| QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
| TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
| (State or other jurisdiction of incorporation or organization) |
(I.R.S. Employer Identification No.) | |
| |
||
(Address of principal executive offices) |
(Zip Code) | |
| Title of each class |
Trading Symbol(s) |
Name of each exchange on which registered | ||
| |
☒ |
Accelerated filer |
☐ | |||
| Non-accelerated filer |
☐ |
Smaller reporting company |
||||
| Emerging growth company |
||||||
Class of Common Stock |
Outstanding at October 25, 2021 | |
| Voting common stock, $.01 par value |
Page of Form 10-Q |
||||||
| Part I. |
Financial Information |
|||||
| Item 1. |
Financial Statements (Unaudited): |
|||||
2 |
||||||
3 |
||||||
4 |
||||||
5 |
||||||
6 |
||||||
7 |
||||||
| Item 2. |
18 |
|||||
| Item 3. |
37 |
|||||
| Item 4. |
37 |
|||||
| Part II. |
||||||
| Item 1. |
37 |
|||||
| Item 1A. |
37 |
|||||
| Item 2. |
37 |
|||||
| Item 6. |
39 |
|||||
40 |
||||||
Quarter |
Nine Months |
|||||||||||||||
2021 |
2020 |
2021 |
2020 |
|||||||||||||
| Revenues |
$ |
$ | $ |
$ | ||||||||||||
| Salaries and benefits |
||||||||||||||||
| Supplies |
||||||||||||||||
| Other operating expenses |
||||||||||||||||
| Government stimulus income reversal |
||||||||||||||||
| Equity in earnings of affiliates |
( |
) |
( |
) | ( |
) |
( |
) | ||||||||
| Depreciation and amortization |
||||||||||||||||
| Interest expense |
||||||||||||||||
| Losses (gains) on sales of facilities |
( |
) |
( |
) | ( |
) |
||||||||||
| Losses on retirement of debt |
||||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Income before income taxes |
||||||||||||||||
| Provision for income taxes |
||||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Net income |
||||||||||||||||
| Net income attributable to noncontrolling interests |
||||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Net income attributable to HCA Healthcare, Inc. |
$ |
$ | $ |
$ | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Per share data: |
||||||||||||||||
| Basic earnings |
$ |
$ | $ |
$ | ||||||||||||
| Diluted earnings |
$ |
$ | $ |
$ | ||||||||||||
| Shares used in earnings per share calculations (in millions): |
||||||||||||||||
| Basic |
||||||||||||||||
| Diluted |
||||||||||||||||
Quarter |
Nine Months |
|||||||||||||||
2021 |
2020 |
2021 |
2020 |
|||||||||||||
| Net income |
$ |
$ | $ |
$ | ||||||||||||
| Other comprehensive income (loss) before taxes: |
||||||||||||||||
| Foreign currency translation |
( |
) |
( |
) |
( |
) | ||||||||||
| Unrealized gains (losses) on available-for-sale |
( |
) |
( |
) |
||||||||||||
| Defined benefit plans |
||||||||||||||||
| Pension costs included in salaries and benefits |
||||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Change in fair value of derivative financial instruments |
( |
) |
( |
) |
( |
) | ||||||||||
| Interest costs included in interest expense |
||||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| ( |
) | |||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Other comprehensive income (loss) before taxes |
( |
) |
( |
) | ||||||||||||
| Income taxes (benefits) related to other comprehensive income items |
( |
) |
( |
) | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Other comprehensive income (loss) |
( |
) |
( |
) | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Comprehensive income |
||||||||||||||||
| Comprehensive income attributable to noncontrolling interests |
||||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Comprehensive income attributable to HCA Healthcare, Inc. |
$ |
$ | $ |
$ | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
September 30, 2021 |
December 31, 2020 |
|||||||
| ASSETS |
||||||||
| Current assets: |
||||||||
| Cash and cash equivalents |
$ |
$ | ||||||
| Accounts receivable |
||||||||
| Inventories |
||||||||
| Other |
||||||||
| |
|
|
|
|||||
| Property and equipment, at cost |
||||||||
| Accumulated depreciation |
( |
) |
( |
) | ||||
| |
|
|
|
|||||
| Investments of insurance subsidiaries |
||||||||
| Investments in and advances to affiliates |
||||||||
| Goodwill and other intangible assets |
||||||||
| Right-of-use |
||||||||
| Other |
||||||||
| |
|
|
|
|||||
$ |
$ | |||||||
| |
|
|
|
|||||
| LIABILITIES AND STOCKHOLDERS’ EQUITY |
||||||||
| Current liabilities: |
||||||||
| Accounts payable |
$ |
$ | ||||||
| Accrued salaries |
||||||||
| Other accrued expenses |
||||||||
| Long-term debt due within one year |
||||||||
| |
|
|
|
|||||
| Long-term debt, less debt issuance costs and discounts of $ |
||||||||
| Professional liability risks |
||||||||
| Right-of-use |
||||||||
| Income taxes and other liabilities |
||||||||
| Stockholders’ equity: |
||||||||
| Common stock $ |
||||||||
| Capital in excess of par value |
||||||||
| Accumulated other comprehensive loss |
( |
) |
( |
) | ||||
| Retained (deficit) earnings |
( |
) |
||||||
| |
|
|
|
|||||
| Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. |
( |
) |
||||||
| Noncontrolling interests |
||||||||
| |
|
|
|
|||||
| |
|
|
|
|||||
$ |
$ | |||||||
| |
|
|
|
|||||
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 |
$ | |
$ | — | $ | ( |
) | $ | ( |
) | $ | $ | ( |
) | ||||||||||||||
| Comprehensive income |
( |
) | ||||||||||||||||||||||||||
| Repurchase of common stock |
( |
) | ( |
) | ( |
) | ||||||||||||||||||||||
| Share-based benefit plans |
( |
) | ( |
) | ||||||||||||||||||||||||
| Cash dividends declared ($ |
( |
) | ( |
) | ||||||||||||||||||||||||
| Distributions |
( |
) | ( |
) | ||||||||||||||||||||||||
| Other |
( |
) | ||||||||||||||||||||||||||
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||
| Balances, March 31, 2020 |
— | ( |
) | ( |
) | ( |
) | |||||||||||||||||||||
| Comprehensive income |
||||||||||||||||||||||||||||
| Share-based benefit plans |
||||||||||||||||||||||||||||
| Distributions |
( |
) | ( |
) | ||||||||||||||||||||||||
| Other |
( |
) | ( |
) | ||||||||||||||||||||||||
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||
| Balances, June 30, 2020 |
( |
) | ( |
) | ||||||||||||||||||||||||
| Comprehensive income |
||||||||||||||||||||||||||||
| Share-based benefit plans |
||||||||||||||||||||||||||||
| Distributions |
( |
) | ( |
) | ||||||||||||||||||||||||
| Other |
||||||||||||||||||||||||||||
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||
| Balances, September 30, 2020 |
( |
) | ( |
) | ||||||||||||||||||||||||
| Comprehensive income |
||||||||||||||||||||||||||||
| Share-based benefit plans |
||||||||||||||||||||||||||||
| Cash dividends declared ($ |
( |
) | ( |
) | ||||||||||||||||||||||||
| Distributions |
( |
) | ( |
) | ||||||||||||||||||||||||
| Other |
||||||||||||||||||||||||||||
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||
| Balances, December 31, 2020 |
( |
) | ||||||||||||||||||||||||||
| Comprehensive income |
||||||||||||||||||||||||||||
| Repurchase of common stock |
( |
) | ( |
) | ( |
) | ( |
) | ||||||||||||||||||||
| Share-based benefit plans |
( |
) | ( |
) | ||||||||||||||||||||||||
| Cash dividends declared ($ |
( |
) | ( |
) | ||||||||||||||||||||||||
| Distributions |
( |
) | ( |
) | ||||||||||||||||||||||||
| Other |
( |
) | ( |
) | ||||||||||||||||||||||||
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||
| Balances, March 31, 2021 |
— | ( |
) | |||||||||||||||||||||||||
| Comprehensive income |
||||||||||||||||||||||||||||
| Repurchase of common stock |
( |
) | ( |
) | ( |
) | ( |
) | ||||||||||||||||||||
| Share-based benefit plans |
||||||||||||||||||||||||||||
| Cash dividends declared ($ |
( |
) | ( |
) | ||||||||||||||||||||||||
| Distributions |
( |
) | ( |
) | ||||||||||||||||||||||||
| Other |
||||||||||||||||||||||||||||
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||
| Balances, June 30, 2021 |
— | ( |
) | ( |
) | |||||||||||||||||||||||
| Comprehensive income |
( |
) |
||||||||||||||||||||||||||
| Repurchase of common stock |
( |
) |
( |
) |
( |
) |
( |
) | ||||||||||||||||||||
| Share-based benefit plans |
||||||||||||||||||||||||||||
| Cash dividends declared ($ |
( |
) |
( |
) | ||||||||||||||||||||||||
| Distributions |
( |
) |
( |
) | ||||||||||||||||||||||||
| Other |
||||||||||||||||||||||||||||
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||
| Balances, September 30, 2021 |
$ |
$ |
— |
$ |
( |
) |
$ |
( |
) |
$ |
$ |
|||||||||||||||||
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||
2021 |
2020 |
|||||||
| Cash flows from operating activities: |
||||||||
| Net income |
$ |
$ | ||||||
| Adjustments to reconcile net income to net cash provided by operating activities: |
||||||||
| Increase (decrease) in cash from operating assets and liabilities: |
||||||||
| Accounts receivable |
( |
) |
||||||
| Inventories and other assets |
( |
) |
( |
) | ||||
| Accounts payable and accrued expenses |
||||||||
| Contract liabilities-deferred revenues |
||||||||
| Depreciation and amortization |
||||||||
| Income taxes |
( |
) | ||||||
| Losses (gains) on sales of facilities |
( |
) |
||||||
| Losses on retirement of debt |
||||||||
| Amortization of debt issuance costs and discounts |
||||||||
| Share-based compensation |
||||||||
| Other |
||||||||
| |
|
|
|
|||||
| Net cash provided by operating activities |
||||||||
| |
|
|
|
|||||
| Cash flows from investing activities: |
||||||||
| Purchase of property and equipment |
( |
) |
( |
) | ||||
| Acquisition of hospitals and health care entities |
( |
) |
( |
) | ||||
| Sales of hospitals and health care entities |
||||||||
| Change in investments |
( |
) |
( |
) | ||||
| Other |
( |
) | ||||||
| |
|
|
|
|||||
| Net cash used in investing activities |
( |
) |
( |
) | ||||
| |
|
|
|
|||||
| Cash flows from financing activities: |
||||||||
| Issuances of long-term debt |
||||||||
| Net change in revolving credit facilities |
( |
) | ||||||
| Repayment of long-term debt |
( |
) |
( |
) | ||||
| Distributions to noncontrolling interests |
( |
) |
( |
) | ||||
| Payment of debt issuance costs |
( |
) |
( |
) | ||||
| Payment of dividends |
( |
) |
( |
) | ||||
| Repurchase of common stock |
( |
) |
( |
) | ||||
| Other |
( |
) |
( |
) | ||||
| |
|
|
|
|||||
| Net cash used in financing activities |
( |
) |
( |
) | ||||
| |
|
|
|
|||||
| Effect of exchange rate changes on cash and cash equivalents |
( |
) |
( |
) | ||||
| |
|
|
|
|||||
| Change in cash and cash equivalents |
( |
) |
||||||
| Cash and cash equivalents at beginning of period |
||||||||
| |
|
|
|
|||||
| Cash and cash equivalents at end of period |
$ |
$ | ||||||
| |
|
|
|
|||||
| Interest payments |
$ |
$ | ||||||
| Income tax payments, net |
$ |
$ | ||||||
Quarter |
||||||||||||||||
2021 |
Ratio |
2020 |
Ratio |
|||||||||||||
| Medicare |
$ |
% |
$ | % | ||||||||||||
| Managed Medicare |
||||||||||||||||
| Medicaid |
||||||||||||||||
| Managed Medicaid |
||||||||||||||||
| Managed care and insurers |
||||||||||||||||
| International (managed care and insurers) |
||||||||||||||||
| Other |
||||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Revenues |
$ |
% |
$ | % | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
Nine Months |
||||||||||||||||
2021 |
Ratio |
2020 |
Ratio |
|||||||||||||
| Medicare |
$ |
% |
$ | % | ||||||||||||
| Managed Medicare |
||||||||||||||||
| Medicaid |
||||||||||||||||
| Managed Medicaid |
||||||||||||||||
| Managed care and insurers |
||||||||||||||||
| International (managed care and insurers) |
||||||||||||||||
| Other |
||||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Revenues |
$ |
% |
$ | % | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
Quarter |
Nine Months |
|||||||||||||||
2021 |
2020 |
2021 |
2020 |
|||||||||||||
| Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) |
$ |
$ | $ |
$ | ||||||||||||
| Cost-to-charges |
% |
% | % |
% | ||||||||||||
| Total uncompensated care |
$ |
$ | $ |
$ | ||||||||||||
| Multiply by the cost-to-charges |
% |
% | % |
% | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Estimated cost of total uncompensated care |
$ |
$ | $ |
$ | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
Quarter |
Nine Months |
|||||||||||||||
2021 |
2020 |
2021 |
2020 |
|||||||||||||
| Net income attributable to HCA Healthcare, Inc. |
$ |
$ | $ |
$ | ||||||||||||
| Weighted average common shares outstanding |
||||||||||||||||
| Effect of dilutive incremental shares |
||||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Shares used for diluted earnings per share |
||||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Earnings per share: |
||||||||||||||||
| Basic earnings |
$ |
$ | $ |
$ | ||||||||||||
| Diluted earnings |
$ |
$ | $ |
$ | ||||||||||||
September 30, 2021 |
||||||||||||||||
Amortized Cost |
Unrealized Amounts |
Fair Value |
||||||||||||||
Gains |
Losses |
|||||||||||||||
| Debt securities |
$ |
$ |
$ |
( |
) |
$ |
||||||||||
| Money market funds and other |
— |
— |
||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
$ |
$ |
$ |
( |
) |
||||||||||||
| |
|
|
|
|
|
|||||||||||
| Amounts classified as current assets |
( |
) | ||||||||||||||
| |
|
|||||||||||||||
| Investment carrying value |
$ |
|||||||||||||||
| |
|
|||||||||||||||
December 31, 2020 |
||||||||||||||||
Amortized Cost |
Unrealized Amounts |
Fair Value |
||||||||||||||
Gains |
Losses |
|||||||||||||||
| Debt securities |
$ | $ | $ | — | $ | |||||||||||
| Money market funds and other |
— | — | ||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| $ | $ | $ | — | |||||||||||||
| |
|
|
|
|
|
|||||||||||
| Amounts classified as current assets |
( |
) | ||||||||||||||
| |
|
|||||||||||||||
| Investment carrying value |
$ | |||||||||||||||
| |
|
|||||||||||||||
Amortized Cost |
Fair Value |
|||||||
| Due in one year or less |
$ | $ | ||||||
| Due after one year through five years |
||||||||
| Due after five years through ten years |
||||||||
| Due after ten years |
||||||||
| |
|
|
|
|||||
| $ | $ | |||||||
| |
|
|
|
|||||
Notional Amount |
Maturity Date |
Fair Value |
||||||||||
| Pay-fixed interest rate swaps |
$ | $ | ( |
) | ||||||||
| Pay-fixed interest rate swaps |
( |
) | ||||||||||
| Derivatives in Cash Flow Hedging Relationships |
Amount of Loss 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 |
$ | Interest expense | $ | |||||||||
September 30, 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 |
$ |
$ |
— |
$ |
$ |
— |
||||||||||
| Money market funds and other |
— |
— |
||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Investments of insurance subsidiaries |
— |
|||||||||||||||
| Less amounts classified as current assets |
( |
) |
( |
) |
( |
) |
— |
|||||||||
| |
|
|
|
|
|
|
|
|||||||||
$ |
$ |
$ |
$ |
— |
||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Liabilities: |
||||||||||||||||
| Interest rate swaps (Other accrued expenses) |
$ |
$ |
— |
$ |
$ |
— |
||||||||||
| Interest rate swaps (Income taxes and other liabilities) |
— |
— |
||||||||||||||
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 |
$ | $ | — | $ | $ | — | ||||||||||
| Money market funds and other |
— | — | ||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Investments of insurance subsidiaries |
— | |||||||||||||||
| Less amounts classified as current assets |
( |
) | ( |
) | ( |
) | — | |||||||||
| |
|
|
|
|
|
|
|
|||||||||
| $ | $ | $ | $ | — | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Liabilities: |
||||||||||||||||
| Interest rate swaps (Income taxes and other liabilities) |
$ | $ | — | $ | $ | — | ||||||||||
September 30, 2021 |
December 31, 2020 |
|||||||
| Senior secured asset-based revolving credit facility (effective interest rate of |
$ |
$ | ||||||
| Senior secured revolving credit facility |
||||||||
| Senior secured term loan facilities (effective interest rate of |
||||||||
| Senior secured notes (effective interest rate of |
||||||||
| Other senior secured debt (effective interest rate of |
||||||||
| |
|
|
|
|||||
| Senior secured debt |
||||||||
| Senior unsecured notes (effective interest rate of |
||||||||
| Debt issuance costs and discounts |
( |
) |
( |
) | ||||
| |
|
|
|
|||||
| Total debt (average life of |
||||||||
| Less amounts due within one year |
||||||||
| |
|
|
|
|||||
$ |
$ | |||||||
| |
|
|
|
|||||
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 |
$ | $ | ( |
) | $ | ( |
) | $ | ( |
) | $ | ( |
) | |||||||
| Unrealized losses on available-for-sale |
( |
) | ( |
) | ||||||||||||||||
| Foreign currency translation adjustments, net of $ |
( |
) | ( |
) | ||||||||||||||||
| Change in fair value of derivative instruments |
( |
) | ( |
) | ||||||||||||||||
| Expense reclassified into operations from other comprehensive income, net of $ |
||||||||||||||||||||
| |
|
|
|
|
|
|
|
|
|
|||||||||||
| Balances at September 30, 2021 |
$ | $ | ( |
) | $ | ( |
) | $ | ( |
) | $ | ( |
) | |||||||
| |
|
|
|
|
|
|
|
|
|
|||||||||||
Quarter |
Nine Months |
|||||||||||||||
2021 |
2020 |
2021 |
2020 |
|||||||||||||
| Revenues: |
||||||||||||||||
| National Group |
$ |
$ | $ |
$ | ||||||||||||
| American Group |
||||||||||||||||
| Corporate and other |
||||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
$ |
$ | $ |
$ | |||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Equity in earnings of affiliates: |
||||||||||||||||
| National Group |
$ |
( |
) |
$ | ( |
) | $ |
( |
) |
$ | ( |
) | ||||
| American Group |
( |
) |
( |
) | ( |
) |
( |
) | ||||||||
| Corporate and other |
( |
) |
( |
) | ( |
) |
||||||||||
| |
|
|
|
|
|
|
|
|||||||||
$ |
( |
) |
$ | ( |
) | $ |
( |
) |
$ | ( |
) | |||||
| |
|
|
|
|
|
|
|
|||||||||
| Adjusted segment EBITDA: |
||||||||||||||||
| National Group |
$ |
$ | $ |
$ | ||||||||||||
| American Group |
||||||||||||||||
| Corporate and other |
( |
) |
( |
) | ( |
) |
( |
) | ||||||||
| |
|
|
|
|
|
|
|
|||||||||
$ |
$ | $ |
$ | |||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Depreciation and amortization: |
||||||||||||||||
| National Group |
$ |
$ | $ |
$ | ||||||||||||
| American Group |
||||||||||||||||
| Corporate and other |
||||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
$ |
$ | $ |
$ | |||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Adjusted segment EBITDA |
$ |
$ | $ |
$ | ||||||||||||
| Depreciation and amortization |
||||||||||||||||
| Interest expense |
||||||||||||||||
| Losses (gains) on sales of facilities |
( |
) |
( |
) | ( |
) |
||||||||||
| Losses on retirement of debt |
||||||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Income before income taxes |
$ |
$ | $ |
$ | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
Quarter |
||||||||||||||||
2021 |
Ratio |
2020 |
Ratio |
|||||||||||||
| Medicare |
$ |
2,645 |
17.3 |
% |
$ | 2,603 | 19.6 | % | ||||||||
| Managed Medicare |
2,124 |
13.9 |
1,760 | 13.2 | ||||||||||||
| Medicaid |
692 |
4.5 |
445 | 3.3 | ||||||||||||
| Managed Medicaid |
813 |
5.3 |
707 | 5.3 | ||||||||||||
| Managed care and insurers |
7,998 |
52.4 |
6,752 | 50.7 | ||||||||||||
| International (managed care and insurers) |
324 |
2.1 |
307 | 2.3 | ||||||||||||
| Other |
680 |
4.5 |
737 | 5.6 | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Revenues |
$ |
15,276 |
100.0 |
% |
$ | 13,311 | 100.0 | % | ||||||||
| |
|
|
|
|
|
|
|
|||||||||
Nine Months |
||||||||||||||||
2021 |
Ratio |
2020 |
Ratio |
|||||||||||||
| Medicare |
$ |
7,816 |
17.9 |
% |
$ | 7,618 | 20.5 | % | ||||||||
| Managed Medicare |
6,281 |
14.4 |
5,074 | 13.6 | ||||||||||||
| Medicaid |
1,722 |
3.9 |
1,423 | 3.8 | ||||||||||||
| Managed Medicaid |
2,369 |
5.4 |
1,904 | 5.1 | ||||||||||||
| Managed care and insurers |
22,300 |
51.0 |
19,028 | 51.0 | ||||||||||||
| International (managed care and insurers) |
995 |
2.3 |
838 | 2.3 | ||||||||||||
| Other |
2,205 |
5.1 |
1,355 | 3.7 | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Revenues |
$ |
43,688 |
100.0 |
% |
$ | 37,240 | 100.0 | % | ||||||||
| |
|
|
|
|
|
|
|
|||||||||
Quarter |
Nine Months |
|||||||||||||||
2021 |
2020 |
2021 |
2020 |
|||||||||||||
| Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) |
$ |
12,803 |
$ | 11,170 | $ |
36,396 |
$ | 32,428 | ||||||||
| Cost-to-charges |
11.8 |
% |
12.0 | % | 11.4 |
% |
12.1 | % | ||||||||
| Total uncompensated care |
$ |
7,782 |
$ | 7,023 | $ |
22,299 |
$ | 21,625 | ||||||||
| Multiply by the cost-to-charges |
11.8 |
% |
12.0 | % | 11.4 |
% |
12.1 | % | ||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Estimated cost of total uncompensated care |
$ |
916 |
$ | 843 | $ |
2,542 |
$ | 2,617 | ||||||||
| |
|
|
|
|
|
|
|
|||||||||
Quarter |
Nine Months |
|||||||||||||||
2021 |
2020 |
2021 |
2020 |
|||||||||||||
| Medicare |
21 |
% |
25 | % | 23 |
% |
26 | % | ||||||||
| Managed Medicare |
21 |
19 | 21 |
19 | ||||||||||||
| Medicaid |
4 |
5 | 5 |
6 | ||||||||||||
| Managed Medicaid |
14 |
13 | 13 |
12 | ||||||||||||
| Managed care and insurers |
32 |
30 | 31 |
29 | ||||||||||||
| Uninsured |
8 |
8 | 7 |
8 | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
100 |
% |
100 | % | 100 |
% |
100 | % | |||||||||
| |
|
|
|
|
|
|
|
|||||||||
Quarter |
Nine Months |
|||||||||||||||
2021 |
2020 |
2021 |
2020 |
|||||||||||||
| Medicare |
22 |
% |
25 | % | 24 |
% |
27 | % | ||||||||
| Managed Medicare |
16 |
15 | 16 |
15 | ||||||||||||
| Medicaid |
7 |
5 | 6 |
5 | ||||||||||||
| Managed Medicaid |
5 |
6 | 6 |
6 | ||||||||||||
| Managed care and insurers |
50 |
49 | 48 |
47 | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
100 |
% |
100 | % | 100 |
% |
100 | % | |||||||||
| |
|
|
|
|
|
|
|
|||||||||
Quarter |
||||||||||||||||
2021 |
2020 |
|||||||||||||||
Amount |
Ratio |
Amount |
Ratio |
|||||||||||||
| Revenues |
$ |
15,276 |
100.0 |
$ | 13,311 | 100.0 | ||||||||||
| Salaries and benefits |
7,094 |
46.4 |
6,097 | 45.8 | ||||||||||||
| Supplies |
2,463 |
16.1 |
2,128 | 16.0 | ||||||||||||
| Other operating expenses |
2,530 |
16.6 |
2,251 | 16.9 | ||||||||||||
| Government stimulus income reversal |
— |
— |
822 | 6.2 | ||||||||||||
| Equity in earnings of affiliates |
(35 |
) |
(0.2 |
) |
(40 | ) | (0.3 | ) | ||||||||
| Depreciation and amortization |
716 |
4.7 |
694 | 5.2 | ||||||||||||
| Interest expense |
398 |
2.6 |
385 | 2.9 | ||||||||||||
| Gains on sales of facilities |
(1,047 |
) |
(6.9 |
) |
(14 | ) | (0.1 | ) | ||||||||
| |
|
|
|
|
|
|
|
|||||||||
12,119 |
79.3 |
12,323 | 92.6 | |||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Income before income taxes |
3,157 |
20.7 |
988 | 7.4 | ||||||||||||
| Provision for income taxes |
685 |
4.5 |
209 | 1.5 | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Net income |
2,472 |
16.2 |
779 | 5.9 | ||||||||||||
| Net income attributable to noncontrolling interests |
203 |
1.3 |
111 | 0.9 | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Net income attributable to HCA Healthcare, Inc. |
$ |
2,269 |
14.9 |
$ | 668 | 5.0 | ||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| % changes from prior year: |
||||||||||||||||
| Revenues |
14.8 |
% |
4.9 | % | ||||||||||||
| Income before income taxes |
219.6 |
0.9 | ||||||||||||||
| Net income attributable to HCA Healthcare, Inc. |
239.7 |
9.0 | ||||||||||||||
| Admissions(a) |
5.9 |
(3.9 | ) | |||||||||||||
| Equivalent admissions(b) |
8.4 |
(9.1 | ) | |||||||||||||
| Revenue per equivalent admission |
5.9 |
15.3 | ||||||||||||||
| Same facility % changes from prior year(c): |
||||||||||||||||
| Revenues |
15.0 |
4.5 | ||||||||||||||
| Admissions(a) |
6.8 |
(3.8 | ) | |||||||||||||
| Equivalent admissions(b) |
9.3 |
(9.0 | ) | |||||||||||||
| Revenue per equivalent admission |
5.2 |
14.8 | ||||||||||||||
Nine Months |
||||||||||||||||
2021 |
2020 |
|||||||||||||||
Amount |
Ratio |
Amount |
Ratio |
|||||||||||||
| Revenues |
$ |
43,688 |
100.0 |
$ | 37,240 | 100.0 | ||||||||||
| Salaries and benefits |
19,780 |
45.3 |
17,545 | 47.1 | ||||||||||||
| Supplies |
7,067 |
16.2 |
5,999 | 16.1 | ||||||||||||
| Other operating expenses |
7,424 |
17.0 |
6,825 | 18.3 | ||||||||||||
| Equity in earnings of affiliates |
(78 |
) |
(0.2 |
) |
(48 | ) | (0.1 | ) | ||||||||
| Depreciation and amortization |
2,125 |
4.8 |
2,059 | 5.6 | ||||||||||||
| Interest expense |
1,168 |
2.7 |
1,201 | 3.2 | ||||||||||||
| Losses (gains) on sales of facilities |
(1,057 |
) |
(2.4 |
) |
6 | — | ||||||||||
| Losses on retirement of debt |
12 |
— |
295 | 0.8 | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
36,441 |
83.4 |
33,882 | 91.0 | |||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Income before income taxes |
7,247 |
16.6 |
3,358 | 9.0 | ||||||||||||
| Provision for income taxes |
1,531 |
3.5 |
665 | 1.8 | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Net income |
5,716 |
13.1 |
2,693 | 7.2 | ||||||||||||
| Net income attributable to noncontrolling interests |
574 |
1.3 |
365 | 0.9 | ||||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| Net income attributable to HCA Healthcare, Inc. |
$ |
5,142 |
11.8 |
$ | 2,328 | 6.3 | ||||||||||
| |
|
|
|
|
|
|
|
|||||||||
| % changes from prior year: |
||||||||||||||||
| Revenues |
17.3 |
% |
(1.5 | )% | ||||||||||||
| Income before income taxes |
115.8 |
(7.7 | ) | |||||||||||||
| Net income attributable to HCA Healthcare, Inc. |
120.8 |
(4.4 | ) | |||||||||||||
| Admissions(a) |
5.9 |
(5.1 | ) | |||||||||||||
| Equivalent admissions(b) |
8.4 |
(9.8 | ) | |||||||||||||
| Revenue per equivalent admission |
8.2 |
9.1 | ||||||||||||||
| Same facility % changes from prior year(c): |
||||||||||||||||
| Revenues |
17.5 |
(2.1 | ) | |||||||||||||
| Admissions(a) |
6.2 |
(5.3 | ) | |||||||||||||
| Equivalent admissions(b) |
8.8 |
(9.9 | ) | |||||||||||||
| Revenue per equivalent admission |
7.9 |
8.6 | ||||||||||||||
| (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. |
| (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. |
Nine Months September 30, 2021 |
Year December 31, 2020 |
|||||||
| Revenues |
$ |
26,140 |
$ | 31,040 | ||||
| Income before income taxes |
4,578 |
4,016 | ||||||
| Net income |
3,546 |
3,172 | ||||||
| Net income attributable to Parent, Subsidiary Issuer and Subsidiary Guarantors |
3,474 |
3,091 | ||||||
| At September 30, 2021 and December 31, 2020: |
||||||||
September 30, 2021 |
December 31, 2020 |
|||||||
| Current assets |
$ |
7,821 |
$ | 7,442 | ||||
| Property and equipment, net |
15,285 |
14,939 | ||||||
| Goodwill and other intangible assets |
5,707 |
5,763 | ||||||
| Total noncurrent assets |
22,277 |
21,771 | ||||||
| Total assets |
30,098 |
29,213 | ||||||
| Current liabilities |
5,859 |
5,316 | ||||||
| Long-term debt, net |
31,597 |
30,444 | ||||||
| Intercompany balances |
3,229 |
2,090 | ||||||
| Income taxes and other liabilities |
1,841 |
1,004 | ||||||
| Total noncurrent liabilities |
37,179 |
34,035 | ||||||
| Stockholders’ deficit attributable to Parent, Subsidiary Issuer and Subsidiary Guarantors |
(13,155 |
) |
(10,247 | ) | ||||
| Noncontrolling interests |
215 |
109 | ||||||
2021 |
2020 |
|||||||
| Number of hospitals in operation at: |
||||||||
| March 31 |
186 |
186 | ||||||
| June 30 |
187 |
186 | ||||||
| September 30 |
183 |
187 | ||||||
| December 31 |
185 | |||||||
| Number of freestanding outpatient surgical centers in operation at: |
||||||||
| March 31 |
121 |
123 | ||||||
| June 30 |
122 |
122 | ||||||
| September 30 |
123 |
121 | ||||||
| December 31 |
121 | |||||||
| Licensed hospital beds at(a): |
||||||||
| March 31 |
49,561 |
49,357 | ||||||
| June 30 |
49,693 |
49,403 | ||||||
| September 30 |
48,950 |
49,473 | ||||||
| December 31 |
49,265 | |||||||
| Weighted average beds in service(b): |
||||||||
| Quarter: |
||||||||
| First |
42,363 |
42,177 | ||||||
| Second |
42,464 |
42,309 | ||||||
| Third |
42,088 |
42,426 | ||||||
| Fourth |
42,072 | |||||||
| Year |
42,246 | |||||||
2021 |
2020 |
|||||||
| Average daily census(c): |
||||||||
| Quarter: |
||||||||
| First |
29,678 |
28,822 | ||||||
| Second |
28,901 |
24,844 | ||||||
| Third |
31,144 |
28,186 | ||||||
| Fourth |
29,065 | |||||||
| Year |
27,734 | |||||||
| Admissions(d): |
||||||||
| Quarter: |
||||||||
| First |
506,380 |
528,244 | ||||||
| Second |
532,041 |
452,992 | ||||||
| Third |
536,848 |
506,756 | ||||||
| Fourth |
521,917 | |||||||
| Year |
2,009,909 | |||||||
| Equivalent admissions(e): |
||||||||
| Quarter: |
||||||||
| First |
832,489 |
889,035 | ||||||
| Second |
916,212 |
723,136 | ||||||
| Third |
905,627 |
835,576 | ||||||
| Fourth |
864,583 | |||||||
| Year |
3,312,330 | |||||||
| Average length of stay (days)(f): |
||||||||
| Quarter: |
||||||||
| First |
5.3 |
5.0 | ||||||
| Second |
4.9 |
5.0 | ||||||
| Third |
5.3 |
5.1 | ||||||
| Fourth |
5.1 | |||||||
| Year |
5.1 | |||||||
| Emergency room visits(g): |
||||||||
| Quarter: |
||||||||
| First |
1,841,778 |
2,264,707 | ||||||
| Second |
2,128,428 |
1,516,116 | ||||||
| Third |
2,338,180 |
1,813,661 | ||||||
| Fourth |
1,855,823 | |||||||
| Year |
7,450,307 | |||||||
| Outpatient surgeries(h): |
||||||||
| Quarter: |
||||||||
| First |
231,228 |
226,319 | ||||||
| Second |
262,107 |
170,911 | ||||||
| Third |
249,192 |
232,493 | ||||||
| Fourth |
252,760 | |||||||
| Year |
882,483 | |||||||
2021 |
2020 |
|||||||
| Inpatient surgeries(i): |
||||||||
| Quarter: |
||||||||
| First |
127,590 |
135,145 | ||||||
| Second |
136,460 |
118,591 | ||||||
| Third |
126,436 |
133,492 | ||||||
| Fourth |
135,157 | |||||||
| Year |
522,385 | |||||||
| Days revenues in accounts receivable(j): |
||||||||
| Quarter: |
||||||||
| First |
48 |
49 | ||||||
| Second |
48 |
50 | ||||||
| Third |
51 |
44 | ||||||
| Fourth |
45 | |||||||
| Outpatient revenues as a % of patient revenues(k): |
||||||||
| Quarter: |
||||||||
| First |
36 |
% |
37 | % | ||||
| Second |
38 |
% |
32 | % | ||||
| Third |
34 |
% |
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 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. |
| (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. |
| 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 |
||||||||||||
| July 1, 2021 through July 31, 2021 |
3,306,380 | $ | 225.33 | 3,306,380 | $ | 4,242 | ||||||||||
| August 1, 2021 through August 31, 2021 |
3,407,927 | $ | 247.73 | 3,407,927 | $ | 3,398 | ||||||||||
| September 1, 2021 through September 30, 2021 |
2,890,043 | $ | 256.08 | 2,890,043 | $ | 2,658 | ||||||||||
| |
|
|
|
|||||||||||||
| Total for third quarter 2021 |
9,604,350 | $ | 242.53 | 9,604,350 | $ | 2,658 | ||||||||||
| |
|
|
|
|||||||||||||
ITEM 6. |
EXHIBITS |
| 22 | — | |||
| 31.1 | — | |||
| 31.2 | — | |||
| 32 | — | |||
| 101 | — | The following financial information from our quarterly report on Form 10-Q for the quarter ended September 30, 2021 filed with the SEC on November 1, 2021, formatted in Inline Extensible Business Reporting Language: (i) the condensed consolidated balance sheets at September 30, 2021 and December 31, 2020, (ii) the condensed consolidated income statements for the quarters and nine months ended September 30, 2021 and 2020, (iii) the condensed consolidated comprehensive income statements for the quarters and nine months ended September 30, 2021 and 2020, (iv) the condensed consolidated statements of stockholders’ equity (deficit) for the quarters and nine months ended September 30, 2021 and 2020, (v) the condensed consolidated statements of cash flows for the nine months ended September 30, 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 September 30, 2021, formatted in Inline XBRL (included in Exhibit 101). | ||
| HCA Healthcare, Inc. | ||
| By: |
/ S / WILLIAM B. RUTHERFORD | |
| William B. Rutherford | ||
Executive Vice President and Chief Financial Officer | ||
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. |
| 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 |
| 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. | ||
| 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 | ||
| 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 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. | ||
| 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 | ||
| 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 | DAG Holdings, LLC | |
| 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. | 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. | |
| 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 | ||
| Utah Holdco, LLC | ||
| 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 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. |
| 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 |
| 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 |
| 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. |
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| 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. |
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| 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. |
| *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 |
| *Reston Hospital Center, LLC |
| *Retreat Hospital, LLC |
| Richmond Imaging Employer Corp. |
| Rio Grande Healthcare MSO, Inc. |
| *Rio Grande Regional Hospital, Inc. |
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| 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. |
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| *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 |
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| 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 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 Kentucky, LLC | ||
| Surgicare of Spotsylvania, LLC | ||
| Surgicare of St. Andrews, Inc. | ||
| Surgicare of StoneSprings, LLC | ||
| Surgicare of Stuart, Inc. |
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| 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 |
| Carolina Regional Surgery Center, Ltd. |
| Centennial Surgery Center, L.P. |
| Central Utah Surgicenter, LLC |
| Centrum Surgery Center, Ltd. |
| Chippenham Ambulatory Surgery Center, LLC |
| Clear Creek Surgery Center, LLC |
| Clear Lake Surgicare, Ltd. |
| Columbia Surgicare of Augusta, Ltd. |
| Comprehensive Digestive Surgicenter, LLC |
| 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 Colinas Surgery Center, Ltd. |
| Las Vegas Surgicare, Ltd. |
| Lincoln Surgery Center, LLC |
| Los Robles Surgicenter, LLC |
| Manatee Surgicare, Ltd. |
| Marietta Outpatient Surgery, Ltd. |
| MEC Endoscopy, LLC |
| Med City Dallas Outpatient Surgery Center, L.P. |
| Medical City Surgery Center of Alliance, LLC |
| Medical City Surgery Center of Frisco, LLC |
| Medical Plaza Ambulatory Surgery Center Associates, L.P. |
| Mt. Ogden Utah Surgical Center, LLC |
| New Port Richey Surgery Center, Ltd. |
| North Florida Regional Freestanding Surgery Center, L.P. |
| 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 Center 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 the Rockies, LLC |
| Surgical Park Center, Ltd. |
| Surgicare of St. Andrews, Ltd. |
| Surgicare of Wichita, LLC |
| Surgicenter of Kansas City, LLC |
| Tallahassee Orthopaedic Surgery Partners, Ltd. |
| Tarrant County Surgery Center, L.P. |
| University Healthcare System, L.C. |
| Urology Surgery Center of Colorado, LLC |
| Utah Surgery Center, L.P. |
| West Hills Surgical Center, Ltd. |
| West Park Surgery Center, L.P. |
48
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: November 1, 2021
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: November 1, 2021
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 September 30, 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 |
November 1, 2021
| By: |
/S/ WILLIAM B. RUTHERFORD | |
| William B. Rutherford | ||
| Executive Vice President and Chief Financial Officer |
November 1, 2021
Condensed Consolidated Income Statements - USD ($) shares in Thousands, $ in Millions |
3 Months Ended | 9 Months Ended | ||
|---|---|---|---|---|
Sep. 30, 2021 |
Sep. 30, 2020 |
Sep. 30, 2021 |
Sep. 30, 2020 |
|
| Income Statement [Abstract] | ||||
| Revenues | $ 15,276 | $ 13,311 | $ 43,688 | $ 37,240 |
| Salaries and benefits | 7,094 | 6,097 | 19,780 | 17,545 |
| Supplies | 2,463 | 2,128 | 7,067 | 5,999 |
| Other operating expenses | 2,530 | 2,251 | 7,424 | 6,825 |
| Government stimulus income reversal | 0 | 822 | 0 | 0 |
| Equity in earnings of affiliates | (35) | (40) | (78) | (48) |
| Depreciation and amortization | 716 | 694 | 2,125 | 2,059 |
| Interest expense | 398 | 385 | 1,168 | 1,201 |
| Losses (gains) on sales of facilities | (1,047) | (14) | (1,057) | 6 |
| Losses on retirement of debt | 0 | 0 | 12 | 295 |
| Total expenses including equity in earnings of affiliates | 12,119 | 12,323 | 36,441 | 33,882 |
| Income before income taxes | 3,157 | 988 | 7,247 | 3,358 |
| Provision for income taxes | 685 | 209 | 1,531 | 665 |
| Net income | 2,472 | 779 | 5,716 | 2,693 |
| Net income attributable to noncontrolling interests | 203 | 111 | 574 | 365 |
| Net income attributable to HCA Healthcare, Inc. | $ 2,269 | $ 668 | $ 5,142 | $ 2,328 |
| Per share data: | ||||
| Basic earnings | $ 7.13 | $ 1.97 | $ 15.67 | $ 6.89 |
| Diluted earnings | $ 7.00 | $ 1.95 | $ 15.43 | $ 6.79 |
| Shares used in earnings per share calculations (in millions): | ||||
| Basic | 318,072 | 338,168 | 328,048 | 338,057 |
| Diluted | 324,029 | 343,346 | 333,248 | 343,014 |
Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Millions |
Sep. 30, 2021 |
Dec. 31, 2020 |
|---|---|---|
| Statement of Financial Position [Abstract] | ||
| Debt issuance costs | $ 253 | $ 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 | 313,502,400 | 339,425,600 |
Condensed Consolidated Statements of Stockholders' Equity (Deficit) (Parenthetical) - $ / shares |
3 Months Ended | ||||
|---|---|---|---|---|---|
Sep. 30, 2021 |
Jun. 30, 2021 |
Mar. 31, 2021 |
Dec. 31, 2020 |
Mar. 31, 2020 |
|
| Statement of Stockholders' Equity [Abstract] | |||||
| Cash dividends declared, per share | $ 0.48 | $ 0.48 | $ 0.48 | $ 0.43 | $ 0.43 |
Basis of Presentation and Significant Accounting Policies |
9 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 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 September 30, 2021, these affiliates owned and operated 183 hospitals, 123 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 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 $117 million for the quarters ended September 30, 2021 and 2020, respectively, and $301 million and $289 million for the nine months ended September 30, 2021 and 2020, respectively. Operating results for the quarter and nine months ended September 30, 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. During the second quarter of 2021, our patient volumes experienced a strong rebound as the effects of the pandemic moderated and certain pandemic-related restrictions and policies were eased. During the third quarter of 2021, our patient volumes remained strong, with the exception of inpatient surgeries, and included a resurgence of COVID-19 admissions. Inpatient surgery volumes were constrained during the quarter as capacity was used to treat the surge of COVID-19 patients. 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 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 and nine months ended September 30, 2021 and 2020 are summarized in the following table (dollars in millions):
To quantify the total impact of the trends related to
The total uncompensated care amounts include Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation. |
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Acquisitions and Dispositions |
9 Months Ended |
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Sep. 30, 2021 | |
| Business Combinations [Abstract] | |
| Acquisitions and Dispositions | NOTE 2 — ACQUISITIONS AND DISPOSITIONS During the nine months ended September 30, 2021, we paid $67 million to acquire two hospital facilities, one in southern Georgia and one in Tennessee, and $91 million to acquire other nonhospital health care entities (noncontrolling interests of $111 million were recorded). We also paid $330 million and assumed certain liabilities to acquire an 80% interest (noncontrolling interests of $101 million were recorded) in a venture providing post-acute care services (home health and hospice). Purchase price amounts have been allocated to the related assets acquired and liabilities assumed based upon their respective fair values. The purchase price paid in excess of the fair value of identifiable net assets of these acquired entities aggregated $601 million for the nine months ended September 30, 2021. During the nine months ended September 30, 2020, we paid $380 million to acquire a hospital in New Hampshire and other 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 nine months ended September 30, 2021, we received proceeds of $860 million and recognized a pretax gain of $655 million related to the sale of four hospital facilities in Georgia (two facilities in northern Georgia and two facilities in southern Georgia). We received proceeds of $647 million on September 30, 2021 related to the of a hospital facility in northern Georgia, which sale was effective October 1, 2021. We also received proceeds of $473 million and recognized a pretax gain of $402 million related to sales of other health care entity investments and minor real estate assets. During the nine months ended September 30, 2020, we received proceeds of $ 68 million and recognized a net pretax loss of $ 6 million related to the of a hospital facility in Mississippi and sales of real estate and other investments. |
Income Taxes |
9 Months Ended |
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Sep. 30, 2021 | |
| Income Tax Disclosure [Abstract] | |
| Income Taxes | NOTE 3 — INCOME TAXES Our provisions for income taxes for the quarters ended September 30, 2021 and 2020 were $685 million and $209 million, respectively, and the effective tax rates were 23.2% and 23.8%, respectively. Our provisions for income taxes for the nine months ended September 30, 2021 and 2020 were $1.531 billion and $665 million, respectively, and the effective tax rates were 22.9% and 22.2%, respectively. Our provisions for income taxes included tax benefits related to settlements of employee equity awards of $96 million and $59 million for the nine months ended September 30, 2021 and 2020, respectively. Our liability for unrecognized tax benefits was $626 million, including accrued interest of $95 million, as of September 30, 2021 ($508 million and $73 million, respectively, as of December 31, 2020). Unrecognized tax benefits of $192 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 September 30, 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. |
Earnings Per Share |
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| 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 and nine months ended September 30, 2021 and 2020 (dollars and shares in millions, except per share amounts):
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Investments of Insurance Subsidiaries |
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| Investments, Debt and Equity Securities [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Investments of Insurance Subsidiaries | NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES A summary of our insurance subsidiaries’ investments at September 30, 2021 and December 31, 2020 follows (dollars in millions):
At September 30, 2021 and December 31, 2020, the investments in debt securities of our insurance subsidiaries were classified as “available-for-sale.” Scheduled maturities of investments in debt securities at September 30, 2021 were as follows (dollars in millions):
The average expected maturity of the investments in debt securities at September 30, 2021 was 5.5 years, compared to the average scheduled maturity of 9.3 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 |
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| 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 September 30, 2021 (dollars in millions):
During the next 12 months, we estimate $17 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 nine months ended September 30, 2021 (dollars in millions):
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 September 30, 2021, we have not been required to post any collateral related to these agreements. If we had breached these provisions at September 30, 2021, we would have been required to settle our obligations under the agreements at their aggregate, estimated termination value of $19 million. |
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Assets and Liabilities Measured at Fair Value |
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| Fair Value Disclosures [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Assets and Liabilities Measured at Fair Value | NOTE 7 — ASSETS AND LIABILITIES MEASURED Accounting Standards Codification 820, Fair Value Measurements and Disclosures 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. Investment Securities The investments of our insurance subsidiaries 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 September 30, 2021 and December 31, 2020, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions):
The estimated fair value of our long-term debt was $36.567 billion and $35.814 billion at September 30, 2021 and December 31, 2020, respectively, compared to carrying amounts, excluding debt issuance costs and discounts, aggregating $32.552 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 |
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| Debt Disclosure [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Long-Term Debt | NOTE 8 — LONG-TERM DEBT A summary of long-term debt at September 30, 2021 and December 31, 2020, including related interest rates at September 30, 2021, follows (dollars in millions):
During June 2021, we issued $2.350 billion aggregate principal amount of senior secured notes comprised of $850 million aggregate principal amount of % notes due 2031 and $1.500 billion aggregate principal amount of % notes due 2051 (the “June 2021 Notes”). We also amended and restated our senior secured revolving credit facility and our senior secured asset-based revolving credit facility, including increasing availability under the asset-based revolving credit facility to $4.500 billion, extending the maturity date on both facilities to June 30, 2026 and entering into a new $1.500 billion term
loan A-7 facility and a new $500 million term loan B-14 facility (the “Credit Agreement Transactions”). We used the net proceeds from the June 2021 Notes and the Credit Agreement Transactions to retire the $1.071 billion term loan A-6 facility, the $1.455 billion term loan B-12 facility and the $1.131 billion term loan B-13 facility. The pretax loss on retirement of debt was $12 million. |
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Contingencies |
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Sep. 30, 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 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 qui tam qui tam |
Share Repurchase Transactions and Other Comprehensive Loss |
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| 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 nine months ended September 30, 2021, we repurchased 29.343 million shares of our common stock at an average price of $209.35 per share through market purchases pursuant to the January 2019 authorization (which was completed during the first quarter of 2021), the January 2020 authorization (which was completed during the second quarter of 2021) and the February 2021 authorization. At September 30, 2021, we had $2.658 billion of repurchase authorization available under the February 2021 authorization. The components of accumulated other comprehensive loss are as follows (dollars in millions):
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Segment and Geographic Information |
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| 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 96 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 80 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, losses and 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 and nine months ended September 30, 2021 and 2020 are summarized in the following table (dollars in millions):
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Basis of Presentation and Significant Accounting Policies (Policies) |
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| Basis of Presentation | Basis of Presentation The accompanying unaudited condensed consolidated financial 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 $117 million for the quarters ended September 30, 2021 and 2020, respectively, and $301 million and $289 million for the nine months ended September 30, 2021 and 2020, respectively. Operating results for the quarter and nine months ended September 30, 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. During the second quarter of 2021, our patient volumes experienced a strong rebound as the effects of the pandemic moderated and certain pandemic-related restrictions and policies were eased. During the third quarter of 2021, our patient volumes remained strong, with the exception of inpatient surgeries, and included a resurgence of COVID-19 admissions. Inpatient surgery volumes were constrained during the quarter as capacity was used to treat the surge of COVID-19 patients. 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. |
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| 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 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 and nine months ended September 30, 2021 and 2020 are summarized in the following table (dollars in millions):
To quantify the total impact of the trends related to
The total uncompensated care amounts include |
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| 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) |
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| 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 and nine months ended September 30, 2021 and 2020 are summarized in the following table (dollars in millions):
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| Schedule of Estimated Cost of Uncompensated Care | A summary of the estimated cost of total uncompensated care for the quarters and nine months ended September 30, 2021 and 2020 follows (dollars in millions):
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Earnings Per Share (Tables) |
9 Months Ended | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 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 and nine months ended September 30, 2021 and 2020 (dollars and shares in millions, except per share amounts):
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Investments of Insurance Subsidiaries (Tables) |
9 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 2021 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Investments, Debt and Equity Securities [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Schedule of Investments | A summary of our insurance subsidiaries’ investments at September 30, 2021 and December 31, 2020 follows (dollars in millions):
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| Schedule of Maturities of Investments | Scheduled maturities of investments in debt securities at September 30, 2021 were as follows (dollars in millions):
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Financial Instruments (Tables) |
9 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 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 September 30, 2021 (dollars in millions):
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| 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 nine months ended September 30, 2021 (dollars in millions):
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Assets and Liabilities Measured at Fair Value (Tables) |
9 Months Ended | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 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 September 30, 2021 and December 31, 2020, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions):
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Long-Term Debt (Tables) |
9 Months Ended | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Sep. 30, 2021 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Debt Disclosure [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Schedule of Long-Term Debt | A summary of long-term debt at September 30, 2021 and December 31, 2020, including related interest rates at September 30, 2021, follows (dollars in millions):
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Share Repurchase Transactions and Other Comprehensive Loss (Tables) |
9 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 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):
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Segment and Geographic Information (Tables) |
9 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 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 and nine months ended September 30, 2021 and 2020 are summarized in the following table (dollars in millions):
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Basis of Presentation and Significant Accounting Policies - Additional Information (Detail) $ in Millions |
3 Months Ended | 9 Months Ended | ||
|---|---|---|---|---|
|
Sep. 30, 2021
USD ($)
Endoscopy_Center
Surgery_Center
State
Hospital
|
Sep. 30, 2020
USD ($)
|
Sep. 30, 2021
USD ($)
Endoscopy_Center
Surgery_Center
State
Hospital
|
Sep. 30, 2020
USD ($)
|
|
| Summary Of Significant Accounting Policies [Line Items] | ||||
| Number of owned and operated hospitals | Hospital | 183 | 183 | ||
| Number of freestanding surgery centers | Surgery_Center | 123 | 123 | ||
| Number of freestanding endoscopy centers | Endoscopy_Center | 21 | 21 | ||
| Number of facilities locations | State | 20 | 20 | ||
| General and administrative expense | $ 87 | $ 117 | $ 301 | $ 289 |
| Performance obligations for inpatient/ outpatient services satisfied period | Our performance obligations for inpatient services are generally satisfied over periodsthat 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. | |||
| Charity care amount | 3,509 | 3,160 | $ 10,135 | 9,972 |
| Estimated costs of charity care | $ 413 | $ 376 | 1,155 | 1,207 |
| Out of Network Services [Member] | ||||
| Summary Of Significant Accounting Policies [Line Items] | ||||
| Revenues | $ 33 | $ 55 | ||
| Minimum [Member] | ||||
| Summary Of Significant Accounting Policies [Line Items] | ||||
| Percentage of income of federal poverty level eligible for charity care | 400.00% | |||
Basis of Presentation and Significant Accounting Policies - Schedule of Estimated Cost of Uncompensated Care (Detail) - USD ($) $ in Millions |
3 Months Ended | 9 Months Ended | ||
|---|---|---|---|---|
Sep. 30, 2021 |
Sep. 30, 2020 |
Sep. 30, 2021 |
Sep. 30, 2020 |
|
| Accounting Policies [Abstract] | ||||
| Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) | $ 12,803 | $ 11,170 | $ 36,396 | $ 32,428 |
| Cost-to-charges ratio (patient care costs as percentage of gross patient charges) | 11.80% | 12.00% | 11.40% | 12.10% |
| Total uncompensated care | $ 7,782 | $ 7,023 | $ 22,299 | $ 21,625 |
| Multiply by the cost-to-charges ratio | 11.80% | 12.00% | 11.40% | 12.10% |
| Estimated cost of total uncompensated care | $ 916 | $ 843 | $ 2,542 | $ 2,617 |
Income Taxes - Additional Information (Detail) - USD ($) $ in Millions |
3 Months Ended | 9 Months Ended | |||
|---|---|---|---|---|---|
Sep. 30, 2021 |
Sep. 30, 2020 |
Sep. 30, 2021 |
Sep. 30, 2020 |
Dec. 31, 2020 |
|
| Income Tax Contingency [Line Items] | |||||
| Effective tax rate | 23.20% | 23.80% | 22.90% | 22.20% | |
| Provision for tax benefits related to settlement of employee awards | $ 96 | $ 59 | |||
| Provision for income taxes | $ 685 | $ 209 | 1,531 | $ 665 | |
| Liability for unrecognized tax benefits | 626 | 626 | $ 508 | ||
| Unrecognized tax benefits, accrued interest | 95 | 95 | 73 | ||
| Unrecognized tax benefits that would impact effective tax rate | $ 192 | $ 192 | $ 157 | ||
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 | 9 Months Ended | ||
|---|---|---|---|---|
Sep. 30, 2021 |
Sep. 30, 2020 |
Sep. 30, 2021 |
Sep. 30, 2020 |
|
| Earnings Per Share [Abstract] | ||||
| Net income attributable to HCA Healthcare, Inc. | $ 2,269 | $ 668 | $ 5,142 | $ 2,328 |
| Weighted average common shares outstanding | 318,072 | 338,168 | 328,048 | 338,057 |
| Effect of dilutive incremental shares | 5,957 | 5,178 | 5,200 | 4,957 |
| Shares used for diluted earnings per share | 324,029 | 343,346 | 333,248 | 343,014 |
| Basic earnings per share | $ 7.13 | $ 1.97 | $ 15.67 | $ 6.89 |
| Diluted earnings per share | $ 7.00 | $ 1.95 | $ 15.43 | $ 6.79 |
Investments of Insurance Subsidiaries - Schedule of Investments (Detail) - USD ($) $ in Millions |
Sep. 30, 2021 |
Dec. 31, 2020 |
|---|---|---|
| Debt Securities, Available-for-sale [Line Items] | ||
| Amounts classified as current assets | $ (112) | $ (116) |
| Investment carrying value | 418 | 388 |
| Amortized Cost | 510 | 472 |
| Unrealized Amounts, Gains | 21 | 32 |
| Unrealized Amounts, Losses | (1) | |
| Fair Value | 530 | 504 |
| Money Market Funds and Other [Member] | ||
| Debt Securities, Available-for-sale [Line Items] | ||
| Amortized Cost | 119 | 88 |
| Fair Value | 119 | 88 |
| Debt Securities [Member] | States and Municipalities [Member] | ||
| Debt Securities, Available-for-sale [Line Items] | ||
| Amortized Cost | 391 | 384 |
| Unrealized Amounts, Gains | 21 | 32 |
| Unrealized Amounts, Losses | (1) | |
| Fair Value | $ 411 | $ 416 |
Investments of Insurance Subsidiaries - Schedule of Maturities of Investments (Detail) $ in Millions |
Sep. 30, 2021
USD ($)
|
|---|---|
| Investments, Debt and Equity Securities [Abstract] | |
| Due in one year or less, Amortized Cost | $ 0 |
| Due after one year through five years, Amortized Cost | 134 |
| Due after five years through ten years, Amortized Cost | 177 |
| Due after ten years, Amortized Cost | 80 |
| Amortized Cost, Total | 391 |
| Due in one year or less, Fair Value | 0 |
| Due after one year through five years, Fair Value | 141 |
| Due after five years through ten years, Fair Value | 187 |
| Due after ten years, Fair Value | 83 |
| Fair Value, Total | $ 411 |
Investments of Insurance Subsidiaries - Additional Information (Detail) |
9 Months Ended |
|---|---|
Sep. 30, 2021 | |
| Investments, Debt and Equity Securities [Abstract] | |
| Available for sale securities expected maturity of debt securities | 5 years 6 months |
| Available for sale securities average scheduled maturity | 9 years 3 months 18 days |
Financial Instruments - Schedule of Interest Rate Swap Agreements Designated as Cash Flow Hedges (Detail) - Pay-Fixed Interest Rate Swaps [Member] $ in Millions |
9 Months Ended |
|---|---|
|
Sep. 30, 2021
USD ($)
| |
| Maturity Date, 2021 [Member] | |
| Derivative Instruments, Gain (Loss) [Line Items] | |
| Notional Amount | $ 2,000 |
| Fair Value | $ (7) |
| Maturity Date | 2021-12 |
| Maturity Date, 2022 [Member] | |
| Derivative Instruments, Gain (Loss) [Line Items] | |
| Notional Amount | $ 500 |
| Fair Value | $ (12) |
| Maturity Date | 2022-12 |
Financial Instruments - Additional Information (Detail) $ in Millions |
9 Months Ended |
|---|---|
|
Sep. 30, 2021
USD ($)
| |
| Derivative Instruments and Hedging Activities Disclosure [Abstract] | |
| Estimated amount reclassified from other comprehensive income and reduce interest expense | $ 17 |
| Estimated termination value | $ 19 |
Financial Instruments - Effect of Interest Rate Swaps on Results of Operations (Detail) $ in Millions |
9 Months Ended |
|---|---|
|
Sep. 30, 2021
USD ($)
| |
| Derivative Instruments, Gain (Loss) [Line Items] | |
| Amount of Loss Recognized in OCI on Derivatives, Net of Tax | $ 1 |
| Interest Rate Swaps [Member] | |
| Derivative Instruments, Gain (Loss) [Line Items] | |
| Amount of Loss 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 | $ 28 |
Assets and Liabilities Measured at Fair Value - Additional Information (Detail) - USD ($) $ in Millions |
Sep. 30, 2021 |
Dec. 31, 2020 |
|---|---|---|
| Fair Value Disclosures [Abstract] | ||
| Estimated fair value of long-term debt | $ 36,567 | $ 35,814 |
| Carrying amounts of long-term debt | $ 32,552 | $ 31,240 |
Long-Term Debt - Schedule of Long-Term Debt (Detail) - USD ($) $ in Millions |
Sep. 30, 2021 |
Dec. 31, 2020 |
|---|---|---|
| Debt Instrument [Line Items] | ||
| Senior secured debt | $ 19,600 | $ 18,288 |
| Net debt issuance costs | (253) | (236) |
| Total debt (average life of 9.5 years, rates averaging 4.9%) | 32,299 | 31,004 |
| Less amounts due within one year | 250 | 209 |
| Long-term debt | 32,049 | 30,795 |
| Senior Secured Asset-Based Revolving Credit Facility [Member] | ||
| Debt Instrument [Line Items] | ||
| Long-term line of credit | 500 | 0 |
| Senior Secured Term Loan Facilities [Member] | ||
| Debt Instrument [Line Items] | ||
| Senior secured debt | 1,980 | 3,671 |
| Senior Secured Notes [Member] | ||
| Debt Instrument [Line Items] | ||
| Senior secured debt | 16,200 | 13,850 |
| Other Senior Secured Debt [Member] | ||
| Debt Instrument [Line Items] | ||
| Other senior secured debt | 920 | 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 |
Long-Term Debt - Schedule of Long-Term Debt (Parenthetical) (Detail) |
9 Months Ended |
|---|---|
Sep. 30, 2021 | |
| Debt Instrument [Line Items] | |
| Total debt average term | 9 years 6 months |
| Total debt average rate | 4.90% |
| Senior Secured Asset-Based Revolving Credit Facility [Member] | |
| Debt Instrument [Line Items] | |
| Effective interest rate | 2.70% |
| Senior Secured Term Loan Facilities [Member] | |
| Debt Instrument [Line Items] | |
| Effective interest rate | 3.10% |
| Senior Secured Notes [Member] | |
| Debt Instrument [Line Items] | |
| Effective interest rate | 4.80% |
| Other Senior Secured Debt [Member] | |
| Debt Instrument [Line Items] | |
| Effective interest rate | 4.20% |
| Senior Unsecured Notes [Member] | |
| Debt Instrument [Line Items] | |
| Effective interest rate | 5.50% |
Share Repurchase Transactions and Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) $ in Millions |
9 Months Ended |
|---|---|
|
Sep. 30, 2021
USD ($)
| |
| Equity [Abstract] | |
| Unrealized gains (losses) on available-for-sale securities, tax benefit | $ 3 |
| Foreign currency translation adjustments, income tax benefit | 2 |
| Defined benefit plans, Expense reclassified into operations from other comprehensive income, Income tax benefits | 5 |
| Change in fair value of derivative instruments, Expense reclassified into operations from other comprehensive income, Income tax benefits | $ 6 |
Share Repurchase Transactions and Other Comprehensive Loss - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions |
9 Months Ended | |||
|---|---|---|---|---|
Sep. 30, 2021 |
Feb. 28, 2021 |
Jan. 31, 2020 |
Jan. 31, 2019 |
|
| Repurchase of common stock, shares | 29,343,000 | |||
| Repurchase price of common stock, per share | $ 209.35 | |||
| Board of Directors Chairman [Member] | ||||
| Share repurchase program authorized amount | $ 2,658 | $ 6,000 | $ 4,000 | $ 2,000 |
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 | 6 Months Ended | 9 Months Ended | ||
|---|---|---|---|---|---|
Sep. 30, 2021 |
Sep. 30, 2020 |
Jun. 30, 2021 |
Sep. 30, 2021 |
Sep. 30, 2020 |
|
| Segment Reporting Information [Line Items] | |||||
| Revenues | $ 15,276 | $ 13,311 | $ 43,688 | $ 37,240 | |
| Equity in earnings of affiliates | (35) | (40) | (78) | (48) | |
| Adjusted segment EBITDA | 3,224 | 2,053 | 9,495 | 6,919 | |
| Depreciation and amortization | 716 | 694 | 2,125 | 2,059 | |
| Interest expense | 398 | 385 | 1,168 | 1,201 | |
| Losses (gains) on sales of facilities | (1,047) | (14) | (1,057) | 6 | |
| Losses on retirement of debt | 0 | 0 | $ 12 | 12 | 295 |
| Income before income taxes | 3,157 | 988 | 7,247 | 3,358 | |
| National Group [Member] | |||||
| Segment Reporting Information [Line Items] | |||||
| Revenues | 7,787 | 6,633 | 22,143 | 18,653 | |
| Equity in earnings of affiliates | (14) | (23) | (30) | (26) | |
| Adjusted segment EBITDA | 1,780 | 1,128 | 5,330 | 3,828 | |
| Depreciation and amortization | 343 | 312 | 1,005 | 930 | |
| American Group [Member] | |||||
| Segment Reporting Information [Line Items] | |||||
| Revenues | 6,767 | 6,073 | 19,562 | 16,920 | |
| Equity in earnings of affiliates | (14) | (15) | (38) | (26) | |
| Adjusted segment EBITDA | 1,604 | 1,130 | 4,698 | 3,653 | |
| Depreciation and amortization | 295 | 286 | 884 | 868 | |
| Corporate and Other [Member] | |||||
| Segment Reporting Information [Line Items] | |||||
| Revenues | 722 | 605 | 1,983 | 1,667 | |
| Equity in earnings of affiliates | (7) | (2) | (10) | 4 | |
| Adjusted segment EBITDA | (160) | (205) | (533) | (562) | |
| Depreciation and amortization | $ 78 | $ 96 | $ 236 | $ 261 | |