rate increases averaged 6.1% for the first quarter of 2021 compared to the first quarter of 2020.

Supplies, as a percentage of revenues, were 15.9% in the first quarter of 2021 and 16.5% in the first quarter of 2020. Supply costs per equivalent admission increased 11.9% in the first quarter of 2021 compared to the first quarter of 2020. Supply costs per equivalent admission increased 7.0% for medical devices, 21.0% for pharmacy supplies and 12.0% for general medical and surgical items in the first quarter of 2021 compared to the first quarter of 2020.

Other operating expenses, as a percentage of revenues, were 17.4% in the first quarter of 2021 and 18.9% in the first quarter of 2020. Other operating expenses is primarily comprised of contract services, professional fees, repairs and maintenance, rents and leases, utilities, insurance (including professional liability insurance) and nonincome taxes. Provisions for losses related to professional liability risks were $134 million and $140 million for the first quarters of 2021 and 2020, respectively.

Equity in earnings of affiliates was $21 million and $7 million in the first quarters of 2021 and 2020, respectively.

24

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Results of Operations (continued)

Quarters Ended March 31, 2021 and 2020 (continued)

Depreciation and amortization increased $23 million, from $674 million in the first quarter of 2020 to $697 million in the first quarter of 2021. The increase in depreciation relates primarily to capital expenditures at our existing facilities.

Interest expense was $384 million in the first quarter of 2021 and $428 million in the first quarter of 2020. Our average debt balance was $31.019 billion for the first quarter of 2021 compared to $34.136 billion for the first quarter of 2020. The average effective interest rate for our long-term debt was 5.0% for both of the quarters ended March 31, 2021 and 2020.

During the first quarters of 2021 and 2020, we recorded gains on sales of facilities of $2 million and $7 million, respectively.

During February 2020, we issued $2.700 billion aggregate principal amount of 3.50% senior unsecured notes due 2030. During March 2020, we used the net proceeds for the redemption of all $1.000 billion outstanding aggregate principal amount of HCA Healthcare, Inc.’s 6.25% senior notes due 2021 and, together with available funds, for the redemption of all $2.000 billion outstanding aggregate principal amount of HCA Inc.’s 7.50% senior notes due 2022. The pretax loss on retirement of debt was $295 million.

The effective tax rates were 21.7% and 16.2% for the first quarters of 2021 and 2020, respectively. The effective tax rate computations exclude net income attributable to noncontrolling interests as it relates to consolidated partnerships. Our provisions for income taxes for the first quarters of 2021 and 2020 included tax benefits of $74 million and $53 million, respectively, related to employee equity award settlements. Excluding the effect of these adjustments, the effective tax rate for the first quarters of 2021 and 2020 would have been 25.7% and 23.8%, respectively.

Net income attributable to noncontrolling interests increased from $117 million for the first quarter of 2020 to $157 million for the first quarter of 2021. The increase in net income attributable to noncontrolling interests related primarily to the operations of two of our Texas markets.

Liquidity and Capital Resources

Cash provided by operating activities totaled $1.988 billion in the first quarter of 2021 compared to $1.375 billion in the first quarter of 2020. The $613 million increase in cash provided by operating activities, in the first quarter of 2021 compared to the first quarter of 2020, related primarily to the net effect of an increase in net income, excluding gains on sales of facilities and losses on retirement of debt, of $659 million and an increase related to income taxes of $218 million, offset by negative changes in working capital of $311 million, primarily related to an increase in accounts receivable. The net combination of interest payments and net income tax refunds in the first quarters of 2021 and 2020 totaled $362 million and $459 million, respectively. Working capital totaled $3.394 billion at March 31, 2021 and $3.629 billion at December 31, 2020.

Cash used in investing activities was $649 million in the first quarter of 2021 compared to $1.145 billion in the first quarter of 2020. Acquisitions of hospitals and health care entities declined from $328 million in the first quarter of 2020 to $22 million in the first quarter of 2021. Excluding acquisitions, capital expenditures were $654 million in the first quarter of 2021 and $853 million in the first quarter of 2020. Planned capital expenditures are expected to approximate $3.7 billion in 2021. At March 31, 2021, there were projects under construction which had estimated additional costs to complete and equip over the next five years of approximately $3.0 billion. We expect to finance capital expenditures with internally generated and borrowed funds.

25

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Liquidity and Capital Resources (continued)

Cash used in financing activities totaled $2.104 billion in the first quarter of 2021 compared to $109 million in the first quarter of 2020. During the first quarter of 2021, net cash flows used in financing activities included a net increase of $33 million in our indebtedness, payment of dividends of $169 million, repurchase of common stock of $1.527 billion and distributions to noncontrolling interests of $234 million. During the first quarter of 2020, net cash flows used in financing activities included an increase of $813 million from net borrowings on our revolving credit facilities and refinancing activity, payment of dividends of $152 million, repurchase of common stock of $441 million, distributions to noncontrolling interests of $154 million and payment of debt issuance costs of $34 million.

We are a highly leveraged company with significant debt service requirements. Our debt totaled $31.072 billion at March 31, 2021. Our interest expense was $384 million for the first quarter of 2021 and $428 million for the first quarter of 2020.

In addition to cash flows from operations, available sources of capital include amounts available under our senior secured credit facilities ($5.590 billion and $5.140 billion available as of March 31, 2021 and April 29, 2021, respectively) and anticipated access to public and private debt markets.

Investments of our insurance subsidiaries, held to maintain statutory equity levels and to provide liquidity to pay claims, totaled $501 million and $504 million at March 31, 2021 and December 31, 2020, respectively. An insurance subsidiary maintained net reserves for professional liability risks of $148 million and $188 million at March 31, 2021 and December 31, 2020, respectively. Our facilities are insured by a 100% owned insurance subsidiary for losses up to $75 million per occurrence; however, this coverage is generally subject, in most cases, to a $15 million per occurrence self-insured retention. Additionally, the insurance subsidiary has entered into reinsurance contracts providing reimbursement for a certain portion of losses in excess of self-insured retentions. Net reserves for the self-insured professional liability risks retained were $1.816 billion and $1.736 billion at March 31, 2021 and December 31, 2020, respectively. Claims payments, net of reinsurance recoveries, during the next 12 months are expected to approximate $463 million. We estimate that approximately $422 million of the expected net claim payments during the next 12 months will relate to claims subject to the self-insured retention.

Management believes that cash flows from operations, amounts available under our senior secured credit facilities and our anticipated access to public and private debt markets will be sufficient to meet expected liquidity needs during the next 12 months.

Summarized Financial Information

HCA Inc., a direct wholly-owned subsidiary of HCA Healthcare, Inc., is the primary obligor under a substantial portion of our indebtedness, including our senior secured credit facilities, senior secured notes and senior unsecured notes. The senior secured notes and senior unsecured notes issued by HCA Inc. are fully and unconditionally guaranteed on an unsecured basis by HCA Healthcare, Inc. The senior secured credit facilities and senior secured notes are fully and unconditionally guaranteed on a senior secured basis by substantially all existing and future, direct and indirect, 100% owned material domestic subsidiaries that are “Unrestricted Subsidiaries” under our Indenture dated December 16, 1993 (except for certain special purpose subsidiaries that only guarantee and pledge their assets under our senior secured asset-based revolving credit facility). For a list of subsidiary guarantors, see Exhibit 22 to this quarterly report on Form 10-Q.

The subsidiary guarantees rank senior in right of payment to all subordinated indebtedness of each subsidiary guarantor, equally in right of payment with all senior indebtedness of the subsidiary guarantors and are structurally subordinated in right of payment to all indebtedness and other liabilities of any nonguarantor subsidiaries of the subsidiary guarantors (other than indebtedness and liabilities owed to one of the subsidiary guarantors). The subsidiary guarantees are secured by first-priority liens on the subsidiary guarantors’ assets,

26

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Liquidity and Capital Resources (continued)

Summarized Financial Information (continued)

subject to certain exceptions, that secure our senior secured cash flow credit facility on a first-priority basis. The subsidiary guarantees are secured by second-priority liens on the subsidiary guarantors’ assets that secure our senior secured asset-based revolving credit facility on a first-priority basis and our senior secured cash flow credit facility on a second-priority basis.

The subsidiary guarantees may be automatically and unconditionally released and discharged upon certain customary events, including in the event such guarantee is released under our senior secured credit facilities. The indentures governing the senior secured notes include a “savings clause” intended to limit each subsidiary guarantor’s obligations as necessary to prevent the guarantee from constituting a fraudulent conveyance under applicable law, which could reduce a subsidiary guarantor’s liability on its guarantee to zero. For further information regarding the guarantees, refer to the applicable indentures that are filed as exhibits to our annual report on Form 10-K for the year ended December 31, 2020.

Summarized financial information is presented on a combined basis and transactions between the combining entities have been eliminated. Financial information for nonguarantor entities has been excluded. The summarized operating results information for the quarter ended March 31, 2021 and year ended December 31, 2020 and the summarized balance sheet information at March 31, 2021 and December 31, 2020, for HCA Healthcare, Inc., HCA Inc. and the subsidiary guarantors (the Parent, Subsidiary Issuer and Subsidiary Guarantors) follow (dollars in millions):

Quarter Ended March 31, 2021 and Year Ended December 31, 2020:

	Quarter March 31, 2021			Year December 31, 2020
Revenues	$	8,401		$	31,040
Income before income taxes		1,479			4,016
Net income		1,168			3,172
Net income attributable to Parent, Subsidiary Issuer and Subsidiary Guarantors		1,148			3,091
At March 31, 2021 and December 31, 2020:
	March 31, 2021			December 31, 2020
Current assets	$	7,198		$	7,442
Property and equipment, net		14,934			14,939
Goodwill and other intangible assets		5,762			5,763
Total noncurrent assets		21,801			21,771
Total assets		28,999			29,213
Current liabilities		5,178			5,316
Long-term debt, net		30,488			30,444
Intercompany balances		2,324			2,090
Income taxes and other liabilities		1,230			1,004
Total noncurrent liabilities		34,559			34,035
Stockholders’ deficit attributable to Parent, Subsidiary Issuer and Subsidiary Guarantors		(10,845	)		(10,247	)
Noncontrolling interests		107			109

27

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Liquidity and Capital Resources (continued)

Summarized Financial Information (continued)

The first-priority liens securing the subsidiary guarantees discussed above include liens on (i) substantially all of the capital stock of substantially all wholly owned first-tier subsidiaries of HCA Inc. or of the subsidiary guarantors (but limited to 65% of the stock of any such wholly owned first-tier subsidiary that is a foreign subsidiary), subject to certain limited exceptions, and (ii) substantially all indebtedness owing to HCA Inc. or to the subsidiary guarantors, including any and all intercompany indebtedness owed by HCA Healthcare, Inc. or any subsidiary thereof to HCA Inc., or any subsidiary guarantor. For a list of affiliates whose securities are pledged as collateral for the senior secured notes, see Exhibit 22 to this quarterly report on Form 10-Q.

Under the first lien intercreditor agreement, the administrative agent for the lenders under the cash flow credit facility, subject to the occurrence of certain events, has the exclusive right to direct foreclosures and take other actions with respect to these liens, and the trustee for the senior secured notes has no right to take any such actions. In certain circumstances, including upon certain events of default under the senior secured credit facilities and the senior secured notes, the collateral agent in respect of the cash flow credit facility and the senior secured notes could proceed against the collateral granted to it to secure such indebtedness, including the aforementioned pledged capital stock and pledged indebtedness, and require such collateral to be delivered to the collateral agent to the extent not already in its possession for purposes of perfecting the lien on such assets. For further information regarding the collateral, including events or circumstances that may require delivery of the collateral, refer to the applicable indentures, the first lien intercreditor agreement, the cash flow credit agreement and the pledge agreement that are filed as exhibits to our annual report on Form 10-K for the year ended December 31, 2020.

There is no trading market for any of HCA Healthcare, Inc.’s affiliates whose securities are pledged as collateral for the senior secured notes.

Rule 13-02 of Regulation S-X requires the presentation of summarized financial information of the combined affiliates whose securities are pledged as collateral for the senior secured notes unless such information is not material. The rule provides that such information is not material if the assets, liabilities and results of operations of the combined affiliates whose securities are pledged as collateral are not materially different than the corresponding amounts presented in the consolidated financial statements of the Registrant. Healthtrust, Inc. — The Hospital Company (“Healthtrust”) is the first-tier subsidiary of HCA Inc., and the common stock of Healthtrust is pledged as collateral for the senior secured notes. Due to the corporate structure relationship of HCA Healthcare, Inc. and Healthtrust, all of HCA Healthcare, Inc.’s operating subsidiaries, including all other affiliates whose securities are pledged as collateral for the senior secured notes, are also subsidiaries of Healthtrust. The corporate structure relationship, combined with the application of push-down accounting in Healthtrust’s consolidated financial statements related to HCA Healthcare Inc.’s debt and financial instruments, mean that the assets, liabilities and results of operations of Healthtrust (and, therefore, of the combined affiliates whose securities are pledged as collateral for the senior secured notes) are not materially different than the corresponding amounts presented in the financial statements of HCA Healthcare, Inc. As a result, summarized financial information of affiliates whose securities are pledged as collateral for the senior secured notes is not required to be presented under Rule 13-02.

Market Risk

We are exposed to market risk related to changes in market values of securities. The investment securities held by our insurance subsidiaries were recorded at $501 million at March 31, 2021. These investments are carried at fair value, with changes in unrealized gains and losses that are not credit-related being recorded as adjustments to other comprehensive income. At March 31, 2021, we had a net unrealized gain of $21 million on the insurance subsidiaries’ investments.

28

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Liquidity and Capital Resources (continued)

Market Risk (continued)

We are exposed to market risk related to market illiquidity. Investment securities held by our insurance subsidiaries could be impaired by the inability to access the capital markets. Should the insurance subsidiaries require significant amounts of cash in excess of normal cash requirements to pay claims and other expenses on short notice, we may have difficulty selling these investments in a timely manner or be forced to sell them at a price less than what we might otherwise have been able to in a normal market environment. We may be required to recognize credit-related impairments on our investment securities in future periods should issuers default on interest payments or should the fair market valuations of the securities deteriorate due to ratings downgrades or other issue-specific factors.

We are also exposed to market risk related to changes in interest rates, and we periodically enter into interest rate swap agreements to manage our exposure to these fluctuations. Our interest rate swap agreements involve the exchange of fixed and variable rate interest payments between two parties, based on common notional principal amounts and maturity dates. The notional amounts of the swap agreements represent balances used to calculate the exchange of cash flows and are not our assets or liabilities. Our credit risk related to these agreements is considered low because the swap agreements are with creditworthy financial institutions. The interest payments under these agreements are settled on a net basis. These derivatives have been recognized in the financial statements at their respective fair values. Changes in the fair value of these derivatives, which are designated as cash flow hedges, are included in other comprehensive income.

With respect to our interest-bearing liabilities, approximately $1.238 billion of long-term debt at March 31, 2021 was subject to variable rates of interest, while the remaining balance in long-term debt of $29.834 billion at March 31, 2021 was subject to fixed rates of interest. Both the general level of interest rates and, for the senior secured credit facilities, our leverage affect our variable interest rates. Our variable debt is comprised primarily of amounts outstanding under the senior secured credit facilities. Borrowings under the senior secured credit facilities bear interest at a rate equal to an applicable margin plus, at our option, either (a) a base rate determined by reference to the higher of (1) the federal funds rate plus 0.50% or (2) the prime rate of Bank of America or (b) a LIBOR rate for the currency of such borrowing for the relevant interest period. The applicable margin for borrowings under the senior secured credit facilities may fluctuate according to a leverage ratio. The average effective interest rate for our long-term debt was 5.0% for both of the quarters ended March 31, 2021 and 2020.

The estimated fair value of our total long-term debt was $34.872 billion at March 31, 2021. The estimates of fair value are based upon the quoted market prices for the same or similar issues of long-term debt with the same maturities. Based on a hypothetical 1% increase in variable interest rates, the potential annualized reduction to future pretax earnings would be approximately $12 million. To mitigate the impact of fluctuations in interest rates, we generally target a portion of our debt portfolio to be maintained at fixed rates.

We are exposed to currency translation risk related to our foreign operations. We currently do not consider the market risk related to foreign currency translation to be material to our consolidated financial statements or our liquidity.

Tax Examinations

The Internal Revenue Service was conducting an examination of the Company’s 2016, 2017 and 2018 federal income tax returns at March 31, 2021. We are also subject to examination by state and foreign taxing authorities. Management believes HCA Healthcare, Inc. and its predecessors, subsidiaries and affiliates properly reported taxable income and paid taxes in accordance with applicable laws and agreements established with IRS,

29

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Tax Examinations (continued)

state and foreign taxing authorities and final resolution of any disputes will not have a material, adverse effect on our results of operations or financial position. However, if payments due upon final resolution of any issues exceed our recorded estimates, such resolutions could have a material, adverse effect on our results of operations or financial position.

Operating Data

	2021		2020
Number of hospitals in operation at:
March 31		186		186
June 30				186
September 30				187
December 31				185
Number of freestanding outpatient surgical centers in operation at:
March 31		121		123
June 30				122
September 30				121
December 31				121
Licensed hospital beds at(a):
March 31		49,561		49,357
June 30				49,403
September 30				49,473
December 31				49,265
Weighted average licensed beds in service(b):
Quarter:
First		42,363		42,177
Second				42,309
Third				42,426
Fourth				42,072
Year				42,246
Average daily census(c):
Quarter:
First		29,678		28,822
Second				24,844
Third				28,186
Fourth				29,065
Year				27,734
Admissions(d):
Quarter:
First		506,380		528,244
Second				452,992
Third				506,756
Fourth				521,917
Year				2,009,909
Equivalent admissions(e):
Quarter:
First		832,489		889,035
Second				723,136
Third				835,576
Fourth				864,583
Year				3,312,330

30

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Operating Data (continued)

	2021			2020
Average length of stay (days)(f):
Quarter:
First		5.3			5.0
Second					5.0
Third					5.1
Fourth					5.1
Year					5.1
Emergency room visits(g):
Quarter:
First		1,841,778			2,264,707
Second					1,516,116
Third					1,813,661
Fourth					1,855,823
Year					7,450,307
Outpatient surgeries(h):
Quarter:
First		231,228			226,319
Second					170,911
Third					232,493
Fourth					252,760
Year					882,483
Inpatient surgeries(i):
Quarter:
First		127,590			135,145
Second					118,591
Third					133,492
Fourth					135,157
Year					522,385
Days revenues in accounts receivable(j):
Quarter:
First		48			49
Second					50
Third					44
Fourth					45
Outpatient revenues as a % of patient revenues(k):
Quarter:
First		36	%		37	%
Second					32	%
Third					36	%
Fourth					35	%
Year					35	%

(a) Licensed beds are those beds for which a facility has been granted approval to operate from the applicable state licensing agency.

(b) Represents the average number of licensed beds in service, weighted based on periods owned.

(c) Represents the average number of patients in our hospital beds each day.

(d) Represents the total number of patients admitted to our hospitals and is used by management and certain investors as a general measure of inpatient volume.

31

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Operating Data (continued)

(e) Equivalent admissions are used by management and certain investors as a general measure of combined inpatient and outpatient volume. Equivalent admissions are computed by multiplying admissions (inpatient volume) by the sum of gross inpatient revenues and gross outpatient revenues and then dividing the resulting amount by gross inpatient revenues. The equivalent admissions computation “equates” outpatient revenues to the volume measure (admissions) used to measure inpatient volume resulting in a general measure of combined inpatient and outpatient volume.

(f) Represents the average number of days admitted patients stay in our hospitals.

(g) Represents the number of patients treated in our emergency rooms.

(h) Represents the number of surgeries performed on patients who were not admitted to our hospitals. Pain management and endoscopy procedures are not included in outpatient surgeries.

(i) Represents the number of surgeries performed on patients who have been admitted to our hospitals. Pain management and endoscopy procedures are not included in inpatient surgeries.

(j) Revenues per day is calculated by dividing revenues for the quarter by the days in the quarter. Days revenues in accounts receivable is then calculated as accounts receivable at the end of the quarter divided by revenues per day.

(k) Represents the percentage of patient revenues related to patients who are not admitted to our hospitals.

32

ITEM 3.    QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

The information called for by this item is provided under the caption “Market Risk” under Item 2, “Management’s Discussion and Analysis of Financial Condition and Results of Operations.”

ITEM 4.    CONTROLS AND PROCEDURES

Evaluation of Disclosure Controls and Procedures

HCA’s management, with participation of HCA’s chief executive officer and chief financial officer, has evaluated the effectiveness of HCA’s disclosure controls and procedures as of March 31, 2021. Based on that evaluation, HCA’s chief executive officer and chief financial officer concluded that HCA’s disclosure controls and procedures were effective as of March 31, 2021.

Changes in Internal Control Over Financial Reporting

During the period covered by this report, there have been no changes in our internal control over financial reporting that have materially affected or are reasonably likely to materially affect our internal control over financial reporting.

PART II. OTHER INFORMATION

ITEM 1.    LEGAL PROCEEDINGS

The information set forth in Note 9 – Contingencies in the notes to the condensed consolidated financial statements is incorporated herein by reference.

ITEM 1A.    RISK FACTORS

Reference is made to the factors set forth under the caption “Forward-Looking Statements” in Part I, Item 2 of this quarterly report on Form 10-Q and other risk factors described in our annual report on Form 10-K for the year ended December 31, 2020, which are incorporated herein by reference. There have not been any material changes to the risk factors previously disclosed in our annual report on Form 10-K for the year ended December 31, 2020.

ITEM 2.     UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS

During January 2020 and 2019, our Board of Directors authorized share repurchase programs for up to $4 billion ($2 billion for each authorization) of our outstanding common stock. During February 2021, our Board of Directors authorized an additional $6 billion for repurchases of our outstanding common stock. During the quarter ended March 31, 2021, we repurchased 8,476,736 shares of our common stock at an average price of $180.11 per share through market purchases pursuant to the $2.0 billion share repurchase program authorized during January 2019 (which was completed during the first quarter of 2021) and the January 2020 authorization. At March 31, 2021, we had $7.274 billion of repurchase authorization available under the January 2020 and February 2021 authorizations.

33

The following table provides certain information with respect to our repurchases of common stock from January 1, 2021 through March 31, 2021 (dollars in millions, except per share amounts).

Period	Total Number of Shares Purchased		Average Price Paid per Share		Total Number of Shares Purchased as Part of Publicly Announced Plans or Programs		Approximate Dollar Value of Shares That May Yet Be Purchased Under Publicly Announced Plans or Programs
January 1, 2021 through January 31, 2021		—	$	—		—	$	2,800
February 1, 2021 through February 28, 2021		4,057,692	$	175.39		4,057,692	$	8,089
March 1, 2021 through March 31, 2021		4,419,044	$	184.44		4,419,044	$	7,274
Total for first quarter 2021		8,476,736	$	180.11		8,476,736	$	7,274

On April 21, 2021, our Board of Directors declared a quarterly dividend of $0.48 per share on our common stock payable on June 30, 2021 to stockholders of record at the close of business on June 16, 2021. Future declarations of quarterly dividends and the establishment of future record and payment dates are subject to the final determination of our Board of Directors. Our ability to declare future dividends may also from time to time be limited by the terms of our debt agreements.

34

ITEM 6.    EXHIBITS

(a) List of Exhibits:

10.1	—	HCA Healthcare, Inc. 2021 Senior Officer Performance Excellence Program (filed as Exhibit 10.1 to the Company’s Current Report on Form 8-K filed April 9, 2021 (File No. 001-11239), and incorporated herein by reference).*
22	—	List of Subsidiary Guarantors and Pledged Securities.
31.1	—	Certification of Chief Executive Officer Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
31.2	—	Certification of Chief Financial Officer Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
32	—	Certification Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
101	—	The following financial information from our quarterly report on Form 10-Q for the quarter ended March 31, 2021 filed with the SEC on April 30, 2021, formatted in Inline Extensible Business Reporting Language: (i) the condensed consolidated balance sheets at March 31, 2021 and December 31, 2020, (ii) the condensed consolidated income statements for the quarters ended March 31, 2021 and 2020, (iii) the condensed consolidated comprehensive income statements for the quarters ended March 31, 2021 and 2020, (iv) the condensed consolidated statements of stockholders’ equity (deficit) for the quarters ended March 31, 2021 and 2020, (v) the condensed consolidated statements of cash flows for the quarters ended March 31, 2021 and 2020 and (vi) the notes to condensed consolidated financial statements. The instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.
104	—	The cover page from the Company’s Quarterly Report on Form 10-Q for the quarter ended March 31, 2021, formatted in Inline XBRL (included in Exhibit 101).

* Management compensatory plan or arrangement.

35

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

HCA Healthcare, Inc.
By:	/S/ WILLIAM B. RUTHERFORD
	William B. Rutherford
	Executive Vice President and Chief Financial Officer

Date: April 30, 2021

36

EX-22

Exhibit 22

List of Subsidiary Guarantors

All of the senior secured notes and senior unsecured notes issued by HCA Inc. are fully and unconditionally guaranteed by HCA Healthcare, Inc. In addition to the guarantee provided by HCA Healthcare, Inc., all of HCA Inc.’s senior secured notes are fully and unconditionally guaranteed by the subsidiary guarantors listed below.

American Medicorp Development Co.

Bay Hospital, Inc.

Brigham City Community Hospital, Inc.

Brookwood Medical Center of Gulfport, Inc.

Capital Division, Inc.

CarePartners HHA Holdings, LLLP

CarePartners HHA, LLLP

CarePartners Rehabilitation Hospital, LLLP

Centerpoint Medical Center of Independence, LLC

Central Florida Regional Hospital, Inc.

Central Shared Services, LLC

Central Tennessee Hospital Corporation

CHCA Bayshore, L.P.

CHCA Conroe, L.P.

CHCA Mainland, L.P.

CHCA Pearland, L.P.

CHCA West Houston, L.P.

CHCA Woman’s Hospital, L.P.

Chippenham & Johnston-Willis Hospitals, Inc.

Citrus Memorial Hospital, Inc.

Citrus Memorial Property Management, Inc.

Clinical Education Shared Services, LLC

Colorado Health Systems, Inc.

Columbia ASC Management, L.P.

Columbia Florida Group, Inc.

Columbia Healthcare System of Louisiana, Inc.

Columbia Jacksonville Healthcare System, Inc.

Columbia LaGrange Hospital, LLC

Columbia Medical Center of Arlington Subsidiary, L.P.

Columbia Medical Center of Denton Subsidiary, L.P.

Columbia Medical Center of Las Colinas, Inc.

Columbia Medical Center of Lewisville Subsidiary, L.P.

Columbia Medical Center of McKinney Subsidiary, L.P.

Columbia Medical Center of Plano Subsidiary, L.P.

Columbia North Hills Hospital Subsidiary, L.P.

Columbia Ogden Medical Center, Inc.

Columbia Parkersburg Healthcare System, LLC

Columbia Physician Services - Florida Group, Inc.

Columbia Plaza Medical Center of Fort Worth Subsidiary, L.P.

Columbia Rio Grande Healthcare, L.P.

Columbia Riverside, Inc.

Columbia Valley Healthcare System, L.P.

Columbia/Alleghany Regional Hospital, Incorporated

Columbia/HCA John Randolph, Inc.

Columbine Psychiatric Center, Inc.

Columbus Cardiology, Inc.

Conroe Hospital Corporation

Cy-Fair Medical Center Hospital, LLC

Dallas/Ft. Worth Physician, LLC

Dublin Community Hospital, LLC

East Florida - DMC, Inc.

Eastern Idaho Health Services, Inc.

Edward White Hospital, Inc.

El Paso Surgicenter, Inc.

Encino Hospital Corporation, Inc.

EP Health, LLC

Fairview Park GP, LLC

Fairview Park, Limited Partnership

FMH Health Services, LLC

Frankfort Hospital, Inc.

Galen Property, LLC

GenoSpace, LLC

Good Samaritan Hospital, L.P.

Goppert-Trinity Family Care, LLC

GPCH-GP, Inc.

Grand Strand Regional Medical Center, LLC

Green Oaks Hospital Subsidiary, L.P.

Greenview Hospital, Inc.

H2U Wellness Centers, LLC

HCA - IT&S Field Operations, Inc.

HCA - IT&S Inventory Management, Inc.

HCA American Finance LLC

HCA Central Group, Inc.

HCA Eastern Group, Inc.

HCA Health Services of Florida, Inc.

HCA Health Services of Louisiana, Inc.

HCA Health Services of Tennessee, Inc.

HCA Health Services of Virginia, Inc.

HCA Management Services, L.P.

HCA Pearland GP, Inc.

HCA Realty, Inc.

HCA-HealthONE LLC

2

HD&S Corp. Successor, Inc.

Health Midwest Office Facilities Corporation

Health Midwest Ventures Group, Inc.

HealthTrust Workforce Solutions, LLC

Hendersonville Hospital Corporation

hInsight-Mobile Heartbeat Holdings, LLC

Hospital Corporation of Tennessee

Hospital Corporation of Utah

Hospital Development Properties, Inc.

Houston - PPH, LLC

Houston NW Manager, LLC

HPG Enterprises, LLC

HSS Holdco, LLC

HSS Systems, LLC

HSS Virginia, L.P.

HTI Memorial Hospital Corporation

HTI MOB, LLC

Integrated Regional Lab, LLC

Integrated Regional Laboratories, LLP

JFK Medical Center Limited Partnership

JPM AA Housing, LLC

KPH-Consolidation, Inc.

Lakeview Medical Center, LLC

Largo Medical Center, Inc.

Las Encinas Hospital

Las Vegas Surgicare, Inc.

Lawnwood Medical Center, Inc.

Lewis-Gale Hospital, Incorporated

Lewis-Gale Medical Center, LLC

Lewis-Gale Physicians, LLC

Lone Peak Hospital, Inc.

Los Robles Regional Medical Center

Management Services Holdings, Inc.

Marietta Surgical Center, Inc.

Marion Community Hospital, Inc.

MCA Investment Company

Medical Centers of Oklahoma, LLC

Medical Office Buildings of Kansas, LLC

MediCredit, Inc.

Memorial Healthcare Group, Inc.

MH Angel Medical Center, LLLP

MH Blue Ridge Medical Center, LLLP

MH Highlands-Cashiers Medical Center, LLLP

MH Hospital Holdings, Inc.

3

MH Hospital Manager, LLC

MH Master Holdings, LLLP

MH Master, LLC

MH Mission Hospital McDowell, LLLP

MH Mission Hospital, LLLP

MH Mission Imaging, LLLP

MH Transylvania Regional Hospital, LLLP

Midwest Division - ACH, LLC

Midwest Division - LSH, LLC

Midwest Division - MCI, LLC

Midwest Division - MMC, LLC

Midwest Division - OPRMC, LLC

Midwest Division - RBH, LLC

Midwest Division - RMC, LLC

Midwest Holdings, Inc.

Mobile Heartbeat, LLC

Montgomery Regional Hospital, Inc.

Mountain Division - CVH, LLC

Mountain View Hospital, Inc.

Nashville Shared Services General Partnership

National Patient Account Services, Inc.

New Iberia Healthcare, LLC

New Port Richey Hospital, Inc.

New Rose Holding Company, Inc.

North Florida Immediate Care Center, Inc.

North Florida Regional Medical Center, Inc.

North Houston - TRMC, LLC

North Texas - MCA, LLC

Northern Utah Healthcare Corporation

Northern Virginia Community Hospital, LLC

Northlake Medical Center, LLC

Notami Hospitals of Louisiana, Inc.

Notami Hospitals, LLC

Okaloosa Hospital, Inc.

Okeechobee Hospital, Inc.

Oklahoma Holding Company, LLC

Outpatient Cardiovascular Center of Central Florida, LLC

Outpatient Services Holdings, Inc.

Oviedo Medical Center, LLC

Palms West Hospital Limited Partnership

Parallon Business Solutions, LLC

Parallon Enterprises, LLC

Parallon Health Information Solutions, LLC

Parallon Holdings, LLC

4

Parallon Payroll Solutions, LLC

Parallon Physician Services, LLC

Parallon Revenue Cycle Services, Inc.

Pasadena Bayshore Hospital, Inc.

PatientKeeper, Inc.

Pearland Partner, LLC

Plantation General Hospital, L.P.

Poinciana Medical Center, Inc.

Primary Health, Inc.

PTS Solutions, LLC

Pulaski Community Hospital, Inc.

Putnam Community Medical Center of North Florida, LLC

Redmond Park Hospital, LLC

Redmond Physician Practice Company

Reston Hospital Center, LLC

Retreat Hospital, LLC

Rio Grande Regional Hospital, Inc.

Riverside Healthcare System, L.P.

Riverside Hospital, Inc.

Samaritan, LLC

San Jose Healthcare System, LP

San Jose Hospital, L.P.

San Jose Medical Center, LLC

San Jose, LLC

Sarah Cannon Research Institute, LLC

Sarasota Doctors Hospital, Inc.

Savannah Health Services, LLC

SCRI Holdings, LLC

Sebring Health Services, LLC

SJMC, LLC

Southeast Georgia Health Services, LLC

Southern Hills Medical Center, LLC

Southpoint, LLC

Spalding Rehabilitation L.L.C.

Spotsylvania Medical Center, Inc.

Spring Branch Medical Center, Inc.

Spring Hill Hospital, Inc.

SSHR Holdco, LLC

Sun City Hospital, Inc.

Sunrise Mountainview Hospital, Inc.

Surgicare of Brandon, Inc.

Surgicare of Florida, Inc.

Surgicare of Houston Women’s, Inc.

Surgicare of Manatee, Inc.

5

Surgicare of Newport Richey, Inc.

Surgicare of Palms West, LLC

Surgicare of Riverside, LLC

Tallahassee Medical Center, Inc.

TCMC Madison-Portland, Inc.

Terre Haute Hospital GP, Inc.

Terre Haute Hospital Holdings, Inc.

Terre Haute MOB, L.P.

Terre Haute Regional Hospital, L.P.

The Regional Health System of Acadiana, LLC

Timpanogos Regional Medical Services, Inc.

Trident Medical Center, LLC

U.S. Collections, Inc.

Utah Medco, LLC

VH Holdco, Inc.

VH Holdings, Inc.

Virginia Psychiatric Company, Inc.

Vision Consulting Group LLC

Vision Holdings, LLC

Walterboro Community Hospital, Inc.

WCP Properties, LLC

Weatherford Health Services, LLC

Wesley Medical Center, LLC

West Florida - MHT, LLC

West Florida - PPH, LLC

West Florida Regional Medical Center, Inc.

West Valley Medical Center, Inc.

Western Plains Capital, Inc.

WHMC, Inc.

Woman’s Hospital of Texas, Incorporated

List of Pledged Securities

The subsidiary guarantees discussed above are secured by first-priority liens on substantially all of the capital stock of substantially all wholly owned first-tier subsidiaries of HCA Inc. or of subsidiary guarantors (but limited to 65% of the stock of any such wholly owned first-tier subsidiary that is a foreign subsidiary), subject to certain limited exceptions. Below is a list of all of the entities in which the identified credit party owns stock, partnership interest, limited liability company membership interest or other equity interest that is pledged as collateral for the senior secured notes.

6

Credit Party	Legal Entity Owned
American Medicorp Development Co.	CVMC Property, LLC
	HCA-HealthONE LLC
	Rapides Healthcare System, L.L.C.
	Surgicare of Evans, Inc.
Bay Hospital, Inc.	Gulf Coast Inpatient Specialists, LLC
Brigham City Community Hospital, Inc.	Brigham City Community Hospital Physician Services, LLC
	MountainStar Brigham General Surgery, LLC
Brookwood Medical Center of Gulfport, Inc.	Coastal Imaging Center of Gulfport, Inc.
	EPIC Properties, Inc.
	Garden Park Investments, L.P.
	Garden Park Physician Group - Specialty Care, LLC
	Garden Park Physician Group, Inc.
	GPCH-GP, Inc.
	Gulf Coast Medical Ventures, Inc.
Capital Division, Inc.	Capital Professional Billing, LLC
	HCA LewisGale Regional Cancer Centers Clinical Co-Management Company, LLC
	HCA Richmond Cardiac Clinical Co-Management Company, LLC
	Virginia Care Partners ACO LLC
	Virginia Quality Care Partners, LLC
CarePartners HHA Holdings, LLLP	CarePartners HHA, LLLP
CarePartners Rehabilitation Hospital, LLLP	MH Anesthesiology Physicians, LLC
	MH Physician Services, LLC
	Mission Health Community Multispecialty Providers, LLC
Centerpoint Medical Center of Independence, LLC	The Regional Health System of Acadiana, LLC
Central Florida Regional Hospital, Inc.	Central Florida Cardiology Interpretations, LLC
	JPM AA Housing, LLC
Central Shared Services, LLC	Clinical Education Shared Services, LLC
CHCA Bayshore, L.P.	HCA-Solis Holdings, Inc.
	Solis Mammography at Bayshore Medical Center, LLC
CHCA Conroe, L.P.	CRMC-M, LLC
	HCA-Solis Holdings, Inc.
	Solis Mammography at Conroe Regional Medical Center, LLC
CHCA Pearland, L.P.	HCA-Solis Holdings, Inc.
	Solis Mammography at Pearland Medical Center, LLC

7

CHCA West Houston, L.P.	HCA-Solis Holdings, Inc.
	Solis Mammography at West Houston Medical Center, LLC
CHCA Woman’s Hospital, L.P.	Fannin MOB Property Management, LLC
	HCA-Solis Holdings, Inc.
	Solis Mammography at Woman’s Hospital of Texas, LLC
Chippenham & Johnston-Willis Hospitals, Inc.	CJW Wound Healing Center, LLC
	Crewe Outpatient Imaging, LLC
	Imaging Services of Richmond, LLC
Colorado Health Systems, Inc.	HealthONE of Denver, Inc.
	New Rose Holding Company, Inc.
Columbia Florida Group, Inc.	Columbia Central Florida Division, Inc.
	Columbia Physician Services - Florida Group, Inc.
	Columbia Tampa Bay Division, Inc.
	East Florida Division, Inc.
	Fort Myers Market, Inc.
	North Florida Division I, Inc.
	West Florida Division, Inc.
Columbia Healthcare System of Louisiana, Inc.	Centerpoint Clinic of Blue Springs, LLC
	Centerpoint Medical Center of Independence, LLC
	Centerpoint Physicians Group, LLC
	Centerpoint Women’s Services, LLC
	Children’s Multi-Specialty Group, LLC
	Columbia/HCA of Baton Rouge, Inc.
	Lafayette OB Hospitalists, LLC
	Lakeview Cardiology Specialists, LLC
	Lakeview Regional Physician Group, LLC
	Research Family Physicians, LLC
	Southwest Medical Center Family Practice, LLC
	Southwest Medical Center Multi-Specialty Group, LLC
	Southwest Medical Center Surgical Group, LLC
	Tchefuncte Cardiology Associates - Lakeview, LLC
	Women’s & Children’s Pediatric Hematology/Oncology Center, LLC
	Women’s Multi-Specialty Group, LLC
Columbia Jacksonville Healthcare System, Inc.	Memorial Family Practice Associates, LLC
	Memorial Health Primary Care at St. Johns Bluff, LLC
	Memorial Healthcare Group, Inc.
	Memorial Neurosurgery Group, LLC
Columbia LaGrange Hospital, LLC	Kendall Regional Medical Center, LLC

8

Columbia Medical Center of Arlington Subsidiary, L.P.	HCA-Solis Holdings, Inc.
	Solis Mammography at Medical Center Arlington, LLC
Columbia Medical Center of Denton Subsidiary, L.P.	HCA-Solis Holdings, Inc.
	Solis Mammography at Denton Regional Medical Center, LLC
Columbia Medical Center of Las Colinas, Inc.	HCA-Solis Holdings, Inc.
	Solis Mammography at Las Colinas Medical Center, LLC
	Tuscan Imaging Center at Las Colinas, LLC
Columbia Medical Center of Lewisville Subsidiary, L.P.	HCA-Solis Holdings, Inc.
	Solis Mammography at Medical Center of Lewisville, LLC
Columbia Medical Center of McKinney Subsidiary, L.P.	HCA-Solis Holdings, Inc.
	Solis Mammography at Medical Center of McKinney, LLC
Columbia Medical Center of Plano Subsidiary, L.P.	HCA-Solis Holdings, Inc.
	Plano Ambulatory Surgery Associates, L.P.
	Plano Heart Management, LLC
	Plano Surgicenter Real Estate Manager, LLC
	Solis Mammography at Medical Center of Plano, LLC
Columbia Ogden Medical Center, Inc.	MountainStar Cardiology Ogden Regional, LLC
	Ogden Regional Medical Center Professional Billing, LLC
	Ogden Senior Center, LLC
Columbia Parkersburg Healthcare System, LLC	Parkersburg SJ Holdings, Inc.
Columbia Physician Services - Florida Group, Inc.	Central Florida Division Practice, Inc.
	North Florida Division Practice, Inc.
	Premier Medical Management, Ltd.
	South Florida Division Practice, Inc.
Columbia Riverside, Inc.	Riverside Healthcare System, L.P.
Columbia/Alleghany Regional Hospital, Incorporated	Alleghany Primary Care, Inc.
	Alleghany Specialists, LLC
Columbia/HCA John Randolph, Inc.	Imaging Services of Appomattox, LLC
Columbine Psychiatric Center, Inc.	HCA-HealthONE LLC

9

Conroe Hospital Corporation	CHCA Conroe, L.P.
	Conroe Partner, LLC
Dublin Community Hospital, LLC	Fairview Park GP, LLC
	Fairview Partner, LLC
Eastern Idaho Health Services, Inc.	EIRMC Hospitalist Services, LLC
El Paso Surgicenter, Inc.	El Paso Surgery Centers, L.P.
EP Health, LLC	Brookwood Medical Center of Gulfport, Inc.
	Coastal Healthcare Services, Inc.
	Epic Diagnostic Centers, Inc.
	Epic Healthcare Management Company
	EPIC Surgery Centers, Inc.
	Grace 1011, LLC
	Health Insight Capital, LLC
	MRT&C, Inc.
	Primary Health Asset Holdings, Ltd.
	PSG Delegated Services, LLC
	SSHR Holdco, LLC
Fairview Park GP, LLC	Fairview Park, Limited Partnership
FMH Health Services, LLC	New Hampshire Imaging Services, Inc.
Frankfort Hospital, Inc.	Frankfort Wound Care, LLC
Galen Property, LLC	Henrico Doctors Hospital - Forest Campus Property, LLC
GPCH-GP, Inc.	Garden Park Community Hospital Limited Partnership
Grand Strand Regional Medical Center, LLC	Grand Strand Senior Health Center, LLC
Greenview Hospital, Inc.	Frankfort Hospital, Inc.
	Southern Kentucky Surgicenter, LLC
H2U Wellness Centers, LLC	Health to You, LLC
HCA Central Group, Inc.	Capital Division, Inc.
	HCA Chattanooga Market, Inc.
	MidAmerica Division, Inc.
	TriStar Health System, Inc.
HCA Eastern Group, Inc.	Columbia Florida Group, Inc.
	South Atlantic Division, Inc.
HCA Health Services of Florida, Inc.	Bradenton Cardiology Physician Network, LLC
	Hilltop 408, LLC
	North Physician Services, Inc.
	Oak Hill Acquisition, Inc.
	Pinnacle Physician Network, LLC
	St. Lucie Medical Center Hyperbarics, LLC
	Surgicare of Bayonet Point, Inc.
	West Florida Physician Network, LLC
	West Florida Trauma Network, LLC
	West Florida Urgent Care Network, LLC

10

HCA Health Services of Louisiana, Inc.	Cedar Creek Medical Group, LLC
	Foot & Ankle Specialty Services, LLC
	Goppert-Trinity Family Care, LLC
	Midwest Cardiovascular & Thoracic Surgery, LLC
	Midwest Division - LSH, LLC
	Midwest Division - MCI, LLC
	Midwest Division - RBH, LLC
	Midwest Division - RMC, LLC
	Midwest Trauma Services, LLC
	Midwest Women’s Healthcare Specialists, LLC
	Raymore Medical Group, LLC
	RMC - Pulmonary, LLC
	Senior Health Associates, LLC
	Women’s Center at Brookside, LLC
HCA Health Services of Tennessee, Inc.	2490 Church, LLC
	Centennial CyberKnife Center, LLC
	Centennial Neuroscience, LLC
	Centennial Surgical Clinic, LLC
	Central Tennessee Hospital Corporation
	HCA-Solis Holdings, Inc.
	Hospitalists at Centennial Medical Center, LLC
	Judson Holdings, LLC
	Neuro Affiliates Company
	Old Fort Village, LLC
	Solis Mammography at StoneCrest Medical Center, LLC
	Southpoint, LLC
	Summit General Partner, Inc.
	Summit Walk-In Clinic, LLC
	Surgicare of Brentwood, LLC
	Surgicare of Southern Hills, Inc.
	TriStar Cardiovascular Surgery, LLC
	TriStar Medical Group - Centennial Primary Care, LLC
HCA Health Services of Virginia, Inc.	Columbia Arlington Healthcare System, L.L.C.
	Columbia/HCA John Randolph, Inc.
	Preferred Hospitals, Inc.
	Reston Hospital Center, LLC
	Retreat Hospital, LLC
	Spotsylvania Medical Center, Inc.
	West Creek Ambulatory Surgery Center, LLC

11

HCA Inc.	HCA American Finance LLC HCA Property GP, LLC Healthtrust, Inc. – The Hospital Company HSS Holdco, LLC
HCA Management Services, L.P.	UR Services, LLC
	HCA Healthcare Marketing and Corporate Affairs, LLC
HCA Pearland GP, Inc.	CHCA Pearland, L.P.
	Pearland Partner, LLC
HCA-HealthONE LLC	Altitude Mid Level Providers, LLC
	Center for Advanced Diagnostics LLC
	HCA-Solis Master, LLC
	HealthONE at Breckenridge, LLC
	HealthONE Aurora Investment, LLC
	HealthONE Care Partners, LLC
	HealthONE CareNow Urgent Care, LLC
	HealthONE Clear Creek, LLC
	HealthONE Clinic Services - Bariatric Medicine, LLC
	HealthONE Clinic Services - Behavioral Health, LLC
	HealthONE Clinic Services - Cardiovascular, LLC
	HealthONE Clinic Services - Medical Specialties, LLC
	HealthONE Clinic Services - Neurosciences, LLC
	HealthONE Clinic Services - Obstetrics and Gynecology, LLC
	HealthONE Clinic Services - Occupational Medicine, LLC
	HealthONE Clinic Services - Oncology Hematology, LLC
	HealthONE Clinic Services - Orthopedic Specialists, LLC
	HealthONE Clinic Services - Otolaryngology Specialists, LLC
	HealthONE Clinic Services - Pediatric Specialties, LLC
	HealthONE Clinic Services - Primary Care, LLC
	HealthONE Clinic Services - Surgery Neurological, LLC
	HealthONE Clinic Services - Surgical Specialties, LLC
	HealthONE Clinic Services - Youth Rehabilitation LLC
	HealthONE Clinic Services LLC
	HealthONE Heart Care LLC
	HealthONE High Street Primary Care Center, LLC

12

	HealthONE IRL Pathology Services, LLC
	HealthONE Lincoln Investment, LLC
	HealthONE Lowry, LLC
	HealthONE Radiation Therapy at Red Rocks, LLC
	HealthONE Radiation Therapy at Thornton, LLC
	HealthONE Surgicare of Ridge View, LLC
	HealthONE Urologic, LLC
	HealthONE Westside Investment, LLC
	Hospital Cooperative Laundry, Inc.
	Hospital Based CRNA Services, Inc.
	HSS Inc.
	Lakewood Surgicare, Inc.
	Medical Care America Colorado, LLC
	Medical Imaging of Colorado LLC
	P/SL Hyperbaric Partnership
	Proaxis Therapy HealthONE LLC
	Rocky Mountain Pediatric Hematology Oncology, LLC
	Rose Health Partners, LLC
	Rose Medical Plaza, Ltd.
	Rose POB, Inc.
	Sky Ridge Spine Manager, LLC
	Solis Mammography at Rose Medical Center, LLC
	Spalding Rehabilitation, L.L.C.
	Surgicare of Denver Mid-Town, Inc.
	Surgicare of Rose, LLC
	Surgicare of Sky Ridge, LLC
	Surgicare of Southeast Denver, Inc.
	Surgicare of Swedish, LLC
	Surgicare of Thornton, LLC
	Swedish Medpro, Inc.
	Swedish MOB Acquisition, Inc.
	Swedish MOB II, Inc.
	Swedish MOB III, Inc.
	Swedish MOB IV, Inc.
HD&S Corp. Successor, Inc.	Plantation General Hospital, L.P.
Health Midwest Ventures Group, Inc.	Clinishare, Inc.
	Eye Care Surgicare, Ltd., a Missouri Limited Partnership
	HCA Midwest Comprehensive Care, Inc.
	Health Midwest Medical Group, Inc.
	Health Midwest Office Facilities Corporation
	HM OMCOS, LLC
	Johnson County Surgicenter, L.L.C.
	Surgicenter of Kansas City, L.L.C.

13

HealthTrust Workforce Solutions, LLC	Martin Fletcher Associates Holdings, Inc.
hInsight-Mobile Heartbeat Holdings, LLC	Mobile Heartbeat, LLC
Hospital Development Properties, Inc.	Lafayette Medical Office Building, Ltd. (A partnership in Commendam)
HPG Enterprises, LLC	HCA Management Services, L.P.
	Healthtrust Purchasing Group, L.P.
	Valify, Inc.
HSS Holdco, LLC	HSS Virginia, L.P.
	Nashville Shared Services General Partnership
	Terre Haute MOB, L.P.
HSS Systems, LLC	HSS Virginia, L.P.
	Nashville Shared Services General Partnership
	Parallon Health Information Solutions, LLC
	Parallon Payroll Solutions, LLC
	Parallon Physician Services, LLC
	Texas HSS, LLC
HSS Virginia, L.P.	Nashville Shared Services General Partnership
HTI Memorial Hospital Corporation	HCA-Solis Holdings, Inc.
	Solis Mammography at Skyline Medical Center, LLC
HTI MOB, LLC	Healthtrust MOB Tennessee, LLC
	Medical Office Buildings of Kansas, LLC
Houston NW Manager, LLC	Houston Northwest Operating Company, L.L.C.
Integrated Regional Lab, LLC	Integrated Regional Laboratories, LLP
Integrated Regional Laboratories, LLP	Integrated Regional Laboratories Pathology Services, LLC
JFK Medical Center Limited Partnership	Palm Beach Hospitalists Program, LLC
	AR Holding 5, LLC
KPH-Consolidation, Inc.	HCA-Solis Holdings, Inc.
	Solis Mammography at Kingwood Medical Center, LLC
Las Encinas Hospital	L E Corporation
Las Vegas Surgicare, Inc.	Las Vegas Surgicare, Ltd., a Nevada Limited Partnership
Lewis-Gale Hospital, Incorporated	Columbia/Alleghany Regional Hospital, Incorporated
	Lewis-Gale Medical Center, LLC
	Lewis-Gale Physicians, LLC
	Roanoke Imaging, LLC
	Roanoke Neurosurgery, LLC
	Salem Hospitalists, LLC
Lewis-Gale Medical Center, LLC	Daleville Imaging Manager, LLC
	Daleville Imaging, L.P.
Los Robles Regional Medical Center	Los Robles Regional Medical Center MOB, LLC
	Los Robles Surgicenter, LLC
	TODIC, L.P.

14

Management Services Holdings, Inc.	HPG Enterprises, LLC
	HPG Solutions, LLC
Marietta Surgical Center, Inc.	Marietta Outpatient Surgery, Ltd.
MCA Investment Company	Columbia ASC Management, L.P.
Medical Centers of Oklahoma, LLC	EPIC Properties, Inc.
	Medical Imaging, Inc.
	SWMC, Inc.
Memorial Healthcare Group, Inc.	Family Care Partners, LLC
	Jacksonville Surgery Center, Ltd.
	MHS Partnership Holdings JSC, Inc.
	MHS Partnership Holdings SDS, Inc.
	MSL Acquisition, LLC
MH Hospital Holdings, Inc.	MH Asheville Specialty Hospital, LLC
	MH Hospital Manager, LLC
	MH Master Holdings, LLLP
	Mission Employer Solutions, LLC
	Mission Health Partners, Inc.
MH Hospital Manager, LLC	MH Master Holdings, LLLP
MH Master Holdings, LLLP	Assuring Affordable, Quality Healthcare in North Carolina, LLC
	CarePartners HHA Holdings, LLLP
	CarePartners Rehabilitation Hospital, LLLP
	Imaging Realty LLC
	MH Angel Medical Center, LLLP
	MH Blue Ridge Medical Center, LLLP
	MH Eckerd Living Center, LLLP
	MH Highlands-Cashiers Medical Center, LLLP
	MH Master, LLC
	MH McDowell Imaging, LLLP
	MH Mission Hospital McDowell, LLLP
	MH Mission Hospital, LLLP
	MH Mission Imaging, LLLP
	MH Transylvania Imaging, LLLP
	MH Transylvania Regional Hospital, LLLP
	Provider-Led, Patient-Centered Care, LLC
	Western North Carolina Healthcare Innovators, LLC
MH Master, LLC	CarePartners HHA Holdings, LLLP
	CarePartners HHA, LLLP
	CarePartners Rehabilitation Hospital, LLLP
	MH Angel Medical Center, LLLP
	MH Blue Ridge Medical Center, LLLP
	MH Eckerd Living Center, LLLP
	MH Highlands-Cashiers Medical Center, LLLP

15

	MH McDowell Imaging, LLLP
	MH Mission Hospital McDowell, LLLP
	MH Mission Hospital, LLLP
	MH Mission Imaging, LLLP
	MH Transylvania Imaging, LLLP
	MH Transylvania Regional Hospital, LLLP
MH Mission Hospital, LLLP	WNC Stone Center, LLC
Midwest Division - OPRMC, LLC	Forward Pathology Solutions Wichita, LLC
	Heartland Women’s Group at Wesley, LLC
	Neurology Associates of Kansas, LLC
	OPRMC-HBP, LLC
	Wesley Physician Services, LLC
	Wesley Physicians - Medical Specialties LLC
	Wesley Urgent Care, LLC
	Wichita CareNow Urgent Care, LLC
Midwest Division - RBH, LLC	Bone & Joint Specialists Physician Group, LLC
Midwest Division - RMC, LLC	RMC Transplant Physicians, LLC
Midwest Holdings, Inc.	Health Midwest Ventures Group, Inc.
	Medical Center Imaging, Inc.
	Midwest Division - ACH, LLC
	Midwest Division - LRHC, LLC
	Mill Creek Outpatient Services, LLC
Montgomery Regional Hospital, Inc.	Blacksburg Imaging, LLC
	Montgomery Cancer Center, LLC
Mountain View Hospital, Inc.	MVH Professional Services, LLC
	Timpanogos Regional Medical Services, Inc.
National Patient Account Services, Inc.	NPAS Solutions, LLC
	NPAS, Inc.
New Iberia Healthcare, LLC	HTI MOB, LLC
New Rose Holding Company, Inc.	HCA-HealthONE LLC
North Florida Regional Medical Center, Inc.	HCA Imaging Services of North Florida, Inc.
	Medical Partners of North Florida, LLC
North Houston - TRMC, LLC	HCA-Solis Holdings, Inc.
	Solis Mammography at Houston Tomball, LLC
North Texas - MCA, LLC	Solis Mammography at Medical Center Alliance, LLC
Northern Utah Healthcare Corporation	Alta Internal Medicine, LLC
	St. Mark’s Investments, Inc.
Notami Hospitals of Louisiana, Inc.	EPIC Properties, Inc.
	Lakeview Medical Center, LLC
Notami Hospitals, LLC	CFC Investments, Inc.

16

	Columbia Good Samaritan Health System Limited Partnership
	EPIC Properties, Inc.
	Good Samaritan Hospital, LLC
	Healdsburg General Hospital, Inc.
	Mission Bay Memorial Hospital, Inc.
	Samaritan, LLC
	San Jose Medical Center, LLC
	SJMC, LLC
	South Valley Hospital, L.P.
	West Lost Angeles Physicians’ Hospital, Inc.
Oklahoma Holding Company, LLC	Edmond General Surgery, LLC
	Edmond Hospitalists, LLC
	Healthcare Oklahoma, Inc.
	Medi Flight of Oklahoma, LLC
	Oklahoma Physicians - Medical Specialties LLC
	Oklahoma Physicians - Obstetrics and Gynecology LLC
	Oklahoma Physicians - Primary Care LLC
	Oklahoma Physicians - Surgical Specialties LLC
Outpatient Services Holdings, Inc.	Eastern Idaho Brachytherapy Equipment Manager, LLC
	HCA Outpatient Imaging Services Group, Inc.
	HCA Research Institute, LLC
	Healthcare Sales National Management Services Group, LLC
	MidAmerica Oncology, LLC
	Midtown Diagnostics, LLC
	National Contact Center Management Group, LLC
	National Transfer Center Management Services, LLC
	North Hills Catheterization Lab, LLC
	Ogden Tomotherapy Manager, LLC
	Red Rock Holdco, LLC
	Riverside CyberKnife Manager, LLC
Parallon Business Solutions, LLC	Central Shared Services, LLC
	HealthTrust Workforce Solutions, LLC
	HSS Systems, LLC
	National Patient Account Services, Inc.
	PTS Solutions, LLC
	U.S. Collections, Inc.
Parallon Holdings, LLC	Parallon Business Solutions, LLC
	Parallon Enterprises, LLC
Parallon Revenue Cycle Services, Inc.	MediCredit, Inc.
Pasadena Bayshore Hospital, Inc.	Bayshore Partner, LLC
	CHCA Bayshore, L.P.
Pearland Partner, LLC	CHCA Pearland, L.P.

17

Primary Health, Inc.	Primary Health Asset Holdings, Ltd.
Redmond Park Hospital, LLC	Surgicare of Rome, Inc.
Regional Health System of Acadiana, LLC, The	RMCA Professionals Mgmt, LLC
	Women’s & Children’s Pulmonology Clinic, LLC
	Women’s and Children’s Professional Management, LLC
Reston Hospital Center, LLC	Ashburn Imaging, LLC
	Generations Family Practice, Inc.
	MRI of Reston Limited Partnership
	Pavilion 2 Condominium Property, LLC
	Reston Hospitalists, LLC
Retreat Hospital, LLC	Surgicare of Hanover, Inc.
Rio Grande Regional Hospital, Inc.	Columbia Rio Grande Healthcare, L.P.
	Rio Grande Healthcare MSO, Inc.
	Rio Grande NP, Inc.
Riverside Healthcare System, L.P.	Surgicare of Riverside, LLC
Riverside Hospital, Inc.	Bay Area Healthcare Group, Ltd.
Samaritan, LLC	Good Samaritan Hospital, L.P.
San Jose Medical Center, LLC	San Jose Hospital, L.P.
San Jose, LLC	San Jose Healthcare System, LP
	San Jose Pathology Outreach, LLC
Sarasota Doctors Hospital, Inc.	Columbia Midtown Joint Venture
Savannah Health Services, LLC	4600 Waters Avenue Professional Building Condominium Association, Inc.
	Georgia Eye Surgicenter, LLC
	Provident Professional Building Condominium Association, Inc.
	Savannah Center for Medical Education and Research, LLC
	Wilmington Island Partners, LLC
SCRI Holdings, LLC	GenoSpace, LLC
	Sarah Cannon Development Innovations, LLC
	Sarah Cannon Research Institute, LLC
	SCRI Global Services Limited
	SCRI Scientifics, LLC
	Summit Research Solutions, LLC
SJMC, LLC	San Jose Hospital, L.P.
Spotsylvania Medical Center, Inc.	Spotsylvania Condominium Property, LLC
SSHR Holdco, LLC	COSCORP, LLC
	HCA Human Resources, LLC
	Parallon Holdings, LLC
Surgicare of Brandon, Inc.	Bay Area Surgicenter, LLC

18

Surgicare of Florida, Inc.	Belleair Surgery Center, Ltd.
Surgicare of Houston Women’s, Inc.	Outpatient Women’s and Children’s Surgery Center, Ltd.
Surgicare of Manatee, Inc.	Manatee Surgicare, Ltd.
Surgicare of Newport Richey, Inc.	New Port Richey Surgery Center, Ltd.
Surgicare of Palms West, LLC	Palms West Surgery Center, Ltd.
Terre Haute Hospital GP, Inc.	Terre Haute Regional Hospital, L.P.
Terre Haute Hospital Holdings, Inc.	Terre Haute Regional Hospital, L.P.
Terre Haute Regional Hospital, L.P.	Hospitalists of the Wabash Valley, LLC
	Terre Haute MOB, L.P.
	Terre Haute Obstetrics and Gynecology, LLC
Timpanogos Regional Medical Services, Inc.	MountainStar Intensivist Services, LLC
	Timpanogos Pain Specialists, LLC
Trident Medical Center, LLC	Trident Behavioral Health Services, LLC
	Trident Neonatology Services, LLC
U.S. Collections, Inc.	Parallon Revenue Cycle Services, Inc.
Utah Medco, LLC	Brigham City Community Hospital, Inc.
	Brigham City Health Plan, Inc.
	Columbia Ogden Medical Center, Inc.
	Healthtrust Utah Management Services, Inc.
	Hospital Corporation of Utah
	HTI Physician Services of Utah, Inc.
	Layton Family Practice, LLC
	Mountain View Hospital, Inc.
	MP Management, LLC
	ODP Manager, LLC
	Ogden Regional Health Plan, Inc.
	Park View Insurance Company
	WCP Properties, LLC
	West Jordan Hospital Corporation
VH Holdco, Inc.	VH Holdings, Inc.
VH Holdings, Inc.	Center for Advanced Imaging, LLC
	EMMC, LLC
	FHAL, LLC
	Galen GOK, LLC
	Galen KY, LLC
	Galen MCS, LLC
	Galen MRMC, LLC
	Galen NMC, LLC
	Galen NSH, LLC
	Galen SOM, LLC
	Galen SSH, LLC

19

	HHNC, LLC
	HPI Hospital Systems Management, Inc.
	Notami, LLC
	POH Holdings, LLC
	Preferred Works WC, LLC
	RCH, LLC
	San Jose, LLC
	Springview KY, LLC
	Value Health Holdings, Inc.
	Value Health Management, Inc.
	WJHC, LLC
Virginia Psychiatric Company, Inc.	Columbia Arlington Healthcare System, L.L.C.
Vision Holdings, LLC	Vision Consulting Group LLC
Walterboro Community Hospital, Inc.	Colleton Medical Anesthesia, LLC
	Colleton Medical Hospitalists, LLC
Weatherford Health Services, LLC	HCA-Solis Holdings, Inc.
	Weatherford Mammography JV, LLC
Wesley Medical Center, LLC	Care for Women, LLC
	Centerpoint Medical Specialists, LLC
	College Park Ancillary, LLC
	College Park Radiology, LLC
	Emergency Physicians at Wesley Medical Center, LLC
	Family Health Medical Group of Overland Park, LLC
	Galichia Anesthesia Services, LLC
	HCA Wesley Rehabilitation Hospital, Inc.
	Health Partners of Kansas, Inc.
	Hospitalists as Wesley Medical Center, LLC
	IRL Pathology Services MidAmerica, LLC
	Johnson County Neurology, LLC
	Kansas CareNow Urgent Care, LLC
	Kansas City Cardiac Arrhythmia Research LLC
	Kansas City Gastroenterology & Hepatology Physicians Group, LLC
	Kansas City Vascular & General Surgery Group, LLC
	Kansas City Women’s Clinic Group, LLC
	Kansas Pulmonary and Sleep Specialists, LLC
	Kansas Trauma and Critical Care Specialists, LLC
	Menorah Medical Group, LLC
	Menorah Urgent Care, LLC
	Midwest Cardiovascular and Thoracic Surgeons of Kansas, LLC
	Midwest Division Spine Care, LLC

20

	Midwest Heart & Vascular Specialists, LLC
	Midwest Oncology Associates, LLC
	Overland Park Cardiovascular, Inc.
	Overland Park Medical Specialists, LLC
	Overland Park Orthopedics, LLC
	Overland Park Surgical Specialties, LLC
	Pediatric Specialty Clinic LLC
	Quivira Internal Medicine, Inc.
	Research Neurology Associates, LLC
	Research Neuroscience Institute, LLC
	Statland Medical Group, LLC
	The Medical Group of Kansas City, LLC
	Town Plaza Family Practice, LLC
	Wesley Physicians - Anesthesiologist, LLC
	Wesley Physicians - Cardiovascular, LLC
	Wesley Physicians - Obstetrics and Gynecology LLC
	Wesley Physicians - Primary Care LLC
	Wesley Select Network, LLC
West Florida - PPH, LLC	SSJ St. Petersburg Holdings, Inc.
West Valley Medical Center, Inc.	Saint Alphonsus Caldwell Cancer Treatment Center, L.L.C.
Western Plains Capital, Inc.	C/HCA Capital, Inc.
WHMC, Inc.	CHCA West Houston, L.P.
	West Houston, LLC
Woman’s Hospital of Texas, Incorporated	CHCA Woman’s Hospital, L.P
	Houston Woman’s Hospital Partner, LLC
	Woman’s Hospital Merger, LLC

The subsidiary guarantees discussed above are also secured by first-priority liens on substantially all indebtedness owing to HCA Inc. or to the subsidiary guarantors, including any and all intercompany indebtedness owed by HCA Healthcare, Inc. or any subsidiary thereof to HCA Inc., or any subsidiary guarantor.

Pursuant to the typical and customary cash management system established by HCA Healthcare, Inc., the affiliates of HCA Healthcare, Inc. listed below have entered into revolving promissory notes with Western Plains Capital, Inc., a subsidiary guarantor. The notes are pledged as collateral for the secured notes to the extent described above. Due to the revolving nature of the intercompany debt, the balance due from one party to another fluctuates based on cash activity from daily operations.

* Subsidiary guarantor.

21

AC Med, LLC

Acadiana Care Center, Inc.

Acadiana Practice Management, Inc.

Acadiana Regional Pharmacy, Inc.

ACH, Inc.

Advanced Bundle Convener, LLC

All About Staffing, Inc.

Alleghany Primary Care, Inc.

Alliance Surgicare, LLC

Alternaco, LLC

Ambulatory Services Management Corporation of Chesterfield County, Inc.

*American Medicorp Development Co.

AOGN, LLC

AOSC Sports Medicine, Inc.

AR Holding 1, LLC

AR Holding 2, LLC

AR Holding 4, LLC

AR Holding 5, LLC

AR Holding 6, LLC

AR Holding 7, LLC

AR Holding 8, LLC

AR Holding 9, LLC

AR Holding 10, LLC

AR Holding 11, LLC

AR Holding 12, LLC

AR Holding 13, LLC

AR Holding 14, LLC

AR Holding 15, LLC

AR Holding 16, LLC

AR Holding 17, LLC

AR Holding 18, LLC

AR Holding 19, LLC

AR Holding 20, LLC

AR Holding 21, LLC

AR Holding 22, LLC

AR Holding 23, LLC

AR Holding 24, LLC

AR Holding 25, LLC

AR Holding 26, LLC

AR Holding 27, LLC

AR Holding 28, LLC

AR Holding 29, LLC

AR Holding 30, LLC

AR Holding 31, LLC

Arlington Diagnostic South, Inc.

Arlington Surgery Center, L.P.

22

Arlington Surgicare, LLC

ASD Shared Services, LLC

Ashburn ASC, LLC

Ashburn Imaging, LLC

Athens Community Hospital, Inc.

Atlanta Healthcare Management, L.P.

Atlanta Market GP, Inc.

Atlanta Outpatient Surgery Center, Inc.

Atlantis Surgicare, LLC

Atrium Surgery Center, L.P.

Atrium Surgicare, LLC

Augusta Management Services, LLC

Austin Medical Center, Inc.

Aventura Cancer Center Manager, LLC

Aventura Comprehensive Cancer Research Group of Florida, Inc.

Bailey Square Outpatient Surgical Center, Inc.

Basic American Medical, Inc.

Bay Area Healthcare Group, Ltd.

Bay Area Surgicare Center, Inc.

*Bay Hospital, Inc.

Bayshore Partner, LLC

Bedford-Northeast Community Hospital, Inc.

Bellaire Imaging, Inc.

Big Cypress Medical Center, Inc.

Bonita Bay Surgery Center, Inc.

Boynton Beach EFL Imaging Center, LLC

Bradenton Outpatient Services, LLC

Brandon Imaging Manager, LLC

Brandon Regional Cancer Center, LLC

*Brigham City Community Hospital, Inc.

Brigham City Health Plan, Inc.

*Brookwood Medical Center of Gulfport, Inc.

Broward Healthcare System, Inc.

Brownsville-Valley Regional Medical Center, Inc.

C/HCA Capital, Inc.

C/HCA Development, Inc.

C/HCA, Inc.

Calloway Creek Surgicare, LLC

Cancer Centers of North Florida, LLC

Cancer Services of Aventura, LLC

*Capital Division, Inc.

Capital Network Services, Inc.

CareOne Home Health Services, Inc.

23

CareOne Home Health Services, Inc.

*CarePartners HHA Holdings, LLLP

*CarePartners HHA, LLLP

*CarePartners Rehabilitation Hospital, LLLP

Carolina Regional Surgery Center, Inc.

Cartersville Medical Center, LLC

Cartersville Occupational Medicine Center, LLC

CCH-GP, Inc.

Centennial CyberKnife Manager, LLC

Center for Advanced Imaging, LLC

*Centerpoint Medical Center of Independence, LLC

Central Florida Cardiology Interpretations, LLC

Central Florida Imaging Services, LLC

*Central Florida Regional Hospital, Inc.

Central Health Holding Company, Inc.

*Central Shared Services, LLC

*Central Tennessee Hospital Corporation

CFC Investments, Inc.

CH Systems

Chatsworth Hospital Corp.

Chattanooga Healthcare Network Partner, Inc.

CHC Finance Co.

CHC Holdings, Inc.

CHC Payroll Agent, Inc.

CHC Payroll Company

CHC Realty Company

CHC Venture Co.

*CHCA Bayshore, L.P.

CHCA Clear Lake, L.P.

*CHCA Conroe, L.P.

*CHCA Mainland, L.P.

*CHCA Pearland, L.P.

*CHCA West Houston, L.P.

*CHCA Woman’s Hospital, L.P.

CHC-El Paso Corp.

CHCK, Inc.

CHC-Miami Corp.

Chicago Grant Hospital, Inc.

Chino Community Hospital Corporation, Inc.

*Chippenham & Johnston-Willis Hospitals, Inc.

Chippenham Ambulatory Surgery Center, LLC

Chugach PT, Inc.

*Citrus Memorial Hospital, Inc.

*Citrus Memorial Property Management, Inc.

24

CLASC Manager, LLC

Clear Lake Cardiac Catheterization Center, L.P.

Clear Lake Cardiac GP, LLC

Clear Lake Merger, LLC

Clear Lake Regional Medical Center, Inc.

Clear Lake Regional Partner, LLC

*Clinical Education Shared Services, LLC

ClinicServ, LLC

Clinishare, Inc.

Coastal Bend Hospital, Inc.

Coastal Carolina Home Care, Inc.

Coastal Healthcare Services, Inc.

Coastal Imaging Center of Gulfport, Inc.

Coliseum Health Group, Inc.

Coliseum Park Hospital, Inc.

College Park Endoscopy Center, LLC

Colleton Ambulatory Care, LLC

Colleton Diagnostic Center, LLC

Collier County Home Health Agency, Inc.

*Colorado Health Systems, Inc.

Columbia Ambulatory Surgery Division, Inc.

*Columbia ASC Management, L.P.

Columbia Bay Area Realty, Ltd.

Columbia Behavioral Healthcare of South Florida, Inc.

Columbia Behavioral Healthcare, Inc.

Columbia Call Center, Inc.

Columbia Central Florida Division, Inc.

Columbia Central Group, Inc.

Columbia Champions Treatment Center, Inc.

Columbia Chicago Division, Inc.

Columbia Coliseum Same Day Surgery Center, Inc.

Columbia Development of Florida, Inc.

Columbia Doctors Hospital of Tulsa, Inc.

*Columbia Florida Group, Inc.

Columbia GP of Mesquite, Inc.

Columbia Greater Houston Division Healthcare Network, Inc.

Columbia Health System of Arkansas, Inc.

*Columbia Healthcare System of Louisiana, Inc.

Columbia Hospital at Medical City Dallas Subsidiary, L.P.

Columbia Hospital Corporation at the Medical Center

Columbia Hospital Corporation of Arlington

Columbia Hospital Corporation of Bay Area

Columbia Hospital Corporation of Central Miami

Columbia Hospital Corporation of Corpus Christi

25

Columbia Hospital Corporation of Fort Worth

Columbia Hospital Corporation of Houston

Columbia Hospital Corporation of Kendall

Columbia Hospital Corporation of Massachusetts, Inc.

Columbia Hospital Corporation of Miami

Columbia Hospital Corporation of Miami Beach

Columbia Hospital Corporation of North Miami Beach

Columbia Hospital Corporation of South Broward

Columbia Hospital Corporation of South Dade

Columbia Hospital Corporation of South Florida

Columbia Hospital Corporation of South Miami

Columbia Hospital Corporation of Tamarac

Columbia Hospital Corporation of West Houston

Columbia Hospital Corporation-Delaware

Columbia Hospital Corporation-SMM

Columbia Hospital-El Paso, Ltd.

Columbia Integrated Health Systems, Inc.

*Columbia LaGrange Hospital, LLC

Columbia Lake Worth Surgical Center Limited Partnership

Columbia Medical Arts Hospital Subsidiary, L.P.

Columbia Medical Center at Lancaster Subsidiary, L.P.

Columbia Medical Center Dallas Southwest Subsidiary, L.P.

*Columbia Medical Center of Arlington Subsidiary, L.P.

*Columbia Medical Center of Denton Subsidiary, L.P.

*Columbia Medical Center of Las Colinas, Inc.

*Columbia Medical Center of Lewisville Subsidiary, L.P.

*Columbia Medical Center of McKinney Subsidiary, L.P.

*Columbia Medical Center of Plano Subsidiary, L.P.

*Columbia North Hills Hospital Subsidiary, L.P.

Columbia North Texas Healthcare System, L.P.

Columbia North Texas Subsidiary GP, LLC

Columbia North Texas Surgery Center Subsidiary, L.P.

Columbia Northwest Medical Center, Inc.

*Columbia Ogden Medical Center, Inc.

Columbia Oklahoma Division, Inc.

Columbia Palm Beach GP, LLC

Columbia Park Healthcare System, Inc.

Columbia Park Medical Center, Inc.

*Columbia Parkersburg Healthcare System, LLC

*Columbia Plaza Medical Center of Fort Worth Subsidiary, L.P.

Columbia Psychiatric Management Co.

Columbia Resource Network, Inc.

*Columbia Rio Grande Healthcare, L.P.

*Columbia Riverside, Inc.

26

Columbia South Texas Division, Inc.

Columbia Specialty Hospital of Dallas Subsidiary, L.P.

Columbia Specialty Hospitals, Inc.

Columbia Surgery Group, Inc.

Columbia Tampa Bay Division, Inc.

*Columbia Valley Healthcare System, L.P.

Columbia West Bank Hospital, Inc.

*Columbia/Alleghany Regional Hospital, Incorporated

Columbia/HCA Healthcare Corporation of Central Texas

Columbia/HCA Healthcare Corporation of Northern Ohio

Columbia/HCA Healthcare Corporation of South Carolina

Columbia/HCA Heartcare of Corpus Christi, Inc.

Columbia/HCA International Group, Inc.

*Columbia/HCA John Randolph, Inc.

Columbia/HCA of Baton Rouge, Inc.

Columbia/HCA of Houston, Inc.

Columbia/HCA of New Orleans, Inc.

Columbia/HCA of North Texas, Inc.

Columbia/HCA San Clemente, Inc.

Columbia-Georgia PT, Inc.

Columbia-Osceola Imaging Center, Inc.

Columbia-Quantum, Inc.

Columbia-SDH Holdings, Inc.

*Columbine Psychiatric Center, Inc.

Columbus Cath Lab, Inc.

Columbus Cath Lab, LLC

Columbus Doctors Hospital, Inc.

Concept EFL Imaging Center, LLC

Concept West EFL Imaging Center, LLC

*Conroe Hospital Corporation

Conroe Partner, LLC

Continental Division I, Inc.

CoralStone Management, Inc.

Corpus Christi Surgery Center, L.P.

Corpus Surgicare, Inc.

COSCORP, LLC

CPS TN Processor 1, Inc.

Crewe Outpatient Imaging, LLC

CRMC-M, LLC

Cumberland Medical Center, Inc.

CVMC Property, LLC

Daleville Imaging Manager, LLC

Daleville Imaging, L.P.

Davie Medical Center, LLC

27

Daytona Medical Center, Inc.

Deep Purple Investments, LLC

Delray EFL Imaging Center, LLC

Denver Surgicenter, LLC

Derry ASC, Inc.

Diagnostic Breast Center, Inc.

Diagnostic Mammography Services, G.P.

Doctors Hospital (Conroe), Inc.

Doctors Hospital Columbus GA-Joint Venture

Doctors Hospital of Augusta, LLC

Doctors Osteopathic Medical Center, Inc.

Doctors Same Day Surgery Center, Inc.

Doctors-I, Inc.

Doctors-II, Inc.

Doctors-III, Inc.

Doctors-IV, Inc.

Doctors-V, Inc.

Doctors-VIII, Inc.

DOMC Property, LLC

*Dublin Community Hospital, LLC

Dura Medical, Inc.

E.P. Physical Therapy Centers, Inc.

East Florida Division, Inc.

East Florida Imaging Holdings, LLC

East Pointe Hospital, Inc.

Eastern Idaho Brachytherapy Equipment Manager, LLC

Eastern Idaho Care Partners ACO, LLC

*Eastern Idaho Health Services, Inc.

Edmond Physician Hospital Organization, Inc.

*Edward White Hospital, Inc.

EHCA, LLC

EHCA Eastside Occupational Medicine Center, LLC

El Paso Healthcare System, Ltd.

El Paso Nurses Unlimited, Inc.

*El Paso Surgicenter, Inc.

Emergency Providers Group LLC

EMMC, LLC

*Encino Hospital Corporation, Inc.

Endoscopy Surgicare of Plano, LLC

Englewood Community Hospital, Inc.

*EP Health, LLC

EP Holdco, LLC

EPIC Development, Inc.

EPIC Diagnostic Centers, Inc.

EPIC Healthcare Management Company

28

EPIC Properties, Inc.

EPIC Surgery Centers, Inc.

*Fairview Park GP, LLC

*Fairview Park, Limited Partnership

Fairview Partner, LLC

Far West Division, Inc.

Fawcett Memorial Hospital, Inc.

FHAL, LLC

Florida Home Health Services-Private Care, Inc.

Flower Mound Surgery Center, Ltd.

*FMH Health Services, LLC

Forest Park Surgery Pavilion, Inc.

Fort Bend Hospital, Inc.

Fort Myers Market, Inc.

Fort Walton Beach Medical Center, Inc.

Fort Worth Investments, Inc.

*Frankfort Hospital, Inc.

Frankfort Wound Care, LLC

Frisco Surgicare, LLC

Frisco Warren Parkway 91, Inc.

Ft. Pierce Surgicare, LLC

Galen (Kansas) Merger, LLC

Galen BH, Inc.

Galen Center for Professional Development, Inc.

Galen Diagnostic Multicenter, Ltd.

Galen Global Finance, Inc.

Galen GOK, LLC

Galen Health Institutes, Inc.

Galen Holdco, LLC

Galen Hospital Alaska, Inc.

Galen Hospital of Baytown, Inc.

Galen Hospital-Pembroke Pines, Inc.

Galen International Holdings, Inc.

Galen KY, LLC

Galen MCS, LLC

Galen Medical Corporation

Galen MRMC, LLC

Galen NMC, LLC

Galen NSH, LLC

Galen of Aurora, Inc.

Galen of Florida, Inc.

Galen of Illinois, Inc.

Galen of Kentucky, Inc.

Galen of Mississippi, Inc.

29

Galen of Virginia, Inc.

Galen of West Virginia, Inc.

*Galen Property, LLC

Galen SOM, LLC

Galen SSH, LLC

Galen Virginia Hospital Corporation

Galencare, Inc.

Galendeco, Inc.

Galen-Soch, Inc.

GalTex, LLC

Gardens EFL Imaging Center, LLC

General Hospitals of Galen, Inc.

*GenoSpace, LLC

Georgia Health Holdings, Inc.

Georgia Psychiatric Company, Inc.

Georgia, L.P.

GHC-Galen Health Care, LLC

*Good Samaritan Hospital, L.P.

Good Samaritan Hospital, LLC

Good Samaritan Surgery Center, L.P.

*GPCH-GP, Inc.

*Grand Strand Regional Medical Center, LLC

Greater Houston Preferred Provider Option, Inc.

*Green Oaks Hospital Subsidiary, L.P.

*Greenview Hospital, Inc.

Gulf Coast Division, Inc.

Gulf Coast Medical Ventures, Inc.

Gulf Coast Physician Administrators, Inc.

Gwinnett Community Hospital, Inc.

Hamilton Memorial Hospital, Inc.

HCA - Information Technology & Services, Inc.

*HCA - IT&S Field Operations, Inc.

*HCA - IT&S Inventory Management, Inc.

HCA - IT&S PBS Field Operations, Inc.

HCA - IT&S TN Field Operations, Inc.

HCA - Raleigh Community Hospital, Inc.

*HCA American Finance LLC

HCA ASD Financial Operations, LLC

HCA ASD Sales Services, LLC

*HCA Central Group, Inc.

HCA Chattanooga Market, Inc.

HCA Development Company, Inc.

*HCA Eastern Group, Inc.

HCA Endocrine Investor, LLC

30

HCA Health Services of California, Inc.

*HCA Health Services of Florida, Inc.

HCA Health Services of Georgia, Inc.

*HCA Health Services of Louisiana, Inc.

HCA Health Services of Miami, Inc.

HCA Health Services of Midwest, Inc.

HCA Health Services of New Hampshire, Inc.

*HCA Health Services of Tennessee, Inc.

HCA Health Services of Texas, Inc.

*HCA Health Services of Virginia, Inc.

HCA Health Services of West Virginia, Inc.

HCA Healthcare Mission Fund, LLC

HCA Healthcare, Inc.

HCA Holdco, LLC

HCA Human Resources, LLC

HCA Imaging Services of North Florida, Inc.

HCA Inc.

HCA Long Term Health Services of Miami, Inc.

*HCA Management Services, L.P.

HCA Midwest Comprehensive Care, Inc.

HCA North Texas GME PLLC

HCA Outpatient Imaging Services Group, Inc.

*HCA Pearland GP, Inc.

HCA Physician Services, Inc.

HCA Plano Imaging, Inc.

HCA Property GP, LLC

HCA Psychiatric Company

*HCA Realty, Inc.

HCA Squared, LLC

HCA Switzerland Holding GmbH

HCA Western Group, Inc.

*HCA-HealthONE LLC

HCA-Solis Holdings, Inc.

HCA-Solis Master, LLC

HCA-Urgent Care Holdings, LLC

HCOL, Inc.

*HD&S Corp. Successor, Inc.

Healdsburg General Hospital, Inc.

Health Care Indemnity, Inc.

Health Insight Capital, LLC

*Health Midwest Office Facilities Corporation

*Health Midwest Ventures Group, Inc.

Health Service Partners, Inc.

Health Services (Delaware), Inc.

31

Health Services Merger, Inc.

Health to You, LLC

Healthcare Sales National Management Services Group, LLC

Healthcare Technology Assessment Corporation

Healthco, LLC

Healthnet of Kentucky, LLC

HealthONE Aurora Investment, LLC

HealthONE Clear Creek, LLC

HealthONE High Street Primary Care Center, LLC

HealthOne Lincoln Investment, LLC

HealthONE Lowry, LLC

HealthONE of Denver, Inc.

HealthONE Radiation Therapy at Red Rocks, LLC

HealthONE Radiation Therapy at Thornton, LLC

HealthONE Surgicare of Ridge View, LLC

HealthONE Urologic, LLC

HealthOne Westside Investment, LLC

Healthserv Acquisition, LLC

HealthTrust Locums, Inc.

Healthtrust MOB Tennessee, LLC

Healthtrust Utah Management Services, Inc.

*HealthTrust Workforce Solutions, LLC

Healthtrust, Inc. - The Hospital Company

Healthtrust, Inc. - The Hospital Company

Healthy State, Inc.

Heart of America Surgicenter, LLC

Hearthstone Home Health, Inc.

Heathrow Imaging, LLC

*Hendersonville Hospital Corporation

Henrico Doctors Hospital - Forest Campus Property, LLC

Heritage Hospital, Inc.

HHNC, LLC

hInsight-BMA Holdings, LLC

hInsight-Customer Care Holdings, LLC

hInsight-Digital Reasoning Holdings, LLC

hInsight-Healthbox Holdings, LLC

hInsight-I2 Holdings, LLC

hInsight-InVivoLink Holdings, LLC

hInsight-Loyale Healthcare Holdings, LLC

hInsight-LS Holdings, LLC

*hInsight-Mobile Heartbeat Holdings, LLC

hInsight-NX, LLC

hInsight-OTM Holdings, LLC

hInsight-Procured Holdings, LLC

32

hInsight-PWS I Holdings, LLC

hInsight-VAI Holdings, LLC

HM Acquisition, LLC

Homecare North, Inc.

Hometrust Management Services, Inc.

Hospital Corp., LLC

Hospital Corporation of America

Hospital Corporation of Lake Worth

*Hospital Corporation of Tennessee

*Hospital Corporation of Utah

*Hospital Development Properties, Inc.

Hospital Partners Merger, LLC

Hospital Realty Corporation

*Houston - PPH, LLC

Houston Healthcare Holdings, Inc.

Houston Northwest Surgical Partners, Inc.

*Houston NW Manager, LLC

Houston Woman’s Hospital Partner, LLC

*HPG Enterprises, LLC

HPG Solutions, LLC

*HSS Holdco, LLC

*HSS Systems, LLC

*HSS Virginia, L.P.

HTI Gulf Coast, Inc.

HTI Health Services of North Carolina, Inc.

HTI Hospital Holdings, Inc.

*HTI Memorial Hospital Corporation

*HTI MOB, LLC

Illinois Psychiatric Hospital Company, Inc.

Imaging Services of Appomattox, LLC

Imaging Services of Jacksonville, LLC

Imaging Services of Louisiana Manager, LLC

Imaging Services of Louisiana, LLC

Imaging Services of Orlando, LLC

Imaging Services of West Boynton, LLC

IMX Holdings, LLC

Independence Surgicare, Inc.

Indian Path Hospital, Inc.

Indianapolis Hospital Partner, LLC

*Integrated Regional Lab, LLC

*Integrated Regional Laboratories, LLP

InVivoLink, Inc.

Isleworth Partners, Inc.

JDGC Management, LLC

33

*JFK Medical Center Limited Partnership

Johnson County Surgicenter, L.L.C.

Jupiter EFL Imaging Center, LLC

KC Surgicare, LLC

Kendall Healthcare Group, Ltd.

Kendall Regional Medical Center, LLC

Kingwood Surgery Center, LLC

*KPH-Consolidation, Inc.

L E Corporation

LAD Imaging, LLC

Lake City Imaging, LLC

*Lakeview Medical Center, LLC

Lakewood Surgicare, Inc.

Laredo Medco, LLC

*Largo Medical Center, Inc.

*Las Encinas Hospital

Las Vegas ASC, LLC

*Las Vegas Surgicare, Inc.

*Lawnwood Medical Center, Inc.

Lebanon Surgicenter, LLC

*Lewis-Gale Hospital, Incorporated

*Lewis-Gale Medical Center, LLC

*Lone Peak Hospital, Inc.

*Los Robles Regional Medical Center

Loudoun Surgery Center, LLC

Louisiana Psychiatric Company, Inc.

Low Country Health Services, Inc. of the Southeast

*Management Services Holdings, Inc.

Marietta Outpatient Medical Building, Inc.

*Marietta Surgical Center, Inc.

*Marion Community Hospital, Inc.

Martin, Fletcher & Associates, L.P.

Maury County Behavioral Health, LLC

Mayhill Cancer Center, LLC

*MCA Investment Company

Meadows DME, LLC

Med Corp., Inc.

Med-Center Hosp./Houston, Inc.

Medi Flight of Oklahoma, LLC

Medical Arts Hospital of Texarkana, Inc.

Medical Care America, LLC

Medical Care Financial Services Corp.

Medical Care Real Estate Finance, Inc.

Medical Care Surgery Center, Inc.

34

Medical Center - West, Inc.

Medical Center Imaging, Inc.

Medical Center of Baton Rouge, Inc.

Medical Center of Plano Partner, LLC

Medical Center of Port St. Lucie, Inc.

Medical Center of Santa Rosa, Inc.

*Medical Centers of Oklahoma, LLC

Medical City Dallas Hospital, Inc.

Medical City Dallas Partner, LLC

Medical Corporation of America

Medical Imaging, Inc.

*Medical Office Buildings of Kansas, LLC

Medical Specialties, Inc.

*MediCredit, Inc.

MediPurchase, Inc.

MediStone Healthcare Ventures, Inc.

MediVision of Mecklenburg County, Inc.

MediVision of Tampa, Inc.

MediVision, Inc.

Med-Point of New Hampshire, Inc.

*Memorial Healthcare Group, Inc.

Metroplex Surgicenters, Inc.

MGH Medical, Inc.

*MH Angel Medical Center, LLLP

MH Asheville Specialty Hospital, LLC

*MH Blue Ridge Medical Center, LLLP

MH Eckerd Living Center, LLLP

*MH Highlands-Cashiers Medical Center, LLLP

*MH Hospital Holdings, Inc.

*MH Hospital Manager, LLC

*MH Master Holdings, LLLP

*MH Master, LLC

MH McDowell Imaging, LLLP

*MH Mission Hospital McDowell, LLLP

*MH Mission Hospital, LLLP

*MH Mission Imaging, LLLP

MH Transylvania Imaging, LLLP

*MH Transylvania Regional Hospital, LLLP

MHS Partnership Holdings JSC, Inc.

MHS Partnership Holdings SDS, Inc.

Miami Beach EFL Imaging Center, LLC

Miami Beach Healthcare Group, Ltd.

MidAmerica Division, Inc.

MidAmerica Oncology, LLC

35

Mid-America Surgery Center, LLC

Mid-Cities Surgi-Center, Inc.

Mid-Continent Health Services, Inc.

Midtown Diagnostics, LLC

*Midwest Division - ACH, LLC

Midwest Division - LRHC, LLC

*Midwest Division - LSH, LLC

*Midwest Division - MCI, LLC

*Midwest Division - MMC, LLC

*Midwest Division - OPRMC, LLC

*Midwest Division - RBH, LLC

*Midwest Division - RMC, LLC

*Midwest Holdings, Inc.

Millenium Health Care of Oklahoma, Inc.

Mission Bay Memorial Hospital, Inc.

Missouri Healthcare System, L.P.

MMC Sleep Lab Management, LLC

Mobile Corps., Inc.

*Mobile Heartbeat, LLC

Montgomery Cancer Center, LLC

*Montgomery Regional Hospital, Inc.

MOSC Sports Medicine, Inc.

*Mountain Division - CVH, LLC

Mountain Division, Inc.

*Mountain View Hospital, Inc.

Mountain West Surgery Center, LLC

MOVCO, Inc.

MP Management, LLC

MRT&C, Inc.

Nashville Psychiatric Company, Inc.

*Nashville Shared Services General Partnership

Nashville Surgicenter, LLC

Natchez Surgery Center, LLC

National Contact Center Management Group, LLC

*National Patient Account Services, Inc.

Navarro Memorial Hospital, Inc.

Network Management Services, Inc.

Network MS of Florida, Inc.

Nevada Surgery Center of Southern Hills, L.P.

Nevada Surgicare of Southern Hills, LLC

*New Iberia Healthcare, LLC

New Iberia Holdings, Inc.

*New Port Richey Hospital, Inc.

*New Rose Holding Company, Inc.

36

Norman Clayman Endocrine Institute, LLC

North Augusta Imaging Management, LLC

North Augusta Imaging Services, LLC

North Augusta Rehab Health Center, LLC

North Brandon Imaging, LLC

North Central Florida Health System, Inc.

North Charleston Diagnostic Imaging Center, LLC

North Florida Cancer Center Lake City, LLC

North Florida Cancer Center Live Oak, LLC

North Florida Cancer Center Tallahassee, LLC

North Florida Division I, Inc.

North Florida GI Center GP, Inc.

North Florida Physician Services, Inc.

North Florida Regional Investments, Inc.

*North Florida Regional Medical Center, Inc.

North Hills Cardiac Catheterization Center, L.P.

North Hills Catheterization Lab, LLC

*North Houston - TRMC, LLC

North Miami Beach Surgical Center, LLC

North Tampa Imaging, LLC

*North Texas - MCA, LLC

North Texas Division, Inc.

North Texas General, L.P.

North Texas Medical Center, Inc.

North Transfer Center, LLC

Northeast Florida Cancer Services, LLC

*Northern Utah Healthcare Corporation

Northern Utah Imaging, LLC

*Northern Virginia Community Hospital, LLC

Northern Virginia Hospital Corporation

Northlake Surgicare, Inc.

Northwest Florida Healthcare Systems, Inc.

Northwest Medical Center, Inc.

Notami (Opelousas), Inc.

Notami Hospitals of Florida, Inc.

*Notami Hospitals of Louisiana, Inc.

Notami Hospitals of Missouri, Inc.

*Notami Hospitals, LLC

Notami, LLC

Notco, LLC

NPAS Solutions, LLC

NPAS, Inc.

NTGP, LLC

37

NTMC Management Company

NTMC Venture, Inc.

Nuclear Diagnosis, Inc.

Ocala Health Imaging Services, LLC

Ocala Regional Outpatient Services, Inc.

Ocala Stereotactic Radiosurgery Partner, LLC

Ocala Stereotactic Radiosurgery, LLC

Occupational and Family Medicine of South Texas

ODP Holdings, LLC

ODP Manager, LLC

ODP Properties, LLC

Ogden Imaging, LLC

Ogden Tomotherapy Manager, LLC

*Okaloosa Hospital, Inc.

*Okeechobee Hospital, Inc.

Oklahoma Surgicare, Inc.

Oncology Services of Corpus Christi Manager, LLC

Oncology Services of Corpus Christi, LLC

OneSourceMed, Inc.

Orange Park Medical Center, Inc.

Orlando Outpatient Surgical Center, Inc.

Orthopaedic Sports Specialty Associates, Inc.

Osceola Regional Hospital, Inc.

*Outpatient Cardiovascular Center of Central Florida, LLC

Outpatient Services - LAD, LLC

*Outpatient Services Holdings, Inc.

*Oviedo Medical Center, LLC

Ozarks Medical Services, Inc.

Pacific Partners Management Services, Inc.

Palm Beach EFL Imaging Center, LLC

Palm Beach Healthcare System, Inc.

*Palms West Hospital Limited Partnership

Paragon of Texas Health Properties, Inc.

Paragon Physicians Hospital Organization of South Texas, Inc.

Paragon SDS, Inc.

Paragon Surgery Centers of Texas, Inc.

Paragon WSC, Inc.

*Parallon Business Solutions, LLC

*Parallon Enterprises, LLC

*Parallon Health Information Solutions, LLC

*Parallon Holdings, LLC

*Parallon Payroll Solutions, LLC

38

*Parallon Physician Services, LLC

*Parallon Revenue Cycle Services, Inc.

Park View Insurance Company

Parkersburg SJ Holdings, Inc.

Parkridge Medical Center, Inc.

Parkside Surgery Center, Inc.

Parkway Cardiac Center, Ltd.

Parkway Hospital, Inc.

Parkway Surgery Services, Ltd.

Parthenon Insurance Company, Limited

*Pasadena Bayshore Hospital, Inc.

*PatientKeeper, Inc.

*Pearland Partner, LLC

Pediatric Surgicare, Inc.

Pinellas Medical, LLC

Pioneer Medical, LLC

Plains Healthcare System, Inc.

Plano Heart Institute, L.P.

Plano Heart Management, LLC

Plano Surgery Center - GP, LLC

*Plantation General Hospital, L.P.

PMM, Inc.

POH Holdings, LLC

*Poinciana Medical Center, Inc.

Preferred Works WC, LLC

Primary Health Asset Holdings, Ltd.

*Primary Health, Inc.

*PTS Solutions, LLC

*Pulaski Community Hospital, Inc.

*Putnam Community Medical Center of North Florida, LLC

Putnam Hospital, Inc.

Putnam Radiation Oncology Manager, LLC

Radiation Oncology Center of Thornton, LLC

Radiation Oncology Manager, LLC

RCH, LLC

Red Rock at Smoke Ranch, LLC

Red Rock Holdco, LLC

Redmond Park Health Services, Inc.

*Redmond Park Hospital, LLC

*Reston Hospital Center, LLC

*Retreat Hospital, LLC

Richmond Imaging Employer Corp.

Rio Grande Healthcare MSO, Inc.

*Rio Grande Regional Hospital, Inc.

39

Riverside CyberKnife Manager, LLC

*Riverside Healthcare System, L.P.

Riverside Holdings, Inc.

*Riverside Hospital, Inc.

Riverside Imaging, LLC

Roanoke Imaging, LLC

Rosewood Medical Center, Inc.

Round Rock Hospital, Inc.

Royal Oaks Surgery Center, L.P.

S.A. Medical Center, Inc.

Salt Lake City Surgicare, Inc.

*Samaritan, LLC

San Antonio Division, Inc.

San Antonio Regional Hospital, Inc.

San Bernardino Imaging, LLC

San Joaquin Surgical Center, Inc.

*San Jose Healthcare System, LP

*San Jose Hospital, L.P.

*San Jose Medical Center, LLC

San Jose Pathology Outreach, LLC

*San Jose, LLC

Sarah Cannon Development Innovations, LLC

*Sarah Cannon Research Institute, LLC

*Sarasota Doctors Hospital, Inc.

*Savannah Health Services, LLC

*SCRI Holdings, LLC

SCRI Scientifics, LLC

*Sebring Health Services, LLC

Selma Medical Center Hospital, Inc.

Silicon Valley Health Holdings, LLC

*SJMC, LLC

Sky Ridge Spine Manager, LLC

South Atlantic Division, Inc.

South Florida Division Practice, Inc.

South Texas Surgicare, Inc.

South Transfer Center, LLC

South Valley Hospital, L.P.

*Southeast Georgia Health Services, LLC

*Southern Hills Medical Center, LLC

*Southpoint, LLC

Southwest Florida Health System, Inc.

Southwest Florida Regional Medical Center, Inc.

*Spalding Rehabilitation L.L.C.

40

*Spotsylvania Medical Center, Inc.

Spotsylvania Regional Surgery Center, LLC

*Spring Branch Medical Center, Inc.

*Spring Hill Hospital, Inc.

Spring Hill Imaging, LLC

Springview KY, LLC

*SSHR Holdco, LLC

St. Mark’s Investments, Inc.

Stafford Imaging, LLC

Stiles Road Imaging LLC

Stones River Hospital, LLC

Suburban Medical Center at Hoffman Estates, Inc.

Sullins Surgical Center, Inc.

Summit General Partner, Inc.

Summit Research Solutions, LLC

Sun Bay Medical Office Building, Inc.

*Sun City Hospital, Inc.

Sun City Imaging, LLC

Sun Towers/Vista Hills Holding Co.

Sun-Med, LLC

Sunrise Hospital and Medical Center, LLC

*Sunrise Mountainview Hospital, Inc.

Sunrise Outpatient Services, Inc.

Surgical Center of Irving, Inc.

Surgical Facility of West Houston, L.P.

Surgicare America - Winter Park, Inc.

Surgicare Merger Company of Louisiana

Surgicare of Alpine, LLC

Surgicare of Altamonte Springs, Inc.

Surgicare of Anchorage, LLC

Surgicare of Arapahoe, LLC

Surgicare of Arlington, LLC

Surgicare of Ashburn, LLC

Surgicare of Augusta, Inc.

Surgicare of Aurora Endoscopy, LLC

Surgicare of Aventura, LLC

Surgicare of Bay Area Endoscopy, LLC

Surgicare of Bay Area, LLC

Surgicare of Bayonet Point, Inc.

Surgicare of Bayside, LLC

Surgicare of Bountiful, LLC

*Surgicare of Brandon, Inc.

41

Surgicare of Brentwood, LLC

Surgicare of Brooksville, LLC

Surgicare of Brownsville, LLC

Surgicare of Central Florida, Inc.

Surgicare of Central San Antonio, Inc.

Surgicare of Chattanooga, LLC

Surgicare of Chippenham, LLC

Surgicare of Citrus, LLC

Surgicare of Clarksville, LLC

Surgicare of Corpus Christi, LLC

Surgicare of Countryside, Inc.

Surgicare of Dallas Specialty, LLC

Surgicare of Denton, Inc.

Surgicare of Denver Mid-Town, Inc.

Surgicare of Denver, LLC

Surgicare of Evans, Inc.

Surgicare of Fairfax, Inc.

*Surgicare of Florida, Inc.

Surgicare of Flower Mound, Inc.

Surgicare of Focus Hand, LLC

Surgicare of Fort Worth Co-GP, LLC

Surgicare of Fort Worth, Inc.

Surgicare of Ft. Pierce, Inc.

Surgicare of Good Samaritan, LLC

Surgicare of Gramercy, Inc.

Surgicare of Greenview, Inc.

Surgicare of Hanover, Inc.

*Surgicare of Houston Women’s, Inc.

Surgicare of Houston, LLC

Surgicare of Indianapolis, Inc.

Surgicare of Kansas City, LLC

Surgicare of Kingwood, LLC

Surgicare of Kissimmee, Inc.

Surgicare of Lakeview, Inc.

Surgicare of Las Vegas, Inc.

Surgicare of Laurel Grove, LLC

Surgicare of Lorain County, Inc.

Surgicare of Los Gatos, Inc.

Surgicare of Los Robles, LLC

Surgicare of Madison, Inc.

*Surgicare of Manatee, Inc.

Surgicare of McKinney, Inc.

Surgicare of Medical City Dallas, LLC

Surgicare of Memorial Endoscopy, LLC

42

Surgicare of Merritt Island, Inc.

Surgicare of Miami Lakes, LLC

Surgicare of Mountain West, LLC

Surgicare of Mt. Ogden, LLC

Surgicare of Nashville, LLC

Surgicare of Natchez, LLC

*Surgicare of Newport Richey, Inc.

Surgicare of North San Antonio, Inc.

Surgicare of Northeast San Antonio, Inc.

Surgicare of Orange Park, Inc.

Surgicare of Orlando, Inc.

Surgicare of Overland Park, LLC

*Surgicare of Palms West, LLC

Surgicare of Park Ridge, LLC

Surgicare of Pasadena, Inc.

Surgicare of Pavilion, LLC

Surgicare of Physicians West El Paso, LLC

Surgicare of Pinellas, Inc.

Surgicare of Plano, Inc.

Surgicare of Plantation, Inc.

Surgicare of Port Charlotte, LLC

Surgicare of Port St. Lucie, Inc.

Surgicare of Portsmouth, LLC

Surgicare of Premier Orthopaedic, LLC

Surgicare of Reston, Inc.

Surgicare of Ridgeline, LLC

Surgicare of Riverwalk, LLC

Surgicare of Roanoke, LLC

Surgicare of Rome, Inc.

Surgicare of Rose, LLC

Surgicare of Round Rock, Inc.

Surgicare of Royal Oaks, LLC

Surgicare of Salem, LLC

Surgicare of Silicon Valley, LLC

Surgicare of Sky Ridge, LLC

Surgicare of South Austin, Inc.

Surgicare of Southeast Denver, Inc.

Surgicare of Southern Hills, Inc.

Surgicare of Southern Kentucky, LLC

Surgicare of Spotsylvania, LLC

Surgicare of St. Andrews, Inc.

Surgicare of StoneSprings, LLC

Surgicare of Stuart, Inc.

43

Surgicare of Sugar Land, Inc.

Surgicare of Swedish, LLC

Surgicare of Tallahassee, Inc.

Surgicare of Terre Haute, LLC

Surgicare of Thornton, LLC

Surgicare of Travis Center, Inc.

Surgicare of Tulsa, Inc.

Surgicare of Utah, LLC

Surgicare of Wasatch Front, LLC

Surgicare of West Hills, Inc.

Surgicare of Westlake, Inc.

Surgicare of Wichita, Inc.

Surgicare of Willis, LLC

Surgicare of Wilson County, LLC

Surgicare of Winchester, LLC

Surgicare Outpatient Center of Baton Rouge, Inc.

Surgicare Outpatient Center of Jackson, Inc.

Surgicenter of East Jefferson, Inc.

Surgico, LLC

SWMC, Inc.

Tallahassee Community Network, Inc.

*Tallahassee Medical Center, Inc.

Tampa Bay Health System, Inc.

Tampa Surgi-Centre, Inc.

TBHI Outpatient Services, LLC

*TCMC Madison-Portland, Inc.

Teays Valley Health Services, LLC

Tennessee Valley Outpatient Diagnostic Center, LLC

*Terre Haute Hospital GP, Inc.

*Terre Haute Hospital Holdings, Inc.

*Terre Haute MOB, L.P.

*Terre Haute Regional Hospital, L.P.

Texas HSS, LLC

Texas Psychiatric Company, Inc.

*The Regional Health System of Acadiana, LLC

The West Texas Division of Columbia, Inc.

*Timpanogos Regional Medical Services, Inc.

Total Imaging - Hudson, LLC

Total Imaging - North St. Petersburg, LLC

Total Imaging - Parsons, LLC

Tri Cities Health Services Corp.

Tri-County Community Hospital, Inc.

*Trident Medical Center, LLC

TriStar Health System, Inc.

Ultra Imaging Management Services, LLC

44

Ultra Imaging of Tampa, LLC

University Hospital, Ltd.

Utah Imaging GP, LLC

*Utah Medco, LLC

Valify, Inc.

Value Health Holdings, Inc.

Value Health Management, Inc.

Venture Medical Management, LLC

*VH Holdco, Inc.

*VH Holdings, Inc.

Vidalia Health Services, LLC

Village Oaks Medical Center, Inc.

VIP, Inc.

Virginia Care Partners ACO LLC

Virginia Hematology & Oncology Associates, Inc.

*Virginia Psychiatric Company, Inc.

Virginia Quality Care Partners, LLC

*Vision Consulting Group LLC

*Vision Holdings, LLC

W & C Hospital, Inc.

*Walterboro Community Hospital, Inc.

Warren County Ambulance Service, LLC

*WCP Properties, LLC

*Weatherford Health Services, LLC

Wesley Cath Lab, LLC

Wesley Manager, LLC

*Wesley Medical Center, LLC

West Boynton Beach Open Imaging Center, LLC

West Creek Ambulatory Surgery Center, LLC

West Creek Medical Center, Inc.

*West Florida - MHT, LLC

*West Florida - PPH, LLC

West Florida Division, Inc.

West Florida HealthWorks, LLC

West Florida Imaging Services, LLC

West Florida PET Services, LLC

West Florida Professional Billing, LLC

*West Florida Regional Medical Center, Inc.

West Hills Hospital

West Houston ASC, Inc.

West Houston Outpatient Medical Facility, Inc.

West Houston Surgicare, Inc.

West Houston, LLC

West Jacksonville Medical Center, Inc.

45

West Jordan Hospital Corporation

West Los Angeles Physicians’ Hospital, Inc.

West McKinney Imaging Services, LLC

West Paces Services, Inc.

West Valley Imaging, LLC

*West Valley Medical Center, Inc.

Westbury Hospital, Inc.

Westminster Community Hospital

WHG Medical, LLC

*WHMC, Inc.

Wildwood Medical Center, Inc.

Wilson County Outpatient Surgery Center, L.P.

WJHC, LLC

Woman’s Hospital Merger, LLC

*Woman’s Hospital of Texas, Incorporated

Women’s & Children’s Pediatric Hematology/Oncology Center, LLC

Women’s & Children’s Pulmonology Clinic, LLC

Women’s Hospital Indianapolis GP, Inc.

Women’s Hospital Indianapolis, L.P.

The affiliates of HCA Healthcare, Inc. listed below have entered into term promissory notes with Western Plains Capital, Inc., a subsidiary guarantor. The notes are owed to Western Plains Capital, Inc. and pledged as collateral for the secured notes.

Ambulatory Surgery Center Group, Ltd.

Arapahoe Surgicenter, LLC

Atlanta Surgery Center, Ltd.

Bay Area Surgicenter, LLC

Bayonet Point Surgery Center, Ltd.

Bayside Ambulatory Center, LLC

Belleair Surgery Center, Ltd.

Brownsville Surgicenter, LLC

Calloway Creek Surgery Center, L.P.

Carolina Regional Surgery Center, Ltd.

Centennial Surgery Center, L.P.

Centrum Surgery Center, Ltd.

Chippenham Ambulatory Surgery Center, LLC

Clarksville Surgicenter, LLC

Clear Creek Surgery Center, LLC

Clear Lake Surgicare, Ltd.

Coliseum Same Day Surgery Center, L.P.

Columbia Surgicare of Augusta, Ltd.

Coral Springs Surgi-Center, Ltd.

46

Countryside Surgery Center, Ltd.

Denton Regional Ambulatory Surgery Center, L.P.

Denver Mid-Town Surgery Center, Ltd.

Denver Surgicenter, LLC

Doctors Hospital Surgery Center, L.P.

Doctors Same Day Surgery Center, Ltd.

El Paso Surgery Centers, L.P.

Fairfax Surgical Center, L.P.

Florida Outpatient Surgery Center, Ltd.

Gramercy Surgery Center, Ltd.

HealthONE Ridge View Endoscopy Center, LLC

Jacksonville Surgery Center, Ltd.

Johnson County Surgery Center, L.P.

KC Pain ASC, LLC

Kingwood Surgery Center, LLC

Las Vegas Surgicare, Ltd.

Lincoln Surgery Center, LLC

Manatee Surgicare, Ltd.

Marietta Outpatient Surgery, Ltd.

Med City Dallas Outpatient Surgery Center, L.P.

Medical Plaza Ambulatory Surgery Center Associates, L.P.

Miami Lakes Surgery Center, Ltd.

Mountain West Surgery Center, LLC

Mt. Ogden Utah Surgical Center, LLC

New Port Richey Surgery Center, Ltd.

North Hills Surgicare, L.P.

North Miami Beach Surgery Center Limited Partnership

North Palm Beach County Surgery Center, LLC

North Suburban Spine Center, L.P.

Northlake Surgical Center, L.P.

ODP Manager, LLC

Oklahoma Outpatient Surgery Limited Partnership

Orlando Surgicare, Ltd.

Outpatient Surgical Services, Ltd.

Outpatient Women’s and Children’s Surgery Center, Ltd.

Palms West Surgery Center, Ltd.

Park Central Surgical Center, Ltd.

Park Ridge Surgery Center, LLC

Physicians Ambulatory Surgery Center, LLC

Physicians West Surgicenter, LLC

Plano Ambulatory Surgery Associates, L.P.

Port St. Lucie Surgery Center, Ltd.

47

Portsmouth Regional Ambulatory Surgery Center, L.L.C.

Premier ASC, LLC

Putnam Radiation Oncology, LLC

Red Rocks Surgery Center, LLC

Reston Surgery Center, L.P.

Riverwalk ASC, LLC

Roanoke Surgery Center, L.P.

Rocky Mountain Surgery Center, LLC

Rose Ambulatory Surgery Center, L.P.

Sahara Outpatient Surgery Center, Ltd.

Sky Ridge Surgery Center, L.P.

Southern Kentucky Surgicenter, LLC

Specialty Surgicare of Las Vegas, LP

St. Mark’s Ambulatory Surgery Associates, L.P.

Sugar Land Surgery Center, Ltd.

Summit Surgery Center, L.P.

Surgery Center of Atlantis, LLC

Surgery Center of Aventura, Ltd.

Surgery Center of Independence, L.P.

Surgery Center of Overland Park, L.P.

Surgery Center of Rome, L.P.

Surgery Center of the Rockies, LLC

Surgicare of St. Andrews, Ltd.

Surgicare of Wichita, LLC

Tallahassee Orthopaedic Surgery Partners, Ltd.

Tarrant County Surgery Center, L.P.

University Healthcare System, L.C.

Utah Surgery Center, L.P.

West Hills Surgical Center, Ltd.

48

EX-31.1

EXHIBIT 31.1

CERTIFICATION

I, Samuel N. Hazen, certify that:

1. I have reviewed this quarterly report on Form 10-Q of HCA Healthcare, Inc.;

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

(b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

(c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

(d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5. The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

(a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

(b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

By:	/s/ SAMUEL N. HAZEN
	Samuel N. Hazen
	Chief Executive Officer

Date: April 30, 2021

EX-31.2

EXHIBIT 31.2

CERTIFICATION

I, William B. Rutherford, certify that:

1. I have reviewed this quarterly report on Form 10-Q of HCA Healthcare, Inc.;

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

(b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

(c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

(d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5. The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

(a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

(b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

By:	/S/ WILLIAM B. RUTHERFORD
	William B. Rutherford
	Executive Vice President and Chief Financial Officer

Date: April 30, 2021

EX-32

EXHIBIT 32

CERTIFICATION PURSUANT TO

18 U.S.C. SECTION 1350,

AS ADOPTED PURSUANT TO

SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Quarterly Report of HCA Healthcare, Inc. (the “Company”) on Form 10-Q for the quarter ended March 31, 2021, as filed with the Securities and Exchange Commission on the date hereof (the “Report”), each of the undersigned certifies, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that:

(1) The Report fully complies with the requirements of section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

(2) The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

By:	/S/ SAMUEL N. HAZEN
	Samuel N. Hazen
	Chief Executive Officer

April 30, 2021

By:	/S/ WILLIAM B. RUTHERFORD
	William B. Rutherford
	Executive Vice President and Chief Financial Officer

April 30, 2021

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Cover Page - shares	3 Months Ended
	Mar. 31, 2021	Apr. 26, 2021
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2021
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q1
Trading Symbol	HCA
Entity Registrant Name	HCA Healthcare, Inc.
Entity Central Index Key	0000860730
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Filer Category	Large Accelerated Filer
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		330,655,500
Entity Interactive Data Current	Yes
Entity File Number	1-11239
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	27-3865930
Entity Address, Address Line One	One Park Plaza
Entity Address, City or Town	Nashville
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37203
City Area Code	615
Local Phone Number	344-9551
Document Quarterly Report	true
Document Transition Report	false
Title of 12(b) Security	Voting common stock, $.01 par value
Security Exchange Name	NYSE

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Condensed Consolidated Income Statements - USD ($) shares in Thousands, $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Income Statement [Abstract]
Revenues	$ 13,977	$ 12,861
Salaries and benefits	6,301	6,118
Supplies	2,224	2,123
Other operating expenses	2,421	2,427
Equity in earnings of affiliates	(21)	(7)
Depreciation and amortization	697	674
Interest expense	384	428
Gains on sales of facilities	(2)	(7)
Losses on retirement of debt	0	295
Total expenses including equity in earnings of affiliates	12,004	12,051
Income before income taxes	1,973	810
Provision for income taxes	393	112
Net income	1,580	698
Net income attributable to noncontrolling interests	157	117
Net income attributable to HCA Healthcare, Inc.	$ 1,423	$ 581
Per share data:
Basic earnings	$ 4.21	$ 1.72
Diluted earnings	$ 4.14	$ 1.69
Shares used in earnings per share calculations (in millions):
Basic	338,123	338,242
Diluted	343,321	344,096

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Condensed Consolidated Comprehensive Income Statements - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Statement of Comprehensive Income [Abstract]
Net income	$ 1,580	$ 698
Other comprehensive income (loss) before taxes:
Foreign currency translation	8	(73)
Unrealized losses on available-for-sale securities	(11)	(5)
Defined benefit plans	0	0
Pension costs included in salaries and benefits	7	4
Total defined benefit plans	7	4
Change in fair value of derivative financial instruments	1	(60)
Interest expense (benefits) included in interest expense	9	(1)
Total change in fair value of derivative financial instruments	10	(61)
Other comprehensive loss before taxes	14	(135)
Income taxes (benefits) related to other comprehensive income items	3	(24)
Other comprehensive income (loss)	11	(111)
Comprehensive income	1,591	587
Comprehensive income attributable to noncontrolling interests	157	117
Comprehensive income attributable to HCA Healthcare, Inc.	$ 1,434	$ 470

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Condensed Consolidated Balance Sheets - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 1,030	$ 1,793
Accounts receivable	7,424	7,051
Inventories	2,068	2,025
Other	1,514	1,464
Total current assets	12,036	12,333
Property and equipment, at cost	49,877	49,317
Accumulated depreciation	(26,689)	(26,118)
Property and equipment, net	23,188	23,199
Investments of insurance subsidiaries	393	388
Investments in and advances to affiliates	427	422
Goodwill and other intangible assets	8,575	8,578
Right-of-use operating lease assets	2,083	2,024
Other	575	546
Total assets	47,277	47,490
Current liabilities:
Accounts payable	3,524	3,535
Accrued salaries	1,767	1,720
Other accrued expenses	3,117	3,240
Long-term debt due within one year	234	209
Total current liabilities	8,642	8,704
Long-term debt, less debt issuance costs and discounts of $229 and $236	30,838	30,795
Professional liability risks	1,553	1,486
Right-of-use operating lease obligations	1,730	1,673
Income taxes and other liabilities	2,032	1,940
Stockholders' equity:
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 338,714,500 shares — 2021 and 339,425,600 shares — 2020	3	3
Capital in excess of par value	0	294
Accumulated other comprehensive loss	(491)	(502)
Retained earnings	735	777
Stockholders' equity attributable to HCA Healthcare, Inc.	247	572
Noncontrolling interests	2,235	2,320
Total stockholders' equity	2,482	2,892
Total liabilities and stockholders' equity	$ 47,277	$ 47,490

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Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Statement of Financial Position [Abstract]
Debt issuance costs	$ 229	$ 236
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	1,800,000,000	1,800,000,000
Common stock, shares outstanding	333,714,500	339,425,600

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Condensed Consolidated Statements of Stockholders' Equity (Deficit) - USD ($) $ in Millions	Total	Common Stock [Member]	Capital in Excess of Par Value [Member]	Accumulated Other Comprehensive Loss [Member]	Retained Earnings (Deficit) [Member]	Equity Attributable to Noncontrolling Interests [Member]
Balances at Dec. 31, 2019	$ (565)	$ 3		$ (460)	$ (2,351)	$ 2,243
Balance, shares at Dec. 31, 2019		338,446,000
Comprehensive income (loss)	587			(111)	581	117
Repurchase of common stock	(441)				(441)
Repurchase of common stock, shares		(3,287,000)
Share-based benefit plans	(33)		$ 2		(35)
Share-based benefit plans, shares		2,449,000
Cash dividends declared	(148)				(148)
Distributions	(154)					(154)
Other	51		(2)			53
Balance at Mar. 31, 2020	(703)	$ 3		(571)	(2,394)	2,259
Balance, shares at Mar. 31, 2020		337,608,000
Comprehensive income (loss)	1,225			9	1,079	137
Share-based benefit plans	93		93
Share-based benefit plans, shares		352,000
Distributions	(45)					(45)
Other	(2)		(5)			3
Balance at Jun. 30, 2020	568	$ 3	88	(562)	(1,315)	2,354
Balance, shares at Jun. 30, 2020		337,960,000
Comprehensive income (loss)	826			47	668	111
Share-based benefit plans	97		97
Share-based benefit plans, shares		410,000
Distributions	(194)					(194)
Other	2					2
Balance at Sep. 30, 2020	1,299	$ 3	185	(515)	(647)	2,273
Balance, shares at Sep. 30, 2020		338,370,000
Comprehensive income (loss)	1,707			13	1,426	268
Share-based benefit plans	108		108
Share-based benefit plans, shares		1,056,000.000
Cash dividends declared	(2)				(2)
Distributions	(233)					(233)
Other	13		1			12
Balance at Dec. 31, 2020	2,892	$ 3	294	(502)	777	2,320
Balance, shares at Dec. 31, 2020		339,426,000
Comprehensive income (loss)	1,591			11	1,423	157
Repurchase of common stock	$ (1,527)		(225)		(1,302)
Repurchase of common stock, shares	(8,477,000)	(8,477,000)
Share-based benefit plans	$ (75)		(75)
Share-based benefit plans, shares		2,765,000
Cash dividends declared	(163)				(163)
Distributions	(234)					(234)
Other	(2)		$ 6			(8)
Balance at Mar. 31, 2021	$ 2,482	$ 3		$ (491)	$ 735	$ 2,235
Balance, shares at Mar. 31, 2021		333,714,000

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Condensed Consolidated Statements of Stockholders' Equity (Deficit) (Parenthetical) - $ / shares	3 Months Ended
	Mar. 31, 2021	Dec. 31, 2020	Mar. 31, 2020
Statement of Stockholders' Equity [Abstract]
Cash dividends declared, per share	$ 0.48	$ 0.43	$ 0.43

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Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Cash flows from operating activities:
Net income	$ 1,580	$ 698
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable	(371)	464
Inventories and other assets	(85)	(196)
Accounts payable and accrued expenses	(371)	(784)
Depreciation and amortization	697	674
Income taxes	406	121
Gains on sales of facilities	(2)	(7)
Losses on retirement of debt	0	295
Amortization of debt issuance costs and discounts	8	7
Share-based compensation	97	82
Other	29	21
Net cash provided by operating activities	1,988	1,375
Cash flows from investing activities:
Purchase of property and equipment	(654)	(853)
Acquisition of hospitals and health care entities	(22)	(328)
Sales of hospitals and health care entities	20	35
Change in investments	(2)	(1)
Other	9	2
Net cash used in investing activities	(649)	(1,145)
Cash flows from financing activities:
Issuances of long-term debt	0	2,700
Net change in revolving credit facilities	80	1,440
Repayment of long-term debt	(47)	(3,327)
Distributions to noncontrolling interests	(234)	(154)
Payment of debt issuance costs	0	(34)
Payment of dividends	(169)	(152)
Repurchase of common stock	(1,527)	(441)
Other	(207)	(141)
Net cash used in financing activities	(2,104)	(109)
Effect of exchange rate changes on cash and cash equivalents	2	(11)
Change in cash and cash equivalents	(763)	110
Cash and cash equivalents at beginning of period	1,793	621
Cash and cash equivalents at end of period	1,030	731
Interest payments	375	468
Income tax refunds, net	$ (13)	$ (9)

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Basis of Presentation and Significant Accounting Policies

3 Months Ended

Mar. 31, 2021

Accounting Policies [Abstract]

Basis of Presentation and Significant Accounting Policies

NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES

Reporting Entity

HCA Healthcare, Inc. is a holding company whose affiliates own and operate hospitals and related health care entities. The term “affiliates” includes direct and indirect subsidiaries of HCA Healthcare, Inc. and partnerships and joint ventures in which such subsidiaries are partners. At March 31, 2021, these affiliates owned and operated 186 hospitals, 121 freestanding surgery centers, 21 freestanding endoscopy centers and provided extensive outpatient and ancillary services. HCA Healthcare, Inc.’s facilities are located in 20 states and England. The terms “Company,” “HCA,” “we,” “our” or “us,” as used herein and unless otherwise stated or indicated by context, refer to HCA Healthcare, Inc. and its affiliates. The terms “facilities” or “hospitals” refer to entities owned and operated by affiliates of HCA and the term “employees” refers to employees of affiliates of HCA.

Basis of Presentation

The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all the information and footnotes required by generally accepted accounting principles for complete consolidated financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation have been included and are of a normal and recurring nature.

The majority of our expenses are “costs of revenues” items. Costs that could be classified as general and administrative would include our corporate office costs, which were $87 million and $96 million for the quarters ended March 31, 2021 and 2020, respectively. Operating results for the quarter ended March 31, 2021 are not necessarily indicative of the results that may be expected for the year ending December 31, 2021. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K for the year ended December 31, 2020.

COVID-19 Pandemic

On March 11, 2020, the World Health Organization designated COVID-19 as a global pandemic. Patient volumes and the related revenues for most of our services were significantly impacted during the latter portion of the first quarter and the first half of the second quarter of 2020 and have continued to be impacted as various policies were implemented by federal, state and local governments in response to the COVID-19 pandemic, and the public remains wary of real or perceived opportunities for exposure to the virus. We believe the extent of the COVID-19 pandemic’s impact on our operating results and financial condition has been and will continue to be driven by many factors, most of which are beyond our control and ability to forecast. Because of these uncertainties, we cannot estimate how long or to what extent the pandemic will impact our operations.

Revenues

Our revenues generally relate to contracts with patients in which our performance obligations are to provide health care services to the patients. Revenues are recorded during the period our obligations to provide health care services are satisfied. Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days, and revenues are recognized based on charges incurred in relation to total expected charges. Our performance obligations for outpatient services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered

through the health insurance exchanges) and the transaction prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges. Medicare generally pays for inpatient and outpatient services at prospectively determined rates based on clinical, diagnostic and other factors. Services provided to patients having Medicaid coverage are generally paid at prospectively determined rates per discharge, per identified service or per covered member. Agreements with commercial insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates. Our revenues for the quarter ended March 31, 2020 include $55 million related to the settlement of Medicare outlier calculations for prior periods. Management continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals.

Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual adjustments under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record these revenues at the estimated amounts we expect to collect. Patients treated at our hospitals for non-elective care, who have income at or below 400% of the federal poverty level, are eligible for charity care. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues. Our revenues by primary third-party payer classification and other (including uninsured patients) for the quarters ended March 31, 2021 and 2020 are summarized in the following table (dollars in millions):

	2021		Ratio			2020		Ratio
Medicare	$	2,559		18.3	%	$	2,743		21.3	%
Managed Medicare		2,053		14.7			1,826		14.2
Medicaid		527		3.8			414		3.2
Managed Medicaid		725		5.2			666		5.2
Managed care and insurers		6,885		49.1			6,645		51.6
International (managed care and insurers)		333		2.4			292		2.3
Other		895		6.5			275		2.2
Revenues	$	13,977		100.0	%	$	12,861		100.0	%

To quantify the total impact of the trends related to uninsured patient accounts, we believe it is beneficial to view total uncompensated care, which is comprised of charity care, uninsured discounts and implicit price concessions. A summary of the estimated cost of total uncompensated care for the quarters ended March 31, 2021 and 2020 follows (dollars in millions):

	2021			2020
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)	$	11,643		$	11,342
Cost-to-charges ratio (patient care costs as percentage of gross patient charges)		11.4	%		11.9	%
Total uncompensated care	$	6,821		$	7,873
Multiply by the cost-to-charges ratio		11.4	%		11.9	%
Estimated cost of total uncompensated care	$	778		$	937

The total uncompensated care amounts include charity care of $2.942 billion and $3.735 billion, respectively, and the related estimated costs of charity care were $335 million and $444 million, respectively, for the quarters ended March 31, 2021 and 2020.

Reclassifications

Certain prior year amounts have been reclassified to conform to the current year presentation.

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Acquisitions and Dispositions

3 Months Ended

Mar. 31, 2021

Business Combinations [Abstract]

Acquisitions and Dispositions

NOTE 2 — ACQUISITIONS AND DISPOSITIONS

During the quarter ended March 31, 2021, we paid $22 million to acquire nonhospital health care entities. Purchase price amounts have been allocated to the related assets acquired and liabilities assumed based upon their respective fair values. During the quarter ended March 31, 2020, we paid  $328 million to acquire a hospital in New Hampshire and nonhospital health care entities. The consolidated financial statements include the accounts and operations of the acquired entities subsequent to the respective acquisition dates. The pro forma effects of these acquired entities on our results of operations for periods prior to the respective acquisition dates were not significant. 

During the quarter ended March 31, 2021, we received proceeds of $20 million and recognized a pretax gain of $2 million related to sales of real estate and other investments. During the quarter ended March 31, 2020, we received proceeds of $35 million and recognized a pretax gain of $7 million related to sales of real estate and other investments.

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Income Taxes

3 Months Ended

Mar. 31, 2021

Income Tax Disclosure [Abstract]

Income Taxes

NOTE 3 — INCOME TAXES

Our provisions for income taxes for the quarters ended March 31, 2021 and 2020 were $393 million and $112 million, respectively, and the effective tax rates were 21.7% and 16.2%, respectively. Our provision for income taxes included tax benefits related to settlements of employee equity awards of  $74 million and $53 million for the quarters ended March 31, 2021 and 2020, respectively.

Our liability for unrecognized tax benefits was $596 million, including accrued interest of $88 million, as of March 31, 2021 ($508 million and $73 million, respectively, as of December 31, 2020). Unrecognized tax benefits of $179 million ($157 million as of December 31, 2020) would affect the effective rate, if recognized.

The Internal Revenue Service was conducting an examination of the Company’s 2016, 2017 and 2018 federal income tax returns at March 31, 2021. We are also subject to examination by state and foreign taxing authorities. Depending on the resolution of any federal, state and foreign tax disputes, the completion of examinations by federal, state or foreign taxing authorities, or the expiration of statutes of limitation for specific taxing jurisdictions, we believe it is reasonably possible that our liability for unrecognized tax benefits may significantly increase or decrease within the next 12 months. However, we are currently unable to estimate the range of any possible change.

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Earnings Per Share

3 Months Ended

Mar. 31, 2021

Earnings Per Share [Abstract]

Earnings Per Share

NOTE 4 — EARNINGS PER SHARE

We compute basic earnings per share using the weighted average number of common shares outstanding. We compute diluted earnings per share using the weighted average number of common shares outstanding, plus the dilutive effect of outstanding equity awards, computed using the treasury stock method.

The following table sets forth the computation of basic and diluted earnings per share for the quarters ended March 31, 2021 and 2020 (dollars and shares in millions, except per share amounts):

	2021		2020
Net income attributable to HCA Healthcare, Inc.	$	1,423	$	581
Weighted average common shares outstanding		338.123		338.242
Effect of dilutive incremental shares		5.198		5.854
Shares used for diluted earnings per share		343.321		344.096
Earnings per share:
Basic earnings	$	4.21	$	1.72
Diluted earnings	$	4.14	$	1.69

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Investments of Insurance Subsidiaries

3 Months Ended

Mar. 31, 2021

Investments, Debt and Equity Securities [Abstract]

Investments of Insurance Subsidiaries

NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES

A summary of our insurance subsidiaries’ investments at March 31, 2021 and December 31, 2020 follows (dollars in millions):

	March 31, 2021
	Amortized Cost		Unrealized Amounts					Fair Value
			Gains		Losses
Debt securities	$	376	$	22	$	(1	)	$	397
Money market funds and other		104		—		—			104
	$	480	$	22	$	(1	)		501
Amounts classified as current assets									(108	)
Investment carrying value								$	393

	December 31, 2020
	Amortized Cost		Unrealized Amounts				Fair Value
			Gains		Losses
Debt securities	$	384	$	32	$	—	$	416
Money market funds and other		88		—		—		88
	$	472	$	32	$	—		504
Amounts classified as current assets								(116	)
Investment carrying value							$	388

At March 31, 2021 and December 31, 2020, the investments in debt securities of our insurance subsidiaries were classified as “available-for-sale.” Changes in unrealized gains and losses that are not credit-related are recorded as adjustments to other comprehensive income (loss).

Scheduled maturities of investments in debt securities at March 31, 2021 were as follows (dollars in millions):

	Amortized Cost		Fair Value
Due in one year or less	$	4	$	4
Due after one year through five years		144		152
Due after five years through ten years		157		167
Due after ten years		71		74
	$	376	$	397

The average expected maturity of the investments in debt securities at March 31, 2021 was 5.0 years, compared to the average scheduled maturity of 9.2 years. Expected and scheduled maturities may differ because the issuers of certain securities have the right to call, prepay or otherwise redeem such obligations prior to their scheduled maturity date.

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Financial Instruments

3 Months Ended

Mar. 31, 2021

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Financial Instruments

NOTE 6 — FINANCIAL INSTRUMENTS

Interest Rate Swap Agreements

We have entered into interest rate swap agreements to manage our exposure to fluctuations in interest rates. These swap agreements involve the exchange of fixed and variable rate interest payments between us and our counterparties based on common notional principal amounts and maturity dates. Pay-fixed interest rate swaps effectively convert variable rate obligations to fixed interest rate obligations. The interest payments under these agreements are settled on a net basis. The net interest payments, based on the notional amounts in these agreements, generally match the timing of the related liabilities for the interest rate swap agreements which have been designated as cash flow hedges. The notional amounts of the swap agreements represent amounts used to calculate the exchange of cash flows and are not our assets or liabilities. Our credit risk related to these agreements is considered low because the swap agreements are with creditworthy financial institutions.

The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at March 31, 2021 (dollars in millions):

	Notional Amount		Maturity Date		Fair Value
Pay-fixed interest rate swaps	$	2,000		December 2021	$	(20	)
Pay-fixed interest rate swaps		500		December 2022		(16	)

During the next 12 months, we estimate $30 million will be reclassified from other comprehensive income (“OCI”) and will be included in interest expense.

Derivatives — Results of Operations

The following table presents the effect of our interest rate swaps on our results of operations for the quarter ended March 31, 2021 (dollars in millions):

Derivatives in Cash Flow Hedging Relationships	Amount of Gain Recognized in OCI on Derivatives, Net of Tax		Location of Loss Reclassified from Accumulated OCI into Operations		Amount of Loss Reclassified from Accumulated OCI into Operations
Interest rate swaps	$	1		Interest expense	$	9

Credit-risk-related Contingent Features

We have agreements with each of our derivative counterparties that contain a provision where we could be declared in default on our derivative obligations if repayment of the underlying indebtedness is accelerated by the lender due to our default on the indebtedness. As of March 31, 2021, we have not been required to post any collateral related to these agreements. If we had breached these provisions at March 31, 2021, we would have been required to settle our obligations under the agreements at their aggregate, estimated termination value of $37 million.

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Assets and Liabilities Measured at Fair Value

3 Months Ended

Mar. 31, 2021

Fair Value Disclosures [Abstract]

Assets and Liabilities Measured at Fair Value

NOTE 7 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE

Accounting Standards Codification 820, Fair Value Measurements and Disclosures (“ASC 820”), emphasizes fair value is a market-based measurement, and fair value measurements should be determined based on the assumptions market participants would use in pricing assets or liabilities. ASC 820 utilizes a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs classified within Levels 1 and 2 of the hierarchy) and the reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy).

Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates, and yield curves observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market

activity. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input significant to the fair value measurement in its entirety. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment.

Cash Traded Investments

Our cash traded investments are generally classified within Level 1 or Level 2 of the fair value hierarchy because they are valued using quoted market prices, broker or dealer quotations, or alternative pricing sources with reasonable levels of price transparency.

Derivative Financial Instruments

We have entered into interest rate swap agreements to manage our exposure to fluctuations in interest rates. The valuation of these instruments is determined using widely accepted valuation techniques, including discounted cash flow analysis on the expected cash flows of each derivative. This analysis reflects the contractual terms of the derivatives, including the period to maturity, and uses observable market-based inputs, including interest rate curves and implied volatilities. We incorporate credit valuation adjustments to reflect both our own nonperformance risk and the respective counterparty’s nonperformance risk in the fair value measurements of these instruments. 

The following tables summarize our assets and liabilities measured at fair value on a recurring basis as of March 31, 2021 and December 31, 2020, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions):

	March 31, 2021
				Fair Value Measurements Using
	Fair Value			Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1)			Significant Other Observable Inputs (Level 2)			Significant Unobservable Inputs (Level 3)
Assets:
Investments of insurance subsidiaries:
Debt securities	$	397		$	—		$	397		$	—
Money market funds and other		104			104			—			—
Investments of insurance subsidiaries		501			104			397			—
Less amounts classified as current assets		(108	)		(101	)		(7	)		—
	$	393		$	3		$	390		$	—
Liabilities:
Interest rate swaps (Income taxes and other liabilities)	$	36		$	—		$	36		$	—

	December 31, 2020
				Fair Value Measurements Using
	Fair Value			Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1)			Significant Other Observable Inputs (Level 2)			Significant Unobservable Inputs (Level 3)
Assets:
Investments of insurance subsidiaries:
Debt securities	$	416		$	—		$	416		$	—
Money market funds and other		88			88			—			—
Investments of insurance subsidiaries		504			88			416			—
Less amounts classified as current assets		(116	)		(87	)		(29	)		—
	$	388		$	1		$	387		$	—
Liabilities:
Interest rate swaps (Income taxes and other liabilities)	$	46		$	—		$	46		$	—

The estimated fair value of our long-term debt was $34.872 billion and $35.814 billion at March 31, 2021 and December 31, 2020, respectively, compared to carrying amounts, excluding debt issuance costs and discounts, aggregating $31.301 billion and $31.240 billion, respectively. The estimates of fair value are generally based upon the quoted market prices or quoted market prices for similar issues of long-term debt with the same maturities.

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Long-Term Debt

3 Months Ended

Mar. 31, 2021

Debt Disclosure [Abstract]

Long-Term Debt

NOTE 8 — LONG-TERM DEBT

A summary of long-term debt at March 31, 2021 and December 31, 2020, including related interest rates at March 31, 2021, follows (dollars in millions):

	March 31, 2021			December 31, 2020
Senior secured asset-based revolving credit facility (effective interest rate of 1.4%)	$	80		$	—
Senior secured revolving credit facility		—			—
Senior secured term loan facilities (effective interest rate of 2.8%)		3,657			3,671
Senior secured notes (effective interest rate of 5.1%)		13,850			13,850
Other senior secured debt (effective interest rate of 4.6%)		762			767
Senior secured debt		18,349			18,288
Senior unsecured notes (effective interest rate of 5.5%)		12,952			12,952
Debt issuance costs and discounts		(229	)		(236	)
Total debt (average life of 8.6 years, rates averaging 5.0%)		31,072			31,004
Less amounts due within one year		234			209
	$	30,838		$	30,795

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Contingencies

3 Months Ended

Mar. 31, 2021

Commitments and Contingencies Disclosure [Abstract]

Contingencies

NOTE 9 — CONTINGENCIES

We operate in a highly regulated and litigious industry. As a result, various lawsuits, claims and legal and regulatory proceedings have been and can be expected to be instituted or asserted against us. We are also subject to claims and suits arising in the ordinary course of business, including claims for personal injuries or wrongful restriction of, or interference with, physicians’ staff privileges. In certain of these actions the claimants may seek punitive damages against us which may not be covered by insurance. We are also subject to claims by various taxing authorities for additional taxes and related interest and penalties. The resolution of any such lawsuits, claims or legal and regulatory proceedings could have a material, adverse effect on our results of operations, financial position or liquidity.

Health care companies are routinely subject to investigations by various governmental agencies. Under the federal False Claims Act (“FCA”), private parties have the right to bring qui tam, or “whistleblower,” suits against companies that submit false claims for payments to, or improperly retain overpayments from, the government. Some states have adopted similar state whistleblower and false claims provisions. Certain of our individual facilities have received, and from time to time, other facilities may receive, government inquiries from, and may be subject to investigation by, federal and state agencies. Depending on whether the underlying conduct in these or future inquiries or investigations could be considered systemic, their resolution could have a material, adverse effect on our results of operations, financial position or liquidity.

Texas operates a state Medicaid program pursuant to a waiver from the Centers for Medicare & Medicaid Services under Section 1115 of the Social Security Act (“Program”). The Program includes uncompensated-care pools; payments from these pools are intended to defray the uncompensated costs of services provided by our and other hospitals to Medicaid eligible or uninsured individuals. Separately, we and other hospitals provide charity care services in several communities in the state. In 2018, the Civil Division of the U.S. Department of Justice and the U.S. Attorney’s Office for the Southern District of Texas requested information about whether the Program, as operated in Harris County, complied with the laws and regulations applicable to provider related donations, and the Company cooperated with that request. On May 21, 2019, a qui tam lawsuit asserting violations of the FCA and the Texas Medicaid Fraud Prevention Act related to the Program, as operated in Harris County, was unsealed by the U.S. District Court for the Southern District of Texas. Both the federal and state governments declined to intervene in the qui tam lawsuit. The Company believes that our participation is and has been consistent with the requirements of the Program and is vigorously defending against the lawsuit being pursued by the relator. We cannot predict what effect, if any, the qui tam lawsuit could have on the Company.

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Share Repurchase Transactions and Other Comprehensive Loss

3 Months Ended

Mar. 31, 2021

Federal Home Loan Banks [Abstract]

Share Repurchases Transactions and Other Comprehensive Loss

NOTE 10 — SHARE REPURCHASE TRANSACTIONS AND OTHER COMPREHENSIVE LOSS

During January 2020 and 2019, our Board of Directors authorized share repurchase programs for up to $4 billion ($2 billion for each authorization) of our outstanding common stock. During February 2021, our Board of Directors authorized an additional $6 billion for repurchases of our outstanding common stock. During the quarter ended March 31, 2021, we repurchased 8.477 million shares of our common stock at an average price of $180.11 per share through market purchases pursuant to the $2.0 billion share repurchase program authorized during January 2019 (which was completed during the first quarter of 2021) and the January 2020 authorization. At March 31, 2021, we had $7.274 billion of repurchase authorization available under the January 2020 and February 2021 authorizations.

The components of accumulated other comprehensive loss are as follows (dollars in millions):

	Unrealized Gains on Available- for-Sale Securities			Foreign Currency Translation Adjustments			Defined Benefit Plans			Change in Fair Value of Derivative Instruments			Total
Balances at December 31, 2020	$	25		$	(271	)	$	(220	)	$	(36	)	$	(502	)
Unrealized losses on available-for-sale securities, net of $2 income tax benefit		(9	)											(9	)
Foreign currency translation adjustments, net of $1 of income tax					7									7
Change in fair value of derivative instruments											1			1
Expense reclassified into operations from other comprehensive income, net of $2 and $2 income tax benefits, respectively								5			7			12
Balances at March 31, 2021	$	16		$	(264	)	$	(215	)	$	(28	)	$	(491	)

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Segment and Geographic Information

3 Months Ended

Mar. 31, 2021

Segment Reporting [Abstract]

Segment and Geographic Information

NOTE 11 — SEGMENT AND GEOGRAPHIC INFORMATION

We operate in one line of business, which is operating hospitals and related health care entities. We operate in two geographically organized groups: the National and American Groups. The National Group includes 97 hospitals located in Alaska, California, Florida, southern Georgia, Idaho, Indiana, northern Kentucky, Nevada, New Hampshire, North Carolina, South Carolina, Utah and Virginia, and the American Group includes 82 hospitals located in Colorado, northern Georgia, Kansas, southern Kentucky, Louisiana, Missouri, Tennessee and Texas. We also operate seven hospitals in England, and these facilities are included in the Corporate and other group.  

Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, gains on sales of facilities, losses on retirement of debt, income taxes and net income attributable to noncontrolling interests. We use adjusted segment EBITDA as an analytical indicator for purposes of allocating resources to geographic areas and assessing their performance. Adjusted segment EBITDA is commonly used as an analytical indicator within the health care industry, and also serves as a measure of leverage capacity and debt service ability. Adjusted segment EBITDA should not be considered as a measure of financial performance under generally accepted accounting principles, and the items excluded from adjusted segment EBITDA are significant components in understanding and assessing financial performance. Because adjusted segment EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, adjusted segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. The geographic distributions of our revenues, equity in earnings of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters ended March 31, 2021 and 2020 are summarized in the following table (dollars in millions): 

	2021		2020
Revenues:
National Group	$	7,056	$	6,474
American Group		6,291		5,744
Corporate and other		630		643
	$	13,977	$	12,861

		2021			2020
Equity in earnings of affiliates:
National Group	$	(7	)	$	1
American Group		(12	)		(9	)
Corporate and other		(2	)		1
	$	(21	)	$	(7	)
Adjusted segment EBITDA:
National Group	$	1,705		$	1,215
American Group		1,501			1,115
Corporate and other		(154	)		(130	)
	$	3,052		$	2,200
Depreciation and amortization:
National Group	$	323		$	306
American Group		293			287
Corporate and other		81			81
	$	697		$	674
Adjusted segment EBITDA	$	3,052		$	2,200
Depreciation and amortization		697			674
Interest expense		384			428
Gains on sales of facilities		(2	)		(7	)
Losses on retirement of debt		—			295
Income before income taxes	$	1,973		$	810

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Basis of Presentation and Significant Accounting Policies (Policies)

3 Months Ended

Mar. 31, 2021

Basis of Presentation

Basis of Presentation

The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all the information and footnotes required by generally accepted accounting principles for complete consolidated financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation have been included and are of a normal and recurring nature.

The majority of our expenses are “costs of revenues” items. Costs that could be classified as general and administrative would include our corporate office costs, which were $87 million and $96 million for the quarters ended March 31, 2021 and 2020, respectively. Operating results for the quarter ended March 31, 2021 are not necessarily indicative of the results that may be expected for the year ending December 31, 2021. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K for the year ended December 31, 2020.

COVID-19 Pandemic

On March 11, 2020, the World Health Organization designated COVID-19 as a global pandemic. Patient volumes and the related revenues for most of our services were significantly impacted during the latter portion of the first quarter and the first half of the second quarter of 2020 and have continued to be impacted as various policies were implemented by federal, state and local governments in response to the COVID-19 pandemic, and the public remains wary of real or perceived opportunities for exposure to the virus. We believe the extent of the COVID-19 pandemic’s impact on our operating results and financial condition has been and will continue to be driven by many factors, most of which are beyond our control and ability to forecast. Because of these uncertainties, we cannot estimate how long or to what extent the pandemic will impact our operations.

Revenues

Revenues

Our revenues generally relate to contracts with patients in which our performance obligations are to provide health care services to the patients. Revenues are recorded during the period our obligations to provide health care services are satisfied. Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days, and revenues are recognized based on charges incurred in relation to total expected charges. Our performance obligations for outpatient services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered

through the health insurance exchanges) and the transaction prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges. Medicare generally pays for inpatient and outpatient services at prospectively determined rates based on clinical, diagnostic and other factors. Services provided to patients having Medicaid coverage are generally paid at prospectively determined rates per discharge, per identified service or per covered member. Agreements with commercial insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates. Our revenues for the quarter ended March 31, 2020 include $55 million related to the settlement of Medicare outlier calculations for prior periods. Management continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals.

Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual adjustments under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record these revenues at the estimated amounts we expect to collect. Patients treated at our hospitals for non-elective care, who have income at or below 400% of the federal poverty level, are eligible for charity care. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues. Our revenues by primary third-party payer classification and other (including uninsured patients) for the quarters ended March 31, 2021 and 2020 are summarized in the following table (dollars in millions):

	2021		Ratio			2020		Ratio
Medicare	$	2,559		18.3	%	$	2,743		21.3	%
Managed Medicare		2,053		14.7			1,826		14.2
Medicaid		527		3.8			414		3.2
Managed Medicaid		725		5.2			666		5.2
Managed care and insurers		6,885		49.1			6,645		51.6
International (managed care and insurers)		333		2.4			292		2.3
Other		895		6.5			275		2.2
Revenues	$	13,977		100.0	%	$	12,861		100.0	%

To quantify the total impact of the trends related to uninsured patient accounts, we believe it is beneficial to view total uncompensated care, which is comprised of charity care, uninsured discounts and implicit price concessions. A summary of the estimated cost of total uncompensated care for the quarters ended March 31, 2021 and 2020 follows (dollars in millions):

	2021			2020
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)	$	11,643		$	11,342
Cost-to-charges ratio (patient care costs as percentage of gross patient charges)		11.4	%		11.9	%
Total uncompensated care	$	6,821		$	7,873
Multiply by the cost-to-charges ratio		11.4	%		11.9	%
Estimated cost of total uncompensated care	$	778		$	937

The total uncompensated care amounts include charity care of $2.942 billion and $3.735 billion, respectively, and the related estimated costs of charity care were $335 million and $444 million, respectively, for the quarters ended March 31, 2021 and 2020.

Reclassifications

Reclassifications

Certain prior year amounts have been reclassified to conform to the current year presentation.

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Basis of Presentation and Significant Accounting Policies (Tables)

3 Months Ended

Mar. 31, 2021

Accounting Policies [Abstract]

Schedule of Revenues from Third Party Payers, Uninsured and Other Payers

Our revenues by primary third-party payer classification and other (including uninsured patients) for the quarters ended March 31, 2021 and 2020 are summarized in the following table (dollars in millions):

	2021		Ratio			2020		Ratio
Medicare	$	2,559		18.3	%	$	2,743		21.3	%
Managed Medicare		2,053		14.7			1,826		14.2
Medicaid		527		3.8			414		3.2
Managed Medicaid		725		5.2			666		5.2
Managed care and insurers		6,885		49.1			6,645		51.6
International (managed care and insurers)		333		2.4			292		2.3
Other		895		6.5			275		2.2
Revenues	$	13,977		100.0	%	$	12,861		100.0	%

Schedule of Estimated Cost of Uncompensated Care

A summary of the estimated cost of total uncompensated care for the quarters ended March 31, 2021 and 2020 follows (dollars in millions):

	2021			2020
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)	$	11,643		$	11,342
Cost-to-charges ratio (patient care costs as percentage of gross patient charges)		11.4	%		11.9	%
Total uncompensated care	$	6,821		$	7,873
Multiply by the cost-to-charges ratio		11.4	%		11.9	%
Estimated cost of total uncompensated care	$	778		$	937

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Earnings Per Share (Tables)

3 Months Ended

Mar. 31, 2021

Earnings Per Share [Abstract]

Schedule of Computations of Basic and Diluted Earnings Per Share

The following table sets forth the computation of basic and diluted earnings per share for the quarters ended March 31, 2021 and 2020 (dollars and shares in millions, except per share amounts):

	2021		2020
Net income attributable to HCA Healthcare, Inc.	$	1,423	$	581
Weighted average common shares outstanding		338.123		338.242
Effect of dilutive incremental shares		5.198		5.854
Shares used for diluted earnings per share		343.321		344.096
Earnings per share:
Basic earnings	$	4.21	$	1.72
Diluted earnings	$	4.14	$	1.69

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Investments of Insurance Subsidiaries (Tables)

3 Months Ended

Mar. 31, 2021

Investments, Debt and Equity Securities [Abstract]

Schedule of Investments

A summary of our insurance subsidiaries’ investments at March 31, 2021 and December 31, 2020 follows (dollars in millions):

	March 31, 2021
	Amortized Cost		Unrealized Amounts					Fair Value
			Gains		Losses
Debt securities	$	376	$	22	$	(1	)	$	397
Money market funds and other		104		—		—			104
	$	480	$	22	$	(1	)		501
Amounts classified as current assets									(108	)
Investment carrying value								$	393

	December 31, 2020
	Amortized Cost		Unrealized Amounts				Fair Value
			Gains		Losses
Debt securities	$	384	$	32	$	—	$	416
Money market funds and other		88		—		—		88
	$	472	$	32	$	—		504
Amounts classified as current assets								(116	)
Investment carrying value							$	388

Schedule of Maturities of Investments

Scheduled maturities of investments in debt securities at March 31, 2021 were as follows (dollars in millions):

	Amortized Cost		Fair Value
Due in one year or less	$	4	$	4
Due after one year through five years		144		152
Due after five years through ten years		157		167
Due after ten years		71		74
	$	376	$	397

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Financial Instruments (Tables)

3 Months Ended

Mar. 31, 2021

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Schedule of Interest Rate Swap Agreements Designated as Cash Flow Hedges

The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at March 31, 2021 (dollars in millions):

	Notional Amount		Maturity Date		Fair Value
Pay-fixed interest rate swaps	$	2,000		December 2021	$	(20	)
Pay-fixed interest rate swaps		500		December 2022		(16	)

Effect of Interest Rate on Results of Operations

The following table presents the effect of our interest rate swaps on our results of operations for the quarter ended March 31, 2021 (dollars in millions):

Derivatives in Cash Flow Hedging Relationships	Amount of Gain Recognized in OCI on Derivatives, Net of Tax		Location of Loss Reclassified from Accumulated OCI into Operations		Amount of Loss Reclassified from Accumulated OCI into Operations
Interest rate swaps	$	1		Interest expense	$	9

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Assets and Liabilities Measured at Fair Value (Tables)

3 Months Ended

Mar. 31, 2021

Fair Value Disclosures [Abstract]

Schedule of Assets Measured at Fair Value on Recurring Basis

The following tables summarize our assets and liabilities measured at fair value on a recurring basis as of March 31, 2021 and December 31, 2020, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions):

	March 31, 2021
				Fair Value Measurements Using
	Fair Value			Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1)			Significant Other Observable Inputs (Level 2)			Significant Unobservable Inputs (Level 3)
Assets:
Investments of insurance subsidiaries:
Debt securities	$	397		$	—		$	397		$	—
Money market funds and other		104			104			—			—
Investments of insurance subsidiaries		501			104			397			—
Less amounts classified as current assets		(108	)		(101	)		(7	)		—
	$	393		$	3		$	390		$	—
Liabilities:
Interest rate swaps (Income taxes and other liabilities)	$	36		$	—		$	36		$	—

	December 31, 2020
				Fair Value Measurements Using
	Fair Value			Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1)			Significant Other Observable Inputs (Level 2)			Significant Unobservable Inputs (Level 3)
Assets:
Investments of insurance subsidiaries:
Debt securities	$	416		$	—		$	416		$	—
Money market funds and other		88			88			—			—
Investments of insurance subsidiaries		504			88			416			—
Less amounts classified as current assets		(116	)		(87	)		(29	)		—
	$	388		$	1		$	387		$	—
Liabilities:
Interest rate swaps (Income taxes and other liabilities)	$	46		$	—		$	46		$	—

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Long-Term Debt (Tables)

3 Months Ended

Mar. 31, 2021

Debt Disclosure [Abstract]

Schedule of Long-Term Debt

A summary of long-term debt at March 31, 2021 and December 31, 2020, including related interest rates at March 31, 2021, follows (dollars in millions):

	March 31, 2021			December 31, 2020
Senior secured asset-based revolving credit facility (effective interest rate of 1.4%)	$	80		$	—
Senior secured revolving credit facility		—			—
Senior secured term loan facilities (effective interest rate of 2.8%)		3,657			3,671
Senior secured notes (effective interest rate of 5.1%)		13,850			13,850
Other senior secured debt (effective interest rate of 4.6%)		762			767
Senior secured debt		18,349			18,288
Senior unsecured notes (effective interest rate of 5.5%)		12,952			12,952
Debt issuance costs and discounts		(229	)		(236	)
Total debt (average life of 8.6 years, rates averaging 5.0%)		31,072			31,004
Less amounts due within one year		234			209
	$	30,838		$	30,795

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Share Repurchase Transactions and Other Comprehensive Loss (Tables)

3 Months Ended

Mar. 31, 2021

Federal Home Loan Banks [Abstract]

Components of Accumulated Other Comprehensive Loss

The components of accumulated other comprehensive loss are as follows (dollars in millions):

	Unrealized Gains on Available- for-Sale Securities			Foreign Currency Translation Adjustments			Defined Benefit Plans			Change in Fair Value of Derivative Instruments			Total
Balances at December 31, 2020	$	25		$	(271	)	$	(220	)	$	(36	)	$	(502	)
Unrealized losses on available-for-sale securities, net of $2 income tax benefit		(9	)											(9	)
Foreign currency translation adjustments, net of $1 of income tax					7									7
Change in fair value of derivative instruments											1			1
Expense reclassified into operations from other comprehensive income, net of $2 and $2 income tax benefits, respectively								5			7			12
Balances at March 31, 2021	$	16		$	(264	)	$	(215	)	$	(28	)	$	(491	)

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Segment and Geographic Information (Tables)

3 Months Ended

Mar. 31, 2021

Segment Reporting [Abstract]

Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization, Assets and Goodwill and other intangible assets.

The geographic distributions of our revenues, equity in earnings of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters ended March 31, 2021 and 2020 are summarized in the following table (dollars in millions): 

	2021		2020
Revenues:
National Group	$	7,056	$	6,474
American Group		6,291		5,744
Corporate and other		630		643
	$	13,977	$	12,861

		2021			2020
Equity in earnings of affiliates:
National Group	$	(7	)	$	1
American Group		(12	)		(9	)
Corporate and other		(2	)		1
	$	(21	)	$	(7	)
Adjusted segment EBITDA:
National Group	$	1,705		$	1,215
American Group		1,501			1,115
Corporate and other		(154	)		(130	)
	$	3,052		$	2,200
Depreciation and amortization:
National Group	$	323		$	306
American Group		293			287
Corporate and other		81			81
	$	697		$	674
Adjusted segment EBITDA	$	3,052		$	2,200
Depreciation and amortization		697			674
Interest expense		384			428
Gains on sales of facilities		(2	)		(7	)
Losses on retirement of debt		—			295
Income before income taxes	$	1,973		$	810

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Basis of Presentation and Significant Accounting Policies - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2021 USD ($) State Hospital Surgery_Center Endoscopy_Center	Mar. 31, 2020 USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of owned and operated hospitals | Hospital	186
Number of freestanding surgery centers | Surgery_Center	121
Number of freestanding endoscopy centers | Endoscopy_Center	21
Number of facilities locations | State	20
General and administrative expense	$ 87	$ 96
Performance obligations for inpatient/ outpatient services satisfied period	Our performance obligations for outpatient services are generally satisfied over a period of less than one day.
Charity care amount	$ 2,942	3,735
Estimated costs of charity care	335	$ 444
Out of Network Services [Member]
Summary Of Significant Accounting Policies [Line Items]
Revenues	$ 55
Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Percentage of income of federal poverty level eligible for charity care	400.00%

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Basis of Presentation and Significant Accounting Policies - Schedule of Revenues from Third Party Payers, Uninsured and Other Payers (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 13,977	$ 12,861
Revenues ratio from third party payers	100.00%	100.00%
Medicare [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 2,559	$ 2,743
Revenues from third party payers, Ratio	18.30%	21.30%
Managed Medicare [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 2,053	$ 1,826
Revenues from third party payers, Ratio	14.70%	14.20%
Medicaid [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 527	$ 414
Revenues from third party payers, Ratio	3.80%	3.20%
Managed Medicaid [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 725	$ 666
Revenues from third party payers, Ratio	5.20%	5.20%
Managed Care and Insurers [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 6,885	$ 6,645
Revenues from third party payers, Ratio	49.10%	51.60%
International (managed care and insurers) [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 333	$ 292
Revenues from third party payers, Ratio	2.40%	2.30%
Other [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 895	$ 275
Other, Ratio	6.50%	2.20%

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Basis of Presentation and Significant Accounting Policies - Schedule of Estimated Cost of Uncompensated Care (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Accounting Policies [Abstract]
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)	$ 11,643	$ 11,342
Cost-to-charges ratio (patient care costs as percentage of gross patient charges)	11.40%	11.90%
Total uncompensated care	$ 6,821	$ 7,873
Multiply by the cost-to-charges ratio	11.40%	11.90%
Estimated cost of total uncompensated care	$ 778	$ 937

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Acquisitions and Dispositions - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Business Acquisition [Line Items]
Proceeds from sale of business	$ 20	$ 35
Real Estate and Other Investments [Member]
Business Acquisition [Line Items]
Pretax gain (loss) before tax	2	7
Proceeds from sale of business	20	35
Nonhospital Health Care [Member]
Business Acquisition [Line Items]
Aggregate purchase price	$ 22	$ 328

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Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Income Tax Contingency [Line Items]
Effective tax rate	21.70%	16.20%
Provision for tax benefits related to settlement of employee awards	$ 74	$ 53
Provision for income taxes	393	$ 112
Liability for unrecognized tax benefits	596		$ 508
Unrecognized tax benefits, accrued interest	88		73
Unrecognized tax benefits that would impact effective tax rate	$ 179		$ 157

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Earnings Per Share - Schedule of Computations of Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Earnings Per Share [Abstract]
Net income attributable to HCA Healthcare, Inc.	$ 1,423	$ 581
Weighted average common shares outstanding	338,123	338,242
Effect of dilutive incremental shares	5,198	5,854
Shares used for diluted earnings per share	343,321	344,096
Basic earnings per share	$ 4.21	$ 1.72
Diluted earnings per share	$ 4.14	$ 1.69

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Investments of Insurance Subsidiaries - Schedule of Investments (Detail) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Debt Securities, Available-for-sale [Line Items]
Amounts classified as current assets	$ (108)	$ (116)
Investment carrying value	393	388
Amortized Cost	480	472
Unrealized Amounts, Gains	22	32
Unrealized Amounts, Losses	(1)
Fair Value	501	504
Money Market Funds and Other [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	104	88
Fair Value	104	88
Debt Securities [Member] | States and Municipalities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	376	384
Unrealized Amounts, Gains	22	32
Unrealized Amounts, Losses	(1)
Fair Value	$ 397	$ 416

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Investments of Insurance Subsidiaries - Schedule of Maturities of Investments (Detail) $ in Millions	Mar. 31, 2021 USD ($)
Investments, Debt and Equity Securities [Abstract]
Due in one year or less, Amortized Cost	$ 4
Due after one year through five years, Amortized Cost	144
Due after five years through ten years, Amortized Cost	157
Due after ten years, Amortized Cost	71
Amortized Cost, Total	376
Due in one year or less, Fair Value	4
Due after one year through five years, Fair Value	152
Due after five years through ten years, Fair Value	167
Due after ten years, Fair Value	74
Fair Value, Total	$ 397

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Investments of Insurance Subsidiaries - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2021
Investments, Debt and Equity Securities [Abstract]
Available for sale securities expected maturity of debt securities	5 years
Available for sale securities average scheduled maturity	9 years 2 months 12 days

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Financial Instruments - Schedule of Interest Rate Swap Agreements Designated as Cash Flow Hedges (Detail) - Pay-Fixed Interest Rate Swaps [Member] $ in Millions	3 Months Ended
	Mar. 31, 2021 USD ($)
Maturity Date, 2021 [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amount	$ 2,000
Fair Value	$ (20)
Maturity Date	2021-12
Maturity Date, 2022 [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amount	$ 500
Fair Value	$ (16)
Maturity Date	2022-12

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Financial Instruments - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2021 USD ($)
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Estimated amount reclassified from other comprehensive income and reduce interest expense	$ 30
Estimated termination value	$ 37

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Financial Instruments - Effect of Interest Rate Swaps on Results of Operations (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2021 USD ($)
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain Recognized in OCI on Derivatives, Net of Tax	$ (1)
Interest Rate Swaps [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain Recognized in OCI on Derivatives, Net of Tax	1
Interest Rate Swaps [Member] | Reclassification out of Accumulated Other Comprehensive Income into Operations [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Interest rate swaps	$ 9

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Assets and Liabilities Measured at Fair Value - Schedule of Assets Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value Disclosure	$ 501	$ 504
Less amounts classified as current assets	(108)	(116)
Investments of insurance subsidiaries, noncurrent	393	388
Interest Rate Swaps [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Derivative Liability	36	46
Money Market Funds and Other [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value Disclosure	104	88
Debt Securities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Debt Securities, Available-for-sale Securities	397	416
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value Disclosure	104	88
Less amounts classified as current assets	(101)	(87)
Investments of insurance subsidiaries, noncurrent	3	1
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member] | Money Market Funds and Other [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value Disclosure	104	88
Significant Other Observable Inputs (Level 2) [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value Disclosure	397	416
Less amounts classified as current assets	(7)	(29)
Investments of insurance subsidiaries, noncurrent	390	387
Significant Other Observable Inputs (Level 2) [Member] | Interest Rate Swaps [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Derivative Liability	36	46
Significant Other Observable Inputs (Level 2) [Member] | Debt Securities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Debt Securities, Available-for-sale Securities	$ 397	$ 416

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Assets and Liabilities Measured at Fair Value - Additional Information (Detail) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Fair Value Disclosures [Abstract]
Estimated fair value of long-term debt	$ 34,872	$ 35,814
Carrying amounts of long-term debt	$ 31,301	$ 31,240

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Long-Term Debt - Schedule of Long-Term Debt (Detail) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Senior secured debt	$ 18,349	$ 18,288
Net debt issuance costs	(229)	(236)
Total debt (average life of [9.4 years, rates averaging 5.4]%)	31,072	31,004
Less amounts due within one year	234	209
Long-term debt	30,838	30,795
Senior Secured Asset-Based Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Long-term line of credit	80	0
Senior Secured Term Loan Facilities [Member]
Debt Instrument [Line Items]
Senior secured debt	3,657	3,671
Senior Secured Notes [Member]
Debt Instrument [Line Items]
Senior secured debt	13,850	13,850
Other Senior Secured Debt [Member]
Debt Instrument [Line Items]
Other senior secured debt	762	767
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes	12,952	12,952
Senior Secured Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Long-term line of credit	$ 0	$ 0

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Long-Term Debt - Schedule of Long-Term Debt (Parenthetical) (Detail)	3 Months Ended
	Mar. 31, 2021
Debt Instrument [Line Items]
Total debt average term	8 years 7 months 6 days
Total debt average rate	5.00%
Senior Secured Asset-Based Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Effective interest rate	1.40%
Senior Secured Term Loan Facilities [Member]
Debt Instrument [Line Items]
Effective interest rate	2.80%
Senior Secured Notes [Member]
Debt Instrument [Line Items]
Effective interest rate	5.10%
Other Senior Secured Debt [Member]
Debt Instrument [Line Items]
Effective interest rate	4.60%
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Effective interest rate	5.50%

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Share Repurchase Transactions and Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2021 USD ($)
Equity [Abstract]
Unrealized gains on available-for-sale securities, beginning balances	$ 25
Unrealized gains (losses) on available-for-sale securities	(9)
Unrealized gains on available-for-sale securities, ending balances	16
Foreign currency translation adjustments, beginning balances	(271)
Foreign currency translation adjustments	7
Foreign currency translation adjustments, ending balances	(264)
Defined benefit plans, beginning balances	(220)
Defined benefit plans, (income) expense reclassified into operations from other comprehensive income	5
Defined benefit plans, ending balances	(215)
Change in fair value of derivative instruments, beginning balances	(36)
Change in fair value of derivative instruments	1
Change in fair value of derivatives instruments, (income) expense reclassified into operations from other comprehensive income	7
Change in fair value of derivative instruments, ending balances	(28)
Accumulated other comprehensive income (loss), net of tax, beginning balances	(502)
Unrealized gains (losses) on available-for-sale securities, net of income taxes	(9)
Foreign currency translation adjustments	7
Change in fair value of derivative instruments, net of income tax benefit	1
Expense (income) reclassified into operations from other comprehensive income, Total	12
Accumulated other comprehensive income (loss), net of tax, ending balances	$ (491)

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Share Repurchase Transactions and Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2021 USD ($)
Equity [Abstract]
Unrealized gains (losses) on available-for-sale securities, tax benefit	$ 2
Foreign currency translation adjustments, income tax expense	1
Defined benefit plans, Expense reclassified into operations from other comprehensive income, Income tax benefits	2
Change in fair value of derivative instruments, Expense reclassified into operations from other comprehensive income, Income tax benefits	$ 2

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Share Repurchase Transactions and Other Comprehensive Loss - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended
	Mar. 31, 2021	Feb. 28, 2021	Jan. 31, 2020	Jan. 31, 2019
Repurchase of common stock, shares	8,477,000
Repurchase price of common stock, per share	$ 180.11
Board of Directors Chairman [Member]
Share repurchase program authorized amount	$ 7,274	$ 6,000	$ 4,000	$ 2,000

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Segment and Geographic Information - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2021 Hospital
Segment Reporting Information [Line Items]
Number of geographically organized groups	2
Number of owned and operated hospitals	186
Reorganization Group [Member] | National Group [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	97
Reorganization Group [Member] | American Group [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	82
Reorganization Group [Member] | Corporate and Other [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	7

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Segment and Geographic Information - Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization and Assets (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Segment Reporting Information [Line Items]
Revenues	$ 13,977	$ 12,861
Equity in earnings of affiliates	(21)	(7)
Adjusted segment EBITDA	3,052	2,200
Depreciation and amortization	697	674
Interest expense	384	428
Gains on sales of facilities	(2)	(7)
Losses on retirement of debt	0	295
Income before income taxes	1,973	810
National Group [Member]
Segment Reporting Information [Line Items]
Revenues	7,056	6,474
Equity in earnings of affiliates	(7)	1
Adjusted segment EBITDA	1,705	1,215
Depreciation and amortization	323	306
American Group [Member]
Segment Reporting Information [Line Items]
Revenues	6,291	5,744
Equity in earnings of affiliates	(12)	(9)
Adjusted segment EBITDA	1,501	1,115
Depreciation and amortization	293	287
Corporate and Other [Member]
Segment Reporting Information [Line Items]
Revenues	630	643
Equity in earnings of affiliates	(2)	1
Adjusted segment EBITDA	(154)	(130)
Depreciation and amortization	$ 81	$ 81