☒
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ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
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☐
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TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
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Delaware
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27-3865930
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(State or Other Jurisdiction of
Incorporation or Organization)
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(I.R.S. Employer
Identification No.)
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One Park Plaza
Nashville
,
Tennessee
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37203
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(Address of Principal Executive Offices)
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(Zip Code)
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Title of Each Class
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Trading
Symbol(s)
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Name of Each Exchange
on Which Registered
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||
Common Stock
, $0.01 Par Value
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HCA
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New York Stock Exchange
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Large accelerated filer
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☒
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Accelerated filer
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☐
|
|||
Non-accelerated
filer
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☐
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Smaller reporting company
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☐
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|||
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Emerging growth company
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☐
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Page
Reference |
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Part I
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Item 1.
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3
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Item 1A.
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30
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Item 1B.
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47
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Item 2.
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4
7
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Item 3.
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48
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Item 4.
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4
8
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Part II
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Item 5.
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49
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Item 6.
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5
1
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Item 7.
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5
3
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Item 7A.
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7
3
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Item 8.
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7
3
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Item 9.
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7
3
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Item 9A.
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7
3
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Item 9B.
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7
5
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Part III
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Item 10.
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7
5
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Item 11.
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7
5
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Item 12.
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7
6
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Item 13.
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7
6
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Item 14.
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7
6
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Part IV
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Item 15.
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7
7
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Item 16.
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9
0
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9
1
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Item 1.
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Business
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• | grow our presence in existing markets; |
• | achieve industry-leading performance in clinical and satisfaction measures; |
• | recruit and employ physicians to meet the need for high quality health services; |
• | continue to leverage our scale and market positions to grow the Company; and |
• | pursue a disciplined development strategy. |
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Years Ended December 31,
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|||||||||||||||||||||||
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2019
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Ratio
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2018
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Ratio
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2017
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Ratio
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||||||||||||
Medicare
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$
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10,798
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21.0
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%
|
$ |
9,831
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21.1
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% | $ |
9,285
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21.3
|
% | ||||||||||
Managed Medicare
|
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6,452
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12.6
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5,497
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11.8
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4,680
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10.7
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||||||||||||||
Medicaid
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1,572
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3.1
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1,358
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2.9
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1,316
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3.0
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Managed Medicaid
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2,450
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4.8
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2,403
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5.1
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2,165
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5.0
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Managed care and other insurers
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26,544
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51.6
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24,467
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52.4
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23,342
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53.5
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||||||||||||||
International (managed care and other insurers)
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1,162
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2.3
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1,156
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2.5
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1,097
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2.5
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||||||||||||||
Other
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2,358
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4.6
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1,965
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4.2
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1,729
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4.0
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||||||||||||||
Revenues
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$
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51,336
|
|
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100.0
|
%
|
$ |
46,677
|
100.0
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% | $ |
43,614
|
100.0
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% | ||||||||||
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Years Ended December 31,
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2019
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2018
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2017
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2016
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2015
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||||||||||
Number of hospitals at end of period
|
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184
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179
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179
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170
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168
|
|||||||||||||
Number of freestanding outpatient surgery centers at end of period
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123
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123
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120
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118
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116
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Number of licensed beds at end of period(a)
|
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49,035
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47,199
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46,738
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44,290
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43,771
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|||||||||||||
Weighted average licensed beds(b)
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48,480
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46,857
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45,380
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44,077
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43,620
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Admissions(c)
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2,108,927
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2,003,753
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1,936,613
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1,891,831
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1,868,789
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Equivalent admissions(d)
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3,646,335
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3,420,406
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3,286,432
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3,191,519
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3,122,746
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Average length of stay (days)(e)
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4.9
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4.9
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4.9
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4.9
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4.9
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|||||||||||||
Average daily census(f)
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28,134
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26,663
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26,000
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25,340
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25,084
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|||||||||||||
Occupancy rate(g)
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58
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%
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57
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% |
57
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% |
58
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% |
58
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% | |||||||||
Emergency room visits(h)
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9,161,129
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8,764,431
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8,624,137
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8,378,340
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8,050,159
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Outpatient surgeries(i)
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1,009,947
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971,537
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941,231
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932,213
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909,386
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Inpatient surgeries(j)
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566,635
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548,220
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540,304
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537,306
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529,900
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(a) | Licensed beds are those beds for which a facility has been granted approval to operate from the applicable state licensing agency. |
(b) | Represents the average number of licensed beds, weighted based on periods owned. |
(c) | 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. |
(d) | 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 revenue and gross outpatient revenue and then dividing the resulting amount by gross inpatient revenue. The equivalent admissions computation “equates” outpatient revenue to the volume measure (admissions) used to measure inpatient volume, resulting in a general measure of combined inpatient and outpatient volume. |
(e) | Represents the average number of days admitted patients stay in our hospitals. |
(f) | Represents the average number of patients in our hospital beds each day. |
(g) | Represents the percentage of hospital licensed beds occupied by patients. Both average daily census and occupancy rate provide measures of the utilization of inpatient rooms. |
(h) | Represents the number of patients treated in our emergency rooms. |
(i) | 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. |
(j) | 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. |
Name
|
Age
|
Position(s)
|
||
Samuel N. Hazen
|
59
|
Chief Executive Officer and Director
|
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Jennifer L. Berres
|
49
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Senior Vice President and Chief Human Resource Officer
|
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Phillip G. Billington
|
52
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Senior Vice President — Internal Audit Services
|
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Jeff E. Cohen
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48
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Senior Vice President — Government Relations
|
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Michael S. Cuffe, M.D.
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54
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President — Physician Services Group
|
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Jane D. Englebright
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62
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Senior Vice President and Chief Nursing Officer
|
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Jon M. Foster
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58
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President — American Group
|
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Charles J. Hall
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66
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President — National Group
|
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A. Bruce Moore, Jr.
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59
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President — Service Line and Operations Integration
|
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Sandra L. Morgan
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57
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Senior Vice President — Provider Relations
|
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J. William B. Morrow
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49
|
Senior Vice President — Finance and Treasurer
|
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P. Martin Paslick
|
60
|
Senior Vice President and Chief Information Officer
|
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Jonathan B. Perlin, M.D.
|
58
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President — Clinical Services Group and Chief Medical Officer
|
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Deborah M. Reiner
|
58
|
Senior Vice President — Marketing and Communications
|
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William B. Rutherford
|
56
|
Executive Vice President and Chief Financial Officer
|
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Joseph A. Sowell, III
|
63
|
Senior Vice President and Chief Development Officer
|
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Kathryn A. Torres
|
56
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Senior Vice President — Payer Contracting and Alignment
|
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Robert A. Waterman
|
66
|
Senior Vice President and General Counsel
|
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Kathleen M. Whalen
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56
|
Senior Vice President and Chief Ethics and Compliance Officer
|
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Christopher F. Wyatt
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42
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Senior Vice President and Controller
|
Item 1A.
|
Risk Factors
|
• | increasing our vulnerability to downturns or adverse changes in general economic, industry or competitive conditions and adverse changes in government regulations; |
• | requiring a substantial portion of cash flows from operations to be dedicated to the payment of principal and interest on our indebtedness, therefore reducing our ability to use our cash flows to fund our operations, capital expenditures and future business opportunities; |
• | exposing us to the risk of increased interest rates to the extent that our existing unhedged borrowings are at variable rates of interest or we seek to refinance our debt in a rising rate environment; |
• | limiting our ability to make strategic acquisitions or causing us to make nonstrategic divestitures; |
• | limiting our ability to obtain additional financing for working capital, capital expenditures, share repurchases, dividends, product or service line development, debt service requirements, acquisitions and general corporate or other purposes; and |
• | limiting our ability to adjust to changing market conditions and placing us at a competitive disadvantage compared to our competitors who are less highly leveraged. |
• | incur additional indebtedness or issue certain preferred shares; |
• | pay dividends on, repurchase or make distributions in respect of our capital stock or make other restricted payments; |
• | make certain investments; |
• | sell or transfer assets; |
• | create liens; |
• | consolidate, merge, sell or otherwise dispose of all or substantially all of our assets; and |
• | enter into certain transactions with our affiliates. |
• | accounting and financial reporting; |
• | billing and collecting accounts; |
• | coding and compliance; |
• | clinical systems and medical devices; |
• | medical records and document storage; |
• | inventory management; |
• | negotiating, pricing and administering managed care contracts and supply contracts; and |
• | monitoring quality of care and collecting data on quality measures necessary for full Medicare payment updates. |
• | billing and coding for services and properly handling overpayments; |
• | appropriateness and classification of level of care provided, including proper classification of inpatient admissions, observation services and outpatient care; |
• | relationships with physicians and other referral sources and referral recipients; |
• | necessity and adequacy of medical care; |
• | quality of medical equipment and services; |
• | qualifications of medical and support personnel; |
• | confidentiality, maintenance, data breach, identity theft and security issues associated with health-related and personal information and medical records; |
• | screening, stabilization and transfer of individuals who have emergency medical conditions; |
• | licensure, certification and enrollment with government programs; |
• | hospital rate or budget review; |
• | debt collection, limits on balance billing and billing for out of network services; |
• | communications with patients and consumers; |
• | preparing and filing of cost reports; |
• | operating policies and procedures; |
• | activities regarding competitors; |
• | addition of facilities and services; and |
• | environmental protection. |
Item 1B.
|
Unresolved Staff Comments
|
Item 2.
|
Properties
|
State
|
Hospitals
|
|
Beds
|
|
||||
Alaska
|
1
|
250
|
||||||
California
|
5
|
1,858
|
||||||
Colorado
|
7
|
2,411
|
||||||
Florida
|
45
|
12,410
|
||||||
Georgia
|
9
|
2,469
|
||||||
Idaho
|
2
|
468
|
||||||
Indiana
|
1
|
278
|
||||||
Kansas
|
4
|
1,374
|
||||||
Kentucky
|
2
|
384
|
||||||
Louisiana
|
3
|
914
|
||||||
Mississippi
|
1
|
130
|
||||||
Missouri
|
5
|
1,058
|
||||||
Nevada
|
3
|
1,421
|
||||||
New Hampshire
|
2
|
306
|
||||||
North Carolina
|
7
|
1,181
|
||||||
South Carolina
|
3
|
949
|
||||||
Tennessee
|
13
|
2,576
|
||||||
Texas
|
46
|
13,395
|
||||||
Utah
|
8
|
1,011
|
||||||
Virginia
|
11
|
3,300
|
||||||
International
|
|
|
|
|
||||
England
|
6
|
892
|
||||||
|
184
|
49,035
|
||||||
Item 3.
|
Legal Proceedings
|
Item 4.
|
Mine Safety Disclosures
|
Item 5.
|
Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
|
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 |
|
||||||||
October 1, 2019 through October 31, 2019
|
898,323
|
$ |
120.23
|
898,323
|
$ |
1,405
|
||||||||||
November 1, 2019 through November 30, 2019
|
585,739
|
$ |
136.44
|
585,739
|
$ |
1,325
|
||||||||||
December 1, 2019 through December 31, 2019
|
585,429
|
$ |
143.49
|
585,429
|
$ |
1,241
|
||||||||||
Total for Fourth Quarter 2019
|
2,069,491
|
$ |
131.40
|
2,069,491
|
$ |
1,241
|
||||||||||
|
12/31/2014
|
|
12/31/2015
|
|
12/31/2016
|
|
12/31/2017
|
|
12/31/2018
|
|
12/31/2019
|
|
||||||||||||
HCA Healthcare, Inc.
|
$
|
100.00
|
|
$
|
92.15
|
|
$
|
100.86
|
|
$
|
119.69
|
|
$
|
171.61
|
|
$
|
206.36
|
|
||||||
S&P 500
|
|
100.00
|
|
|
101.38
|
|
|
113.51
|
|
|
138.29
|
|
|
132.23
|
|
|
173.86
|
|
||||||
S&P Health Care
|
|
100.00
|
|
|
106.89
|
|
|
104.01
|
|
|
126.98
|
|
|
135.19
|
|
|
163.34
|
|
Item 6.
|
Selected Financial Data
|
|
2019
|
|
2018
|
|
2017
|
|
2016
|
|
2015
|
|
||||||||||
Summary of Operations:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Revenues
|
$
|
51,336
|
|
$ |
46,677
|
$ |
43,614
|
$ |
41,490
|
$ |
39,678
|
|||||||||
Salaries and benefits
|
|
23,560
|
|
21,425
|
20,059
|
18,897
|
18,115
|
|||||||||||||
Supplies
|
|
8,481
|
|
7,724
|
7,316
|
6,933
|
6,638
|
|||||||||||||
Other operating expenses
|
|
9,481
|
|
8,608
|
8,051
|
7,496
|
7,056
|
|||||||||||||
Equity in earnings of affiliates
|
|
(43
|
)
|
(29
|
) |
(45
|
) |
(54
|
) |
(46
|
) | |||||||||
Depreciation and amortization
|
|
2,596
|
|
2,278
|
2,131
|
1,966
|
1,904
|
|||||||||||||
Interest expense
|
|
1,824
|
|
1,755
|
1,690
|
1,707
|
1,665
|
|||||||||||||
Losses (gains) on sales of facilities
|
|
(18
|
)
|
(428
|
) |
(8
|
) |
(23
|
) |
5
|
||||||||||
Losses on retirement of debt
|
|
211
|
|
9
|
39
|
4
|
135
|
|||||||||||||
Legal claim (benefits) costs
|
|
—
|
|
—
|
—
|
(246
|
) |
249
|
||||||||||||
|
|
46,092
|
|
41,342
|
39,233
|
36,680
|
35,721
|
|||||||||||||
Income before income taxes
|
|
5,244
|
|
5,335
|
4,381
|
4,810
|
3,957
|
|||||||||||||
Provision for income taxes
|
|
1,099
|
|
946
|
1,638
|
1,378
|
1,261
|
|||||||||||||
Net income
|
|
4,145
|
|
4,389
|
2,743
|
3,432
|
2,696
|
|||||||||||||
Net income attributable to noncontrolling interests
|
|
640
|
|
602
|
527
|
542
|
567
|
|||||||||||||
Net income attributable to HCA Healthcare, Inc.
|
$
|
3,505
|
|
$ |
3,787
|
$ |
2,216
|
$ |
2,890
|
$ |
2,129
|
|||||||||
Per common share data:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Basic earnings per share
|
$
|
10.27
|
|
$ |
10.90
|
$ |
6.12
|
$ |
7.53
|
$ |
5.14
|
|||||||||
Diluted earnings per share
|
$
|
10.07
|
|
$ |
10.66
|
$ |
5.95
|
$ |
7.30
|
$ |
4.99
|
|||||||||
Cash dividends declared per share
|
$
|
1.60
|
|
$ |
1.40
|
—
|
—
|
—
|
||||||||||||
Financial Position:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Assets
|
$
|
45,058
|
|
$ |
39,207
|
$ |
36,593
|
$ |
33,758
|
$ |
32,744
|
|||||||||
Working capital
|
|
3,439
|
|
2,644
|
3,819
|
3,252
|
3,716
|
|||||||||||||
Long-term debt, net, including amounts due within one year
|
|
33,722
|
|
32,821
|
33,058
|
31,376
|
30,488
|
|||||||||||||
Noncontrolling interests
|
|
2,243
|
|
2,032
|
1,811
|
1,669
|
1,553
|
|||||||||||||
Stockholders’ deficit
|
|
(565
|
)
|
(2,918
|
) |
(4,995
|
) |
(5,633
|
) |
(6,046
|
) | |||||||||
Cash Flow Data:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Cash provided by operating activities
|
$
|
7,602
|
|
$ |
6,761
|
$ |
5,426
|
$ |
5,653
|
$ |
4,734
|
|||||||||
Cash used in investing activities
|
|
(5,720
|
)
|
(3,901
|
) |
(4,279
|
) |
(3,240
|
) |
(2,583
|
) | |||||||||
Purchase of property and equipment
|
|
(4,158
|
)
|
(3,573
|
) |
(3,015
|
) |
(2,760
|
) |
(2,375
|
) | |||||||||
Cash used in financing activities
|
|
(1,771
|
)
|
(3,075
|
) |
(1,061
|
) |
(2,508
|
) |
(1,976
|
) |
|
2019
|
|
2018
|
|
2017
|
|
2016
|
|
2015
|
|
||||||||||
Operating Data:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Number of hospitals at end of period
|
|
184
|
|
179
|
179
|
170
|
168
|
|||||||||||||
Number of freestanding outpatient surgical centers at end of period
|
|
123
|
|
123
|
120
|
118
|
116
|
|||||||||||||
Number of licensed beds at end of period(a)
|
|
49,035
|
|
47,199
|
46,738
|
44,290
|
43,771
|
|||||||||||||
Weighted average licensed beds(b)
|
|
48,480
|
|
46,857
|
45,380
|
44,077
|
43,620
|
|||||||||||||
Admissions(c)
|
|
2,108,927
|
|
2,003,753
|
1,936,613
|
1,891,831
|
1,868,789
|
|||||||||||||
Equivalent admissions(d)
|
|
3,646,335
|
|
3,420,406
|
3,286,432
|
3,191,519
|
3,122,746
|
|||||||||||||
Average length of stay (days)(e)
|
|
4.9
|
|
4.9
|
4.9
|
4.9
|
4.9
|
|||||||||||||
Average daily census(f)
|
|
28,134
|
|
26,663
|
26,000
|
25,340
|
25,084
|
|||||||||||||
Occupancy(g)
|
|
58
|
%
|
57
|
% |
57
|
% |
58
|
% |
58
|
% | |||||||||
Emergency room visits(h)
|
|
9,161,129
|
|
8,764,431
|
8,624,137
|
8,378,340
|
8,050,159
|
|||||||||||||
Outpatient surgeries(i)
|
|
1,009,947
|
|
971,537
|
941,231
|
932,213
|
909,386
|
|||||||||||||
Inpatient surgeries(j)
|
|
566,635
|
|
548,220
|
540,304
|
537,306
|
529,900
|
|||||||||||||
Days revenues in accounts receivable(k)
|
|
50
|
|
51
|
52
|
50
|
53
|
|||||||||||||
Outpatient revenues as a % of patient revenues(l)
|
|
39
|
%
|
38
|
% |
38
|
% |
38
|
% |
40
|
% |
(a) | Licensed beds are those beds for which a facility has been granted approval to operate from the applicable state licensing agency. |
(b) | Represents the average number of licensed beds, weighted based on periods owned. |
(c) | 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. |
(d) | 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 revenue and gross outpatient revenue and then dividing the resulting amount by gross inpatient revenue. The equivalent admissions computation “equates” outpatient revenue to the volume measure (admissions) used to measure inpatient volume, resulting in a general measure of combined inpatient and outpatient volume. |
(e) | Represents the average number of days admitted patients stay in our hospitals. |
(f) | Represents the average number of patients in our hospital beds each day. |
(g) | Represents the percentage of hospital licensed beds occupied by patients. Both average daily census and occupancy rate provide measures of the utilization of inpatient rooms. |
(h) | Represents the number of patients treated in our emergency rooms. |
(i) | 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. |
(j) | 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. |
(k) | Revenues per day is calculated by dividing the revenues for the fourth quarter of each year by the days in the quarter. Days revenues in accounts receivable is then calculated as accounts receivable at the end of the period divided by revenues per day. |
(l) | Represents the percentage of patient revenues related to patients who are not admitted to our hospitals. |
Item 7.
|
Management’s Discussion and Analysis of Financial Condition and Results of Operations
|
|
2019
|
|
2018
|
|
2017
|
|
||||||
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)
|
$
|
44,118
|
|
$ |
40,035
|
$ |
37,557
|
|||||
Cost-to-charges
ratio (patient care costs as percentage of gross patient charges)
|
|
12.0
|
%
|
12.4
|
% |
12.9
|
% | |||||
Total uncompensated care
|
$
|
31,105
|
|
$ |
26,757
|
$ |
23,420
|
|||||
Multiply by the
cost-to-charges
ratio
|
|
12.0
|
%
|
12.4
|
% |
12.9
|
% | |||||
Estimated cost of total uncompensated care
|
$
|
3,733
|
|
$ |
3,318
|
$ |
3,021
|
|||||
|
2019
|
|
2018
|
|
2017
|
|
||||||
Net reserves for professional liability claims, January 1
|
$
|
1,692
|
|
$ |
1,603
|
$ |
1,494
|
|||||
Provision for current year claims
|
|
499
|
|
486
|
467
|
|||||||
Favorable development related to prior years’ claims
|
|
(2
|
)
|
(39
|
) |
(1
|
) | |||||
Total provision
|
|
497
|
|
447
|
466
|
|||||||
Payments for current year claims
|
|
8
|
|
3
|
7
|
|||||||
Payments for prior years’ claims
|
|
400
|
|
355
|
350
|
|||||||
Total claim payments
|
|
408
|
|
358
|
357
|
|||||||
Net reserves for professional liability claims, December 31
|
$
|
1,781
|
|
$ |
1,692
|
$ |
1,603
|
|||||
|
Years Ended December 31,
|
|||||||||||
|
2019
|
|
2018
|
|
2017
|
|
||||||
Medicare
|
|
29
|
%
|
30
|
% |
30
|
% | |||||
Managed Medicare
|
|
18
|
|
17
|
16
|
|||||||
Medicaid
|
|
5
|
|
5
|
6
|
|||||||
Managed Medicaid
|
|
12
|
|
12
|
12
|
|||||||
Managed care and insurers
|
|
28
|
|
28
|
28
|
|||||||
Uninsured
|
|
8
|
|
8
|
8
|
|||||||
|
|
100
|
%
|
100
|
% |
100
|
% | |||||
|
Years Ended December 31,
|
|||||||||||
|
2019
|
|
2018
|
|
2017
|
|
||||||
Medicare
|
|
28
|
%
|
28
|
% |
28
|
% | |||||
Managed Medicare
|
|
15
|
|
14
|
13
|
|||||||
Medicaid
|
|
5
|
|
4
|
5
|
|||||||
Managed Medicaid
|
|
5
|
|
6
|
5
|
|||||||
Managed care and insurers
|
|
47
|
|
48
|
49
|
|||||||
|
|
100
|
%
|
100
|
% |
100
|
% | |||||
|
2019
|
2018
|
2017
|
|||||||||||||||||||||
|
Amount
|
|
Ratio
|
|
Amount
|
|
Ratio
|
|
Amount
|
|
Ratio
|
|
||||||||||||
Revenues
|
$
|
51,336
|
|
|
100.0
|
|
$ |
46,677
|
100.0
|
$ |
43,614
|
100.0
|
||||||||||||
Salaries and benefits
|
|
23,560
|
|
|
45.9
|
|
21,425
|
45.9
|
20,059
|
46.0
|
||||||||||||||
Supplies
|
|
8,481
|
|
|
16.5
|
|
7,724
|
16.5
|
7,316
|
16.8
|
||||||||||||||
Other operating expenses
|
|
9,481
|
|
|
18.5
|
|
8,608
|
18.5
|
8,051
|
18.4
|
||||||||||||||
Equity in earnings of affiliates
|
|
(43
|
)
|
|
(0.1
|
)
|
(29
|
) |
(0.1
|
) |
(45
|
) |
(0.1
|
) | ||||||||||
Depreciation and amortization
|
|
2,596
|
|
|
5.0
|
|
2,278
|
4.9
|
2,131
|
4.9
|
||||||||||||||
Interest expense
|
|
1,824
|
|
|
3.6
|
|
1,755
|
3.8
|
1,690
|
3.9
|
||||||||||||||
Gain on sales of facilities
|
|
(18
|
)
|
|
—
|
|
(428
|
) |
(0.9
|
) |
(8
|
) |
—
|
|||||||||||
Losses on retirement of debt
|
|
211
|
|
|
0.4
|
|
9
|
—
|
39
|
0.1
|
||||||||||||||
|
|
46,092
|
|
|
89.8
|
|
41,342
|
88.6
|
39,233
|
90.0
|
||||||||||||||
Income before income taxes
|
|
5,244
|
|
|
10.2
|
|
5,335
|
11.4
|
4,381
|
10.0
|
||||||||||||||
Provision for income taxes
|
|
1,099
|
|
|
2.1
|
|
946
|
2.0
|
1,638
|
3.7
|
||||||||||||||
Net income
|
|
4,145
|
|
|
8.1
|
|
4,389
|
9.4
|
2,743
|
6.3
|
||||||||||||||
Net income attributable to noncontrolling interests
|
|
640
|
|
|
1.3
|
|
602
|
1.3
|
527
|
1.2
|
||||||||||||||
Net income attributable to HCA Healthcare, Inc.
|
$
|
3,505
|
|
|
6.8
|
|
$ |
3,787
|
8.1
|
$ |
2,216
|
5.1
|
||||||||||||
% changes from prior year:
|
|
|
|
|
|
|
|
|
||||||||||||||||
Revenues
|
|
10.0
|
%
|
|
7.0
|
% |
|
5.1
|
% |
|
||||||||||||||
Income before income taxes
|
|
(1.7
|
)
|
|
21.8
|
|
(8.9
|
) |
|
|||||||||||||||
Net income attributable to HCA Healthcare, Inc.
|
|
(7.4
|
)
|
|
70.9
|
|
(23.3
|
) |
|
|||||||||||||||
Admissions(a)
|
|
5.2
|
|
|
3.5
|
|
2.4
|
|
||||||||||||||||
Equivalent admissions(b)
|
|
6.6
|
|
|
4.1
|
|
3.0
|
|
||||||||||||||||
Revenue per equivalent admission
|
|
3.2
|
|
|
2.8
|
|
2.1
|
|
||||||||||||||||
Same facility % changes from prior year(c):
|
|
|
|
|
|
|
|
|
||||||||||||||||
Revenues
|
|
5.9
|
|
|
6.5
|
|
3.8
|
|
||||||||||||||||
Admissions(a)
|
|
2.8
|
|
|
2.5
|
|
1.1
|
|
||||||||||||||||
Equivalent admissions(b)
|
|
3.5
|
|
|
2.5
|
|
1.5
|
|
||||||||||||||||
Revenue per equivalent admission
|
|
2.3
|
|
|
3.9
|
|
2.2
|
|
(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 revenue and gross outpatient revenue and then dividing the resulting amount by gross inpatient revenue. The equivalent admissions computation “equates” outpatient revenue 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 that were either acquired, divested or removed from service during the current and prior year. |
|
Payments Due by Period
|
|||||||||||||||||||
Contractual Obligations(a)
|
Total
|
|
Current
|
|
2-3
Years
|
|
4-5
Years
|
|
After 5 Years
|
|
||||||||||
Long-term debt including interest, excluding the senior secured credit facilities(b)
|
$ |
42,756
|
$ |
1,667
|
$ |
6,061
|
$ |
7,227
|
$ |
27,801
|
||||||||||
Loans outstanding under the senior secured credit facilities, including interest(b)
|
7,132
|
266
|
3,031
|
1,284
|
2,551
|
|||||||||||||||
Professional liability risks(c)
|
1,827
|
457
|
774
|
399
|
197
|
|||||||||||||||
Right-of-use operating lease obligations
|
2,530
|
411
|
635
|
410
|
1,074
|
|||||||||||||||
Other obligations(d)
|
25
|
22
|
2
|
1
|
—
|
|||||||||||||||
Total contractual obligations
|
$ |
54,270
|
$ |
2,823
|
$ |
10,503
|
$ |
9,321
|
$ |
31,623
|
||||||||||
|
Commitment Expiration by Period
|
|||||||||||||||||||
Other Commercial Commitments Not Recorded on the
Consolidated Balance Sheet |
Total
|
|
Current
|
|
2-3
Years
|
|
4-5
Years
|
|
After 5 Years
|
|
||||||||||
Surety bonds(e)
|
$ |
60
|
$ |
59
|
$ |
1
|
$ |
—
|
$ |
—
|
||||||||||
Letters of credit(e)
|
33
|
18
|
15
|
—
|
—
|
|||||||||||||||
Physician commitments(f)
|
37
|
30
|
7
|
—
|
—
|
|||||||||||||||
Total commercial commitments
|
$ |
130
|
$ |
107
|
$ |
23
|
$ |
—
|
$ |
—
|
||||||||||
(a) | We have not included obligations related to unrecognized tax benefits of $550 million at December 31, 2019, as we cannot reasonably estimate the timing or amounts of cash payments, if any, at this time. |
(b) | Estimates of interest payments assume that interest rates and borrowing spreads at December 31, 2019, remain constant during the period presented. |
(c) | The estimation of the timing of payments for professional liability risks beyond a year can vary significantly. The time period required to resolve these claims can vary depending upon the jurisdiction and whether the claim is settled or litigated. |
(d) | Amounts include physician commitments that are recorded in our consolidated balance sheet. Amounts also include future other obligations that are not recorded in our consolidated balance sheet. |
(e) | Amounts relate primarily to instances in which we have agreed to indemnify various commercial insurers and lenders who have provided surety bonds and letters of credit to cover damages for legal cases which were awarded to plaintiffs by the courts, Medicaid provider bonds, educational administrative bonds and utility and construction deposits. |
(f) | In consideration for physicians relocating to the communities in which our hospitals are located and agreeing to engage in private practice for the benefit of the respective communities, we make advances to physicians to assist in establishing the physicians’ practices. The actual amount of these commitments to be advanced often depends upon the financial results of the physicians’ private practice during the recruitment agreement payment period. The physician commitments reflected were based on our maximum exposure on effective agreements at December 31, 2019. |
Item 7A.
|
Quantitative and Qualitative Disclosures about Market Risk
|
Item 8.
|
Financial Statements and Supplementary Data
|
Item 9.
|
Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
|
Item 9A.
|
Controls and Procedures
|
Item 9B.
|
Other Information
|
Item 10.
|
Directors, Executive Officers and Corporate Governance
|
Item 11.
|
Executive Compensation
|
Item 12.
|
Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
|
|
(a)
|
|
(b)
|
|
(c)
|
|
||||||
|
Number of securities
to be issued upon exercise of outstanding options, warrants and rights |
|
Weighted-average
exercise price of outstanding options, warrants and rights |
|
Number of securities remaining
available for future issuance under equity compensation plans (excluding securities reflected in column(a)) |
|
||||||
Equity compensation plans approved by security holders
|
16.849
|
(1) | $ |
71.79
|
(1) |
27.211
|
(2) | |||||
Equity compensation plans not approved by security holders
|
—
|
—
|
—
|
|||||||||
Total
|
16.849
|
$ |
71.79
|
27.211
|
||||||||
(1) | Includes 2.620 million restricted share units which vest solely based upon continued employment over a specific period of time and 3.035 million performance share units which vest based upon continued employment over a specific period of time and the achievement of predetermined financial targets over time. The performance share units reported reflect the number of performance share units that would vest upon achievement of target performance; the number of performance share units that vest can vary from zero (for actual performance less than 90% of target for 2019 grants and 80% of target for 2018 and prior grants) to two times the units granted (for actual performance of 110% or more of target for 2019 grants and 120% or more of target for 2018 and prior grants). The weighted average exercise price does not take these restricted share units and performance share units into account. |
(2) | Includes 20.328 million shares available for future grants under the 2006 Stock Incentive Plan for Key Employees of HCA Holdings, Inc. and its Affiliates, as Amended and Restated, and 6.883 million shares of common stock reserved for future issuance under the HCA Holdings, Inc. Employee Stock Purchase Plan. |
* | For additional information concerning our equity compensation plans, see the discussion in Note 2 — Share-Based Compensation in the notes to the consolidated financial statements. |
Item 13.
|
Certain Relationships and Related Transactions, and Director Independence
|
Item 14.
|
Principal Accountant Fees and Services
|
Item 15.
|
Exhibits and Financial Statement Schedules
|
2.1
|
—
|
|||||
2.2
|
—
|
|||||
3.1
|
—
|
|||||
3.2
|
—
|
|||||
4.1
|
—
|
|||||
4.2
|
—
|
|||||
4.3
|
—
|
|||||
4.4
|
—
|
|||||
4.5(a)
|
—
|
4.9(b)
|
—
|
|||||
4.9(c)
|
—
|
|||||
4.10(a)
|
—
|
|||||
4.10(b)
|
—
|
|||||
4.10(c)
|
—
|
|||||
4.10(d)
|
—
|
|||||
4.10(e)
|
—
|
|||||
4.10(f)
|
—
|
|||||
4.10(g)
|
—
|
|||||
4.10(h)
|
—
|
4.10(i)
|
—
|
|||||
4.11
|
—
|
|||||
4.12
|
—
|
|||||
4.13
|
—
|
|||||
4.14(a)
|
—
|
|||||
4.14(b)
|
—
|
|||||
4.14(c)
|
—
|
|||||
4.14(d)
|
—
|
|||||
4.14(e)
|
—
|
|||||
4.15
|
—
|
|||||
4.16
|
—
|
|||||
4.17
|
—
|
|||||
4.18
|
—
|
|||||
4.19
|
—
|
|||||
4.20
|
—
|
4.21
|
—
|
|||||
4.22
|
—
|
|||||
4.23
|
—
|
|||||
4.24
|
—
|
|||||
4.25
|
—
|
|||||
4.26
|
—
|
|||||
4.27
|
—
|
|||||
4.28(a)
|
—
|
|||||
4.28(b)
|
—
|
|||||
4.28(c)
|
—
|
|||||
4.29
|
—
|
|||||
4.30
|
—
|
|||||
4.31
|
—
|
|||||
4.32
|
—
|
|||||
4.33
|
—
|
4.47
|
—
|
|||||
4.48
|
—
|
|||||
4.49
|
—
|
|||||
4.50
|
—
|
|||||
4.51
|
—
|
|||||
4.52
|
—
|
|||||
4.53
|
—
|
|||||
4.54
|
—
|
|||||
4.55
|
—
|
|||||
4.56
|
—
|
|||||
4.57
|
—
|
|||||
4.58
|
—
|
|||||
4.59
|
—
|
|||||
4.60
|
—
|
4.61
|
—
|
|||||
4.62
|
—
|
|||||
4.63
|
—
|
|||||
4.64
|
—
|
|||||
4.65
|
—
|
|||||
4.66
|
—
|
|||||
4.67
|
—
|
|||||
4.68
|
—
|
|||||
4.69
|
—
|
|||||
10.1
|
—
|
|||||
10.2(a)
|
—
|
|||||
10.2(b)
|
—
|
|||||
10.2(c)
|
—
|
|||||
10.3(a)
|
—
|
10.3(b)
|
—
|
|||||
10.4
|
—
|
|||||
10.5(a)
|
—
|
|||||
10.5(b)
|
—
|
|||||
10.6
|
—
|
|||||
10.7
|
—
|
|||||
10.8
|
—
|
|||||
10.9(a)
|
—
|
|||||
10.9(b)
|
—
|
|||||
10.9(c)
|
—
|
|||||
10.9(d)
|
—
|
|||||
10.9(e)
|
—
|
|||||
10.9(f)
|
—
|
|||||
10.9(g)
|
—
|
10.9(h)
|
—
|
|||||
10.9(i)
|
—
|
|||||
10.10
|
—
|
|||||
10.11
|
—
|
|||||
10.12
|
—
|
|||||
10.13
|
—
|
|||||
10.14
|
—
|
|||||
10.15
|
—
|
|||||
10.16
|
—
|
|||||
10.17
|
—
|
|||||
10.18
|
—
|
|||||
10.19
|
—
|
|||||
10.20
|
—
|
10.21
|
—
|
|||||
10.22
|
—
|
|||||
10.23
|
—
|
|||||
10.24
|
—
|
|||||
10.25
|
—
|
|||||
10.26
|
—
|
|||||
10.27
|
—
|
|||||
10.28
|
—
|
|||||
10.29
|
—
|
|||||
10.30
|
—
|
|||||
10.31
|
—
|
|||||
10.32
|
—
|
|||||
10.33
|
—
|
|||||
21
|
—
|
23
|
—
|
|||||
31.1
|
—
|
|||||
31.2
|
—
|
|||||
32
|
—
|
|||||
101
|
—
|
The following financial information from our annual report on Form
10-K
for the year ended December 31, 2019, filed with the SEC on February 20, 2020, formatted in Extensible Business Reporting Language (XBRL): (i) the consolidated balance sheets at December 31, 2019 and 2018, (ii) the consolidated income statements for the years ended December 31, 2019, 2018 and 2017, (iii) the consolidated comprehensive income statements for the years ended December 31, 2019, 2018 and 2017, (iv) the consolidated statements of stockholders’ deficit for the years ended December 31, 2019, 2018 and 2017, (v) the consolidated statements of cash flows for the years ended December 31, 2019, 2018 and 2017, and (vi) the notes to consolidated financial statements.
|
||||
104
|
—
|
The cover page from the Company’s Annual Report on Form
10-K
for the year ended December 31, 2019, formatted in Inline XBRL (included in Exhibit 101).
|
* | Management compensatory plan or arrangement. |
Item 16.
|
Form 10-K Summary
|
HCA HEALTHCARE, INC.
|
||
By:
|
/s/
Samuel N. Hazen
|
|
|
Samuel N. Hazen
Chief Executive Officer
|
|
Signature
|
Title
|
Date
|
||
/s/
Samuel N. Hazen
Samuel N. Hazen
|
Chief Executive Officer and Director
(Principal Executive Officer)
|
February 20, 2020
|
||
/s/
William B. Rutherford
William B. Rutherford
|
Executive Vice President and
Chief Financial Officer
(Principal Financial Officer and
Principal Accounting Officer)
|
February 20, 2020
|
||
/s/
Thomas F. Frist III
Thomas F. Frist III
|
Chairman and Director
|
February 20, 2020
|
||
/s/
Meg G. Crofton
Meg G. Crofton
|
Director
|
February 20, 2020
|
||
/s/
Robert J. Dennis
Robert J. Dennis
|
Director
|
February 20, 2020
|
||
/s/
Nancy-Ann DeParle
Nancy-Ann
DeParle
|
Director
|
February 20, 2020
|
||
/s/
William R. Frist
William R. Frist
|
Director
|
February 20, 2020
|
||
/s/
Charles O. Holliday, Jr.
Charles O. Holliday, Jr.
|
Director
|
February 20, 2020
|
||
/s/
Geoffrey G. Meyers
Geoffrey G. Meyers
|
Director
|
February 20, 2020
|
||
/s/
Michael W. Michelson
Michael W. Michelson
|
Director
|
February 20, 2020
|
||
/s/
Wayne J. Riley
Wayne J. Riley
|
Director
|
February 20, 2020
|
||
/s/
John W. Rowe
John W. Rowe
|
Director
|
February 20, 2020
|
|
Page
|
|
||
F-
2
|
||||
Consolidated Financial Statements:
|
|
|||
F-
5
|
||||
F-
6
|
||||
F-
7
|
||||
F-
8
|
||||
F-
9
|
||||
F-
10
|
||||
F-
46
|
|
Revenue Recognition
|
|
Description of the Matter
|
For the year ended December 31, 2019, the Company’s revenues were $51.336 billion. As discussed in Note 1 to the consolidated financial statements, revenues are based upon the estimated amounts the Company expects to be entitled to receive from patients and third-party payers. Estimates of contractual allowances under managed care, commercial, and governmental insurance plans are based upon the payment terms specified in the related contractual agreements or as mandated under government payer programs. Management continually reviews the contractual allowances estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care insurance coverage may have discounts applied (uninsured discounts and contractual discounts). The Company also records estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record these revenues and accounts receivable at the estimated amounts the Company expects to collect. The primary collection risks relate to uninsured patient accounts, including amounts owed from patients after insurance has paid the amounts covered by the applicable agreement. Implicit price concessions relate primarily to amounts due directly from patients and are based upon management’s assessment of historical write-offs and expected net collections, business and economic conditions, trends in federal, state and private employer health care coverage and other collection indicators.
Auditing management’s estimates of contractual allowances and implicit price concessions was complex and judgmental due to the significant data inputs and subjective assumptions utilized in determining related amounts.
|
|
How We Addressed the Matter in Our Audit
|
We tested internal controls that address the risks of material misstatement related to the measurement and valuation of revenues, including estimation of contractual allowances and implicit price concessions. For example, we tested management’s internal controls over the key data inputs to the contractual allowances and implicit price concessions models, significant assumptions underlying management’s models, and management’s internal controls over retrospective hindsight reviews of historical reserve accuracy.
To test the estimated contractual allowances and implicit price concessions, we performed audit procedures that included, among others, assessing methodologies and evaluating the significant assumptions discussed above and testing the completeness and accuracy of the underlying data used by the Company in its estimates. We compared the significant assumptions used by management to current industry and economic trends and considered changes, if any, to the Company’s business and other relevant factors. We also assessed the historical accuracy of management’s estimates as a source of potential corroborative or contrary evidence.
|
|
|
Professional Liability Claims
|
|
Description of the Matter
|
At December 31, 2019, the Company’s reserves for professional liability risks were $1.827 billion and the Company’s related provision for losses for the year ended December 31, 2019 was $497 million. As discussed in Note 1 to the consolidated financial statements, reserves for professional liability risks represent the estimated ultimate cost of all reported and unreported losses incurred and unpaid as of the
|
|
consolidated balance sheet date. Management determines professional liability reserves and provisions for losses using individual case-basis valuations and actuarial analyses. Trends in the average frequency (number of claims) and ultimate average severity (cost per claim) of claims are significant assumptions in estimating the reserves.
Auditing management’s professional liability claims reserves was complex and judgmental due to the significant estimations required in determining the reserves, particularly the actuarial methodology and assumptions related to the severity and frequency of claims.
|
|
How We Addressed the Matter in Our Audit
|
We tested management’s internal controls that address the risks of material misstatement over the Company’s professional liability claims reserve estimation process. For example, we tested internal controls over management’s review of the actuarial methodology and significant assumptions, and the completeness and accuracy of claims data supporting the recorded reserves.
To test the Company’s determination of the estimated professional liability expense and reserves, we performed audit procedures that included, among others, testing the completeness and accuracy of underlying claims data used by the Company and its actuaries in its determination of reserves and reviewing the Company’s insurance contracts to assess self-insured limits, deductibles and coverage limits. Additionally, with the involvement of our actuarial specialists, we performed audit procedures that included, among others, assessing the actuarial valuation methodologies utilized by management and its actuaries, testing the significant assumptions, including consideration of Company-specific claim reporting and payment data, assessing the accuracy of management’s historical reserve estimates, and developing an independent range of reserves for comparison to the Company’s recorded amounts.
|
|
2019
|
|
2018
|
|
2017
|
|
||||||
Revenues
|
$
|
51,336
|
|
$ |
46,677
|
$ |
43,614
|
|||||
Salaries and benefits
|
|
23,560
|
|
21,425
|
20,059
|
|||||||
Supplies
|
|
8,481
|
|
7,724
|
7,316
|
|||||||
Other operating expenses
|
|
9,481
|
|
8,608
|
8,051
|
|||||||
Equity in earnings of affiliates
|
|
(43
|
)
|
(29
|
) |
(45
|
) | |||||
Depreciation and amortization
|
|
2,596
|
|
2,278
|
2,131
|
|||||||
Interest expense
|
|
1,824
|
|
1,755
|
1,690
|
|||||||
Gains on sales of facilities
|
|
(18
|
)
|
(428
|
) |
(8
|
) | |||||
Losses on retirement of debt
|
|
211
|
|
9
|
39
|
|||||||
|
|
46,092
|
|
41,342
|
39,233
|
|||||||
Income before income taxes
|
|
5,244
|
|
5,335
|
4,381
|
|||||||
Provision for income taxes
|
|
1,099
|
|
946
|
1,638
|
|||||||
Net income
|
|
4,145
|
|
4,389
|
2,743
|
|||||||
Net income attributable to noncontrolling interests
|
|
640
|
|
602
|
527
|
|||||||
Net income attributable to HCA Healthcare, Inc.
|
$
|
3,505
|
|
$ |
3,787
|
$ |
2,216
|
|||||
Per share data:
|
|
|
|
|
|
|||||||
Basic earnings per share
|
$
|
10.27
|
|
$ |
10.90
|
$ |
6.12
|
|||||
Diluted earnings per share
|
$
|
10.07
|
|
$ |
10.66
|
$ |
5.95
|
|||||
Shares used in earnings per share calculations (in millions):
|
|
|
|
|
|
|||||||
Basic
|
|
341.210
|
|
347.297
|
362.305
|
|||||||
Diluted
|
|
348.226
|
|
355.303
|
372.221
|
|
2019
|
|
2018
|
|
2017
|
|
||||||
Net income
|
$
|
4,145
|
|
$ |
4,389
|
$ |
2,743
|
|||||
Other comprehensive income (loss) before taxes:
|
|
|
|
|
|
|||||||
Foreign currency translation
|
|
5
|
|
(71
|
) |
97
|
||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
Unrealized gains (losses) on
available-for-sale
securities
|
|
15
|
|
(7
|
) |
1
|
||||||
Realized gains included in other operating expenses
|
|
—
|
|
—
|
(2
|
) | ||||||
|
|
15
|
|
(7
|
) |
(1
|
) | |||||
|
|
|
|
|
|
|
|
|
|
|
|
|
Defined benefit plans
|
|
(63
|
)
|
44
|
(43
|
) | ||||||
Pension costs included in salaries and benefits
|
|
13
|
|
21
|
18
|
|||||||
|
|
(50
|
)
|
65
|
(25
|
) | ||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
Change in fair value of derivative financial instruments
|
|
(50
|
)
|
23
|
11
|
|||||||
Interest (benefits) costs included in interest expense
|
|
(17
|
)
|
(10
|
) |
20
|
||||||
|
|
(67
|
)
|
13
|
31
|
|||||||
Other comprehensive (loss) income before taxes
|
|
(97
|
)
|
—
|
102
|
|||||||
Income taxes (benefits) related to other comprehensive income items
|
|
(18
|
)
|
8
|
42
|
|||||||
Other comprehensive (loss) income
|
|
(79
|
)
|
(8
|
) |
60
|
||||||
Comprehensive income
|
|
4,066
|
|
4,381
|
2,803
|
|||||||
Comprehensive income attributable to noncontrolling interests
|
|
640
|
|
602
|
527
|
|||||||
Comprehensive income attributable to HCA Healthcare, Inc.
|
$
|
3,426
|
|
$ |
3,779
|
$ |
2,276
|
|||||
|
2019
|
|
2018
|
|
||||
ASSETS
|
|
|
|
|
|
|
||
Current assets:
|
|
|
||||||
Cash and cash equivalents
|
$
|
621
|
|
$ |
502
|
|||
Accounts receivable
|
|
7,380
|
|
6,789
|
||||
Inventories
|
|
1,849
|
|
1,732
|
||||
Other
|
|
1,346
|
|
1,190
|
||||
|
|
11,196
|
|
10,213
|
||||
Property and equipment, at cost:
|
|
|
|
|
||||
Land
|
|
2,178
|
|
1,944
|
||||
Buildings
|
|
17,669
|
|
15,659
|
||||
Equipment
|
|
25,756
|
|
23,577
|
||||
Construction in progress
|
|
1,632
|
|
1,785
|
||||
|
|
47,235
|
|
42,965
|
||||
Accumulated depreciation
|
|
(24,520
|
)
|
(23,208
|
) | |||
|
|
22,715
|
|
19,757
|
||||
Investments of insurance subsidiaries
|
|
315
|
|
362
|
||||
Investments in and advances to affiliates
|
|
249
|
|
232
|
||||
Goodwill and other intangible assets
|
|
8,269
|
|
7,953
|
||||
Right-of-use
operating lease assets
|
|
1,834
|
|
—
|
||||
Other
|
|
480
|
|
690
|
||||
|
$
|
45,058
|
|
$ |
39,207
|
|||
LIABILITIES AND STOCKHOLDERS’ DEFICIT
|
|
|
|
|
|
|
||
Current liabilities:
|
|
|
|
|
||||
Accounts payable
|
$
|
2,905
|
|
$ |
2,577
|
|||
Accrued salaries
|
|
1,775
|
|
1,580
|
||||
Other accrued expenses
|
|
2,932
|
|
2,624
|
||||
Long-term debt due within one year
|
|
145
|
|
788
|
||||
|
|
7,757
|
|
7,569
|
||||
Long-term debt, less debt issuance costs and discounts of $
239
and $
157
|
|
33,577
|
|
32,033
|
||||
Professional liability risks
|
|
1,370
|
|
1,275
|
||||
Right-of-use
operating lease obligations
|
|
1,499
|
|
—
|
||||
Income taxes and other liabilities
|
|
1,420
|
|
1,248
|
||||
Stockholders’ deficit:
|
|
|
|
|
||||
Common stock $
0.01
par; authorized
1,800,000,000
338,445,600
shares — 2019 and
342,895,200
shares — 2018
|
|
3
|
|
3
|
||||
Accumulated other comprehensive loss
|
|
(460
|
)
|
(381
|
) | |||
Retained deficit
|
|
(2,351
|
)
|
(4,572
|
) | |||
Stockholders’ deficit attributable to HCA Healthcare, Inc.
|
|
(2,808
|
)
|
(4,950
|
) | |||
Noncontrolling interests
|
|
2,243
|
|
2,032
|
||||
|
|
(565
|
)
|
(2,918
|
) | |||
|
$
|
45,058
|
|
$ |
39,207
|
|||
|
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
Deficit |
|
|||||||||||||||||||||
|
Shares
(in millions) |
|
Par
Value |
|
||||||||||||||||||||||||
Balances, December 31, 2016
|
370.536
|
$ |
4
|
$ |
—
|
$ |
(338
|
) | $ |
(6,968
|
) | $ |
1,669
|
$ |
(5,633
|
) | ||||||||||||
Comprehensive income
|
|
|
|
60
|
2,216
|
527
|
2,803
|
|||||||||||||||||||||
Repurchase of common stock
|
(25.092
|
) |
|
(271
|
) |
|
(1,780
|
) |
|
(2,051
|
) | |||||||||||||||||
Share-based benefit plans
|
4.648
|
|
281
|
|
|
|
281
|
|||||||||||||||||||||
Distributions
|
|
|
|
|
|
(448
|
) |
(448
|
) | |||||||||||||||||||
Other
|
|
|
(10
|
) |
|
|
63
|
53
|
||||||||||||||||||||
Balances, December 31, 2017
|
350.092
|
4
|
—
|
(278
|
) |
(6,532
|
) |
1,811
|
(4,995
|
) | ||||||||||||||||||
Comprehensive income (loss)
|
|
|
|
(8
|
) |
3,787
|
602
|
4,381
|
||||||||||||||||||||
Repurchase of common stock
|
(14.070
|
) |
(1
|
) |
(103
|
) |
|
(1,426
|
) |
|
(1,530
|
) | ||||||||||||||||
Share-based benefit plans
|
6.873
|
|
115
|
|
|
|
115
|
|||||||||||||||||||||
Cash dividends declared ($
1.40
share)
|
|
|
|
|
(496
|
) |
|
(496
|
) | |||||||||||||||||||
Distributions
|
|
|
|
|
|
(441
|
) |
(441
|
) | |||||||||||||||||||
Reclassification of stranded tax effects
|
|
|
|
(95
|
) |
95
|
|
—
|
||||||||||||||||||||
Other
|
|
|
(12
|
) |
|
|
60
|
48
|
||||||||||||||||||||
Balances, December 31, 2018
|
342.895
|
3
|
—
|
(381
|
) |
(4,572
|
) |
2,032
|
(2,918
|
) | ||||||||||||||||||
Comprehensive income (loss)
|
|
|
|
|
|
|
|
|
|
|
(79
|
)
|
|
3,505
|
|
|
640
|
|
|
4,066
|
|
|||||||
Repurchase of common stock
|
|
(7.949
|
)
|
|
|
|
|
(302
|
)
|
|
|
|
|
(729
|
)
|
|
|
|
|
(1,031
|
)
|
|||||||
Share-based benefit plans
|
|
3.500
|
|
|
|
|
|
313
|
|
|
|
|
|
|
|
|
|
|
|
313
|
|
|||||||
Cash dividends declared ($
1.60
share)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(555
|
)
|
|
|
|
|
(555
|
)
|
|||||||
Distributions
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(542
|
)
|
|
(542
|
)
|
|||||||
Other
|
|
|
|
|
|
|
|
(11
|
)
|
|
|
|
|
|
|
|
113
|
|
|
102
|
|
|||||||
Balances, December 31, 2019
|
|
338.446
|
|
$
|
3
|
|
$
|
—
|
|
$
|
(460
|
)
|
$
|
(2,351
|
)
|
$
|
2,243
|
|
$
|
(565
|
)
|
|||||||
|
2019
|
|
2018
|
|
2017
|
|
||||||
Cash flows from operating activities:
|
|
|
|
|
|
|
|
|
|
|||
Net income
|
$
|
4,145
|
|
$ |
4,389
|
$ |
2,743
|
|||||
Adjustments to reconcile net income to net cash provided by operating activities:
|
|
|
|
|
|
|||||||
Increase (decrease) in cash from operating assets and liabilities:
|
|
|
|
|
|
|||||||
Accounts receivable
|
|
(326
|
)
|
(423
|
) |
(601
|
) | |||||
Inventories and other assets
|
|
(158
|
)
|
(242
|
) |
(69
|
) | |||||
Accounts payable and accrued expenses
|
|
396
|
|
698
|
374
|
|||||||
Depreciation and amortization
|
|
2,596
|
|
2,278
|
2,131
|
|||||||
Income taxes
|
|
250
|
|
74
|
433
|
|||||||
Gains on sales of facilities
|
|
(18
|
)
|
(428
|
) |
(8
|
) | |||||
Losses on retirement of debt
|
|
211
|
|
9
|
39
|
|||||||
Amortization of debt issuance costs
|
|
30
|
|
31
|
31
|
|||||||
Share-based compensation
|
|
347
|
|
268
|
270
|
|||||||
Other
|
|
129
|
|
107
|
83
|
|||||||
Net cash provided by operating activities
|
|
7,602
|
|
6,761
|
5,426
|
|||||||
Cash flows from investing activities:
|
|
|
|
|
|
|
|
|
|
|||
Purchase of property and equipment
|
|
(4,158
|
)
|
(3,573
|
) |
(3,015
|
) | |||||
Acquisition of hospitals and health care entities
|
|
(1,682
|
)
|
(1,253
|
) |
(1,212
|
) | |||||
Sales of hospitals and health care entities
|
|
61
|
|
808
|
25
|
|||||||
Change in investments
|
|
25
|
|
57
|
(73
|
) | ||||||
Other
|
|
34
|
|
60
|
(4
|
) | ||||||
Net cash used in investing activities
|
|
(5,720
|
)
|
(3,901
|
) |
(4,279
|
) | |||||
Cash flows from financing activities:
|
|
|
|
|
|
|
|
|
|
|||
Issuances of long-term debt
|
|
6,451
|
|
2,000
|
1,502
|
|||||||
Net change in revolving bank credit facilities
|
|
(560
|
)
|
(640
|
) |
760
|
||||||
Repayment of long-term debt
|
|
(5,324
|
)
|
(1,704
|
) |
(753
|
) | |||||
Distributions to noncontrolling interests
|
|
(542
|
)
|
(441
|
) |
(448
|
) | |||||
Payment of debt issuance costs
|
|
(73
|
)
|
(25
|
) |
(26
|
) | |||||
Payment of dividends
|
|
(550
|
)
|
(487
|
) |
—
|
||||||
Repurchases of common stock
|
|
(1,031
|
)
|
(1,530
|
) |
(2,051
|
) | |||||
Other
|
|
(142
|
)
|
(248
|
) |
(45
|
) | |||||
Net cash used in financing activities
|
|
(1,771
|
)
|
(3,075
|
) |
(1,061
|
) | |||||
Effect of exchange rate changes on cash and cash equivalents
|
|
8
|
|
(15
|
) |
—
|
||||||
Change in cash and cash equivalents
|
|
119
|
|
(230
|
) |
86
|
||||||
Cash and cash equivalents at beginning of period
|
|
502
|
|
732
|
646
|
|||||||
Cash and cash equivalents at end of period
|
$
|
621
|
|
$ |
502
|
$ |
732
|
|||||
Interest payments
|
$
|
1,914
|
|
$ |
1,744
|
$ |
1,700
|
|||||
Income tax payments, net
|
$
|
849
|
|
$ |
872
|
$ |
1,205
|
|
Years Ended December 31,
|
|||||||||||||||||||||||
|
2019
|
|
Ratio
|
|
2018
|
Ratio
|
|
2017
|
|
Ratio
|
|
|||||||||||||
Medicare
|
$
|
10,798
|
|
|
21.0
|
%
|
$ |
9,831
|
21.1
|
% | $ |
9,285
|
21.3
|
% | ||||||||||
Managed Medicare
|
|
6,452
|
|
|
12.6
|
|
5,497
|
11.8
|
4,680
|
10.7
|
||||||||||||||
Medicaid
|
|
1,572
|
|
|
3.1
|
|
1,358
|
2.9
|
1,316
|
3.0
|
||||||||||||||
Managed Medicaid
|
|
2,450
|
|
|
4.8
|
|
2,403
|
5.1
|
2,165
|
5.0
|
||||||||||||||
Managed care and other insurers
|
|
26,544
|
|
|
51.6
|
|
24,467
|
52.4
|
23,342
|
53.5
|
||||||||||||||
International (managed care and
other
|
|
1,162
|
|
|
2.3
|
|
1,156
|
2.5
|
1,097
|
2.5
|
||||||||||||||
Other
|
|
2,358
|
|
|
4.6
|
|
1,965
|
4.2
|
1,729
|
4.0
|
||||||||||||||
Revenues
|
$
|
51,336
|
|
|
100.0
|
%
|
$ |
46,677
|
100.0
|
% | $ |
43,614
|
100.0
|
% | ||||||||||
|
2019
|
|
2018
|
|
2017
|
|
||||||
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)
|
$
|
44,118
|
|
$ |
40,035
|
$ |
37,557
|
|||||
Cost-to-charges
ratio (patient care costs as percentage of gross patient charges)
|
|
12.0
|
%
|
12.4
|
% |
12.9
|
% | |||||
Total uncompensated care
|
$
|
31,105
|
|
$ |
26,757
|
$ |
23,420
|
|||||
Multiply by the
cost-to-charges
ratio
|
|
12.0
|
%
|
12.4
|
% |
12.9
|
% | |||||
Estimated cost of total uncompensated care
|
$
|
3,733
|
|
$ |
3,318
|
$ |
3,021
|
|||||
|
2019
|
|
2018
|
|
2017
|
|
||||||
Risk-free interest rate
|
|
2.50
|
%
|
2.62
|
% |
2.13
|
% | |||||
Expected volatility
|
|
27
|
%
|
29
|
% |
31
|
% | |||||
Expected life, in years
|
|
6.18
|
|
6.15
|
6.17
|
|||||||
Expected dividend yield
|
|
1.16
|
%
|
1.37
|
% |
—
|
|
Time
Stock Options and SARs |
|
Performance
Stock Options and SARs |
|
Total
Stock Options and SARs |
|
Weighted
Average Exercise Price |
|
Weighted
Average Remaining Contractual Term |
|
Aggregate
Intrinsic Value (dollars in millions) |
|
||||||||||||
Options and SARs outstanding, December 31, 2016
|
10,936
|
6,130
|
17,066
|
$ |
35.65
|
|
|
|||||||||||||||||
Granted
|
1,879
|
—
|
1,879
|
81.83
|
|
|
||||||||||||||||||
Exercised
|
(1,549
|
) |
(1,366
|
) |
(2,915
|
) |
21.49
|
|
|
|||||||||||||||
Cancelled
|
(110
|
) |
(178
|
) |
(288
|
) |
52.92
|
|
|
|||||||||||||||
Options and SARs outstanding, December 31, 2017
|
11,156
|
4,586
|
15,742
|
43.47
|
|
|
||||||||||||||||||
Granted
|
2,342
|
—
|
2,342
|
101.96
|
|
|
||||||||||||||||||
Exercised
|
(3,917
|
) |
(1,774
|
) |
(5,691
|
) |
27.86
|
|
|
|||||||||||||||
Cancelled
|
(221
|
) |
(145
|
) |
(366
|
) |
68.43
|
|
|
|||||||||||||||
Options and SARs outstanding, December 31, 2018
|
9,360
|
2,667
|
12,027
|
61.49
|
|
|
||||||||||||||||||
Granted
|
|
1,349
|
|
|
—
|
|
|
1,349
|
|
|
138.31
|
|
|
|
|
|
|
|
||||||
Exercised
|
|
(1,137
|
)
|
|
(523
|
)
|
|
(1,660
|
)
|
|
44.45
|
|
|
|
|
|
|
|
||||||
Cancelled
|
|
(522
|
)
|
|
—
|
|
|
(522
|
)
|
|
93.26
|
|
|
|
|
|
|
|
||||||
Options and SARs outstanding, December 31, 2019
|
|
9,050
|
|
|
2,144
|
|
|
11,194
|
|
$
|
71.79
|
|
|
5.7
y
ears
|
|
$
|
851
|
|
||||||
Options and SARs exercisable, December 31, 2019
|
|
5,273
|
|
|
2,144
|
|
|
7,417
|
|
$
|
53.09
|
|
|
4.4
years
|
|
$
|
703
|
|
|
Time RSUs
|
|
Performance
RSUs |
|
PSUs
|
|
Total RSUs
and PSUs |
|
Weighted
Average Grant Date Fair Value |
|
||||||||||
RSUs and PSUs outstanding, December 31, 2016
|
4,111
|
790
|
2,386
|
7,287
|
$ |
61.21
|
||||||||||||||
Granted
|
1,484
|
—
|
1,304
|
2,788
|
81.90
|
|||||||||||||||
Vested
|
(1,824
|
) |
(430
|
) |
—
|
(2,254
|
) |
51.20
|
||||||||||||
Cancelled
|
(306
|
) |
(133
|
) |
(128
|
) |
(567
|
) |
64.06
|
|||||||||||
RSUs and PSUs outstanding, December 31, 2017
|
3,465
|
227
|
3,562
|
7,254
|
72.05
|
|||||||||||||||
Granted
|
1,464
|
—
|
1,261
|
2,725
|
101.85
|
|||||||||||||||
Performance adjustment
|
—
|
—
|
1,250
|
1,250
|
69.27
|
|||||||||||||||
Vested
|
(1,487
|
) |
(136
|
) |
(2,500
|
) |
(4,123
|
) |
67.33
|
|||||||||||
Cancelled
|
(319
|
) |
(91
|
) |
(151
|
) |
(561
|
) |
78.82
|
|||||||||||
RSUs and PSUs outstanding, December 31, 2018
|
3,123
|
—
|
3,422
|
6,545
|
86.32
|
|||||||||||||||
Granted
|
|
973
|
|
|
—
|
|
|
796
|
|
|
1,769
|
|
|
138.45
|
|
|||||
Performance adjustment
|
|
—
|
|
|
—
|
|
|
227
|
|
|
227
|
|
|
69.94
|
|
|||||
Vested
|
|
(1,216
|
)
|
|
—
|
|
|
(1,251
|
)
|
|
(2,467
|
)
|
|
75.97
|
|
|||||
Cancelled
|
|
(260
|
)
|
|
—
|
|
|
(159
|
)
|
|
(419
|
)
|
|
103.27
|
|
|||||
RSUs and PSUs outstanding, December 31, 2019
|
|
2,620
|
|
|
—
|
|
|
3,035
|
|
|
5,655
|
|
$
|
105.23
|
|
|||||
|
2019
|
|
2018
|
|
2017
|
|
||||||
Current:
|
|
|
|
|||||||||
Federal
|
$
|
670
|
|
$ |
759
|
$ |
1,067
|
|||||
State
|
|
134
|
|
149
|
120
|
|||||||
Foreign
|
|
17
|
|
23
|
19
|
|||||||
Deferred:
|
|
|
|
|
|
|||||||
Federal
|
|
254
|
|
9
|
423
|
|||||||
State
|
|
29
|
|
13
|
3
|
|||||||
Foreign
|
|
(5
|
)
|
(7
|
) |
6
|
||||||
|
$
|
1,099
|
|
$ |
946
|
$ |
1,638
|
|||||
|
2019
|
|
2018
|
|
2017
|
|
||||||
Federal statutory rate
|
|
21.0
|
%
|
21.0
|
% |
35.0
|
% | |||||
State income taxes, net of federal tax benefit
|
|
2.7
|
|
2.9
|
2.2
|
|||||||
Change in liability for uncertain tax positions
|
|
0.4
|
(0.1
|
) |
—
|
|||||||
Tax benefit from settlements of employee equity awards
|
|
(1.3
|
)
|
(2.4
|
) |
(2.0
|
) | |||||
Impact of Tax Act on deferred tax balances
|
|
—
|
(1.6
|
) |
7.8
|
|||||||
Other items, net
|
|
1.1
|
|
0.2
|
(0.5
|
) | ||||||
Effective income tax rate on income attributable to HCA Healthcare, Inc.
|
|
23.9
|
|
20.0
|
42.5
|
|||||||
Income attributable to noncontrolling interests from consolidated partnerships
|
|
(2.9
|
)
|
(2.3
|
) |
(5.1
|
) | |||||
Effective income tax rate on income before income taxes
|
|
21.0
|
%
|
17.7
|
% |
37.4
|
% | |||||
|
2019
|
2018
|
||||||||||||||
|
Assets
|
|
Liabilities
|
|
Assets
|
|
Liabilities
|
|
||||||||
Depreciation and fixed asset basis differences
|
$
|
—
|
|
$
|
601
|
|
$ |
—
|
$ |
340
|
||||||
Allowances for professional liability and other risks
|
|
376
|
|
|
—
|
|
355
|
—
|
||||||||
Accounts receivable
|
|
307
|
|
|
—
|
|
274
|
—
|
|
|||||||
Compensation
|
|
292
|
|
|
—
|
|
256
|
—
|
||||||||
Right-of-use lease assets and obligations
|
|
369
|
|
|
366
|
|
—
|
—
|
||||||||
Other
|
|
461
|
|
|
538
|
|
424
|
491
|
||||||||
|
$
|
1,805
|
|
$
|
1,505
|
|
$ |
1,309
|
$ |
831
|
||||||
|
2019
|
|
2018
|
|
||||
Balance at January 1
|
$ |
390
|
|
$ |
399
|
|||
Additions based on tax positions related to the current year
|
|
29
|
|
22
|
||||
Additions for tax positions of prior years
|
|
119
|
|
10
|
||||
Reductions for tax positions of prior years
|
|
(3
|
)
|
(14
|
) | |||
Settlements
|
|
—
|
(2
|
) | ||||
Lapse of applicable statutes of limitations
|
|
(13
|
)
|
(25
|
) | |||
Balance at December 31
|
$ |
522
|
|
$ |
390
|
|||
|
2019
|
|
2018
|
|
2017
|
|
||||||
Net income attributable to HCA Healthcare, Inc.
|
$
|
3,505
|
|
$ |
3,787
|
$ |
2,216
|
|||||
Weighted average common shares outstanding
|
|
341.210
|
|
347.297
|
362.305
|
|||||||
Effect of dilutive incremental shares
|
|
7.016
|
|
8.006
|
9.916
|
|||||||
Shares used for diluted earnings per share
|
|
348.226
|
|
355.303
|
372.221
|
|||||||
Earnings per share:
|
|
|
|
|
|
|||||||
Basic earnings per share
|
$
|
10.27
|
|
$ |
10.90
|
$ |
6.12
|
|||||
Diluted earnings per share
|
$
|
10.07
|
|
$ |
10.66
|
$ |
5.95
|
|
2019
|
|||||||||||||||
|
Amortized
Cost |
|
Unrealized
Amounts |
Fair
Value |
|
|||||||||||
|
Gains
|
|
Losses
|
|
||||||||||||
Debt securities
|
$
|
359
|
|
$
|
18
|
|
$
|
—
|
|
$
|
377
|
|
||||
Money market funds and other
|
|
85
|
|
|
—
|
|
|
—
|
|
|
85
|
|
||||
|
$
|
444
|
|
$
|
18
|
|
$
|
—
|
|
|
462
|
|
||||
Amounts classified as current assets
|
|
|
|
|
|
|
|
|
|
|
(147
|
)
|
||||
Investment carrying value
|
|
|
|
|
|
|
|
|
|
$
|
315
|
|
||||
|
2018
|
|||||||||||||||
|
Amortized
Cost |
|
Unrealized
Amounts |
Fair
Value |
|
|||||||||||
|
Gains
|
|
Losses
|
|
||||||||||||
Debt securities
|
$ |
338
|
$ |
5
|
$ |
(2
|
) | $ |
341
|
|||||||
Money market funds and other
|
68
|
—
|
—
|
68
|
||||||||||||
|
$ |
406
|
$ |
5
|
$ |
(2
|
) |
409
|
||||||||
Amounts classified as current assets
|
|
|
|
(47
|
) | |||||||||||
Investment carrying value
|
|
|
|
$ |
362
|
|||||||||||
|
Amortized
Cost |
|
Fair
Value |
|
||||
Due in one year or less
|
$ |
9
|
$ |
9
|
||||
Due after one year through five years
|
85
|
88
|
||||||
Due after five years through ten years
|
190
|
202
|
||||||
Due after ten years
|
75
|
78
|
||||||
|
$ |
359
|
$ |
377
|
||||
|
Notional
Amount |
|
Maturity Date
|
|
Fair
Value |
|
||||||
Pay-fixed
interest rate swaps
|
$ |
2,000
|
December 2021
|
$ |
3
|
|||||||
Pay-fixed
interest rate swaps
|
500
|
December 2022
|
(7
|
) |
Derivatives in Cash Flow Hedging
Relationships |
Amount of Loss
Recognized in OCI on Derivatives, Net of Tax |
|
Location of Gain
Reclassified from Accumulated OCI into Operations |
|
Amount of Gain
Reclassified from Accumulated OCI into Operations |
|
||||||
Interest rate swaps
|
$ |
37
|
Interest expense
|
$ |
17
|
|
December 31, 2019
|
|||||||||||||||
|
Fair Value
|
|
Fair Value Measurements Using
|
|||||||||||||
|
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
|
$
|
377
|
|
$
|
—
|
|
$
|
377
|
|
$
|
—
|
|
||||
Money market funds and other
|
|
85
|
|
|
85
|
|
|
—
|
|
|
—
|
|
||||
Investments of insurance subsidiaries
|
|
462
|
|
|
85
|
|
|
377
|
|
|
—
|
|
||||
Less amounts classified as current assets
|
|
(147
|
)
|
|
(83
|
)
|
|
(64
|
)
|
|
—
|
|
||||
|
$
|
315
|
|
|
2
|
|
$
|
313
|
|
$
|
—
|
|
||||
Interest rate swaps (Other)
|
$
|
3
|
|
$
|
—
|
|
$
|
3
|
|
$
|
—
|
|
||||
Liabilities:
|
|
|
|
|
||||||||||||
Interest rate swaps (Income taxes and other liabilities)
|
$
|
7
|
|
$
|
—
|
|
$
|
7
|
|
$
|
—
|
|
|
December 31, 2018
|
|||||||||||||||
|
Fair Value
|
|
Fair Value Measurements Using
|
|||||||||||||
|
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
|
$ |
341
|
$ |
—
|
$ |
341
|
$ |
—
|
||||||||
Money market funds and other
|
68
|
68
|
—
|
—
|
||||||||||||
Investments of insurance subsidiaries
|
409
|
68
|
341
|
—
|
||||||||||||
Less amounts classified as current assets
|
(47
|
) |
(47
|
) |
—
|
—
|
||||||||||
|
$ |
362
|
$ |
21
|
$ |
341
|
$ |
—
|
||||||||
Interest rate swaps (Other)
|
$ |
63
|
$ |
—
|
$ |
63
|
$ |
—
|
|
2019
|
|
2018
|
|
||||
Senior secured asset-based revolving credit facility (effective interest rate of 3.0%)
|
$
|
2,480
|
|
$ |
3,040
|
|||
Senior secured revolving credit facility
|
|
—
|
|
—
|
||||
Senior secured term loan facilities (effective interest rate of 3.3%)
|
|
3,725
|
|
3,801
|
||||
Senior secured notes (effective interest rate of 5.1%)
|
|
13,850
|
|
13,800
|
||||
Other senior secured debt (effective interest rate of 5.4%)
|
|
654
|
|
585
|
||||
Senior secured debt
|
|
20,709
|
|
21,226
|
||||
Senior unsecured notes (effective interest rate of 6.3%)
|
|
13,252
|
|
11,752
|
||||
Net debt issuance costs
|
|
(239
|
)
|
(157
|
) | |||
Total debt (average life of
8.6
years, rates averaging
5.2
%)
|
|
33,722
|
|
32,821
|
||||
Less amounts due within one year
|
|
145
|
|
788
|
||||
|
$
|
33,577
|
|
$ |
32,033
|
|||
• | a first-priority lien on the capital stock owned by HCA Inc., or by any U.S. guarantor, in each of their respective first-tier subsidiaries; |
• | a first-priority lien on substantially all present and future assets of HCA Inc. and of each U.S. guarantor other than (i) “Principal Properties” (as defined in the 1993 Indenture), (ii) certain other real properties and (iii) deposit accounts, other bank or securities accounts, cash, leaseholds, motor-vehicles and certain other exceptions; and |
• | a second-priority lien on certain of the Receivables Collateral. |
|
Balance Sheet Classification
|
December 31,
2019
|
|
|||
Assets:
|
|
|
||||
Operating leases
|
Right-of-use
operating lease assets
|
$ |
1,834
|
|||
Finance leases
|
Property and equipment
|
520
|
||||
Total lease assets
|
|
$ |
2,354
|
|||
Liabilities:
|
|
|
||||
Current:
|
|
|
||||
Operating leases
|
Other accrued expenses
|
$ |
350
|
|||
Finance leases
|
Long-term debt due within one year
|
87
|
||||
Noncurrent:
|
|
|
||||
Operating leases
|
Right-of-use
operating lease obligations
|
1,499
|
||||
Finance leases
|
Long-term debt
|
470
|
||||
Total lease liabilities
|
|
$ |
2,406
|
|||
Weighted-average remaining term:
|
|
|
||||
Operating leases
|
|
10.8
years
|
||||
Finance leases
|
|
12.0
years
|
||||
Weighted-average discount rate:
|
|
|
||||
Operating leases(1)
|
|
5.3
|
% | |||
Finance leases
|
|
6.0
|
% |
(1) | Upon adoption of the new lease standard, discount rates used for existing leases were established at January 1, 2019. |
|
Year Ended
December 31, 2019 |
|
||
Finance lease expense:
|
|
|||
Amortization of leased assets
|
$ |
93
|
||
Interest on lease liabilities
|
32
|
|||
Operating leases(2)
|
389
|
|||
Short-term lease expense(2)
|
316
|
|||
Variable lease expense(2)
|
150
|
|||
|
$ |
980
|
||
(2) | Expenses are included in “other operating expenses” in our consolidated income statements. |
|
Operating
Leases |
|
Finance
Leases |
|
||||
Year 1
|
$ |
411
|
$ |
110
|
||||
Year 2
|
350
|
105
|
||||||
Year 3
|
285
|
99
|
||||||
Year 4
|
228
|
58
|
||||||
Year 5
|
182
|
60
|
||||||
Thereafter
|
1,074
|
368
|
||||||
Total minimum lease payments
|
2,530
|
800
|
||||||
Less: amount of lease payments representing interest
|
(681
|
) |
(243
|
) | ||||
Present value of future minimum lease payments
|
1,849
|
557
|
||||||
Less: current lease obligations
|
(350
|
) |
(87
|
) | ||||
Long-term lease obligations
|
$ |
1,499
|
$ |
470
|
||||
|
|
For the Years Ended December 31,
|
|
|||||||||
|
|
2019
|
|
|
2018
|
|
|
2017
|
|
|||
Revenues:
|
|
|
|
|
|
|
|
|
|
|
|
|
National Group
|
|
$
|
25,913
|
|
|
$
|
22,581
|
|
|
$
|
20,772
|
|
American Group
|
|
|
23,173
|
|
|
|
21,959
|
|
|
|
20,912
|
|
Corporate and other
|
|
|
2,250
|
|
|
|
2,137
|
|
|
|
1,930
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
$
|
51,336
|
|
|
$
|
46,677
|
|
|
$
|
43,614
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Equity in earnings of affiliates:
|
|
|
|
|
|
|
|
|
|
|
|
|
National Group
|
|
$
|
(2
|
)
|
|
$
|
(4
|
)
|
|
$
|
(21
|
)
|
American Group
|
|
|
(44
|
)
|
|
|
(40
|
)
|
|
|
(37
|
)
|
Corporate and other
|
|
|
3
|
|
|
|
15
|
|
|
|
13
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
$
|
(43
|
)
|
|
$
|
(29
|
)
|
|
$
|
(45
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Adjusted segment EBITDA:
|
|
|
|
|
|
|
|
|
|
|
|
|
National Group
|
|
$
|
5,634
|
|
|
$
|
4,980
|
|
|
$
|
4,600
|
|
American Group
|
|
|
4,904
|
|
|
|
4,593
|
|
|
|
4,231
|
|
Corporate and other
|
|
|
(681
|
)
|
|
|
(624
|
)
|
|
|
(598
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
$
|
9,857
|
|
|
$
|
8,949
|
|
|
$
|
8,233
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Depreciation and amortization:
|
|
|
|
|
|
|
|
|
|
|
|
|
National Group
|
|
$
|
1,161
|
|
|
$
|
946
|
|
|
$
|
867
|
|
American Group
|
|
|
1,117
|
|
|
|
1,027
|
|
|
|
986
|
|
Corporate and other
|
|
|
318
|
|
|
|
305
|
|
|
|
278
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
$
|
2,596
|
|
|
$
|
2,278
|
|
|
$
|
2,131
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
For the Years Ended December 31,
|
|||||||||||
|
2019
|
|
2018
|
|
2017
|
|
||||||
Adjusted segment EBITDA
|
$
|
9,857
|
|
$ |
8,949
|
$ |
8,233
|
|||||
Depreciation and amortization
|
|
2,596
|
|
2,278
|
2,131
|
|||||||
Interest expense
|
|
1,824
|
|
1,755
|
1,690
|
|||||||
Gains on sales of facilities
|
|
(18
|
)
|
(428
|
) |
(8
|
) | |||||
Losses on retirement of debt
|
|
211
|
|
9
|
39
|
|||||||
Income before income taxes
|
$
|
5,244
|
|
$ |
5,335
|
$ |
4,381
|
|||||
|
December 31,
|
|||||||||||
|
2019
|
|
2018
|
|
2017
|
|
||||||
Assets:
|
|
|
|
|||||||||
National Group
|
$
|
18,290
|
|
$ |
14,839
|
$ |
13,097
|
|||||
American Group
|
|
20,608
|
|
19,122
|
18,136
|
|||||||
Corporate and other
|
|
6,160
|
|
5,246
|
5,360
|
|||||||
|
$
|
45,058
|
|
$ |
39,207
|
$ |
36,593
|
|||||
|
National
Group |
|
American
Group |
|
Corporate
and Other |
|
Total
|
|
||||||||
Goodwill and other intangible assets:
|
|
|
|
|
||||||||||||
Balance at December 31, 2016
|
$ |
1,458
|
$ |
4,661
|
$ |
585
|
$ |
6,704
|
||||||||
Acquisitions
|
19
|
612
|
62
|
693
|
||||||||||||
Foreign currency translation, amortization and other
|
(3
|
) |
(8
|
) |
8
|
(3
|
) | |||||||||
Balance at December 31, 2017
|
1,474
|
5,265
|
655
|
7,394
|
||||||||||||
Acquisitions
|
132
|
504
|
—
|
636
|
||||||||||||
Foreign currency translation, amortization and other
|
(9
|
) |
(40
|
) |
(28
|
) |
(77
|
) | ||||||||
Balance at December 31, 2018
|
1,597
|
5,729
|
627
|
7,953
|
||||||||||||
Acquisitions
|
|
155
|
|
|
39
|
|
|
138
|
|
|
332
|
|
||||
F
oreign currency translation, amortization and other
|
|
(13
|
)
|
|
(3
|
)
|
|
—
|
|
|
(16
|
)
|
||||
Balance at December 31, 2019
|
$
|
1,739
|
|
$
|
5,765
|
|
$
|
765
|
|
$
|
8,269
|
|
||||
|
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, 2016
|
$ |
7
|
$ |
(211
|
) | $ |
(146
|
) | $ |
12
|
$ |
(338
|
) | |||||||
Unrealized gains on
available-for-sale
securities
|
1
|
—
|
—
|
—
|
1
|
|||||||||||||||
Foreign currency translation adjustments, net of $35 of income taxes
|
—
|
62
|
—
|
—
|
62
|
|||||||||||||||
Defined benefit plans, net of $10 income tax benefit
|
—
|
—
|
(33
|
) |
—
|
(33
|
) | |||||||||||||
Change in fair value of derivative instruments, net of $4 of income taxes
|
—
|
—
|
—
|
7
|
7
|
|||||||||||||||
Expense (income) reclassified into operations from other comprehensive income, net of $1 of income taxes and $7 and $7 income tax benefits, respectively
|
(1
|
) |
—
|
11
|
13
|
23
|
||||||||||||||
Balances at December 31, 2017
|
7
|
(149
|
) |
(168
|
) |
32
|
(278
|
) | ||||||||||||
Unrealized losses on
available-for-sale
securities, net of $2 income tax benefit
|
(5
|
) |
—
|
—
|
—
|
(5
|
) | |||||||||||||
Foreign currency translation adjustments, net of $8 income tax benefit
|
—
|
(63
|
) |
—
|
—
|
(63
|
) | |||||||||||||
Defined benefit plans, net of $10 of income taxes
|
—
|
—
|
34
|
—
|
34
|
|||||||||||||||
Change in fair value of derivative instruments, net of $5 of income taxes
|
—
|
—
|
—
|
18
|
18
|
|||||||||||||||
Expense (income) reclassified into operations from other comprehensive income, net of $5 income tax benefit and $2 of income taxes, respectively
|
—
|
—
|
16
|
(8
|
) |
8
|
||||||||||||||
Reclassification of stranded tax effects
|
1
|
(71
|
) |
(30
|
) |
5
|
(95
|
) | ||||||||||||
Balances at December 31, 2018
|
3
|
(283
|
) |
(148
|
) |
47
|
(381
|
) | ||||||||||||
Unrealized
gains
on
available-for-sale
securities, net of $4 of income taxes
|
|
11
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
11
|
|
|||||
Foreign currency translation adjustments, net of $5 of income taxes
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|||||
Defined benefit plans, net of $14 income tax benefit
|
|
—
|
|
|
—
|
|
|
(49
|
)
|
|
—
|
|
|
(49
|
)
|
|||||
Change in fair value of derivative instruments, net of $13 income tax benefit
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(37
|
)
|
|
(37
|
)
|
|||||
Expense (income) reclassified into operations from other comprehensive income, net of $3 income tax benefit and $3 of income taxes, respectively
|
|
—
|
|
|
—
|
|
|
10
|
|
|
(14
|
)
|
|
(4
|
)
|
|||||
Balances at December 31, 2019
|
$
|
14
|
|
$
|
(283
|
)
|
$
|
(187
|
)
|
$
|
(4
|
)
|
$
|
(460
|
)
|
|||||
|
2019
|
|
2018
|
|
||||
Professional liability risks
|
$
|
457
|
|
$ |
466
|
|||
Defined contribution benefit plan
|
|
528
|
|
459
|
||||
Interest
|
|
368
|
|
429
|
||||
Right-of-use
operating lease
|
|
350
|
|
—
|
||||
Taxes other than income
|
|
325
|
|
308
|
||||
Other
|
|
904
|
|
962
|
||||
|
$
|
2,932
|
|
$ |
2,624
|
|||
|
HCA
Healthcare, Inc. Issuer |
|
HCA Inc.
Issuer |
|
Subsidiary
Guarantors |
|
Subsidiary
Non- Guarantors |
|
Eliminations
|
|
Condensed
Consolidated |
|
||||||||||||
Revenues
|
$ |
—
|
$ |
—
|
$ |
29,220
|
$ |
22,116
|
$ |
—
|
$ |
51,336
|
||||||||||||
Salaries and benefits
|
—
|
—
|
12,898
|
10,662
|
—
|
23,560
|
||||||||||||||||||
Supplies
|
—
|
—
|
4,802
|
3,679
|
—
|
8,481
|
||||||||||||||||||
Other operating expenses
|
7
|
—
|
4,643
|
4,831
|
—
|
9,481
|
||||||||||||||||||
Equity in earnings of affiliates
|
(3,597
|
) |
—
|
(6
|
) |
(37
|
) |
3,597
|
(43
|
) | ||||||||||||||
Depreciation and amortization
|
—
|
—
|
1,447
|
1,149
|
—
|
2,596
|
||||||||||||||||||
Interest expense (income)
|
64
|
4,025
|
(2,001
|
) |
(264
|
) |
—
|
1,824
|
||||||||||||||||
Gains on sales of facilities
|
—
|
—
|
(14
|
) |
(4
|
) |
—
|
(18
|
) | |||||||||||||||
Losses on retirement of debt
|
—
|
211
|
—
|
—
|
—
|
211
|
||||||||||||||||||
Management fees
|
—
|
—
|
(768
|
) |
768
|
—
|
—
|
|||||||||||||||||
|
(3,526
|
) |
4,236
|
21,001
|
20,784
|
3,597
|
46,092
|
|||||||||||||||||
Income (loss) before income taxes
|
3,526
|
(4,236
|
) |
8,219
|
1,332
|
(3,597
|
) |
5,244
|
||||||||||||||||
Provision (benefit) for income taxes
|
21
|
(976
|
) |
1,874
|
180
|
—
|
1,099
|
|||||||||||||||||
Net income (loss)
|
3,505
|
(3,260
|
) |
6,345
|
1,152
|
(3,597
|
) |
4,145
|
||||||||||||||||
Net income attributable to noncontrolling interests
|
—
|
—
|
91
|
549
|
—
|
640
|
||||||||||||||||||
Net income (loss) attributable to HCA Healthcare, Inc.
|
$ |
3,505
|
$ |
(3,260
|
) | $ |
6,254
|
$ |
603
|
$ |
(3,597
|
) | $ |
3,505
|
||||||||||
Comprehensive income (loss) attributable to HCA Healthcare, Inc.
|
$ |
3,426
|
$ |
(3,311
|
) | $ |
6,215
|
$ |
614
|
$ |
(3,518
|
) | $ |
3,426
|
||||||||||
|
HCA
Healthcare, Inc. Issuer |
|
HCA Inc.
Issuer |
|
Subsidiary
Guarantors |
|
Subsidiary
Non- Guarantors |
|
Eliminations
|
|
Condensed
Consolidated |
|
||||||||||||
Revenues
|
$ |
—
|
$ |
—
|
$ |
27,482
|
$ |
19,195
|
$ |
—
|
$ |
46,677
|
||||||||||||
Salaries and benefits
|
—
|
—
|
12,287
|
9,138
|
—
|
21,425
|
||||||||||||||||||
Supplies
|
—
|
—
|
4,560
|
3,164
|
—
|
7,724
|
||||||||||||||||||
Other operating expenses
|
8
|
—
|
4,463
|
4,137
|
—
|
8,608
|
||||||||||||||||||
Equity in earnings of affiliates
|
(3,688
|
) |
—
|
(7
|
) |
(22
|
) |
3,688
|
(29
|
) | ||||||||||||||
Depreciation and amortization
|
—
|
—
|
1,335
|
943
|
—
|
2,278
|
||||||||||||||||||
Interest expense (income)
|
64
|
3,580
|
(1,635
|
) |
(254
|
) |
—
|
1,755
|
||||||||||||||||
Gains on sales of facilities
|
—
|
—
|
(357
|
) |
(71
|
) |
—
|
(428
|
) | |||||||||||||||
Losses on retirement of debt
|
—
|
9
|
—
|
—
|
—
|
9
|
||||||||||||||||||
Management fees
|
—
|
—
|
(639
|
) |
639
|
—
|
—
|
|||||||||||||||||
|
(3,616
|
) |
3,589
|
20,007
|
17,674
|
3,688
|
41,342
|
|||||||||||||||||
Income (loss) before income taxes
|
3,616
|
(3,589
|
) |
7,475
|
1,521
|
(3,688
|
) |
5,335
|
||||||||||||||||
Provision (benefit) for income taxes
|
(171
|
) |
(834
|
) |
1,714
|
237
|
—
|
946
|
||||||||||||||||
Net income (loss)
|
3,787
|
(2,755
|
) |
5,761
|
1,284
|
(3,688
|
) |
4,389
|
||||||||||||||||
Net income attributable to noncontrolling interests
|
—
|
—
|
99
|
503
|
—
|
602
|
||||||||||||||||||
Net income (loss) attributable to HCA Healthcare, Inc.
|
$ |
3,787
|
$ |
(2,755
|
) | $ |
5,662
|
$ |
781
|
$ |
(3,688
|
) | $ |
3,787
|
||||||||||
Comprehensive income (loss) attributable to HCA Healthcare, Inc.
|
$ |
3,779
|
$ |
(2,745
|
) | $ |
5,712
|
$ |
713
|
$ |
(3,680
|
) | $ |
3,779
|
||||||||||
|
HCA
Healthcare, Inc. Issuer |
|
HCA Inc.
Issuer |
|
Subsidiary
Guarantors |
|
Subsidiary
Non- Guarantors |
|
Eliminations
|
|
Condensed
Consolidated |
|
||||||||||||
Revenues
|
$ |
—
|
$ |
—
|
$ |
25,774
|
$ |
17,840
|
$ |
—
|
$ |
43,614
|
||||||||||||
Salaries and benefits
|
—
|
—
|
11,619
|
8,440
|
—
|
20,059
|
||||||||||||||||||
Supplies
|
—
|
—
|
4,286
|
3,030
|
—
|
7,316
|
||||||||||||||||||
Other operating expenses
|
6
|
—
|
4,249
|
3,796
|
—
|
8,051
|
||||||||||||||||||
Equity in earnings of affiliates
|
(2,476
|
) |
—
|
(6
|
) |
(39
|
) |
2,476
|
(45
|
) | ||||||||||||||
Depreciation and amortization
|
—
|
—
|
1,237
|
894
|
—
|
2,131
|
||||||||||||||||||
Interest expense (income)
|
64
|
3,088
|
(1,309
|
) |
(153
|
) |
—
|
1,690
|
||||||||||||||||
Gains on sales of facilities
|
—
|
—
|
(2
|
) |
(6
|
) |
—
|
(8
|
) | |||||||||||||||
Losses on retirement of debt
|
—
|
39
|
—
|
—
|
—
|
39
|
||||||||||||||||||
Management fees
|
—
|
—
|
(621
|
) |
621
|
—
|
—
|
|||||||||||||||||
|
(2,406
|
) |
3,127
|
19,453
|
16,583
|
2,476
|
39,233
|
|||||||||||||||||
Income (loss) before income taxes
|
2,406
|
(3,127
|
) |
6,321
|
1,257
|
(2,476
|
) |
4,381
|
||||||||||||||||
Provision (benefit) for income taxes
|
190
|
(1,154
|
) |
2,293
|
309
|
—
|
1,638
|
|||||||||||||||||
Net income (loss)
|
2,216
|
(1,973
|
) |
4,028
|
948
|
(2,476
|
) |
2,743
|
||||||||||||||||
Net income attributable to noncontrolling interests
|
—
|
—
|
108
|
419
|
—
|
527
|
||||||||||||||||||
Net income (loss) attributable to HCA Healthcare, Inc.
|
$ |
2,216
|
$ |
(1,973
|
) | $ |
3,920
|
$ |
529
|
$ |
(2,476
|
) | $ |
2,216
|
||||||||||
Comprehensive income (loss) attributable to HCA Healthcare, Inc.
|
$ |
2,276
|
$ |
(1,953
|
) | $ |
3,898
|
$ |
591
|
$ |
(2,536
|
) | $ |
2,276
|
||||||||||
|
HCA
Healthcare, Inc. Issuer |
|
HCA Inc.
Issuer |
|
Subsidiary
Guarantors |
|
Subsidiary
Non- Guarantors |
|
Eliminations
|
|
Condensed
Consolidated |
|
||||||||||||
ASSETS
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Current assets:
|
|
|
|
|
|
|
||||||||||||||||||
Cash and cash equivalents
|
$ |
—
|
$ |
—
|
$ |
118
|
$ |
503
|
$ |
—
|
$ |
621
|
||||||||||||
Accounts receivable, net
|
—
|
—
|
4,037
|
3,343
|
—
|
7,380
|
||||||||||||||||||
Inventories
|
—
|
—
|
1,208
|
641
|
—
|
1,849
|
||||||||||||||||||
Other
|
—
|
—
|
727
|
619
|
—
|
1,346
|
||||||||||||||||||
|
—
|
—
|
6,090
|
5,106
|
—
|
11,196
|
||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Property and equipment, net
|
—
|
—
|
13,418
|
9,297
|
—
|
22,715
|
||||||||||||||||||
Investments of insurance subsidiaries
|
—
|
—
|
—
|
315
|
—
|
315
|
||||||||||||||||||
Investments in and advances to affiliates
|
36,684
|
—
|
29
|
220
|
(36,684
|
) |
249
|
|||||||||||||||||
Goodwill and other intangible assets
|
—
|
—
|
5,743
|
2,526
|
—
|
8,269
|
||||||||||||||||||
Right-of-use
operating lease assets
|
—
|
—
|
455
|
1,379
|
—
|
1,834
|
||||||||||||||||||
Other
|
300
|
3
|
29
|
148
|
—
|
480
|
||||||||||||||||||
|
$ |
36,984
|
$ |
3
|
$ |
25,764
|
$ |
18,991
|
$ |
(36,684
|
) | $ |
45,058
|
|||||||||||
LIABILITIES AND STOCKHOLDERS’
(DEFICIT) EQUITY
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Current liabilities:
|
|
|
|
|
|
|
||||||||||||||||||
Accounts payable
|
$ |
—
|
$ |
—
|
$ |
1,903
|
$ |
1,002
|
$ |
—
|
$ |
2,905
|
||||||||||||
Accrued salaries
|
—
|
—
|
1,070
|
705
|
—
|
1,775
|
||||||||||||||||||
Other accrued expenses
|
85
|
341
|
1,001
|
1,505
|
—
|
2,932
|
||||||||||||||||||
Long-term debt due within one year
|
—
|
54
|
50
|
41
|
—
|
145
|
||||||||||||||||||
|
85
|
395
|
4,024
|
3,253
|
—
|
7,757
|
||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Long-term debt, net
|
998
|
32,016
|
213
|
350
|
—
|
33,577
|
||||||||||||||||||
Intercompany balances
|
38,089
|
(4,314
|
) |
(33,828
|
) |
53
|
—
|
—
|
||||||||||||||||
Professional liability risks
|
—
|
—
|
—
|
1,370
|
—
|
1,370
|
||||||||||||||||||
Right-of-use
operating lease obligations
|
—
|
—
|
345
|
1,154
|
—
|
1,499
|
||||||||||||||||||
Income taxes and other liabilities
|
620
|
7
|
252
|
541
|
—
|
1,420
|
||||||||||||||||||
|
39,792
|
28,104
|
(28,994
|
) |
6,721
|
—
|
45,623
|
|||||||||||||||||
Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc.
|
(2,808
|
) |
(28,101
|
) |
54,652
|
10,133
|
(36,684
|
) |
(2,808
|
) | ||||||||||||||
Noncontrolling interests
|
—
|
—
|
106
|
2,137
|
—
|
2,243
|
||||||||||||||||||
|
(2,808
|
) |
(28,101
|
) |
54,758
|
12,270
|
(36,684
|
) |
(565
|
) | ||||||||||||||
|
$ |
36,984
|
$ |
3
|
$ |
25,764
|
$ |
18,991
|
$ |
(36,684
|
) | $ |
45,058
|
|||||||||||
|
HCA
Healthcare, Inc. Issuer |
|
HCA Inc.
Issuer |
|
Subsidiary
Guarantors |
|
Subsidiary
Non- Guarantors |
|
Eliminations
|
|
Condensed
Consolidated |
|
||||||||||||
ASSETS
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Current assets:
|
|
|
|
|
|
|
||||||||||||||||||
Cash and cash equivalents
|
$ |
—
|
$ |
—
|
$ |
174
|
$ |
328
|
$ |
—
|
$ |
502
|
||||||||||||
Accounts receivable, net
|
—
|
—
|
3,964
|
2,825
|
—
|
6,789
|
||||||||||||||||||
Inventories
|
—
|
—
|
1,178
|
554
|
—
|
1,732
|
||||||||||||||||||
Other
|
—
|
—
|
669
|
521
|
—
|
1,190
|
||||||||||||||||||
|
—
|
—
|
5,985
|
4,228
|
—
|
10,213
|
||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Property and equipment, net
|
—
|
—
|
12,450
|
7,307
|
—
|
19,757
|
||||||||||||||||||
Investments of insurance subsidiaries
|
—
|
—
|
—
|
362
|
—
|
362
|
||||||||||||||||||
Investments in and advances to affiliates
|
33,166
|
—
|
29
|
203
|
(33,166
|
) |
232
|
|||||||||||||||||
Goodwill and other intangible assets
|
—
|
—
|
5,724
|
2,229
|
—
|
7,953
|
||||||||||||||||||
Other
|
478
|
64
|
35
|
113
|
—
|
690
|
||||||||||||||||||
|
$ |
33,644
|
$ |
64
|
$ |
24,223
|
$ |
14,442
|
$ |
(33,166
|
) | $ |
39,207
|
|||||||||||
LIABILITIES AND STOCKHOLDERS’
(DEFICIT) EQUITY
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Current liabilities:
|
|
|
|
|
|
|
||||||||||||||||||
Accounts payable
|
$ |
—
|
$ |
—
|
$ |
1,721
|
$ |
856
|
$ |
—
|
$ |
2,577
|
||||||||||||
Accrued salaries
|
—
|
—
|
998
|
582
|
—
|
1,580
|
||||||||||||||||||
Other accrued expenses
|
142
|
403
|
905
|
1,174
|
—
|
2,624
|
||||||||||||||||||
Long-term debt due within one year
|
—
|
696
|
55
|
37
|
—
|
788
|
||||||||||||||||||
|
142
|
1,099
|
3,679
|
2,649
|
—
|
7,569
|
||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Long-term debt, net
|
996
|
30,544
|
212
|
281
|
—
|
32,033
|
||||||||||||||||||
Intercompany balances
|
36,951
|
(6,789
|
) |
(28,415
|
) |
(1,747
|
) |
—
|
—
|
|||||||||||||||
Professional liability risks
|
—
|
—
|
—
|
1,275
|
—
|
1,275
|
||||||||||||||||||
Income taxes and other liabilities
|
505
|
—
|
223
|
520
|
—
|
1,248
|
||||||||||||||||||
|
38,594
|
24,854
|
(24,301
|
) |
2,978
|
—
|
42,125
|
|||||||||||||||||
Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc.
|
(4,950
|
) |
(24,790
|
) |
48,437
|
9,519
|
(33,166
|
) |
(4,950
|
) | ||||||||||||||
Noncontrolling interests
|
—
|
—
|
87
|
1,945
|
—
|
2,032
|
||||||||||||||||||
|
(4,950
|
) |
(24,790
|
) |
48,524
|
11,464
|
(33,166
|
) |
(2,918
|
) | ||||||||||||||
|
$ |
33,644
|
$ |
64
|
$ |
24,223
|
$ |
14,442
|
$ |
(33,166
|
) | $ |
39,207
|
|||||||||||
|
HCA
Healthcare, Inc. Issuer |
|
HCA Inc.
Issuer |
|
Subsidiary
Guarantors |
|
Subsidiary
Non- Guarantors |
|
Eliminations
|
|
Condensed
Consolidated |
|
||||||||||||
Cash flows from operating activities:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Net income (loss)
|
$ |
3,505
|
$ |
(3,260
|
) | $ |
6,345
|
$ |
1,152
|
$ |
(3,597
|
) | $ |
4,145
|
||||||||||
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
|
|
|
|
|
|
|
||||||||||||||||||
Change in operating assets and liabilities
|
—
|
(62
|
) |
17
|
(43
|
) |
—
|
(88
|
) | |||||||||||||||
Depreciation and amortization
|
—
|
—
|
1,447
|
1,149
|
—
|
2,596
|
||||||||||||||||||
Income taxes
|
250
|
—
|
—
|
—
|
—
|
250
|
||||||||||||||||||
Gains on sales of facilities
|
—
|
—
|
(14
|
) |
(4
|
) |
—
|
(18
|
) | |||||||||||||||
Losses on retirement of debt
|
—
|
211
|
—
|
—
|
—
|
211
|
||||||||||||||||||
Amortization of debt issuance costs
|
—
|
30
|
—
|
—
|
—
|
30
|
||||||||||||||||||
Share-based compensation
|
—
|
—
|
347
|
—
|
—
|
347
|
||||||||||||||||||
Equity in earnings of affiliates
|
(3,597
|
) |
—
|
—
|
—
|
3,597
|
—
|
|||||||||||||||||
Other
|
109
|
—
|
23
|
(3
|
) |
—
|
129
|
|||||||||||||||||
Net cash provided by (used in) operating activities
|
267
|
(3,081
|
) |
8,165
|
2,251
|
—
|
7,602
|
|||||||||||||||||
Cash flows from investing activities:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Purchase of property and equipment
|
—
|
—
|
(2,342
|
) |
(1,816
|
) |
—
|
(4,158
|
) | |||||||||||||||
Acquisition of hospitals and health care entities
|
—
|
—
|
(43
|
) |
(1,639
|
) |
—
|
(1,682
|
) | |||||||||||||||
Sales of hospitals and health care entities
|
—
|
—
|
42
|
19
|
—
|
61
|
||||||||||||||||||
Change in investments
|
—
|
—
|
6
|
19
|
—
|
25
|
||||||||||||||||||
Other
|
—
|
—
|
(7
|
) |
41
|
—
|
34
|
|||||||||||||||||
Net cash used in investing activities
|
—
|
—
|
(2,344
|
) |
(3,376
|
) |
—
|
(5,720
|
) | |||||||||||||||
Cash flows from financing activities:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Issuance of long-term debt
|
—
|
6,451
|
—
|
—
|
—
|
6,451
|
||||||||||||||||||
Net change in revolving bank credit facilities
|
—
|
(560
|
) |
—
|
—
|
—
|
(560
|
) | ||||||||||||||||
Repayment of long-term debt
|
—
|
(5,227
|
) |
(59
|
) |
(38
|
) |
—
|
(5,324
|
) | ||||||||||||||
Distributions to noncontrolling interests
|
—
|
—
|
(104
|
) |
(438
|
) |
—
|
(542
|
) | |||||||||||||||
Payment of debt issuance costs
|
—
|
(73
|
) |
—
|
—
|
—
|
(73
|
) | ||||||||||||||||
Payment of dividends
|
(550
|
) |
—
|
—
|
—
|
—
|
(550
|
) | ||||||||||||||||
Repurchases of common stock
|
(1,031
|
) |
—
|
—
|
—
|
—
|
(1,031
|
) | ||||||||||||||||
Changes in intercompany balances with affiliates, net
|
1,457
|
2,490
|
(5,714
|
) |
1,767
|
—
|
—
|
|||||||||||||||||
Other
|
(143
|
) |
—
|
—
|
1
|
—
|
(142
|
) | ||||||||||||||||
Net cash (used in) provided by financing activities
|
(267
|
) |
3,081
|
(5,877
|
) |
1,292
|
—
|
(1,771
|
) | |||||||||||||||
Effect of exchange rate changes on cash and cash equivalents
|
—
|
—
|
—
|
8
|
—
|
8
|
||||||||||||||||||
Change in cash and cash equivalents
|
—
|
—
|
(56
|
) |
175
|
—
|
119
|
|||||||||||||||||
Cash and cash equivalents at beginning of period
|
—
|
—
|
174
|
328
|
—
|
502
|
||||||||||||||||||
Cash and cash equivalents at end of period
|
$ |
—
|
$ |
—
|
$ |
118
|
$ |
503
|
$ |
—
|
$ |
621
|
||||||||||||
|
HCA
Healthcare, Inc. Issuer |
|
HCA Inc.
Issuer |
|
Subsidiary
Guarantors |
|
Subsidiary
Non- Guarantors |
|
Eliminations
|
|
Condensed
Consolidated |
|
||||||||||||
Cash flows from operating activities:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Net income (loss)
|
$ |
3,787
|
$ |
(2,755
|
) | $ |
5,761
|
$ |
1,284
|
$ |
(3,688
|
) | $ |
4,389
|
||||||||||
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
|
|
|
|
|
|
|
||||||||||||||||||
Change in operating assets and liabilities
|
—
|
23
|
(178
|
) |
188
|
—
|
33
|
|||||||||||||||||
Depreciation and amortization
|
—
|
—
|
1,335
|
943
|
—
|
2,278
|
||||||||||||||||||
Income taxes
|
74
|
—
|
—
|
—
|
—
|
74
|
||||||||||||||||||
Gains on sales of facilities
|
—
|
—
|
(357
|
) |
(71
|
) |
—
|
(428
|
) | |||||||||||||||
Losses on retirement of debt
|
—
|
9
|
—
|
—
|
—
|
9
|
||||||||||||||||||
Amortization of debt issuance costs
|
—
|
31
|
—
|
—
|
—
|
31
|
||||||||||||||||||
Share-based compensation
|
—
|
—
|
268
|
—
|
—
|
268
|
||||||||||||||||||
Equity in earnings of affiliates
|
(3,688
|
) |
—
|
—
|
—
|
3,688
|
—
|
|||||||||||||||||
Other
|
91
|
—
|
25
|
(9
|
) |
—
|
107
|
|||||||||||||||||
Net cash provided by (used in) operating activities
|
264
|
(2,692
|
) |
6,854
|
2,335
|
—
|
6,761
|
|||||||||||||||||
Cash flows from investing activities:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Purchase of property and equipment
|
—
|
—
|
(2,008
|
) |
(1,565
|
) |
—
|
(3,573
|
) | |||||||||||||||
Acquisition of hospitals and health care entities
|
—
|
—
|
(897
|
) |
(356
|
) |
—
|
(1,253
|
) | |||||||||||||||
Sales of hospitals and health care entities
|
—
|
—
|
770
|
38
|
—
|
808
|
||||||||||||||||||
Change in investments
|
—
|
—
|
12
|
45
|
—
|
57
|
||||||||||||||||||
Other
|
—
|
—
|
(9
|
) |
69
|
—
|
60
|
|||||||||||||||||
Net cash used in investing activities
|
—
|
—
|
(2,132
|
) |
(1,769
|
) |
—
|
(3,901
|
) | |||||||||||||||
Cash flows from financing activities:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Issuance of long-term debt
|
—
|
2,000
|
—
|
—
|
—
|
2,000
|
||||||||||||||||||
Net change in revolving bank credit facilities
|
—
|
(640
|
) |
—
|
—
|
—
|
(640
|
) | ||||||||||||||||
Repayment of long-term debt
|
—
|
(1,590
|
) |
(72
|
) |
(42
|
) |
—
|
(1,704
|
) | ||||||||||||||
Distributions to noncontrolling interests
|
—
|
—
|
(83
|
) |
(358
|
) |
—
|
(441
|
) | |||||||||||||||
Payment of debt issuance costs
|
—
|
(25
|
) |
—
|
—
|
—
|
(25
|
) | ||||||||||||||||
Payment of dividends
|
(487
|
) |
—
|
—
|
—
|
—
|
(487
|
) | ||||||||||||||||
Repurchases of common stock
|
(1,530
|
) |
—
|
—
|
—
|
—
|
(1,530
|
) | ||||||||||||||||
Changes in intercompany balances with affiliates, net
|
2,004
|
2,947
|
(4,505
|
) |
(446
|
) |
—
|
—
|
||||||||||||||||
Other
|
(252
|
) |
—
|
—
|
4
|
—
|
(248
|
) | ||||||||||||||||
Net cash (used in) provided by financing activities
|
(265
|
) |
2,692
|
(4,660
|
) |
(842
|
) |
—
|
(3,075
|
) | ||||||||||||||
Effect of exchange rate changes on cash and cash equivalents
|
—
|
—
|
—
|
(15
|
) |
—
|
(15
|
) | ||||||||||||||||
Change in cash and cash equivalents
|
(1
|
) |
—
|
62
|
(291
|
) |
—
|
(230
|
) | |||||||||||||||
Cash and cash equivalents at beginning of period
|
1
|
—
|
112
|
619
|
—
|
732
|
||||||||||||||||||
Cash and cash equivalents at end of period
|
$ |
—
|
$ |
—
|
$ |
174
|
$ |
328
|
$ |
—
|
$ |
502
|
||||||||||||
|
HCA
Healthcare, Inc. Issuer |
|
HCA Inc.
Issuer |
|
Subsidiary
Guarantors |
|
Subsidiary
Non- Guarantors |
|
Eliminations
|
|
Condensed
Consolidated |
|
||||||||||||
Cash flows from operating activities:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Net income (loss)
|
$ |
2,216
|
$ |
(1,973
|
) | $ |
4,028
|
$ |
948
|
$ |
(2,476
|
) | $ |
2,743
|
||||||||||
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
|
|
|
|
|
|
|
||||||||||||||||||
Change in operating assets and liabilities
|
—
|
(193
|
) |
(219
|
) |
116
|
—
|
(296
|
) | |||||||||||||||
Depreciation and amortization
|
—
|
—
|
1,237
|
894
|
—
|
2,131
|
||||||||||||||||||
Income taxes
|
433
|
—
|
—
|
—
|
—
|
433
|
||||||||||||||||||
Gains on sales of facilities
|
—
|
—
|
(2
|
) |
(6
|
) |
—
|
(8
|
) | |||||||||||||||
Losses on retirement of debt
|
—
|
39
|
—
|
—
|
—
|
39
|
||||||||||||||||||
Amortization of debt issuance costs
|
—
|
31
|
—
|
—
|
—
|
31
|
||||||||||||||||||
Share-based compensation
|
—
|
—
|
270
|
—
|
—
|
270
|
||||||||||||||||||
Equity in earnings of affiliates
|
(2,476
|
) |
—
|
—
|
—
|
2,476
|
—
|
|||||||||||||||||
Other
|
78
|
—
|
—
|
5
|
—
|
83
|
||||||||||||||||||
Net cash provided by (used in) operating activities
|
251
|
(2,096
|
) |
5,314
|
1,957
|
—
|
5,426
|
|||||||||||||||||
Cash flows from investing activities:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Purchase of property and equipment
|
—
|
—
|
(1,681
|
) |
(1,334
|
) |
—
|
(3,015
|
) | |||||||||||||||
Acquisition of hospitals and health care entities
|
—
|
—
|
(26
|
) |
(1,186
|
) |
—
|
(1,212
|
) | |||||||||||||||
Sales of hospitals and health care entities
|
—
|
—
|
14
|
11
|
—
|
25
|
||||||||||||||||||
Change in investments
|
—
|
—
|
(1
|
) |
(72
|
) |
—
|
(73
|
) | |||||||||||||||
Other
|
—
|
—
|
—
|
(4
|
) |
—
|
(4
|
) | ||||||||||||||||
Net cash used in investing activities
|
—
|
—
|
(1,694
|
) |
(2,585
|
) |
—
|
(4,279
|
) | |||||||||||||||
Cash flows from financing activities:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Issuance of long-term debt
|
—
|
1,500
|
—
|
2
|
—
|
1,502
|
||||||||||||||||||
Net change in revolving bank credit facilities
|
—
|
760
|
—
|
—
|
—
|
760
|
||||||||||||||||||
Repayment of long-term debt
|
—
|
(628
|
) |
(77
|
) |
(48
|
) |
—
|
(753
|
) | ||||||||||||||
Distributions to noncontrolling interests
|
—
|
—
|
(140
|
) |
(308
|
) |
—
|
(448
|
) | |||||||||||||||
Payment of debt issuance costs
|
—
|
(26
|
) |
—
|
—
|
—
|
(26
|
) | ||||||||||||||||
Repurchases of common stock
|
(2,051
|
) |
—
|
—
|
—
|
—
|
(2,051
|
) | ||||||||||||||||
Changes in intercompany balances with affiliates, net
|
1,867
|
490
|
(3,404
|
) |
1,047
|
—
|
—
|
|||||||||||||||||
Other
|
(66
|
) |
—
|
—
|
21
|
—
|
(45
|
) | ||||||||||||||||
Net cash (used in) provided by financing activities
|
(250
|
) |
2,096
|
(3,621
|
) |
714
|
—
|
(1,061
|
) | |||||||||||||||
Change in cash and cash equivalents
|
1
|
—
|
(1
|
) |
86
|
—
|
86
|
|||||||||||||||||
Cash and cash equivalents at beginning of period
|
—
|
—
|
113
|
533
|
—
|
646
|
||||||||||||||||||
Cash and cash equivalents at end of period
|
$ |
1
|
$ |
—
|
$ |
112
|
$ |
619
|
$ |
—
|
$ |
732
|
||||||||||||
|
2019
|
|
2018
|
|
2017
|
|
||||||
Presentation in HCA Healthcare, Inc. Consolidated Statements of Stockholders’ Deficit:
|
|
|
|
|||||||||
Repurchases of common stock
|
$
|
(1,031
|
)
|
$ |
(1,530
|
) | $ |
(2,051
|
) | |||
Share-based benefit plans
|
|
313
|
|
115
|
281
|
|||||||
Cash dividends declared ($1.60 per share — 2019 and $1.40 per share — 2018)
|
|
(555
|
)
|
(496
|
) |
—
|
||||||
Other
|
|
(11
|
)
|
(12
|
) |
(10
|
) | |||||
Presentation in Healthtrust, Inc. — The Hospital Company Consolidated Statements of Stockholder’s Deficit:
|
|
|
|
|
|
|||||||
Distributions to HCA Healthcare, Inc., net of contributions from HCA Healthcare, Inc.
|
$
|
(1,284
|
)
|
$ |
(1,923
|
) | $ |
(1,780
|
) | |||
Presentation in HCA Healthcare, Inc. Consolidated Statements of Cash Flows (cash flows from financing activities):
|
|
|
|
|
|
|||||||
Repurchases of common stock
|
$
|
(1,031
|
)
|
$ |
(1,530
|
) | $ |
(2,051
|
) | |||
Payment of dividends
|
|
(550
|
)
|
(487
|
) |
—
|
||||||
Presentation in Healthtrust, Inc. — The Hospital Company Consolidated Statements of Cash Flows (cash flows from financing activities):
|
|
|
|
|
|
|||||||
Cash distributions to HCA Healthcare, Inc.
|
$
|
(1,581
|
)
|
$ |
(2,017
|
) | $ |
(2,051
|
) | |||
|
2019
|
|||||||||||||||
|
First
|
|
Second
|
|
Third
|
|
Fourth
|
|
||||||||
Revenues
|
$
|
12,517
|
|
$
|
12,602
|
|
$
|
12,694
|
|
$
|
13,523
|
|
||||
Net income
|
$
|
1,181
|
(a)
|
$
|
927
|
(b)
|
$
|
764
|
(c)
|
$
|
1,273
|
|||||
Net income attributable to HCA Healthcare, Inc.
|
$
|
1,039
|
(a)
|
$
|
783
|
(b)
|
$
|
612
|
(c)
|
$
|
1,071
|
|||||
Basic earnings per share
|
$
|
3.03
|
|
$
|
2.29
|
|
$
|
1.80
|
|
$
|
3.16
|
|||||
Diluted earnings per share
|
$
|
2.97
|
|
$
|
2.25
|
|
$
|
1.76
|
|
$
|
3.09
|
|
|
2018
|
|||||||||||||||
|
First
|
|
Second
|
|
Third
|
|
Fourth
|
|
||||||||
Revenues
|
$ |
11,423
|
$ |
11,529
|
$ |
11,451
|
$ |
12,274
|
||||||||
Net income
|
$ |
1,282
|
(
d
)
|
$ |
966
|
(
e
)
|
$ |
896
|
(
f
)
|
$ |
1,245
|
(
g
)
|
||||
Net income attributable to HCA Healthcare, Inc.
|
$ |
1,144
|
(
d
)
|
$ |
820
|
(
e
)
|
$ |
759
|
(
f
)
|
$ |
1,064
|
(
g
)
|
||||
Basic earnings per share
|
$ |
3.26
|
$ |
2.35
|
$ |
2.20
|
$ |
3.09
|
||||||||
Diluted earnings per share
|
$ |
3.18
|
$ |
2.31
|
$ |
2.15
|
$ |
3.01
|
(a) | First quarter results include $1 million of losses on sales of facilities (See Note 3 of the notes to consolidated financial statements). |
(b) | Second quarter results include $14 million of gains on sales of facilities (See Note 3 of the notes to consolidated financial statements). |
(c) |
Third quarter results include $
162
million of losses on retirement of debt (See Note 9 of the notes to consolidated financial statements).
|
(d) |
F
irst
quarter results include $305 million of gains on sales of facilities (See Note 3 of the notes to consolidated financial statements).
|
(
e
)
|
Second quarter results include $8 million of gains on sales of facilities (See Note 3 of the notes to consolidated financial statements). |
(
f
)
|
Third quarter results include $
5
million of gains on sales of facilities (See Note 3 of the notes to consolidated financial statements) and $7 million of losses on retirement of debt (See Note 9 of the notes to consolidated financial statements).
|
(
g
)
|
Fourth quarter results include $6 million of gains on sales of facilities (See Note 3 of the notes to consolidated financial statements). |
Exhibit 4.1
DESCRIPTION OF THE REGISTRANTS SECURITIES
REGISTERED PURSUANT TO SECTION 12 OF THE
SECURITIES EXCHANGE ACT OF 1934
As of December 31, 2019, HCA Healthcare, Inc. had one class of securities registered under Section 12 of the Securities Exchange Act of 1934, as amended: our common stock.
In this Exhibit 4.1, when we refer to the Company, we, us or our or when we otherwise refer to ourselves, we mean HCA Healthcare, Inc., excluding, unless otherwise expressly stated, our subsidiaries and affiliates.
The following description is a summary of the material terms of our Certificate of Incorporation, as amended (the Certificate of Incorporation), and our Bylaws, as amended (the Bylaws), as currently in effect. This description is subject to, and qualified in its entirety by reference to, our Certificate of Incorporation and our Bylaws, each of which are incorporated by reference as an exhibit to the Annual Report on Form 10-K of which this Exhibit 4.1 is a part. We encourage you to read our Certificate of Incorporation, our Bylaws and the applicable provisions of the Delaware General Corporation Law (DGCL), for additional information.
Authorized Capital
As of December 31, 2019, our authorized capital stock consisted of 1,800,000,000 shares of common stock, par value $.01 per share and 200,000,000 shares of preferred stock.
Common Stock
Voting Rights. Under the terms of the Certificate of Incorporation, each holder of common stock is entitled to one vote for each share on all matters submitted to a vote of the stockholders, including the election of directors. Our stockholders do not have cumulative voting rights. Because of this, the holders of a majority of the shares of common stock entitled to vote and present in person or by proxy at any annual meeting of stockholders are able to elect all of the directors standing for election, if they should so choose.
Dividends. Subject to preferences that may be applicable to any then outstanding preferred stock, holders of common stock are entitled to receive ratably those dividends, if any, as may be declared from time to time by the Board of Directors out of legally available assets or funds.
Liquidation. In the event of our liquidation, dissolution, or winding up, holders of common stock are entitled to share ratably in the net assets legally available for distribution to stockholders after the payment of all of our debts and other liabilities and the satisfaction of any liquidation preference granted to the holders of any outstanding shares of preferred stock.
Rights and Preferences. Holders of common stock have no preemptive or conversion rights, and there are no redemption or sinking fund provisions applicable to the common stock. The rights, preferences, and privileges of the holders of common stock are subject to, and may be adversely affected by, the rights of the holders of shares of any series of preferred stock, which we may designate in the future.
Board of Directors
The Certificate of Incorporation provides for a Board of Directors of not less than three members, the exact number to be determined from time to time by resolution adopted by the affirmative vote of a majority of the total number of directors then in office. The Certificate of Incorporation provides that directors will be elected to hold office for a term expiring at the next annual meeting of stockholders and until a successor is duly elected and qualified or until his or her earlier death, resignation, disqualification or removal. In uncontested director elections each director is elected by the vote of the majority of the votes cast. An incumbent nominee not receiving a majority of the votes cast in an uncontested election shall continue to serve until (i) the directors successor is elected and qualifies or (ii) the Board of Directors accepts the directors resignation. Newly created directorships and vacancies may be filled, so long as there is at least one remaining director, only by the Board of Directors.
Amendment to Bylaws
The Certificate of Incorporation and Bylaws provide that the Board of Directors is expressly authorized to make, alter, amend, change, add to or repeal the Bylaws of the Company by the affirmative vote of a majority of the total number of directors then in office. Any amendment, alteration, change, addition or repeal of the Bylaws of the Company by the stockholders of the Company shall require the affirmative vote of the holders of at least a majority of the outstanding shares of the Company, voting together as a class, entitled to vote on such amendment, alteration, change, addition or repeal.
Amendment to Certificate of Incorporation
The Certificate of Incorporation provides that the affirmative vote of the holders of at least a majority of the voting power of all outstanding shares of the Company entitled to vote generally in the election of directors, voting together in a single class, is required to adopt any provision inconsistent with, to amend or repeal any provision of, or to adopt a bylaw inconsistent with certain specified provisions of the Certificate of Incorporation.
Special Meetings of Stockholders
The Certificate of Incorporation provides that special meetings of stockholders of the Company may be called only by either the Board of Directors, pursuant to a resolution adopted by the affirmative vote of the majority of the total number of directors then in office, or by the Chairman of the Board or the Chief Executive Officer of the Company.
Action on Written Consent
Pursuant to the Certificate of Incorporation and Bylaws, any action required or permitted to be taken at an annual or special meeting of stockholders of the Company may be taken only upon the vote of the stockholders at an annual or special meeting duly called and may not be taken by written consent of the stockholders.
Corporate Opportunities
The Certificate of Incorporation provides that we renounce any interest or expectancy of the Company in the business opportunities of certain of our current and prior investors and of their officers, directors, agents, shareholders, members, partners, affiliates and subsidiaries and each such party shall not have any obligation to offer us those opportunities unless presented to a director or officer of the Company in his or her capacity as a director or officer of the Company.
Advance Notice Requirements for Stockholder Proposals and Director Nominations
Our Bylaws provide that stockholders seeking to nominate candidates for election as directors or to bring business before an annual or special meeting of stockholders must provide timely notice of their proposal in writing to the secretary of the Company. Generally, to be timely, a stockholders notice must be delivered to, mailed or received at our principal executive offices, addressed to the secretary of the Company, and within the following time periods:
|
in the case of an annual meeting, no earlier than 120 days and no later than 90 days prior to the first anniversary of the date of the preceding years annual meeting; provided, however, that if (A) the annual meeting is advanced by more than 30 days, or delayed by more than 60 days, from the first anniversary of the preceding years annual meeting, or (B) no annual meeting was held during the preceding year, to be timely the stockholder notice must be received no earlier than 120 days before such annual meeting and no later than the later of 90 days before such annual meeting or the tenth day after the day on which public disclosure of the date of such meeting is first made; and |
|
in the case of a nomination of a person or persons for election to the Board of Directors at a special meeting of the stockholders called for the purpose of electing directors, no earlier than 120 days before such special meeting and no later than the later of 90 days before such annual or special meeting or the tenth day after the day on which public disclosure of the date of such meeting is first made. |
In no event shall an adjournment, postponement or deferral, or public disclosure of an adjournment, postponement or deferral, of a meeting of the stockholders commence a new time period (or extend any time period) for the giving of the stockholders notice.
We have also adopted a proxy access right that permits a stockholder, or a group of up to 20 stockholders, owning continuously for at least three years shares of our stock representing an aggregate of at least 3% of the voting power entitled to vote in the election of directors, to nominate and include in our proxy materials director nominees, provided that the stockholder(s) and the nominee(s) satisfy the requirements in our Bylaws. Under our Bylaws, to be considered timely, compliant notice of proxy access director nominations for next years proxy statement and form of proxy must be submitted to the Corporate Secretary at the address specified in our proxy statement no earlier than 150 days and no later than 120 days prior to the first anniversary of the date the Company mailed its proxy statement for the preceding years annual meeting; provided, however, that if (A) the annual meeting is not within 30 days before or after the anniversary date of the preceding years annual meeting, or (B) no annual meeting was held during the preceding year, to be timely the stockholder notice must be received no later than 90 days prior to such annual meeting or, if later, the tenth day after the day on which notice of the date of the meeting was mailed or public disclosure of the date of such meeting is first made, whichever occurs first.
Authorized but Unissued Capital Stock
Our Certificate of Incorporation authorizes our Board of Directors, without further action by the stockholders, to issue up to 200,000,000 shares of preferred stock, par value $.01 per share, in one or more classes or series, to establish from time to time the number of shares to be included in each such class or series, to fix the rights, powers and preferences of the shares of each such class or series and any qualifications, limitations, or restrictions thereon.
Delaware law does not require stockholder approval for any issuance of authorized shares. However, the listing requirements of the New York Stock Exchange, which would apply as long as our common stock is listed on the New York Stock Exchange, require stockholder approval of certain issuances equal to or exceeding 20% of the then outstanding voting power or then outstanding number of shares of common stock. These additional shares may be used for a variety of corporate purposes, including future public offerings, to raise additional capital or to facilitate acquisitions.
One of the effects of the existence of unissued and unreserved common stock or preferred stock may be to enable our Board of Directors to issue shares to persons friendly to current management, which issuance could render more difficult or discourage an attempt to obtain control of our company by means of a merger, tender offer, proxy contest or otherwise, and thereby protect the continuity of our management and possibly deprive the stockholder of opportunities to sell their shares of common stock at prices higher than prevailing market prices.
Limitation on Directors Liability and Indemnification
Section 145(a) of the DGCL grants each corporation organized thereunder the power to indemnify any person who was or is a party or is threatened to be made a party to any threatened, pending or completed action, suit or proceeding, whether civil, criminal, administrative or investigative (other than an action by or in the right of the corporation) by reason of the fact that the person is or was a director, officer, employee or agent of the corporation, or is or was serving at the request of the corporation as a director, officer, employee or agent of another corporation, partnership, joint venture, trust or other enterprise, against expenses (including attorneys fees), judgments, fines and amounts paid in settlement that were actually and reasonably incurred by the person in connection with such action, suit or proceeding if the person acted in good faith and in a manner the person reasonably believed to be in or not opposed to the best interests of the corporation, and, with respect to any criminal action or proceeding, had no reasonable cause to believe the persons conduct was unlawful. The termination of any action, suit or proceeding by judgment, order, settlement, conviction, or upon a plea of nolo contendere or its equivalent, shall not, of itself, create a presumption that the person did not act in good faith and in a manner which the person reasonably believed to be in or not opposed to the best interests of the corporation, and, with respect to any criminal action or proceeding, had reasonable cause to believe that the persons conduct was unlawful.
Section 145(b) of the DGCL grants each corporation organized thereunder the power to indemnify any person who was or is a party or is threatened to be made a party to any threatened, pending or completed action or suit by or in the right of the corporation to procure a judgment in its favor by reason of the fact that the person is or was a director, officer, employee or agent of the corporation, or is or was serving at the request of the corporation as a director, officer, employee or agent of another corporation, partnership, joint venture, trust or other enterprise against expenses (including attorneys fees) actually and reasonably incurred by the person in connection with the defense or settlement of such action or suit if the person acted in good faith and in a manner the person reasonably believed to be in or not opposed to the best interests of the corporation and except that no indemnification shall be made pursuant to Section 145(b) of the DGCL in respect of any claim, issue or matter as to which such person shall have been adjudged to be liable to the corporation unless and only to the extent that the Delaware Court of Chancery or the court in which such action or suit was brought shall determine upon application that, despite the adjudication of liability but in view of all the circumstances of the case, such person is fairly and reasonably entitled to indemnity for such expenses which the Court of Chancery or such other court shall deem proper.
Section 145(c) of the DGCL provides that to the extent that a present or former director or officer of a corporation has been successful on the merits or otherwise in defense of any action, suit or proceeding referred to in Sections 145(a) and (b) of the DGCL, as described in the preceding paragraphs, or in defense of any claim, issue or matter therein, such person shall be indemnified against expenses (including attorneys fees) actually and reasonably incurred by such person in connection therewith.
Section 145(g) of the DGCL provides, in general, that a corporation shall have the power to purchase and maintain insurance on behalf of any person who is or was a director, officer, employee or agent of the corporation against any liability asserted against the person in any such capacity, or arising out of the persons status as such, regardless of whether the corporation would have the power to indemnify the person against such liability under the provisions of the DGCL. We maintain a directors and officers insurance policy that insures our directors and officers against liabilities incurred in their capacity as such for which they are not otherwise indemnified, subject to certain exclusions.
Section 102(b)(7) of the DGCL enables a corporation in its certificate of incorporation, or an amendment thereto, to eliminate or limit the personal liability of a director to the corporation or its stockholders of monetary damages for violations of the directors fiduciary duty of care as a director, except (i) for any breach of the directors duty of loyalty to the corporation or its stockholders, (ii) for acts or omissions not in good faith or that involve intentional misconduct or a knowing violation of law, (iii) pursuant to Section 174 of the DGCL (providing for director liability in the event of unlawful payment of dividends or unlawful stock purchases or redemptions) or (iv) for any transaction from which a director derived an improper personal benefit. Our Certificate of Incorporation indemnifies the directors and officers to the full extent of the DGCL and also allows the Board of Directors to indemnify all other employees. Such right of indemnification is not exclusive of any right to which such officer or director may be entitled as a matter of law and shall extend and apply to the estates, heirs, executors and administrators of such persons.
We maintain a directors and officers insurance policy. The policy insures directors and officers against unindemnified losses arising from certain wrongful acts in their capacities as directors and officers and reimburses us for those losses for which we have lawfully indemnified the directors and officers. The policy contains various exclusions that are normal and customary for policies of this type.
Our employment agreements with certain of our officers provide indemnification for adverse tax consequences they may suffer pursuant to their employment agreements.
We have entered into an indemnification priority and information sharing agreement with certain of our current and prior investors and certain of their affiliated funds to clarify the priority of advancement and indemnification obligations among us and any of our directors appointed by such investors and other related matters.
We believe that our Certificate of Incorporation, Bylaws and insurance policies are necessary to attract and retain qualified persons to serve as directors and officers of the Company.
The limitation of liability and indemnification provisions in our Certificate of Incorporation and Bylaws may discourage stockholders from bringing a lawsuit against directors for breach of their fiduciary duty. They may also reduce the likelihood of derivative litigation against directors and officers, even though an action, if successful, might benefit us and other stockholders. Furthermore, a stockholders investment may be adversely affected to the extent we pay the costs of settlement and damage awards against directors and officers as required or allowed by these indemnification provisions.
Insofar as indemnification for liabilities arising under the Securities Act may be permitted to directors, officers or persons controlling us pursuant to the foregoing provisions or any other provisions described in this prospectus, we have been informed that in the opinion of the Securities and Exchange Commission such indemnification is against public policy as expressed in the Securities Act and is therefore unenforceable.
Delaware Anti-Takeover Statutes
Certain Delaware law provisions may make it more difficult for someone to acquire us through a tender offer, proxy contest or otherwise.
Section 203 of the DGCL provides that, subject to certain stated exceptions, an interested stockholder is any person (other than the corporation and any direct or indirect majority-owned subsidiary) who owns 15% or more of the outstanding voting stock of the corporation or is an affiliate or associate of the corporation and was the owner of 15% or more of the outstanding voting stock of the corporation at any time within the three-year period immediately prior to the date of determination, and the affiliates and associates of such person. A corporation may not engage in a business combination with any interested stockholder for a period of three years following the time that such stockholder became an interested stockholder unless:
|
prior to such time the board of directors of the corporation approved either the business combination or transaction which resulted in the stockholder becoming an interested stockholder; |
|
upon consummation of the transaction which resulted in the stockholder becoming an interested stockholder, the interested stockholder owned at least 85% of the voting stock of the corporation outstanding at the time the transaction commenced, excluding shares owned by (i) persons who are directors and also officers and (ii) employee stock plans in which participants do not have the right to determine confidentially whether shares held subject to the plan will be tendered in a tender or exchange offer; or |
|
at or subsequent to such time, the business combination is approved by the board of directors and authorized at an annual or special meeting of stockholders, and not by written consent, by the affirmative vote of at least 66 2/3% of the outstanding voting stock which is not owned by the interested stockholder. |
The effect of these provisions may make a change in control of our business more difficult by delaying, deferring or preventing a tender offer or other takeover attempt that a stockholder might consider in its best interest. This includes attempts that might result in the payment of a premium to stockholders over the market price for their shares. These provisions also may promote the continuity of our management by making it more difficult for a person to remove or change the incumbent members of the board of directors.
Transfer Agent and Registrar
EQ Shareowner Services is the transfer agent and registrar for our common stock.
Listing
Our common stock is listed on the New York Stock Exchange under the symbol HCA.
Exhibit 4.5(k)
Schedule of Omitted Supplements to U.S. Guarantee Agreement
The supplements to the U.S. guarantee agreement referenced below are substantially identical in all material respects to the Supplement No. 14 dated as of November 9, 2015 to the U.S. Guarantee dated as of November 17, 2006, as amended and restated as of February 26, 2014, as supplemented (the U.S. Guarantee Agreement) and filed as Exhibit 4.5(j) to the Companys annual report on Form 10-K for the fiscal year ended December 31, 2019 (the Annual Report), except as to the names of the additional U.S. guarantors listed on the signature pages thereto and the dates on which such supplements to the U.S. Guarantee Agreement were entered into. These supplements to the U.S. Guarantee Agreement are not being filed as exhibits to the Annual Report in reliance on Instruction 2 to Item 601 of Regulation S-K.
Supplements to the U.S. Guarantee Agreement entered into among HCA Inc., Bank of America, N.A., as administrative agent, and the following subsidiaries as additional U.S. guarantors, as of the dates indicated:
Supplement Number |
Date |
Additional U.S. Guarantors |
||
No. 13 | January 9, 2015 |
Citrus Memorial Hospital, Inc.
Citrus Memorial Property Management, Inc.
CHCA Pearland, L.P
Columbia Healthcare System of Louisiana, Inc.
HCA Pearland GP, Inc.
Mountain Division CVH, LLC
Pearland Partner, LLC
Primary Health, Inc.
Sarah Cannon Research Institute, LLC
SCRI Holdings, LLC
Southpoint, LLC
Vision Consulting Group LLC
Vision Holdings, LLC
WCP Properties, LLC |
||
No. 15 | January 10, 2017 |
East Florida DMC, Inc.
H2U Wellness Centers, LLC
JPM AA Housing, LLC
MediCredit, Inc.
Oklahoma Holding Company, LLC
Outpatient Services Holdings, Inc.
Oviedo Medical Center, LLC
SSHR Holdco, LLC
The Outsource Group, Inc. |
No. 16 | January 3, 2018 |
Cy-Fair Medical Center Hospital, LLC
Houston NW Manager, LLC
Houston PPH, LLC
North Houston TRMC, LLC
Savannah Health Services, LLC
Sebring Health Services, LLC
Southeast Georgia Health Services, LLC
Weatherford Health Services, LLC |
2
Exhibit 4.6(c)
Schedule of Omitted Supplements to Security Agreement
The supplements to the security agreement referenced below are substantially identical in all material respects to the Supplement No. 2 dated as of October 27, 2011 to the Security Agreement dated as of November 17, 2006, amended and restated as of March 2, 2009, as supplemented (the Security Agreement) and filed as Exhibit 4.6(b) to the Companys annual report on Form 10-K for the fiscal year ended December 31, 2019 (the Annual Report), except as to the names of the additional subsidiary grantors listed on the signature pages thereto and the dates on which such supplements to the Security Agreement were entered into. These supplements to the Security Agreement are not being filed as exhibits to the Annual Report in reliance on Instruction 2 to Item 601 of Regulation S-K.
Supplements to the Security Agreement entered into among HCA Inc., Bank of America, N.A., as collateral agent, and the following subsidiaries as additional subsidiary grantors, as of the dates indicated:
Supplement Number |
Date |
Additional Subsidiary Grantors |
||
No. 3 | November 4, 2011 | Spalding Rehabilitation L.L.C. | ||
No. 4 | January 27, 2012 |
HealthTrust Workforce Solutions, LLC
Parallon Business Solutions, LLC
Parallon Enterprises, LLC
Parallon Health Information Solutions, LLC
Parallon Payroll Solutions, LLC
Parallon Physician Services, LLC
PTS Solutions, LLC |
||
No. 5 | December 7, 2012 | HCA American Finance LLC | ||
No. 7 | December 6, 2013 | Poinciana Medical Center, Inc. | ||
No. 8 | December 6, 2013 | U.S. Collections, Inc. | ||
No. 9 | December 6, 2013 | West Florida MHT, LLC | ||
No. 10 | December 6, 2013 | West Florida PPH, LLC | ||
No. 12 | December 6, 2013 | North Texas MCA, LLC | ||
No. 13 | January 9, 2015 |
Citrus Memorial Hospital, Inc.
Citrus Memorial Property Management, Inc.
CHCA Pearland, L.P
Columbia Healthcare System of Louisiana, Inc.
HCA Pearland GP, Inc.
Mountain Division CVH, LLC
Pearland Partner, LLC
Primary Health, Inc.
Sarah Cannon Research Institute, LLC
SCRI Holdings, LLC
Southpoint, LLC
Vision Consulting Group LLC
Vision Holdings, LLC
WCP Properties, LLC |
No. 14 | November 9, 2015 |
PatientKeeper, Inc.
Putnam Community Medical Center of North Florida, LLC |
||
No. 15 | January 10, 2017 |
East Florida DMC, Inc.
H2U Wellness Centers, LLC
JPM AA Housing, LLC
MediCredit, Inc.
Oklahoma Holding Company, LLC
Outpatient Services Holdings, Inc.
Oviedo Medical Center, LLC
SSHR Holdco, LLC
Parallon Revenue Cycle Services, Inc. |
||
No. 16 | January 3, 2018 |
Cy-Fair Medical Center Hospital, LLC
Houston NW Manager, LLC
Houston PPH, LLC
North Houston TRMC, LLC
Savannah Health Services, LLC
Sebring Health Services, LLC
Southeast Georgia Health Services, LLC
Weatherford Health Services, LLC |
2
Exhibit 4.7(c)
Schedule of Omitted Supplements to Pledge Agreement
The supplements to the pledge agreement referenced below are substantially identical in all material respects to the Supplement No. 1 dated as of October 27, 2011 to the Pledge Agreement dated as of November 6, 2006, and amended and restated as of March 2, 2009, as supplemented (the Pledge Agreement) and filed as Exhibit 4.7(b) to the Companys annual report on Form 10-K for the fiscal year ended December 31, 2019 (the Annual Report), except as to the names of the additional pledgors listed on the signature pages thereto and the dates on which such supplements to the Pledge Agreement were entered into. These supplements to the Pledge Agreement are not being filed as exhibits to the Annual Report in reliance on Instruction 2 to Item 601 of Regulation S-K.
Supplements to the Pledge Agreement entered into among HCA Inc., Bank of America, N.A., as collateral agent, and the following subsidiaries as additional pledgors, as of the dates indicated:
Supplement Number |
Date |
Additional Pledgors |
||
No. 2 | November 4, 2011 | Spalding Rehabilitation L.L.C. | ||
No. 3 | January 27, 2012 |
HealthTrust Workforce Solutions, LLC Parallon Business Solutions, LLC Parallon Enterprises, LLC Parallon Health Information Solutions, LLC Parallon Payroll Solutions, LLC Parallon Physician Services, LLC PTS Solutions, LLC |
||
No. 4 | December 7, 2012 | HCA American Finance LLC | ||
No. 6 | December 6, 2013 | Poinciana Medical Center, Inc. | ||
No. 7 | December 6, 2013 | U.S. Collections, Inc. | ||
No. 8 | December 6, 2013 | West Florida MHT, LLC | ||
No. 9 | December 6, 2013 | West Florida PPH, LLC | ||
No. 11 | December 6, 2013 | North Texas MCA, LLC |
No. 12 | January 9, 2015 |
Citrus Memorial Hospital, Inc. Citrus Memorial Property Management, Inc. CHCA Pearland, L.P Columbia Healthcare System of Louisiana, Inc. HCA Pearland GP, Inc. Mountain Division CVH, LLC Pearland Partner, LLC Primary Health, Inc. Sarah Cannon Research Institute, LLC SCRI Holdings, LLC Southpoint, LLC Vision Consulting Group LLC Vision Holdings, LLC WCP Properties, LLC |
||
No. 13 | November 9, 2015 |
PatientKeeper, Inc. Putnam Community Medical Center of North Florida, LLC |
||
No. 14 | January 10, 2017 |
East Florida DMC, Inc. H2U Wellness Centers, LLC JPM AA Housing, LLC MediCredit, Inc. Oklahoma Holding Company, LLC Outpatient Services Holdings, Inc. Oviedo Medical Center, LLC SSHR Holdco, LLC The Outsource Group, Inc. |
||
No. 15 | January 3, 2018 |
Cy-Fair Medical Center Hospital, LLC Houston NW Manager, LLC Houston PPH, LLC North Houston TRMC, LLC Savannah Health Services, LLC Sebring Health Services, LLC Southeast Georgia Health Services, LLC Weatherford Health Services, LLC |
2
Exhibit 4.9(c)
Schedule of Omitted Supplements to Security Agreement
The supplements to the security agreement referenced below are substantially identical in all material respects to the Supplement No. 1 dated as of October 27, 2011 to the Security Agreement dated as of September 30, 2011, as supplemented (the Security Agreement) and filed as Exhibit 4.9(b) to the Companys annual report on Form 10-K for the fiscal year ended December 31, 2019 (the Annual Report), except as to the names of the additional subsidiary grantors listed on the signature pages thereto and the dates on which such supplements to the Security Agreement were entered into. These supplements to the Security Agreement are not being filed as exhibits to the Annual Report in reliance on Instruction 2 to Item 601 of Regulation S-K.
Supplements to the Security Agreement entered into among HCA Inc., Bank of America, N.A., as collateral agent, and the following subsidiaries as additional subsidiary grantors, as of the dates indicated:
Supplement Number |
Date |
Additional Subsidiary Grantors |
||
No. 2 | November 4, 2011 | Spalding Rehabilitation L.L.C. | ||
No. 3 | January 27, 2012 |
HealthTrust Workforce Solutions, LLC Parallon Business Solutions, LLC Parallon Enterprises, LLC Parallon Health Information Solutions, LLC Parallon Payroll Solutions, LLC Parallon Physician Services, LLC PTS Solutions, LLC |
||
No. 4 | December 7, 2012 | HCA American Finance LLC | ||
No. 6 | December 6, 2013 | Poinciana Medical Center, Inc. | ||
No. 7 | December 6, 2013 | U.S. Collections, Inc. | ||
No. 8 | December 6, 2013 | West Florida MHT, LLC | ||
No. 9 | December 6, 2013 | West Florida PPH, LLC | ||
No. 11 | December 6, 2013 | North Texas MCA, LLC | ||
No. 12 | March 25, 2014 | AR Holding 31, LLC | ||
No. 12 | January 9, 2015 |
Citrus Memorial Hospital, Inc. Citrus Memorial Property Management, Inc. CHCA Pearland, L.P Columbia Healthcare System of Louisiana, Inc. HCA Pearland GP, Inc. Mountain Division CVH, LLC Pearland Partner, LLC Primary Health, Inc. Sarah Cannon Research Institute, LLC SCRI Holdings, LLC Southpoint, LLC Vision Consulting Group LLC Vision Holdings, LLC WCP Properties, LLC |
No. 13 | November 9, 2015 |
PatientKeeper, Inc. Putnam Community Medical Center of North Florida, LLC |
||
No. 14 | January 10, 2017 |
East Florida DMC, Inc. H2U Wellness Centers, LLC JPM AA Housing, LLC MediCredit, Inc. Oklahoma Holding Company, LLC Outpatient Services Holdings, Inc. Oviedo Medical Center, LLC SSHR Holdco, LLC Parallon Revenue Cycle Services, Inc. |
||
No. 15 | January 3, 2018 |
Cy-Fair Medical Center Hospital, LLC Houston NW Manager, LLC Houston PPH, LLC North Houston TRMC, LLC Savannah Health Services, LLC Sebring Health Services, LLC Southeast Georgia Health Services, LLC Weatherford Health Services, LLC |
2
Exhibit 4.28(c)
Schedule of Omitted Supplemental Indentures to Supplemental Indentures relating to the Companys Senior Secured Notes
4.75% Senior Secured Notes due 2023 (Sixth Supplemental Indenture)
The supplemental indentures referenced below are substantially identical in all material respects to the Supplemental Indenture, dated as of January 3, 2018 (the Supplement to the Sixth Supplemental Indenture), to the indenture, dated as of August 1, 2011 (the Base Indenture) and filed as Exhibit 4.28(b) to the Companys annual report on Form 10-K for the fiscal year ended December 31, 2019 (the Annual Report) as supplemented by the Sixth Supplemental Indenture dated as of October 23, 2012, and filed as Exhibit 4.28(a) to the Annual Report, except as to the names of the subsidiary guarantors listed on the signature pages thereto and the dates on which such supplemental indentures were entered into. These supplemental indentures are not being filed as exhibits to the Annual Report in reliance on Instruction 2 to Item 601 of Regulation S-K.
Supplemental indentures to the Sixth Supplemental Indenture entered into among Delaware Trust Company, as trustee and Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent, and the following subsidiary guarantors on the dates indicated:
|
January 10, 2017 |
|
Oviedo Medical Center, LLC |
|
East Florida - DMC, LLC |
|
Oklahoma Holding Company, LLC |
|
Medicredit, Inc. |
|
The Outsource Group, Inc. |
|
Outpatient Services Holdings, Inc. |
|
H2U Wellness Centers, Inc. |
|
SSHR Holdco, LLC |
|
JPM AA Housing, LLC |
|
November 9, 2015 |
|
Putnam Community Medical Center of North Florida, LLC |
|
PatientKeeper, Inc. |
|
January 9, 2015 |
|
Mountain Division - CVH, LLC |
|
Citrus Memorial Hospital, Inc. |
|
Citrus Memorial Property Management, Inc. |
|
Primary Health, Inc. |
|
Pearland Partner, LLC |
|
HCA Pearland GP, Inc. |
|
Columbia Healthcare System of Louisiana, Inc. |
|
SCRI Holdings LLC |
|
Vision Consulting Group, LLC |
|
Vision Holdings, LLC |
|
Southpoint, LLC |
|
WCP Properties, LLC |
|
CHCA Pearland, L.P. |
|
Sarah Cannon Research Institute, LLC |
|
December 6, 2013 |
|
Poinciana Medical Center, Inc. |
|
U.S. Collections, Inc. |
|
West Florida - MHT, LLC |
|
West Florida - PPH, LLC |
|
North Texas - MCA, LLC |
|
December 7, 2012 |
|
HCA American Finance LLC |
5.00% Senior Secured Notes due 2024 (Eighth Supplemental Indenture)
The supplemental indentures referenced below are substantially identical in all material respects to the Supplement to the Sixth Supplemental Indenture, except as to the indenture being supplemented, the names of the subsidiary guarantors listed on the signature pages thereto and the dates on which such supplemental indentures were entered into. These supplemental indentures are not being filed as exhibits to the Annual Report in reliance on Instruction 2 to Item 601 of Regulation S-K.
Supplemental indentures to the Base Indenture as supplemented by the Eighth Supplemental Indenture dated as of March 17, 2014 and filed as Exhibit 4.34 to the Annual Report, entered into among Delaware Trust Company, as trustee and Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent, and the following subsidiary guarantors on the dates indicated:
|
January 3, 2018 |
|
Southeast Georgia Health Service, LLC |
|
Sebring Health Services, LLC |
|
Houston - PPH, LLC |
|
Cy-Fair Medical Center Hospital, LLC |
|
North Houston - TRMC, LLC |
|
Savannah Health Services, LLC |
|
Houston NW Manager, LLC |
|
Weatherford Health Services, LLC |
|
January 10, 2017 |
|
Oviedo Medical Center, LLC |
|
East Florida - DMC, LLC |
|
Oklahoma Holding Company, LLC |
|
Medicredit, Inc. |
|
The Outsource Group, Inc. |
|
Outpatient Services Holdings, Inc. |
|
H2U Wellness Centers, Inc. |
|
SSHR Holdco, LLC |
|
JPM AA Housing, LLC |
|
November 9, 2015 |
|
Putnam Community Medical Center of North Florida, LLC |
|
PatientKeeper, Inc. |
|
January 9, 2015 |
|
Mountain Division - CVH, LLC |
|
Citrus Memorial Hospital, Inc. |
|
Citrus Memorial Property Management, Inc. |
|
Primary Health, Inc. |
|
Pearland Partner, LLC |
|
HCA Pearland GP, Inc. |
|
Columbia Healthcare System of Louisiana, Inc. |
|
SCRI Holdings LLC |
|
Vision Consulting Group, LLC |
|
Vision Holdings, LLC |
|
Southpoint, LLC |
|
WCP Properties, LLC |
|
CHCA Pearland, L.P. |
|
Sarah Cannon Research Institute, LLC |
2
5.25% Senior Secured Notes due 2025 (Tenth Supplemental Indenture)
The supplemental indentures referenced below are substantially identical in all material respects to the Supplement to the Sixth Supplemental Indenture, except as to the indenture being supplemented, the names of the subsidiary guarantors listed on the signature pages thereto and the dates on which such supplemental indentures were entered into. These supplemental indentures are not being filed as exhibits to the Annual Report in reliance on Instruction 2 to Item 601 of Regulation S-K.
Supplemental indentures to the Base Indenture as supplemented by the Tenth Supplemental Indenture dated as of October 17, 2014 and filed as Exhibit 4.37 to the Annual Report, entered into among Delaware Trust Company, as trustee and Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent, and the following subsidiary guarantors on the dates indicated:
|
January 3, 2018 |
|
Southeast Georgia Health Service, LLC |
|
Sebring Health Services, LLC |
|
Houston - PPH, LLC |
|
Cy-Fair Medical Center Hospital, LLC |
|
North Houston - TRMC, LLC |
|
Savannah Health Services, LLC |
|
Houston NW Manager, LLC |
|
Weatherford Health Services, LLC |
|
January 10, 2017 |
|
Oviedo Medical Center, LLC |
|
East Florida - DMC, LLC |
|
Oklahoma Holding Company, LLC |
|
Medicredit, Inc. |
|
The Outsource Group, Inc. |
|
Outpatient Services Holdings, Inc. |
|
H2U Wellness Centers, Inc. |
|
SSHR Holdco, LLC |
|
JPM AA Housing, LLC |
|
November 9, 2015 |
|
Putnam Community Medical Center of North Florida, LLC |
|
PatientKeeper, Inc. |
|
January 9, 2015 |
|
Mountain Division - CVH, LLC |
|
Citrus Memorial Hospital, Inc. |
|
Citrus Memorial Property Management, Inc. |
|
Primary Health, Inc. |
|
Pearland Partner, LLC |
|
HCA Pearland GP, Inc. |
|
Columbia Healthcare System of Louisiana, Inc. |
|
SCRI Holdings LLC |
|
Vision Consulting Group, LLC |
|
Vision Holdings, LLC |
|
Southpoint, LLC |
|
WCP Properties, LLC |
|
CHCA Pearland, L.P. |
|
Sarah Cannon Research Institute, LLC |
5.25% Senior Secured Notes due 2026 (Fifteenth Supplemental Indenture)
The supplemental indentures referenced below are substantially identical in all material respects to the Supplement to the Sixth Supplemental Indenture, except as to the indenture being supplemented, the names of the subsidiary
3
guarantors listed on the signature pages thereto and the dates on which such supplemental indentures were entered into. These supplemental indentures are not being filed as exhibits to the Annual Report in reliance on Instruction 2 to Item 601 of Regulation S-K.
Supplemental indentures to the Base Indenture as supplemented by the Fifteenth Supplemental Indenture dated as of March 15, 2016 and filed as Exhibit 4.46 to the Annual Report, entered into among Delaware Trust Company, as trustee and Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent, and the following subsidiary guarantors on the dates indicated:
|
January 3, 2018 |
|
Southeast Georgia Health Service, LLC |
|
Sebring Health Services, LLC |
|
Houston - PPH, LLC |
|
Cy-Fair Medical Center Hospital, LLC |
|
North Houston - TRMC, LLC |
|
Savannah Health Services, LLC |
|
Houston NW Manager, LLC |
|
Weatherford Health Services, LLC |
|
January 10, 2017 |
|
Oviedo Medical Center, LLC |
|
East Florida - DMC, LLC |
|
Oklahoma Holding Company, LLC |
|
Medicredit, Inc. |
|
The Outsource Group, Inc. |
|
Outpatient Services Holdings, Inc. |
|
H2U Wellness Centers, Inc. |
|
SSHR Holdco, LLC |
|
JPM AA Housing, LLC |
4.50% Senior Secured Notes due 2027 (Sixteenth Supplemental Indenture)
The supplemental indentures referenced below are substantially identical in all material respects to the Supplement to the Sixth Supplemental Indenture, except as to the indenture being supplemented, the names of the subsidiary guarantors listed on the signature pages thereto and the dates on which such supplemental indentures were entered into. These supplemental indentures are not being filed as exhibits to the Annual Report in reliance on Instruction 2 to Item 601 of Regulation S-K.
Supplemental indentures to the Base Indenture as supplemented by the Sixteenth Supplemental Indenture dated as of August 15, 2016 and filed as Exhibit 4.49 to the Annual Report, entered into among Delaware Trust Company, as trustee and Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent, and the following subsidiary guarantors on the dates indicated:
|
January 3, 2018 |
|
Southeast Georgia Health Service, LLC |
|
Sebring Health Services, LLC |
|
Houston - PPH, LLC |
|
Cy-Fair Medical Center Hospital, LLC |
|
North Houston - TRMC, LLC |
|
Savannah Health Services, LLC |
|
Houston NW Manager, LLC |
|
Weatherford Health Services, LLC |
|
January 10, 2017 |
|
Oviedo Medical Center, LLC |
|
East Florida - DMC, LLC |
|
Oklahoma Holding Company, LLC |
4
|
Medicredit, Inc. |
|
The Outsource Group, Inc. |
|
Outpatient Services Holdings, Inc. |
|
H2U Wellness Centers, Inc. |
|
SSHR Holdco, LLC |
|
JPM AA Housing, LLC |
5.50% Senior Secured Notes due 2047 (Eighteenth Supplemental Indenture)
The supplemental indentures referenced below are substantially identical in all material respects to the Supplement to the Sixth Supplemental Indenture, except as to the indenture being supplemented, the names of the subsidiary guarantors listed on the signature pages thereto and the dates on which such supplemental indentures were entered into. These supplemental indentures are not being filed as exhibits to the Annual Report in reliance on Instruction 2 to Item 601 of Regulation S-K.
Supplemental indentures to the Base Indenture as supplemented by the Eighteenth Supplemental Indenture dated as of June 22, 2017 and filed as Exhibit 4.53 to the Annual Report, entered into among Delaware Trust Company, as trustee and Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent, and the following subsidiary guarantors on the date indicated:
|
January 3, 2018 |
|
Southeast Georgia Health Service, LLC |
|
Sebring Health Services, LLC |
|
Houston - PPH, LLC |
|
Cy-Fair Medical Center Hospital, LLC |
|
North Houston - TRMC, LLC |
|
Savannah Health Services, LLC |
|
Houston NW Manager, LLC |
|
Weatherford Health Services, LLC |
5
Exhibit 10.32
Form of HCA Healthcare, Inc.
Stock Appreciation Rights Agreement
This STOCK APPRECIATION RIGHTS AGREEMENT (the Agreement), dated as of (the Grant Date) is made by and between HCA Healthcare, Inc., a Delaware corporation (together with its Subsidiaries, Successors and other applicable Service Recipients, hereinafter referred to as the Company), and the individual whose name is set forth below, who is an employee of the Company and hereinafter referred to as the Grantee. Any capitalized terms herein not otherwise defined in Article I shall have the meaning set forth in the 2006 Stock Incentive Plan for Key Employees of HCA Holdings, Inc. and its Affiliates, as amended and restated (the Plan).
WHEREAS, the Company wishes to carry out the Plan, the terms of which are hereby incorporated by reference and made a part of this Agreement; and
WHEREAS, the Compensation Committee of the Board of Directors of the Company, including any subcommittee formed pursuant to Section 3(a) of the Plan, (or, if no such committee is appointed, the Board of Directors of the Company) (the Committee) has determined that it would be to the advantage and best interest of the Company and its shareholders to grant an award of Stock Appreciation Rights (SARs) as provided for herein to the Grantee as an incentive for increased efforts during his or her term of office, employment or service with the Company, and has advised the Company thereof and instructed the undersigned officers to issue said SARs;
NOW, THEREFORE, in consideration of the mutual covenants herein contained and other good and valuable consideration, receipt of which is hereby acknowledged, the parties hereto do hereby agree as follows:
STOCK APPRECIATION RIGHTS GRANT
Grantee: |
[Participant Name] |
|
[Participant Address] |
||
Aggregate number of SARs granted hereunder: |
[SAR Award] |
|
Base Price of all SARs granted hereunder: |
[Base Price] |
|
Grant Date of Award (Grant Date): |
[Grant Date] |
ARTICLE I
DEFINITIONS
Whenever the following terms are used in this Agreement, they shall have the meaning specified below unless the context clearly indicates to the contrary.
Section 1.1. Cause
Cause shall mean Cause as such term may be defined in any employment agreement or change-in-control agreement in effect at the time of termination of employment between the Grantee and the Company or, if there is no such employment or change-in-control agreement, Cause shall mean (i) willful and continued failure by Grantee (other than by reason of a Permanent Disability) to perform his or her material duties with respect to the Company which continues beyond ten (10) business days after a written demand for substantial performance is delivered to Grantee by the Company (the Cure Period); (ii) willful or intentional engaging by Grantee in material misconduct that causes material and demonstrable injury, monetarily or otherwise, to the Company or its Affiliates; (iii) conviction of, or a plea of nolo contendere to, a crime constituting (x) a felony under the laws of the United States or any state thereof or (y) a misdemeanor for which a sentence of more than six months imprisonment is imposed; or (iv) Grantees engaging in any action in breach of restrictive covenants made by Grantee under any agreement containing restrictive covenants (e.g., covenants not to disclose confidential information, to compete with the business of the Company or to solicit the employees thereof to terminate their employment) or any employment or change-in-control agreement between the Grantee and the Company, which continues beyond the Cure Period (to the extent that, in the Boards reasonable judgment, such breach can be cured).
Section 1.2. Good Reason
Good Reason shall mean Good Reason as such term may be defined in any employment agreement or change-in-control agreement in effect at the time of termination of employment between the Grantee and the Company, or, if there is no such employment or change-in-control agreement, Good Reason shall mean (i) (A) a reduction in Grantees base salary (other than a general reduction in base salary that affects all similarly situated employees (defined as all employees within the same Company pay grade as that of Grantee) in substantially the same proportions that the Board implements in good faith after consultation with the Chief Executive Officer and Chief Operating Officer of the Company, if any); (B) a reduction in Grantees annual incentive compensation opportunity; or (C) the reduction of benefits payable to Grantee under the Companys Supplemental Executive Retirement Plan (if Grantee is a participant in such plan), in each case other than any isolated, insubstantial and
2
inadvertent failure by the Company that is not in bad faith and is cured within ten (10) business days after Grantee gives the Company written notice of such event; provided that the events described in (i)(A) or (i)(B) above will not be deemed to give rise to Good Reason if employment is terminated, but Grantee declines an offer of employment involving a loss of compensation of less than 15% from a purchaser, transferee, outsourced vendor, new operating entity or affiliated employer; (ii) a substantial diminution in Grantees title, duties and responsibilities, other than any isolated, insubstantial and inadvertent failure by the Company that is not in bad faith and is cured within ten (10) business days after Grantee gives the Company written notice of such event; or (iii) a transfer of Grantees primary workplace to a location that is more than twenty (20) miles from his or her workplace as of the date of this Agreement; provided that Good Reason shall not be deemed to occur merely because Grantees willful decision to change position or status within the Company causes one or more of the occurrences described in (i), (ii), or (iii) to come about.
Section 1.3. Permanent Disability
Permanent Disability shall mean Disability as such term is defined in any employment agreement between Grantee and the Company, or, if there is no such employment agreement, Disability as defined in the long-term disability plan of the Company applicable to Grantee or that would apply to the Grantee if the Grantee were employed with the Company at the applicable time.
Section 1.4. Retirement
Retirement shall mean Grantees resignation from service with the Company (i) after attaining 65 years of age or (ii) after attaining 60 years of age and completing twenty (20) years of service with the Company.
Section 1.5. SARs
SARs shall mean the aggregate number of SARs granted under Section 2.1 of this Agreement.
Section 1.6. Secretary
Secretary shall mean the Secretary of the Company.
ARTICLE II
GRANT OF SARS
Section 2.1. Grant of SARs
For good and valuable consideration, on and as of the date hereof the Company grants to the Grantee an award of SARs (the Award) on the terms
3
and conditions set forth in this Agreement. Each SAR represents the right to receive pursuant to this Agreement, upon exercise of the SAR, a payment from the Company in shares of Common Stock having a value equal to the excess of the Fair Market Value of one Share on the exercise date over the Base Price (as defined below).
Section 2.2. Base Price
Subject to Section 2.4, the base price of each SAR granted pursuant to this Agreement (the Base Price) shall be as set forth on the first page of this Agreement.
Section 2.3. No Guarantee of Employment
Nothing in this Agreement or in the Plan shall confer upon the Grantee any right to continue in the employ of the Company nor interfere with or restrict in any way the rights of the Company, which are hereby expressly reserved, to terminate the employment of the Grantee at any time for any reason whatsoever, with or without cause, subject to the applicable provisions of, if any, the Grantees employment agreement with the Company or offer letter provided by the Company to the Grantee.
Section 2.4. Adjustments to SARs
The SARs shall be subject to the adjustment provisions of Sections 8 and 9 of the Plan, provided, however, that in the event of the payment of an extraordinary dividend by the Company to its stockholders, then: first, the Base Price of each SAR shall be reduced by the amount of the dividend per share paid, but only to the extent the Committee determines it to be permitted under applicable tax laws and it will not have adverse tax consequences to the Grantee; and, if such reduction cannot be fully effected due to such tax laws, second, the Company shall pay to the Grantee a cash payment, on a per SAR basis, equal to the balance of the amount of the dividend not permitted to be applied to reduce the Base Price of the applicable SARs as follows: (a) for each Share with respect to which a vested SAR relates, promptly following the date of such dividend payment; and (b), for each Share with respect to which an unvested SAR relates, on the date on which such SAR becomes vested and exercisable with respect to such Share.
ARTICLE III
PERIOD OF EXERCISABILITY
Section 3.1. Commencement of Exercisability
(a) So long as the Grantee continues to be employed by the
4
Company, this Award shall become vested and exercisable with respect to 25% of the SARs on each of the first four anniversaries of the Grant Date (each such date, a Vesting Date). Except as provided in Section 3.1(b), or as otherwise provided by the Committee, no part of this Award shall become vested as to any additional SARs as of any date following the termination of Grantees employment with the Company for any reason and any SAR, which is (or determined to be) unvested as of the Grantees termination of employment, shall immediately expire without payment therefor.
(b) Notwithstanding the foregoing, any unvested SARs may become vested prior to the applicable Vesting Date, or continue to vest (and not be forfeited) following Grantees termination of employment, under the following circumstances:
(1) Upon the occurrence of a Change in Control (the definition of which is set forth on Schedule A attached hereto):
(A) In the event the entity surviving the Change in Control (the Successor) assumes the Award granted hereby, if the Grantees employment with the Successor is terminated without Cause by the Successor, or terminates for Good Reason by the Grantee or on account of Grantees death, Permanent Disability, or Retirement prior to an applicable Vesting Date, all unvested SARs not previously forfeited shall immediately vest and become exercisable as of the date of such termination of employment for the applicable period set forth in Section 3.2;
(B) In the event the Successor does not assume the Award granted hereby, all SARs not previously forfeited shall vest (if not already vested) immediately prior to the effective date of the Change in Control, and shall be cancelled in exchange for the payment described in Section 9(a)(ii)(A) of the Plan as of the effective date of the Change in Control;
(2) Upon the Grantees Retirement on or after the first anniversary of the Grant Date, except as otherwise provided by Section 3.1(b)(1), any unvested SARs shall immediately thereupon vest and shall not be forfeited, but shall become exercisable only at the time such SARs would have become exercisable in accordance with Section 3(a) or this Section 3(b) had the Grantee remained employed with the Company through each applicable Vesting Date or Grantees earlier death or Permanent Disability; for the avoidance of doubt, in the event of Grantees Retirement prior to such one year anniversary of the Grant Date, unless otherwise provided in Section 3.1(b)(1)(A), no part of this Award shall become vested and all SARs subject to this Award shall immediately expire without payment therefor;
(3) In the event of the Grantees termination of employment on account of Grantees death or Permanent Disability on or after the first anniversary of the Grant Date, all unexercised SARs not previously forfeited shall vest and become exercisable immediately upon such termination.
5
Section 3.2. Expiration of SARs
The Grantee may not exercise any SAR granted pursuant to this Award, and any unexercised SAR shall immediately expire without any payment therefor, after the first to occur of the following events:
(a) The tenth anniversary of the Grant Date so long as the Grantee remains employed with the Company or a Successor through such date;
(b) The fourth anniversary of the date of the Grantees termination of employment with the Company or a Successor, if the Grantees employment terminates by reason of death or Permanent Disability;
(c) Immediately upon the date of the Grantees termination of employment by the Company or a Successor for Cause;
(d) One hundred and eighty (180) days after the date of the Grantees termination of employment by the Company or a Successor without Cause (for any reason other than as set forth in Section 3.2(b));
(e) One hundred and eighty (180) days after the date of the Grantees termination of employment with the Company or a Successor by the Grantee for Good Reason;
(f) The fourth anniversary of the date of the Grantees termination of employment with the Company or a Successor by the Grantee upon Retirement; or
(g) Sixty (60) days after the date of the Grantees termination of employment with the Company or a Successor by the Grantee without Good Reason (except due to Retirement, death or Permanent Disability).
For the avoidance of doubt, for purposes of this Agreement, Grantees employment shall not be deemed to have terminated so long as Grantee remains employed by any Service Recipient.
ARTICLE IV
EXERCISE
Section 4.1. Person Eligible to Exercise
The Grantee may exercise only that portion of this Award that has both vested and become exercisable at the time Grantee desires to exercise this Award and that has not expired pursuant to Section 3.2. During the lifetime of the
6
Grantee, only the Grantee (or his or her duly authorized legal representative) may exercise the SARs granted pursuant to this Award or any portion thereof. After the death of the Grantee, any vested and exercisable portion of this Award may, prior to the time when such portion becomes unexercisable under Section 3.2, be exercised by his personal representative or by any person empowered to do so under the Grantees will or under the then applicable laws of descent and distribution.
Section 4.2. Partial Exercise
Any vested and exercisable portion of this Award, or the entire Award, if then wholly vested and exercisable, may be exercised in whole or in part at any time prior to the time when the Award or portion thereof becomes unexercisable under Section 3.2.
Section 4.3. Manner of Exercise
Subject to the Companys code of conduct and securities trading policies as in effect from time to time, this Award, or any exercisable portion thereof, may be exercised solely by delivering to the Company or its designated agent all of the following prior to the time when the Award or such portion expires under Section 3.2:
(a) Notice in writing (or such other medium acceptable to the Company or its designated agent) signed or acknowledged by the Grantee or other person then entitled to exercise the Award, stating the number of SARs subject to the Award in respect of which the Award is thereby being exercised, such notice complying with all applicable rules established by the Committee;
(b) (i) Full payment (in cash or by check or by a combination thereof) to satisfy the minimum withholding tax obligation with respect to which the Award or portion thereof is exercised or (ii) indication that the Grantee elects to satisfy the withholding tax obligation through an arrangement that is compliant with the Sarbanes-Oxley Act of 2002 (and any other applicable laws and exchange rules) and that provides for the delivery of irrevocable instructions to a broker to sell Shares obtained upon the exercise of the Award and to deliver promptly to the Company an amount to satisfy the minimum withholding tax obligation that would otherwise be required to be paid by the Grantee to the Company pursuant to clause (i) of this subsection (b), or (iii) if made available by the Company, indication that the Grantee elects to have the number of Shares that would otherwise be issued to the Grantee upon exercise of such Award (or portion thereof) reduced by a number of Shares having an aggregate Fair Market Value, on the date of such exercise, equal to the payment to satisfy the minimum withholding tax obligation that would otherwise be required to be made by the Grantee to the Company pursuant to clause (i) of this subsection (b).
(c) If required by the Company, a bona fide written
7
representation and agreement, in a form satisfactory to the Company, signed by the Grantee or other person then entitled to exercise such Award or portion thereof, stating that the shares of Common Stock are being acquired for his own account, for investment and without any present intention of distributing or reselling said shares or any of them except as may be permitted under the Securities Act of 1933, as amended (the Act), and then applicable rules and regulations thereunder, and that the Grantee or other person then entitled to exercise such Award or portion thereof will indemnify the Company against and hold it free and harmless from any loss, damage, expense or liability resulting to the Company if any sale or distribution of the shares by such person is contrary to the representation and agreement referred to above; provided, however, that the Company may, in its reasonable discretion, take whatever additional actions it deems reasonably necessary to ensure the observance and performance of such representation and agreement and to effect compliance with the Act and any other federal or state securities laws or regulations; and
(d) In the event the Award or portion thereof shall be exercised pursuant to Section 4.1 by any person or persons other than the Grantee, appropriate proof of the right of such person or persons to exercise the Award.
Without limiting the generality of the foregoing, the Company may require an opinion of counsel acceptable to it to the effect that any subsequent transfer of shares acquired on exercise of this Award (or portion thereof) does not violate the Act, and may issue stop-transfer orders covering such Shares. Share certificates evidencing stock issued on exercise of any portion of this Award shall bear an appropriate legend referring to the provisions of subsection (c) above and the agreements herein. The written representation and agreement referred to in subsection (c) above shall, however, not be required if the shares to be issued pursuant to such exercise have been registered under the Act, and such registration is then effective in respect of such shares.
Section 4.4. Conditions to Issuance of Stock Certificates
The Shares issuable (whether by certificate or otherwise) upon the exercise of this Award, or any portion thereof, may be either previously authorized but unissued Shares or issued Shares, which have then been reacquired by the Company. Such Shares shall be fully paid and nonassessable. If share certificates are to be issued, the Company shall not be required to issue or deliver any certificate or certificates for Shares purchased upon the exercise of this Award or portion thereof prior to fulfillment of all of the following conditions:
(a) The obtaining of approval or other clearance from any state or federal governmental agency which the Committee shall, in its reasonable and good faith discretion, determine to be necessary or advisable; and
(b) The lapse of such reasonable period of time following the exercise of the Award as the Committee may from time to time establish for reasons of administrative convenience or as may otherwise be required by applicable law.
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Section 4.5. Rights as Stockholder
Except as otherwise provided in Section 2.4 of this Agreement, the holder of any SARs subject to this Award shall not be, nor have any of the rights or privileges of, a stockholder of the Company in respect of any Shares issuable upon the exercise of this Award or any portion thereof unless and until certificates representing such Shares shall have been issued by the Company to such holder, or the Company or its designated agent has otherwise recorded the appropriate book entries evidencing Grantees ownership of the Shares.
ARTICLE V
MISCELLANEOUS
Section 5.1. Administration
The Committee shall have the power to interpret the Plan and this Agreement and to adopt such rules for the administration, interpretation and application of the Plan as are consistent therewith and to interpret or revoke any such rules. All actions taken and all interpretations and determinations made by the Committee shall be final and binding upon the Grantee, the Company and all other interested persons. No member of the Committee shall be personally liable for any action, determination or interpretation made in good faith with respect to the Plan or this Award. In its absolute discretion, the Board may at any time and from time to time exercise any and all rights and duties of the Committee under the Plan and this Agreement.
Section 5.2. Award Not Transferable
No part of, or interest in, this Award shall be liable for the debts, contracts or engagements of the Grantee or his successors in interest or shall be subject to disposition by transfer, alienation, anticipation, pledge, encumbrance, assignment or any other means whether such disposition be voluntary or involuntary or by operation of law by judgment, levy, attachment, garnishment or any other legal or equitable proceedings (including bankruptcy), and any attempted disposition thereof shall be null and void and of no effect; provided, however, that this Section 5.2 shall not prevent transfers by will or by the applicable laws of descent and distribution.
Section 5.3. Notices
Any notice to be given under the terms of this Agreement to the Company shall be addressed to the Company in care of its Secretary or its designee, and any notice to be given to the Grantee shall be addressed to him at
9
the address (including an electronic address) reflected in the Companys books and records. By a notice given pursuant to this Section 5.3, either party may hereafter designate a different address for notices to be given to him. Any notice, which is required to be given to the Grantee, shall, if the Grantee is then deceased, be given to the Grantees personal representative if such representative has previously informed the Company of his status and address by written notice under this Section 5.3. Any notice shall have been deemed duly given when (i) delivered in person, (ii) delivered in an electronic form approved by the Company, (iii) enclosed in a properly sealed envelope or wrapper addressed as aforesaid, deposited (with postage prepaid) in a post office or branch post office regularly maintained by the United States Postal Service, or (iv) enclosed in a properly sealed envelope or wrapper addressed as aforesaid, deposited (with fees prepaid) in an office regularly maintained by FedEx, UPS, or comparable non-public mail carrier.
Section 5.4. Titles; Pronouns
Titles are provided herein for convenience only and are not to serve as a basis for interpretation or construction of this Agreement. The masculine pronoun shall include the feminine and neuter, and the singular the plural, where the context so indicates.
Section 5.5. Applicability of Plan
The Grantee hereby acknowledges receipt of a copy of the Plan and agrees to be bound by all the terms and provisions thereof. The terms of this Agreement are governed by the terms of the Plan, and in the case of any inconsistency between the terms of this Agreement and the terms of the Plan, the terms of the Plan shall govern.
Section 5.6. Amendment
Subject to Section 10 of the Plan, this Agreement may be amended only by a writing executed by the parties hereto, which specifically states that it is amending this Agreement.
Section 5.7 Governing Law
The laws of the State of Delaware shall govern the interpretation, validity and performance of the terms of this Agreement regardless of the law that might be applied under principles of conflicts of laws.
Section 5.8 Arbitration
In the event of any controversy among the parties hereto arising out of, or relating to, this Agreement which cannot be settled amicably by the parties,
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such controversy shall be finally, exclusively and conclusively settled by mandatory arbitration conducted expeditiously in accordance with the American Arbitration Association rules, by a single independent arbitrator. Such arbitration process shall take place within the Nashville, Tennessee metropolitan area. The decision of the arbitrator shall be final and binding upon all parties hereto and shall be rendered pursuant to a written decision, which contains a detailed recital of the arbitrators reasoning. Judgment upon the award rendered may be entered in any court having jurisdiction thereof. Each party shall bear its own legal fees and expenses, unless otherwise determined by the arbitrator. If the Grantee substantially prevails on any of his or her substantive legal claims, then the Company shall reimburse all legal fees and arbitration fees incurred by the Grantee to arbitrate the dispute.
IN WITNESS WHEREOF, this Agreement has been executed and delivered by the parties hereto.
HCA HEALTHCARE, INC. |
By: |
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Its: |
Grantee: |
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(electronically accepted) |
11
Schedule A
Definition of Change in Control
For purposes of this Agreement, the term Change in Control shall mean, in lieu of any definition contained in the Plan:
(i) the sale or disposition, in one or a series of related transactions, of all or substantially all of the assets of the Company to any Person or Group other than an employee benefit plan (or trust forming a part thereof) maintained by (1) the Company or (2) any corporation or other Person of which a majority of its voting power of its voting equity securities or equity interest is owned, directly or indirectly, by the Company (a Permitted Holder); or
(ii) any Person or Group, other than a Permitted Holder, becomes the Beneficial Owner (as such term is defined in Rule 13d-3 under the Exchange Act (or any successor rule thereto) (except that a Person shall be deemed to have beneficial ownership of all shares that any such Person has the right to acquire, whether such right is exercisable immediately or only after the passage of time)), directly or indirectly, of more than 50% of the total voting power of the voting stock of the Company (or any entity which controls the Company), including by way of merger, consolidation, tender or exchange offer or otherwise; or
(iii) a reorganization, recapitalization, merger or consolidation (a Corporate Transaction) involving the Company, unless securities representing more than 50% of the combined voting power of the then outstanding voting securities entitled to vote generally in the election of directors of the Company or the corporation resulting from such Corporate Transaction (or the parent of such corporation) are Beneficially Owned subsequent to such transaction by the Person or Persons who were the Beneficial Owners of the outstanding voting securities entitled to vote generally in the election of directors of the Company immediately prior to such Corporate Transaction, in substantially the same proportions as their ownership immediately prior to such Corporate Transaction; or
(iv) during any period of 12 months, individuals who at the beginning of such period constituted the Board (together with any new directors whose election by such Board or whose nomination for election by the shareholders of the Company was approved by a vote of a majority of the directors of the Company, then still in office, who were either directors at the beginning of such period or whose election or nomination for election was previously so approved) cease for any reason to constitute a majority of the Board then in office.
Exhibit 10.33
Form of HCA Healthcare, Inc.
Performance Share Unit Agreement
This PERFORMANCE SHARE UNIT AGREEMENT (this Agreement) is made and entered into as of the day of , 20 (the Grant Date), between HCA Healthcare, Inc., a Delaware corporation (together with its Subsidiaries and Affiliates, as applicable, the Company), and [Participant Name], (the Grantee). Capitalized terms not otherwise defined herein shall have the meaning ascribed to such terms in the Companys 2006 Stock Incentive Plan for Key Employees of HCA Holdings, Inc. and its Affiliates, as Amended and Restated (the Plan).
WHEREAS, the Company has adopted the Plan, which permits the issuance of Other Stock-Based Awards, including an award that provides the right to receive Shares upon the completion of the attainment of performance objectives (a Performance Share Unit); and
WHEREAS, the Compensation Committee of the Board of Directors of the Company or a subcommittee thereof (or if no such committee is appointed, the Board of Directors of the Company) (each, the Committee) has determined that Grantee is entitled to an award thereunder, a portion of which is payable as a Performance Share Unit award under the Plan;
NOW, THEREFORE, the parties hereto agree as follows:
PERFORMANCE SHARE UNIT GRANT
Grantee: |
[Participant Name] |
|
[Participant Address] |
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Target Number of Performance Share Units |
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Granted Hereunder (Target Award): |
[Award] |
|
Grant Date: |
[Grant Date] |
1. Grant of Performance Share Unit Award.
1.1 The Company hereby grants to the Grantee the award (Award) of Performance Share Units (PSUs) set forth above on the terms and conditions set forth in this Agreement and as otherwise provided in the Plan. A bookkeeping account will be maintained by the Company to keep track of the PSUs and any dividend equivalent units that may accrue as provided in Section 3.
1.2 The Grantees rights with respect to the Award shall remain forfeitable at all times prior to the dates on which the PSUs shall vest in accordance
with Section 2 hereof. This Award may not be assigned, alienated, pledged, attached, sold or otherwise transferred or encumbered by Grantee other than by will or the laws of descent and distribution. Any sale, assignment, transfer, pledge, hypothecation, loan or other disposition other than in accordance with this Section 1.2 shall be null and void.
2. Vesting and Payment.
2.1 General. Except as provided in Section 2.2, Section 2.3 or Section 2.4, the Award shall vest as of the end of the Performance Period (as defined in this Section 2.1(a)) (the Normal Vesting Date), but only if (a) and to the extent the Company has achieved the performance targets over the period (the Performance Period) set forth on Exhibit A attached hereto as certified by the Committee, and (b) the Grantee has remained in service with the Company continuously until the Normal Vesting Date. The number of PSUs that vest may be greater than or less than the Target Award, as more specifically set forth on Exhibit A.
2.2 Death; Disability; Retirement; Involuntary Termination Without Cause.
(a) Notwithstanding Section 2.1, in the event the Grantees employment with the Company terminates prior to the Normal Vesting Date on account of Grantees death, Grantee shall immediately vest in a number of PSUs equal to the Target Award, multiplied by a fraction, the numerator of which is the number of days during the Performance Period during which Grantee was employed by the Company, and the denominator of which is the total number of days in the Performance Period (such fraction, the Proration Factor); provided, that this Section 2.2(a) shall not apply if Grantees death occurs prior to the first anniversary of the Grant Date.
(b) Notwithstanding Section 2.1, in the event of the Grantees employment with the Company terminates prior to the Normal Vesting Date on account of Grantees Permanent Disability, Grantee shall vest on the Normal Vesting Date in a number of PSUs equal to the number of PSUs that would have vested if the Grantee had remained employed with the Company until the Normal Vesting Date (based on the attainment of the performance targets determined by the Committee in accordance with Exhibit A hereto), multiplied by the Proration Factor; provided, that this Section 2.2(b) shall not apply if Grantees employment terminates prior to the first anniversary of the Grant Date. Any such PSUs shall settle at the time set forth in Section 2.5 as if they had vested on the Normal Vesting Date, or if earlier, upon the determination of the number of PSUs that shall be eligible to vest in connection with a Change in Control as described in Section 2.4. For purposes of this Agreement, Permanent Disability shall have the meaning as set forth in any employment agreement between Grantee and the Company, or if there is no such employment agreement, as defined in the long-term disability plan of the Company applicable to Grantee or that would apply to the Grantee if the Grantee were employed with the Company at the applicable time.
(c) Notwithstanding Section 2.1, in the event Grantees employment terminates on account of Retirement or as a result of an involuntary termination without Cause by the Company, Grantee shall vest on the Normal Vesting Date in a number of PSUs equal to the number of PSUs that would have vested if the Grantee had remained employed with the Company until the Normal Vesting Date (based on the attainment of the performance targets determined by the Committee in accordance with Exhibit A hereto), multiplied by the Proration Factor; provided, that this Section 2.2(c) shall not apply if Grantees employment terminates prior to the first anniversary of the Grant Date. Any such PSUs shall settle at the time set forth in Section 2.5 as if they had vested on the Normal Vesting Date, or if earlier, upon the determination of the number of PSUs that shall be eligible to vest in connection with a Change in Control as described in Section 2.4.
For purposes of this Agreement, unless otherwise defined in any other contractual agreement between Grantee and the Successor, (1) Retirement means Grantees resignation from service with the Company (i) after attaining 65 years of age, or (ii) after attaining 60 years of age and completing twenty years of service with the Company; and (2) Cause means Cause as such term may be defined in any employment agreement or change-in-control agreement in effect at the time of termination of employment between the Grantee and the Company, or, if there is no such employment or change-in-control agreement, Cause shall mean (i) willful and continued failure by Grantee (other than by reason of a Permanent Disability) to perform his or her material duties with respect to the Company which continues beyond ten (10) business days after a written demand for substantial performance is delivered to Grantee by the Company (the Cure Period); (ii) willful or intentional engaging by Grantee in material misconduct that causes material and demonstrable injury, monetarily or otherwise, to the Company; (iii) conviction of, or a plea of nolo contendere to, a crime constituting (x) a felony under the laws of the United States or any state thereof or (y) a misdemeanor for which a sentence of more than six months imprisonment is imposed; or (iv) Grantees engaging in any action in breach of restrictive covenants made by Grantee under any agreement containing restrictive covenants (e.g., covenants not to disclose confidential information, to compete with the business of the Company or to solicit the employees thereof to terminate their employment) or any employment or change-in-control agreement between the Grantee and the Company, which continues beyond the Cure Period (to the extent that, in the Company reasonable judgment, such breach can be cured).
(d) In the event Grantees employment has terminated as described in Section 2.2(b) or Section 2.2(c), and Grantee subsequently dies more than six months prior to the Normal Vesting Date, the provisions of Section 2.2(b) or Section 2.2(c) shall be applied as if the performance targets had been achieved at the 100% Target Award level, and the applicable number of PSUs (after applying the applicable proration) shall immediately thereupon vest.
2.3 Termination of Employment. Except as provided in Section 2.2, Section 2.4 or as otherwise provided by the Committee, if the Grantees service as an employee of the Company terminates for any reason prior to the Normal Vesting Date, the Grantee shall forfeit all rights with respect to all PSUs that are not vested on such date of termination.
2.4 Change in Control. Upon the occurrence of a Change in Control (the definition of which is set forth on Schedule A attached hereto),
(a) Subject to Section 2.4(c), in the event the entity surviving the Change in Control (together with its Affiliates, the Successor) assumes the Award granted hereby, (1) any in process Performance Periods shall end upon the date immediately preceding the Change in Control, (2) the number of PSUs that shall be eligible to vest shall be the Target Award, (3) such Target Award shall vest on the Normal Vesting Date, provided that Grantee remains employed with the Successor through the Normal Vesting Date and (4) notwithstanding Section 2.3 and the previous clause, in the event the Grantees employment with the Successor is terminated without Cause by the Successor, or terminates for Good Reason by the Grantee or on account of Grantees death or Permanent Disability prior to the Normal Vesting Date, the Target Award shall immediately vest and the applicable Shares shall be released to the Grantee (or Grantees estate or other legal representative) upon the Grantees termination of employment.
(b) In the event the Successor does not assume the Award granted hereby, a number of PSUs equal to the Target Award shall vest as of the effective date of the Change in Control and the appropriate number of Shares shall be released in accordance with Section 2.5.
(c) In the event Grantee is Retirement eligible at the time of a Change in Control and the Successor assumes the Award granted hereby, a number of PSUs equal to the Target Award, multiplied by the Proration Factor applied as if the Grantees employment terminated on account of Retirement on the effective date of the Change in Control, shall vest as of the effective date of the Change in Control and the appropriate number of Shares shall be released in accordance with Section 2.5. In addition, a number of PSUs equal to the difference between the Target Award and the number of PSUs settled on the effective date of the Change in Control shall remain unvested but shall become eligible to vest under terms and conditions similar to those set forth in Section 2.4(a)(3) and Section 2.4(a)(4).
(d) For purposes of this Agreement, unless otherwise defined in any other contractual agreement between Grantee and the Successor, Good Reason shall mean Good Reason as such term may be defined in any employment agreement or change-in-control agreement in effect at the time of termination of employment between the Grantee and the Successor, or, if there is no such employment or change-in-control agreement, Good Reason shall mean (i) (A) a reduction in Grantees base salary (other than a general reduction in base salary that affects all similarly situated employees (defined as all employees within the same Successor pay grade as that of Grantee) in substantially the same proportions that the Successor implements in good faith, if any); (B) a reduction in
Grantees annual incentive compensation opportunity; or (C) the reduction of benefits payable to Grantee under the Companys Supplemental Executive Retirement Plan (if Grantee is a participant in such plan), in each case other than any isolated, insubstantial and inadvertent failure by the Successor that is not in bad faith and is cured within ten (10) business days after Grantee gives the Successor written notice of such event; provided that the events described in (i)(A) or (i)(B) above will not be deemed to give rise to Good Reason if employment is terminated, but Grantee declines an offer of employment involving a loss of compensation of less than 15% from the Successor; (ii) a substantial diminution in Grantees title, duties and responsibilities, other than any isolated, insubstantial and inadvertent failure by the Successor that is not in bad faith and is cured within ten (10) business days after Grantee gives the Successor written notice of such event; or (iii) a transfer of Grantees primary workplace to a location that is more than twenty (20) miles from his or her workplace as of the date of this Agreement; provided that Good Reason shall not be deemed to occur merely because Grantees willful decision to change position or status within the Successor causes one or more of the occurrences described in (i), (ii), or (iii) to come about. For purposes of this Section 2.4, the definitions of Cause and Permanent Disability shall be applied with respect to the Successor as well as the Company.
2.5 Settlement. The Grantee shall be entitled to settlement of the PSUs covered by this Agreement at the time that such PSUs vest pursuant to Section 2.1, Section 2.2 or Section 2.4, as applicable, or if applicable, the date on which the Committee provides the certification set forth in Section 2.1(a) (any such date, the Settlement Date). Such settlement shall be made as promptly as practicable thereafter (but in no event after the earlier of the thirtieth day following the Settlement Date or the date that is two months and fifteen days following the Normal Vesting Date), through the issuance to the Grantee (or to the executors or administrators of Grantees estate in the event of the Grantees death) of a stock certificate (or evidence such Shares have been registered in the name of the Grantee with the relevant stock agent) for a number of Shares equal to the number of such vested PSUs and any Dividend Equivalent Units that may have accrued pursuant to Section 3 hereof; provided, that any cash-based dividend equivalent rights granted pursuant to Section 3 hereof and any fractional Dividend Equivalent Units shall be paid in cash when (and only if) the PSUs to which they relate settle to the Grantee.
2.6 Withholding Obligations. Except as otherwise provided by the Committee, upon the settlement of any PSUs subject to this Award, the Company shall reduce the number of Shares (and the amount of cash, in the case of cash-based dividend equivalent rights) that would otherwise be issued to the Grantee upon settlement of the Award by a number of Shares (and cash, if applicable) having an aggregate Fair Market Value on the date of such issuance equal to the payment to satisfy the minimum withholding tax obligation of the Company with respect to which the Award is being settled.
3. Dividend Rights.
The Grantee shall receive dividend equivalent rights in respect of the PSUs covered by this Award at the time of any payment of dividends to stockholders on Shares. At the Companys option, the PSUs will be credited with either (a) additional Performance Share Units (the Dividend Equivalent Units) (including fractional units) for cash dividends paid on shares of the Companys Common Stock by (i) multiplying the cash dividend paid per Share by the number of PSUs (and previously credited Dividend Equivalent Units) outstanding and unpaid, and (ii) dividing the product determined above by the Fair Market Value of a Share, in each case, on the date the dividend record date, or (b) a cash amount equal to the amount that would be payable to the Grantee as a stockholder in respect of a number of Shares equal to the number of PSUs (and previously credited Dividend Equivalent Units) outstanding and unpaid as of the dividend record date; provided, that cash-based dividend equivalents shall be credited unless the Committee affirmatively elects to credit Dividend Equivalent Units. The PSUs will be credited with Dividend Equivalent Units for stock dividends paid on shares of the Companys Common Stock by multiplying the stock dividend paid per Share by the number of PSUs (and previously credited Dividend Equivalent Units) outstanding and unpaid on the dividend record date. Each Dividend Equivalent Unit shall have a value equal to one Share. Each Dividend Equivalent Unit or cash dividend equivalent right will vest and be settled or payable at the same time as the PSU to which the dividend equivalent right relates. For the avoidance of doubt, no dividend equivalent rights shall accrue under this Section 3 in the event that any dividend equivalent rights or other applicable adjustments pursuant to Section 5 hereof provide similar benefits.
4. No Right to Continued Service.
Nothing in this Agreement or the Plan shall be interpreted or construed to confer upon the Grantee any right to continue service as an officer or employee of the Company.
5. Adjustments.
The provisions of Section 8 and Section 9 of the Plan are hereby incorporated by reference, and the PSUs (and any Dividend Equivalent Units) are subject to such provisions. Any determination made by the Committee or the Board pursuant to such provisions shall be made in accordance with the provisions of the Plan and shall be final and binding for all purposes of the Plan and this Agreement.
6. Administration Subject to Plan.
The Grantee hereby acknowledges receipt of a copy of the Plan and agrees to be bound by all the terms and provisions thereof. The terms of this Agreement are governed by the terms of the Plan, and in the case of any inconsistency between the terms of this Agreement and the terms of the Plan, the terms of the Plan shall govern. The Committee shall have the power to interpret the Plan and
this Agreement and to adopt such rules for the administration, interpretation and application of the Plan as are consistent therewith and to interpret or revoke any such rules. All actions taken and all interpretations and determinations made by the Committee shall be final and binding upon the Grantee, the Company and all other interested persons. No member of the Committee shall be personally liable for any action, determination or interpretation made in good faith with respect to the Plan or this Award.
7. Modification of Agreement.
Subject to the restrictions contained in Sections 6 and 10 of the Plan, the Committee may waive any conditions or rights under, amend any terms of, or alter, suspend, discontinue, cancel or terminate, the Award, prospectively or retroactively; provided that any such waiver, amendment, alteration, suspension, discontinuance, cancellation or termination that would adversely affect the rights of the Grantee or any holder or beneficiary of the Award in more than a de minimis way shall not to that extent be effective without the consent of the Grantee, holder or beneficiary affected.
8. Section 409A.
Notwithstanding anything herein to the contrary, to the maximum extent permitted by applicable law, the settlement of the PSUs (including any dividend equivalent rights related thereto) to be made to the Grantee pursuant to this Agreement is intended to qualify as a short-term deferral pursuant to Section 1.409A-1(b)(4) of the Regulations and this Agreement shall be interpreted consistently therewith. However, under certain circumstances, settlement of the PSUs or any dividend equivalent rights may not so qualify, and in that case, the Committee shall administer the grant and settlement of such PSUs and any dividend equivalent rights in strict compliance with Section 409A of the Code. Further, notwithstanding anything herein to the contrary, if at the time of a Participants termination of employment with the Company and all Service Recipients, the Participant is a specified employee as defined in Section 409A of the Code, and the deferral of the commencement of any payments or benefits otherwise payable hereunder as a result of such termination of service is necessary in order to prevent the imposition of any accelerated or additional tax under Section 409A of the Code, then the Company will defer the commencement of the payment of any such payments or benefits hereunder (without any reduction in such payments or benefits ultimately paid or provided to the Participant) to the minimum extent necessary to satisfy Section 409A of the Code until the date that is six months and one day following the Participants termination of employment with the Company (or the earliest date as is permitted under Section 409A of the Code), if such payment or benefit is payable upon a termination of employment. For purposes of this Agreement, a termination of employment shall have the same meaning as separation from service under Section 409A of the Code and Grantee shall be deemed to have remained employed so long as Grantee has not separated from service with the Company or Successor. Each payment of PSUs (and related dividend equivalent units) constitutes a separate payment for purposes of Section 409A of the Code.
9. Severability.
If any provision of this Agreement is, or becomes, or is deemed to be invalid, illegal, or unenforceable in any jurisdiction or as to any Person or the Award, or would disqualify the Plan or Award under any laws deemed applicable by the Committee, such provision shall be construed or deemed amended to conform to the applicable laws, or if it cannot be construed or deemed amended without, in the determination of the Committee, materially altering the intent of the Plan or the Award, such provision shall be stricken as to such jurisdiction, Person or Award, and the remainder of the Plan and Award shall remain in full force and effect.
10. Governing Law.
The validity, interpretation, construction and performance of this Agreement shall be governed by the laws of the State of Delaware without giving effect to the conflicts of law principles thereof, except to the extent that such laws are preempted by Federal law.
11. Successors in Interest.
This Agreement shall inure to the benefit of and be binding upon any successor to the Company. This Agreement shall inure to the benefit of the Grantees legal representatives. All obligations imposed upon the Grantee and all rights granted to the Company under this Agreement shall be binding upon the Grantees heirs, executors, administrators and successors.
12. Resolution of Disputes.
Any dispute or disagreement which may arise under, or as a result of, or in any way related to, the interpretation, construction or application of this Agreement shall be determined by the Committee. Any determination made hereunder shall be final, binding and conclusive on the Grantee and the Company for all purposes.
13. Notices.
Any notice to be given under the terms of this Agreement to the Company shall be addressed to the Company in care of its Secretary or its designee, and any notice to be given to the Grantee shall be addressed to him at the address (including an electronic address) then reflected in the Companys books and records. By a notice given pursuant to this Section 13, either party may hereafter designate a different address for notices to be given to him. Any notice, which is required to be given to the Grantee, shall, if the Grantee is then deceased, be given to the Grantees personal representative if such representative has previously informed the Company of his status and address by written notice under this Section 13. Any notice shall have been deemed duly given when (i) delivered in person, (ii) delivered in an electronic form approved by the Company, (iii) enclosed in a properly sealed envelope or wrapper addressed as aforesaid, deposited (with postage prepaid) in a post office or branch post office regularly maintained by the United States Postal Service, or (iv) enclosed in a properly sealed envelope or wrapper addressed as aforesaid, deposited (with fees prepaid) in an office regularly maintained by FedEx, UPS, or comparable non-public mail carrier.
IN WITNESS WHEREOF, the parties have caused this Performance Share Unit Agreement to be duly executed effective as of the day and year first above written.
HCA Healthcare, Inc. |
By: |
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Grantee: |
||
(electronically accepted) |
Schedule A
Definition of Change in Control
For purposes of this Agreement, the term Change in Control shall mean, in lieu of any definition contained in the Plan:
(i) the sale or disposition, in one or a series of related transactions, of all or substantially all of the assets of the Company to any Person or Group other than an employee benefit plan (or trust forming a part thereof) maintained by (1) the Company or (2) any corporation or other Person of which a majority of its voting power of its voting equity securities or equity interest is owned, directly or indirectly, by the Company (a Permitted Holder); or
(ii) any Person or Group, other than a Permitted Holder, becomes the Beneficial Owner (as such term is defined in Rule 13d-3 under the Exchange Act (or any successor rule thereto) (except that a Person shall be deemed to have beneficial ownership of all shares that any such Person has the right to acquire, whether such right is exercisable immediately or only after the passage of time)), directly or indirectly, of more than 50% of the total voting power of the voting stock of the Company (or any entity which controls the Company), including by way of merger, consolidation, tender or exchange offer or otherwise; or
(iii) a reorganization, recapitalization, merger or consolidation (a Corporate Transaction) involving the Company, unless securities representing more than 50% of the combined voting power of the then outstanding voting securities entitled to vote generally in the election of directors of the Company or the corporation resulting from such Corporate Transaction (or the parent of such corporation) are Beneficially Owned subsequent to such transaction by the Person or Persons who were the Beneficial Owners of the outstanding voting securities entitled to vote generally in the election of directors of the Company immediately prior to such Corporate Transaction, in substantially the same proportions as their ownership immediately prior to such Corporate Transaction; or
(iv) during any period of 12 months, individuals who at the beginning of such period constituted the Board (together with any new directors whose election by such Board or whose nomination for election by the shareholders of the Company was approved by a vote of a majority of the directors of the Company, then still in office, who were either directors at the beginning of such period or whose election or nomination for election was previously so approved) cease for any reason to constitute a majority of the Board then in office.
Exhibit A
HCA Healthcare, Inc.
2020 Performance Share Unit Award
Performance Targets
1. Target Award. The target number of PSUs for the Grantee is as set forth on the first page of the Award Agreement. For the avoidance of doubt, all percentages associated with the Award shall be of the Target Award.
2. Performance Period. The Performance Period for this Award shall begin on January 1, 2020 and end on December 31, 2022.
3. Performance Goal. The Performance Goal for this Award is Cumulative EPS over the Performance Period. For purposes of this Exhibit A, Cumulative EPS means the sum of the Companys diluted earnings per share of each of the three fiscal years of the Company within the Performance Period as reported in the Companys audited financial statements for each such year, adjusted to exclude the effects of: (a) gains or losses on sales of facilities, (b) gains or losses on extinguishment of debt, (c) asset or investment impairment charges, (d) legal claim costs (disclosed as separate line item in consolidated income statement), (e) expenses, or adjustments to expenses, for share-based compensation recognized under ASC Topic 718 related to the Performance Share Units that results from EPS performance above or below the Target EPS during the Performance Period, (f) gains or losses on acquisition or disposition of controlling interest in equity investment or consolidated entity, and (g) any other gains, expenses or losses resulting from significant, unusual and/or nonrecurring events, as described in managements discussion and analysis of financial condition and results of operations appearing in the Companys annual report for the applicable fiscal year, as determined in good faith by the Board or the Committee.
4. Percentage of PSUs Earned. Following the end of the Performance Period, the Committee will determine the extent to which PSUs have become earned and shall vest according to the following schedule:
Cumulative EPS |
Percentage of Target PSUs Earned |
|
Greater than or equal to 110% of Target EPS |
200% | |
100% of Target EPS |
100% | |
90% of Target EPS |
25% | |
Less than 90% of Target EPS |
0% |
Thus, up to 200% of the Target Award may be earned if maximum performance is achieved for the Performance Period. Vesting related to performance between the percentages of Target EPS listed above will be determined by straight line interpolation. Any PSUs not earned and vested as provided above on the applicable determination date shall be forfeited.
Exhibit 21
ALABAMA
CareOne Home Health Services, Inc.
Four Rivers Medical Center PHO, Inc.
Selma Medical Center Hospital, Inc.
ALASKA
Alaska Regional Medical Group, LLC
Anchorage Surgicenter, LLC
Chugach PT, Inc.
Columbia Behavioral Healthcare, Inc.
Columbia North Alaska Healthcare, Inc.
Surgicare of Anchorage, LLC
ARIZONA
DS Real Estate Holdings, LLC
Urgent Care Extra - Ann & Simmons, LLC
Urgent Care Extra - Cactus & Southern Highlands, LLC
Urgent Care Extra - Charleston & Decatur, LLC
Urgent Care Extra - Charleston/Sloan, LLC
Urgent Care Extra - Craig & Clayton, LLC
Urgent Care Extra - Craig & Decatur, LLC
Urgent Care Extra - Durango & Cheyenne, LLC
Urgent Care Extra - Durango & Flamingo, LLC
Urgent Care Extra - Eastern & Horizon Ridge, LLC
Urgent Care Extra - Rainbow/Mardon, LLC
Urgent Care Extra - Warm Springs & Green Valley, LLC
Urgent Care Extra-Tropicana & Jones, LLC
ARKANSAS
Columbia Health System of Arkansas, Inc.
BERMUDA
Parthenon Insurance Company, Limited
CALIFORNIA
Center for Advanced Imaging, LLC
CFC Investments, Inc.
CH Systems
Chino Community Hospital Corporation, Inc.
Columbia ASC Management, L.P.
Columbia Good Samaritan Health System Limited Partnership
Columbia Riverside, Inc.
Columbia/HCA San Clemente, Inc.
Encino Hospital Corporation, Inc.
Far West Division, Inc.
Galen-Soch, Inc.
Good Samaritan Surgery Center, L.P.
HCA Health Services of California, Inc.
Healdsburg General Hospital, Inc.
L E Corporation
Las Encinas Hospital
Los Gatos Surgical Center, a California Limited Partnership
Los Robles Regional Medical Center
Los Robles Regional Medical Center MOB, LLC
Los Robles SurgiCenter, LLC
MCA Investment Company
Mission Bay Memorial Hospital, Inc.
Neuro Affiliates Company
Pacific Partners Management Services, Inc.
Riverside Healthcare System, L.P.
Riverside Holdings, Inc.
San Joaquin Surgical Center, Inc.
San Jose Pathology Outreach, LLC
Silicon Valley Health Holdings, LLC
Southwest Surgical Clinic, Inc.
Surgicare of Good Samaritan, LLC
Surgicare of Los Gatos, Inc.
Surgicare of Los Robles, LLC
Surgicare of Riverside, LLC
Surgicare of West Hills, Inc.
West Hills Hospital
West Hills Surgical Center, Ltd.
West Los Angeles Physicians Hospital, Inc.
Westminster Community Hospital
COLORADO
Altitude Mid Level Providers, LLC
Arapahoe Surgicenter, LLC
Center for Advanced Diagnostics LLC
Centrum Surgery Center, Ltd.
Clear Creek Surgery Center, LLC
Colorado Health Systems, Inc.
Columbine Psychiatric Center, Inc.
Continental Division I, Inc.
Denver Mid-Town Surgery Center, Ltd.
Denver Surgicenter, LLC
Diagnostic Mammography Services, G.P.
Galen of Aurora, Inc.
HCA-HealthONE LLC
Health Care Indemnity, Inc.
HealthONE at Breckenridge, LLC
HealthONE Aurora Investment, 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 - Cancer Care LLC
HealthONE Clinic Services - Cancer Specialties, 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 Cardiovascular Surgery, LLC
HealthONE Clinic Services - Pediatric Specialties, LLC
HealthONE Clinic Services - Primary Care, LLC
HealthONE Clinic Services - Spine Specialists, LLC
HealthONE Clinic Services - Spine Surgeons LLC
HealthONE Clinic Services - Surgery Neurological, LLC
HealthONE Clinic Services - Surgical Specialties, LLC
HealthONE Clinic Services - Transplant Services, LLC
HealthONE Clinic Services - Womens Services, LLC
HealthONE Clinic Services - Youth Rehabilitation LLC
HealthONE Clinic Services LLC
HealthOne Heart Care LLC
HealthONE High Street Primary Care Center, LLC
HealthONE Institutes for Clinical Research, LLC
HealthONE IRL Pathology Services, 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 Ridge View Endoscopy Center, LLC
HealthONE Surgicare of Ridge View, LLC
HealthONE Urologic, LLC
HealthOne Westside Investment, LLC
Hospital-Based CRNA Services, Inc.
Lakewood Surgicare, Inc.
Lincoln Surgery Center, LLC
Medical Care America Colorado, LLC
Medical Imaging of Colorado LLC
Mountain View MRI Associates, Ltd.
MOVCO, Inc.
New Rose Holding Company, Inc.
North Suburban Spine Center, L.P.
P/SL Hyperbaric Partnership
Park Ridge Surgery Center, LLC
Proaxis Therapy HealthOne LLC
Red Rocks Surgery Center, LLC
Rocky Mountain Pediatric Hematology Oncology, LLC
Rocky Mountain Surgery Center, LLC
Rose Ambulatory Surgery Center, L.P.
Rose Health Partners, LLC
Rose Medical Plaza, Ltd.
Rose POB, Inc.
Sky Ridge Spine Manager, LLC
Sky Ridge Surgery Center, L.P.
Southwest Medpro, Ltd.
Surgery Center of the Rockies, LLC
Surgicare of Arapahoe, LLC
Surgicare of Denver Mid-Town, Inc.
Surgicare of Denver, LLC
Surgicare of Park Ridge, LLC
Surgicare of Rose, LLC
Surgicare of Sky Ridge Womens Center, LLC
Surgicare of Sky Ridge, LLC
Surgicare of Southeast Denver, Inc.
Surgicare of Swedish, LLC
Surgicare of Thornton, LLC
Swedish Medpro, Inc.
Swedish MOB I, Ltd.
Swedish MOB II, Inc.
Swedish MOB III, Inc.
Swedish MOB IV, Inc.
Swedish MOB, LLC
Urology Surgery Center of Colorado, LLC
DELAWARE
AC Med, LLC
ADC Surgicenter, LLC
Aligned Business Consortium Group, L.P.
Alliance Surgicare, LLC
Alpine Surgicenter, LLC
Alternaco, LLC
American Medicorp Development Co.
AOGN, LLC
Appledore Medical Group, Inc.
AR Holding 1, 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 2, 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
AR Holding 4, LLC
AR Holding 5, LLC
AR Holding 6, LLC
AR Holding 7, LLC
AR Holding 8, LLC
AR Holding 9, LLC
ASD Shared Services, LLC
Atlanta Healthcare Management, L.P.
Atlanta Market GP, Inc.
Augusta CyberKnife, LLC
Augusta Management Services, LLC
Aurora Endoscopy Surgicenter, LLC
Austin GI Surgicenter, LLC
Aventura Cancer Center Manager, LLC
Bay Area Surgicenter, LLC
Bayshore Partner, LLC
Belton Family Practice Clinic, LLC
Boynton Beach EFL Imaging Center, LLC
Bradenton Outpatient Services, LLC
Brandon Imaging Manager, LLC
Brandon Regional Cancer Center, LLC
Brentwood ASC, LLC
Brighton Surgicenter, LLC
Brownsville Surgicenter, LLC
C/HCA Capital, Inc.
C/HCA, Inc.
California Imaging Center Manager, LLC
California Urgent Care, LLC
Cancer Centers of North Florida, LLC
Cancer Services of Aventura, LLC
Capital Division - CCA, Inc.
CAREOS, Surgicenter, LLC
CarePartners HHA Holdings, LLLP
CarePartners HHA, LLLP
CarePartners Rehabilitation Hospital, LLLP
CareSpot of Brentwood (210 Franklin Road), LLC
CareSpot of Cool Springs (100 International Drive), LLC
CareSpot of Donelson (2372 Lebanon Road), LLC
CareSpot of Hendersonville (280 Indian Lake Boulevard), LLC
CareSpot of Hermitage (5225 Old Hickory Boulevard), LLC
CareSpot of Lebanon (1705 West Main Street), LLC
CareSpot of Mt. Juliet (S. Mt. Juliet Road), LLC
CareSpot of Murfreesboro (1340 Broad Street), LLC
CareSpot of Nashville (2001 Glen Echo Road), LLC
CareSpot of Nashville (West End Avenue), LLC
CareSpot Professional Services of Middle Tennessee, LLC
Carolina Forest Imaging Manager, LLC
Centennial CyberKnife Center, LLC
Centennial CyberKnife Manager, LLC
Centerpoint Medical Center of Independence, LLC
Central Florida Imaging Services, LLC
Central Florida Management Services, LLC
Central Health Holding Company, Inc.
Charleston CareNow Urgent Care, LLC
CHC Finance Co.
CHC Payroll Agent, Inc.
CHCA Bayshore, L.P.
CHCA Clear Lake, L.P.
CHCA Conroe, L.P.
CHCA Mainland, L.P.
CHCA West Houston, L.P.
CHCA Womans Hospital, L.P.
Clear Lake Cardiac Catheterization Center, L.P.
Clear Lake Cardiac GP, LLC
Clear Lake Merger, LLC
Clear Lake Regional Partner, LLC
ClinicServ, LLC
Coastal Bend Hospital, Inc.
Coastal Healthcare Services, Inc.
Coliseum Health Group, LLC
Coliseum Medical Center, LLC
Coliseum Surgery Center, L.L.C.
Columbia Hospital Corporation of Fort Worth
Columbia Hospital Corporation of Houston
Columbia Hospital Corporation-Delaware
Columbia Palm Beach GP, LLC
Columbia Rio Grande Healthcare, L.P.
Columbia Valley Healthcare System, L.P.
Columbia Westbank Healthcare, L.P.
Columbia/HCA Middle East Management Company
Columbia-SDH Holdings, Inc.
Columbus Cath Lab, Inc.
Columbus Cath Lab, LLC
Concept EFL Imaging Center, LLC
Concept West EFL Imaging Center, LLC
Conroe Partner, LLC
CoralStone Management, Inc.
Corpus Christi Surgicenter, LLC
COSCORP, LLC
CPS TN Processor 1, Inc.
CRMC-M, LLC
Cy-Fair Medical Center Hospital, LLC
Dallas/Ft. Worth Physician, LLC
Delray EFL Imaging Center, LLC
Denver Clinic Surgicenter, LLC
Doctors Hospital of Augusta, LLC
East Florida CareNow Urgent Care, LLC
East Florida Imaging Holdings, LLC
Eastern Idaho Brachytherapy Equipment Manager, LLC
Eastern Idaho Brachytherapy Equipment, LLC
Eastern Idaho Care Partners ACO, LLC
Eastern Idaho Care Partners Holdings, LLC
Eastern Idaho Care Partners, LLC
EASTSIDE URGENT CARE LLC
EMMC, LLC
EP Health, LLC
EP Holdco, LLC
EPIC Development, Inc.
EPIC Diagnostic Centers, Inc.
EPIC Healthcare Management Company
EPIC Surgery Centers, Inc.
Fairview Park GP, LLC
Fairview Partner, LLC
Family Care of E. Jackson County, LLC
FHAL, LLC
FMH Health Services, LLC
Focus Hand Surgicenter, LLC
Forest Park Surgery Pavilion, Inc.
Forest Park Surgery Pavilion, L.P.
Fort Bend Hospital, Inc.
Frisco Surgicare, LLC
GA PHYSICIAN SERVICES LLC
GA Urgentcare Holding LLC
Galen (Kansas) Merger, LLC
Galen BH, Inc.
Galen Global Finance, Inc.
Galen GOK, LLC
Galen Health Institutes, Inc.
Galen Holdco, LLC
Galen Hospital Alaska, Inc.
Galen International Holdings, Inc.
Galen KY, LLC
Galen MCS, LLC
Galen Medical Corporation
Galen MRMC, LLC
Galen NMC, LLC
Galen NSH, LLC
Galen SOM, LLC
Galen SSH, LLC
Galendeco, Inc.
GalTex, LLC
Garden Park Community Hospital Limited Partnership
Gardens EFL Imaging Center, LLC
GenoSpace, LLC
Georgia Health Holdings, Inc.
Georgia, L.P.
GHC-Galen Health Care, LLC
Good Samaritan Hospital, L.P.
Good Samaritan Hospital, LLC
Goppert-Trinity Family Care, LLC
GPCH-GP, Inc.
Gramercy Eye Surgicenter, LLC
Grand Strand Regional Medical Center, LLC
Grandview Health Care Clinic, LLC
HCA - IT&S Field Operations, Inc.
HCA - IT&S Inventory Management, Inc.
HCA - IT&S TN Field Operations, Inc.
HCA American Finance LLC
HCA Health Services of Midwest, Inc.
HCA Healthcare Mission Fund, LLC
HCA Holdco, LLC
HCA Imaging Services of North Florida, Inc.
HCA Inc.
HCA Management Services, L.P.
HCA Outpatient Imaging Services Group, Inc.
HCA Property GP, LLC
HCA Psychiatric Company
HCA SF LLC
HCA SFB 1 LLC
HCA Squared, LLC
HCA Wesley Rehabilitation Hospital, Inc.
HCA-Access Healthcare Holdings, LLC
HCA-Access Healthcare Partner, Inc.
HCA-California Urgent Care Holdings, LLC
HCA-EmCare Holdings, LLC
HCA-EMS Holdings, LLC
HCA-Georgia Urgent Care Holdings, LLC
HCA-HBPS Holdings, LLC
HCAPS Anesthesia Manager, LLC
HCA-Solis Holdings, Inc.
HCA-Solis Mammography Service Holdings of Continental, LLC
HCA-Solis Mammography Service Holdings of Gulf Coast, LLC
HCA-Solis Mammography Service Holdings of North Texas, LLC
HCA-Solis Mammography Service Holdings of TriStar, LLC
HCA-Solis Mammography Services, LLC
HCA-Solis Master, LLC
HCA-Urgent Care Holdings, LLC
Health Insight Capital, LLC
Health Services (Delaware), Inc.
Health Services Merger, Inc.
Healthcare Purchasing Alliance, LLC
Healthcare Technology Assessment Corporation
Healthco, LLC
Healthnet of Kentucky, LLC
HealthONE Care Partners, LLC
Healthserv Acquisition, LLC
Healthtrust MOB Tennessee, LLC
Healthtrust Purchasing Group, L.P.
Healthtrust, Inc. - The Hospital Company
Hearthstone Home Health, Inc.
Heathrow Imaging, LLC
Hendersonville ODC, LLC
Henrico Doctors Hospital - Forest Campus Property, LLC
HHBY Holdings, LLC
HHNC, LLC
HICCH-SCL, LLC
hInsight-Airstrip Holdings, 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-Procured Holdings, LLC
hInsight-PWS I Holdings, LLC
hInsight-VAI Holdings, LLC
HM OMCOS, LLC
Hospital Corp., LLC
Hospital Development Properties, Inc.
Hospital Partners Merger, LLC
Houston - PPH, LLC
Houston Healthcare Holdings, Inc.
Houston NW Manager, LLC
Houston Urologic Surgicenter, LLC
Houston Womans Hospital Partner, LLC
HPG Enterprises, LLC
HPG Solutions, LLC
HSS Holdco, LLC
HSS Systems, LLC
HTI Hospital Holdings, Inc.
HTI MOB, LLC
HTI MSO, LLC
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 Richmond, LLC
Imaging Services of Roanoke, LLC
Imaging Services of West Boynton, LLC
IMX Holdings, LLC
Independence Regional Medical Group, LLC
Indianapolis Hospital Partner, LLC
Integrated Regional Laboratories, LLP
InVivoLink, Inc.
Jackson County Medical Group, LLC
JCSH, LLC
JFK Medical Center Limited Partnership
Jupiter EFL Imaging Center, LLC
Kansas Healthserv, LLC
Kendall Regional Medical Center, LLC
Kingwood Surgicenter, LLC
Lake City Imaging, LLC
Lakeside Radiology, LLC
Lakeview Medical Center, LLC
Laredo Medco, LLC
Lees Summit Family Care, LLC
Lewis-Gale Medical Center, LLC
Lewisville Surgicare, LLC
Loveland Surgicenter, LLC
Low Country Health Services, Inc. of the Southeast
Lowry Surgicenter, LLC
Macon Healthcare, LLC
Macon Northside Health Group, LLC
Macon Northside Hospital, LLC
Management Services Holdings, Inc.
Maury County Behavioral Health, LLC
Mayhill Cancer Center, LLC
MCA-CTMC Holdings, LLC
Medical Arts Hospital of Texarkana, Inc.
Medical Care America, LLC
Medical Care Financial Services Corp.
Medical Care Real Estate Finance, Inc.
Medical Center of Plano Partner, LLC
Medical Centers of Oklahoma, LLC
Medical City Dallas Partner, LLC
Medical City Specialty Surgicenter of Dallas, LLC
Medical City Surgery Center of Alliance, LLC
Medical City Surgery Center of Frisco, LLC
Medical City Surgery Center of Lewisville, LLC
Medical Corporation of America
Medical Office Buildings of Kansas, LLC
Medical Specialties, Inc.
MediStone Healthcare Ventures, Inc.
MediVision of Mecklenburg County, Inc.
MediVision of Tampa, Inc.
MediVision, Inc.
Methodist Ambulatory Surgery Center of Boerne, LLC
Methodist Ambulatory Surgery Center of Landmark, LLC
MH Anesthesiology Physicians, LLC
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 Physician Services, LLC
MH Transylvania Imaging, LLLP
MH Transylvania Regional Hospital, LLLP
Miami Beach EFL Imaging Center, LLC
MidAmerica Oncology, LLC
Mid-Continent Health Services, Inc.
Middle Georgia Hospital, LLC
Midtown Diagnostics, LLC
Midwest Division - ACH, LLC
Midwest Division - CMC, LLC
Midwest Division - LRHC, LLC
Midwest Division - LSH, LLC
Midwest Division - MCI, LLC
Midwest Division - MMC, LLC
Midwest Division - OPRMC, LLC
Midwest Division - RMC, LLC
Midwest Holdings, Inc.
Midwest Medicine Associates, LLC
Midwest Metropolitan Physicians Group, LLC
Mobile Corps., Inc.
Mobile Heartbeat, LLC
MRT&C, Inc.
Nashville Shared Services General Partnership
NeighborMD Management, LLC
Nevada Urgent Care Holdings, Inc.
New Iberia Holdings, Inc.
North Augusta Imaging Management, LLC
North Augusta Imaging Services, LLC
North Brandon Imaging, LLC
North Florida Cancer Center Lake City, LLC
North Florida Cancer Center Live Oak, LLC
North Florida Cancer Center Tallahassee, LLC
North Florida Radiation Oncology, LLC
North Houston - TRMC, LLC
North Miami Beach Surgery Center Limited Partnership
North Miami Beach Surgical Center, LLC
North Tampa Imaging, LLC
North Texas Medical Center, Inc.
Northeast Florida Cancer Services, LLC
Northern Virginia Surgicenter, LLC
Northwest Fla. Home Health Agency, Inc.
Notami Hospitals, LLC
Notami, LLC
Notco, LLC
NTGP, LLC
NTMC Management Company
NTMC Venture, Inc.
Ocala Stereotactic Radiosurgery Partner, LLC
Ocala Stereotactic Radiosurgery, LLC
ODP Holdings, LLC
ODP Manager, LLC
ODP Properties, LLC
Ogden Tomotherapy Manager, LLC
Ogden Tomotherapy, LLC
OHH Imaging Services, LLC
Oklahoma Holding Company, LLC
Oncology Services of Corpus Christi Manager, LLC
Oncology Services of Corpus Christi, LLC
Orlando Outpatient Surgical Center, Inc.
Outpatient Cardiovascular Center of Central Florida, LLC
Outpatient GP, LLC
Outpatient Services - LAD, LLC
Outpatient Services Holdings, Inc.
Palm Beach EFL Imaging Center, LLC
Palms West Hospital Limited Partnership
Paragon SDS, Inc.
Paragon WSC, Inc.
Parallon Holdings, LLC
Parkland Physician Services, Inc.
Parkway Hospital, Inc.
PatientKeeper, Inc.
Pavilion Surgicenter, LLC
Pearland Partner, LLC
Physicians West Surgicenter, LLC
Pinellas Medical, LLC
Pioneer Medical, LLC
Plano Heart Institute, L.P.
Plano Heart Management, LLC
Plantation General Hospital, L.P.
PMM, Inc.
POH Holdings, LLC
Portsmouth Regional Ambulatory Surgery Center, LLC
Portsmouth Surgicenter, LLC
Preferred Works WC, LLC
Primary Medical Management, Inc.
Putnam Radiation Oncology Manager, LLC
Putnam Radiation Oncology, 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
Riverside CyberKnife Manager, LLC
Riverside Hospital, Inc.
Riverside Imaging, LLC
ROi CPS, LLC
Round Rock Hospital, Inc.
Samaritan, LLC
San Bernardino Imaging, LLC
San Jose Healthcare System, LP
San Jose Hospital, L.P.
San Jose Medical Center, LLC
San Jose, LLC
San Marcos ASC, LLC
San Marcos Surgicenter, LLC
Sarah Cannon Research Institute, LLC
Savannah Health Network, LLC
Savannah Health Services, LLC
SCRI Holdings, LLC
Sebring Health Services, LLC
Silicon Valley Surgery Center, L.P.
Silicon Valley Surgicenter, LLC
SJMC, LLC
Solis Mammography at Bayshore Medical Center, LLC
Solis Mammography at Clear Lake Regional Medical Center, LLC
Solis Mammography at Conroe Regional Medical Center, LLC
Solis Mammography at Denton Regional Medical Center, LLC
Solis Mammography at HCA Houston Tomball, LLC
Solis Mammography at Kingwood Medical Center, LLC
Solis Mammography at Las Colinas Medical Center, LLC
Solis Mammography at Medical Center Alliance, LLC
Solis Mammography at Medical Center Arlington, LLC
Solis Mammography at Medical Center of Lewisville, LLC
Solis Mammography at Medical Center of McKinney, LLC
Solis Mammography at Medical Center of Plano, LLC
Solis Mammography at Medical City Dallas, LLC
Solis Mammography at Pearland Medical Center, LLC
Solis Mammography at Rose Medical Center, LLC
Solis Mammography at Skyline Medical Center, LLC
Solis Mammography at StoneCrest Medical Center, LLC
Solis Mammography at West Houston Medical Center, LLC
Solis Mammography at Womans Hospital of Texas, LLC
Solis Mammography of Cedar Hill, LLC
Solis Mammography of CyFair, LLC
Solis Mammography of Dallas, LLC
Solis Mammography of Flower Mound, LLC
Solis Mammography of Frisco, LLC
Solis Mammography of Garland, LLC
Solis Mammography of Grand Prairie, LLC
Solis Mammography of Houston NW, LLC
Solis Mammography of Katy, LLC
Solis Mammography of Louetta/249, LLC
Solis Mammography of Mainland, LLC
Solis Mammography of Mansfield, LLC
Solis Mammography of Mesquite, LLC
Solis Mammography of Montgomery, LLC
Solis Mammography of North Cypress, LLC
Solis Mammography of North Loop, LLC
Solis Mammography of Sugar Land, LLC
Solis Mammography of West Plano, LLC
Solis Mammography of Womans Place, LLC
South Austin Surgical Management, LLC
South Austin Surgicenter, LLC
South Brandon Imaging, LLC
South Valley Hospital, L.P.
Southeast Georgia Health Services, LLC
Southern Kentucky Surgicenter, LLC
Southtown Womens Clinic, LLC
Spalding Rehabilitation L.L.C.
Spring Hill Imaging, LLC
Springview KY, LLC
SSHR Holdco, LLC
SSJ St. Petersburg Holdings, Inc.
Steamboat Springs Surgicenter, LLC
Stiles Road Imaging LLC
StoneCrest Surgery Center, LLC
Stones River Hospital, LLC
StoneSprings Surgicenter, LLC
Suburban Medical Center at Hoffman Estates, Inc.
Summit General Partner, Inc.
Summit Outpatient Diagnostic Center, LLC
Sun Bay Medical Office Building, Inc.
Sun City Imaging, LLC
Sun-Med, LLC
Sunrise Hospital and Medical Center, LLC
Surgicare of ADC, LLC
Surgicare of AGI, LLC
Surgicare of Alpine, LLC
Surgicare of Aurora Endoscopy, LLC
Surgicare of Bay Area, LLC
Surgicare of Brentwood, LLC
Surgicare of Brighton, LLC
Surgicare of Brownsville, LLC
Surgicare of CAREOS, LLC
Surgicare of Corpus Christi, LLC
Surgicare of Dallas Specialty, LLC
Surgicare of Denton, Inc.
Surgicare of Denver Clinic, LLC
Surgicare of Focus Hand, LLC
Surgicare of Houston Kingwood, LLC
Surgicare of Houston, LLC
Surgicare of Loveland, LLC
Surgicare of Nashville, LLC
Surgicare of Pavilion, LLC
Surgicare of Physicians West El Paso, LLC
Surgicare of Plano, Inc.
Surgicare of Portsmouth, LLC
Surgicare of Silicon Valley, LLC
Surgicare of Southern Kentucky, LLC
Surgicare of Steamboat Springs, LLC
Surgicare of StoneCrest, LLC
Surgicare of StoneSprings, LLC
Surgicare of Willis, LLC
Surgico, LLC
Swedish MOB Acquisition, Inc.
TBHI Outpatient Services, LLC
Terre Haute Hospital GP, Inc.
Terre Haute Hospital Holdings, Inc.
Terre Haute Regional Hospital, L.P.
The Cancer Care Center of North Florida, LLC
Total Imaging - Parsons, LLC
Town Plaza Family Practice, LLC
Trident Medical Center, LLC
TriStar Maury Behavioral Healthcare, LLC
U.S. Collections, Inc.
Ultra Imaging Management Services, LLC
Ultra Imaging of Tampa, LLC
Urgent Care Enterprise, LLC
Utah CareNow Urgent Care, LLC
Utah Medco, LLC
Valify, Inc.
Value Health Management, Inc.
VHSC Plantation, LLC
Vision Consulting Group LLC
Washington Holdco, LLC
Weatherford Health Services, LLC
Weatherford Mammography JV, LLC
Wesley Cath Lab, LLC
Wesley Manager, LLC
Wesley Medical Center, LLC
West Boynton Beach Open Imaging Center, LLC
West Florida Imaging Services, LLC
West Florida PET Services, LLC
West Houston, LLC
Westbury Hospital, Inc.
WHG Medical, LLC
Willis Surgicenter, LLC
WJHC, LLC
Womans Hospital Merger, LLC
Womens Hospital Indianapolis GP, Inc.
Womens Hospital Indianapolis, L.P.
FLORIDA
Access 2 Health Care Physicians, LLC
Access Health Care Physicians, LLC
Access Management Co., LLC
Ace Leasing II, LLC
All About Staffing, Inc.
Ambulatory Laser Associates, GP
Ambulatory Surgery Center Group, Ltd.
Atlantis Surgicare, LLC
Aventura Comprehensive Cancer Research Group of Florida, Inc.
Aventura Healthcare Specialists LLC
Aventura Neurosurgery, LLC
BAMI Property, LLC
Bannerman Family Care, LLC
Bay Hospital, Inc.
Bayonet Point Surgery Center, Ltd.
Bayside Ambulatory Center, LLC
Behavioral Health Sciences of West Florida, LLC
Belleair Surgery Center, Ltd.
Big Cypress Medical Center, Inc.
Bonita Bay Surgery Center, Inc.
Bonita Bay Surgery Center, Ltd.
Bradenton Cardiology Physician Network, LLC
Broward Cardiovascular Surgeons, LLC
Broward Healthcare System, Inc.
Broward Neurosurgeons, LLC
Capital Regional Healthcare, LLC
Capital Regional Heart Associates LLC
Capital Regional Psychiatry Associates, LLC
CCH-GP, Inc.
Cedars International Cardiology Consultants, LLC
Cedars Medical Center Hospitalists, LLC
Central Florida Cardiology Interpretations, LLC
Central Florida Division Practice, Inc.
Central Florida Health Services, LLC
Central Florida Obstetrics & Gynecology Associates, LLC
Central Florida Physician Network, LLC
Central Florida Regional Hospital, Inc.
Central Pasco, LLC
Citrus Memorial Hospital, Inc.
Citrus Memorial Property Management, Inc.
Citrus Primary Care, Inc.
Citrus Specialty Group, Inc.
Citrus Surgicenter, LLC
Collier County Home Health Agency, Inc.
Columbia Behavioral Health, Ltd.
Columbia Behavioral Healthcare of South Florida, Inc.
Columbia Central Florida Division, Inc.
Columbia Development of Florida, Inc.
Columbia Eye and Specialty Surgery Center, Ltd.
Columbia Florida Group, Inc.
Columbia Hospital Corporation of Central Miami
Columbia Hospital Corporation of Kendall
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-SMM
Columbia Jacksonville Healthcare System, Inc.
Columbia Lake Worth Surgical Center Limited Partnership
Columbia Midtown Joint Venture
Columbia North Central Florida Health System Limited Partnership
Columbia North Florida Regional Medical Center Limited Partnership
Columbia Ocala Regional Medical Center Physician Group, Inc.
Columbia Palm Beach Healthcare System Limited Partnership
Columbia Park Healthcare System, Inc.
Columbia Park Medical Center, Inc.
Columbia Physician Services - Florida Group, Inc.
Columbia Primary Care, LLC
Columbia Resource Network, Inc.
Columbia Tampa Bay Division, Inc.
Columbia-Osceola Imaging Center, Inc.
Community Hospital Family Practice, LLC
Comprehensive Radiation Oncology, LLC
Coral Springs Surgi-Center, Ltd.
Countryside Surgery Center, Ltd.
Davie Medical Center, LLC
Daytona Medical Center, Inc.
Dean 4641, LLC
Diagnostic Breast Center, Inc.
Doctors Osteopathic Medical Center, Inc.
Doctors Same Day Surgery Center, Inc.
Doctors Same Day Surgery Center, Ltd.
DOMC Property, LLC
East Florida - DMC, Inc.
East Florida Behavioral Health Network, LLC
East Florida Cardiology Network, LLC
East Florida Division, Inc.
East Florida Emergency Physician Group, LLC
East Florida Healthcare, LLC
East Florida Hospitalists, LLC
East Florida Primary Care, LLC
East Pointe Hospital, Inc.
Edward White Hospital, Inc.
Emergency Providers Group LLC
Englewood Community Hospital Auxiliary, Inc.
Englewood Community Hospital, Inc.
Family Care Partners, LLC
Fawcett Memorial Hospital, Inc.
Florida Care Partners Orlando, LLC
Florida Care Partners, LLC
Florida Home Health Services-Private Care, Inc.
Florida Outpatient Surgery Center, Ltd.
Fort Myers Market, Inc.
Fort Pierce Immediate Care Center, Inc.
Fort Pierce Orthopaedics, LLC
Fort Pierce Surgery Center, Ltd.
Fort Walton Beach Medical Center, Inc.
Freeport Family Medicine, LLC
Ft. Pierce Surgicare, LLC
Ft. Walton Beach Anesthesia Services, LLC
Gainesville GYN Oncology of North Florida Regional Medical Center, LLC
Gainesville Physicians, LLC
Galen Diagnostic Multicenter, Ltd.
Galen Hospital-Pembroke Pines, Inc.
Galen of Florida, Inc.
Galencare, Inc.
GME Services of Osceola, LLC
Grant Center Hospital of Ocala, Inc.
Greater Tampa Bay Physician Network, LLC
Greater Tampa Bay Physician Specialists, LLC
Greater Tampa Bay Physicians - Pinellas, LLC
Gulf Coast Inpatient Specialists, LLC
Gulf Coast Medical Center Primary Care, LLC
Gulf Coast Multispecialty Services, LLC
Hamilton Memorial Hospital, Inc.
HCA - Viera ALF, LLC
HCA - WHS Progressive, LLC
HCA - WHS Services, LLC
HCA Health Services of Florida, Inc.
HCA Health Services of Miami, Inc.
HCA Outpatient Clinic Services of Miami, Inc.
HCA Sarasota Orthopedic and Spine Clinical Co-Management Company, LLC
HD&S Corp. Successor, Inc.
HealthCoast Physician Group, LLC
Heathrow Internal Medicine, LLC
Heritage Family Care, LLC
HMMG 1226, LLC
Homecare North, Inc.
Hospital Corporation of Lake Worth
Institute for Womens Health and Body, LLC
Integrated Regional Lab, LLC
Integrated Regional Laboratories Pathology Services, LLC
Intensive Care Consortium, Inc.
Jacksonville CareNow Urgent Care, LLC
Jacksonville Multispecialty Services, LLC
Jacksonville Surgery Center, Ltd.
JFK Internal Medicine Faculty Practice, LLC
JPM AA Housing, LLC
Kendall Healthcare Group, Ltd.
Kendall Regional Urgent Care, LLC
Kissimmee Surgicare, Ltd.
LAD Imaging, LLC
Lake City Regional Medical Group, LLC
Largo Medical Center, Inc.
Largo Physician Group, LLC
Lawnwood Cardiovascular Surgery, LLC
Lawnwood Healthcare Specialists, LLC
Lawnwood Medical Center, Inc.
Live Oak Immediate Care Center, LLC
Manatee Surgicare, Ltd.
Marion Community Hospital, Inc.
Medical Associates of Ocala, LLC
Medical Center of Port St. Lucie, Inc.
Medical Center of Santa Rosa, Inc.
Medical Center of Southwest Florida, LLC
Medical Partners of North Florida, LLC
Memorial Family Practice Associates, LLC
Memorial Health Primary Care at St. Johns Bluff, LLC
Memorial Healthcare Group, Inc.
Memorial Neurosurgery Group, LLC
Mercy ASC, LLC
MHS Partnership Holdings JSC, Inc.
MHS Partnership Holdings SDS, Inc.
Miami Beach Healthcare Group, Ltd.
Miami Dade Surgical Specialists, LLC
Miami Lakes Surgery Center, Ltd.
Miami-Dade Cardiology Consultants, LLC
MSL Acquisition, LLC
Network MS of Florida, Inc.
New Port Richey Hospital, Inc.
New Port Richey Surgery Center, Ltd.
Niceville Family Practice, LLC
North Central Florida Health System, Inc.
North Florida Division I, Inc.
North Florida Division Practice, Inc.
North Florida GI Center GP, Inc.
North Florida GI Center, Ltd.
North Florida Immediate Care Center, Inc.
North Florida Neurosurgery, LLC
North Florida Outpatient Imaging Center, Ltd.
North Florida Physician Services, Inc.
North Florida Physicians, LLC
North Florida Regional Company Care, LLC
North Florida Regional Investments, Inc.
North Florida Regional Medical Center, Inc.
North Florida Regional Psychiatry, LLC
North Florida Regional Trauma, LLC
North Florida Rehab Investments, LLC
North Florida Surgical Associates, LLC
North Palm Beach County Surgery Center, LLC
North River Physician Network, LLC
North Transfer Center, LLC
Northside MRI, Inc.
Northwest Florida Healthcare Systems, Inc.
Northwest Florida Multispecialty Physicians, LLC
Northwest Florida Primary Care, LLC
Northwest Medical Center, Inc.
Notami Hospitals of Florida, Inc.
Oak Hill Acquisition, Inc.
Oak Hill Family Care, LLC
Oak Hill Hospitalists, LLC
Ocala Health Company Care, LLC
Ocala Health Imaging Services, LLC
Ocala Health Primary Care, LLC
Ocala Health Surgical Group, LLC
Ocala Health Trauma, LLC
Ocala Regional Outpatient Services, Inc.
Okaloosa Hospital, Inc.
Okeechobee Hospital, Inc.
Orange County Healthcare, LLC
Orange Park Hospitalists, LLC
Orange Park Medical Center, Inc.
Orlando CareNow Urgent Care, LLC
Orlando Surgicare, Ltd.
Osceola Neurological Associates, LLC
Osceola Physician Network, LLC
Osceola Regional Hospital, Inc.
Osceola Regional Hospitalists, LLC
Osceola Surgical Associates, LLC
Outpatient Surgical Services, Ltd.
Oviedo Medical Center, LLC
P&L Associates
Palm Beach General Surgery, LLC
Palm Beach Healthcare System, Inc.
Palm Beach Hospitalists Program, LLC
Palms West Gastroenterology, LLC
Palms West Surgery Center, Ltd.
Park South Imaging Center, Ltd.
Pediatric Intensivist Group, LLC
Pensacola Primary Care, Inc.
Pinnacle Physician Network, LLC
Poinciana Medical Center, Inc.
Port St. Lucie Surgery Center, Ltd.
Premier Medical Management, Ltd.
Primary Care Medical Associates, Inc.
Primary Care Services of Orlando, LLC
Psychiatry Services of Osceola, LLC
Pulmonary Renal Intensivist Group, LLC
Putnam Community Medical Center of North Florida, LLC
Putnam Hospital, Inc.
Putnam Surgical Group, LLC
Raulerson Gastroenterology, LLC
Raulerson GYN, LLC
Raulerson Primary Care, LLC
Riverwalk ASC, LLC
Sarasota Doctors Hospital, Inc.
South Florida Division Practice, Inc.
South Transfer Center, LLC
Southwest Florida Health System, Inc.
Southwest Florida Regional Medical Center, Inc.
St. Lucie Hospitalists, LLC
St. Lucie Medical Center Hyperbarics, LLC
St. Lucie Medical Center Walk-In Clinic, LLC
St. Lucie Medical Specialists, LLC
St. Lucie West Primary Care, LLC
St. Petersburg General Surgery, LLC
Sun City Hospital, Inc.
Surgery Center of Atlantis, LLC
Surgery Center of Aventura, Ltd.
Surgery Center of Port Charlotte, Ltd.
Surgical Park Center, Ltd.
Surgicare America - Winter Park, Inc.
Surgicare of Altamonte Springs, Inc.
Surgicare of Aventura, LLC
Surgicare of Bayonet Point, Inc.
Surgicare of Bayside, LLC
Surgicare of Brandon, Inc.
Surgicare of Brooksville, LLC
Surgicare of Central Florida, Inc.
Surgicare of Citrus, LLC
Surgicare of Countryside, Inc.
Surgicare of Florida, Inc.
Surgicare of Ft. Pierce, Inc.
Surgicare of Kissimmee, Inc.
Surgicare of Laurel Grove, LLC
Surgicare of Manatee, Inc.
Surgicare of Merritt Island, Inc.
Surgicare of Miami Lakes, LLC
Surgicare of Newport Richey, Inc.
Surgicare of Orange Park II, LLC
Surgicare of Orange Park, Inc.
Surgicare of Orange Park, Ltd.
Surgicare of Orlando, Inc.
Surgicare of Palms West, LLC
Surgicare of Pinellas, Inc.
Surgicare of Plantation, Inc.
Surgicare of Port Charlotte, LLC
Surgicare of Port St. Lucie, Inc.
Surgicare of Riverwalk, LLC
Surgicare of St. Andrews, Inc.
Surgicare of St. Andrews, Ltd.
Surgicare of Stuart, Inc.
Surgicare of Tallahassee, Inc.
Tallahassee Community Network, Inc.
Tallahassee Medical Center, Inc.
Tallahassee Orthopaedic Surgery Partners, Ltd.
Tampa Bay Health System, Inc.
Tampa Surgi-Centre, Inc.
Telehealth Physician Services, LLC
The Neurohealth Sciences Center, LLC
Total Imaging - Hudson, LLC
Total Imaging - North St. Petersburg, LLC
Travel Medicine and Infections, LLC
University Healthcare Specialists, LLC
University Hospital, Ltd.
Venture Ambulatory Surgery Center, LLC
Venture Medical Management, LLC
West Florida - MHT, LLC
West Florida - PPH, LLC
West Florida Behavioral Health, Inc.
West Florida Cardiology Network, LLC
West Florida Cardiology Physicians, LLC
West Florida CareNow Urgent Care, LLC
West Florida Division, Inc.
West Florida Gulf Coast Primary Care, LLC
West Florida HealthWorks, LLC
West Florida Internal Medicine, LLC
West Florida Physician Network, LLC
West Florida Professional Billing, LLC
West Florida Regional Medical Center, Inc.
West Florida Specialty Physicians, LLC
West Florida Trauma Network, LLC
West Florida Urgent Care Network, LLC
West Jacksonville Medical Center, Inc.
Westside Surgery Center, Ltd.
Wildwood Medical Center, Inc.
Womens Health Center of Central Florida, LLC
GEORGIA
4600 Waters Avenue Professional Building Condominium Association, Inc.
Acworth Immediate Care, LLC
Albany Family Practice, LLC
AOSC Sports Medicine, Inc.
AppleCare/Memorial Immediate Care Joint Venture, LLC
Atlanta Home Care, L.P.
Atlanta Outpatient Surgery Center, Inc.
Atlanta Surgery Center, Ltd.
Augusta Inpatient Services, LLC
Augusta Multispecialty Services, LLC
Augusta Primary Care Services, LLC
Augusta Specialty Hospitalists, LLC
Augusta Urgent Care Services, LLC
Byron Family Practice, LLC
Cartersville Medical Center, LLC
Cartersville Occupational Medicine Center, LLC
Cartersville Physician Practice I, LLC
CCBH Psychiatric Hospitalists, LLC
Center for Occupational Medicine, LLC
Chatsworth Hospital Corp.
Church Street Partners
Coliseum Health Group, Inc.
Coliseum Park Hospital, Inc.
Coliseum Primary Care Services, LLC
Coliseum Primary Healthcare - Macon, LLC
Coliseum Primary Healthcare - Riverside, LLC
Coliseum Professional Associates, LLC
Coliseum Same Day Surgery Center, L.P.
Columbia Coliseum Same Day Surgery Center, Inc.
Columbia Surgicare of Augusta, Ltd.
Columbia-Georgia PT, Inc.
Columbus Cardiology, Inc.
Columbus Doctors Hospital, Inc.
Diagnostic Services, G.P.
Doctors Hospital Columbus GA-Joint Venture
Doctors Hospital of Augusta Neurology, LLC
Doctors Hospital Surgery Center, L.P.
Doctors-I, Inc.
Doctors-II, Inc.
Doctors-III, Inc.
Doctors-IV, Inc.
Doctors-IX, Inc.
Doctors-V, Inc.
Doctors-VI, Inc.
Doctors-VII, Inc.
Doctors-VIII, Inc.
Doctors-X, Inc.
Dublin Community Hospital, LLC
Dublin Heart Specialists, LLC
Dublin Multispecialty, LLC
Eastside Behavioral Health Associates, LLC
Eastside General Surgery, LLC
Eastside Heart and Vascular, LLC
Eastside Medical Center, LLC
Eastside Surgery Center, LLC
EHCA Diagnostics, LLC
EHCA Eastside Occupational Medicine Center, LLC
EHCA Metropolitan, LLC
EHCA Parkway, LLC
EHCA Peachtree, LLC
EHCA West Paces, LLC
EHCA, LLC
Fairview Medical Services, LLC
Fairview Park, Limited Partnership
Georgia Psychiatric Company, Inc.
Grace Family Practice, LLC
Grayson Primary Care, LLC
Greater Gwinnett Internal Medicine Associates, LLC
Greater Gwinnett Physician Corporation
Gwinnett Community Hospital, Inc.
HCA Health Services of Georgia, Inc.
HCOL, Inc.
Heritage Medical Care, LLC
Hospitalists at Fairview Park, LLC
JDGC Management, LLC
Macon Psychiatric Hospitalists, LLC
Marietta Outpatient Medical Building, Inc.
Marietta Outpatient Surgery, Ltd.
Marietta Surgical Center, Inc.
Med Corp., Inc.
Medical Center - West, Inc.
Medical Oncology Associates, LLC
Memorial Satilla Specialists, LLC
Middle Georgia Urgent Care Services, LLC
MOSC Sports Medicine, Inc.
Neurosurgery Atlanta, LLC
North Georgia Primary Care Group, LLC
Northlake Medical Center, LLC
Northlake Physician Practice Network, Inc.
Northlake Surgical Center, L.P.
Northlake Surgicare, Inc.
Orthopaedic Specialty Associates, L.P.
Orthopaedic Sports Specialty Associates, Inc.
Peach State Anesthesia Partners, LLC
Provident Professional Building Condominium Association, Inc.
Redmond Anesthesia Services, LLC
Redmond Hospital Services, LLC
Redmond Neurosurgery, LLC
Redmond Park Health Services, Inc.
Redmond Park Hospital, LLC
Redmond Physician Practice Company
Redmond Specialty Services, LLC
Rome Imaging Center Limited Partnership
Savannah Behavioral Health Associates, LLC
Savannah Inpatient Services, LLC
Savannah Multispecialty Associates, LLC
Savannah Pediatric Care, LLC
Savannah Primary Care Associates, LLC
Surgery Center of Rome, L.P.
Surgicare of Augusta, Inc.
Surgicare of Buckhead, LLC
Surgicare of Eastside, LLC
Surgicare of Evans, Inc.
Surgicare of Rome, Inc.
The Rankin Foundation
Urology Center of North Georgia, LLC
West Paces Services, Inc.
IDAHO
East Falls Cardiovascular and Thoracic Surgery, LLC
East Falls Family Medicine, LLC
East Falls Plastic Surgery, LLC
Eastern Idaho Health Services, Inc.
Eastern Idaho Regional Medical Center Inpatient Services, LLC
EIRMC Hospitalist Services, LLC
Idaho Behavioral Health Services, LLC
Idaho Physician Services, Inc.
Patients First Neurology, LLC
West Valley Medical Center, Inc.
West Valley Medical Group Specialty Services LLC
West Valley Medical Group, LLC
West Valley Therapy Services, LLC
ILLINOIS
Chicago Grant Hospital, Inc.
Columbia Chicago Division, Inc.
Columbia LaGrange Hospital, LLC
Galen of Illinois, Inc.
Illinois Psychiatric Hospital Company, Inc.
Smith Laboratories, Inc.
INDIA
All About Staffing (India) Ltd.
INDIANA
Advanced Plastic Surgery Center of Terre Haute, LLC
Basic American Medical, Inc.
Hospitalists of the Wabash Valley, LLC
Regional Hospital Healthcare Partners, LLC
Surgicare of Indianapolis, Inc.
Surgicare of Terre Haute, LLC
Terre Haute MOB, L.P.
Terre Haute Obstetrics and Gynecology, LLC
KANSAS
Care for Women, LLC
Centerpoint Medical Specialists, LLC
College Park Ancillary, LLC
College Park Endoscopy Center, LLC
College Park Radiology, LLC
Emergency Physicians at Wesley Medical Center, LLC
Family Health Medical Group of Overland Park, LLC
Galichia Anesthesia Services, LLC
Galichia Emergency Physicians, LLC
Health Partners of Kansas, Inc.
Heart of America ASC, LLC
Heart of America Surgicenter, LLC
Heartland Womens Group at Wesley, LLC
Hospitalists at Wesley Medical Center, LLC
IRL Pathology Services MidAmerica, LLC
Johnson County Neurology, LLC
Johnson County Surgery Center, L.P.
Johnson County Surgicenter, L.L.C.
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 Womens Clinic Group, LLC
Kansas Pulmonary and Sleep Specialists, LLC
Kansas Trauma and Critical Care Specialists, LLC
Menorah Medical Group, LLC
Menorah Urgent Care, LLC
MidAmerica Division, Inc.
Mid-America Surgery Center, LLC
Mid-America Surgery Institute, LLC
Midwest Cardiology Specialists, LLC
Midwest Cardiovascular and Thoracic Surgeons of Kansas, LLC
Midwest Heart & Vascular Specialists, LLC
Midwest Oncology Associates, LLC
Mill Creek Outpatient Services, LLC
MMC Sleep Lab Management, LLC
Neurology Associates of Kansas, LLC
OPRMC-HBP, LLC
Overland Park Cardiovascular, Inc.
Overland Park Medical Specialists, LLC
Overland Park Orthopedics, LLC
Overland Park Surgical Specialties, LLC
Pediatric Specialty Clinic LLC
Physician Associates of Corporate Woods, LLC
Quivira Internal Medicine, Inc.
Research Neurology Associates, LLC
Research Neuroscience Institute, LLC
Statland Medical Group, LLC
Surgery Center of Overland Park, L.P.
Surgicare of Overland Park, LLC
Surgicare of Wichita, Inc.
Surgicare of Wichita, LLC
Surgicenter of Johnson County, Ltd., a Kansas limited partnership
The Medical Group of Kansas City, LLC
Wesley Physician Services, LLC
Wesley Physicians - Anesthesiologist, LLC
Wesley Physicians - Cardiovascular, LLC
Wesley Physicians - Medical Specialties LLC
Wesley Physicians - Obstetrics and Gynecology LLC
Wesley Physicians - Primary Care LLC
Wesley Select Network, LLC
Wesley Urgent Care, LLC
Wichita CareNow Urgent Care, LLC
KENTUCKY
CHCK, Inc.
Commonwealth Specialists of Kentucky, LLC
Frankfort Hospital, Inc.
Frankfort Wound Care, LLC
Galen Center for Professional Development, Inc.
Galen of Kentucky, Inc.
Greenview Hospital, Inc.
Greenview PrimeCare, LLC
Greenview Specialty Associates, LLC
Hospitalists at Greenview Regional Hospital, LLC
Isleworth Partners, Inc.
Mikrod Services, Inc.
Southern Kentucky Medicine Associates, LLC
Surgery Center of Greenview, L.P.
Surgicare of Greenview, Inc.
Tri-County Community Hospital, Inc.
Warren County Ambulance Service, LLC
LOUISIANA
Acadiana Care Center, Inc.
Acadiana Practice Management, Inc.
Acadiana Regional Pharmacy, Inc.
Center for Digestive Diseases, LLC
Childrens Multi-Specialty Group, LLC
CLASC Manager, LLC
Columbia Healthcare System of Louisiana, Inc.
Columbia West Bank Hospital, Inc.
Columbia/HCA of Baton Rouge, Inc.
Columbia/HCA of New Orleans, Inc.
HCA Health Services of Louisiana, Inc.
Lafayette OB Hospitalists, LLC
Lafayette Urogynecology & Urology Center, LLC
Lakeside Womens Services, LLC
Lakeview Cardiology Specialists, LLC
Lakeview Regional Physician Group, LLC
Louisiana Psychiatric Company, Inc.
Medical Center of Baton Rouge, Inc.
Metairie Primary Care Associates, LLC
New Iberia Healthcare, LLC
Notami (Opelousas), Inc.
Notami Hospitals of Louisiana, Inc.
Rapides After Hours Clinic, L.L.C.
Rapides Healthcare System, L.L.C.
Rapides Regional Physician Group Primary Care, LLC
Rapides Regional Physician Group Specialty Care, LLC
Rapides Regional Physician Group, LLC
Rapides Surgery Center, LLC
RMCA Professionals Mgmt, LLC
Southwest Medical Center Family Practice, LLC
Southwest Medical Center Multi-Specialty Group, LLC
Southwest Medical Center Surgical Group, LLC
Surgicare Merger Company of Louisiana
Surgicare of Lakeview, Inc.
Surgicare Outpatient Center of Baton Rouge, Inc.
Surgicenter of East Jefferson, Inc.
Tchefuncte Cardiology Associates - Lakeview, LLC
The Regional Health System of Acadiana, LLC
TUHC Anesthesiology Group, LLC
TUHC Hospitalist Group, LLC
TUHC Physician Group, LLC
TUHC Primary Care and Pediatrics Group, LLC
TUHC Radiology Group, LLC
Tulane Clinic, LLC
Tulane Professionals Management, L.L.C.
University Healthcare System, L.C.
Uptown Primary Care Associates, LLC
Womens & Childrens Pediatric Hematology/Oncology Center, LLC
Womens & Childrens Pulmonology Clinic, LLC
Womens and Childrens Professional Management, L.L.C.
Womens Multi-Specialty Group, LLC
LUXEMBOURG
HCA Luxembourg 1 Sarl
HCA Luxembourg 2 Sarl
HCA Luxembourg Equities Sàrl
HCA Luxembourg Investments Sàrl
HCA Switzerland Limited
MASSACHUSETTS
Columbia Hospital Corporation of Massachusetts, Inc.
Orlando Outpatient Surgical Center, Ltd.
MISSISSIPPI
Brookwood Medical Center of Gulfport, Inc.
Coastal Imaging Center of Gulfport, Inc.
Coastal Imaging Center, L.P.
Galen of Mississippi, Inc.
Garden Park Hospitalist Program, LLC
Garden Park Investments, L.P.
Garden Park Physician Group - Specialty Care, LLC
Garden Park Physician Group, Inc.
Gulf Coast Medical Ventures, Inc.
VIP, Inc.
MISSOURI
Bone & Joint Specialists Physician Group, LLC
Cardiology Associates Medical Group, LLC
Cedar Creek Medical Group, LLC
Centerpoint Cardiology Services, LLC
Centerpoint Clinic of Blue Springs, LLC
Centerpoint Hospital Based Physicians, LLC
Centerpoint Orthopedics, LLC
Centerpoint Physicians Group, LLC
Centerpoint Womens Services, LLC
Clinishare, Inc.
Endocrinology Associates of Lees Summit, LLC
Eye Care Surgicare, Ltd., a Missouri limited partnership
Family Health Specialists of Lees Summit, LLC
Foot & Ankle Specialty Services, LLC
HCA Midwest Comprehensive Care, Inc.
Health Midwest Medical Group, Inc.
Health Midwest Office Facilities Corporation
Health Midwest Ventures Group, Inc.
HM Acquisition, LLC
Independence Neurosurgery Services, LLC
Independence Surgicare, Inc.
Jackson County Pulmonary Medical Group, LLC
Kansas City Neurology Associates, LLC
Kansas City Pulmonology Practice, LLC
Kansas City Surgery Center Properties, LLC
KC Pain ASC, LLC
KC Surgicare, LLC
Medical Center Imaging, Inc.
MediCredit, Inc.
Metropolitan Multispecialty Physicians Group, Inc.
Midwest Cardiovascular & Thoracic Surgery, LLC
Midwest Division - RBH, LLC
Midwest Division Spine Care, LLC
Midwest Doctors Group, LLC
Midwest Infectious Disease Specialists, LLC
Midwest Trauma Services, LLC
Midwest Womens Healthcare Specialists, LLC
Missouri Healthcare System, L.P.
National Association of Senior Friends
Notami Hospitals of Missouri, Inc.
Nuclear Diagnosis, Inc.
Ozarks Medical Services, Inc.
Parallon Revenue Cycle Services, Inc.
Raymore Medical Group, LLC
Research Cardiology Associates, LLC
Research Family Physicians, LLC
Research Internal Medicine, LLC
Resource Optimization & Innovation, L.L.C.
RMC - Pulmonary, LLC
RMC Transplant Physicians, LLC
Senior Health Associates, LLC
Surgery Center of Independence, L.P.
Surgical Care Medical Group, LLC
Surgicare of Kansas City, LLC
Surgicenter of Kansas City, L.L.C.
Womens Center at Brookside, LLC
NEVADA
CHC Holdings, Inc.
CHC Venture Co.
Columbia Hospital Corporation of West Houston
Fremont Womens Health, LLC
Health Service Partners, Inc.
Las Vegas ASC, LLC
Las Vegas Surgicare, Inc.
Las Vegas Surgicare, Ltd., a Nevada Limited Partnership
MountainView GME Primary Care, LLC
Nevada Surgery Center of Southern Hills, L.P.
Nevada Surgicare of Southern Hills, LLC
Rhodes Limited-Liability Company
Sahara Outpatient Surgery Center, Ltd.
Southern Hills Medical Center, LLC
Specialty Surgicare of Las Vegas, LP
Sunrise Flamingo Holdings, LLC
Sunrise Flamingo Surgery Center, Limited Partnership
Sunrise Mountainview Hospital, Inc.
Sunrise Mountainview Multi-Specialty Clinics, LLC
Sunrise Outpatient Services, Inc.
Sunrise Physician Services, LLC
Sunrise Trauma Services, LLC
Surgicare of Las Vegas, Inc.
Urgent Care Extra Silverado & Maryland LLC
Urgent Care Nevada LLC
Value Health Holdings, Inc.
VH Holdco, Inc.
VH Holdings, Inc.
Western Plains Capital, Inc.
NEW HAMPSHIRE
Appledore Medical Group II, Inc.
Derry ASC, Inc.
HCA Health Services of New Hampshire, Inc.
Med-Point of New Hampshire, Inc.
Occupational Health Services of PRH, LLC
Parkland Hospitalists Program, LLC
Parkland Oncology, LLC
Salem Surgery Center, Limited Partnership
Surgicare of Salem, LLC
NORTH CAROLINA
Blue Ridge-TKC, LLC
CareOne Home Health Services, Inc.
Cumberland Medical Center, Inc.
HCA - Raleigh Community Hospital, Inc.
Healthy State, Inc.
Heritage Hospital, Inc.
HTI Health Services of North Carolina, Inc.
Imaging Realty, LLC
Mecklenburg Surgical Land Development, Ltd.
Mission Community Anesthesiology Specialists, LLC
Mission Employer Solutions, LLC
Mission Health Partners, Inc.
Raleigh Community Medical Office Building, Ltd.
Spruce Pine Healthcare, LLC
OHIO
Columbia/HCA Healthcare Corporation of Northern Ohio
Columbia-CSA/HS Greater Canton Area Healthcare System, L.P.
Columbia-CSA/HS Greater Cleveland Area Healthcare System, L.P.
Lorain County Surgery Center, Ltd.
Surgicare of Lorain County, Inc.
Surgicare of Westlake, Inc.
Westlake Surgicare, L.P.
OKLAHOMA
Columbia Doctors Hospital of Tulsa, Inc.
Columbia Oklahoma Division, Inc.
Edmond General Surgery, LLC
Edmond Hospitalists, LLC
Edmond Physician Hospital Organization, Inc.
Healthcare Oklahoma, Inc.
Medi Flight of Oklahoma, LLC
Medical Imaging, Inc.
Millenium Health Care of Oklahoma, Inc.
Oklahoma Outpatient Surgery Limited Partnership
Oklahoma Physicians - Medical Specialties LLC
Oklahoma Physicians - Obstetrics and Gynecology LLC
Oklahoma Physicians - Primary Care LLC
Oklahoma Physicians - Surgical Specialties LLC
Oklahoma Surgicare, Inc.
Plains Healthcare System, Inc.
Surgicare of Tulsa, Inc.
SWMC, Inc.
PHILIPPINES
All About Staffing Philippines, Inc.
Career Staffing USA, Inc.
SOUTH CAROLINA
C/HCA Development, Inc.
Carolina Regional Surgery Center, Inc.
Carolina Regional Surgery Center, Ltd.
Coastal Carolina Home Care, Inc.
Coastal Carolina Multispecialty Associates, LLC
Coastal Carolina Primary Care, LLC
Coastal Inpatient Physicians, LLC
Colleton Ambulatory Care, LLC
Colleton Diagnostic Center, LLC
Colleton Medical Anesthesia, LLC
Colleton Medical Hospitalists, LLC
Colleton Otolaryngology, Head and Neck Surgery, LLC
Columbia/HCA Healthcare Corporation of South Carolina
Doctors Memorial Hospital of Spartanburg Limited Partnership
Grand Strand Senior Health Center, LLC
Grand Strand Specialty Associates, LLC
Grand Strand Surgical Specialists, LLC
North Augusta Rehab Health Center, LLC
North Charleston Diagnostic Imaging Center, LLC
South Atlantic Division, Inc.
Tri-County Surgical Specialists, LLC
Trident Behavioral Health Services, LLC
Trident Eye Surgery Center, L.P.
Trident Medical Services, Inc.
Trident Neonatology Services, LLC
Walterboro Community Hospital, Inc.
Waterway Primary Care, LLC
SWITZERLAND
HCA Switzerland Holding GmbH
Glemm SA
HCA Switzerland Finance GmbH
TENNESSEE
2490 Church, LLC
Advanced Bundle Convener, LLC
Arthritis Specialists of Nashville, Inc.
Athens Community Hospital, Inc.
Centennial Cardiovascular Consultants, LLC
Centennial Heart, LLC
Centennial Hospitalists, LLC
Centennial Neuroscience, LLC
Centennial Psychiatric Associates, LLC
Centennial Surgery Center, L.P.
Centennial Surgical Associates, LLC
Centennial Surgical Clinic, LLC
Centennial Womens Group, LLC
Central Tennessee Hospital Corporation
Chattanooga ASC Acquisition, Inc.
Chattanooga Diagnostic Associates, LLC
Chattanooga Healthcare Network Partner, Inc.
Chattanooga Healthcare Network, L.P.
Clarksville Surgicenter, LLC
Clinical Education Shared Services, LLC
Columbia Integrated Health Systems, Inc.
Columbia Medical Group - Centennial, Inc.
Columbia Medical Group - Daystar, Inc.
Columbia Medical Group - Parkridge, Inc.
Columbia Medical Group - Southern Hills, Inc.
Columbia Medical Group - The Frist Clinic, Inc.
Dickson Surgery Center, L.P.
Envision Stakes, LLC
Frist Clinic Express, LLC
Gastroenterology Specialists of Middle Tennessee, LLC
H2U Wellness Centers, LLC
HCA - Information Technology & Services, Inc.
HCA - IT&S PBS Field Operations, Inc.
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 Health Services of Tennessee, Inc.
HCA Human Resources, LLC
HCA Long Term Health Services of Miami, Inc.
HCA Medical Services, Inc.
HCA Patient Safety Organization, LLC
HCA Physician Services, Inc.
HCA Realty, Inc.
Health to You, LLC
Healthcare Sales National Management Services Group, LLC
HealthTrust Workforce Solutions, LLC
Healthtrust, Inc. - The Hospital Company
Hendersonville Hospital Corporation
Hendersonville Hospitalist Services, Inc.
Hendersonville OB/GYN, LLC
Hendersonville Primary Care, LLC
Hermitage Primary Care, LLC
Hometrust Management Services, Inc.
Horizon Orthopedics, LLC
Horizon Surgical, LLC
Hospital Corporation of Tennessee
Hospital Realty Corporation
Hospitalists at Centennial Medical Center, LLC
Hospitalists at Horizon Medical Center, LLC
Hospitalists at Parkridge, LLC
Hospitalists at StoneCrest, LLC
HTI Memorial Hospital Corporation
Indian Path Hospital, Inc.
Internal Medicine Associates of Southern Hills, LLC
Madison Behavioral Health, LLC
Med Group - Southern Hills Hospitalists, LLC
Medical Center Surgery Associates, L.P.
Medical Group - Dickson, Inc.
Medical Group - Southern Hills of Brentwood, LLC
Medical Group - Southern Hills of Nolensville, LLC
Medical Group - StoneCrest FP, Inc.
Medical Group - Stonecrest Pulmonology, LLC
Medical Group - StoneCrest, Inc.
Medical Group - Summit, Inc.
Medical Plaza Ambulatory Surgery Center Associates, L.P.
Middle Tennessee Neurology LLC
MP Management, LLC
Nashville Psychiatric Company, Inc.
Nashville Surgicenter, LLC
Natchez Medical Associates, LLC
Natchez Surgery Center, LLC
National Contact Center Management Group, LLC
National Transfer Center Management Services, LLC
Network Management Services, Inc.
Neurology Associates of Hendersonville, LLC
North Florida Regional Freestanding Surgery Center, L.P.
NPAS Solutions, LLC
NPAS, Inc.
Old Fort Village, LLC
OneSourceMed, Inc.
Palmer Medical Center, LLC
Parallon Business Solutions, LLC
Parallon Enterprises, LLC
Parallon Health Information Solutions, LLC
Parallon Payroll Solutions, LLC
Parallon Physician Services, LLC
Park View Insurance Company
Parkridge East Specialty Associates, LLC
Parkridge Hospitalists, Inc.
Parkridge Medical Associates, LLC
Parkridge Medical Center, Inc.
Parkridge Professionals, Inc.
Parkside Surgery Center, Inc.
Plano Ambulatory Surgery Associates, L.P.
Portland Primary Care, LLC
Premier ASC, LLC
PSG Delegated Services, LLC
PTS Solutions, LLC
Sarah Cannon Development Innovations, LLC
SCRI Scientifics, LLC
Skyline Medical Group, LLC
Skyline Neuroscience Associates, LLC
Skyline Rehab Associates, LLC
Skyline Specialty Associates, LLC
Southern Hills Neurology Consultants, LLC
Southpoint, LLC
Spring Hill Hospital, Inc.
Spring Hill Physicians, LLC
St. Marks Ambulatory Surgery Associates, L.P.
Sterling Primary Care Associates, LLC
Stonecrest Medical Group - Family Practice of Murfreesboro, LLC
Stonecrest Medical Group - SC Murfreesboro Family Practice, LLC
Sullins Surgical Center, Inc.
Summit Convenient Care at Lebanon, LLC
Summit Heart, LLC
Summit Research Solutions, LLC
Summit Surgery Center, L.P.
Summit Surgical Associates, LLC
Summit Walk-in Clinic, LLC
Surgicare of Chattanooga, LLC
Surgicare of Clarksville, LLC
Surgicare of Dickson, LLC
Surgicare of Madison, Inc.
Surgicare of Natchez, LLC
Surgicare of Premier Orthopaedic, LLC
Surgicare of Southern Hills, Inc.
Surgicare of Wilson County, LLC
Surgicare Outpatient Center of Jackson, Inc.
TCMC Madison-Portland, Inc.
Tennessee Healthcare Management, Inc.
Tennessee Valley Outpatient Diagnostic Center, LLC
The Charter Cypress Behavioral Health System, L.L.C.
Trident Ambulatory Surgery Center, L.P.
TriStar Bone Marrow Transplant, LLC
TriStar Cardiovascular Surgery, LLC
TriStar Family Care, LLC
TriStar Gynecology Oncology, LLC
TriStar Health System, Inc.
TriStar Joint Replacement Institute, LLC
TriStar Medical Group - Centennial Primary Care, LLC
TriStar Medical Group - Legacy Health, LLC
TriStar Medical Network, LLC
TriStar OB/GYN, LLC
TriStar Orthopedics, LLC
TriStar Physicians, LLC
TriStar Radiation Oncology, LLC
Vascular and Endovascular Specialists, LLC
Vision Holdings, LLC
WCP Properties, LLC
Wilson County Outpatient Surgery Center, L.P.
Womens and Childrens Specialists, LLC
TEXAS
360 Community Alliance, LLC
Acute Kids Urgent Care of Medical City Childrens Hospital, PLLC
Administrative Physicians of North Texas, PLLC
Advanced Practice Providers of Gulf Coast, PLLC
Ambulatory Endoscopy Clinic of Dallas, Ltd.
Ambulatory Endoscopy Holdco, LLC
Arlington Diagnostic South, Inc.
Arlington Neurosurgeons, PLLC
Arlington Primary Care, PLLC
Arlington Primary Medicine, PLLC
Austin Heart Cardiology MSO, LLC
Austin Medical Center, Inc.
Austin Physicians Management, LLC
Austin Urogynecology, PLLC
Bailey Square Ambulatory Surgical Center, Ltd.
Bailey Square Outpatient Surgical Center, Inc.
Barrow Medical Center CT Services, Ltd.
Bay Area Healthcare Group, Ltd.
Bay Area Surgical Center Investors, Ltd.
Bay Area Surgicare Center, Inc.
Bayshore Family Practitioners, PLLC
Bayshore Multi-Specialty Group, PLLC
Bayshore Occupational and Family Medicine, PLLC
Bayshore Radiation Oncology Services, PLLC
Bayshore Surgery Center, Ltd.
Bedford-Northeast Community Hospital, Inc.
Bellaire Imaging, Inc.
Brownsville Specialists of Texas, PLLC
Brownsville Surgery, PLLC
Brownsville Surgical Specialists, PLLC
Brownsville-Valley Regional Medical Center, Inc.
C. Medrano, M.D., PLLC
Calder Immediate Care, PLLC
Calloway Creek Surgery Center, L.P.
Calloway Creek Surgicare, LLC
Capital Area Cardiology
Capital Area CareNow Physician Associates
Capital Area Multispecialty Providers
Capital Area Neurosurgeons
Capital Area Occupational Medicine, PLLC
Capital Area Primary Care Providers
Capital Area Primary Care, PLLC
Capital Area Providers
Capital Area Specialists, PLLC
Capital Area Specialty Providers
Capital Area Surgeons, PLLC
Cardio Vascular Surgeons of North Texas, PLLC
Cardiology Clinic of San Antonio, PLLC
Cardiology Specialists of North Texas, PLLC
Cardiovascular and Thoracic Surgeons of Texas, PLLC
CC Clinic, PLLC
Central San Antonio Surgical Center Investors, Ltd.
Central Texas Cardiac Arrhythmia Physicians, PLLC
CHC Management, Ltd.
CHC Payroll Company
CHC Realty Company
CHCA Pearland, L.P.
CHC-El Paso Corp.
CHC-Miami Corp.
Christina Cano-Gonzalez, M.D., PLLC
City of San Antonio H2U Employee Health and Wellness Center, PLLC
Clear Lake Family Physicians, PLLC
Clear Lake Medical Tower Owners Association, Inc.
Clear Lake Multi-Specialty Group, PLLC
Clear Lake Regional Medical Center, Inc.
Clear Lake Surgicare, Ltd.
Coastal Bend Hospital CT Services, Ltd.
Collin County Diagnostic Associates, PLLC
COL-NAMC Holdings, Inc.
Columbia Ambulatory Surgery Division, Inc.
Columbia Bay Area Realty, Ltd.
Columbia Call Center, Inc.
Columbia Central Group, Inc.
Columbia Champions Treatment Center, Inc.
Columbia GP of Mesquite, Inc.
Columbia Greater Houston Division Healthcare Network, 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 Corpus Christi
Columbia Hospital-El Paso, Ltd.
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 Partners, Ltd.
Columbia Northwest Medical Center, Inc.
Columbia Plaza Medical Center of Fort Worth Subsidiary, L.P.
Columbia Psychiatric Management Co.
Columbia South Texas Division, Inc.
Columbia Specialty Hospital of Dallas Subsidiary, L.P.
Columbia Specialty Hospitals, Inc.
Columbia Surgery Group, Inc.
Columbia/HCA Healthcare Corporation of Central Texas
Columbia/HCA Heartcare of Corpus Christi, Inc.
Columbia/HCA International Group, Inc.
Columbia/HCA of Houston, Inc.
Columbia/HCA of North Texas, Inc.
Columbia/HCA Physician Hospital Organization Medical Center Hospital
Columbia-Quantum, Inc.
Comprehensive Radiology Management Services, Ltd.
Congenital Heart Surgery Center, PLLC
Conroe Hospital Corporation
Conroe Montgomery Physicians Group, PLLC
Conroe Orthopedic Specialists, PLLC
Conroe Specialists of Texas, PLLC
Corpus Christi Healthcare Group, Ltd.
Corpus Christi Heart Clinic, PLLC
Corpus Christi Primary Care Associates, PLLC
Corpus Christi Psychiatric Specialists, PLLC
Corpus Christi Radiation Oncology, PLLC
Corpus Christi Surgery Center, L.P.
Corpus Christi Surgery, Ltd.
Corpus Surgicare, Inc.
CP Surgery Center, LLC
CUC, PLLC
Dallas Cardiology Specialists, PLLC
Dallas CardioThoracic Surgery Consultants, PLLC
Dallas Hand Surgery Center, PLLC
Dallas Medical Specialists, PLLC
Dallas Neuro-Stroke Affiliates, PLLC
Dallas Pediatric Neurosurgery Specialists, PLLC
Deep Purple Investments, LLC
Del Sol Bariatric Clinic, PLLC
Denton Cancer Center, PLLC
Denton County Hospitalist Program, PLLC
Denton Pediatric Physicians, PLLC
Denton Regional Ambulatory Surgery Center, L.P.
DFW Physicians Group, PLLC
Doctors Bay Area Physician Hospital Organization
Doctors Hospital (Conroe), Inc.
Dura Medical, Inc.
E.P. Physical Therapy Centers, Inc.
East Houston Primary Care, PLLC
East Houston Specialists, PLLC
East Orthopedics, PLLC
El Paso CareNow Urgent Care, PLLC
El Paso Healthcare Provider Network
El Paso Healthcare System Physician Services, LLC
El Paso Healthcare System, Ltd.
El Paso Nurses Unlimited, Inc.
El Paso Primary Care, PLLC
El Paso Surgery Centers, L.P.
El Paso Surgicenter, Inc.
Eldridge Family Practitioners, PLLC
Elite Family Health of Plano, PLLC
Elite OB-GYN Services of El Paso, PLLC
Elite Orthopaedics of El Paso, PLLC
Elite Orthopaedics of Irving, PLLC
Elite Orthopaedics of Plano, PLLC
Emergency Psychiatric Medicine, PLLC
Endoscopy of Plano, L.P.
Endoscopy Surgicare of Plano, LLC
EPIC Properties, Inc.
EPSC, L.P.
Family First Medicine in Brownsville, PLLC
Family Practitioners of Montgomery, PLLC
Family Practitioners of Pearland, PLLC
Fannin MOB Property Management, LLC
Fannin MOB, LLC
Flower Mound Surgery Center, Ltd.
Fort Worth Investments, Inc.
Frisco Warren Parkway 91, Inc.
G. Rowe, M.D., PLLC
G. Schnider, M.D., PLLC
G. Voorhees, M.D., PLLC
G.P. Martin Fletcher & Associates, LLC
Galen Hospital of Baytown, Inc.
General and Cardiovascular Surgeons of Conroe, PLLC
General Surgeons of Houston, PLLC
General Surgeons of North Richland Hills, PLLC
General Surgeons of Pasadena, PLLC
GI Associates of Denton, PLLC
GI Associates of Lewisville, PLLC
Gramercy Surgery Center, Ltd.
Greater Houston Preferred Provider Option, Inc.
Green Oaks Hospital Subsidiary, L.P.
Gulf Coast Division, Inc.
Gulf Coast Electrophysiology Associates, PLLC
Gulf Coast Physician Administrators, Inc.
Gulf Coast Provider Network, Inc.
H2U Wellness Centers Conroe ISD, PLLC
H2U Wellness Centers Corpus Christi, PLLC
H2U Wellness Centers Clear Lake Regional Medical Center, PLLC
H2U Wellness Centers Conroe Regional Medical Center, PLLC
H2U Wellness Centers - Del Sol Medical Center, PLLC
H2U Wellness Centers El Paso, PLLC
H2U Wellness Centers - Las Palmas Medical Center, PLLC
H2U Wellness Centers - Medical City Dallas, PLLC
H2U Wellness Centers PISD, PLLC
H2U Wellness Centers San Benito CISD, PLLC
H2U Wellness Centers - St. Davids Medical Center, PLLC
HBP Lone Star, Inc.
HCA Central/West Texas Physicians Management, LLC
HCA Gulf Coast GME, PLLC
HCA Health Services of Texas, Inc.
HCA Pearland GP, Inc.
HCA Plano Imaging, Inc.
HCA Western Group, Inc.
HCAPS Conroe Affiliation, Inc.
HealthTrust Locums, Inc.
Heart Specialist of North Texas, PLLC
Heartcare of Texas, Ltd.
Hidalgo County Family Practitioners, PLLC
Hidden Lakes Health Center, PLLC
Hip & Joint Specialists of North Texas, PLLC
Houston CareNow Urgent Care, PLLC
Houston Northwest Concessions, L.L.C.
Houston Northwest Operating Company, L.L.C.
Houston Northwest Surgical Partners, Inc.
Houston Obstetrics and Gynecology for Women, PLLC
Houston Pediatric Specialty Group, PLLC
HPG Energy, L.P.
HPG GP, LLC
HTI Gulf Coast, Inc.
HWCA, PLLC
ICU Associates of West Houston, PLLC
Internal Medicine Associates of Huntsville, PLLC
Internal Medicine of Pasadena, PLLC
Internist Associates of Houston, PLLC
J. M. Garcia, M.D., PLLC
Kathy L. Summers, M.D., PLLC
Kennedale Primary Care PLLC
Kingwood Multi-Specialty Group, PLLC
Kingwood Surgery Center, LLC
KPH-Consolidation, Inc.
Kyle Primary Care, PLLC
Lake Forest Family Health, PLLC
Las Colinas Primary Care, PLLC
Las Colinas Surgery Center, Ltd.
Las Palmas Del Sol Cardiology, PLLC
Las Palmas Del Sol Internal Medicine, PLLC
Las Palmas Del Sol Urgent Care, PLLC
Leadership Healthcare Holdings II L.P., L.L.P.
Leadership Healthcare Holdings L.P., L.L.P.
Leslie Cohan, M.D., PLLC
Lewisville Primary Care, PLLC
Lone Star Intensivists at Gulf Coast, PLLC
Lonestar Provider Network
Longview Regional Physician Hospital Organization, Inc.
LPN TeleBehavioral Health, PLLC
M. Jamshidi, D.O., PLLC
Mainland Family Medicine, PLLC
Mainland Multi-Specialty Group, PLLC
Mainland Primary Care Physicians, PLLC
Mark Gottesman, M.D., PLLC
Martin Fletcher Associates Holdings, Inc.
Martin, Fletcher & Associates, L.P.
Mary Alice Cowan, M.D., PLLC
Maternal Fetal Medicine Specialists of Corpus Christi, PLLC
McAllen Comprehensive Upper Extremity Center, PLLC
McKinney Surgeons, PLLC
MEC Endoscopy, LLC
Med City Dallas Outpatient Surgery Center, L.P.
Med-Center Hosp./Houston, Inc.
Medical Care Surgery Center, Inc.
Medical City Dallas Hospital, Inc.
Medical City Dallas Primary Care, PLLC
Medical City OB-GYN, PLLC
Medical City Pediatrics, PLLC
Medical City Transplant, PLLC
MediPurchase, Inc.
Methodist Cardiology Physicians
Methodist CareNow Physician Associates
Methodist CareNow Urgent Care, PLLC
Methodist Healthcare System of San Antonio, Ltd., L.L.P.
Methodist Inpatient Management Group
Methodist Medical Center ASC, L.P.
Methodist Physician Alliance
Methodist Physician Practice Services, LLC
Methodist Physician Practices, PLLC
Metroplex Surgicenters, Inc.
MFA G.P., LLC
MFM Fact, PLLC
MGH Medical, Inc.
MHS SC Partner, L.L.C.
MHS Surgery Centers, L.P.
Michael Mann, M.D., PLLC
Mid-Cities Surgi-Center, Inc.
Movement Disorders of North Texas, PLLC
National Patient Account Services, Inc.
Navarro Memorial Hospital, Inc.
Neuro-Hospitalist of Clear Lake, PLLC
NeuroHospitalist of McAllen, PLLC
Neurological Eye Specialists of North Texas, PLLC
Neurological Specialists of McKinney, PLLC
Neurological Specialists, PLLC
Neurosurgery of Kingwood, PLLC
Neurosurgical Associates of North Texas, PLLC
Neurosurgical Specialists of El Paso, PLLC
Neurosurgical Specialists of North Texas, PLLC
North Austin Plastic Surgery Associates, PLLC
North Austin Surgery Center, L.P.
North Central Methodist ASC, L.P.
North Hills Cardiac Catheterization Center, L.P.
North Hills Catheterization Lab, LLC
North Hills Orthopaedic Surgeons, PLLC
North Hills Surgicare, L.P.
North Shore Specialists of Texas, PLLC
North Texas - MCA, LLC
North Texas Cardiology, PLLC
North Texas Craniofacial Fellowship Program, PLLC
North Texas Division, Inc.
North Texas General, L.P.
North Texas Geriatrics, PLLC
North Texas Heart Surgery Center, PLLC
North Texas Internal Medicine Specialists, PLLC
North Texas Neuro Stroke OP, PLLC
North Texas of Hope, PLLC
North Texas Pulmonary Critical Care, PLLC
North Texas Sports and Orthopedics Center, PLLC
North Texas Stroke Center, PLLC
Northeast Methodist Surgicare, Ltd.
Northeast PHO, Inc.
NT Urgent Care, PLLC
NTX Pathology Program, PLLC
Oakwood Surgery Center, Ltd., LLP
OB Hospitalists of Womans Hospital, PLLC
OB/Gyn Associates of Denton, PLLC
OB/GYN of Brownsville, PLLC
Occupational and Family Medicine of South Texas
On-Site Primary Care, PLLC
Orthopedic Hospital, Ltd.
Outpatient Womens and Childrens Surgery Center, Ltd.
Paragon of Texas Health Properties, Inc.
Paragon Physicians Hospital Organization of South Texas, Inc.
Paragon Surgery Centers of Texas, Inc.
Park Central Surgical Center, Ltd.
Parkway Cardiac Center, Ltd.
Parkway Surgery Services, Ltd.
Pasadena Bayshore Hospital, Inc.
Pearland Institute for Womens Health, PLLC
Pediatric Anesthesia Consultants of San Antonio, PLLC
Pediatric Cardiac Intensivists of North Texas, PLLC
Pediatric Critical Care of Clear Lake, PLLC
Pediatric Hospitalists of Conroe, PLLC
Pediatric Intensivists of El Paso, PLLC
Pediatric Intensivists of North Texas, PLLC
Pediatric Specialists of Clear Lake, PLLC
Pediatric Surgicare, Inc.
Pediatrics of Greater Houston, PLLC
Physicians Ambulatory Surgery Center, LLC
Plano Surgery Center - GP, LLC
Plano Surgery Center Real Estate, LLC
Plano Surgicenter Real Estate Manager, LLC
Plano Urology, PLLC
Plaza Medical Specialists, PLLC
Plaza Primary Care, PLLC
Plaza Transplant Center, PLLC
Podiatry of Clear Lake, PLLC
Primary Care Plano, PLLC
Primary Care South, PLLC
Primary Care West, PLLC
Primary Health Asset Holdings, Ltd.
Primary Health Network of South Texas
Primary Health Physicians, PLLC
Primary Health, Inc.
Quantum/Bellaire Imaging, Ltd.
Rim Building Partners, L.P.
Rio Grande Healthcare MSO, Inc.
Rio Grande NP, Inc.
Rio Grande Regional Hospital, Inc.
Rio Grande Valley Cardiology, PLLC
Rio Grande Valley CareNow Urgent Care, PLLC
Rio Grande Valley Urology, PLLC
Rosewood Medical Center, Inc.
Rosewood Professional Building, Ltd.
Round Rock Trauma Surgeons, PLLC
Royal Oaks Surgery Center, L.P.
S.A. Medical Center, Inc.
San Antonio Division, Inc.
San Antonio Regional Hospital, Inc.
San Antonio Surgicenter, LLC
Sante Fe Family Practitioners, PLLC
SAPN, LLC
South Austin Surgery Center, Ltd.
South Texas Surgicare, Inc.
Southern Texas Physicians Network
Specialists in Obstetrics and Gynecology, PLLC
Specialty Associates of West Houston, PLLC
Spring Branch Family Practitioners, PLLC
Spring Branch Medical Center, Inc.
St. Davids Healthcare Partnership, L.P., LLP
St. Davids Austin Area ASC, LLC
St. Davids Cardiology, PLLC
St. Davids CareNow Urgent Care, PLLC
St. Davids Heart & Vascular, PLLC
St. Davids Neurology, PLLC
St. Davids OB Hospitalist, PLLC
St. Davids Ortho, Neuro and Rehab, PLLC
St. Davids Physical Medicine and Rehabilitation, PLLC
St. Davids Quality Alliance, LLC
St. Davids Specialized Womens Services, PLLC
St. Davids Trauma Surgeons, PLLC
STPN Manager, LLC
Sugar Land Surgery Center Anesthesia, LLC
Sugar Land Surgery Center, Ltd.
Sun Towers/Vista Hills Holding Co.
Surgery Associates of NTX, PLLC
Surgery Center of Bay Area Houston, LLC
Surgical Center of Irving, Inc.
Surgical Facility of West Houston, L.P.
Surgical Specialists of Clear Lake, PLLC
Surgical Specialists of Conroe, PLLC
Surgical Specialists of Corpus Christi, PLLC
Surgicare of Arlington, LLC
Surgicare of Bay Area Endoscopy, LLC
Surgicare of Central Park Surgery Center, LLC
Surgicare of Central San Antonio, Inc.
Surgicare of Flower Mound, Inc.
Surgicare of Fort Worth Co-GP, LLC
Surgicare of Fort Worth, Inc.
Surgicare of Gramercy, Inc.
Surgicare of Houston Womens, Inc.
Surgicare of Kingwood, LLC
Surgicare of McKinney, Inc.
Surgicare of Medical City Dallas, LLC
Surgicare of Memorial Endoscopy, LLC
Surgicare of North Austin, LLC
Surgicare of North San Antonio, Inc.
Surgicare of Northeast San Antonio, Inc.
Surgicare of Pasadena, Inc.
Surgicare of Round Rock, Inc.
Surgicare of Royal Oaks, LLC
Surgicare of South Austin, Inc.
Surgicare of Southwest Houston, LLC
Surgicare of St. Davids Austin, LLC
Surgicare of Sugar Land, Inc.
Surgicare of Travis Center, Inc.
Tarrant County Surgery Center, L.P.
Texas CareNow Physician Associates
Texas HSS, LLC
Texas Institute of Medicine and Surgery
Texas Psychiatric Company, Inc.
The Austin Diagnostic Clinic, PLLC
The Cardiovascular Partnership for Quality, LLC
The West Texas Division of Columbia, Inc.
THN Physicians Association, Inc.
Travis Surgery Center, L.P.
Tuscan Imaging Center at Las Colinas, LLC
Urological Specialists of Arlington, PLLC
Urology Services of El Paso, PLLC
Urology Specialists of Kingwood, PLLC
Village Oaks Medical Center, Inc.
W & C Hospital, Inc.
West Houston ASC, Inc.
West Houston Healthcare Group, Ltd.
West Houston Internal Specialists, PLLC
West Houston Medical, PLLC
West Houston Outpatient Medical Facility, Inc.
West Houston Surgicare, Inc.
West LPN Fort Worth Oncology, PLLC
West LPN, Inc.
West McKinney Imaging Services, LLC
West Park Surgery Center, L.P.
WHMC, Inc.
Womans Health Group, PLLC
Womans Hospital of Texas, Incorporated
Women Practitioners of Houston, PLLC
Women Specialists of Bayshore, PLLC
Women Specialists of Clear Lake, PLLC
Women Specialists of Mainland, PLLC
Womens Link Specialty Obstetrical Referral Clinic, PLLC
Womens Surgical Specialists of Texas, PLLC
UNITED KINGDOM
52 Alderley Road LLP
Backlogs Limited
Basil Street Practice Limited
Blossoms Healthcare LLP
Catalog360 Limited
Chelsea Outpatient Centre LLP
Chiswick Outpatient Centre LLP
Elstree Outpatient Centre LLP
Galen Health Partners Limited
General Medical Clinics Limited
Hamsard 3160 Limited
Harley Street Clinic @ The Groves LLP
Hathor Chelsea, Ltd.
HCA Carenow Limited
HCA Global Capital LLP
HCA Healthcare UK Limited
HCA International Holdings Limited
HCA International Limited
HCA Luxembourg Finance Limited
HCA Medical City Limited
HCA Purchasing Limited
HCA Staffing Limited
HCA Swiss Capital 1 LLP
HCA Swiss Capital 2 LLP
HCA UK Capital Limited
HCA UK Holdings Limited
HCA UK Investments Limited
HCA UK Limited
HCA UK Services Limited
Health International Billing Partners Limited
HealthTrust Europe Company Limited
HealthTrust Europe LLP
Leaders in Oncology Care Limited
LOC @ The Christie LLP
LOC @ The London Bridge Hospital LLP
LOC Partnership LLP
London Oncology Clinic LLP
London Pathology Limited
London Radiography & Radiotherapy Services Limited
OBS Diagnostic and Treatment Centre LLP
Online Pathology Services Limited
PET CT LLP
Robotic Radiosurgery LLP
Roodlane Medical Limited
Sarah Cannon Research Institute UK Limited
SCRI Global Services Limited
St. Martins Healthcare Limited
St. Martins Ltd.
St. Martins Medical Services Limited
The Christie Clinic LLP
The Glynne Medical Practice Limited
The Harley Street Cancer Clinic Limited
The Physicians Clinic Limited
The Prostate Centre Limited
Urology Associates (London) Limited
Urology Specialists Devonshire LLP
Urology Specialists London LLP
Welbeck Street Diagnostic Centre LLP
Wellington Diagnostic Services LLP
UTAH
Alta Internal Medicine, LLC
Bountiful Surgery Center, LLC
Brigham City Community Hospital Physician Services, LLC
Brigham City Community Hospital, Inc.
Brigham City Health Plan, Inc.
Columbia Ogden Medical Center, Inc.
East Layton Internal Medicine, LLC
General Hospitals of Galen, Inc.
Gynecology Specialists of Utah, LLC
Healthtrust Utah Management Services, Inc.
Hospital Corporation of Utah
HTI Physician Services of Utah, Inc.
Jordan Family Health, L.L.C.
Lakeview Hospital Physician Services, LLC
Lakeview Internal Medicine, LLC
Lakeview Regional Medical Center Inpatient Services, LLC
Lakeview Urology & General Surgery, LLC
Layton Family Practice, LLC
Lone Peak Hospital, Inc.
Maternal Fetal Services of Utah, LLC
Mountain Division - CVH, LLC
Mountain Division, Inc.
Mountain View Hospital, Inc.
Mountain West Surgery Center, LLC
MountainStar Behavioral Health, LLC
MountainStar Brigham General Surgery, LLC
Mountainstar Brigham OBGYN, LLC
MountainStar Canyon Surgical Clinic, LLC
MountainStar Cardiology Ogden Regional, LLC
MountainStar Cardiology St. Marks, LLC
Mountainstar Cardiovascular Services, LLC
MountainStar Intensivist Services, LLC
MountainStar Medical Group - Cache Valley, LLC
MountainStar Medical Group - Ogden Regional Medical Center, LLC
MountainStar Medical Group - St. Marks Hospital, LLC
MountainStar Medical Group Neurosurgery-St. Marks, LLC
MountainStar Medical Group Timpanogos Primary Care, LLC
MountainStar Medical Group Timpanogos Specialty Care, LLC
Mountainstar Ogden Pediatrics, LLC
MountainStar Specialty Services, LLC
MountainStar Urgent Care, LLC
Mt. Ogden Utah Surgical Center, LLC
MVH Professional Services, LLC
Northern Utah Healthcare Corporation
Northern Utah Healthcare Imaging Holdco, LLC
Northern Utah Imaging, LLC
Ogden Imaging, LLC
Ogden Internal Medicine & Urology, LLC
Ogden Regional Health Plan, Inc.
Ogden Regional Medical Center Professional Billing, LLC
Ogden Senior Center, LLC
Ridgeline Surgicenter, LLC
Salt Lake City Surgicare, Inc.
St. Marks Gynecology Oncology Care, LLC
St. Marks Investments, Inc.
St. Marks Physician Billing, LLC
St. Marks Professional Services, LLC
St. Marks South Jordan Family Practice, LLC
Surgicare of Bountiful, LLC
Surgicare of Mountain West, LLC
Surgicare of Mt. Ogden, LLC
Surgicare of Ridgeline, LLC
Surgicare of Utah, LLC
Surgicare of Wasatch Front, LLC
The Wasatch Endoscopy Center, Ltd.
Timpanogos Pain Specialists, LLC
Timpanogos Regional Medical Services, Inc.
Utah Imaging GP, LLC
Utah Surgery Center, L.P.
Wasatch Front Surgery Center, LLC
West Jordan Hospital Corporation
West Valley Imaging, LLC
VIRGIN ISLANDS
The London Breast Institute UK Ltd
VIRGINIA
Alleghany General and Bariatric Services, LLC
Alleghany Hospitalists, LLC
Alleghany Primary Care, Inc.
Alleghany Specialists, LLC
Ambulatory Services Management Corporation of Chesterfield County, Inc.
Appomattox Imaging, LLC
Arlington Surgery Center, L.P.
Arlington Surgicare, LLC
Ashburn ASC, LLC
Ashburn Imaging, LLC
Atrium Surgery Center, L.P.
Atrium Surgicare, LLC
Behavioral Health Wellness Center, LLC
Blacksburg Family Care, LLC
Buford Road Imaging, L.L.C.
Capital Anesthesia Services, LLC
Capital Division, Inc.
Capital Professional Billing, LLC
Cardiac Surgical Associates, LLC
Carlin Springs Urgent Care, LLC
Central Shared Services, LLC
Chesterfield Imaging, LLC
Chippenham & Johnston-Willis Hospitals, Inc.
Chippenham & Johnston-Willis Sports Medicine, LLC
Chippenham Ambulatory Surgery Center, LLC
Chippenham Pediatric Specialists, LLC
Christiansburg Family Medicine, LLC
Christiansburg Internal Medicine, LLC
CJW Infectious Disease, LLC
CJW Wound Healing Center, LLC
Columbia Arlington Healthcare System, L.L.C.
Columbia Healthcare of Central Virginia, Inc.
Columbia Medical Group - Southwest Virginia, Inc.
Columbia Pentagon City Hospital, L.L.C.
Columbia/Alleghany Regional Hospital, Incorporated
Columbia/HCA John Randolph, Inc.
Commonwealth Perinatal Services, LLC
Crewe Outpatient Imaging, LLC
CVMC Property, LLC
Daleville Imaging Manager, LLC
Daleville Imaging, L.P.
Dominion Hospital Physicians Group, LLC
Fairfax Surgical Center, L.P.
Family Medicine of Blacksburg, LLC
Family Practice at Forest Hill, LLC
Family Practice at Retreat, LLC
Fort Chiswell Family Practice, LLC
Forward Pathology Solutions, LLC
Galen of Virginia, Inc.
Galen Property, LLC
Galen Virginia Hospital Corporation
Generations Family Practice, Inc.
GYN-Oncology of Southwest Virginia, LLC
HCA Health Services of Virginia, Inc.
HCA LewisGale Regional Cancer Centers Clinical Co-Management Company, LLC
HCA Richmond Cardiac Clinical Co-Management Company, LLC
HDH Thoracic Surgeons, LLC
Henrico Doctors Neurology Associates, LLC
Henrico Doctors OB GYN Specialists, LLC
Henrico Surgical Specialists, LLC
HSS Virginia, L.P.
Institute of Advanced ENT Surgery, LLC
Internal Medicine of Blacksburg, LLC
James River Internists, LLC
John Randolph Family Practice, LLC
John Randolph OB/GYN, LLC
John Randolph Surgeons, LLC
Lewis-Gale Hospital, Incorporated
Lewis-Gale Physicians, LLC
LGMC Ambulatory Surgery Center, LLC
Loudoun Surgery Center, LLC
Mechanicsville Imaging, LLC
Montgomery Cancer Center, LLC
Montgomery Hospitalists, LLC
Montgomery Regional Hospital, Inc.
Montgomery Surgery Associates, LLC
Northern Virginia CareNow Urgent Care, LLC
Northern Virginia Community Hospital, LLC
Northern Virginia Hospital Corporation
Orthopedics Specialists, LLC
Pavilion 2 Condominium Property, LLC
Pavilion 2 Medical Office Building Condominium Association, Inc.
Preferred Hospitals, Inc.
Primary Care of West End, LLC
Primary Health Group, Inc.
Pulaski Community Hospital, Inc.
Pulaski Urology, LLC
Quick Care Centers, LLC
Radford Family Medicine, LLC
Reston Hospitalists, LLC
Reston Surgery Center, L.P.
Retreat Cardiology, LLC
Retreat Hospital, LLC
Retreat Internal Medicine, LLC
Retreat Surgical Associates, LLC
Richmond Imaging Employer Corp.
Richmond Multi-Specialty, LLC
Richmond Pediatric Surgeons, LLC
Roanoke Imaging, LLC
Roanoke Neurosurgery, LLC
Roanoke Surgery Center, L.P.
Roanoke Valley Gynecology, LLC
Salem Hospitalists, LLC
Short Pump Imaging, LLC
Southwest Virginia Orthopedics and Spine, LLC
Specialty Physicians of Northern Virginia, LLC
Spotsylvania Condominium Property, LLC
Spotsylvania Medical Center, Inc.
Spotsylvania Multi-Specialty Group, LLC
Spotsylvania Regional Surgery Center, LLC
Stafford Imaging, LLC
StoneSprings Medical Office Building Property, LLC
Surgical Associates of Southwest Virginia, LLC
Surgicare of Ashburn, LLC
Surgicare of Chippenham, LLC
Surgicare of Fairfax, Inc.
Surgicare of Hanover, Inc.
Surgicare of Reston, Inc.
Surgicare of Roanoke, LLC
Surgicare of Spotsylvania, LLC
Surgicare of Winchester, LLC
Tri-City Multi-Specialty, LLC
Urology Specialists of Richmond, LLC
Virginia Care Partners ACO LLC
Virginia Gynecologic Oncology, LLC
Virginia Hematology & Oncology Associates, Inc.
Virginia Hospitalists, Inc.
Virginia Psychiatric Company, Inc.
Virginia Quality Care Partners, LLC
West Creek Ambulatory Surgery Center, LLC
West Creek Medical Center, Inc.
Womens & Childrens Center, LLC
Womens Health Center of SWVA, LLC
WASHINGTON
ACH, Inc.
Capital Network Services, Inc.
WEST VIRGINIA
Columbia Parkersburg Healthcare System, LLC
Galen of West Virginia, Inc.
HCA Health Services of West Virginia, Inc.
Hospital Corporation of America
Parkersburg SJ Holdings, Inc.
Teays Valley Health Services, LLC
Tri Cities Health Services Corp.
Exhibit 23
Consent of Independent Registered Public Accounting Firm
We consent to the incorporation by reference in the following Registration Statements:
(1) |
Registration Statement (Form S-8 No. 333-197656) pertaining to the HCA Healthcare, Inc. Employee Stock Purchase Plan, |
(2) |
Registration Statement (Form S-8 No. 333-172887) pertaining to the 2006 Stock Incentive Plan for Key Employees of HCA Healthcare, Inc. and its Affiliates, as Amended and Restated, |
(3) |
Registration Statement (Form S-8 No. 333-150714) pertaining to the 2006 Stock Incentive Plan for Key Employees of HCA Inc. and its Affiliates, and |
(4) |
Registration Statement (Form S-3 No. 333- 226709) of HCA Healthcare, Inc.; |
of our reports dated February 20, 2020, with respect to the consolidated financial statements of HCA Healthcare, Inc. and the effectiveness of internal control over financial reporting of HCA Healthcare, Inc., included in this Annual Report (Form 10-K) of HCA Healthcare, Inc. for the year ended December 31, 2019.
/s/ Ernst & Young LLP
Nashville, Tennessee
February 20, 2020
EXHIBIT 31.1
CERTIFICATIONS
I, Samuel N. Hazen, certify that:
1. I have reviewed this annual report on Form 10-K 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 registrants 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 registrants 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 registrants internal control over financial reporting that occurred during the registrants most recent fiscal quarter (the registrants fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrants internal control over financial reporting; and
5. The registrants other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrants auditors and the audit and compliance committee of the registrants 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 registrants 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 registrants internal control over financial reporting.
By: |
/s/ SAMUEL N. HAZEN |
|
Samuel N. Hazen Chief Executive Officer |
Date: February 20, 2020
EXHIBIT 31.2
CERTIFICATIONS
I, William B. Rutherford, certify that:
1. I have reviewed this annual report on Form 10-K 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 registrants 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 registrants 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 registrants internal control over financial reporting that occurred during the registrants most recent fiscal quarter (the registrants fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrants internal control over financial reporting; and
5. The registrants other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrants auditors and the audit and compliance committee of the registrants 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 registrants 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 registrants internal control over financial reporting.
By: |
/s/ WILLIAM B. RUTHERFORD |
|
William B. Rutherford Executive Vice President and Chief Financial Officer |
Date: February 20, 2020
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 Annual Report of HCA Healthcare, Inc. (the Company) on Form 10-K for the year ended December 31, 2019, 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 |
February 20, 2020
By: |
/s/ WILLIAM B. RUTHERFORD |
|
William B. Rutherford Executive Vice President and Chief Financial Officer |
February 20, 2020