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10-Q

HCA Healthcare, Inc. (HCA)

10-Q 2021-04-30 For: 2021-03-31
View Original
Added on April 08, 2026

Table of Contents

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

Form 10-Q

(Mark One)

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

For the quarterly period ended March 31, 2021

Or

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

For the transition period from                to

Commission file number 1-11239

HCA Healthcare, Inc.

(Exact name of registrant as specified in its charter)

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

(615) 344-9551

(Registrant’s telephone number, including area code)

Not Applicable

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

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

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

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

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

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

Large accelerated filer Accelerated filer
Non-accelerated<br> filer Smaller reporting company
Emerging growth company

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

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

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

Class of Common Stock Outstanding at April 26, 2021
Voting common stock, $.01 par value 330,655,500 shares

Table of Contents

HCA HEALTHCARE, INC.

Form 10-Q

March 31, 2021

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

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HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED INCOME STATEMENTS

FOR THE QUARTERS ENDED MARCH 31, 2021 AND 2020

Unaudited

(Dollars in millions, except per share amounts)

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

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

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HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED COMPREHENSIVE INCOME STATEMENTS

FOR THE QUARTERS ENDED MARCH 31, 2021 AND 2020

Unaudited

(Dollars in millions)

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

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

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HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS

Unaudited

(Dollars in millions)

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

All values are in US Dollars.

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

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HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY (DEFICIT)

FOR THE QUARTERS ENDED MARCH 31, 2021 AND 2020

Unaudited

(Dollars in millions)

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

All values are in US Dollars.

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

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HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

FOR THE QUARTERS ENDED MARCH 31, 2021 AND 2020

Unaudited

(Dollars in millions)

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

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

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HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES

Reporting Entity

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

Basis of Presentation

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

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

COVID-19 Pandemic

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

Revenues

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

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HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

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

Revenues (continued)

through the health insurance exchanges) and the transaction prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges. Medicare generally pays for inpatient and outpatient services at prospectively determined rates based on clinical, diagnostic and other factors. Services provided to patients having Medicaid coverage are generally paid at prospectively determined rates per discharge, per identified service or per covered member. Agreements with commercial insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates. Our revenues for the quarter ended March 31, 2020 include

$ 55

million related to the settlement of Medicare outlier calculations for prior periods. Management continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals.

Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual adjustments under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record these revenues at the estimated amounts we expect to collect. Patients treated at our hospitals for

non-elective

care, who have income at or below

400

%

of the federal poverty level, are eligible for charity care. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues.

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

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

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HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

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

Revenues (continued)

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

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

The total uncompensated care amounts include charity care of $2.942 billion and $3.735 billion, respectively, and the related estimated costs of charity care were $335 million and $444 million,

respectively, for the quarters ended March 31, 2021 and 2020 .

Reclassifications

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

NOTE 2 — ACQUISITIONS AND DISPOSITIONS

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

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

NOTE 3 — INCOME TAXES

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

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

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HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 3 — INCOME TAXES (continued)

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

NOTE 4 — EARNINGS PER SHARE

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

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

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

NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES

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

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

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HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES (continued)

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

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

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

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

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

NOTE 6 — FINANCIAL INSTRUMENTS

Interest Rate Swap Agreements

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

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HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 6 — FINANCIAL INSTRUMENTS (continued)

Interest Rate Swap Agreements (continued)

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

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

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

Derivatives — Results of Operations

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

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

Credit-risk-related Contingent Features

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

NOTE 7 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE

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

Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates, and yield curves observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related marke t

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HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

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

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

Cash Traded Investments

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

Derivative Financial Instruments

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

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

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

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HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

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

Derivative Financial Instruments (continued)

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

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

NOTE 8 — LONG-TERM DEBT

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

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

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HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 9 — CONTINGENCIES

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

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

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

NOTE 10 — SHARE REPURCHASE TRANSACTIONS AND OTHER COMPREHENSIVE LOSS

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

authorizations .

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HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

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

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

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

All values are in US Dollars.

NOTE 11 — SEGMENT AND GEOGRAPHIC INFORMATION

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

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

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

202<br>1 2020
Revenues:
National Group $ 7,056 $ 6,474
American Group 6,291 5,744
Corporate and other 630 643
$ 13,977 $ 12,861

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HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 11 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

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

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS

Forward-Looking Statements

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

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Forward-Looking Statements (continued)

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

COVID-19 Pandemic

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

First Quarter 2021 Operations Summary

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

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

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

First Quarter 2021 Operations Summary (continued)

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

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

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

Results of Operations

Revenue/Volume Trends

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

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

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Results of Operations (continued)

Revenue/Volume Trends (continued)

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

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

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

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

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

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

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Results of Operations (continued)

Revenue/Volume Trends (continued)

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

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

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

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

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

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

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

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

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Results of Operations (continued)

Revenue/Volume Trends (continued)

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

Key Performance Indicators

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

Operating Results Summary

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

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

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Results of Operations (continued)

Operating Results Summary (continued)

(b) Equivalent admissions are used by management and certain investors as a general measure of combined inpatient and outpatient volume. Equivalent admissions are computed by multiplying admissions (inpatient volume) by the sum of gross inpatient revenues and gross outpatient revenues and then dividing the resulting amount by gross inpatient revenues. The equivalent admissions computation “equates” outpatient revenues to the volume measure (admissions) used to measure inpatient volume, resulting in a general measure of combined inpatient and outpatient volume.
(c) Same facility information excludes the operations of hospitals and their related facilities which were either acquired or divested during the current and prior period.
--- ---

Quarters Ended March 31, 2021 and 2020

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

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

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

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

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

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

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Results of Operations (continued)

Quarters Ended March 31, 2021 and 2020 (continued)

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

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

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

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

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

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

Liquidity and Capital Resources

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

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

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Liquidity and Capital Resources (continued)

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

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

In addition to cash flows from operations, available sources of capital include amounts available under our senior secured credit facilities ($5.590 billion an

d $5.140 b

illion available as of March 31, 2021 and April 29, 2021, respectively) and anticipated access to public and private debt markets.

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

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

Summarized Financial Information

HCA Inc., a direct wholly-owned subsidiary of HCA Healthcare, Inc., is the primary obligor under a substantial portion of our indebtedness, including our senior secured credit facilities, senior secured notes and senior unsecured notes. The senior secured notes and senior unsecured notes issued by HCA Inc. are fully and unconditionally guarantee

d on an unsecured basis b

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

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

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Liquidity and Capital Resources (continued)

Summarized Financial Information (continued)

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

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

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

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

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

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Liquidity and Capital Resources (continued)

Summarized Financial Information (continued)

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

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

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

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

Market Risk

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

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Liquidity and Capital Resources (continued)

Market Risk (continued)

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

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

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

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

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

Tax Examinations

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

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Tax Examinations (continued)

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

Operating Data

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

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Operating Data (continued)

2021 2020
Average length of stay (days)(f):
Quarter:
First 5.3 5.0
Second 5.0
Third 5.1
Fourth 5.1
Year 5.1
Emergency room visits(g):
Quarter:
First 1,841,778 2,264,707
Second 1,516,116
Third 1,813,661
Fourth 1,855,823
Year 7,450,307
Outpatient surgeries(h):
Quarter:
First 231,228 226,319
Second 170,911
Third 232,493
Fourth 252,760
Year 882,483
Inpatient surgeries(i):
Quarter:
First 127,590 135,145
Second 118,591
Third 133,492
Fourth 135,157
Year 522,385
Days revenues in accounts receivable(j):
Quarter:
First 48 49
Second 50
Third 44
Fourth 45
Outpatient revenues as a % of patient revenues(k):
Quarter:
First 36 % 37 %
Second 32 %
Third 36 %
Fourth 35 %
Year 35 %
(a) Licensed beds are those beds for which a facility has been granted approval to operate from the applicable state licensing agency.
--- ---
(b) Represents the average number of licensed beds in service, weighted based on periods owned.
--- ---
(c) Represents the average number of patients in our hospital beds each day.
--- ---
(d) Represents the total number of patients admitted to our hospitals and is used by management and certain investors as a general measure of inpatient volume.
--- ---

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)

Operating Data (continued)

(e) Equivalent admissions are used by management and certain investors as a general measure of combined inpatient and outpatient volume. Equivalent admissions are computed by multiplying admissions (inpatient volume) by the sum of gross inpatient revenues and gross outpatient revenues and then dividing the resulting amount by gross inpatient revenues. The equivalent admissions computation “equates” outpatient revenues to the volume measure (admissions) used to measure inpatient volume resulting in a general measure of combined inpatient and outpatient volume.
(f) Represents the average number of days admitted patients stay in our hospitals.
--- ---
(g) Represents the number of patients treated in our emergency rooms.
--- ---
(h) Represents the number of surgeries performed on patients who were not admitted to our hospitals. Pain management and endoscopy procedures are not included in outpatient surgeries.
--- ---
(i) Represents the number of surgeries performed on patients who have been admitted to our hospitals. Pain management and endoscopy procedures are not included in inpatient surgeries.
--- ---
(j) Revenues per day is calculated by dividing revenues for the quarter by the days in the quarter. Days revenues in accounts receivable is then calculated as accounts receivable at the end of the quarter divided by revenues per day.
--- ---
(k) Represents the percentage of patient revenues related to patients who are not admitted to our hospitals.
--- ---

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ITEM 3.    QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

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

ITEM 4.    CONTROLS AND PROCEDURES

Evaluation of Disclosure Controls and Procedures

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

Changes in Internal Control Over Financial Reporting

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

PART II. OTHER INFORMATION

ITEM 1.    LEGAL PROCEEDINGS

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

ITEM 1A.    RISK FACTORS

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

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

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

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

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

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

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ITEM 6.    EXHIBITS

(a) List of Exhibits:

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

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SIGNATURES

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

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

Date: April 30, 2021

36

EX-22

Exhibit 22

List of Subsidiary Guarantors

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

American Medicorp Development Co.
Bay Hospital, Inc.
Brigham City Community Hospital, Inc.
Brookwood Medical Center of Gulfport, Inc.
Capital Division, Inc.
CarePartners HHA Holdings, LLLP
CarePartners HHA, LLLP
CarePartners Rehabilitation Hospital, LLLP
Centerpoint Medical Center of Independence, LLC
Central Florida Regional Hospital, Inc.
Central Shared Services, LLC
Central Tennessee Hospital Corporation
CHCA Bayshore, L.P.
CHCA Conroe, L.P.
CHCA Mainland, L.P.
CHCA Pearland, L.P.
CHCA West Houston, L.P.
CHCA Woman’s Hospital, L.P.
Chippenham & Johnston-Willis Hospitals, Inc.
Citrus Memorial Hospital, Inc.
Citrus Memorial Property Management, Inc.
Clinical Education Shared Services, LLC
Colorado Health Systems, Inc.
Columbia ASC Management, L.P.
Columbia Florida Group, Inc.
Columbia Healthcare System of Louisiana, Inc.
Columbia Jacksonville Healthcare System, Inc.
Columbia LaGrange Hospital, LLC
Columbia Medical Center of Arlington Subsidiary, L.P.
Columbia Medical Center of Denton Subsidiary, L.P.
Columbia Medical Center of Las Colinas, Inc.
Columbia Medical Center of Lewisville Subsidiary, L.P.
Columbia Medical Center of McKinney Subsidiary, L.P.
Columbia Medical Center of Plano Subsidiary, L.P.
Columbia North Hills Hospital Subsidiary, L.P.
Columbia Ogden Medical Center, Inc.
Columbia Parkersburg Healthcare System, LLC
Columbia Physician Services - Florida Group, Inc.
Columbia Plaza Medical Center of Fort Worth Subsidiary, L.P.
---
Columbia Rio Grande Healthcare, L.P.
Columbia Riverside, Inc.
Columbia Valley Healthcare System, L.P.
Columbia/Alleghany Regional Hospital, Incorporated
Columbia/HCA John Randolph, Inc.
Columbine Psychiatric Center, Inc.
Columbus Cardiology, Inc.
Conroe Hospital Corporation
Cy-Fair Medical Center Hospital, LLC
Dallas/Ft. Worth Physician, LLC
Dublin Community Hospital, LLC
East Florida - DMC, Inc.
Eastern Idaho Health Services, Inc.
Edward White Hospital, Inc.
El Paso Surgicenter, Inc.
Encino Hospital Corporation, Inc.
EP Health, LLC
Fairview Park GP, LLC
Fairview Park, Limited Partnership
FMH Health Services, LLC
Frankfort Hospital, Inc.
Galen Property, LLC
GenoSpace, LLC
Good Samaritan Hospital, L.P.
Goppert-Trinity Family Care, LLC
GPCH-GP, Inc.
Grand Strand Regional Medical Center, LLC
Green Oaks Hospital Subsidiary, L.P.
Greenview Hospital, Inc.
H2U Wellness Centers, LLC
HCA - IT&S Field Operations, Inc.
HCA - IT&S Inventory Management, Inc.
HCA American Finance LLC
HCA Central Group, Inc.
HCA Eastern Group, Inc.
HCA Health Services of Florida, Inc.
HCA Health Services of Louisiana, Inc.
HCA Health Services of Tennessee, Inc.
HCA Health Services of Virginia, Inc.
HCA Management Services, L.P.
HCA Pearland GP, Inc.
HCA Realty, Inc.
HCA-HealthONE LLC

2

HD&S Corp. Successor, Inc.
Health Midwest Office Facilities Corporation
Health Midwest Ventures Group, Inc.
HealthTrust Workforce Solutions, LLC
Hendersonville Hospital Corporation
hInsight-Mobile Heartbeat Holdings, LLC
Hospital Corporation of Tennessee
Hospital Corporation of Utah
Hospital Development Properties, Inc.
Houston - PPH, LLC
Houston NW Manager, LLC
HPG Enterprises, LLC
HSS Holdco, LLC
HSS Systems, LLC
HSS Virginia, L.P.
HTI Memorial Hospital Corporation
HTI MOB, LLC
Integrated Regional Lab, LLC
Integrated Regional Laboratories, LLP
JFK Medical Center Limited Partnership
JPM AA Housing, LLC
KPH-Consolidation, Inc.
Lakeview Medical Center, LLC
Largo Medical Center, Inc.
Las Encinas Hospital
Las Vegas Surgicare, Inc.
Lawnwood Medical Center, Inc.
Lewis-Gale Hospital, Incorporated
Lewis-Gale Medical Center, LLC
Lewis-Gale Physicians, LLC
Lone Peak Hospital, Inc.
Los Robles Regional Medical Center
Management Services Holdings, Inc.
Marietta Surgical Center, Inc.
Marion Community Hospital, Inc.
MCA Investment Company
Medical Centers of Oklahoma, LLC
Medical Office Buildings of Kansas, LLC
MediCredit, Inc.
Memorial Healthcare Group, Inc.
MH Angel Medical Center, LLLP
MH Blue Ridge Medical Center, LLLP
MH Highlands-Cashiers Medical Center, LLLP
MH Hospital Holdings, Inc.

3

MH Hospital Manager, LLC
MH Master Holdings, LLLP
MH Master, LLC
MH Mission Hospital McDowell, LLLP
MH Mission Hospital, LLLP
MH Mission Imaging, LLLP
MH Transylvania Regional Hospital, LLLP
Midwest Division - ACH, LLC
Midwest Division - LSH, LLC
Midwest Division - MCI, LLC
Midwest Division - MMC, LLC
Midwest Division - OPRMC, LLC
Midwest Division - RBH, LLC
Midwest Division - RMC, LLC
Midwest Holdings, Inc.
Mobile Heartbeat, LLC
Montgomery Regional Hospital, Inc.
Mountain Division - CVH, LLC
Mountain View Hospital, Inc.
Nashville Shared Services General Partnership
National Patient Account Services, Inc.
New Iberia Healthcare, LLC
New Port Richey Hospital, Inc.
New Rose Holding Company, Inc.
North Florida Immediate Care Center, Inc.
North Florida Regional Medical Center, Inc.
North Houston - TRMC, LLC
North Texas - MCA, LLC
Northern Utah Healthcare Corporation
Northern Virginia Community Hospital, LLC
Northlake Medical Center, LLC
Notami Hospitals of Louisiana, Inc.
Notami Hospitals, LLC
Okaloosa Hospital, Inc.
Okeechobee Hospital, Inc.
Oklahoma Holding Company, LLC
Outpatient Cardiovascular Center of Central Florida, LLC
Outpatient Services Holdings, Inc.
Oviedo Medical Center, LLC
Palms West Hospital Limited Partnership
Parallon Business Solutions, LLC
Parallon Enterprises, LLC
Parallon Health Information Solutions, LLC
Parallon Holdings, LLC

4

Parallon Payroll Solutions, LLC
Parallon Physician Services, LLC
Parallon Revenue Cycle Services, Inc.
Pasadena Bayshore Hospital, Inc.
PatientKeeper, Inc.
Pearland Partner, LLC
Plantation General Hospital, L.P.
Poinciana Medical Center, Inc.
Primary Health, Inc.
PTS Solutions, LLC
Pulaski Community Hospital, Inc.
Putnam Community Medical Center of North Florida, LLC
Redmond Park Hospital, LLC
Redmond Physician Practice Company
Reston Hospital Center, LLC
Retreat Hospital, LLC
Rio Grande Regional Hospital, Inc.
Riverside Healthcare System, L.P.
Riverside Hospital, Inc.
Samaritan, LLC
San Jose Healthcare System, LP
San Jose Hospital, L.P.
San Jose Medical Center, LLC
San Jose, LLC
Sarah Cannon Research Institute, LLC
Sarasota Doctors Hospital, Inc.
Savannah Health Services, LLC
SCRI Holdings, LLC
Sebring Health Services, LLC
SJMC, LLC
Southeast Georgia Health Services, LLC
Southern Hills Medical Center, LLC
Southpoint, LLC
Spalding Rehabilitation L.L.C.
Spotsylvania Medical Center, Inc.
Spring Branch Medical Center, Inc.
Spring Hill Hospital, Inc.
SSHR Holdco, LLC
Sun City Hospital, Inc.
Sunrise Mountainview Hospital, Inc.
Surgicare of Brandon, Inc.
Surgicare of Florida, Inc.
Surgicare of Houston Women’s, Inc.
Surgicare of Manatee, Inc.

5

Surgicare of Newport Richey, Inc.
Surgicare of Palms West, LLC
Surgicare of Riverside, LLC
Tallahassee Medical Center, Inc.
TCMC Madison-Portland, Inc.
Terre Haute Hospital GP, Inc.
Terre Haute Hospital Holdings, Inc.
Terre Haute MOB, L.P.
Terre Haute Regional Hospital, L.P.
The Regional Health System of Acadiana, LLC
Timpanogos Regional Medical Services, Inc.
Trident Medical Center, LLC
U.S. Collections, Inc.
Utah Medco, LLC
VH Holdco, Inc.
VH Holdings, Inc.
Virginia Psychiatric Company, Inc.
Vision Consulting Group LLC
Vision Holdings, LLC
Walterboro Community Hospital, Inc.
WCP Properties, LLC
Weatherford Health Services, LLC
Wesley Medical Center, LLC
West Florida - MHT, LLC
West Florida - PPH, LLC
West Florida Regional Medical Center, Inc.
West Valley Medical Center, Inc.
Western Plains Capital, Inc.
WHMC, Inc.
Woman’s Hospital of Texas, Incorporated

List of Pledged Securities

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

6

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

7

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

8

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

9

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

10

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

11

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

12

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

13

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

14

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

15

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

16

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

17

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

18

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

19

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

20

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

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

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

* Subsidiary guarantor.

21

AC Med, LLC
Acadiana Care Center, Inc.
Acadiana Practice Management, Inc.
---
Acadiana Regional Pharmacy, Inc.
ACH, Inc.
Advanced Bundle Convener, LLC
All About Staffing, Inc.
Alleghany Primary Care, Inc.
Alliance Surgicare, LLC
Alternaco, LLC
Ambulatory Services Management Corporation of Chesterfield County, Inc.
*American Medicorp Development Co.
AOGN, LLC
AOSC Sports Medicine, Inc.
AR Holding 1, LLC
AR Holding 2, LLC
AR Holding 4, LLC
AR Holding 5, LLC
AR Holding 6, LLC
AR Holding 7, LLC
AR Holding 8, LLC
AR Holding 9, LLC
AR Holding 10, LLC
AR Holding 11, LLC
AR Holding 12, LLC
AR Holding 13, LLC
AR Holding 14, LLC
AR Holding 15, LLC
AR Holding 16, LLC
AR Holding 17, LLC
AR Holding 18, LLC
AR Holding 19, LLC
AR Holding 20, LLC
AR Holding 21, LLC
AR Holding 22, LLC
AR Holding 23, LLC
AR Holding 24, LLC
AR Holding 25, LLC
AR Holding 26, LLC
AR Holding 27, LLC
AR Holding 28, LLC
AR Holding 29, LLC
AR Holding 30, LLC
AR Holding 31, LLC
Arlington Diagnostic South, Inc.
Arlington Surgery Center, L.P.

22

Arlington Surgicare, LLC
ASD Shared Services, LLC
Ashburn ASC, LLC
Ashburn Imaging, LLC
Athens Community Hospital, Inc.
Atlanta Healthcare Management, L.P.
Atlanta Market GP, Inc.
Atlanta Outpatient Surgery Center, Inc.
Atlantis Surgicare, LLC
Atrium Surgery Center, L.P.
Atrium Surgicare, LLC
Augusta Management Services, LLC
Austin Medical Center, Inc.
Aventura Cancer Center Manager, LLC
Aventura Comprehensive Cancer Research Group of Florida, Inc.
Bailey Square Outpatient Surgical Center, Inc.
Basic American Medical, Inc.
Bay Area Healthcare Group, Ltd.
Bay Area Surgicare Center, Inc.
*Bay Hospital, Inc.
Bayshore Partner, LLC
Bedford-Northeast Community Hospital, Inc.
Bellaire Imaging, Inc.
Big Cypress Medical Center, Inc.
Bonita Bay Surgery Center, Inc.
Boynton Beach EFL Imaging Center, LLC
Bradenton Outpatient Services, LLC
Brandon Imaging Manager, LLC
Brandon Regional Cancer Center, LLC
*Brigham City Community Hospital, Inc.
Brigham City Health Plan, Inc.
*Brookwood Medical Center of Gulfport, Inc.
Broward Healthcare System, Inc.
Brownsville-Valley Regional Medical Center, Inc.
C/HCA Capital, Inc.
C/HCA Development, Inc.
C/HCA, Inc.
Calloway Creek Surgicare, LLC
Cancer Centers of North Florida, LLC
Cancer Services of Aventura, LLC
*Capital Division, Inc.
Capital Network Services, Inc.
CareOne Home Health Services, Inc.

23

CareOne Home Health Services, Inc.
*CarePartners HHA Holdings, LLLP
*CarePartners HHA, LLLP
*CarePartners Rehabilitation Hospital, LLLP
Carolina Regional Surgery Center, Inc.
Cartersville Medical Center, LLC
Cartersville Occupational Medicine Center, LLC
CCH-GP, Inc.
Centennial CyberKnife Manager, LLC
Center for Advanced Imaging, LLC
*Centerpoint Medical Center of Independence, LLC
Central Florida Cardiology Interpretations, LLC
Central Florida Imaging Services, LLC
*Central Florida Regional Hospital, Inc.
Central Health Holding Company, Inc.
*Central Shared Services, LLC
*Central Tennessee Hospital Corporation
CFC Investments, Inc.
CH Systems
Chatsworth Hospital Corp.
Chattanooga Healthcare Network Partner, Inc.
CHC Finance Co.
CHC Holdings, Inc.
CHC Payroll Agent, Inc.
CHC Payroll Company
CHC Realty Company
CHC Venture Co.
*CHCA Bayshore, L.P.
CHCA Clear Lake, L.P.
*CHCA Conroe, L.P.
*CHCA Mainland, L.P.
*CHCA Pearland, L.P.
*CHCA West Houston, L.P.
*CHCA Woman’s Hospital, L.P.
CHC-El Paso Corp.
CHCK, Inc.
CHC-Miami Corp.
Chicago Grant Hospital, Inc.
Chino Community Hospital Corporation, Inc.
*Chippenham & Johnston-Willis Hospitals, Inc.
Chippenham Ambulatory Surgery Center, LLC
Chugach PT, Inc.
*Citrus Memorial Hospital, Inc.
*Citrus Memorial Property Management, Inc.

24

CLASC Manager, LLC
Clear Lake Cardiac Catheterization Center, L.P.
Clear Lake Cardiac GP, LLC
Clear Lake Merger, LLC
Clear Lake Regional Medical Center, Inc.
Clear Lake Regional Partner, LLC
*Clinical Education Shared Services, LLC
ClinicServ, LLC
Clinishare, Inc.
Coastal Bend Hospital, Inc.
Coastal Carolina Home Care, Inc.
Coastal Healthcare Services, Inc.
Coastal Imaging Center of Gulfport, Inc.
Coliseum Health Group, Inc.
Coliseum Park Hospital, Inc.
College Park Endoscopy Center, LLC
Colleton Ambulatory Care, LLC
Colleton Diagnostic Center, LLC
Collier County Home Health Agency, Inc.
*Colorado Health Systems, Inc.
Columbia Ambulatory Surgery Division, Inc.
*Columbia ASC Management, L.P.
Columbia Bay Area Realty, Ltd.
Columbia Behavioral Healthcare of South Florida, Inc.
Columbia Behavioral Healthcare, Inc.
Columbia Call Center, Inc.
Columbia Central Florida Division, Inc.
Columbia Central Group, Inc.
Columbia Champions Treatment Center, Inc.
Columbia Chicago Division, Inc.
Columbia Coliseum Same Day Surgery Center, Inc.
Columbia Development of Florida, Inc.
Columbia Doctors Hospital of Tulsa, Inc.
*Columbia Florida Group, Inc.
Columbia GP of Mesquite, Inc.
Columbia Greater Houston Division Healthcare Network, Inc.
Columbia Health System of Arkansas, Inc.
*Columbia Healthcare System of Louisiana, Inc.
Columbia Hospital at Medical City Dallas Subsidiary, L.P.
Columbia Hospital Corporation at the Medical Center
Columbia Hospital Corporation of Arlington
Columbia Hospital Corporation of Bay Area
Columbia Hospital Corporation of Central Miami
Columbia Hospital Corporation of Corpus Christi

25

Columbia Hospital Corporation of Fort Worth
Columbia Hospital Corporation of Houston
Columbia Hospital Corporation of Kendall
Columbia Hospital Corporation of Massachusetts, Inc.
Columbia Hospital Corporation of Miami
Columbia Hospital Corporation of Miami Beach
Columbia Hospital Corporation of North Miami Beach
Columbia Hospital Corporation of South Broward
Columbia Hospital Corporation of South Dade
Columbia Hospital Corporation of South Florida
Columbia Hospital Corporation of South Miami
Columbia Hospital Corporation of Tamarac
Columbia Hospital Corporation of West Houston
Columbia Hospital Corporation-Delaware
Columbia Hospital Corporation-SMM
Columbia Hospital-El Paso, Ltd.
Columbia Integrated Health Systems, Inc.
*Columbia LaGrange Hospital, LLC
Columbia Lake Worth Surgical Center Limited Partnership
Columbia Medical Arts Hospital Subsidiary, L.P.
Columbia Medical Center at Lancaster Subsidiary, L.P.
Columbia Medical Center Dallas Southwest Subsidiary, L.P.
*Columbia Medical Center of Arlington Subsidiary, L.P.
*Columbia Medical Center of Denton Subsidiary, L.P.
*Columbia Medical Center of Las Colinas, Inc.
*Columbia Medical Center of Lewisville Subsidiary, L.P.
*Columbia Medical Center of McKinney Subsidiary, L.P.
*Columbia Medical Center of Plano Subsidiary, L.P.
*Columbia North Hills Hospital Subsidiary, L.P.
Columbia North Texas Healthcare System, L.P.
Columbia North Texas Subsidiary GP, LLC
Columbia North Texas Surgery Center Subsidiary, L.P.
Columbia Northwest Medical Center, Inc.
*Columbia Ogden Medical Center, Inc.
Columbia Oklahoma Division, Inc.
Columbia Palm Beach GP, LLC
Columbia Park Healthcare System, Inc.
Columbia Park Medical Center, Inc.
*Columbia Parkersburg Healthcare System, LLC
*Columbia Plaza Medical Center of Fort Worth Subsidiary, L.P.
Columbia Psychiatric Management Co.
Columbia Resource Network, Inc.
*Columbia Rio Grande Healthcare, L.P.
*Columbia Riverside, Inc.

26

Columbia South Texas Division, Inc.
Columbia Specialty Hospital of Dallas Subsidiary, L.P.
Columbia Specialty Hospitals, Inc.
Columbia Surgery Group, Inc.
Columbia Tampa Bay Division, Inc.
*Columbia Valley Healthcare System, L.P.
Columbia West Bank Hospital, Inc.
*Columbia/Alleghany Regional Hospital, Incorporated
Columbia/HCA Healthcare Corporation of Central Texas
Columbia/HCA Healthcare Corporation of Northern Ohio
Columbia/HCA Healthcare Corporation of South Carolina
Columbia/HCA Heartcare of Corpus Christi, Inc.
Columbia/HCA International Group, Inc.
*Columbia/HCA John Randolph, Inc.
Columbia/HCA of Baton Rouge, Inc.
Columbia/HCA of Houston, Inc.
Columbia/HCA of New Orleans, Inc.
Columbia/HCA of North Texas, Inc.
Columbia/HCA San Clemente, Inc.
Columbia-Georgia PT, Inc.
Columbia-Osceola Imaging Center, Inc.
Columbia-Quantum, Inc.
Columbia-SDH Holdings, Inc.
*Columbine Psychiatric Center, Inc.
Columbus Cath Lab, Inc.
Columbus Cath Lab, LLC
Columbus Doctors Hospital, Inc.
Concept EFL Imaging Center, LLC
Concept West EFL Imaging Center, LLC
*Conroe Hospital Corporation
Conroe Partner, LLC
Continental Division I, Inc.
CoralStone Management, Inc.
Corpus Christi Surgery Center, L.P.
Corpus Surgicare, Inc.
COSCORP, LLC
CPS TN Processor 1, Inc.
Crewe Outpatient Imaging, LLC
CRMC-M, LLC
Cumberland Medical Center, Inc.
CVMC Property, LLC
Daleville Imaging Manager, LLC
Daleville Imaging, L.P.
Davie Medical Center, LLC

27

Daytona Medical Center, Inc.
Deep Purple Investments, LLC
Delray EFL Imaging Center, LLC
Denver Surgicenter, LLC
Derry ASC, Inc.
Diagnostic Breast Center, Inc.
Diagnostic Mammography Services, G.P.
Doctors Hospital (Conroe), Inc.
Doctors Hospital Columbus GA-Joint Venture
Doctors Hospital of Augusta, LLC
Doctors Osteopathic Medical Center, Inc.
Doctors Same Day Surgery Center, Inc.
Doctors-I, Inc.
Doctors-II, Inc.
Doctors-III, Inc.
Doctors-IV, Inc.
Doctors-V, Inc.
Doctors-VIII, Inc.
DOMC Property, LLC
*Dublin Community Hospital, LLC
Dura Medical, Inc.
E.P. Physical Therapy Centers, Inc.
East Florida Division, Inc.
East Florida Imaging Holdings, LLC
East Pointe Hospital, Inc.
Eastern Idaho Brachytherapy Equipment Manager, LLC
Eastern Idaho Care Partners ACO, LLC
*Eastern Idaho Health Services, Inc.
Edmond Physician Hospital Organization, Inc.
*Edward White Hospital, Inc.
EHCA, LLC
EHCA Eastside Occupational Medicine Center, LLC
El Paso Healthcare System, Ltd.
El Paso Nurses Unlimited, Inc.
*El Paso Surgicenter, Inc.
Emergency Providers Group LLC
EMMC, LLC
*Encino Hospital Corporation, Inc.
Endoscopy Surgicare of Plano, LLC
Englewood Community Hospital, Inc.
*EP Health, LLC
EP Holdco, LLC
EPIC Development, Inc.
EPIC Diagnostic Centers, Inc.
EPIC Healthcare Management Company

28

EPIC Properties, Inc.
EPIC Surgery Centers, Inc.
*Fairview Park GP, LLC
*Fairview Park, Limited Partnership
Fairview Partner, LLC
Far West Division, Inc.
Fawcett Memorial Hospital, Inc.
FHAL, LLC
Florida Home Health Services-Private Care, Inc.
Flower Mound Surgery Center, Ltd.
*FMH Health Services, LLC
Forest Park Surgery Pavilion, Inc.
Fort Bend Hospital, Inc.
Fort Myers Market, Inc.
Fort Walton Beach Medical Center, Inc.
Fort Worth Investments, Inc.
*Frankfort Hospital, Inc.
Frankfort Wound Care, LLC
Frisco Surgicare, LLC
Frisco Warren Parkway 91, Inc.
Ft. Pierce Surgicare, LLC
Galen (Kansas) Merger, LLC
Galen BH, Inc.
Galen Center for Professional Development, Inc.
Galen Diagnostic Multicenter, Ltd.
Galen Global Finance, Inc.
Galen GOK, LLC
Galen Health Institutes, Inc.
Galen Holdco, LLC
Galen Hospital Alaska, Inc.
Galen Hospital of Baytown, Inc.
Galen Hospital-Pembroke Pines, Inc.
Galen International Holdings, Inc.
Galen KY, LLC
Galen MCS, LLC
Galen Medical Corporation
Galen MRMC, LLC
Galen NMC, LLC
Galen NSH, LLC
Galen of Aurora, Inc.
Galen of Florida, Inc.
Galen of Illinois, Inc.
Galen of Kentucky, Inc.
Galen of Mississippi, Inc.

29

Galen of Virginia, Inc.
Galen of West Virginia, Inc.
*Galen Property, LLC
Galen SOM, LLC
Galen SSH, LLC
Galen Virginia Hospital Corporation
Galencare, Inc.
Galendeco, Inc.
Galen-Soch, Inc.
GalTex, LLC
Gardens EFL Imaging Center, LLC
General Hospitals of Galen, Inc.
*GenoSpace, LLC
Georgia Health Holdings, Inc.
Georgia Psychiatric Company, Inc.
Georgia, L.P.
GHC-Galen Health Care, LLC
*Good Samaritan Hospital, L.P.
Good Samaritan Hospital, LLC
Good Samaritan Surgery Center, L.P.
*GPCH-GP, Inc.
*Grand Strand Regional Medical Center, LLC
Greater Houston Preferred Provider Option, Inc.
*Green Oaks Hospital Subsidiary, L.P.
*Greenview Hospital, Inc.
Gulf Coast Division, Inc.
Gulf Coast Medical Ventures, Inc.
Gulf Coast Physician Administrators, Inc.
Gwinnett Community Hospital, Inc.
Hamilton Memorial Hospital, Inc.
HCA - Information Technology & Services, Inc.
*HCA - IT&S Field Operations, Inc.
*HCA - IT&S Inventory Management, Inc.
HCA - IT&S PBS Field Operations, Inc.
HCA - IT&S TN Field Operations, Inc.
HCA - Raleigh Community Hospital, Inc.
*HCA American Finance LLC
HCA ASD Financial Operations, LLC
HCA ASD Sales Services, LLC
*HCA Central Group, Inc.
HCA Chattanooga Market, Inc.
HCA Development Company, Inc.
*HCA Eastern Group, Inc.
HCA Endocrine Investor, LLC

30

HCA Health Services of California, Inc.
*HCA Health Services of Florida, Inc.
HCA Health Services of Georgia, Inc.
*HCA Health Services of Louisiana, Inc.
HCA Health Services of Miami, Inc.
HCA Health Services of Midwest, Inc.
HCA Health Services of New Hampshire, Inc.
*HCA Health Services of Tennessee, Inc.
HCA Health Services of Texas, Inc.
*HCA Health Services of Virginia, Inc.
HCA Health Services of West Virginia, Inc.
HCA Healthcare Mission Fund, LLC
HCA Healthcare, Inc.
HCA Holdco, LLC
HCA Human Resources, LLC
HCA Imaging Services of North Florida, Inc.
HCA Inc.
HCA Long Term Health Services of Miami, Inc.
*HCA Management Services, L.P.
HCA Midwest Comprehensive Care, Inc.
HCA North Texas GME PLLC
HCA Outpatient Imaging Services Group, Inc.
*HCA Pearland GP, Inc.
HCA Physician Services, Inc.
HCA Plano Imaging, Inc.
HCA Property GP, LLC
HCA Psychiatric Company
*HCA Realty, Inc.
HCA Squared, LLC
HCA Switzerland Holding GmbH
HCA Western Group, Inc.
*HCA-HealthONE LLC
HCA-Solis Holdings, Inc.
HCA-Solis Master, LLC
HCA-Urgent Care Holdings, LLC
HCOL, Inc.
*HD&S Corp. Successor, Inc.
Healdsburg General Hospital, Inc.
Health Care Indemnity, Inc.
Health Insight Capital, LLC
*Health Midwest Office Facilities Corporation
*Health Midwest Ventures Group, Inc.
Health Service Partners, Inc.
Health Services (Delaware), Inc.

31

Health Services Merger, Inc.
Health to You, LLC
Healthcare Sales National Management Services Group, LLC
Healthcare Technology Assessment Corporation
Healthco, LLC
Healthnet of Kentucky, LLC
HealthONE Aurora Investment, LLC
HealthONE Clear Creek, LLC
HealthONE High Street Primary Care Center, LLC
HealthOne Lincoln Investment, LLC
HealthONE Lowry, LLC
HealthONE of Denver, Inc.
HealthONE Radiation Therapy at Red Rocks, LLC
HealthONE Radiation Therapy at Thornton, LLC
HealthONE Surgicare of Ridge View, LLC
HealthONE Urologic, LLC
HealthOne Westside Investment, LLC
Healthserv Acquisition, LLC
HealthTrust Locums, Inc.
Healthtrust MOB Tennessee, LLC
Healthtrust Utah Management Services, Inc.
*HealthTrust Workforce Solutions, LLC
Healthtrust, Inc. - The Hospital Company
Healthtrust, Inc. - The Hospital Company
Healthy State, Inc.
Heart of America Surgicenter, LLC
Hearthstone Home Health, Inc.
Heathrow Imaging, LLC
*Hendersonville Hospital Corporation
Henrico Doctors Hospital - Forest Campus Property, LLC
Heritage Hospital, Inc.
HHNC, LLC<br><br><br>hInsight-BMA Holdings, LLC<br><br><br>hInsight-Customer Care Holdings, LLC<br> <br>hInsight-Digital Reasoning<br>Holdings, LLC<br> <br>hInsight-Healthbox Holdings, LLC<br> <br>hInsight-I2 Holdings, LLC<br> <br>hInsight-InVivoLink Holdings, LLC<br><br><br>hInsight-Loyale Healthcare Holdings, LLC<br> <br>hInsight-LS Holdings, LLC
*hInsight-Mobile Heartbeat Holdings, LLC<br> <br>hInsight-NX, LLC<br> <br>hInsight-OTM Holdings, LLC<br><br><br>hInsight-Procured Holdings, LLC

32

hInsight-PWS I Holdings, LLC
hInsight-VAI Holdings, LLC
HM Acquisition, LLC
Homecare North, Inc.
Hometrust Management Services, Inc.
Hospital Corp., LLC
Hospital Corporation of America
Hospital Corporation of Lake Worth
*Hospital Corporation of Tennessee
*Hospital Corporation of Utah
*Hospital Development Properties, Inc.
Hospital Partners Merger, LLC
Hospital Realty Corporation
*Houston - PPH, LLC
Houston Healthcare Holdings, Inc.
Houston Northwest Surgical Partners, Inc.
*Houston NW Manager, LLC
Houston Woman’s Hospital Partner, LLC
*HPG Enterprises, LLC
HPG Solutions, LLC
*HSS Holdco, LLC
*HSS Systems, LLC
*HSS Virginia, L.P.
HTI Gulf Coast, Inc.
HTI Health Services of North Carolina, Inc.
HTI Hospital Holdings, Inc.
*HTI Memorial Hospital Corporation
*HTI MOB, LLC
Illinois Psychiatric Hospital Company, Inc.
Imaging Services of Appomattox, LLC
Imaging Services of Jacksonville, LLC
Imaging Services of Louisiana Manager, LLC
Imaging Services of Louisiana, LLC
Imaging Services of Orlando, LLC
Imaging Services of West Boynton, LLC
IMX Holdings, LLC
Independence Surgicare, Inc.
Indian Path Hospital, Inc.
Indianapolis Hospital Partner, LLC
*Integrated Regional Lab, LLC
*Integrated Regional Laboratories, LLP
InVivoLink, Inc.
Isleworth Partners, Inc.
JDGC Management, LLC

33

*JFK Medical Center Limited Partnership
Johnson County Surgicenter, L.L.C.
Jupiter EFL Imaging Center, LLC
KC Surgicare, LLC
Kendall Healthcare Group, Ltd.
Kendall Regional Medical Center, LLC
Kingwood Surgery Center, LLC
*KPH-Consolidation, Inc.
L E Corporation
LAD Imaging, LLC
Lake City Imaging, LLC
*Lakeview Medical Center, LLC
Lakewood Surgicare, Inc.
Laredo Medco, LLC
*Largo Medical Center, Inc.
*Las Encinas Hospital
Las Vegas ASC, LLC
*Las Vegas Surgicare, Inc.
*Lawnwood Medical Center, Inc.
Lebanon Surgicenter, LLC
*Lewis-Gale Hospital, Incorporated
*Lewis-Gale Medical Center, LLC
*Lone Peak Hospital, Inc.
*Los Robles Regional Medical Center
Loudoun Surgery Center, LLC
Louisiana Psychiatric Company, Inc.
Low Country Health Services, Inc. of the Southeast
*Management Services Holdings, Inc.
Marietta Outpatient Medical Building, Inc.
*Marietta Surgical Center, Inc.
*Marion Community Hospital, Inc.
Martin, Fletcher & Associates, L.P.
Maury County Behavioral Health, LLC
Mayhill Cancer Center, LLC
*MCA Investment Company
Meadows DME, LLC
Med Corp., Inc.
Med-Center Hosp./Houston, Inc.
Medi Flight of Oklahoma, LLC
Medical Arts Hospital of Texarkana, Inc.
Medical Care America, LLC
Medical Care Financial Services Corp.
Medical Care Real Estate Finance, Inc.
Medical Care Surgery Center, Inc.

34

Medical Center - West, Inc.
Medical Center Imaging, Inc.
Medical Center of Baton Rouge, Inc.
Medical Center of Plano Partner, LLC
Medical Center of Port St. Lucie, Inc.
Medical Center of Santa Rosa, Inc.
*Medical Centers of Oklahoma, LLC
Medical City Dallas Hospital, Inc.
Medical City Dallas Partner, LLC
Medical Corporation of America
Medical Imaging, Inc.
*Medical Office Buildings of Kansas, LLC
Medical Specialties, Inc.
*MediCredit, Inc.
MediPurchase, Inc.
MediStone Healthcare Ventures, Inc.
MediVision of Mecklenburg County, Inc.
MediVision of Tampa, Inc.
MediVision, Inc.
Med-Point of New Hampshire, Inc.
*Memorial Healthcare Group, Inc.
Metroplex Surgicenters, Inc.
MGH Medical, Inc.
*MH Angel Medical Center, LLLP
MH Asheville Specialty Hospital, LLC
*MH Blue Ridge Medical Center, LLLP
MH Eckerd Living Center, LLLP
*MH Highlands-Cashiers Medical Center, LLLP
*MH Hospital Holdings, Inc.
*MH Hospital Manager, LLC
*MH Master Holdings, LLLP
*MH Master, LLC
MH McDowell Imaging, LLLP
*MH Mission Hospital McDowell, LLLP
*MH Mission Hospital, LLLP
*MH Mission Imaging, LLLP
MH Transylvania Imaging, LLLP
*MH Transylvania Regional Hospital, LLLP
MHS Partnership Holdings JSC, Inc.
MHS Partnership Holdings SDS, Inc.
Miami Beach EFL Imaging Center, LLC
Miami Beach Healthcare Group, Ltd.
MidAmerica Division, Inc.
MidAmerica Oncology, LLC

35

Mid-America Surgery Center, LLC
Mid-Cities Surgi-Center, Inc.
Mid-Continent Health Services, Inc.
Midtown Diagnostics, LLC
*Midwest Division - ACH, LLC
Midwest Division - LRHC, LLC
*Midwest Division - LSH, LLC
*Midwest Division - MCI, LLC
*Midwest Division - MMC, LLC
*Midwest Division - OPRMC, LLC
*Midwest Division - RBH, LLC
*Midwest Division - RMC, LLC
*Midwest Holdings, Inc.
Millenium Health Care of Oklahoma, Inc.
Mission Bay Memorial Hospital, Inc.
Missouri Healthcare System, L.P.
MMC Sleep Lab Management, LLC
Mobile Corps., Inc.
*Mobile Heartbeat, LLC
Montgomery Cancer Center, LLC
*Montgomery Regional Hospital, Inc.
MOSC Sports Medicine, Inc.
*Mountain Division - CVH, LLC
Mountain Division, Inc.
*Mountain View Hospital, Inc.
Mountain West Surgery Center, LLC
MOVCO, Inc.
MP Management, LLC
MRT&C, Inc.
Nashville Psychiatric Company, Inc.
*Nashville Shared Services General Partnership
Nashville Surgicenter, LLC
Natchez Surgery Center, LLC
National Contact Center Management Group, LLC
*National Patient Account Services, Inc.
Navarro Memorial Hospital, Inc.
Network Management Services, Inc.
Network MS of Florida, Inc.
Nevada Surgery Center of Southern Hills, L.P.
Nevada Surgicare of Southern Hills, LLC
*New Iberia Healthcare, LLC
New Iberia Holdings, Inc.
*New Port Richey Hospital, Inc.
*New Rose Holding Company, Inc.

36

Norman Clayman Endocrine Institute, LLC
North Augusta Imaging Management, LLC
North Augusta Imaging Services, LLC
North Augusta Rehab Health Center, LLC
North Brandon Imaging, LLC
North Central Florida Health System, Inc.
North Charleston Diagnostic Imaging Center, LLC
North Florida Cancer Center Lake City, LLC
North Florida Cancer Center Live Oak, LLC
North Florida Cancer Center Tallahassee, LLC
North Florida Division I, Inc.
North Florida GI Center GP, Inc.
North Florida Physician Services, Inc.
North Florida Regional Investments, Inc.
*North Florida Regional Medical Center, Inc.
North Hills Cardiac Catheterization Center, L.P.
North Hills Catheterization Lab, LLC
*North Houston - TRMC, LLC
North Miami Beach Surgical Center, LLC
North Tampa Imaging, LLC
*North Texas - MCA, LLC
North Texas Division, Inc.
North Texas General, L.P.
North Texas Medical Center, Inc.
North Transfer Center, LLC
Northeast Florida Cancer Services, LLC
*Northern Utah Healthcare Corporation
Northern Utah Imaging, LLC
*Northern Virginia Community Hospital, LLC
Northern Virginia Hospital Corporation
Northlake Surgicare, Inc.
Northwest Florida Healthcare Systems, Inc.
Northwest Medical Center, Inc.
Notami (Opelousas), Inc.
Notami Hospitals of Florida, Inc.
*Notami Hospitals of Louisiana, Inc.
Notami Hospitals of Missouri, Inc.
*Notami Hospitals, LLC
Notami, LLC
Notco, LLC
NPAS Solutions, LLC
NPAS, Inc.
NTGP, LLC

37

NTMC Management Company
NTMC Venture, Inc.
Nuclear Diagnosis, Inc.
Ocala Health Imaging Services, LLC
Ocala Regional Outpatient Services, Inc.
Ocala Stereotactic Radiosurgery Partner, LLC
Ocala Stereotactic Radiosurgery, LLC
Occupational and Family Medicine of South Texas
ODP Holdings, LLC
ODP Manager, LLC
ODP Properties, LLC
Ogden Imaging, LLC
Ogden Tomotherapy Manager, LLC
*Okaloosa Hospital, Inc.
*Okeechobee Hospital, Inc.
Oklahoma Surgicare, Inc.
Oncology Services of Corpus Christi Manager, LLC
Oncology Services of Corpus Christi, LLC
OneSourceMed, Inc.
Orange Park Medical Center, Inc.
Orlando Outpatient Surgical Center, Inc.
Orthopaedic Sports Specialty Associates, Inc.
Osceola Regional Hospital, Inc.
*Outpatient Cardiovascular Center of Central Florida, LLC
Outpatient Services - LAD, LLC
*Outpatient Services Holdings, Inc.
*Oviedo Medical Center, LLC
Ozarks Medical Services, Inc.
Pacific Partners Management Services, Inc.
Palm Beach EFL Imaging Center, LLC
Palm Beach Healthcare System, Inc.
*Palms West Hospital Limited Partnership
Paragon of Texas Health Properties, Inc.
Paragon Physicians Hospital Organization of South Texas, Inc.
Paragon SDS, Inc.
Paragon Surgery Centers of Texas, Inc.
Paragon WSC, Inc.
*Parallon Business Solutions, LLC
*Parallon Enterprises, LLC
*Parallon Health Information Solutions, LLC
*Parallon Holdings, LLC
*Parallon Payroll Solutions, LLC

38

*Parallon Physician Services, LLC
*Parallon Revenue Cycle Services, Inc.
Park View Insurance Company
Parkersburg SJ Holdings, Inc.
Parkridge Medical Center, Inc.
Parkside Surgery Center, Inc.
Parkway Cardiac Center, Ltd.
Parkway Hospital, Inc.
Parkway Surgery Services, Ltd.
Parthenon Insurance Company, Limited
*Pasadena Bayshore Hospital, Inc.
*PatientKeeper, Inc.
*Pearland Partner, LLC
Pediatric Surgicare, Inc.
Pinellas Medical, LLC
Pioneer Medical, LLC
Plains Healthcare System, Inc.
Plano Heart Institute, L.P.
Plano Heart Management, LLC
Plano Surgery Center - GP, LLC
*Plantation General Hospital, L.P.
PMM, Inc.
POH Holdings, LLC
*Poinciana Medical Center, Inc.
Preferred Works WC, LLC
Primary Health Asset Holdings, Ltd.
*Primary Health, Inc.
*PTS Solutions, LLC
*Pulaski Community Hospital, Inc.
*Putnam Community Medical Center of North Florida, LLC
Putnam Hospital, Inc.
Putnam Radiation Oncology Manager, LLC
Radiation Oncology Center of Thornton, LLC
Radiation Oncology Manager, LLC
RCH, LLC
Red Rock at Smoke Ranch, LLC
Red Rock Holdco, LLC
Redmond Park Health Services, Inc.
*Redmond Park Hospital, LLC
*Reston Hospital Center, LLC
*Retreat Hospital, LLC
Richmond Imaging Employer Corp.
Rio Grande Healthcare MSO, Inc.
*Rio Grande Regional Hospital, Inc.

39

Riverside CyberKnife Manager, LLC
*Riverside Healthcare System, L.P.
Riverside Holdings, Inc.
*Riverside Hospital, Inc.
Riverside Imaging, LLC
Roanoke Imaging, LLC
Rosewood Medical Center, Inc.
Round Rock Hospital, Inc.
Royal Oaks Surgery Center, L.P.
S.A. Medical Center, Inc.
Salt Lake City Surgicare, Inc.
*Samaritan, LLC
San Antonio Division, Inc.
San Antonio Regional Hospital, Inc.
San Bernardino Imaging, LLC
San Joaquin Surgical Center, Inc.
*San Jose Healthcare System, LP
*San Jose Hospital, L.P.
*San Jose Medical Center, LLC
San Jose Pathology Outreach, LLC
*San Jose, LLC
Sarah Cannon Development Innovations, LLC
*Sarah Cannon Research Institute, LLC
*Sarasota Doctors Hospital, Inc.
*Savannah Health Services, LLC
*SCRI Holdings, LLC
SCRI Scientifics, LLC
*Sebring Health Services, LLC
Selma Medical Center Hospital, Inc.
Silicon Valley Health Holdings, LLC
*SJMC, LLC
Sky Ridge Spine Manager, LLC
South Atlantic Division, Inc.
South Florida Division Practice, Inc.
South Texas Surgicare, Inc.
South Transfer Center, LLC
South Valley Hospital, L.P.
*Southeast Georgia Health Services, LLC
*Southern Hills Medical Center, LLC
*Southpoint, LLC
Southwest Florida Health System, Inc.
Southwest Florida Regional Medical Center, Inc.
*Spalding Rehabilitation L.L.C.

40

*Spotsylvania Medical Center, Inc.
Spotsylvania Regional Surgery Center, LLC
*Spring Branch Medical Center, Inc.
*Spring Hill Hospital, Inc.
Spring Hill Imaging, LLC
Springview KY, LLC
*SSHR Holdco, LLC
St. Mark’s Investments, Inc.
Stafford Imaging, LLC
Stiles Road Imaging LLC
Stones River Hospital, LLC
Suburban Medical Center at Hoffman Estates, Inc.
Sullins Surgical Center, Inc.
Summit General Partner, Inc.
Summit Research Solutions, LLC
Sun Bay Medical Office Building, Inc.
*Sun City Hospital, Inc.
Sun City Imaging, LLC
Sun Towers/Vista Hills Holding Co.
Sun-Med, LLC
Sunrise Hospital and Medical Center, LLC
*Sunrise Mountainview Hospital, Inc.
Sunrise Outpatient Services, Inc.
Surgical Center of Irving, Inc.
Surgical Facility of West Houston, L.P.
Surgicare America - Winter Park, Inc.
Surgicare Merger Company of Louisiana
Surgicare of Alpine, LLC
Surgicare of Altamonte Springs, Inc.
Surgicare of Anchorage, LLC
Surgicare of Arapahoe, LLC
Surgicare of Arlington, LLC
Surgicare of Ashburn, LLC
Surgicare of Augusta, Inc.
Surgicare of Aurora Endoscopy, LLC
Surgicare of Aventura, LLC
Surgicare of Bay Area Endoscopy, LLC
Surgicare of Bay Area, LLC
Surgicare of Bayonet Point, Inc.
Surgicare of Bayside, LLC
Surgicare of Bountiful, LLC
*Surgicare of Brandon, Inc.

41

Surgicare of Brentwood, LLC
Surgicare of Brooksville, LLC
Surgicare of Brownsville, LLC
Surgicare of Central Florida, Inc.
Surgicare of Central San Antonio, Inc.
Surgicare of Chattanooga, LLC
Surgicare of Chippenham, LLC
Surgicare of Citrus, LLC
Surgicare of Clarksville, LLC
Surgicare of Corpus Christi, LLC
Surgicare of Countryside, Inc.
Surgicare of Dallas Specialty, LLC
Surgicare of Denton, Inc.
Surgicare of Denver Mid-Town, Inc.
Surgicare of Denver, LLC
Surgicare of Evans, Inc.
Surgicare of Fairfax, Inc.
*Surgicare of Florida, Inc.
Surgicare of Flower Mound, Inc.
Surgicare of Focus Hand, LLC
Surgicare of Fort Worth Co-GP, LLC
Surgicare of Fort Worth, Inc.
Surgicare of Ft. Pierce, Inc.
Surgicare of Good Samaritan, LLC
Surgicare of Gramercy, Inc.
Surgicare of Greenview, Inc.
Surgicare of Hanover, Inc.
*Surgicare of Houston Women’s, Inc.
Surgicare of Houston, LLC
Surgicare of Indianapolis, Inc.
Surgicare of Kansas City, LLC
Surgicare of Kingwood, LLC
Surgicare of Kissimmee, Inc.
Surgicare of Lakeview, Inc.
Surgicare of Las Vegas, Inc.
Surgicare of Laurel Grove, LLC
Surgicare of Lorain County, Inc.
Surgicare of Los Gatos, Inc.
Surgicare of Los Robles, LLC
Surgicare of Madison, Inc.
*Surgicare of Manatee, Inc.
Surgicare of McKinney, Inc.
Surgicare of Medical City Dallas, LLC
Surgicare of Memorial Endoscopy, LLC

42

Surgicare of Merritt Island, Inc.
Surgicare of Miami Lakes, LLC
Surgicare of Mountain West, LLC
Surgicare of Mt. Ogden, LLC
Surgicare of Nashville, LLC
Surgicare of Natchez, LLC
*Surgicare of Newport Richey, Inc.
Surgicare of North San Antonio, Inc.
Surgicare of Northeast San Antonio, Inc.
Surgicare of Orange Park, Inc.
Surgicare of Orlando, Inc.
Surgicare of Overland Park, LLC
*Surgicare of Palms West, LLC
Surgicare of Park Ridge, LLC
Surgicare of Pasadena, Inc.
Surgicare of Pavilion, LLC
Surgicare of Physicians West El Paso, LLC
Surgicare of Pinellas, Inc.
Surgicare of Plano, Inc.
Surgicare of Plantation, Inc.
Surgicare of Port Charlotte, LLC
Surgicare of Port St. Lucie, Inc.
Surgicare of Portsmouth, LLC
Surgicare of Premier Orthopaedic, LLC
Surgicare of Reston, Inc.
Surgicare of Ridgeline, LLC
Surgicare of Riverwalk, LLC
Surgicare of Roanoke, LLC
Surgicare of Rome, Inc.
Surgicare of Rose, LLC
Surgicare of Round Rock, Inc.
Surgicare of Royal Oaks, LLC
Surgicare of Salem, LLC
Surgicare of Silicon Valley, LLC
Surgicare of Sky Ridge, LLC
Surgicare of South Austin, Inc.
Surgicare of Southeast Denver, Inc.
Surgicare of Southern Hills, Inc.
Surgicare of Southern Kentucky, LLC
Surgicare of Spotsylvania, LLC
Surgicare of St. Andrews, Inc.
Surgicare of StoneSprings, LLC
Surgicare of Stuart, Inc.

43

Surgicare of Sugar Land, Inc.
Surgicare of Swedish, LLC
Surgicare of Tallahassee, Inc.
Surgicare of Terre Haute, LLC
Surgicare of Thornton, LLC
Surgicare of Travis Center, Inc.
Surgicare of Tulsa, Inc.
Surgicare of Utah, LLC
Surgicare of Wasatch Front, LLC
Surgicare of West Hills, Inc.
Surgicare of Westlake, Inc.
Surgicare of Wichita, Inc.
Surgicare of Willis, LLC
Surgicare of Wilson County, LLC
Surgicare of Winchester, LLC
Surgicare Outpatient Center of Baton Rouge, Inc.
Surgicare Outpatient Center of Jackson, Inc.
Surgicenter of East Jefferson, Inc.
Surgico, LLC
SWMC, Inc.
Tallahassee Community Network, Inc.
*Tallahassee Medical Center, Inc.
Tampa Bay Health System, Inc.
Tampa Surgi-Centre, Inc.<br> <br>TBHI Outpatient<br>Services, LLC<br> <br>*TCMC Madison-Portland, Inc.
Teays Valley Health Services, LLC
Tennessee Valley Outpatient Diagnostic Center, LLC
*Terre Haute Hospital GP, Inc.
*Terre Haute Hospital Holdings, Inc.
*Terre Haute MOB, L.P.
*Terre Haute Regional Hospital, L.P.
Texas HSS, LLC
Texas Psychiatric Company, Inc.
*The Regional Health System of Acadiana, LLC
The West Texas Division of Columbia, Inc.
*Timpanogos Regional Medical Services, Inc.
Total Imaging - Hudson, LLC
Total Imaging - North St. Petersburg, LLC
Total Imaging - Parsons, LLC
Tri Cities Health Services Corp.
Tri-County Community Hospital, Inc.
*Trident Medical Center, LLC
TriStar Health System, Inc.
Ultra Imaging Management Services, LLC

44

Ultra Imaging of Tampa, LLC
University Hospital, Ltd.
Utah Imaging GP, LLC
*Utah Medco, LLC
Valify, Inc.
Value Health Holdings, Inc.
Value Health Management, Inc.
Venture Medical Management, LLC
*VH Holdco, Inc.
*VH Holdings, Inc.
Vidalia Health Services, LLC
Village Oaks Medical Center, Inc.
VIP, Inc.
Virginia Care Partners ACO LLC
Virginia Hematology & Oncology Associates, Inc.
*Virginia Psychiatric Company, Inc.
Virginia Quality Care Partners, LLC
*Vision Consulting Group LLC
*Vision Holdings, LLC
W & C Hospital, Inc.
*Walterboro Community Hospital, Inc.
Warren County Ambulance Service, LLC
*WCP Properties, LLC
*Weatherford Health Services, LLC
Wesley Cath Lab, LLC
Wesley Manager, LLC
*Wesley Medical Center, LLC
West Boynton Beach Open Imaging Center, LLC
West Creek Ambulatory Surgery Center, LLC
West Creek Medical Center, Inc.
*West Florida - MHT, LLC
*West Florida - PPH, LLC
West Florida Division, Inc.
West Florida HealthWorks, LLC
West Florida Imaging Services, LLC
West Florida PET Services, LLC
West Florida Professional Billing, LLC
*West Florida Regional Medical Center, Inc.
West Hills Hospital
West Houston ASC, Inc.
West Houston Outpatient Medical Facility, Inc.
West Houston Surgicare, Inc.
West Houston, LLC
West Jacksonville Medical Center, Inc.

45

West Jordan Hospital Corporation
West Los Angeles Physicians’ Hospital, Inc.
West McKinney Imaging Services, LLC
West Paces Services, Inc.
West Valley Imaging, LLC
*West Valley Medical Center, Inc.
Westbury Hospital, Inc.
Westminster Community Hospital
WHG Medical, LLC
*WHMC, Inc.
Wildwood Medical Center, Inc.
Wilson County Outpatient Surgery Center, L.P.
WJHC, LLC
Woman’s Hospital Merger, LLC
*Woman’s Hospital of Texas, Incorporated
Women’s & Children’s Pediatric Hematology/Oncology Center, LLC
Women’s & Children’s Pulmonology Clinic, LLC
Women’s Hospital Indianapolis GP, Inc.
Women’s Hospital Indianapolis, L.P.

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

Ambulatory Surgery Center Group, Ltd.
Arapahoe Surgicenter, LLC
Atlanta Surgery Center, Ltd.
Bay Area Surgicenter, LLC
Bayonet Point Surgery Center, Ltd.
Bayside Ambulatory Center, LLC
Belleair Surgery Center, Ltd.
Brownsville Surgicenter, LLC
Calloway Creek Surgery Center, L.P.
Carolina Regional Surgery Center, Ltd.
Centennial Surgery Center, L.P.
Centrum Surgery Center, Ltd.
Chippenham Ambulatory Surgery Center, LLC
Clarksville Surgicenter, LLC
Clear Creek Surgery Center, LLC
Clear Lake Surgicare, Ltd.
Coliseum Same Day Surgery Center, L.P.
Columbia Surgicare of Augusta, Ltd.
Coral Springs Surgi-Center, Ltd.

46

Countryside Surgery Center, Ltd.
Denton Regional Ambulatory Surgery Center, L.P.
Denver Mid-Town Surgery Center, Ltd.
Denver Surgicenter, LLC
Doctors Hospital Surgery Center, L.P.
Doctors Same Day Surgery Center, Ltd.
El Paso Surgery Centers, L.P.
Fairfax Surgical Center, L.P.
Florida Outpatient Surgery Center, Ltd.
Gramercy Surgery Center, Ltd.
HealthONE Ridge View Endoscopy Center, LLC
Jacksonville Surgery Center, Ltd.
Johnson County Surgery Center, L.P.
KC Pain ASC, LLC
Kingwood Surgery Center, LLC
Las Vegas Surgicare, Ltd.
Lincoln Surgery Center, LLC
Manatee Surgicare, Ltd.
Marietta Outpatient Surgery, Ltd.
Med City Dallas Outpatient Surgery Center, L.P.
Medical Plaza Ambulatory Surgery Center Associates, L.P.
Miami Lakes Surgery Center, Ltd.
Mountain West Surgery Center, LLC
Mt. Ogden Utah Surgical Center, LLC
New Port Richey Surgery Center, Ltd.
North Hills Surgicare, L.P.
North Miami Beach Surgery Center Limited Partnership
North Palm Beach County Surgery Center, LLC
North Suburban Spine Center, L.P.
Northlake Surgical Center, L.P.
ODP Manager, LLC
Oklahoma Outpatient Surgery Limited Partnership
Orlando Surgicare, Ltd.
Outpatient Surgical Services, Ltd.
Outpatient Women’s and Children’s Surgery Center, Ltd.
Palms West Surgery Center, Ltd.
Park Central Surgical Center, Ltd.
Park Ridge Surgery Center, LLC
Physicians Ambulatory Surgery Center, LLC
Physicians West Surgicenter, LLC
Plano Ambulatory Surgery Associates, L.P.
Port St. Lucie Surgery Center, Ltd.

47

Portsmouth Regional Ambulatory Surgery Center, L.L.C.
Premier ASC, LLC
Putnam Radiation Oncology, LLC
Red Rocks Surgery Center, LLC
Reston Surgery Center, L.P.
Riverwalk ASC, LLC
Roanoke Surgery Center, L.P.
Rocky Mountain Surgery Center, LLC
Rose Ambulatory Surgery Center, L.P.
Sahara Outpatient Surgery Center, Ltd.
Sky Ridge Surgery Center, L.P.
Southern Kentucky Surgicenter, LLC
Specialty Surgicare of Las Vegas, LP
St. Mark’s Ambulatory Surgery Associates, L.P.
Sugar Land Surgery Center, Ltd.
Summit Surgery Center, L.P.
Surgery Center of Atlantis, LLC
Surgery Center of Aventura, Ltd.
Surgery Center of Independence, L.P.
Surgery Center of Overland Park, L.P.
Surgery Center of Rome, L.P.
Surgery Center of the Rockies, LLC
Surgicare of St. Andrews, Ltd.
Surgicare of Wichita, LLC
Tallahassee Orthopaedic Surgery Partners, Ltd.
Tarrant County Surgery Center, L.P.
University Healthcare System, L.C.
Utah Surgery Center, L.P.
West Hills Surgical Center, Ltd.

48

EX-31.1

EXHIBIT 31.1

CERTIFICATION

I, Samuel N. Hazen, certify that:

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

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

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

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

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

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

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

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

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

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

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

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

Date: April 30, 2021

EX-31.2

EXHIBIT 31.2

CERTIFICATION

I, William B. Rutherford, certify that:

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

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

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

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

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

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

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

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

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

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

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

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

Date: April 30, 2021

EX-32

EXHIBIT 32

CERTIFICATION PURSUANT TO

18 U.S.C. SECTION 1350,

AS ADOPTED PURSUANT TO

SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

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

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

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

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

April 30, 2021

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

April 30, 2021