hospitals in the communities

2018 Annual Report
to Shareholders
HCAhealthcare.com
Competition
Generally, other hospitals in the communities we serve provide services similar to those offered by our
hospitals. Additionally, in recent years the number of freestanding specialty hospitals, surgery centers,
emergency departments, urgent care centers and diagnostic and imaging centers in the geographic areas in which
we operate has increased significantly. As a result, most of our hospitals operate in a highly competitive
environment. In some cases, competing hospitals are more established than our hospitals. Some competing
facilities are physician-owned or are owned by tax-supported government agencies and many others are owned
by not-for-profit entities that may be supported by endowments, charitable contributions and/or tax revenues and
are exempt from sales, property and income taxes. Such exemptions and support are not available to our hospitals
and may provide the tax-supported or not-for-profit entities an advantage in funding capital expenditures. In
certain localities there are large teaching hospitals that provide highly specialized facilities, equipment and
services that may not be available at most of our hospitals. We also face competition from specialty hospitals and
from both our own and unaffiliated freestanding ASCs for market share in certain high margin services.
Psychiatric hospitals frequently attract patients from areas outside their immediate locale and, therefore, our
psychiatric hospitals and units compete with both local and regional hospitals, including the psychiatric units of
general, acute care hospitals.
Our strategies are designed to ensure our hospitals are competitive. We believe our hospitals compete within
local communities on the basis of many factors, including the quality of care, ability to attract and retain quality
physicians, skilled clinical personnel and other health care professionals, location, breadth of services,
technology offered, quality and condition of the facilities and prices charged. Hospitals must publish online a list
of their standard charges for items and services. We have increased our focus on operating outpatient services
with improved accessibility and more convenient service for patients and increased predictability and efficiency
for physicians.
Two of the most significant factors to the competitive position of a hospital are the number and quality of
physicians affiliated with or employed by the hospital. Although physicians may at any time terminate their
relationship with a hospital we operate, our hospitals seek to retain physicians with varied specialties on the
hospitals’ medical staffs and to attract other qualified physicians. We believe physicians refer patients to a
hospital on the basis of the quality and scope of services it renders to patients and physicians, the quality of
physicians on the medical staff, the location of the hospital and the quality of the hospital’s facilities, equipment
and employees. Accordingly, we strive to maintain and provide quality facilities, equipment, employees and
services for physicians and patients. Our hospitals face competition from competitors that are implementing
physician alignment strategies, such as employing physicians, acquiring physician practice groups and
participating in ACOs or other clinical integration models.
Another major factor in the competitive position of our hospitals is our ability to negotiate service contracts
with group purchasers of health care services. Managed care plans attempt to direct and control the use of
hospital services and obtain discounts from hospitals’ established gross charges. Similarly, employers and
traditional health insurers continue to attempt to contain costs through negotiations with hospitals for managed
care programs and discounts from established gross charges. Generally, hospitals compete for service contracts
with group purchasers of health care services on the basis of price, market reputation, geographic location,
quality and range of services, quality of the medical staff and convenience. Our future success will depend, in
part, on our ability to retain and renew our contracts with third-party payers and enter into new contracts on
favorable terms. Other health care providers may impact our ability to enter into contracts with third-party payers
or negotiate increases in our reimbursement and other favorable terms and conditions. For example, some of our
competitors may negotiate exclusivity provisions with managed care plans or otherwise restrict the ability of
managed care companies to contract with us. Increasing vertical integration efforts involving third-party payers
and health care providers may increase these challenges. Moreover, the trend toward consolidation among private
third-party payers tends to increase payer bargaining power over fee structures.
16
Item 1B. Unresolved Staff Comments
None.
Item 2. Properties
The following table lists, by state, the number of hospitals (general, acute care, psychiatric and
rehabilitation) directly or indirectly owned and operated by us as of December 31, 2018:
State Hospitals Beds
Alaska . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 250
California . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 1,858
Colorado . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 2,415
Florida . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 12,057
Georgia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 2,459
Idaho . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 468
Indiana . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 278
Kansas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 1,374
Kentucky . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 384
Louisiana . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 1,049
Mississippi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 130
Missouri . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 1,030
Nevada . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1,283
New Hampshire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 295
South Carolina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 941
Tennessee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 2,544
Texas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 13,252
Utah . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 1,011
Virginia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 3,284
International
England . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 837
179 47,199
In addition to the hospitals listed in the above table, we directly or indirectly operate 123 freestanding
surgery centers. We also operate medical office buildings in conjunction with some of our hospitals. These office
buildings are primarily occupied by physicians who practice at our hospitals. Fourteen of our general, acute care
hospitals and two of our other properties have been mortgaged to support our obligations under our senior
secured cash flow credit facility and first lien secured notes.
We maintain our headquarters in approximately 2,129,000 square feet of space in the Nashville, Tennessee
area. In addition to the headquarters in Nashville, we maintain regional service centers related to our shared
services initiatives. These service centers are located in markets in which we operate hospitals.
We believe our headquarters, hospitals and other facilities are suitable for their respective uses and are, in
general, adequate for our present needs. Our properties are subject to various federal, state and local statutes and
ordinances regulating their operation. Management does not believe that compliance with such statutes and
ordinances will materially affect our financial position or results of operations.
47
Item 6. Selected Financial Data
HCA HEALTHCARE, INC.
SELECTED FINANCIAL DATA
AS OF AND FOR THE YEARS ENDED DECEMBER 31
(Dollars in millions, except per share amounts)
2018 2017 2016 2015 2014
Summary of Operations:
Revenues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $46,677 $43,614 $41,490 $39,678 $36,918
Salaries and benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . .

21,425 20,059 18,897 18,115 16,641
7,724 7,316 6,933 6,638 6,262
8,608
(29)
2,278
8,051
(45)
2,131
7,496
(54)
1,966
7,056
(46)
1,904
6,630
(43)
1,820
1,755 1,690 1,707 1,665 1,743

Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other operating expenses . . . . . . . . . . . . . . . . . . . . . . . . Equity in earnings of affiliates . . . . . . . . . . . . . . . . . . . . Depreciation and amortization . . . . . . . . . . . . . . . . . . . . Interest expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Losses (gains) on sales of facilities . . . . . . . . . . . . . . . . (428) (8) (23) 5 (29)
Losses on retirement of debt . . . . . . . . . . . . . . . . . . . . . 9 39 4 135 335
Legal claim (benefits) costs . . . . . . . . . . . . . . . . . . . . . . — — (246) 249 78
41,342 39,233 36,680 35,721 33,437
Income before income taxes . . . . . . . . . . . . . . . . . . . . . . 5,335 4,381 4,810 3,957 3,481
Provision for income taxes . . . . . . . . . . . . . . . . . . . . . . . 946 1,638 1,378 1,261 1,108
Net income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,389 2,743 3,432 2,696 2,373
Net income attributable to noncontrolling interests . . . . 602 527 542 567 498
Net income attributable to HCA Healthcare,
Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,787 $ 2,216 $ 2,890 $ 2,129 $ 1,875
Per common share data:
Basic earnings per share . . . . . . . . . . . . . . . . . . . . . . . . . $ 10.90 $ 6.12 $ 7.53 $ 5.14 $ 4.30
Diluted earnings per share . . . . . . . . . . . . . . . . . . . . . . . $ 10.66 $ 5.95 $ 7.30 $ 4.99 $ 4.16
Cash dividends declared per share . . . . . . . . . . . . . . . . . $ 1.40 — — — —
Financial Position:
Assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $39,207 $36,593 $33,758 $32,744 $30,980
Working capital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,644 3,819 3,252 3,716 3,450
Long-term debt, net, including amounts due within one
year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

32,821 33,058 31,376 30,488 29,426
2,032
(2,918)
1,811
(4,995)
1,669
(5,633)
1,553
(6,046)
1,396
(6,498)

Noncontrolling interests . . . . . . . . . . . . . . . . . . . . . . . . . Stockholders’ deficit . . . . . . . . . . . . . . . . . . . . . . . . . . . Cash Flow Data:
Cash provided by operating activities . . . . . . . . . . . . . . $ 6,761 $ 5,426 $ 5,653 $ 4,734 $ 4,448
Cash used in investing activities . . . . . . . . . . . . . . . . . .

(3,901)
(3,573)
(3,075)
(4,279)
(3,015)
(1,061)
(3,240)
(2,760)
(2,508)
(2,583)
(2,375)
(1,976)
(2,918)
(2,176)
(1,378)

Purchase of property and equipment . . . . . . . . . . . . . . . Cash used in financing activities . . . . . . . . . . . . . . . . . . 51
2018 2017 2016 2015 2014
Operating Data:
Number of hospitals at end of period . . . . . . . 179 179 170 168 166
Number of freestanding outpatient surgical
centers at end of period . . . . . . . . . . . . . . . . 123 120 118 116 113
Number of licensed beds at end of
period(a) . . . . . . . . . . . . . . . . . . . . . . . . . . .

47,199 46,738 44,290 43,771 43,356
46,857 45,380 44,077 43,620 43,132
2,003,753 1,936,613 1,891,831 1,868,789 1,795,312
3,420,406 3,286,432 3,191,519 3,122,746 2,958,674
4.9
26,663
57%
4.9
26,000
57%
4.9
25,340
58%
4.9
25,084
58%
4.8
23,835
55%
8,764,431 8,624,137 8,378,340 8,050,159 7,450,748
971,537 941,231* 932,213 909,386 891,633

Weighted average licensed beds(b) . . . . . . . . . Admissions(c) . . . . . . . . . . . . . . . . . . . . . . . . . Equivalent admissions(d) . . . . . . . . . . . . . . . . Average length of stay (days)(e) . . . . . . . . . . . Average daily census(f) . . . . . . . . . . . . . . . . . . Occupancy(g) . . . . . . . . . . . . . . . . . . . . . . . . . Emergency room visits(h) . . . . . . . . . . . . . . . . Outpatient surgeries(i) . . . . . . . . . . . . . . . . . . . Inpatient surgeries(j) . . . . . . . . . . . . . . . . . . . . 548,220 540,304* 537,306 529,900 518,881
Days revenues in accounts receivable(k) . . . . 51 52 50 53 54
Outpatient revenues as a % of patient
revenues(l) . . . . . . . . . . . . . . . . . . . . . . . . . . 38% 38% 38% 40% 38%
(a) Licensed beds are those beds for which a facility has been granted approval to operate from the applicable
state licensing agency.
(b) Represents the average number of licensed beds, weighted based on periods owned.
(c) Represents the total number of patients admitted to our hospitals and is used by management and certain
investors as a general measure of inpatient volume.
(d) Equivalent admissions are used by management and certain investors as a general measure of combined
inpatient and outpatient volume. Equivalent admissions are computed by multiplying admissions (inpatient
volume) by the sum of gross inpatient revenue and gross outpatient revenue and then dividing the resulting
amount by gross inpatient revenue. The equivalent admissions computation “equates” outpatient revenue to
the volume measure (admissions) used to measure inpatient volume, resulting in a general measure of
combined inpatient and outpatient volume.
(e) Represents the average number of days admitted patients stay in our hospitals.
(f) Represents the average number of patients in our hospital beds each day.
(g) Represents the percentage of hospital licensed beds occupied by patients. Both average daily census and
occupancy rate provide measures of the utilization of inpatient rooms.
(h) Represents the number of patients treated in our emergency rooms.
(i) Represents the number of surgeries performed on patients who were not admitted to our hospitals. Pain
management and endoscopy procedures are not included in outpatient surgeries.
(j) Represents the number of surgeries performed on patients who have been admitted to our hospitals. Pain
management and endoscopy procedures are not included in inpatient surgeries.
(k) Revenues per day is calculated by dividing the revenues for the fourth quarter of each year by the days in
the quarter. Days revenues in accounts receivable is then calculated as accounts receivable at the end of the
period divided by revenues per day.
(l) Represents the percentage of patient revenues related to patients who are not admitted to our hospitals.
* Reclassifications between inpatient surgery cases and outpatient surgery cases for 2017 have been made to
conform to the 2018 presentation.
52
HCA HEALTHCARE, INC.
MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION
AND RESULTS OF OPERATIONS (Continued)
Critical Accounting Policies and Estimates (continued)
Revenues (continued)
The estimates for implicit price concessions are based upon management’s assessment of historical
writeoffs and expected net collections, business and economic conditions, trends in federal, state and private
employer health care coverage and other collection indicators. Management relies on the results of detailed
reviews of historical writeoffs and collections at facilities that represent a majority of our revenues and accounts
receivable (the “hindsight analysis”) as a primary source of information in estimating the collectability of our
accounts receivable. We perform the hindsight analysis quarterly, utilizing rolling twelve-months accounts
receivable collection and writeoff data. We believe our quarterly updates to the estimated implicit price
concession amounts at each of our hospital facilities provide reasonable estimates of our revenues and valuations
of our accounts receivable. These routine, quarterly changes in estimates have not resulted in material
adjustments to the valuations of our accounts receivable or period-to-period comparisons of our results of
operations. At December 31, 2018 and December 31, 2017, estimated implicit price concessions of $6.280 billion
and $5.488 billion, respectively, had been recorded as reductions to our accounts receivable balances to enable us
to record our revenues and accounts receivable at the estimated amounts we expect to collect.
To quantify the total impact of and trends related to uninsured 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 years ended December 31,
follows (dollars in millions):
2018 2017 2016
Patient care costs (salaries and benefits, supplies, other operating expenses and
depreciation and amortization) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $40,035 $37,557 $35,304
Cost-to-charges ratio (patient care costs as percentage of gross patient
charges) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.4% 12.9% 13.5%
Total uncompensated care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $26,757 $23,420 $20,455
Multiply by the cost-to-charges ratio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.4% 12.9% 13.5%
Estimated cost of total uncompensated care . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,318 $ 3,021 $ 2,761
Total uncompensated care as a percentage of the sum of revenues and total uncompensated care was 36.4%
for 2018, 34.9% for 2017 and 33.0% for 2016. Days revenues in accounts receivable were 51 days, 52 days and
50 days at December 31, 2018, 2017 and 2016, respectively. Management expects a continuation of the
challenges related to the collection of the patient due accounts. Adverse changes in the percentage of our patients
having adequate health care coverage, increases in patient responsibility amounts under certain health care
coverages, general economic conditions, patient accounting service center operations, payer mix, or trends in
federal, state, and private employer health care coverage could affect the collection of accounts receivable, cash
flows and results of operations.
Professional Liability Claims
We, along with virtually all health care providers, operate in an environment with professional liability
risks. Our facilities are insured by our 100% owned insurance subsidiary for losses up to $50 million per
occurrence, subject, in most cases, to a $15 million per occurrence self-insured retention. The insurance
subsidiary has obtained reinsurance for professional liability risks generally above a retention level.
58
HCA HEALTHCARE, INC.
MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION
AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Revenue/Volume Trends (continued)
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 waiver
requests to CMS to replace their existing supplemental payment programs. It is possible these reviews and
waiver requests will result in the restructuring of such supplemental payment programs and could result in the
payment programs 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.
Operating Results Summary
The following are comparative summaries of operating results for the years ended December 31, 2018, 2017
and 2016 (dollars in millions):
2018 2017 2016
Amount Ratio Amount Ratio Amount Ratio
Revenues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$46,677
21,425
100.0
45.9
7,724 16.5
8,608
(29)
2,278
18.5
(0.1)
4.9
1,755 3.8

$43,614 100.0 $41,490 100.0
Salaries and benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20,059 46.0 18,897 45.5
Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,316 16.8 6,933 16.7
Other operating expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,051 18.4 7,496 18.1
Equity in earnings of affiliates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (45) (0.1) (54) (0.1)
Depreciation and amortization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,131 4.9 1,966 4.8
Interest expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,690 3.9 1,707 4.1
Gain on sales of facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(428)
9
(0.9)

(8) — (23) (0.1)
Losses on retirement of debt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 0.1 4 —
Legal claim benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . — — (246) (0.6)
41,342 88.6 39,233 90.0 36,680 88.4
Income before income taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,335 11.4 4,381 10.0 4,810 11.6
Provision for income taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 946 2.0 1,638 3.7 1,378 3.3
Net income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,389 9.4 2,743 6.3 3,432 8.3
Net income attributable to noncontrolling interests . . . . . . . . . . . . . . . . . . . . . . . 602 1.3 527 1.2 542 1.3
Net income attributable to HCA Healthcare, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,787 8.1 $ 2,216 5.1 $ 2,890 7.0
% changes from prior year:
Revenues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.0% 5.1% 4.6%
Income before income taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.8 (8.9) 21.6
Net income attributable to HCA Healthcare, Inc. . . . . . . . . . . . . . . . . . . . . . 70.9 (23.3) 35.8
Admissions(a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.5 2.4 1.2
Equivalent admissions(b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1 3.0 2.2
Revenue per equivalent admission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.8 2.1 2.3
Same facility % changes from prior year(c):
Revenues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.5 3.8 4.1
Admissions(a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5 1.1 1.1
Equivalent admissions(b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5 1.5 1.9
Revenue per equivalent admission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.9 2.2 2.2
(a) Represents the total number of patients admitted to our hospitals and is used by management and certain investors as a general measure
of inpatient volume.
(b) Equivalent admissions are used by management and certain investors as a general measure of combined inpatient and outpatient volume.
Equivalent admissions are computed by multiplying admissions (inpatient volume) by the sum of gross inpatient revenue and gross
outpatient revenue and then dividing the resulting amount by gross inpatient revenue. The equivalent admissions computation “equates”
outpatient revenue to the volume measure (admissions) used to measure inpatient volume, resulting in a general measure of combined
inpatient and outpatient volume.
(c) Same facility information excludes the operations of hospitals and their related facilities that were either acquired, divested or removed
from service during the current and prior year.
63
HCA HEALTHCARE, INC.
CONSOLIDATED INCOME STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2018, 2017 AND 2016
(Dollars in millions, except per share amounts)
2018 2017 2016
Revenues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 46,677 $ 43,614 $ 41,490
Salaries and benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21,425 20,059 18,897
Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,724 7,316 6,933
Other operating expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,608 8,051 7,496
Equity in earnings of affiliates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (29) (45) (54)
Depreciation and amortization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,278 2,131 1,966
Interest expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,755 1,690 1,707
Gains on sales of facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (428) (8) (23)
Losses on retirement of debt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 39 4
Legal claim benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . — — (246)
41,342 39,233 36,680
Income before income taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,335 4,381 4,810
Provision for income taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 946 1,638 1,378
Net income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,389 2,743 3,432
Net income attributable to noncontrolling interests . . . . . . . . . . . . . . . . . . . . . . 602 527 542
Net income attributable to HCA Healthcare, Inc. . . . . . . . . . . . . . . . . . . . $ 3,787 $ 2,216 $ 2,890
Per share data:
Basic earnings per share . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10.90

$
$
6.12
5.95
$
$
7.53
7.30

Diluted earnings per share . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10.66 Shares used in earnings per share calculations (in millions):
Basic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347.297 362.305 383.591
Diluted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355.303 372.221 395.851
The accompanying notes are an integral part of the consolidated financial statements.
F-3
HCA HEALTHCARE, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 1 — ACCOUNTING POLICIES (continued)
Revenues (continued)
To quantify the total impact of the trends related to uninsured 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 years ended December 31,
follows (dollars in millions):
2018 2017 2016
Patient care costs (salaries and benefits, supplies, other operating expenses and
depreciation and amortization) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $40,035 $37,557 $35,304
Cost-to-charges ratio (patient care costs as percentage of gross patient
charges) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.4% 12.9% 13.5%
Total uncompensated care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $26,757 $23,420 $20,455
Multiply by the cost-to-charges ratio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.4% 12.9% 13.5%
Estimated cost of total uncompensated care . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,318 $ 3,021 $ 2,761
Total uncompensated care as a percentage of the sum of revenues and total uncompensated care was 36.4%
for 2018, 34.9% for 2017 and 33.0% for 2016. The total uncompensated care amounts include charity care of
$8.611 billion, $4.861 billion and $4.151 billion, and the related estimated costs of charity care were
$1.068 billion, $627 million and $560 million for the years ended December 31, 2018, 2017 and 2016,
respectively.
Recent Pronouncements
In February 2016, the FASB issued Accounting Standards Update 2016-02, Leases (“ASU 2016-02”), which
requires lessees to recognize assets and liabilities for most leases. ASU 2016-02 is effective for public business
entities for annual and interim periods beginning after December 15, 2018. We plan to adopt ASU 2016-02
effective January 1, 2019 applying a modified retrospective approach in which we will not adjust comparable
prior period information and disclosures. We expect to utilize the practical expedients being made available,
including the package of practical expedients to not reassess whether a contract is or contains a lease, the lease
classification and initial direct costs. We believe the primary effect of adopting the new standard will be to record
right-of-use assets and obligations for our leases currently classified as operating leases, and we expect the
amount of right-of-use assets and obligations resulting from the adoption of ASU 2016-02 to be approximately
$1.6 billion.
In February 2018, the FASB issued Accounting Standards Update 2018-02, Reclassification of Certain Tax
Effects from Accumulated Other Comprehensive Income (“ASU 2018-02”). In implementing the provisions of
the Tax Cuts and Jobs Act of 2017 (the “Tax Act”), the remeasurement of our deferred tax assets and liabilities
was recorded as a component of our provision for income taxes. For deferred tax amounts that were originally
recorded through accumulated other comprehensive income (“AOCI”), the remeasurement of deferred tax assets
and liabilities through the provision for income taxes resulted in these amounts becoming “stranded” in AOCI.
ASU 2018-02 permits companies to reclassify the stranded tax amounts recorded in AOCI to retained earnings,
and we reclassified $95 million of stranded tax effects from AOCI to retained earnings effective October 1, 2018.
Cash and Cash Equivalents
Cash and cash equivalents include highly liquid investments with a maturity of three months or less when
purchased. Our insurance subsidiaries’ cash equivalent investments in excess of the amounts required to pay
F-11
One Park Plaza Nashville,
Tennessee 37203
www.hcahealthcare.com
Corporate Information
Transfer Agent and Registrar
EQ Shareowner Services
P.O. Box 64874
St. Paul, Minnesota 55164-0874
Toll free: 800-468-9716
Certified/Overnight Mail
EQ Shareowner Services
1110 Centre Pointe Curve, Suite 101
Mendota Heights, Minnesota 55120
Independent Registered Public
Accounting Firm
Ernst & Young LLP
Nashville, Tennessee
Corporate Headquarters
One Park Plaza
Nashville, Tennessee 37203
615-344-9551
Form 10-K
The Company has filed an annual
report on Form 10-K for the year
ended December 31, 2018 with the
United States Securities and Exchange
Commission (SEC). Shareholders may
obtain a copy of this report, without
charge, by writing:
Investor Relations, HCA Healthcare,
Inc., One Park Plaza, Nashville, TN
37203 or by visiting the Company’s
website at www.hcahealthcare.com.
Common Stock and Dividend
Information
The Common Stock of HCA
Healthcare, Inc. is listed on the New
York Stock Exchange (NYSE) under
the symbol “HCA”. On March 7, 2019,
the Company had approximately 380
shareholders of record. On January 29,
2019, the Company’s Board of Directors
declared a quarterly dividend of
$0.40 per share on our common
stock payable on March 29, 2019 to
shareholders of record on March 1,
2019. Future declarations of quarterly
dividends and the establishment of
future record and payment dates are
subject to the final determination of
the Company’s Board of Directors.
Annual Meeting of Shareholders
The annual meeting of shareholders will
be held on April 26, 2019, at 2:00 pm
local time at the HCA corporate offices
located at One Park Plaza, Nashville,
Tennessee 37203. Shareholders of
record as of March 7, 2019, are invited
to attend.

Reference no: EM132069492

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