10-K

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

Form 10-K

(Mark One)
þ	ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
	For the fiscal year ended December 31, 2011
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 HOLDINGS, INC.

(Exact Name of Registrant as Specified in its Charter)

Delaware	27-3865930
(State or Other Jurisdiction of Incorporation or Organization)	(I.R.S. Employer Identification No.)
One Park Plaza Nashville, Tennessee	37203
(Address of Principal Executive Offices)	(Zip Code)

Registrant’s telephone number, including area code: (615) 344-9551

Securities Registered Pursuant to Section 12(b) of the Act:

Title of Each Class	Name of Each Exchange on Which Registered
Common Stock, $0.01 Par Value	New York Stock Exchange

Securities Registered Pursuant to Section 12(g) of the Act: None

Indicate by check mark if the Registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.     Yes   þ     No   ¨

Indicate by check mark if the Registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act.     Yes   ¨     No   þ

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  þ    No  ¨

Indicate by check mark whether the Registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted 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 and post such files).    Yes  þ    No  ¨

Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K (§ 229.405 of this chapter) is not contained herein, and will not be contained, to the best of Registrant’s knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any amendment to this Form 10-K.    ¨

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

Large accelerated filer þ	Accelerated filer ¨	Non-accelerated filer ¨	Smaller reporting company ¨
		(Do not check if a smaller reporting company)

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

As of January 31, 2012, there were 437,618,000 outstanding shares of the Registrant’s common stock. As of June 30, 2011, the aggregate market value of the common stock held by nonaffiliates was approximately $5.186 billion. For purposes of the foregoing calculation only, Hercules Holding II, LLC and the Registrant’s directors and executive officers have been deemed to be affiliates.

DOCUMENTS INCORPORATED BY REFERENCE

Portions of the Registrant’s definitive proxy materials for its 2012 Annual Meeting of Stockholders are incorporated by reference into Part III hereof.

INDEX

		Page Reference
PART I
Item 1.	Business		3
Item 1A.	Risk Factors		39
Item 1B.	Unresolved Staff Comments		52
Item 2.	Properties		53
Item 3.	Legal Proceedings		53
Item 4.	Mine Safety Disclosures		55
PART II
Item 5.	Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities		55
Item 6.	Selected Financial Data		58
Item 7.	Management’s Discussion and Analysis of Financial Condition and Results of Operations		60
Item 7A.	Quantitative and Qualitative Disclosures about Market Risk		85
Item 8.	Financial Statements and Supplementary Data		85
Item 9.	Changes in and Disagreements with Accountants on Accounting and Financial Disclosure		85
Item 9A.	Controls and Procedures		85
Item 9B.	Other Information		88
PART III
Item 10.	Directors, Executive Officers and Corporate Governance		88
Item 11.	Executive Compensation		88
Item 12.	Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters		88
Item 13.	Certain Relationships and Related Transactions, and Director Independence		89
Item 14.	Principal Accountant Fees and Services		89
PART IV
Item 15.	Exhibits and Financial Statement Schedules		90
	Signatures		101

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PART I

Item 1.    Business

General

HCA Holdings, Inc. is one of the leading health care services companies in the United States. At December 31, 2011, we operated 163 hospitals, comprised of 157 general, acute care hospitals; five psychiatric hospitals; and one rehabilitation hospital. In addition, we operated 108 freestanding surgery centers. Our 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 Inc. and its affiliates prior to the Corporate Reorganization (as defined below) and to HCA Holdings, Inc. and its affiliates after the Corporate Reorganization. The term “affiliates” means direct and indirect subsidiaries of HCA Holdings, Inc. and partnerships and joint ventures in which such subsidiaries are partners. 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.

Our primary objective is to provide a comprehensive array of quality health care services in the most cost-effective manner possible. Our general, acute care hospitals typically provide a full range of services to accommodate such medical specialties as internal medicine, general surgery, cardiology, oncology, neurosurgery, orthopedics and obstetrics, as well as diagnostic and emergency services. Outpatient and ancillary health care services are provided by our general, acute care hospitals, freestanding surgery centers, diagnostic centers and rehabilitation facilities. Our psychiatric hospitals provide a full range of mental health care services through inpatient, partial hospitalization and outpatient settings.

On November 17, 2006, HCA Inc. was acquired by a private investor group, including affiliates of or funds sponsored by Bain Capital Partners, LLC, Kohlberg Kravis Roberts & Co., BAML Capital Partners and HCA founder, Dr. Thomas F. Frist, Jr. (collectively, the “Investors”) and by members of management and certain other investors. The transaction was accounted for as a recapitalization in our financial statements, with no adjustments to the historical basis of our assets and liabilities.

During February 2011, our Board of Directors approved an increase in the number of our authorized shares to 1,800,000,000 shares of common stock and a 4.505-to-one split of our issued and outstanding common shares. All common share and per common share amounts in these consolidated financial statements and notes to consolidated financial statements reflect the 4.505-to-one split. During March 2011, we completed the initial public offering of 87,719,300 shares of our common stock at a price of $30.00 per share (before deducting underwriter discounts, commissions and other related offering expenses). Certain of our stockholders also sold 57,410,700 shares of our common stock in this offering. We did not receive any proceeds from the shares sold by the selling stockholders. Our common stock is now traded on the New York Stock Exchange (symbol “HCA”).

The Company was incorporated in Nevada in January 1990 and reincorporated in Delaware in September 1993. Our principal executive offices are located at One Park Plaza, Nashville, Tennessee 37203, and our telephone number is (615) 344-9551.

Corporate Reorganization

On November 22, 2010, HCA Inc. reorganized by creating a new holding company structure (the “Corporate Reorganization”). We are the new parent company, and HCA Inc. is now our wholly-owned direct subsidiary. As part of the Corporate Reorganization, HCA Inc.’s outstanding shares of capital stock were automatically converted, on a share for share basis, into identical shares of our common stock. As a result of the

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Corporate Reorganization, we are deemed the successor registrant to HCA Inc. under the Exchange Act. As part of the Corporate Reorganization, we became a guarantor but did not assume the debt of HCA Inc.’s outstanding secured notes.

We have assumed all of HCA Inc.’s obligations with respect to the outstanding shares previously registered on Form S-8 for distribution pursuant to HCA Inc.’s stock incentive plan and have also assumed HCA Inc.’s other equity incentive plans that provide for the right to acquire HCA Inc.’s common stock. The agreements and plans we assumed were each deemed to be automatically amended as necessary to provide that references therein to HCA Inc. now refer to HCA Holdings, Inc. Following the Corporate Reorganization, the right to receive HCA Inc.’s common stock under its various compensation plans and agreements automatically converted into rights for the same number of shares of our common stock, with the same rights and conditions as the corresponding HCA Inc. rights prior to the Corporate Reorganization.

Available Information

We file certain reports with the Securities and Exchange Commission (the “SEC”), including annual reports on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K. The public may read and copy any materials we file with the SEC at the SEC’s Public Reference Room at 100 F Street, N.E., Washington, DC 20549. The public may obtain information on the operation of the Public Reference Room by calling the SEC at 1-800-SEC-0330. We are an electronic filer, and the SEC maintains an Internet site at http://www.sec.gov that contains the reports, proxy and information statements and other information we file electronically. Our website address is www.hcahealthcare.com. Please note that our website address is provided as an inactive textual reference only. We make available free of charge, through our website, our annual report on Form 10-K, quarterly reports on Form 10-Q, current reports on Form 8-K and all amendments to those reports filed or furnished pursuant to Section 13 or 15(d) of the Exchange Act, as soon as reasonably practicable after such material is electronically filed with or furnished to the SEC. The information provided on our website is not part of this report, and is therefore not incorporated by reference unless such information is specifically referenced elsewhere in this report.

Our Code of Conduct is available free of charge upon request to our Corporate Secretary, HCA Holdings, Inc., One Park Plaza, Nashville, Tennessee 37203.

Business Strategy

We are committed to providing the communities we serve with high quality, cost-effective health care while growing our business, increasing our profitability and creating long-term value for our stockholders. To achieve these objectives, we align our efforts around the following growth agenda:

• grow our presence in existing markets;

• achieve industry-leading performance in clinical and satisfaction measures;

• recruit and employ physicians to meet the need for high quality health services;

• continue to leverage our scale and market positions to enhance profitability; and

• selectively pursue a disciplined development strategy.

Health Care Facilities

We currently own, manage or operate hospitals; freestanding surgery centers; diagnostic and imaging centers; radiation and oncology therapy centers; comprehensive rehabilitation and physical therapy centers; and various other facilities.

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At December 31, 2011, we owned and operated 157 general, acute care hospitals with 40,988 licensed beds. Most of our general, acute care hospitals provide medical and surgical services, including inpatient care, intensive care, cardiac care, diagnostic services and emergency services. The general, acute care hospitals also provide outpatient services such as outpatient surgery, laboratory, radiology, respiratory therapy, cardiology and physical therapy. Each hospital has an organized medical staff and a local board of trustees or governing board, made up of members of the local community.

Our hospitals do not typically engage in extensive medical research and education programs. However, some of our hospitals are affiliated with medical schools and may participate in the clinical rotation of medical interns and residents and other education programs.

At December 31, 2011, we operated five psychiatric hospitals with 506 licensed beds. Our psychiatric hospitals provide therapeutic programs including child, adolescent and adult psychiatric care, adult and adolescent alcohol and drug abuse treatment and counseling.

We also operate outpatient health care facilities which include freestanding ambulatory surgery centers (“ASCs”), freestanding emergency care facilities, diagnostic and imaging centers, comprehensive outpatient rehabilitation and physical therapy centers, outpatient radiation and oncology therapy centers and various other facilities. These outpatient services are an integral component of our strategy to develop comprehensive health care networks in select communities. Most of our ASCs are operated through partnerships or limited liability companies, with majority ownership of each partnership or limited liability company typically held by a general partner or subsidiary that is an affiliate of HCA.

Certain of our affiliates provide a variety of management services to our health care facilities, including patient safety programs; ethics and compliance programs; national supply contracts; equipment purchasing and leasing contracts; accounting, financial and clinical systems; governmental reimbursement assistance; construction planning and coordination; information technology systems and solutions; legal counsel; human resources services; and internal audit services.

Sources of Revenue

Hospital revenues depend upon inpatient occupancy levels, the medical and ancillary services ordered by physicians and provided to patients, the volume of outpatient procedures and the charges or payment rates for such services. Charges and reimbursement rates for inpatient services vary significantly depending on the type of payer, the type of service (e.g., medical/surgical, intensive care or psychiatric) and the geographic location of the hospital. Inpatient occupancy levels fluctuate for various reasons, many of which are beyond our control.

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We receive payments for patient services from the federal government under the Medicare program, state governments under their respective Medicaid or similar programs, managed care plans, private insurers and directly from patients. Our revenues from third-party payers and the uninsured for the years ended December 31, 2011, 2010 and 2009 are summarized in the following table (dollars in millions):

	Years Ended December 31,
	2011			Ratio			2010			Ratio			2009			Ratio
Medicare	$	7,653			25.8	%	$	7,203			25.7	%	$	6,866			25.6	%
Managed Medicare		2,442			8.2			2,162			7.7			2,006			7.5
Medicaid		1,845			6.2			1,962			7.0			1,691			6.3
Managed Medicaid		1,265			4.3			1,165			4.2			1,113			4.2
Managed care and other insurers		15,703			52.9			14,762			52.7			14,323			53.5
International (managed care and other insurers)		938			3.2			784			2.8			702			2.6
		29,846			100.6			28,038			100.1			26,701			99.7
Uninsured		1,846			6.2			1,732			6.2			2,350			8.8
Other		814			2.7			913			3.3			1,001			3.7
Revenues before provision for doubtful accounts		32,506			109.5			30,683			109.6			30,052			112.2
Provision for doubtful accounts		(2,824	)		(9.5	)		(2,648	)		(9.6	)		(3,276	)		(12.2	)
Revenues	$	29,682			100.0	%	$	28,035			100.0	%	$	26,776			100.0	%

Medicare is a federal program that provides certain hospital and medical insurance benefits to persons age 65 and over, some disabled persons, persons with end-stage renal disease and persons with Lou Gehrig’s Disease. Medicaid is a federal-state program, administered by the states, which provides hospital and medical benefits to qualifying individuals who are unable to afford health care. All of our general, acute care hospitals located in the United States are certified as health care services providers for persons covered under Medicare and Medicaid programs. Amounts received under Medicare and Medicaid programs are generally significantly less than established hospital gross charges for the services provided.

Our hospitals generally offer discounts from established charges to certain group purchasers of health care services, including private insurance companies, employers, health maintenance organizations (“HMOs”), preferred provider organizations (“PPOs”) and other managed care plans. These discount programs generally limit our ability to increase revenues in response to increasing costs. See Item 1, “Business — Competition.” Patients are generally not responsible for the total difference between established hospital gross charges and amounts reimbursed for such services under Medicare, Medicaid, HMOs, PPOs and other managed care plans, but are responsible to the extent of any exclusions, deductibles or coinsurance features of their coverage. The amount of such exclusions, deductibles and coinsurance continues to increase. Collection of amounts due from individuals is typically more difficult than from governmental or third-party payers. We provide discounts to uninsured patients who do not qualify for Medicaid or charity care under our charity care policy. These discounts are similar to those provided to many local managed care plans. In implementing the discount policy, we attempt to qualify uninsured patients for Medicaid, other federal or state assistance or charity care under our charity care policy. If an uninsured patient does not qualify for these programs, the uninsured discount is applied.

Medicare

Inpatient Acute Care

Under the Medicare program, we receive reimbursement under a prospective payment system (“PPS”) for general, acute care hospital inpatient services. Under the hospital inpatient PPS, fixed payment amounts per inpatient discharge are established based on the patient’s assigned Medicare severity diagnosis-related group

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(“MS-DRG”). MS-DRGs classify treatments for illnesses according to the estimated intensity of hospital resources necessary to furnish care for each principal diagnosis. MS-DRG weights represent the average resources for a given MS-DRG relative to the average resources for all MS-DRGs. MS-DRG payments are adjusted for area wage differentials. Hospitals, other than those defined as “new,” receive PPS reimbursement for inpatient capital costs based on MS-DRG weights multiplied by a geographically adjusted federal rate. When the cost to treat certain patients falls well outside the normal distribution, providers typically receive additional “outlier” payments.

MS-DRG rates are updated and MS-DRG weights are recalibrated using cost relative weights each federal fiscal year (which begins October 1). The index used to update the MS-DRG rates (the “market basket”) gives consideration to the inflation experienced by hospitals and entities outside the health care industry in purchasing goods and services. The Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, the “Health Reform Law”) provides for annual decreases to the market basket, including the following reductions for each of the following federal fiscal years: 0.25% in 2011, 0.1% in 2012 and 2013, 0.3% in 2014, 0.2% in 2015 and 2016 and 0.75% in 2017, 2018 and 2019. For federal fiscal year 2012 and each subsequent federal fiscal year, the Health Reform Law provides for the annual market basket update to be further reduced by a productivity adjustment. The amount of that reduction will be the projected, nationwide productivity gains over the preceding 10 years. To determine the projection, the Department of Health and Human Services (“HHS”) will use the Bureau of Labor Statistics (“BLS”) 10-year moving average of changes in specified economy-wide productivity (the BLS data is typically a few years old). The Health Reform Law does not contain guidelines for use by HHS in projecting the productivity figure. CMS estimates that the combined market basket and productivity adjustments will reduce Medicare payments under the inpatient PPS by $112.6 billion from 2010 to 2019. A decrease in payment rates or an increase in rates that is below the increase in our costs may adversely affect our results of operations.

CMS increased the MS-DRG rate for federal fiscal year 2011 by 2.35%, representing the full market basket of 2.6% minus the 0.25% reduction required by the Health Reform Law. CMS also applied a documentation and coding adjustment of negative 2.9% in federal fiscal year 2011 to account for increases in aggregate payments during implementation of the MS-DRG system, which resulted in an aggregate adjustment of negative 0.55% in federal fiscal year 2011. For federal fiscal year 2012, CMS issued a final rule that results in a net increase of 1.0%. This increase reflects the 2.9% market basket increase, a prospective documentation and coding adjustment of negative 2.0%, a productivity adjustment of negative 1.0%, and a 1.1% increase in light of a January 2011 court decision. In addition, CMS intends to make an additional negative 1.9% documentation and coding adjustment in the future, but has not specified when the adjustment will be made.

Further realignments in the MS-DRG system could also reduce the payments we receive for certain specialties, including cardiology and orthopedics. CMS has focused on payment levels for such specialties in recent years in part because of the proliferation of specialty hospitals. Changes in the payments received for specialty services could have an adverse effect on our results of operations.

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (“MMA”) provides for hospitals to receive a 2% reduction to their market basket updates if they fail to submit data for patient care quality indicators to the Secretary of HHS. As required by the Deficit Reduction Act of 2005 (“DRA 2005”), CMS has expanded, through a series of rulemakings, the number of quality measures that must be reported to avoid the market basket reduction. In federal fiscal year 2012, CMS requires hospitals to report 55 quality measures in order to avoid the market basket reduction for inpatient PPS payments in federal fiscal year 2013. All of our hospitals paid under the Medicare inpatient PPS are participating in the quality initiative by submitting the requested quality data. While we will endeavor to comply with all data submission requirements as additional requirements continue to be added, our submissions may not be deemed timely or sufficient to entitle us to the full market basket adjustment for all of our hospitals.

As part of CMS’ goal of transforming Medicare from a passive payer to an active purchaser of quality goods and services, Medicare does not allow an inpatient hospital discharge to be assigned to a higher paying MS-DRG

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if a selected hospital acquired condition (“HAC”) was not present on admission. In this situation, the case is paid as though the secondary diagnosis was not present. Currently, there are ten categories of conditions on the list of HACs. In addition, CMS has established three National Coverage Determinations that prohibit Medicare reimbursement for erroneous surgical procedures performed on an inpatient or outpatient basis. The Health Reform Law provides for reduced payments based on a hospital’s HAC rates. Beginning in federal fiscal year 2015, the 25% of hospitals with the worst national risk-adjusted HAC rates in the previous year will receive a 1% reduction in their total inpatient operating Medicare payments. In addition, effective July 1, 2011, the Health Reform Law prohibits the use of federal funds under the Medicaid program to reimburse providers for medical services provided to treat HACs.

The Health Reform Law also provides for reduced payments to hospitals based on readmission rates. Beginning in federal fiscal year 2013, inpatient payments will be reduced if a hospital experiences “excessive” readmissions within the 30-day time period from the date of discharge for heart attack, heart failure, pneumonia or other conditions that may be designated by CMS. Hospitals with what CMS defines as excessive readmissions for these conditions will receive reduced payments for all inpatient discharges, not just discharges relating to the conditions subject to the excessive readmission standard. Each hospital’s performance will be publicly reported by CMS. On August 1, 2011, CMS issued a final rule implementing portions of this program but indicated that it will issue in future rulemakings additional policies with respect to excessive readmissions, including the specific payment adjustment methodology.

The Health Reform Law additionally establishes a value-based purchasing program to further link payments to quality and efficiency. In federal fiscal year 2013, HHS is directed to implement a value-based purchasing program for inpatient hospital services. Beginning in federal fiscal year 2013, CMS will reduce the inpatient PPS payment amount for all discharges by the following: 1% for 2013; 1.25% for 2014; 1.5% for 2015; 1.75% for 2016; and 2% for 2017 and subsequent years. For each federal fiscal year, the total amount collected from these reductions will be pooled and used to fund payments to reward hospitals that meet certain quality performance standards established by HHS. The Health Reform Law provides HHS with considerable discretion over the value-based purchasing program. On April 29, 2011, CMS issued a final rule establishing the value-based purchasing program for hospital inpatient services. Under this final rule, CMS estimates it will distribute $850 million in federal fiscal year 2013 to hospitals based on their overall performance on a set of quality measures that have been linked to improved clinical processes of care and patient satisfaction. For payments in federal fiscal year 2013, hospitals will be scored based on a weighted average of patient experience scores using the Hospital Consumer Assessment of Healthcare Providers and Systems survey and 12 clinical process-of-care measures. CMS will score each hospital based on achievement (relative to other hospitals) and improvement ranges (relative to the hospital’s own past performance) for each applicable measure. Because the Health Reform Law provides that the pool will be fully distributed, hospitals that meet or exceed the quality performance standards will receive greater reimbursement under the value-based purchasing program than they would have otherwise. Hospitals that do not achieve the necessary quality performance will receive reduced Medicare inpatient hospital payments. CMS will notify each hospital of the amount of its value-based incentive payment for fiscal year 2013 discharges on November 1, 2012.

Historically, the Medicare program has set aside 5.10% of Medicare inpatient payments to pay for outlier cases. For federal fiscal year 2011, CMS established an outlier threshold of $23,075, and for federal fiscal year 2012, CMS reduced the outlier threshold to $22,385. We do not anticipate that the decrease to the outlier threshold for federal fiscal year 2012 will have a material impact on our results of operations.

Outpatient

CMS reimburses hospital outpatient services (and certain Medicare Part B services furnished to hospital inpatients who have no Part A coverage) on a PPS basis. CMS uses fee schedules to pay for physical, occupational and speech therapies, durable medical equipment, clinical diagnostic laboratory services and nonimplantable orthotics and prosthetics, freestanding surgery center services and services provided by independent diagnostic testing facilities.

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Hospital outpatient services paid under PPS are classified into groups called ambulatory payment classifications (“APCs”). Services for each APC are similar clinically and in terms of the resources they require. A payment rate is established for each APC. Depending on the services provided, a hospital may be paid for more than one APC for a patient visit. The APC payment rates are updated for each calendar year. For calendar year 2011, CMS increased APC payment rates by 2.35%, which represented a market basket update of 2.6% and a 0.25% reduction required by the Health Reform Law. The Health Reform Law also provides for the following reductions to the market basket update for each of the following calendar years: 0.1% in 2012 and 2013, 0.3% in 2014, 0.2% in 2015 and 2016 and 0.75% in 2017, 2018 and 2019. For calendar year 2012 and each subsequent calendar year, the Health Reform Law provides for an annual market basket update to be further reduced by a productivity adjustment. The amount of that reduction will be the projected, nationwide productivity gains over the preceding 10 years. To determine the projection, HHS will use the BLS 10-year moving average of changes in specified economy-wide productivity (the BLS data is typically a few years old). The Health Reform Law does not contain guidelines for use by HHS in projecting the productivity figure. However, CMS estimates that the combined market basket and productivity adjustments will reduce Medicare payments under the outpatient PPS by $26.3 billion from 2010 to 2019. CMS has issued a final rule that increases the APC payment rate for calendar year 2012 by 1.9%, which includes the full market basket update of 3.0%, a negative 1.0% productivity adjustment and the negative 0.1% adjustment required by the Health Reform Law. CMS continues to require hospitals to submit quality data relating to outpatient care to avoid receiving a 2% reduction to the market basket update under the outpatient PPS. CMS required hospitals to report data on 15 quality measures in calendar year 2011 for the payment determination in calendar year 2012 and requires hospitals to report 23 quality measures in calendar year 2012 to avoid reduced payments in calendar year 2013.

Rehabilitation

CMS reimburses inpatient rehabilitation facilities (“IRFs”) on a PPS basis. Under the IRF PPS, patients are classified into case mix groups based upon impairment, age, comorbidities (additional diseases or disorders from which the patient suffers) and functional capability. IRFs are paid a predetermined amount per discharge that reflects the patient’s case mix group and is adjusted for area wage levels, low-income patients, rural areas and high-cost outliers. For federal fiscal year 2011, CMS updated the market basket by 2.25%, which represented the full market basket of 2.5% reduced by 0.25% as required by the Health Reform Law. The Health Reform Law also provides for the following reductions to the market basket update for each of the following federal fiscal years: 0.1% in 2012 and 2013, 0.3% in 2014, 0.2% in 2015 and 2016 and 0.75% in 2017, 2018 and 2019. For federal fiscal year 2012 and each subsequent federal fiscal year, the Health Reform Law provides for the annual market basket update to be further reduced by a productivity adjustment. The amount of that reduction will be the projected, nationwide productivity gains over the preceding 10 years. To determine the projection, HHS will use the BLS 10-year moving average of changes in specified economy-wide productivity (the BLS data is typically a few years old). The Health Reform Law does not contain guidelines for use by HHS in projecting the productivity figure. However, CMS estimates that the combined market basket and productivity adjustments will reduce Medicare payments under the IRF PPS by $5.7 billion from 2010 to 2019. For federal fiscal year 2012, CMS has issued a final rule updating inpatient rehabilitation payment rates by 2.2%, which reflects a 2.9% market basket increase, a negative 1.0% productivity adjustment, a 0.1% reduction required by the Health Reform Law, and a 0.4% increase resulting from an update to the outlier threshold amount. Beginning in federal fiscal year 2014, IRFs will be required to report quality measures to CMS or will receive a two percentage point reduction to the market basket update.

In order to qualify for classification as an IRF, at least 60% of a facility’s inpatients during the most recent 12-month CMS-defined review period must have required intensive rehabilitation services for one or more of 13 specified conditions. IRFs must also meet additional coverage criteria, including patient selection and care requirements relating to pre-admission screenings, post-admission evaluations, ongoing coordination of care and involvement of rehabilitation physicians. A facility that fails to meet the 60% threshold or other criteria to be classified as an IRF will be paid under the acute care hospital inpatient or outpatient PPS, which generally provide for lower payment amounts. As of December 31, 2011, we had one rehabilitation hospital and 42 hospital rehabilitation units.

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Psychiatric

Inpatient hospital services furnished in psychiatric hospitals and psychiatric units of general, acute care hospitals and critical access hospitals are reimbursed under a prospective payment system (the “IPF PPS”), a per diem payment, with adjustments to account for certain patient and facility characteristics. The IPF PPS contains an “outlier” policy for extraordinarily costly cases and an adjustment to a facility’s base payment if it maintains a full-service emergency department. CMS has established the IPF PPS payment rate in a manner intended to be budget neutral and historically has used a July 1 update cycle, with each twelve month period referred to as a “rate year.” However, CMS has issued a final rule that will transition the IPF PPS to a federal fiscal year update cycle. Accordingly, the rates for 2012 will be effective from July 1, 2011 through September 30, 2012, with future updates coinciding with the federal fiscal year (from October 1 through September 30). The rehabilitation, psychiatric and long-term care (“RPL”) market basket update is used to update the IPF PPS. For rate year 2011, CMS updated the market basket by 2.15%, representing the full market basket of 2.4% reduced by 0.25% as required by the Health Reform Law. The Health Reform Law also provides for the following reductions to the market basket update for payment years that begin in the following calendar years: 0.1% in 2012 and 2013, 0.3% in 2014, 0.2% in 2015 and 2016 and 0.75% in 2017, 2018 and 2019. For rate year 2012 and each subsequent payment year, the Health Reform Law provides for the annual market basket update to be further reduced by a productivity adjustment. The amount of that reduction will be the projected, nationwide productivity gains over the preceding 10 years. To determine the projection, HHS will use the BLS 10-year moving average of changes in specified economy-wide productivity (the BLS data is typically a few years old). The Health Reform Law does not contain guidelines for use by HHS in projecting the productivity figure. However, CMS estimates that the combined market basket and productivity adjustments will reduce Medicare payments under the IPF PPS by $4.3 billion from 2010 to 2019. For rate year 2012, which will span 15 months from July 1, 2011 through September 30, 2012, CMS increased inpatient psychiatric payment rates by 2.95%, which includes a market basket increase of 3.2% and a 0.25% reduction required by the Health Reform Law. As of December 31, 2011, we had five psychiatric hospitals and 36 hospital psychiatric units.

Ambulatory Surgery Centers

CMS reimburses ASCs using a predetermined fee schedule. Reimbursements for ASC overhead costs are limited to no more than the overhead costs paid to hospital outpatient departments under the Medicare hospital outpatient PPS for the same procedure. If CMS determines that a procedure is commonly performed in a physician’s office, the ASC reimbursement for that procedure is limited to the reimbursement allowable under the Medicare Part B Physician Fee Schedule, with limited exceptions. All surgical procedures, other than those that pose a significant safety risk or generally require an overnight stay, are payable as ASC procedures. From time to time, CMS considers expanding the services that may be performed in ASCs, which may result in more Medicare procedures that historically have been performed in hospitals being moved to ASCs, reducing surgical volume in our hospitals. Also, more Medicare procedures that historically have been performed in ASCs may be moved to physicians’ offices. Commercial third-party payers may adopt similar policies. For federal fiscal year 2011 and each subsequent federal fiscal year, the Health Reform Law provides for the annual market basket update to be reduced by a productivity adjustment. The amount of that reduction will be the projected nationwide productivity gains over the preceding 10 years. To determine the projection, HHS will use the BLS 10-year moving average of changes in specified economy-wide productivity (the BLS data is typically a few years old). The Health Reform Law also required HHS to submit a report to Congress on plans for developing a value-based purchasing program for ASCs. In its report, HHS recommends a phased-in approach for implementing a value-based purchasing program but states additional statutory authority would be required to allow performance-based payments. CMS issued a final rule on November 1, 2011 that provides for a 1.6% annual update to ASC payments for calendar year 2012, which includes the market basket update of 2.7% and a negative 1.1% productivity adjustment. The final rule also establishes a quality reporting program for ASCs under which ASCs that fail to report on five quality measures beginning on October 1, 2012 will receive a 2% reduction in reimbursement for calendar year 2014.

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Physician Services

Physician services are reimbursed under the physician fee schedule (“PFS”) system, under which CMS has assigned a national relative value unit (“RVU”) to most medical procedures and services that reflects the various resources required by a physician to provide the services relative to all other services. Each RVU is calculated based on a combination of work required in terms of time and intensity of effort for the service, practice expense (overhead) attributable to the service and malpractice insurance expense attributable to the service. These three elements are each modified by a geographic adjustment factor to account for local practice costs and are then aggregated. The aggregated amount is multiplied by a conversion factor that accounts for inflation and targeted growth in Medicare expenditures (as calculated by the sustainable growth rate (“SGR”)) to arrive at the payment amount for each service. While RVUs for various services may change in a given year, any alterations are required by statute to be virtually budget neutral, such that total payments made under the PFS may not differ by more than $20 million from what payments would have been if adjustments were not made.

The PFS rates are adjusted each year, and reductions in both current and future payments are anticipated. The SGR formula, if implemented as mandated by statute, would result in significant reductions to payments under the PFS. Since 2003, the U.S. Congress has passed multiple legislative acts delaying application of the SGR to the PFS. The most recent legislative delay extends calendar year 2011 payment rates through December 31, 2012. We cannot predict whether the U.S. Congress will intervene to prevent this reduction to payments in the future. Barring delay or repeal of the SGR by Congress, Medicare payments to physicians are scheduled to be cut by more than 30% effective January 1, 2013.

Other

Under PPS, the payment rates are adjusted for the area differences in wage levels by a factor (“wage index”) reflecting the relative wage level in the geographic area compared to the national average wage level. Beginning in federal fiscal year 2007, CMS adjusted 100% of the wage index factor for occupational mix. The redistributive impact of wage index changes, while slightly negative in the aggregate, is not anticipated to have a material financial impact for 2012. However, the Health Reform Law requires HHS to provide Congress with recommendations on how to comprehensively reform the Medicare wage index system.

Medicare reimburses hospitals for a portion of bad debts resulting from deductible and coinsurance amounts that are uncollectible from Medicare beneficiaries. The Middle Class Tax Relief and Jobs Creation Act of 2012 (the “Jobs Creation Act”) reduces the percentage of bad debt amounts that Medicare reimburses from 70% to 65% beginning in federal fiscal year 2013. These reductions are intended to offset, in part, the impact of the most recent legislative delay of the SGR reductions in physician compensation under the PFS. The U.S. Congress has not permanently addressed the SGR reductions, and any further delays or revisions to the SGR may be offset by additional reductions in Medicare payments to other types of providers.

As required by the MMA, CMS is implementing contractor reform whereby CMS has competitively bid the Medicare fiscal intermediary and Medicare carrier functions to 15 Medicare Administrative Contractors (“MACs”), which are geographically assigned and service both Part A and Part B providers within a given jurisdiction. Although CMS has awarded initial contracts to all 15 MAC jurisdictions, full transition to the MAC jurisdictions has been delayed due to CMS resoliciting some bids and implementing other corrective actions in response to filed protests. While chain providers had the option of having all hospitals use one home office MAC, HCA chose to use the MACs assigned to the geographic areas in which our hospitals are located. The individual MAC jurisdictions are in varying phases of transition. During the transition periods and for a potentially unforeseen period thereafter, all of these changes could impact claims processing functions and the resulting cash flow; however, we are unable to predict the impact at this time.

Under the Recovery Audit Contractor (“RAC”) program, CMS contracts with RACs on a contingency basis to conduct post-payment reviews to detect and correct improper payments in the fee-for-service Medicare program. CMS has implemented the RAC program on a permanent, nationwide basis as required by statute.

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Managed Medicare

Managed Medicare plans relate to situations where a private company contracts with CMS to provide members with Medicare Part A, Part B and Part D benefits. Managed Medicare plans can be structured as HMOs, PPOs or private fee-for-service plans. The Medicare program allows beneficiaries to choose enrollment in certain managed Medicare plans. In 2003, MMA increased reimbursement to managed Medicare plans and expanded Medicare beneficiaries’ health care options. Since 2003, the number of beneficiaries choosing to receive their Medicare benefits through such plans has increased. However, the Medicare Improvements for Patients and Providers Act of 2008 imposed new restrictions and implemented focused cuts to certain managed Medicare plans. In addition, the Health Reform Law reduces, over a three year period starting in 2012, premium payments to managed Medicare plans such that CMS’ managed care per capita premium payments are, on average, equal to traditional Medicare. The Health Reform Law also implements fee payment adjustments based on service benchmarks and quality ratings. The Congressional Budget Office (“CBO”) has estimated that, as a result of these changes, payments to plans will be reduced by $138 billion between 2010 and 2019, while CMS has estimated the reduction to be $145 billion. In addition, the Health Reform Law expands the RAC program to include managed Medicare plans. In light of the current economic downturn and the Health Reform Law, managed Medicare plans may experience reduced premium payments, which may lead to decreased enrollment in such plans.

Medicaid

Medicaid programs are funded jointly by the federal government and the states and are administered by states under approved plans. Most state Medicaid program payments are made under a PPS or are based on negotiated payment levels with individual hospitals. Medicaid reimbursement is often less than a hospital’s cost of services. The Health Reform Law requires states to expand Medicaid coverage to all individuals under age 65 with incomes up to 133% of the federal poverty level (“FPL”) by 2014. However, the Health Reform Law also requires states to apply a “5% income disregard” to the Medicaid eligibility standard, so that Medicaid eligibility will effectively be extended to those with incomes up to 138% of the FPL. In addition, effective July 1, 2011, the Health Reform Law prohibits the use of federal funds under the Medicaid program to reimburse providers for medical assistance provided to treat HACs. However, CMS has delayed enforcement of this prohibition until July 1, 2012. In a final rule issued June 1, 2011, CMS authorizes states to add additional provider-preventable conditions to the list of HACs for which Medicaid reimbursement will not be allowed.

Since most states must operate with balanced budgets and since the Medicaid program is often the state’s largest program, states can be expected to adopt or consider adopting legislation designed to reduce their Medicaid expenditures. The current economic downturn has increased the budgetary pressures on most states, and these budgetary pressures have resulted and likely will continue to result in decreased spending, or decreased spending growth, for Medicaid programs in many states. The American Recovery and Reinvestment Act of 2009 (“ARRA”) allocated approximately $87.0 billion to temporarily increase the share of program costs paid by the federal government to fund each state’s Medicaid program. Although initially scheduled to expire at the end of 2010, Congress allocated additional funds to extend this increased federal funding to states through June 2011. Although these increased funds provided a benefit to state Medicaid programs by temporarily helping to avoid more extensive program and reimbursement cuts, the expiration of the increased federal funding could result in significant reductions to state Medicaid programs.

Certain states in which we operate have adopted broad-based provider taxes to fund the non-federal share of Medicaid programs. Many states have also adopted, or are considering, legislation designed to reduce coverage, enroll Medicaid recipients in managed care programs and/or impose additional taxes on hospitals to help finance or expand the states’ Medicaid systems. Effective March 23, 2010, the Health Reform Law requires states to at least maintain Medicaid eligibility standards established prior to the enactment of the law for adults until January 1, 2014 and for children until October 1, 2019. However, states with budget deficits may seek a waiver from this requirement to address eligibility standards that apply to adults making more than 133% of the FPL.

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Through DRA 2005, Congress has expanded the federal government’s involvement in fighting fraud, waste and abuse in the Medicaid program by creating the Medicaid Integrity Program. Among other things, DRA 2005 requires CMS to employ private contractors, referred to as Medicaid Integrity Contractors (“MICs”), to perform post-payment audits of Medicaid claims and identify overpayments. MICs are assigned to five geographic regions and have commenced audits in states assigned to those regions. The Health Reform Law increases federal funding for the MIC program for federal fiscal year 2011 and later years. In addition to MICs, several other contractors and state Medicaid agencies have increased their review activities. The Health Reform Law expands the RAC program’s scope to include Medicaid claims.

Managed Medicaid

Managed Medicaid programs enable states to contract with one or more entities for patient enrollment, care management and claims adjudication. The states usually do not relinquish program responsibilities for financing, eligibility criteria and core benefit plan design. We generally contract directly with one of the designated entities, usually a managed care organization. The provisions of these programs are state-specific.

Enrollment in managed Medicaid plans has increased in recent years, as state governments seek to control the cost of Medicaid programs. However, general economic conditions in the states in which we operate may require reductions in premium payments to these plans and may reduce enrollment in these plans.

Accountable Care Organizations and Bundled Payment Initiatives

The Health Reform Law requires HHS to establish a Medicare Shared Savings Program (“MSSP”) that promotes accountability and coordination of care through the creation of Accountable Care Organizations (“ACOs”), beginning no later than January 1, 2012. The program will allow certain providers and suppliers (including hospitals, physicians and other designated professionals) to voluntarily form ACOs and work together along with other ACO participants to invest in infrastructure and redesign delivery processes to achieve high quality and efficient delivery of services. The program is intended to produce savings as a result of improved quality and operational efficiency. ACOs that achieve quality performance standards established by HHS will be eligible to share in a portion of the amounts saved by the Medicare program. HHS has significant discretion to determine key elements of the program. In 2011, CMS, the HHS Office of Inspector General (the “OIG”) and certain other federal agencies released a series of rules and guidance further defining and implementing the ACO program. These rules and guidance provide for two different ACO tracks, the first of which allows ACOs to share only in the savings under the MSSP. The second track requires ACOs to share in any savings or losses under the MSSP but offers ACOs a greater share of any savings realized under the MSSP. As authorized by the Health Reform Law, the rules and guidance also provide for certain waivers from fraud and abuse laws for ACOs. In addition, beginning January 1, 2012, CMS has authorized 32 organizations to participate in the “Pioneer” ACO program, which is similar to, but separate from, the ACOs created under the MSSP regulations.

The Health Reform Law created the Center for Medicare and Medicaid Innovation with responsibility for establishing demonstration projects and other initiatives in order to identify, develop, test and encourage the adoption of new methods of delivering and paying for healthcare that create savings under the Medicare and Medicaid programs while improving quality of care. For example, the Center for Medicare and Medicaid Innovation has announced a voluntary bundled payment initiative that will link payments to participating providers for services provided during an episode of care. In addition, the Health Reform Law requires HHS to establish a five-year, voluntary national bundled payment pilot program for Medicare services beginning no later than January 1, 2013. Under the program, providers would agree to receive one payment for services provided to Medicare patients for certain medical conditions or episodes of care. In addition, the Health Reform Law provides for a five-year bundled payment pilot program for Medicaid services. HHS may select up to eight states to participate, and these state programs may target particular categories of beneficiaries, selected diagnoses or geographic regions of the state. The selected state programs will provide one payment for both hospital and physician services provided to Medicaid patients for certain episodes of inpatient care.

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Disproportionate Share Hospital Payments

In addition to making payments for services provided directly to beneficiaries, Medicare makes additional payments to hospitals that treat a disproportionately large number of low-income patients (Medicaid and Medicare patients eligible to receive Supplemental Security Income). Disproportionate share hospital (“DSH”) payments are determined annually based on certain statistical information required by HHS and are calculated as a percentage addition to MS-DRG payments.

Under the Health Reform Law, beginning in federal fiscal year 2014, Medicare DSH payments will be reduced to 25% of the amount they otherwise would have been absent the law. The remaining 75% of the amount that would otherwise be paid under Medicare DSH will be effectively pooled, and this pool will be reduced further each year by a formula that reflects reductions in the national level of uninsured who are under 65 years of age. Each DSH hospital will then be paid, out of the reduced DSH payment pool, an amount allocated based upon its level of uncompensated care. It is difficult to predict the full impact of the Medicare DSH reductions. The CBO estimates $22 billion in reductions to Medicare DSH payments between 2010 and 2019, while for the same time period, CMS estimates reimbursement reductions totaling $50 billion.

Hospitals that provide care to a disproportionately high number of low-income patients may receive Medicaid DSH payments. The federal government distributes federal Medicaid DSH funds to each state based on a statutory formula. The states then distribute the DSH funding among qualifying hospitals. States have broad discretion to define which hospitals qualify for Medicaid DSH payments and the amount of such payments. The Health Reform Law will reduce funding for the Medicaid DSH hospital program in federal fiscal years 2014 through 2020 by the following amounts: 2014 ($500 million); 2015 ($600 million); 2016 ($600 million); 2017 ($1.8 billion); 2018 ($5 billion); 2019 ($5.6 billion); and 2020 ($4 billion). In addition, the Jobs Creation Act provides for an additional Medicaid DSH reduction of $4.1 billion in federal fiscal year 2021. How such cuts are allocated among the states and how the states allocate these cuts among providers, have yet to be determined.

TRICARE

TRICARE is the Department of Defense’s health care program for members of the armed forces. For inpatient services, TRICARE reimburses hospitals based on a DRG system modeled on the Medicare inpatient PPS. The Department of Defense has also implemented a PPS for hospital outpatient services furnished to TRICARE beneficiaries similar to that utilized for services furnished to Medicare beneficiaries. Because the Medicare outpatient PPS APC rates have historically been below TRICARE rates, the adoption of this payment methodology for TRICARE beneficiaries has reduced our reimbursement; however, TRICARE outpatient services do not represent a significant portion of our patient volumes.

Annual Cost Reports

All hospitals participating in the Medicare, Medicaid and TRICARE programs, whether paid on a reasonable cost basis or under a PPS, are required to meet certain financial reporting requirements. Federal and, where applicable, state regulations require the submission of annual cost reports covering the revenues, costs and expenses associated with the services provided by each hospital to Medicare beneficiaries and Medicaid recipients.

Annual cost reports required under the Medicare and Medicaid programs are subject to routine audits, which may result in adjustments to the amounts ultimately determined to be due to us under these reimbursement programs. These audits often require several years to reach the final determination of amounts due to or from us under these programs. Providers also have rights of appeal, and it is common to contest issues raised in audits of cost reports.

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Managed Care and Other Discounted Plans

Most of our hospitals offer discounts from established charges to certain large group purchasers of health care services, including managed care plans and private insurance companies. Admissions reimbursed by commercial managed care and other insurers were 31%, 32%, and 34% of our total admissions for the years ended December 31, 2011, 2010 and 2009, respectively. Managed care contracts are typically negotiated for terms between one and three years. While we generally received contracted annual average increases that were expected to yield 5% to 6% from managed care payers during 2011, there can be no assurance that we will continue to receive increases in the future. It is not clear what impact, if any, the increased obligations on managed care payers and other health plans imposed by the Health Reform Law will have on our ability to negotiate reimbursement increases.

Uninsured and Self-Pay Patients

A high percentage of our uninsured patients are initially admitted through our emergency rooms. For the year ended December 31, 2011, approximately 82% of our admissions of uninsured patients occurred through our emergency rooms. The Emergency Medical Treatment and Labor Act (“EMTALA”) requires any hospital that participates in the Medicare program to conduct an appropriate medical screening examination of every person who presents to the hospital’s emergency room for treatment and, if the individual is suffering from an emergency medical condition, to either stabilize that condition or make an appropriate transfer of the individual to a facility that can handle the condition. The obligation to screen and stabilize emergency medical conditions exists regardless of an individual’s ability to pay for treatment. The Health Reform Law requires health plans to reimburse hospitals for emergency services provided to enrollees without prior authorization and without regard to whether a participating provider contract is in place. Further, as enacted, the Health Reform Law contains provisions that seek to decrease the number of uninsured individuals, including requirements and incentives, which do not become effective until 2014, for individuals to obtain, and large employers to provide, insurance coverage. These mandates may reduce the financial impact of screening for and stabilizing emergency medical conditions. However, many factors are unknown regarding the impact of the Health Reform Law, including how many previously uninsured individuals will obtain coverage as a result of the law or the change, if any, in the volume of inpatient and outpatient hospital services that are sought by and provided to previously uninsured individuals and the payer mix. In addition, it is difficult to predict the full impact of the Health Reform Law due to the law’s complexity, lack of implementing regulations or interpretive guidance, gradual and potentially delayed implementation, pending court challenges and possible amendment or repeal.

Electronic Health Record Incentives

ARRA provides for Medicare and Medicaid incentive payments beginning in federal fiscal year 2011 for eligible hospitals and calendar year 2011 for eligible professionals that adopt and meaningfully use certified electronic health record (“EHR”) technology. A total of at least $20 billion in incentives is being made available through the Medicare and Medicaid EHR incentive programs to eligible hospitals and eligible professionals in the adoption of EHRs.

Under the Medicare incentive program, eligible hospitals that demonstrate meaningful use will receive incentive payments for up to four fiscal years. The Medicare incentive payment amount is the product of three factors: (1) an initial amount comprised of a base amount of $2,000,000, plus $200 for each acute care inpatient discharge, beginning with a hospital’s 1,150th discharge of the applicable year and ending with a hospital’s 23,000th discharge of the applicable year; (2) the “Medicare share,” which is the sum of Medicare Part A and Part C acute care inpatient-bed-days divided by the product of the total acute care inpatient-bed-days and a charity care factor; and (3) a transition factor applicable to the payment year. In order to maximize their incentive payments, acute care hospitals must participate in the incentive program by federal fiscal year 2013. Beginning in federal fiscal year 2015, acute care hospitals that fail to demonstrate meaningful use of certified EHR technology will receive reduced market basket updates under inpatient PPS.

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Eligible professionals who demonstrate meaningful use are entitled to incentive payments for up to five payment years in an amount equal to 75% of their estimated Medicare allowed charges for covered professional services furnished during the relevant calendar year, subject to an annual limit. Eligible professionals must participate in the incentive payment program by calendar year 2012 in order to maximize their incentive payments and must participate by calendar year 2014 in order to receive any incentive payments. Beginning in calendar year 2015, eligible professionals who do not demonstrate meaningful use of certified EHR technology will face Medicare payment reductions.

The Medicaid EHR incentive program is voluntary for states to implement. For participating states, the Medicaid EHR incentive program will provide incentive payments for acute care hospitals and eligible professionals that meet certain volume percentages of Medicaid patients, as well as children’s hospitals. Providers may only participate in a single state’s Medicaid EHR incentive program. Eligible professionals can only participate in either the Medicaid incentive program or the Medicare incentive program and can change this election only one time. Eligible hospitals may participate in both the Medicare and Medicaid incentive programs.

To qualify for incentive payments under the Medicaid program, providers must either adopt, implement, upgrade or demonstrate meaningful use of, certified EHR technology during their first participation year or successfully demonstrate meaningful use of certified EHR technology in subsequent participation years. Payments may be received for up to six participation years. For hospitals, the aggregate Medicaid EHR incentive amount is the product of two factors: (1) the overall EHR amount which is comprised of a base amount of $2,000,000 plus a discharge-related amount, multiplied by the Medicare share (which is set at one by statute) multiplied by a transition factor, and (2) the “Medicaid share,” which is the estimated Medicaid inpatient-bed days plus estimated Medicaid managed care inpatient bed-days, divided by the product of the estimated total inpatient bed-days and a charity care factor. Under the Medicaid incentive program, eligible professionals may receive payments based on their EHR costs, up to total amount of $63,750, or for pediatricians, $42,500. There is no penalty for hospitals or professionals under Medicaid for failing to meet EHR meaningful use requirements.

Hospital Utilization

We believe the most important factors relating to the overall utilization of a hospital are the quality and market position of the hospital and the number and quality of physicians and other health care professionals providing patient care within the facility. Generally, we believe the ability of a hospital to be a market leader is determined by its breadth of services, level of technology, quality and condition of the facilities, emphasis on quality of care and convenience for patients and physicians. Other factors that impact utilization include the growth in local population, local economic conditions and market penetration of managed care programs.

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The following table sets forth certain operating statistics for our health care facilities. Health care facility operations are subject to certain seasonal fluctuations, including decreases in patient utilization during holiday periods and increases in the cold weather months. The data set forth in this table includes only those facilities that are consolidated for financial reporting purposes.

	Years Ended December 31,
	2011			2010			2009			2008			2007
Number of hospitals at end of period(a)		163			156			155			158			161
Number of freestanding outpatient surgery centers at end of period(b)		108			97			97			97			99
Number of licensed beds at end of period(c)		41,594			38,827			38,839			38,504			38,405
Weighted average licensed beds(d)		39,735			38,655			38,825			38,422			39,065
Admissions(e)		1,620,400			1,554,400			1,556,500			1,541,800			1,552,700
Equivalent admissions(f)		2,595,900			2,468,400			2,439,000			2,363,600			2,352,400
Average length of stay (days)(g)		4.8			4.8			4.8			4.9			4.9
Average daily census(h)		21,123			20,523			20,650			20,795			21,049
Occupancy rate(i)		53	%		53	%		53	%		54	%		54	%
Emergency room visits(j)		6,143,500			5,706,200			5,593,500			5,246,400			5,116,100
Outpatient surgeries(k)		799,200			783,600			794,600			797,400			804,900
Inpatient surgeries(l)		484,500			487,100			494,500			493,100			516,500

(a) Excludes eight facilities in 2010, 2009, 2008 and 2007 that were not consolidated (accounted for using the equity method) for financial reporting purposes.

(b) Excludes one facility in 2011, nine facilities in 2010 and 2007 and eight facilities in 2009 and 2008 that were not consolidated (accounted for using the equity method) for financial reporting purposes.

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

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

(e) 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.

(f) 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.

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

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

(i) 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.

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

(k) 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.

(l) 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.

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Competition

Generally, other hospitals in the local communities served by most of our hospitals provide services similar to those offered by our hospitals. Additionally, in recent years the number of freestanding ASCs and diagnostic centers (including facilities owned by physicians) 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 hospitals 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 which may not be available at most of our hospitals. We also face competition from specialty hospitals, some of which are physician-owned, 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 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. The Health Reform Law requires hospitals to publish annually 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.

Another major factor in the competitive position of a hospital is our ability to negotiate service contracts with purchasers of group health care services. Managed care plans attempt to direct and control the use of hospital services and obtain discounts from hospitals’ established gross charges. In addition, 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 health care services purchasers 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 managed care contracts and enter into new managed care contracts on favorable terms. Other health care providers may impact our ability to enter into managed care contracts 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. The trend toward consolidation among non-government payers tends to increase their bargaining power over fee structures. In addition, as various provisions of the Health Reform Law are implemented, including the establishment of American Health Benefit Exchanges (“Exchanges”) and limitations on rescissions of coverage and pre-existing condition exclusions, non-government payers may increasingly demand reduced fees or be unwilling to negotiate reimbursement increases. The

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importance of obtaining contracts with managed care organizations varies from community to community, depending on the market strength of such organizations.

State certificate of need (“CON”) laws, which place limitations on a hospital’s ability to expand hospital services and facilities, make capital expenditures and otherwise make changes in operations, may also have the effect of restricting competition. We currently operate health care facilities in a number of states with CON laws. Before issuing a CON, these states consider the need for additional or expanded health care facilities or services. In those states which have no CON laws or which set relatively high levels of expenditures before they become reviewable by state authorities, competition in the form of new services, facilities and capital spending is more prevalent. See Item 1, “Business — Regulation and Other Factors.”

We and the health care industry as a whole face the challenge of continuing to provide quality patient care while dealing with rising costs and strong competition for patients. Changes in medical technology, existing and future legislation, regulations and interpretations and managed care contracting for provider services by private and government payers remain ongoing challenges.

Admissions, average lengths of stay and reimbursement amounts continue to be negatively affected by payer-required pre-admission authorization, utilization review and payer pressure to maximize outpatient and alternative health care delivery services for less acutely ill patients. The Health Reform Law potentially expands the use of prepayment review by Medicare contractors by eliminating statutory restrictions on their use. Increased competition, admission constraints and payer pressures are expected to continue. To meet these challenges, we intend to expand and update our facilities or acquire or construct new facilities where appropriate, to enhance the provision of a comprehensive array of outpatient services, offer market competitive pricing to private payer groups, upgrade facilities and equipment and offer new or expanded programs and services.

Regulation and Other Factors

Licensure, Certification and Accreditation

Health care facility construction and operation are subject to numerous federal, state and local regulations relating to the adequacy of medical care, equipment, personnel, operating policies and procedures, maintenance of adequate records, fire prevention, rate-setting and compliance with building codes and environmental protection laws. Facilities are subject to periodic inspection by governmental and other authorities to assure continued compliance with the various standards necessary for licensing and accreditation. We believe our health care facilities are properly licensed under applicable state laws. Each of our acute care hospitals is certified for participation in the Medicare and Medicaid programs and is accredited by The Joint Commission. If any facility were to lose its Medicare or Medicaid certification, the facility would be unable to receive reimbursement from federal health care programs. If any facility were to lose accreditation by The Joint Commission, the facility would be subject to state surveys, potentially be subject to increased scrutiny by CMS and likely lose payment from non-government payers. Management believes our facilities are in substantial compliance with current applicable federal, state, local and independent review body regulations and standards. The requirements for licensure, certification and accreditation are subject to change and, in order to remain qualified, it may become necessary for us to make changes in our facilities, equipment, personnel and services. The requirements for licensure, certification and accreditation also include notification or approval in the event of the transfer or change of ownership or certain other changes. Failure to provide required notifications or obtain necessary approvals in these circumstances can result in the inability to complete an acquisition or change of ownership, loss of licensure or other penalties.

Certificates of Need

In some states where we operate hospitals and other health care facilities, the construction or expansion of health care facilities, the acquisition of existing facilities, the transfer or change of ownership and the addition of

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new beds or services may be subject to review by and prior approval of, or notifications to, state regulatory agencies under a CON program. Such laws generally require the reviewing state agency to determine the public need for additional or expanded health care facilities and services. Failure to provide required notifications or obtain necessary state approvals can result in the inability to expand facilities, complete an acquisition or change ownership or other penalties.

State Rate Review

Some states have adopted legislation mandating rate or budget review for hospitals or have adopted taxes on hospital revenues, assessments or licensure fees to fund indigent health care within the state. In the aggregate, indigent tax provisions have not materially, adversely affected our results of operations. Although we do not currently operate facilities in states that mandate rate or budget reviews, we cannot predict whether we will operate in such states in the future, or whether the states in which we currently operate may adopt legislation mandating such reviews.

Federal Health Care Program Regulations

Participation in any federal health care program, including the Medicare and Medicaid programs, is heavily regulated by statute and regulation. If a hospital fails to substantially comply with the numerous conditions of participation in the Medicare and Medicaid programs or performs certain prohibited acts, the hospital’s participation in the federal health care programs may be terminated, or civil and/or criminal penalties may be imposed.

Anti-kickback Statute

A section of the Social Security Act known as the “Anti-kickback Statute” prohibits providers and others from directly or indirectly soliciting, receiving, offering or paying any remuneration with the intent of generating referrals or orders for services or items covered by a federal health care program. Courts have interpreted this statute broadly and held that there is a violation of the Anti-kickback Statute if just one purpose of the remuneration is to generate referrals, even if there are other lawful purposes. Furthermore, the Health Reform Law provides that knowledge of the law or the intent to violate the law is not required. Violations of the Anti-kickback Statute may be punished by a criminal fine of up to $25,000 for each violation or imprisonment, civil money penalties of up to $50,000 per violation and damages of up to three times the total amount of the remuneration and/or exclusion from participation in federal health care programs, including Medicare and Medicaid. The Health Reform Law provides that submission of a claim for services or items generated in violation of the Anti-kickback Statute constitutes a false or fraudulent claim and may be subject to additional penalties under the federal False Claims Act (“FCA”).

The OIG, among other regulatory agencies, is responsible for identifying and eliminating fraud, abuse and waste. The OIG carries out this mission through a nationwide program of audits, investigations and inspections. The OIG provides guidance to the industry through various methods including advisory opinions and “Special Fraud Alerts.” These Special Fraud Alerts do not have the force of law, but identify features of arrangements or transactions that the government believes may cause the arrangements or transactions to violate the Anti-kickback Statute or other federal health care laws. The OIG has identified several incentive arrangements that constitute suspect practices, including: (a) payment of any incentive by a hospital each time a physician refers a patient to the hospital, (b) the use of free or significantly discounted office space or equipment in facilities usually located close to the hospital, (c) provision of free or significantly discounted billing, nursing or other staff services, (d) free training for a physician’s office staff in areas such as management techniques and laboratory techniques, (e) guarantees which provide, if the physician’s income fails to reach a predetermined level, the hospital will pay any portion of the remainder, (f) low-interest or interest-free loans, or loans which may be forgiven if a physician refers patients to the hospital, (g) payment of the costs of a physician’s travel and expenses for conferences, (h) coverage on the hospital’s group health insurance plans at an inappropriately low cost to the physician, (i) payment for services (which may include consultations at the hospital) which require few, if any, substantive duties by the physician, (j) purchasing goods or services from physicians at prices in

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excess of their fair market value, and (k) rental of space in physician offices, at other than fair market value terms, by persons or entities to which physicians refer. The OIG has encouraged persons having information about hospitals who offer the above types of incentives to physicians to report such information to the OIG.

The OIG also issues Special Advisory Bulletins as a means of providing guidance to health care providers. These bulletins, along with the Special Fraud Alerts, have focused on certain arrangements that could be subject to heightened scrutiny by government enforcement authorities, including: (a) contractual joint venture arrangements and other joint venture arrangements between those in a position to refer business, such as physicians, and those providing items or services for which Medicare or Medicaid pays, and (b) certain “gainsharing” arrangements, i.e., the practice of giving physicians a share of any reduction in a hospital’s costs for patient care attributable in part to the physician’s efforts.

In addition to issuing Special Fraud Alerts and Special Advisory Bulletins, the OIG issues compliance program guidance for certain types of health care providers. The OIG guidance identifies a number of risk areas under federal fraud and abuse statutes and regulations. These areas of risk include compensation arrangements with physicians, recruitment arrangements with physicians and joint venture relationships with physicians.

As authorized by Congress, the OIG has published safe harbor regulations that outline categories of activities deemed protected from prosecution under the Anti-kickback Statute. Currently, there are statutory exceptions and safe harbors for various activities, including the following: certain investment interests, space rental, equipment rental, practitioner recruitment, personnel services and management contracts, sale of practice, referral services, warranties, discounts, employees, group purchasing organizations, waiver of beneficiary coinsurance and deductible amounts, managed care arrangements, obstetrical malpractice insurance subsidies, investments in group practices, freestanding surgery centers, ambulance replenishing, and referral agreements for specialty services.

The fact that conduct or a business arrangement does not fall within a safe harbor, or it is identified in a Special Fraud Alert, Special Advisory Bulletin or other guidance or as a risk area in the Supplemental Compliance Guidelines for Hospitals, does not necessarily render the conduct or business arrangement illegal under the Anti-kickback Statute. However, such conduct and business arrangements may lead to increased scrutiny by government enforcement authorities.

We have a variety of financial relationships with physicians and others who either refer or influence the referral of patients to our hospitals and other health care facilities, including employment contracts, leases, medical director agreements and professional service agreements. We also have similar relationships with physicians and facilities to which patients are referred from our facilities. In addition, we provide financial incentives, including minimum revenue guarantees, to recruit physicians into the communities served by our hospitals. While we endeavor to comply with the applicable safe harbors, certain of our current arrangements, including joint ventures and financial relationships with physicians and other referral sources and persons and entities to which we refer patients, do not qualify for safe harbor protection.

Although we believe our arrangements with physicians and other referral sources have been structured to comply with current law and available interpretations, there can be no assurance regulatory authorities enforcing these laws will determine these financial arrangements comply with the Anti-kickback Statute or other applicable laws. An adverse determination could subject us to liabilities under the Social Security Act and other laws, including criminal penalties, civil monetary penalties and exclusion from participation in Medicare, Medicaid or other federal health care programs.

Stark Law

The Social Security Act also includes a provision commonly known as the “Stark Law.” The Stark Law prohibits physicians from referring Medicare and Medicaid patients to entities with which they or any of their

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immediate family members have a financial relationship, if these entities provide certain “designated health services” reimbursable by Medicare or Medicaid unless an exception applies. The Stark Law also prohibits entities that provide designated health services reimbursable by Medicare and Medicaid from billing the Medicare and Medicaid programs for any items or services that result from a prohibited referral and requires the entities to refund amounts received for items or services provided pursuant to the prohibited referral. “Designated health services” include inpatient and outpatient hospital services, clinical laboratory services and radiology services. Sanctions for violating the Stark Law include denial of payment, civil monetary penalties of up to $15,000 per claim submitted and exclusion from the federal health care programs. The statute also provides for a penalty of up to $100,000 for a circumvention scheme. There are exceptions to the self-referral prohibition for many of the customary financial arrangements between physicians and providers, including employment contracts, leases and recruitment agreements. Unlike safe harbors under the Anti-kickback Statute with which compliance is voluntary, an arrangement must comply with every requirement of a Stark Law exception or the arrangement is in violation of the Stark Law. Although there is an exception for a physician’s ownership interest in an entire hospital, the Health Reform Law prohibits newly created physician-owned hospitals from billing for Medicare patients referred by their physician owners. As a result, the law effectively prevents the formation of new physician-owned hospitals after December 31, 2010. While the Health Reform Law grandfathers existing physician-owned hospitals, it does not allow these hospitals to increase the percentage of physician ownership and significantly restricts their ability to expand services.

Through a series of rulemakings, CMS has issued final regulations implementing the Stark Law. Additional changes to these regulations, which became effective October 1, 2009, further restrict the types of arrangements facilities and physicians may enter, including additional restrictions on certain leases, percentage compensation arrangements, and agreements under which a hospital purchases services “under arrangements.” While these regulations were intended to clarify the requirements of the exceptions to the Stark Law, it is unclear how the government will interpret many of these exceptions for enforcement purposes. Further, we do not always have the benefit of significant regulatory or judicial interpretation of the Stark Law and its implementing regulations. We attempt to structure our relationships to meet an exception to the Stark Law, but the regulations implementing the exceptions are detailed and complex, and we cannot assure that every relationship complies fully with the Stark Law.

Similar State Laws

Many states in which we operate also have laws similar to the Anti-kickback Statute that prohibit payments to physicians for patient referrals and laws similar to the Stark Law that prohibit certain self-referrals. The scope of these state laws is broad, since they can often apply regardless of the source of payment for care, and little precedent exists for their interpretation or enforcement. These statutes typically provide for criminal and civil penalties, as well as loss of facility licensure.

Other Fraud and Abuse Provisions

HIPAA broadened the scope of certain fraud and abuse laws by adding several criminal provisions for health care fraud offenses that apply to all health benefit programs. The Social Security Act also imposes criminal and civil penalties for making false claims and statements to Medicare and Medicaid. False claims include, but are not limited to, billing for services not rendered or for misrepresenting actual services rendered in order to obtain higher reimbursement, billing for unnecessary goods and services and cost report fraud. Federal enforcement officials have the ability to exclude from Medicare and Medicaid any investors, officers and managing employees associated with business entities that have committed health care fraud, even if the officer or managing employee had no knowledge of the fraud. Criminal and civil penalties may be imposed for a number of other prohibited activities, including failure to return known overpayments, certain gainsharing arrangements, billing Medicare amounts that are substantially in excess of a provider’s usual charges, offering remuneration to influence a Medicare or Medicaid beneficiary’s selection of a health care provider, contracting with an individual or entity known to be excluded from a federal health care program, making or accepting a payment to induce a physician to reduce or limit services, and soliciting or receiving any remuneration in return for referring an

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individual for an item or service payable by a federal health care program. Like the Anti-kickback Statute, these provisions are very broad. Under the Health Reform Law, civil penalties may be imposed for the failure to report and return an overpayment within 60 days of identifying the overpayment or by the date a corresponding cost report is due, whichever is later. To avoid liability, providers must, among other things, carefully and accurately code claims for reimbursement, promptly return overpayments and accurately prepare cost reports.

Some of these provisions, including the federal Civil Monetary Penalty Law, require a lower burden of proof than other fraud and abuse laws, including the Anti-kickback Statute. Civil monetary penalties that may be imposed under the federal Civil Monetary Penalty Law range from $10,000 to $50,000 per act, and in some cases may result in penalties of up to three times the remuneration offered, paid, solicited or received. In addition, a violator may be subject to exclusion from federal and state health care programs. Federal and state governments increasingly use the federal Civil Monetary Penalty Law, especially where they believe they cannot meet the higher burden of proof requirements under the Anti-kickback Statute. Further, individuals can receive up to $1,000 for providing information on Medicare fraud and abuse that leads to the recovery of at least $100 of Medicare funds under the Medicare Integrity Program.

The Federal False Claims Act and Similar State Laws

The qui tam, or whistleblower, provisions of the FCA allow private individuals to bring actions on behalf of the government alleging that the defendant has defrauded the federal government. Further, the government may use the FCA to prosecute Medicare and other government program fraud in areas such as coding errors, billing for services not provided and submitting false cost reports. When a private party brings a qui tam action under the FCA, the defendant is not made aware of the lawsuit until the government commences its own investigation or makes a determination whether it will intervene. If a defendant is determined by a court of law to be liable under the FCA, the defendant may be required to pay three times the actual damages sustained by the government, plus mandatory civil penalties of between $5,500 and $11,000 for each separate false claim. There are many potential bases for liability under the FCA. Liability often arises when an entity knowingly submits a false claim for reimbursement to the federal government. The FCA defines the term “knowingly” broadly. Though simple negligence will not give rise to liability under the FCA, submitting a claim with reckless disregard to its truth or falsity constitutes a “knowing” submission under the FCA and, therefore, may create liability. The Fraud Enforcement and Recovery Act of 2009 expanded the scope of the FCA by, among other things, creating liability for knowingly and improperly avoiding repayment of an overpayment received from the government and broadening protections for whistleblowers. Under the Health Reform Law, the FCA is implicated by the knowing failure to report and return an overpayment within 60 days of identifying the overpayment or by the date a corresponding cost report is due, whichever is later. Further, the Health Reform Law expands the scope of the FCA to cover payments in connection with the Exchanges to be created by the Health Reform Law, if those payments include any federal funds.

In some cases, whistleblowers and the federal government have taken the position, and some courts have held, that providers who allegedly have violated other statutes, such as the Anti-kickback Statute and the Stark Law, have thereby submitted false claims under the FCA. The Health Reform Law clarifies this issue with respect to the Anti-kickback Statute by providing that submission of claims for services or items generated in violation of the Anti-kickback Statute constitutes a false or fraudulent claim under the FCA. Every entity that receives at least $5 million annually in Medicaid payments must have written policies for all employees, contractors or agents, providing detailed information about false claims, false statements and whistleblower protections under certain federal laws, including the FCA, and similar state laws. In addition, federal law provides an incentive to states to enact false claims laws comparable to the FCA. A number of states in which we operate have adopted their own false claims provisions as well as their own whistleblower provisions under which a private party may file a civil lawsuit in state court. We have adopted and distributed policies pertaining to the FCA and relevant state laws.

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HIPAA Administrative Simplification and Privacy and Security Requirements

The Administrative Simplification Provisions of HIPAA require the use of uniform electronic data transmission standards for certain health care claims and payment transactions submitted or received electronically. These provisions are intended to encourage electronic commerce in the health care industry. HHS has issued regulations implementing the HIPAA Administrative Simplification Provisions and compliance with these regulations is mandatory for our facilities. The Health Reform Law requires HHS to adopt standards for additional electronic transactions and to establish operating rules to promote uniformity in the implementation of each standardized electronic transaction. In addition, HIPAA requires that each provider use a National Provider Identifier. CMS has also published a final rule requiring the use of updated standard code sets for certain diagnoses and procedures known as ICD-10 code sets. Implementing the ICD-10 code sets will require significant administrative changes. By regulation, use of the ICD-10 code sets is required beginning October 1, 2013, but CMS has announced that it intends to extend this deadline.

The privacy and security regulations promulgated pursuant to HIPAA extensively regulate the use and disclosure of individually identifiable health information and require covered entities, including health plans and most health care providers, to implement administrative, physical and technical safeguards to protect the security of such information. ARRA broadened the scope of the HIPAA privacy and security regulations. In addition, ARRA extends the application of certain provisions of the security and privacy regulations to business associates (entities that handle identifiable health information on behalf of covered entities) and subjects business associates to civil and criminal penalties for violation of the regulations. On July 14, 2010, HHS issued a proposed rule that would implement many of these ARRA provisions. If finalized, these changes would likely require amendments to existing agreements with business associates and would subject business associates and their subcontractors to direct liability under the HIPAA privacy and security regulations. We currently enforce a HIPAA compliance plan, which we believe complies with HIPAA privacy and security requirements and under which a HIPAA compliance group monitors our compliance. The privacy regulations and security regulations have and will continue to impose significant costs on our facilities in order to comply with these standards.

As required by ARRA, HHS published an interim final rule on August 24, 2009, that requires covered entities to report breaches of unsecured protected health information to affected individuals without unreasonable delay but not to exceed 60 days of discovery of the breach by a covered entity or its agents. Notification must also be made to HHS and, in certain situations involving large breaches, to the media. HHS is required to publish on its website a list of all covered entities that report a breach involving more than 500 individuals. Various state laws and regulations may also require us to notify affected individuals in the event of a data breach involving individually identifiable information.

Violations of the HIPAA privacy and security regulations may result in civil and criminal penalties, and ARRA has strengthened the enforcement provisions of HIPAA, which may result in increased enforcement activity. As required by ARRA, HHS has announced a pilot program to perform audits of up to 150 covered entities by the end of 2012. ARRA broadens the applicability of the criminal penalty provisions to employees of covered entities and requires HHS to impose penalties for violations resulting from willful neglect. ARRA also significantly increases the amount of the civil penalties, with penalties of up to $50,000 per violation for a maximum civil penalty of $1,500,000 in a calendar year for violations of the same requirement. In addition, ARRA authorizes state attorneys general to bring civil actions seeking either injunction or damages in response to violations of HIPAA privacy and security regulations that threaten the privacy of state residents.

There are numerous other laws and legislative and regulatory initiatives at the federal and state levels addressing privacy and security concerns. Our facilities remain subject to any federal or state privacy-related laws that are more restrictive than the privacy regulations issued under HIPAA. These laws vary and could impose additional penalties.

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EMTALA

All of our hospitals in the United States are subject to EMTALA. This federal law requires any hospital participating in the Medicare program to conduct an appropriate medical screening examination of every individual who presents to the hospital’s emergency room for treatment and, if the individual is suffering from an emergency medical condition, to either stabilize the condition or make an appropriate transfer of the individual to a facility able to handle the condition. The obligation to screen and stabilize emergency medical conditions exists regardless of an individual’s ability to pay for treatment. There are severe penalties under EMTALA if a hospital fails to screen or appropriately stabilize or transfer an individual or if the hospital delays appropriate treatment in order to first inquire about the individual’s ability to pay. Penalties for violations of EMTALA include civil monetary penalties and exclusion from participation in the Medicare program. In addition, an injured individual, the individual’s family or a medical facility that suffers a financial loss as a direct result of a hospital’s violation of the law can bring a civil suit against the hospital.

The government broadly interprets EMTALA to cover situations in which individuals do not actually present to a hospital’s emergency room, but present for emergency examination or treatment to the hospital’s campus, generally, or to a hospital-based clinic that treats emergency medical conditions or are transported in a hospital-owned ambulance, subject to certain exceptions. At least one court has interpreted the law also to apply to a hospital that has been notified of a patient’s pending arrival in a non-hospital owned ambulance. EMTALA does not generally apply to individuals admitted for inpatient services. The government has expressed its intent to investigate and enforce EMTALA violations actively in the future. We believe our hospitals operate in substantial compliance with EMTALA.

Corporate Practice of Medicine/Fee Splitting

Some of the states in which we operate have laws prohibiting corporations and other entities from employing physicians, practicing medicine for a profit and making certain direct and indirect payments or fee-splitting arrangements between health care providers designed to induce or encourage the referral of patients to, or the recommendation of, particular providers for medical products and services. Possible sanctions for violation of these restrictions include loss of license and civil and criminal penalties. In addition, agreements between the corporation and the physician may be considered void and unenforceable. These statutes vary from state to state, are often vague and have seldom been interpreted by the courts or regulatory agencies.

Health Care Industry Investigations

Significant media and public attention has focused in recent years on the hospital industry. This media and public attention, changes in government personnel or other factors may lead to increased scrutiny of the health care industry. Except as may be disclosed in our SEC filings, we are not aware of any material investigations of the Company under federal or state health care laws or regulations. It is possible that governmental entities could initiate investigations or litigation in the future at facilities we operate and that such matters could result in significant penalties, as well as adverse publicity. It is also possible that our executives and managers could be included in governmental investigations or litigation or named as defendants in private litigation.

Our substantial Medicare, Medicaid and other governmental billings result in heightened scrutiny of our operations. We continue to monitor all aspects of our business and have developed a comprehensive ethics and compliance program that is designed to meet or exceed applicable federal guidelines and industry standards. Because the law in this area is complex and constantly evolving, governmental investigations or litigation may result in interpretations that are inconsistent with our or industry practices.

In public statements surrounding current investigations, governmental authorities have taken positions on a number of issues, including some for which little official interpretation previously has been available, that appear to be inconsistent with practices that have been common within the industry and that previously have not been challenged in this manner. In some instances, government investigations that have in the past been conducted under the civil provisions of federal law may now be conducted as criminal investigations.

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Both federal and state government agencies have increased their focus on and coordination of civil and criminal enforcement efforts in the health care area. The OIG and the Department of Justice (“DOJ”) have, from time to time, established national enforcement initiatives, targeting all hospital providers that focus on specific billing practices or other suspected areas of abuse. The Health Reform Law includes additional federal funding of $350 million over the next 10 years to fight health care fraud, waste and abuse, including $105 million for federal fiscal year 2011 and $65 million in federal fiscal year 2012. In addition, governmental agencies and their agents, such as MACs, fiscal intermediaries and carriers, may conduct audits of our health care operations. Private payers may conduct similar post-payment audits, and we also perform internal audits and monitoring.

In addition to national enforcement initiatives, federal and state investigations have addressed a wide variety of routine health care operations such as: cost reporting and billing practices, including for Medicare outliers; financial arrangements with referral sources; physician recruitment activities; physician joint ventures; and hospital charges and collection practices for self-pay patients. We engage in many of these routine health care operations and other activities that could be the subject of governmental investigations or inquiries. For example, we have significant Medicare and Medicaid billings, numerous financial arrangements with physicians who are referral sources to our hospitals, and joint venture arrangements involving physician investors. Certain of our individual facilities have received, and other facilities may receive, government inquiries from, and may be subject to investigation by, federal and state agencies. Any additional investigations of the Company, our executives or managers could result in significant liabilities or penalties to us, as well as adverse publicity.

Health Care Reform

As enacted, the Health Reform Law will change how health care services are covered, delivered and reimbursed through expanded coverage of uninsured individuals, reduced growth in Medicare program spending, reductions in Medicare and Medicaid DSH payments, and the establishment of programs where reimbursement is tied to quality and integration. In addition, the law reforms certain aspects of health insurance, expands existing efforts to tie Medicare and Medicaid payments to performance and quality, and contains provisions intended to strengthen fraud and abuse enforcement. Numerous lawsuits have challenged the constitutionality of the Health Reform Law. Some federal courts have upheld the constitutionality of the Health Reform Law or dismissed cases on procedural grounds. Others have held unconstitutional the requirement that individuals maintain health insurance or pay a penalty and have either found the Health Reform Law void in its entirety or left the remainder of the law intact. The U.S. Supreme Court is expected to decide the constitutionality of the Health Reform Law in 2012. Based on the outcome of the U.S. Supreme Court’s review, the Health Reform Law, or individual components of it, may be upheld, invalidated or modified. In addition, repeal of the Health Reform Law has become a theme in political campaigns during this election year.

Expanded Coverage

Based on CBO and CMS estimates made prior to enactment of the Health Reform Law, by 2019, the Health Reform Law will expand coverage to 32 to 34 million additional individuals (resulting in coverage of an estimated 94% of the legal U.S. population). This increased coverage will occur through a combination of public program expansion and private sector health insurance and other reforms.

Medicaid Expansion

The primary public program coverage expansion will occur through changes in Medicaid, and to a lesser extent, expansion of the Children’s Health Insurance Program (“CHIP”). The most significant changes will expand the categories of individuals eligible for Medicaid coverage and permit individuals with relatively higher incomes to qualify. The federal government reimburses the majority of a state’s Medicaid expenses, and it conditions its payment on the state meeting certain requirements. The federal government currently requires that states provide coverage for only limited categories of low-income adults under 65 years old (e.g., women who are pregnant, and the blind or disabled). In addition, the income level required for individuals and families to qualify for Medicaid varies widely from state to state.

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The Health Reform Law materially changes the requirements for Medicaid eligibility. Commencing January 1, 2014, all state Medicaid programs are required to provide, and the federal government will subsidize, Medicaid coverage to virtually all adults under 65 years old with incomes at or under 133% of the federal poverty level (“FPL”). This expansion will create a minimum Medicaid eligibility threshold that is uniform across states. Further, the Health Reform Law also requires states to apply a “5% income disregard” to the Medicaid eligibility standard, so that Medicaid eligibility will effectively be extended to those with incomes up to 138% of the FPL. According to the CBO’s March 2011 projection, the new eligibility requirements will expand Medicaid and CHIP coverage by an estimated 17 million persons nationwide. A disproportionately large percentage of the new Medicaid coverage is likely to be in states that currently have relatively low income eligibility requirements.

As Medicaid is a joint federal and state program, the federal government provides states with “matching funds” in a defined percentage, known as the federal medical assistance percentage (“FMAP”). Beginning in 2014, states will receive an enhanced FMAP for the individuals enrolled in Medicaid pursuant to the Health Reform Law. The FMAP percentage is as follows: 100% for calendar years 2014 through 2016; 95% for 2017; 94% in 2018; 93% in 2019; and 90% in 2020 and thereafter.

The Health Reform Law also provides that the federal government will subsidize states that create non-Medicaid plans for residents whose incomes are greater than 133% of the FPL but do not exceed 200% of the FPL. Approved state plans will be eligible to receive federal funding. The amount of that funding per individual will be equal to 95% of subsidies that would have been provided for that individual had he or she enrolled in a health plan offered through one of the Exchanges, as discussed below.

Historically, states often have attempted to reduce Medicaid spending by limiting benefits and tightening Medicaid eligibility requirements. However, the Health Reform Law requires states to at least maintain Medicaid eligibility standards established prior to the enactment of the law for adults until January 1, 2014 and for children until October 1, 2019. States with budget deficits may seek a waiver from this requirement, but only to address eligibility standards that apply to adults making more than 133% of the FPL.

Private Sector Expansion

The expansion of health coverage through the private sector as a result of the Health Reform Law will occur through new requirements applicable to health insurers, employers and individuals. Health insurers must keep their annual nonmedical costs lower than 15% of premium revenue for the group market and lower than 20% in the small group and individual markets or rebate to enrollees the amount spent in excess of the percentage. In addition, health insurers are not permitted to deny coverage to children based upon a pre-existing condition and must allow dependent care coverage for children up to 26 years old. Commencing January 1, 2014, health insurers will be prohibited from imposing annual coverage limits, dropping coverage, excluding persons based upon pre-existing conditions or denying coverage for any individual who is willing to pay the premiums for such coverage.

Larger employers will be subject to new requirements and incentives to provide health insurance benefits to their full time employees. Effective January 1, 2014, employers with 50 or more employees that do not offer health insurance will be held subject to a penalty if an employee obtains government-subsidized coverage through an Exchange. The employer penalties will range from $2,000 to $3,000 per employee, subject to certain thresholds and conditions.

As enacted, the Health Reform Law uses various means to induce individuals who do not have health insurance to obtain coverage. By January 1, 2014, individuals will be required to maintain health insurance for a minimum defined set of benefits or pay a tax penalty. The penalty in most cases is $95 in 2014, $325 in 2015, $695 in 2016, and indexed to a cost of living adjustment in subsequent years. The Internal Revenue Service (“IRS”), in consultation with HHS, is responsible for enforcing the tax penalty, although the Health Reform Law

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limits the availability of certain IRS enforcement mechanisms. In addition, for individuals and families below 400% of the FPL, the cost of obtaining health insurance through the Exchanges will be subsidized by the federal government. Those with lower incomes will be eligible to receive greater subsidies. It is anticipated that those at the lowest income levels will have the majority of their premiums subsidized by the federal government, in some cases in excess of 95% of the premium amount.

To facilitate the purchase of health insurance by individuals and small employers, each state must establish an Exchange by January 1, 2014. Based on CBO estimates issued in March 2011, approximately 24 million individuals will obtain their health insurance coverage through an Exchange by 2021. This amount will include individuals who were previously uninsured and individuals who have switched from their prior insurance coverage to a plan obtained through the Exchange. The Health Reform Law requires that the Exchanges be designed to make the process of evaluating, comparing and acquiring coverage simple for consumers. For example, each state’s Exchange must maintain an internet website through which consumers may access health plan ratings that are assigned by the state based on quality and price, view governmental health program eligibility requirements and calculate the actual cost of health coverage. Health insurers participating in an Exchange must offer a set of minimum benefits to be defined by HHS and may offer more benefits. Health insurers must offer at least two, and up to five, levels of plans that vary by the percentage of medical expenses that must be paid by the enrollee. These levels are referred to as platinum, gold, silver, bronze and catastrophic plans, with gold and silver being the two mandatory levels of plans. Each level of plan must require the enrollee to share the following percentages of medical expenses up to the deductible/copayment limit: platinum, 10%; gold, 20%; silver, 30%; bronze, 40%; and catastrophic, 100%. Health insurers may establish varying deductible/copayment levels, up to the statutory maximum (estimated to be between $6,000 and $7,000 for an individual). The health insurers must cover 100% of the amount of medical expenses in excess of the deductible/copayment limit. For example, an individual making 100% to 200% of the FPL will have copayments and deductibles reduced to about one-third of the amount payable by those with the same plan with incomes at or above 400% of the FPL.

Public Program Spending

The Health Reform Law provides for Medicare, Medicaid and other federal health care program spending reductions between 2010 and 2019. In March 2010, CMS estimated Medicare fee-for-service reductions from 2010 to 2019 would be $233 billion and the Medicare and Medicaid DSH reductions would be an additional $64 billion. In February 2011, the CBO estimated that from 2012 to 2021, the Health Reform Law reductions would include $379 billion in Medicare fee-for-service market basket and productivity reimbursement reductions, the majority of which will come from hospitals. The CBO estimate included an additional $57 billion in reductions in Medicare and Medicaid DSH funding.

Payments for Hospitals and Ambulatory Surgery Centers

Inpatient Market Basket and Productivity Adjustment.    Under the Medicare program, hospitals receive reimbursement under a PPS for general, acute care hospital inpatient services. CMS establishes fixed PPS payment amounts per inpatient discharge based on the patient’s assigned MS-DRG. These MS-DRG rates are updated each federal fiscal year, which begins October 1, using a market basket index that takes into account inflation experienced by hospitals and other entities outside the health care industry in purchasing goods and services.

The Health Reform Law provides for three types of annual reductions in the market basket. The first is a general reduction of a specified percentage each federal fiscal year starting in 2010 and extending through 2019. These reductions are as follows: federal fiscal year 2010, 0.25% for discharges occurring on or after April 1, 2010; 2011 (0.25%); 2012 (0.1%); 2013 (0.1%); 2014 (0.3%); 2015 (0.2%); 2016 (0.2%); 2017 (0.75%); 2018 (0.75%); and 2019 (0.75%).

The second type of reduction to the market basket is a “productivity adjustment” that was implemented by HHS beginning in federal fiscal year 2012. The amount of that reduction is the projected nationwide productivity

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gains over the preceding 10 years. To determine the projection, HHS uses the BLS 10-year moving average of changes in specified economy-wide productivity (the BLS data is typically a few years old). The Health Reform Law does not contain guidelines for HHS to use in projecting the productivity figure. For federal fiscal year 2012, CMS has announced a negative 1.0% productivity adjustment to the market basket. CMS estimates that the combined market basket and productivity adjustments will reduce Medicare payments under the inpatient PPS by $112.6 billion from 2010 to 2019.

The third type of reduction is in connection with the value-based purchasing program discussed in more detail below. Beginning in federal fiscal year 2013, CMS will reduce the inpatient PPS payment amount for all discharges by the following: 1% for 2013; 1.25% for 2014; 1.5% for 2015; 1.75% for 2016; and 2% for 2017 and subsequent years. For each federal fiscal year, the total amount collected from these reductions will be pooled and used to fund payments to hospitals that satisfy certain quality metrics. While some or all of these reductions may be recovered if a hospital satisfies these quality metrics, the recovery amounts may be delayed.

If the aggregate of the three market basket reductions described above is more than the annual market basket adjustments made to account for inflation, there will be a reduction in the MS-DRG rates paid to hospitals. For example, for the federal fiscal year 2011 hospital inpatient PPS, the market basket increase to account for inflation was 2.6% and the aggregate reduction due to the Health Reform Law and the documentation and coding adjustment was 3.15%. Thus, the rates paid to a hospital for inpatient services in federal fiscal year 2011 were 0.55% less than rates paid for the same services in the prior year.

Quality-Based Payment Adjustments and Reductions for Inpatient Services.    The Health Reform Law establishes or expands three provisions to promote value-based purchasing and to link payments to quality and efficiency. First, in federal fiscal year 2013, HHS is directed to implement a value-based purchasing program for inpatient hospital services. This program will reward hospitals that meet certain quality performance standards established by HHS. The Health Reform Law provides HHS considerable discretion over the value-based purchasing program. On April 29, 2011, CMS issued a final rule establishing the value-based purchasing program for hospital inpatient services. Under this final rule, CMS states that it estimates it will distribute $850 million in federal fiscal year 2013 to hospitals based on their overall performance on a set of quality measures that have been linked to improved clinical processes of care and patient satisfaction. For payments in federal fiscal year 2013, hospitals will be scored based on a weighted average of patient experience scores using the Hospital Consumer Assessment of Healthcare Providers and Systems survey and 12 clinical process-of-care measures. CMS will score each hospital based on achievement (relative to other hospitals) and improvement ranges (relative to the hospital’s own past performance) for each applicable measure. Because the Health Reform Law provides that the pool will be fully distributed, hospitals that meet or exceed the quality performance standards set by HHS will receive greater reimbursement under the value-based purchasing program than they would have otherwise. Hospitals that do not achieve the necessary quality performance will receive reduced Medicare inpatient hospital payments. CMS will notify each hospital of the amount of its value-based incentive payment for fiscal year 2013 discharges on November 1, 2012.

Second, beginning in federal fiscal year 2013, inpatient payments will be reduced if a hospital experiences “excessive readmissions” within the 30-day period from the date of discharge for heart attack, heart failure, pneumonia or other conditions that may be designated by CMS. Hospitals with what CMS defines as “excessive readmissions” for these conditions will receive reduced payments for all inpatient discharges, not just discharges relating to the conditions subject to the excessive readmission standard. Each hospital’s performance will be publicly reported by CMS. On August 1, 2011, CMS issued a final rule implementing portions of this program but indicated that it will issue in future rulemakings additional policies with respect to excessive readmissions, including the specific payment adjustment methodology.

Third, reimbursement will be reduced based on a facility’s HAC rates. An HAC is a condition that is acquired by a patient while admitted as an inpatient in a hospital, such as a surgical site infection. Beginning in federal fiscal year 2015, the 25% of hospitals with the worst national risk-adjusted HAC rates in the previous

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year will receive a 1% reduction in their total inpatient operating Medicare payments. In addition, effective July 1, 2011, the Health Reform Law prohibits the use of federal funds under the Medicaid program to reimburse providers for medical services provided to treat HACs. However, CMS has delayed enforcement of this prohibition until July 1, 2012. In a final rule issued June 1, 2011, CMS authorizes states to add additional provider-preventable conditions to the list of HACs for which Medicaid reimbursement will not be allowed.

Outpatient Market Basket and Productivity Adjustment.    Hospital outpatient services paid under PPS are classified into APCs. The APC payment rates are updated each calendar year based on the market basket. The first two market basket changes outlined above — the general reduction and the productivity adjustment — apply to outpatient services as well as inpatient services, although these are applied on a calendar year basis. The percentage changes specified in the Health Reform Law summarized above as the general reduction for inpatients — e.g., 0.2% in 2015 — are the same for outpatients.

Medicare and Medicaid DSH Payments.    The Medicare DSH program provides for additional payments to hospitals that treat a disproportionate share of low-income patients. Under the Health Reform Law, beginning in federal fiscal year 2014, Medicare DSH payments will be reduced to 25% of the amount they otherwise would have been absent the law. The remaining 75% of the amount that would otherwise be paid under Medicare DSH will be effectively pooled, and this pool will be reduced further each year by a formula that reflects reductions in the national level of uninsured who are under 65 years of age. In other words, the greater the level of coverage for the uninsured nationally, the more the Medicare DSH payment pool will be reduced. Each hospital will then be paid, out of the reduced DSH payment pool, an amount allocated based upon its level of uncompensated care.

It is difficult to predict the full impact of the Medicare DSH reductions, and CBO and CMS estimates differ by $38 billion. The Health Reform Law does not mandate what data source HHS must use to determine the reduction, if any, in the uninsured population nationally. In addition, the Health Reform Law does not contain a definition of “uncompensated care.” As a result, it is unclear how a hospital’s share of the Medicare DSH payment pool will be calculated. CMS could use the definition of “uncompensated care” used in connection with hospital cost reports. However, in July 2009, CMS proposed material revisions to the definition of “uncompensated care” used for cost report purposes. Those revisions would exclude certain significant costs that had historically been covered, such as unreimbursed costs of Medicaid services. CMS has not issued a final rule, and the Health Reform Law does not require HHS to use this definition, even if finalized, for DSH purposes. How CMS ultimately defines “uncompensated care” for purposes of these DSH funding provisions could have a material effect on a hospital’s Medicare DSH reimbursements.

In addition to Medicare DSH funding, hospitals that provide care to a disproportionately high number of low-income patients may receive Medicaid DSH payments. The federal government distributes federal Medicaid DSH funds to each state based on a statutory formula. The states then distribute the DSH funding among qualifying hospitals. Although federal Medicaid law defines some level of hospitals that must receive Medicaid DSH funding, states have broad discretion to define additional hospitals that also may qualify for Medicaid DSH payments and the amount of such payments. The Health Reform Law will reduce funding for the Medicaid DSH hospital program in federal fiscal years 2014 through 2020 by the following amounts: 2014 ($500 million); 2015 ($600 million); 2016 ($600 million); 2017 ($1.8 billion); 2018 ($5 billion); 2019 ($5.6 billion); and 2020 ($4 billion). In addition, the Jobs Creation Act provides for an additional Medicaid DSH reduction of $4.1 billion in federal fiscal year 2021. How such cuts are allocated among the states, and how the states allocate these cuts among providers, have yet to be determined.

ACOs.    The Health Reform Law requires HHS to establish the MSSP, which promotes accountability and coordination of care through the creation of ACOs. Beginning no later than January 1, 2012, the program will allow certain providers and suppliers (including hospitals, physicians and other designated professionals) to voluntarily form ACOs and work together along with other ACO participants to invest in infrastructure and redesign delivery processes to achieve high quality and efficient delivery of services. The program is intended to produce savings as a result of improved quality and operational efficiency. ACOs that achieve quality performance standards established by HHS will be eligible to share in a portion of the amounts saved by the

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Medicare program. HHS has significant discretion to determine key elements of the program. In 2011, CMS, the OIG and certain other federal agencies released a series of rules and guidance further defining and implementing the ACO program. These rules and guidance provide for two different ACO tracks, the first of which allows ACOs to share only in the savings under the MSSP. The second track requires ACOs to share in any savings or losses under the MSSP but offers ACOs a greater share of any savings realized under the MSSP. As authorized by the Health Reform Law, the rules and guidance also provide for certain waivers from fraud and abuse laws for ACOs. In addition, beginning January 1, 2012, CMS has authorized 32 organizations to participate in the “Pioneer” ACO program, which is similar to, but separate from, the ACOs created under the MSSP regulations.

Bundled Payment Pilot Programs.    The Health Reform Law created the Center for Medicare and Medicaid Innovation with responsibility for establishing demonstration projects and other initiatives in order to identify, develop, test and encourage the adoption of new methods of delivering and paying for healthcare that create savings under the Medicare and Medicaid programs while improving quality of care. In addition, the Health Reform Law requires HHS to establish a five-year, voluntary national bundled payment pilot program for Medicare services beginning no later than January 1, 2013. Under the program, providers would agree to receive one payment for services provided to Medicare patients for certain medical conditions or episodes of care. HHS will have the discretion to determine how the program will function. For example, HHS will determine what medical conditions will be included in the program and the amount of the payment for each condition. In addition, the Health Reform Law provides for a five-year bundled payment pilot program for Medicaid services. HHS may select up to eight states to participate based on the potential to lower costs under the Medicaid program while improving care. State programs may target particular categories of beneficiaries, selected diagnoses or geographic regions of the state. The selected state programs will provide one payment for both hospital and physician services provided to Medicaid patients for certain episodes of inpatient care. For both pilot programs, HHS will determine the relationship between the programs and restrictions in certain existing laws, including the Civil Monetary Penalty Law, the Anti-kickback Statute, the Stark Law and the HIPAA privacy, security and transaction standard requirements. However, the Health Reform Law does not authorize HHS to waive other laws that may impact the ability of hospitals and other eligible participants to participate in the pilot programs, such as antitrust laws.

Ambulatory Surgery Centers.    The Health Reform Law reduces reimbursement for ASCs through a productivity adjustment to the market basket similar to the productivity adjustment for inpatient and outpatient hospital services, beginning in federal fiscal year 2011. On November 1, 2011, CMS issued a final rule establishing a quality reporting program for ASCs by which ASCs that fail to report on five quality measures beginning on October 1, 2012, will receive a 2% reduction in reimbursement for calendar year 2014.

Medicare Managed Care (Medicare Advantage or “MA”).    Under the MA program, the federal government contracts with private health plans to provide inpatient and outpatient benefits to beneficiaries who enroll in such plans. For 2012, approximately 12.8 million Medicare beneficiaries have elected to enroll in MA plans. Effective in 2014, the Health Reform Law requires MA plans to keep annual administrative costs lower than 15% of annual premium revenue. The Health Reform Law reduces, over a three year period starting in 2012, premium payments to the MA plans such that CMS’ managed care per capita premium payments are, on average, equal to traditional Medicare. In addition, the Health Reform Law implements fee payment adjustments based on service benchmarks and quality ratings. As a result of these changes, payments to MA plans are estimated to be reduced by $138 to $145 billion between 2010 and 2019. These reductions to MA plan premium payments may cause some plans to raise premiums or limit benefits, which in turn might cause some Medicare beneficiaries to terminate their MA coverage and enroll in traditional Medicare.

Specialty Hospital Limitations

Over the last decade, we have faced significant competition from hospitals that have physician ownership. The Health Reform Law prohibits newly created physician-owned hospitals from billing for Medicare patients referred by their physician owners. As a result, the law effectively prevents the formation of new physician-owned hospitals after December 31, 2010. While the law grandfathers existing physician-owned hospitals, it does not allow these hospitals to increase the percentage of physician ownership and significantly restricts their ability to expand services.

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Program Integrity and Fraud and Abuse

The Health Reform Law makes several significant changes to health care fraud and abuse laws, provides additional enforcement tools to the government, increases cooperation between agencies by establishing mechanisms for the sharing of information and enhances criminal and administrative penalties for non-compliance. For example, the Health Reform Law: (1) provides $350 million in increased federal funding over the next 10 years to fight health care fraud, waste and abuse; (2) expands the scope of the RAC program to include MA plans and Medicaid; (3) authorizes HHS, in consultation with the OIG, to suspend Medicare and Medicaid payments to a provider of services or a supplier “pending an investigation of a credible allegation of fraud;” (4) provides Medicare contractors with additional flexibility to conduct random prepayment reviews; and (5) tightens up the rules for returning overpayments made by governmental health programs and expands FCA liability to include failure to timely repay identified overpayments.

Impact of Health Reform Law on the Company

The expansion of health insurance coverage under the Health Reform Law may result in a material increase in the number of patients using our facilities who have either private or public program coverage. In addition, a disproportionately large percentage of the new Medicaid coverage is likely to be in states that currently have relatively low income eligibility requirements. Two such states are Texas and Florida, where about one-half of the Company’s licensed beds are located. We also have a significant presence in other relatively low income eligibility states, including Georgia, Kansas, Louisiana, Missouri, Oklahoma and Virginia. Further, the Health Reform Law provides for a value-based purchasing program, the establishment of ACOs and bundled payment pilot programs, which will create possible sources of additional revenue.

However, it is difficult to predict the size of the potential revenue gains to the Company as a result of these elements of the Health Reform Law, because of uncertainty surrounding a number of material factors, including the following:

• how many previously uninsured individuals will obtain coverage as a result of the Health Reform Law (while the CBO estimates 32 million by 2016 and 34 million by 2021, CMS estimates almost 34 million by 2019; both agencies made a number of assumptions to derive that figure, including how many individuals will ignore substantial subsidies and decide to pay the penalty rather than obtain health insurance and what percentage of people in the future will meet the new Medicaid income eligibility requirements);

• what percentage of the newly insured patients will be covered under the Medicaid program and what percentage will be covered by private health insurers;

• the extent to which states will enroll new Medicaid participants in managed care programs;

• the pace at which insurance coverage expands, including the pace of different types of coverage expansion;

• the change, if any, in the volume of inpatient and outpatient hospital services that are sought by and provided to previously uninsured individuals;

• the rate paid to hospitals by private payers for newly covered individuals, including those covered through the newly created Exchanges and those who might be covered under the Medicaid program under contracts with the state;

• the rate paid by state governments under the Medicaid program for newly covered individuals;

• the effect of the value-based purchasing program on our hospitals’ revenues and the effects of other quality programs;

• the percentage of individuals in the Exchanges who select the high deductible plans, since health insurers offering those kinds of products have traditionally sought to pay lower rates to hospitals;

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• whether the net effect of the Health Reform Law, including the prohibition on excluding individuals based on pre-existing conditions, the requirement to keep medical costs at or above a specified minimum percentage of premium revenue, other health insurance reforms and the annual fee applied to all health insurers, will be to put pressure on the bottom line of health insurers, which in turn might cause them to seek to reduce payments to hospitals with respect to both newly insured individuals and their existing business; and

• the possibility that implementation of the provisions expanding health insurance coverage or the entire Health Reform Law will be delayed due to court challenges or revised or eliminated as a result of court challenges and efforts to repeal or amend the law. Numerous lawsuits have challenged the constitutionality of the Health Reform Law. Some federal courts have upheld the constitutionality of the Health Reform Law or dismissed cases on procedural grounds. Others have held unconstitutional the requirement that individuals maintain health insurance or pay a penalty and have either found the Health Reform Law void in its entirety or left the remainder of the law intact. The U.S. Supreme Court is expected to decide the constitutionality of the Health Reform Law in 2012. In addition, repeal of the Health Reform Law has become a theme in political campaigns during this election year.

On the other hand, the Health Reform Law provides for significant reductions in the growth of Medicare spending, reductions in Medicare and Medicaid DSH payments and the establishment of programs where reimbursement is tied to quality and integration. Since 44.5% of our revenues in 2011 were from Medicare and Medicaid, reductions to these programs may significantly impact the Company and could offset any positive effects of the Health Reform Law. It is difficult to predict the size of the revenue reductions to Medicare and Medicaid spending, because of uncertainty regarding a number of material factors, including the following:

• the amount of overall revenues the Company will generate from Medicare and Medicaid business when the reductions are implemented;

• whether reductions required by the Health Reform Law will be changed by statute or by judicial decision prior to becoming effective;

• the size of the Health Reform Law’s annual productivity adjustment to the market basket;

• the amount of the Medicare DSH reductions that will be made, commencing in federal fiscal year 2014;

• the allocation to our hospitals of the Medicaid DSH reductions, commencing in federal fiscal year 2014;

• what the losses in revenues will be, if any, from the Health Reform Law’s quality initiatives;

• how successful ACOs will be at coordinating care and reducing costs or whether they will decrease reimbursement;

• the scope and nature of potential changes to Medicare reimbursement methods, such as an emphasis on bundling payments or coordination of care programs;

• whether the Company’s revenues from upper payment limit (“UPL”) programs, or other Medicaid supplemental programs developed through a federally approved waiver program (“Waiver Program”), will be adversely affected because there may be reductions in available state and local government funding for the programs; and

• reductions to Medicare payments CMS may impose for “excessive readmissions.”

Because of the many variables involved, we are unable to predict the net effect on the Company of the expected increases in insured individuals using our facilities, reductions in Medicare spending, reductions in Medicare and Medicaid DSH funding, and numerous other provisions in the Health Reform Law that may affect the Company. Further, it is unclear how efforts to repeal or revise the Health Reform Law and federal lawsuits challenging its constitutionality will be resolved or what the impact would be of any resulting changes to the law.

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General Economic and Demographic Factors

The United States economy has weakened significantly in recent years. Depressed consumer spending and higher unemployment rates continue to pressure many industries. During economic downturns, governmental entities often experience budget deficits as a result of increased costs and lower than expected tax collections. These budget deficits have forced federal, state and local government entities to decrease spending for health and human service programs, including Medicare, Medicaid and similar programs, which represent significant payer sources for our hospitals. Other risks we face from general economic weakness include potential declines in the population covered under managed care agreements, increased patient decisions to postpone or cancel elective and nonemergency health care procedures, increases in the uninsured and underinsured populations, increased adoption of health plan structures that shift financial responsibility to patients and further difficulties in our collecting patient copayment and deductible receivables. The Health Reform Law seeks to decrease over time the number of uninsured individuals, by among other things requiring employers to offer, and individuals to carry, health insurance or be subject to penalties. However, it is difficult to predict the full impact of the Health Reform Law due to the law’s complexity, lack of implementing regulations or interpretive guidance, gradual and potentially delayed implementation, pending court challenges, and possible amendment or repeal.

The health care industry is impacted by the overall United States economy. The federal deficit, the growing magnitude of Medicare expenditures and the aging of the United States population will continue to place pressure on federal health care programs.

Compliance Program

We maintain a comprehensive ethics and compliance program that is designed to meet or exceed applicable federal guidelines and industry standards. The program is intended to monitor and raise awareness of various regulatory issues among employees and to emphasize the importance of complying with governmental laws and regulations. As part of the ethics and compliance program, we provide annual ethics and compliance training to our employees and encourage all employees to report any violations to their supervisor, an ethics and compliance officer or a toll-free telephone ethics line. The Health Reform Law requires providers to implement core elements of compliance program criteria to be established by HHS, on a timeline to be established by HHS, as a condition of enrollment in the Medicare or Medicaid programs, and we may have to modify our compliance programs to comply with these new criteria.

Antitrust Laws

The federal government and most states have enacted antitrust laws that prohibit certain types of conduct deemed to be anti-competitive. These laws prohibit price fixing, concerted refusal to deal, market monopolization, price discrimination, tying arrangements, acquisitions of competitors and other practices that have, or may have, an adverse effect on competition. Violations of federal or state antitrust laws can result in various sanctions, including criminal and civil penalties. Antitrust enforcement in the health care industry is currently a priority of the Federal Trade Commission. We believe we are in compliance with such federal and state laws, but courts or regulatory authorities may reach a determination in the future that could adversely affect our operations.

Environmental Matters

We are subject to various federal, state and local statutes and ordinances regulating the discharge of materials into the environment. We do not believe that we will be required to expend any material amounts in order to comply with these laws and regulations.

Insurance

As is typical in the health care industry, we are subject to claims and legal actions by patients in the ordinary course of business. Subject to a $5 million per occurrence self-insured retention, our facilities are insured by our wholly-owned insurance subsidiary for losses up to $50 million per occurrence. The insurance subsidiary has

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obtained reinsurance for professional liability risks generally above a retention level of $15 million per occurrence. We also maintain professional liability insurance with unrelated commercial carriers for losses in excess of amounts insured by our insurance subsidiary.

We purchase, from unrelated insurance companies, coverage for directors and officers liability and property loss in amounts we believe are adequate. The directors and officers liability coverage includes a $25 million corporate deductible for the period prior to November 2006, a $1 million corporate deductible for the period subsequent to November 2006 until our initial public offering in March 2011 and a $5 million corporate deductible subsequent to our initial public offering in March 2011. In addition, we will continue to purchase coverage for our directors and officers on an ongoing basis. The property coverage includes varying deductibles depending on the cause of the property damage. These deductibles range from $500,000 per claim up to 5% of the affected property values for certain flood and wind and earthquake related incidents.

Employees and Medical Staffs

At December 31, 2011, we had approximately 199,000 employees, including approximately 49,000 part-time employees. References herein to “employees” refer to employees of our affiliates. We are subject to various state and federal laws that regulate wages, hours, benefits and other terms and conditions relating to employment. At December 31, 2011, employees at 38 of our hospitals are represented by various labor unions. While no elections are expected in 2012, it is possible additional hospitals may unionize in the future. We consider our employee relations to be good and have not experienced work stoppages that have materially, adversely affected our business or results of operations. Our hospitals, like most hospitals, have experienced rising labor costs. In some markets, nurse and medical support personnel availability has become a significant operating issue to health care providers. To address this challenge, we have implemented several initiatives to improve retention, recruiting, compensation programs and productivity.

Our hospitals are staffed by licensed physicians, including both employed physicians and physicians who are not employees of our hospitals. Some physicians provide services in our hospitals under contracts, which generally describe a term of service, provide and establish the duties and obligations of such physicians, require the maintenance of certain performance criteria and fix compensation for such services. Any licensed physician may apply to be accepted to the medical staff of any of our hospitals, but the hospital’s medical staff and the appropriate governing board of the hospital, in accordance with established credentialing criteria, must approve acceptance to the staff. Members of the medical staffs of our hospitals often also serve on the medical staffs of other hospitals and may terminate their affiliation with one of our hospitals at any time.

We may be required to continue to enhance wages and benefits to recruit and retain nurses and other medical support personnel or to hire more expensive temporary or contract personnel. As a result, our labor costs could increase. We also depend on the available labor pool of semi-skilled and unskilled employees in each of the markets in which we operate. Certain proposed changes in federal labor laws and the National Labor Relations Board’s (the “NLRB”) modification of its election procedures could increase the likelihood of employee unionization attempts. To the extent a significant portion of our employee base unionizes, our costs could increase materially. In addition, the states in which we operate could adopt mandatory nurse-staffing ratios or could reduce mandatory nurse-staffing ratios already in place. State-mandated nurse-staffing ratios could significantly affect labor costs, and have an adverse impact on revenues if we are required to limit patient admissions in order to meet the required ratios.

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Executive Officers of the Registrant

As of February 17, 2012, our executive officers were as follows:

Name	Age		Position(s)
Richard M. Bracken		59	Chairman of the Board and Chief Executive Officer
R. Milton Johnson		55	President, Chief Financial Officer and Director
David G. Anderson		64	Senior Vice President — Finance and Treasurer
Victor L. Campbell		65	Senior Vice President
Jana J. Davis		53	Senior Vice President — Communications
Jon M. Foster		50	President — Southwest Group
Charles J. Hall		58	President — National Group
Samuel N. Hazen		51	President — Operations
A. Bruce Moore, Jr.		51	President — Service Line and Operations Integration
Michael P. O’Boyle		55	President and CEO — Parallon Business Solutionssm
Jonathan B. Perlin, M.D.		50	President — Clinical and Physician Services Group and Chief Medical Officer
W. Paul Rutledge		57	President — Central Group
Joseph A. Sowell, III		55	Senior Vice President and Chief Development Officer
Joseph N. Steakley		57	Senior Vice President — Internal Audit Services
John M. Steele		56	Senior Vice President — Human Resources
Donald W. Stinnett		55	Senior Vice President and Controller
Juan Vallarino		51	Senior Vice President — Strategic Pricing and Analytics
Robert A. Waterman		58	Senior Vice President, General Counsel and Chief Labor Relations Officer
Noel Brown Williams		56	Senior Vice President and Chief Information Officer
Alan R. Yuspeh		62	Senior Vice President and Chief Ethics and Compliance Officer

Richard M. Bracken has served as Chief Executive Officer of the Company since January 2009 and was appointed as Chairman of the Board in December 2009. Mr. Bracken served as President and Chief Executive Officer from January 2009 to December 2009. Mr. Bracken was appointed Chief Operating Officer in July 2001 and served as President and Chief Operating Officer from January 2002 to January 2009. Mr. Bracken served as President — Western Group of the Company from August 1997 until July 2001. From January 1995 to August 1997, Mr. Bracken served as President of the Pacific Division of the Company. Prior to 1995, Mr. Bracken served in various hospital Chief Executive Officer and Administrator positions with HCA-Hospital Corporation of America.

R. Milton Johnson has served as President and Chief Financial Officer of the Company since February 2011 and was appointed as a director in December 2009. Mr. Johnson served as Executive Vice President and Chief Financial Officer from July 2004 to February 2011 and as Senior Vice President and Controller of the Company from July 1999 until July 2004. Mr. Johnson served as Vice President and Controller of the Company from November 1998 to July 1999. Prior to that time, Mr. Johnson served as Vice President — Tax of the Company from April 1995 to October 1998. Prior to that time, Mr. Johnson served as Director of Tax for Healthtrust, Inc. — The Hospital Company from September 1987 to April 1995.

David G. Anderson has served as Senior Vice President — Finance and Treasurer of the Company since July 1999. Mr. Anderson served as Vice President — Finance of the Company from September 1993 to July 1999 and was appointed to the additional position of Treasurer in November 1996. From March 1993 until September 1993, Mr. Anderson served as Vice President — Finance and Treasurer of Galen Health Care, Inc. From July 1988 to March 1993, Mr. Anderson served as Vice President — Finance and Treasurer of Humana Inc.

Victor L. Campbell has served as Senior Vice President of the Company since February 1994. Prior to that time, Mr. Campbell served as HCA-Hospital Corporation of America’s Vice President for Investor, Corporate

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and Government Relations. Mr. Campbell joined HCA-Hospital Corporation of America in 1972. Mr. Campbell serves on the board of the Nashville Health Care Council, as a member of the American Hospital Association’s President’s Forum, and on the board and Executive Committee of the Federation of American Hospitals.

Jana J. Davis was appointed Senior Vice President — Communications in February 2011. Prior to that time, she served as Vice President of Communications for the Company from November 1997 to February 2011. Ms. Davis joined HCA in 1997 from Burson-Marsteller, where she was a Managing Director and served as Corporate Practice Chair for Latin American operations. Ms. Davis also held a number of Public Affairs positions in the George H.W. Bush and Reagan Administrations. Ms. Davis is an attorney and serves on the Board of Governors for the Federation of American Hospitals.

Jon M. Foster was appointed President Southwest Group in February 2011. Prior to that, Mr. Foster served as Division President for the Central and West Texas Division from January 2006 to February 2011. Mr. Foster joined HCA in March 2001 as President and CEO of St. David’s HealthCare in Austin, Texas and served in that position until February 2011. Prior to joining the Company, Mr. Foster served in various executive capacities within the Baptist Health System, Knoxville, Tennessee and The Methodist Hospital System in Houston, Texas.

Charles J. Hall was appointed President-National Group in February 2011. Prior to that, Mr. Hall served as President — Eastern Group from October 2006 to February 2011. Mr. Hall had previously served the Company as President — North Florida Division from April 2003 until October 2006, as President of the East Florida Division from January 1999 until April 2003, as a Market President in the East Florida Division from January 1998 until December 1998, as President of the South Florida Division from February 1996 until December 1997, and as President of the Southwest Florida Division from October 1994 until February 1996, and in various other capacities since 1987.

Samuel N. Hazen was appointed President — Operations of the Company in February 2011. Mr. Hazen served as President — Western Group from July 2001 to February 2011 and as Chief Financial Officer — Western Group of the Company from August 1995 to July 2001. Mr. Hazen served as Chief Financial Officer — North Texas Division of the Company from February 1994 to July 1995. Prior to that time, Mr. Hazen served in various hospital and regional Chief Financial Officer positions with Humana Inc. and Galen Health Care, Inc.

A. Bruce Moore, Jr., was appointed President — Service Line and Operations Integration in February 2011. Prior to that, Mr. Moore had served as President — Outpatient Services Group since January 2006. Mr. Moore served as Senior Vice President and as Chief Operating Officer — Outpatient Services Group from July 2004 to January 2006 and as Senior Vice President — Operations Administration from July 1999 until July 2004. Mr. Moore served as Vice President — Operations Administration of the Company from September 1997 to July 1999, as Vice President — Benefits from October 1996 to September 1997, and as Vice President — Compensation from March 1995 until October 1996.

Michael O’Boyle was appointed President and Chief Executive Officer of Parallon Business Solutions in January 2012. Prior to that, Mr. O’Boyle served as President of UnitedHealth Networks from 2008 to 2012. From 2005 to 2008, he served as the Chief Operating Officer of the Cleveland Clinic. He joined the Cleveland Clinic as Chief Financial Officer in 2001. From 1991 to 2001, he served as Chief Financial Officer for Medlantic Healthcare Group and MedStar Health, Inc. From 1987 to 1991, he held several financial leadership roles, including Chief Financial Officer, for three hospitals.

Dr. Jonathan B. Perlin was appointed President — Clinical and Physician Services Group and Chief Medical Officer in February 2011. Dr. Perlin had served as President — Clinical Services Group and Chief Medical Officer from November 2007 to February 2011 and as Chief Medical Officer and Senior Vice President — Quality of the Company from August 2006 to November 2007. Prior to joining the Company, Dr. Perlin served as Under Secretary for Health in the U.S. Department of Veterans Affairs since April 2004. Dr. Perlin joined the Veterans Health Administration in November 1999 where he served in various capacities, including as Deputy Under Secretary for Health from July 2002 to April 2004, and as Chief Quality and Performance Officer from November 1999 to September 2002.

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W. Paul Rutledge has served as President — Central Group since October 2005. Mr. Rutledge served as President of the MidAmerica Division from January 2001 to October 2005. He served as President of TriStar Health System from June 1996 to January 2001 and served as President of Centennial Medical Center from May 1993 to June 1996. He has served in leadership capacities with HCA for more than 29 years, working with hospitals in the United States and London, England.

Joseph A. Sowell, III was appointed as Senior Vice President and Chief Development Officer of the Company in December 2009. From 1987 to 1996 and again from 1999 to 2009, Mr. Sowell was a partner at the law firm of Waller Lansden Dortch & Davis where he specialized in the areas of health care law, mergers and acquisitions, joint ventures, private equity financing, tax law and general corporate law. He also co-managed the firm’s corporate and commercial transactions practice. From 1996 to 1999, Mr. Sowell served as the head of development, and later as the Chief Operating Officer of Arcon Healthcare.

Joseph N. Steakley has served as Senior Vice President — Internal Audit Services of the Company since July 1999. Mr. Steakley served as Vice President — Internal Audit Services from November 1997 to July 1999. From October 1989 until October 1997, Mr. Steakley was a partner with Ernst & Young LLP. Mr. Steakley is a member of the board of directors of J. Alexander’s Corporation, where he serves on the compensation committee and as chairman of the audit committee.

John M. Steele has served as Senior Vice President — Human Resources of the Company since November 2003. Mr. Steele served as Vice President — Compensation and Recruitment of the Company from November 1997 to October 2003. From March 1995 to November 1997, Mr. Steele served as Assistant Vice President — Recruitment.

Donald W. Stinnett has served as Senior Vice President and Controller since December 2008. Mr. Stinnett served as Chief Financial Officer — Eastern Group from October 2005 to December 2008 and Chief Financial Officer of the Far West Division from July 1999 to October 2005. Mr. Stinnett served as Chief Financial Officer and Vice President of Finance of Franciscan Health System of the Ohio Valley from 1995 until 1999, and served in various capacities with Franciscan Health System of Cincinnati and Providence Hospital in Cincinnati prior to that time.

Juan Vallarino was appointed Senior Vice President — Strategic Pricing and Analytics in February 2011. Prior to that time, Mr. Vallarino had served as Vice President — Strategic Pricing and Analytics since October 2006. Prior to that, Mr. Vallarino served as Vice President of Managed Care for the Western Group of the Company from January 1998 to October 2006.

Robert A. Waterman has served as Senior Vice President and General Counsel of the Company since November 1997 and Chief Labor Relations Officer since March 2009. Mr. Waterman served as a partner in the law firm of Latham & Watkins from September 1993 to October 1997; he was Chair of the firm’s health care group during 1997.

Noel Brown Williams has served as Senior Vice President and Chief Information Officer of the Company since October 1997. From October 1996 to September 1997, Ms. Williams served as Chief Information Officer for American Service Group/Prison Health Services, Inc. From September 1995 to September 1996, Ms. Williams worked as an independent consultant. From June 1993 to June 1995, Ms. Williams served as Vice President, Information Services for HCA Information Services. From February 1979 to June 1993, she held various positions with HCA-Hospital Corporation of America Information Services.

Alan R. Yuspeh has served as Senior Vice President and Chief Ethics and Compliance Officer of the Company since May 2007. From October 1997 to May 2007, Mr. Yuspeh served as Senior Vice President — Ethics, Compliance and Corporate Responsibility of the Company. From September 1991 until October 1997, Mr. Yuspeh was a partner with the law firm of Howrey & Simon. As a part of his law practice, Mr. Yuspeh served from 1987 to 1997 as Coordinator of the Defense Industry Initiative on Business Ethics and Conduct.

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Item 1A.    Risk Factors

If any of the events discussed in the following risk factors were to occur, our business, financial position, results of operations, cash flows or prospects could be materially, adversely affected. Additional risks and uncertainties not presently known, or currently deemed immaterial, may also constrain our business and operations.

Our substantial leverage could adversely affect our ability to raise additional capital to fund our operations, limit our ability to react to changes in the economy or our industry, expose us to interest rate risk to the extent of our variable rate debt and prevent us from meeting our obligations.

We are highly leveraged. As of December 31, 2011, our total indebtedness was $27.052 billion. As of December 31, 2011, we had availability of $1.935 billion under our senior secured revolving credit facility and $202 million under our asset-based revolving credit facility, after giving effect to letters of credit and borrowing base limitations. Our high degree of leverage could have important consequences, including:

• increasing our vulnerability to downturns or adverse changes in general economic, industry or competitive conditions and adverse changes in government regulations;

• requiring a substantial portion of cash flow from operations to be dedicated to the payment of principal and interest on our indebtedness, therefore reducing our ability to use our cash flow to fund our operations, capital expenditures and future business opportunities;

• exposing us to the risk of increased interest rates as certain of our unhedged borrowings are at variable rates of interest;

• limiting our ability to make strategic acquisitions or causing us to make nonstrategic divestitures;

• limiting our ability to obtain additional financing for working capital, capital expenditures, product or service line development, debt service requirements, acquisitions and general corporate or other purposes; and

• limiting our ability to adjust to changing market conditions and placing us at a competitive disadvantage compared to our competitors who are less highly leveraged.

We and our subsidiaries have the ability to incur additional indebtedness in the future, subject to the restrictions contained in our senior secured credit facilities and the indentures governing our outstanding notes. If new indebtedness is added to our current debt levels, the related risks that we now face could intensify.

We may not be able to generate sufficient cash to service all of our indebtedness and may not be able to refinance our indebtedness on favorable terms. If we are unable to do so, we may be forced to take other actions to satisfy our obligations under our indebtedness, which may not be successful.

Our ability to make scheduled payments on or to refinance our debt obligations depends on our financial condition and operating performance, which are subject to prevailing economic and competitive conditions and to certain financial, business and other factors beyond our control. We cannot assure you we will maintain a level of cash flows from operating activities sufficient to permit us to pay the principal, premium, if any, and interest on our indebtedness.

In addition, we conduct our operations through our subsidiaries. Accordingly, repayment of our indebtedness is dependent on the generation of cash flow by our subsidiaries and their ability to make such cash available to us by dividend, debt repayment or otherwise. Our subsidiaries may not be able to, or may not be permitted to, make distributions to enable us to make payments in respect of our indebtedness. Each subsidiary is a distinct legal entity, and, under certain circumstances, legal and contractual restrictions may limit our ability to obtain cash from our subsidiaries.

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We may find it necessary or prudent to refinance our outstanding indebtedness with longer-maturity debt at a higher interest rate. Our ability to refinance our indebtedness on favorable terms, or at all, is directly affected by the current global economic and financial conditions. In addition, our ability to incur secured indebtedness (which would generally enable us to achieve better pricing than the incurrence of unsecured indebtedness) depends in part on the value of our assets, which depends, in turn, on the strength of our cash flows and results of operations, and on economic and market conditions and other factors.

If our cash flows and capital resources are insufficient to fund our debt service obligations or we are unable to refinance our indebtedness, we may be forced to reduce or delay investments and capital expenditures, or to sell assets, seek additional capital or restructure our indebtedness. These alternative measures may not be successful and may not permit us to meet our scheduled debt service obligations. If our operating results and available cash are insufficient to meet our debt service obligations, we could face substantial liquidity problems and might be required to dispose of material assets or operations to meet our debt service and other obligations. We may not be able to consummate those dispositions, or the proceeds from the dispositions may not be adequate to meet any debt service obligations then due.

Our debt agreements contain restrictions that limit our flexibility in operating our business.

Our senior secured credit facilities and the indentures governing our outstanding notes contain various covenants that limit our ability to engage in specified types of transactions. These covenants limit our and certain of our subsidiaries’ ability to, among other things:

• incur additional indebtedness or issue certain preferred shares;

• pay dividends on, repurchase or make distributions in respect of our capital stock or make other restricted payments;

• make certain investments;

• sell or transfer assets;

• create liens;

• consolidate, merge, sell or otherwise dispose of all or substantially all of our assets; and

• enter into certain transactions with our affiliates.

Under our asset-based revolving credit facility, when (and for as long as) the combined availability under our asset-based revolving credit facility and our senior secured revolving credit facility is less than a specified amount for a certain period of time or, if a payment or bankruptcy event of default has occurred and is continuing, funds deposited into any of our depository accounts will be transferred on a daily basis into a blocked account with the administrative agent and applied to prepay loans under the asset-based revolving credit facility and to cash collateralize letters of credit issued thereunder.

Under our senior secured credit facilities, we are required to satisfy and maintain specified financial ratios. Our ability to meet those financial ratios can be affected by events beyond our control, and there can be no assurance we will continue to meet those ratios. A breach of any of these covenants could result in a default under both the cash flow credit facility and the asset-based revolving credit facility. Upon the occurrence of an event of default under the senior secured credit facilities, the lenders thereunder could elect to declare all amounts outstanding under the senior secured credit facilities to be immediately due and payable and terminate all commitments to extend further credit. If we were unable to repay those amounts, the lenders under the senior secured credit facilities could proceed against the collateral granted to them to secure such indebtedness. We have pledged a significant portion of our assets under our senior secured credit facilities and that collateral (other than certain European collateral securing our senior secured European term loan facility) is also pledged as collateral under our first lien notes. If any of the lenders under the senior secured credit facilities accelerate the repayment of borrowings, there can be no assurance there will be sufficient assets to repay the senior secured credit facilities, the first lien notes and our other indebtedness.

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Our hospitals face competition for patients from other hospitals and health care providers.

The health care business is highly competitive, and competition among hospitals and other health care providers for patients has intensified in recent years. Generally, other hospitals in the local communities we serve provide services similar to those offered by our hospitals. In addition, CMS publicizes on its Hospital Compare website performance data related to quality measures and data on patient satisfaction surveys hospitals submit in connection with their Medicare reimbursement. Federal law provides for the future expansion of the number of quality measures that must be reported. Additional quality measures and future trends toward clinical transparency may have an unanticipated impact on our competitive position and patient volumes. Further, the Health Reform Law requires all hospitals to annually establish, update and make public a list of the hospital’s standard charges for items and services. If any of our hospitals achieve poor results (or results that are lower than our competitors) on these quality measures or on patient satisfaction surveys or if our standard charges are higher than our competitors, our patient volumes could decline.

In addition, the number of freestanding specialty hospitals, surgery 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. Some of the facilities that compete with our hospitals are owned by governmental agencies or not-for-profit corporations supported by endowments, charitable contributions and/or tax revenues and can finance capital expenditures and operations on a tax-exempt basis. Our hospitals face competition from specialty hospitals, some of which are physician-owned, and from both our own and unaffiliated freestanding surgery centers for market share in certain high margin services and for quality physicians and personnel. If ambulatory surgery centers are better able to compete in this environment than our hospitals, our hospitals may experience a decline in patient volume, and we may experience a decrease in margin, even if those patients use our ambulatory surgery centers. In states that do not require a CON for the purchase, construction or expansion of health care facilities or services, competition in the form of new services, facilities and capital spending is more prevalent. Further, if our competitors are better able to attract patients, make capital expenditures and maintain modern and technologically upgraded facilities and equipment, recruit physicians, expand services or obtain favorable managed care contracts at their facilities than our hospitals and ambulatory surgery centers, we may experience an overall decline in patient volume. See Item 1, “Business — Competition.”

The growth of uninsured and patient due accounts and a deterioration in the collectibility of these accounts could adversely affect our results of operations.

The primary collection risks of our accounts receivable relate to the uninsured patient accounts and patient accounts for which the primary insurance carrier has paid the amounts covered by the applicable agreement, but patient responsibility amounts (exclusions, deductibles and copayments) remain outstanding. The provision for doubtful accounts relates primarily to amounts due directly from patients. Although Medicare reimburses hospitals for a portion of Medicare bad debts, the Jobs Creation Act will reduce the reimbursement level from 70% of eligible bad debts to 65% beginning in federal fiscal year 2013.

The amount of the provision for doubtful accounts is based upon management’s assessment of historical write-offs and expected net collections, business and economic conditions, trends in federal and state governmental and private employer health care coverage, the rate of growth in uninsured patient admissions and other collection indicators. At December 31, 2011, our allowance for doubtful accounts represented approximately 92% of the $4.478 billion patient due accounts receivable balance. The sum of the provision for doubtful accounts, uninsured discounts and charity care increased from $8.362 billion for 2009 to $9.626 billion for 2010 and to $11.214 billion for 2011.

A continuation of the trends that have resulted in an increasing proportion of accounts receivable being comprised of uninsured accounts and a deterioration in the collectibility of these accounts will adversely affect our collection of accounts receivable, cash flows and results of operations. We may also be adversely affected by the growth in patient responsibility accounts as a result of increases in the adoption of plan structures, including

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health savings accounts, that shift greater responsibility for care to individuals through greater exclusions and copayment and deductible amounts. Prior to the Health Reform Law being fully implemented, our facilities may experience growth in bad debts, uninsured discounts and charity care as a result of a number of factors, including the economic downturn and continued high unemployment. The Health Reform Law seeks to decrease, over time, the number of uninsured individuals through reforms that mostly will become effective January 1, 2014, provided the law is not found to be unconstitutional or otherwise revised. Even after full implementation of the Health Reform Law, we may continue to experience bad debts and have to provide uninsured discounts and charity care for undocumented aliens who are not permitted to enroll in a health insurance exchange or government health care programs and certain others who may not have insurance coverage. Further, implementation of the Health Reform Law could result in some patients terminating their current insurance plans in favor of lower cost Medicaid plans or other insurance coverage with lower reimbursement levels. Patient responsibility accounts may continue to increase even with expanded health plan coverage as a result of increases in plan exclusions and deductibles and copayment amounts.

It is difficult to predict the full impact of the Health Reform Law due to the law’s complexity, lack of implementing regulations or interpretive guidance, gradual and potentially delayed implementation, pending court challenges and possible amendment or repeal, as well as our inability to foresee how individuals and businesses will respond to the choices afforded them by the law.

Changes in government health care programs may adversely affect our revenues.

A significant portion of our patient volume is derived from government health care programs, principally Medicare and Medicaid. Specifically, we derived 44.5% of our revenues from the Medicare and Medicaid programs in 2011. Changes in government health care programs may reduce the reimbursement we receive and could adversely affect our business and results of operations.

In recent years, legislative and regulatory changes have resulted in limitations on and, in some cases, reductions in levels of payments to health care providers for certain services under the Medicare program. The Budget Control Act of 2011 (the “BCA”) provides for new spending on program integrity initiatives intended to reduce fraud and abuse under the Medicare program. Further, pursuant to the BCA, a bipartisan joint congressional committee was created to identify additional deficit reductions. Because the committee failed to propose a plan to cut the deficit by an additional $1.2 trillion by the November 23, 2011, deadline, the BCA requires automatic spending reductions of $1.2 trillion for federal fiscal years 2013 through 2021, minus any deficit reductions enacted by Congress and debt service costs. However, the percentage reduction for Medicare may not be more than 2% for a fiscal year, with a uniform percentage reduction across all Medicare programs. We are unable to predict how these spending reductions will be structured, what other deficit reduction initiatives may be proposed by Congress or whether Congress will attempt to suspend or restructure the automatic budget cuts.

These reductions will be in addition to reductions mandated by the Health Reform Law, which provides for material reductions in the growth of Medicare program spending, including reductions in Medicare market basket updates and Medicare DSH funding. Further, from time to time, CMS revises the reimbursement systems used to reimburse health care providers, including changes to the MS-DRG system and other payment systems, which may result in reduced Medicare payments.

Since most states must operate with balanced budgets and since the Medicaid program is often a state’s largest program, some states have enacted or may consider enacting legislation designed to reduce their Medicaid expenditures. Further, many states have also adopted, or are considering, legislation designed to reduce coverage, enroll Medicaid recipients in managed care programs and/or impose additional taxes on hospitals to help finance or expand the states’ Medicaid systems. The current economic environment has increased the budgetary pressures on many states, and these budgetary pressures have resulted, and likely will continue to result, in decreased spending, or decreased spending growth, for Medicaid programs and the Children’s Health Insurance

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Program in many states. For example, in May 2011, the Florida legislature passed a budget agreement for the fiscal year beginning July 1, 2011 that reduces Medicaid reimbursements to hospitals. As a result, we estimate that Florida Medicaid payments to our hospitals may be reduced by approximately $35 million during the first half of calendar year 2012. Additionally, the Texas legislature passed a budget agreement effective September 1, 2011 that reduces Medicaid reimbursements to hospitals. As a result, we estimate that Texas Medicaid payments to our hospitals may be reduced by approximately $60 million in 2012. Some states that provide Medicaid supplemental payments are reviewing these programs or have filed waiver requests with CMS to replace these programs, which could result in Medicaid supplemental payments being reduced or eliminated. CMS approved a Medicaid waiver in December 2011 that allows Texas to continue receiving supplemental Medicaid reimbursement while expanding its Medicaid managed care program. However, we cannot predict whether the Texas private supplemental Medicaid Waiver Program will continue or guarantee that revenues recognized from the program will not decrease.

The Health Reform Law has changed and will likely result in additional changes to the Medicaid program. For example, the Health Reform Law provides for material reductions to Medicaid DSH funding. Effective March 23, 2010, the Health Reform Law requires states to at least maintain Medicaid eligibility standards established prior to the enactment of the law for adults until January 1, 2014 and for children until October 1, 2019. However, states with budget deficits may seek a waiver from this requirement to address eligibility standards that apply to adults making more than 133% of the federal poverty level. The Health Reform Law also provides for significant expansions to the Medicaid program, but these changes are not required until 2014. In addition, the Health Reform Law will result in increased state legislative and regulatory changes in order for states to comply with new federal mandates, such as the requirement to establish Exchanges, and to participate in grants and other incentive opportunities.

In some cases, commercial third-party payers rely on all or portions of Medicare payment systems to determine payment rates. Changes to government health care programs that reduce payments under these programs may negatively impact payments from commercial third-party payers.

Current or future health care reform and deficit reduction efforts, changes in laws or regulations regarding government health care programs, other changes in the administration of government health care programs and changes to commercial third-party payers in response to health care reform and other changes to government health care programs could have a material, adverse effect on our financial position and results of operations.

We are unable to predict the impact of the Health Reform Law, which represents a significant change to the health care industry.

As enacted, the Health Reform Law will change how health care services are covered, delivered, and reimbursed through expanded coverage of uninsured individuals, reduced growth in Medicare program spending, reductions in Medicare and Medicaid DSH payments and the establishment of programs where reimbursement is tied to quality and integration. In addition, the law reforms certain aspects of health insurance, expands existing efforts to tie Medicare and Medicaid payments to performance and quality, and contains provisions intended to strengthen fraud and abuse enforcement. The expansion of health insurance coverage under the Health Reform Law may result in a material increase in the number of patients using our facilities who have either private or public program coverage. In addition, a disproportionately large percentage of the new Medicaid coverage is likely to be in states that currently have relatively low income eligibility requirements. Two such states are Texas and Florida, where about one-half of the Company’s licensed beds are located. The Company also has a significant presence in other relatively low income eligibility states, including Georgia, Kansas, Louisiana, Missouri, Oklahoma and Virginia. Further, the Health Reform Law provides for a value-based purchasing program, the establishment of ACOs and bundled payment pilot programs, which will create possible sources of additional revenue.

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However, it is difficult to predict the size of the potential revenue gains to the Company as a result of these elements of the Health Reform Law, because of uncertainty surrounding a number of material factors, including the following:

• how many previously uninsured individuals will obtain coverage as a result of the Health Reform Law (while the CBO estimates 32 million by 2016 and 34 million by 2021, CMS estimates almost 34 million by 2019; both agencies made a number of assumptions to derive that figure, including how many individuals will ignore substantial subsidies and decide to pay the penalty rather than obtain health insurance and what percentage of people in the future will meet the new Medicaid income eligibility requirements);

• what percentage of the newly insured patients will be covered under the Medicaid program and what percentage will be covered by private health insurers;

• the extent to which states will enroll new Medicaid participants in managed care programs;

• the pace at which insurance coverage expands, including the pace of different types of coverage expansion;

• the change, if any, in the volume of inpatient and outpatient hospital services that are sought by and provided to previously uninsured individuals;

• the rate paid to hospitals by private payers for newly covered individuals, including those covered through the newly created Exchanges and those who might be covered under the Medicaid program under contracts with the state;

• the rate paid by state governments under the Medicaid program for newly covered individuals;

• the effect of the value-based purchasing program on our hospitals’ revenues and the effects of other quality programs;

• the percentage of individuals in the Exchanges who select the high deductible plans, since health insurers offering those kinds of products have traditionally sought to pay lower rates to hospitals;

• whether the net effect of the Health Reform Law, including the prohibition on excluding individuals based on pre-existing conditions, the requirement to keep medical costs at or above a specified minimum percentage of premium revenue, other health insurance reforms and the annual fee applied to all health insurers, will be to put pressure on the bottom line of health insurers, which in turn might cause them to seek to reduce payments to hospitals with respect to both newly insured individuals and their existing business; and

• the possibility that implementation of the provisions expanding health insurance coverage or the entire Health Reform Law will be delayed, revised or eliminated as a result of court challenges and efforts to repeal or amend the law. Numerous lawsuits have challenged the constitutionality of the Health Reform Law. Some federal courts have upheld the constitutionality of the Health Reform Law or dismissed cases on procedural grounds. Others have held unconstitutional the requirement that individuals maintain health insurance or pay a penalty and have either found the Health Reform Law void in its entirety or left the remainder of the law intact. The U.S. Supreme Court is expected to decide the constitutionality of the Health Reform Law in 2012. In addition, repeal of the Health Reform Law has become a theme in political campaigns during this election year.

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On the other hand, the Health Reform Law provides for significant reductions in the growth of Medicare spending, reductions in Medicare and Medicaid DSH payments and the establishment of programs where reimbursement is tied to quality and integration. Since 44.5% of our revenues in 2011 were from Medicare and Medicaid, reductions to these programs may significantly impact the Company and could offset any positive effects of the Health Reform Law. It is difficult to predict the size of the revenue reductions to Medicare and Medicaid spending, because of uncertainty regarding a number of material factors, including the following:

• the amount of overall revenues the Company will generate from Medicare and Medicaid business when the reductions are implemented;

• whether reductions required by the Health Reform Law will be changed by statute or by judicial decision prior to becoming effective;

• the size of the Health Reform Law’s annual productivity adjustment to the market basket;

• the amount of the Medicare DSH reductions that will be made, commencing in federal fiscal year 2014;

• the allocation to our hospitals of the Medicaid DSH reductions, commencing in federal fiscal year 2014;

• what the losses in revenues will be, if any, from the Health Reform Law’s quality initiatives;

• how successful ACOs will be at coordinating care and reducing costs or whether they will decrease reimbursement;

• the scope and nature of potential changes to Medicare reimbursement methods, such as an emphasis on bundling payments or coordination of care programs;

• whether the Company’s revenues from upper payment limit (“UPL”) programs, or other Medicaid supplemental programs developed through a federally approved waiver program (“Waiver Program”), will be adversely affected because there may be reductions in available state and local government funding for the programs; and

• reductions to Medicare payments CMS may impose for “excessive readmissions.”

Because of the many variables involved, we are unable to predict the net effect on the Company of the expected increases in insured individuals using our facilities, reductions in Medicare spending, reductions in Medicare and Medicaid DSH funding, and numerous other provisions in the Health Reform Law that may affect the Company. Further, it is unclear how efforts to repeal or revise the Health Reform Law and federal lawsuits challenging its constitutionality will be resolved or what the impact would be of any resulting changes to the law.

If we are unable to retain and negotiate favorable contracts with nongovernment payers, including managed care plans, our revenues may be reduced.

Our ability to obtain favorable contracts with nongovernment payers, including HMOs, PPOs and other managed care plans significantly affects the revenues and operating results of our facilities. Revenues derived from these entities and other insurers accounted for 52.9% and 52.7% of our revenues for 2011 and 2010, respectively. Nongovernment payers, including managed care payers, continue to demand discounted fee structures, and the trend toward consolidation among nongovernment payers tends to increase their bargaining power over fee structures. As various provisions of the Health Reform Law are implemented, including the establishment of the Exchanges, nongovernment payers increasingly may demand reduced fees. Our future success will depend, in part, on our ability to retain and renew our managed care contracts and enter into new managed care contracts on terms favorable to us. Other health care providers may impact our ability to enter into managed care contracts 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. It is not clear what impact, if any, the increased obligations on managed care payers and other payers imposed by the Health Reform Law will have on our ability to negotiate reimbursement increases. If we are unable to retain and negotiate favorable contracts with managed care plans or experience reductions in payment increases or amounts received from nongovernment payers, our revenues may be reduced.

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Our performance depends on our ability to recruit and retain quality physicians.

The success of our hospitals depends in part on the number and quality of the physicians on the medical staffs of our hospitals, the admitting and utilization practices of those physicians, maintaining good relations with those physicians and controlling costs related to the employment of physicians. Although we employ some physicians, physicians are often not employees of the hospitals at which they practice and, in many of the markets we serve, most physicians have admitting privileges at other hospitals in addition to our hospitals. Such physicians may terminate their affiliation with our hospitals at any time. If we are unable to provide adequate support personnel or technologically advanced equipment and hospital facilities that meet the needs of those physicians and their patients, they may be discouraged from referring patients to our facilities, admissions may decrease and our operating performance may decline.

Our hospitals face competition for staffing, which may increase labor costs and reduce profitability.

Our operations are dependent on the efforts, abilities and experience of our management and medical support personnel, such as nurses, pharmacists and lab technicians, as well as our physicians. We compete with other health care providers in recruiting and retaining qualified management and support personnel responsible for the daily operations of each of our hospitals, including nurses and other nonphysician health care professionals. In some markets, the availability of nurses and other medical support personnel has been a significant operating issue to health care providers. We may be required to continue to enhance wages and benefits to recruit and retain nurses and other medical support personnel or to hire more expensive temporary or contract personnel. As a result, our labor costs could increase. We also depend on the available labor pool of semi-skilled and unskilled employees in each of the markets in which we operate. Certain proposed changes in federal labor laws and the NLRB’s modification of its election procedures could increase the likelihood of employee unionization attempts. To the extent a significant portion of our employee base unionizes, it is possible our labor costs could increase materially. When negotiating collective bargaining agreements with unions, whether such agreements are renewals or first contracts, there is the possibility that strikes could occur during the negotiation process, and our continued operation during any strikes could increase our labor costs. In addition, the states in which we operate could adopt mandatory nurse-staffing ratios or could reduce mandatory nurse staffing ratios already in place. State-mandated nurse-staffing ratios could significantly affect labor costs and have an adverse impact on revenues if we are required to limit admissions in order to meet the required ratios. If our labor costs increase, we may not be able to raise rates to offset these increased costs. Because a significant percentage of our revenues consists of fixed, prospective payments, our ability to pass along increased labor costs is constrained. Our failure to recruit and retain qualified management, nurses and other medical support personnel, or to control labor costs, could have a material, adverse effect on our results of operations.

If we fail to comply with extensive laws and government regulations, we could suffer penalties or be required to make significant changes to our operations.

The health care industry is required to comply with extensive and complex laws and regulations at the federal, state and local government levels relating to, among other things:

• billing and coding for services and properly handling overpayments;

• classification of level of care provided, including proper classification of inpatient admissions, observation services and outpatient care;

• relationships with physicians and other referral sources;

• necessity and adequacy of medical care;

• quality of medical equipment and services;

• qualifications of medical and support personnel;

• confidentiality, maintenance, data breach, identity theft and security issues associated with health-related and personal information and medical records;

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• screening, stabilization and transfer of individuals who have emergency medical conditions;

• licensure and certification;

• hospital rate or budget review;

• preparing and filing of cost reports;

• operating policies and procedures;

• activities regarding competitors; and

• addition of facilities and services.

Among these laws are the federal Anti-kickback Statute, the federal Stark Law, the federal FCA and similar state laws. We have a variety of financial relationships with physicians and others who either refer or influence the referral of patients to our hospitals and other health care facilities, and these laws govern those relationships. The OIG has enacted safe harbor regulations that outline practices deemed protected from prosecution under the Anti-kickback Statute. While we endeavor to comply with the applicable safe harbors, certain of our current arrangements, including joint ventures and financial relationships with physicians and other referral sources and persons and entities to which we refer patients, do not qualify for safe harbor protection. Failure to qualify for a safe harbor does not mean the arrangement necessarily violates the Anti-kickback Statute but may subject the arrangement to greater scrutiny. However, we cannot offer assurance that practices outside of a safe harbor will not be found to violate the Anti-kickback Statute. Allegations of violations of the Anti-kickback Statute may be brought under the federal Civil Monetary Penalty Law, which requires a lower burden of proof than other fraud and abuse laws, including the Anti-kickback Statute.

Our financial relationships with referring physicians and their immediate family members must comply with the Stark Law by meeting an exception. We attempt to structure our relationships to meet an exception to the Stark Law, but the regulations implementing the exceptions are detailed and complex, and we cannot provide assurance that every relationship complies fully with the Stark Law. Unlike the Anti-kickback Statute, failure to meet an exception under the Stark Law results in a violation of the Stark Law, even if such violation is technical in nature.

Additionally, if we violate the Anti-kickback Statute or Stark Law, or if we improperly bill for our services, we may be found to violate the FCA, either under a suit brought by the government or by a private person under a qui tam, or “whistleblower,” suit. See Item 1, “Business — Regulation and Other Factors.”

If we fail to comply with the Anti-kickback Statute, the Stark Law, the FCA or other applicable laws and regulations, we could be subjected to liabilities, including civil penalties (including the loss of our licenses to operate one or more facilities), exclusion of one or more facilities from participation in the Medicare, Medicaid and other federal and state health care programs and, for violations of certain laws and regulations, criminal penalties.

We do not always have the benefit of significant regulatory or judicial interpretation of these laws and regulations. In the future, different interpretations or enforcement of, or amendment to, these laws and regulations could subject our current or past practices to allegations of impropriety or illegality or could require us to make changes in our facilities, equipment, personnel, services, capital expenditure programs and operating expenses. A determination that we have violated these laws, or the public announcement that we are being investigated for possible violations of these laws, could have a material, adverse effect on our business, financial condition, results of operations or prospects, and our business reputation could suffer significantly. In addition, other legislation or regulations at the federal or state level may be adopted that adversely affect our business.

We have been and could become the subject of governmental investigations, claims and litigation.

Health care companies are subject to numerous investigations by various governmental agencies. Further, under the FCA, private parties have the right to bring qui tam, or “whistleblower,” suits against companies that

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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 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 financial position, results of operations and liquidity.

Governmental agencies and their agents, such as the Medicare Administrative Contractors, fiscal intermediaries and carriers, as well as the OIG, CMS and state Medicaid programs, conduct audits of our health care operations. Private payers may conduct similar post-payment audits, and we also perform internal audits and monitoring. Depending on the nature of the conduct found in such audits and whether the underlying conduct could be considered systemic, the resolution of these audits could have a material, adverse effect on our financial position, results of operations and liquidity.

As required by statute, CMS has implemented the RAC program on a nationwide basis. Under the program, CMS contracts with RACs on a contingency fee basis to conduct post-payment reviews to detect and correct improper payments in the fee-for-service Medicare program. The Health Reform Law expands the RAC program’s scope to include managed Medicare plans and to include Medicaid claims. In addition, CMS employs MICs to perform post-payment audits of Medicaid claims and identify overpayments. The Health Reform Law increases federal funding for the MIC program. In addition to RACs and MICs, the state Medicaid agencies and other contractors have increased their review activities.

Should we be found out of compliance with any of these laws, regulations or programs, depending on the nature of the findings, our business, our financial position and our results of operations could be negatively impacted.

Physician utilization practices and treatment methodologies or governmental or managed care controls designed to reduce inpatient services or surgical procedures may reduce our revenues.

Controls imposed by Medicare, managed Medicare, Medicaid, managed Medicaid and commercial third-party payers designed to reduce admissions, intensity of services, surgical volumes and lengths of stay, in some instances referred to as “utilization review,” have affected and are expected to continue to affect our facilities. Utilization review entails the review of the admission and course of treatment of a patient by health plans. Inpatient utilization, average lengths of stay and occupancy rates continue to be negatively affected by payer-required preadmission authorization and utilization review and by payer pressure to maximize outpatient and alternative health care delivery services for less acutely ill patients. Efforts to impose more stringent cost controls are expected to continue. For example, the Health Reform Law potentially expands the use of prepayment review by Medicare contractors by eliminating statutory restrictions on their use. Although we are unable to predict the effect these changes will have on our operations, significant limits on the scope of services reimbursed and on reimbursement rates and fees could have a material, adverse effect on our business, financial position and results of operations. Additionally, trends in physician treatment protocols and managed care health plan design, such as plans that shift increased costs and accountability for care to patients, could reduce our surgical volumes and admissions in favor of lower intensity and lower cost treatment methodologies.

Our overall business results may suffer from the economic downturn.

During periods of high unemployment, governmental entities often experience budget deficits as a result of increased costs and lower than expected tax collections. These budget deficits at federal, state and local government entities have decreased, and may continue to decrease, spending for health and human service programs, including Medicare, Medicaid and similar programs, which represent significant payer sources for our hospitals. Other risks we face during periods of high unemployment include potential declines in the population covered under managed care agreements, patient decisions to postpone or cancel elective and non-emergency health care procedures (including delaying surgical procedures), potential increases in the uninsured and underinsured populations and further difficulties in our collecting patient copayment and deductible receivables.

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The industry trend towards value-based purchasing may negatively impact our revenues.

There is a trend in the health care industry towards value-based purchasing of health care services. These value-based purchasing programs include both public reporting of quality data and preventable adverse events tied to the quality and efficiency of care provided by facilities. Governmental programs including Medicare currently require hospitals to report certain quality data to receive full reimbursement updates. In addition, Medicare does not reimburse for care related to certain preventable adverse events (also called “never events”). Many large commercial payers currently require hospitals to report quality data, and several commercial payers do not reimburse hospitals for certain preventable adverse events. Further, we have implemented a policy pursuant to which we do not bill patients or third-party payers for fees or expenses incurred due to certain preventable adverse events.

Effective July 1, 2011, the Health Reform Law also prohibits the use of federal funds under the Medicaid program to reimburse providers for medical assistance provided to treat HACs. Beginning in federal fiscal year 2015, the 25% of hospitals with the worst national risk-adjusted HAC rates in the previous year will receive a 1% reduction in their total inpatient operating Medicare payments. Beginning in fiscal year 2013, hospitals with excessive readmissions for conditions designated by HHS will receive a reduction of 1% in operating payments for all inpatient discharges, not just discharges relating to the conditions subject to the excessive readmission standard. This rate will increase by 1% each year up to 3% in federal fiscal year 2015.

The Health Reform Law also requires HHS to implement a value-based purchasing program for inpatient hospital services. The Health Reform Law requires HHS to reduce inpatient hospital payments for all discharges by a percentage beginning at 1% in federal fiscal year 2013 and increasing by 0.25% each fiscal year up to 2% in federal fiscal year 2017 and subsequent years. HHS will pool the amount collected from these reductions to fund payments to reward hospitals that meet or exceed certain quality performance standards established by HHS. According to the value-based purchasing program final rule, CMS estimates that it will distribute $850 million to hospitals in federal fiscal year 2013 based on their achievement (relative to other hospitals) and improvement ranges (relative to the hospital’s own past performance). Hospitals that meet or exceed the quality performance standards will receive greater reimbursement under the value-based purchasing program than they would have otherwise.

We expect value-based purchasing programs, including programs that condition reimbursement on patient outcome measures, to become more common and to involve a higher percentage of reimbursement amounts. We are unable at this time to predict how this trend will affect our results of operations, but it could negatively impact our revenues.

Our operations could be impaired by a failure of our information systems.

Any system failure that causes an interruption in service or availability of our systems could adversely affect operations or delay the collection of revenues. Even though we have implemented network security measures, our servers are vulnerable to computer viruses, break-ins and similar disruptions from unauthorized tampering. The occurrence of any of these events could result in interruptions, delays, the loss or corruption of data, cessations in the availability of systems or liability under privacy and security laws, all of which could have a material adverse effect on our financial position and results of operations and harm our business reputation.

The performance of our information technology and systems is critical to our business operations. In addition to our shared services initiatives, our information systems are essential to a number of critical areas of our operations, including:

• accounting and financial reporting;

• billing and collecting accounts;

• coding and compliance;

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• clinical systems;

• medical records and document storage;

• inventory management;

• negotiating, pricing and administering managed care contracts and supply contracts; and

• monitoring quality of care and collecting data on quality measures necessary for full Medicare payment updates.

If we fail to effectively and timely implement electronic health record systems and transition to the ICD-10 coding system, our operations could be adversely affected.

As required by ARRA, the Secretary of HHS has developed and implemented an incentive payment program for eligible hospitals and health care professionals that adopt and meaningfully use certified EHR technology. HHS uses the Provider Enrollment, Chain and Ownership System (“PECOS”) to verify Medicare enrollment prior to making EHR incentive program payments. During 2011, we received Medicare and Medicaid incentive payments for being a meaningful user of certified EHR technology and recorded incentive income of $210 million for the year. EHR incentive income for our eligible hospitals and professionals is estimated to range from $325 million to $350 million for 2012. Actual incentive payments could vary from our estimates due to certain factors such as availability of federal funding for both Medicare and Medicaid incentive payments, timing of the approval of state Medicaid incentive payment plans by CMS and our ability to continue to demonstrate meaningful use of certified EHR technology.

We have incurred and will continue to incur both capital costs and operating expenses in order to implement our certified EHR technology and meet meaningful use requirements. These expenses are ongoing and are projected to continue over all stages of implementation of meaningful use. The timing of expenses will not correlate with the receipt of the incentive payments and the recognition of incentive income. During 2011, we incurred $77 million of operating expenses to implement our certified EHR technology and to meet meaningful use. We estimate that operating expenses to implement our certified EHR technology and meet meaningful use will range from $140 million to $160 million for 2012. Actual operating expenses could vary from these estimates. If our eligible hospitals and employed professionals are unable to meet the requirements for participation in the incentive payment program, including having an enrollment record in PECOS, we will not be eligible to receive incentive payments that could offset some of the costs of implementing EHR systems. Further, eligible providers that fail to demonstrate meaningful use of certified EHR technology will be subject to reduced payments from Medicare, beginning in federal fiscal year 2015 for eligible hospitals and calendar year 2015 for eligible professionals. Failure to implement certified EHR systems effectively and in a timely manner could have a material, adverse effect on our financial position and results of operations.

Health plans and providers, including our hospitals, are required to transition to the new ICD-10 coding system, which greatly expands the number and detail of billing codes used for inpatient claims. Under current regulations, use of the ICD-10 system is required beginning October 1, 2013, but CMS has announced its intent to extend this deadline. Transition to the new ICD-10 system requires significant investment in coding technology and software as well as the training of staff involved in the coding and billing process. In addition to these upfront costs of transition to ICD-10, it is possible that our hospitals could experience disruption or delays in payment due to technical or coding errors or other implementation issues involving our systems or the systems and implementation efforts of health plans and their business partners. Further, the transition to the more detailed ICD-10 coding system could result in decreased reimbursement if the use of ICD-10 codes results in conditions being reclassified to MS-DRGs or commercial payer payment groupings with lower levels of reimbursement than assigned under the previous system.

State efforts to regulate the construction or expansion of health care facilities could impair our ability to operate and expand our operations.

Some states, particularly in the eastern part of the country, require health care providers to obtain prior approval, known as a CON, for the purchase, construction or expansion of health care facilities, to make certain

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capital expenditures or to make changes in services or bed capacity. In giving approval, these states consider the need for additional or expanded health care facilities or services. We currently operate health care facilities in a number of states with CON laws. The failure to obtain any requested CON could impair our ability to operate or expand operations. Any such failure could, in turn, adversely affect our ability to attract patients and physicians to our facilities and grow our revenues, which would have an adverse effect on our results of operations.

Our facilities are heavily concentrated in Florida and Texas, which makes us sensitive to regulatory, economic, environmental and competitive conditions and changes in those states.

We operated 163 hospitals at December 31, 2011, and 75 of those hospitals are located in Florida and Texas. Our Florida and Texas facilities’ combined revenues represented approximately 50% of our consolidated revenues for the year ended December 31, 2011. This concentration makes us particularly sensitive to regulatory, economic, environmental and competitive conditions and changes in those states. Any material change in the current payment programs or regulatory, economic, environmental or competitive conditions in those states could have a disproportionate effect on our overall business results.

In addition, our hospitals in Florida, Texas and other areas across the Gulf Coast are located in hurricane-prone areas. In the past, hurricanes have had a disruptive effect on the operations of our hospitals in Florida, Texas and other coastal states, and the patient populations in those states. Our business activities could be harmed by a particularly active hurricane season or even a single storm, and the property insurance we obtain may not be adequate to cover losses from future hurricanes or other natural disasters.

We may be subject to liabilities from claims by the Internal Revenue Service.

We are currently contesting certain claimed deficiencies and adjustments proposed by the IRS Examination Division in connection with its audit of HCA Inc.’s 2005 and 2006 federal income tax returns. The disputed items include the timing of recognition of certain patient service revenues, the deductibility of certain debt retirement costs and our method for calculating the tax allowance for doubtful accounts. The IRS Examination Division began an audit of HCA Inc.’s 2007, 2008 and 2009 federal income tax returns in 2010.

Management believes HCA Holdings, Inc., its predecessors, subsidiaries and affiliates properly reported taxable income and paid taxes in accordance with applicable laws and agreements established with the IRS and final resolution of these disputes will not have a material, adverse effect on our results of operations or financial position. However, if payments due upon final resolution of these issues exceed our recorded estimates, such resolutions could have a material, adverse effect on our results of operations or financial position.

We may be subject to liabilities from claims brought against our facilities.

We are subject to litigation relating to our business practices, including claims and legal actions by patients and others in the ordinary course of business alleging malpractice, product liability or other legal theories. Many of these actions involve large claims and significant defense costs. We insure a portion of our professional liability risks through a wholly-owned subsidiary. Management believes our reserves for self-insured retentions and insurance coverage are sufficient to cover insured claims arising out of the operation of our facilities. Our wholly-owned insurance subsidiary has entered into certain reinsurance contracts, and the obligations covered by the reinsurance contracts are included in its reserves for professional liability risks, as the subsidiary remains liable to the extent that the reinsurers do not meet their obligations under the reinsurance contracts. If payments for claims exceed actuarially determined estimates, are not covered by insurance, or reinsurers, if any, fail to meet their obligations, our results of operations and financial position could be adversely affected.

We are exposed to market risks related to changes in the market values of securities and interest rate changes.

We are exposed to market risk related to changes in market values of securities. The investments in debt and equity securities of our wholly-owned insurance subsidiaries were $621 million and $7 million, respectively, at

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December 31, 2011. These investments are carried at fair value, with changes in unrealized gains and losses being recorded as adjustments to other comprehensive income. At December 31, 2011, we had a net unrealized gain of $11 million on the insurance subsidiaries’ investment securities.

We are exposed to market risk related to market illiquidity. Investments in debt and equity securities of our wholly-owned insurance subsidiaries could be impaired by the inability to access the capital markets. Should the wholly-owned 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 other-than-temporary impairments on long-term investments 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.

The Investors control us and may have conflicts of interest with us in the future.

As of December 31, 2011, the Investors indirectly owned approximately 62% of our capital stock. As a result, the Investors have control over our decisions to enter into any significant corporate transaction and have the ability to prevent any transaction that requires the approval of stockholders. For example, the Investors could cause us to make acquisitions that increase the amount of our indebtedness or sell assets.

Additionally, the Investors are in the business of making investments in companies and may acquire and hold interests in businesses that compete directly or indirectly with us. One or more of the Investors may also pursue acquisition opportunities that may be complementary to our business and, as a result, those acquisition opportunities may not be available to us. So long as investment funds associated with or designated by the Investors continue to indirectly own a significant amount of the outstanding shares of our common stock, even if such amount is less than 50%, the Investors will continue to be able to strongly influence or effectively control our decisions.

Item 1B.    Unresolved Staff Comments

None.

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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, 2011:

State	Hospitals		Beds
Alaska		1		250
California		5		1,617
Colorado		7		2,259
Florida		39		10,335
Georgia		9		1,588
Idaho		2		480
Indiana		1		278
Kansas		4		1,286
Kentucky		2		384
Louisiana		6		1,264
Mississippi		1		130
Missouri		6		1,055
Nevada		3		1,092
New Hampshire		2		295
Oklahoma		2		784
South Carolina		3		748
Tennessee		12		2,327
Texas		36		10,619
Utah		6		901
Virginia		10		3,074
International
England		6		828
		163		41,594

In addition to the hospitals listed in the above table, we directly or indirectly operate 108 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 three of our other properties have been mortgaged to support our obligations under our senior secured cash flow credit facility and first lien secured notes. These three other properties are also subject to second mortgages to support our obligations under our second lien secured notes.

We maintain our headquarters in approximately 1,300,000 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.

Item 3.    Legal Proceedings

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. The resolution of any such lawsuits, claims or legal and regulatory proceedings could materially and adversely affect our results of operations and financial position in a given period.

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Government Investigations, Claims and Litigation

Health care companies are subject to numerous investigations by various governmental agencies. Further, under the federal 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 financial position, results of operations and liquidity.

The DOJ has contacted the Company in connection with its nationwide review of whether, in certain cases, hospital charges to the federal government relating to implantable cardio-defibrillators (“ICDs”) met the CMS criteria. In connection with this nationwide review, the DOJ has indicated that it will be reviewing certain ICD billing and medical records at 95 HCA hospitals; the review covers the period from October 2003 to the present. The review could potentially give rise to claims against the Company under the federal FCA or other statutes, regulations or laws. At this time, we cannot predict what effect, if any, this review or any resulting claims could have on the Company.

New Hampshire Hospital Litigation

In 2006, the Foundation for Seacoast Health (the “Foundation”) filed suit against HCA in state court in New Hampshire. The Foundation alleged that both the 2006 recapitalization transaction and a prior 1999 intra-corporate transaction violated a 1983 agreement that placed certain restrictions on transfers of the Portsmouth Regional Hospital. In May 2007, the trial court ruled against the Foundation on all its claims. On appeal, the New Hampshire Supreme Court affirmed the ruling on the 2006 recapitalization, but remanded to the trial court the claims based on the 1999 intra-corporate transaction. The trial court ruled in December 2009 that the 1999 intra-corporate transaction breached the transfer restriction provisions of the 1983 agreement. In September of 2011, the trial court issued its remedies phase decision and held that the only remedy to which the Foundation was entitled was rescission of the intra-corporate transfer that breached the transfer restriction (the Company has complied with the Court’s order, and it is not expected that such compliance will have any material effect on our operations or financial position). The Court awarded the Foundation, under the terms of the Asset Purchase Agreement, a “fraction” of its attorney fees. The Foundation appealed the remedy phase ruling, and the Company cross-appealed the liability determination. On October 31, 2011, the New Hampshire Supreme Court, on its own, raised the question whether the appeal needed to await the trial court’s further ruling on attorney fees. On November 21, 2011, after the parties briefed the issue, the New Hampshire Supreme Court dismissed the appeal as premature and remanded the case to the trial court. In February 2012, the trial court certified the case for a possible interlocutory appeal without addressing the attorney fees issue.

Securities Class Action Litigation

On October 28, 2011, a shareholder action, Schuh v. HCA Holdings, Inc. et al., was filed in the United States District Court for the Middle District of Tennessee seeking monetary relief. The case seeks to include as a class all persons who acquired the Company’s stock pursuant or traceable to the Company’s Registration Statement and Prospectus issued in connection with the March 9, 2011 initial public offering. The lawsuit asserts a claim under Section 11 of the Securities Act of 1933 against the Company, certain members of the board of directors, and certain underwriters in the offering. It further asserts a claim under Section 15 of the Securities Act of 1933 against the same members of the board of directors. The action alleges deficiencies in the Company’s disclosures in the Registration Statement relating to: (1) accounting for its 2006 recapitalization and 2010 reorganization; (2) the Company’s failure to maintain effective internal controls relating to its accounting for such transactions; and (3) the Company’s revenue growth rate. Subsequently, two additional class action complaints, Kishtah v. HCA Holdings, Inc. et al. and Daniels v. HCA Holdings, Inc. et al., setting forth substantially similar claims against substantially the same defendants in addition to Ernst & Young, LLP were filed in the same federal court on November 16, 2011 and December 12, 2011, respectively. All three of the cases have been consolidated, and the parties have agreed to initial scheduling matters.

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In addition to the above described shareholder class actions, on December 8, 2011, a federal shareholder derivative action, Sutton v. Bracken, et al., putatively initiated in the name of the Company, was filed in the United States District Court for the Middle District of Tennessee against certain officers and present and former directors of the Company seeking monetary relief. The action alleges breaches of fiduciary duties by the named officers and directors in connection with the accounting and earnings claims set forth in the shareholder class actions. Setting forth substantially similar claims against substantially the same defendants, an additional federal derivative action, Schroeder v. Bracken, et al., was filed in the United States District Court for the Middle District of Tennessee on December 16, 2011, and a state derivative action, Bagot v. Bracken, et al., was filed in Tennessee state court in the Davidson County Circuit Court on December 20, 2011. The federal derivative actions have been consolidated in the Middle District of Tennessee and the parties have agreed that those cases shall be stayed pending developments in the shareholder class actions. The state derivative action has been stayed pending developments in the shareholder class actions.

General Liability and Other Claims

We are subject to claims for additional income taxes and related interest. For a description of those proceedings, see Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations — IRS Disputes” and Note 5 to our consolidated financial statements.

We are also subject to claims and suits arising in the ordinary course of business, including claims for personal injuries or for wrongful restriction of, or interference with, physicians’ staff privileges. In certain of these actions the claimants have asked for punitive damages against us, which may not be covered by insurance. In the opinion of management, the ultimate resolution of these pending claims and legal proceedings will not have a material, adverse effect on our results of operations or financial position.

Item 4.    Mine Safety Disclosures

None.

PART II

Item 5.    Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities

See Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations — Liquidity and Capital Resources — Financing Activities” for a description of the restrictions on our ability to pay dividends. We did not declare any dividends in 2009 or 2011.

On January 27, 2010, our Board of Directors declared a distribution to the Company’s stockholders and holders of vested stock options. The distribution was $3.88 per share and vested stock option, or $1.751 billion in the aggregate. The distribution was paid on February 5, 2010 to holders of record on February 1, 2010. Pursuant to the terms of our stock option plans, the holders of nonvested stock options received a $3.88 per share reduction to the exercise price of their share-based awards.

On May 5, 2010, our Board of Directors declared a distribution to the Company’s stockholders and holders of vested stock options. The distribution was $1.11 per share and vested stock option, or $500 million in the aggregate. The distribution was paid on May 14, 2010 to holders of record on May 6, 2010. Pursuant to the terms of our stock option plans, the holders of nonvested stock options received a $1.11 per share reduction to the exercise price of their share-based awards.

On November 23, 2010, our Board of Directors declared a distribution to the Company’s stockholders and holders of stock options. The distribution was $4.44 per share and vested stock option, or approximately $2.1 billion in the aggregate. The distribution to stockholders and holders of vested options was paid on December 1, 2010 to holders of record on November 24, 2010. Pursuant to the terms of our stock option plans, the holders of nonvested options received $4.44 per share reductions (subject to certain tax imitations that resulted in deferred distributions for a portion of the declared distribution, which will be paid upon the vesting of the applicable stock options) to the exercise price of the share-based awards.

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During February 2011, our Board of Directors approved an increase in the number of our authorized shares to 1,800,000,000 shares of common stock and a 4.505-to-one split of our issued and outstanding common shares. All common share and per common share amounts in this Form 10-K reflect the 4.505-to-one split. During March 2011, we completed the initial public offering of 87,719,300 shares of our common stock at a price of $30.00 per share (before deducting underwriter discounts, commissions and other related offering expenses). Certain of our stockholders also sold 57,410,700 shares of our common stock in this offering. We did not receive any proceeds from the shares sold by the selling stockholders. Our common stock is now traded on the New York Stock Exchange (the “NYSE”) (symbol “HCA”). Our first day of trading was March 10, 2011.

On September 21, 2011, we repurchased 80,771,143 shares of our common stock beneficially owned by affiliates of Bank of America Corporation at a purchase price of $18.61 per share, the closing price of the Company’s common stock on the NYSE on September 14, 2011. The repurchase was financed using a combination of cash on hand and borrowings under available credit facilities. The shares repurchased represented approximately 15.6% of our total shares outstanding at the time of the repurchase.

The table below sets forth, for the calendar quarters indicated, the high and low sales prices per share reported on the NYSE for our common stock.

	Sales Price
	High		Low
2011
First Quarter	$	34.57	$	30.36
Second Quarter		35.37		30.75
Third Quarter		34.92		17.03
Fourth Quarter		26.86		17.43

At the close of business on January 12, 2012, there were approximately 1,030 holders of record of our common stock.

On February 3, 2012, our Board of Directors declared a cash distribution to the Company’s stockholders and holders of vested stock options. The distribution was $2.00 per share and vested stock option, or approximately $975 million in the aggregate (inclusive of the distributions to holders of stock options and restricted share units). The distribution will be paid on February 29, 2012 to the holders of record on February 16, 2012. The distribution will be funded through existing cash and borrowings under our existing senior secured credit facilities. Pursuant to the terms of our equity incentive plans, (1) the holders of any unvested options will receive $2.00 per share reductions (subject to certain tax limitations that resulted in deferred distributions for a portion of the declared distribution, which will be paid upon vesting of the applicable stock options) to the exercise price of the stock option awards; (2) the holders of any unvested stock appreciation rights will receive $2.00 per share reductions to the base price of the stock appreciation right awards; and (3) the holders of any unvested restricted share units will receive $2.00 per unit, which will be paid upon vesting of the applicable restricted share units.

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	3/10/2011		3/31/2011		6/30/2011		9/30/2011		12/30/2011
HCA Holdings, Inc.		100.00		109.19		106.38		64.99		71.02
S&P 500		100.00		100.04		100.14		86.25		96.44
S&P Health Care		100.00		101.90		109.91		98.90		108.76

The graph shows the cumulative total return to our stockholders beginning as of March 10, 2011, the day our stock began trading on the NYSE, and through December 30, 2011, in comparison to the cumulative returns of the S&P 500 Index and the S&P Health Care Index. The graph assumes $100 invested on March 10, 2011 in our common stock and in each index with the subsequent reinvestment of dividends. The stock performance shown on the graph represents historical stock performance and is not necessarily indicative of future stock price performance.

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Item 6.    Selected Financial Data

HCA HOLDINGS, INC.

SELECTED FINANCIAL DATA

AS OF AND FOR THE YEARS ENDED DECEMBER 31

(Dollars in millions, except per share amounts)

	2011			2010			2009			2008			2007
Summary of Operations:
Revenues before provision for doubtful accounts	$	32,506		$	30,683		$	30,052		$	28,374		$	26,858
Provision for doubtful accounts		2,824			2,648			3,276			3,409			3,130
Revenues		29,682			28,035			26,776			24,965			23,728
Salaries and benefits		13,440			12,484			11,958			11,440			10,714
Supplies		5,179			4,961			4,868			4,620			4,395
Other operating expenses		5,470			5,004			4,724			4,554			4,233
Electronic health record incentive income		(210	)		—			—			—			—
Equity in earnings of affiliates		(258	)		(282	)		(246	)		(223	)		(206	)
Depreciation and amortization		1,465			1,421			1,425			1,416			1,426
Interest expense		2,037			2,097			1,987			2,021			2,215
Losses (gains) on sales of facilities		(142	)		(4	)		15			(97	)		(471	)
Gain on acquisition of controlling interest in equity investment		(1,522	)		—			—			—			—
Impairments of long-lived assets		—			123			43			64			24
Losses on retirement of debt		481			—			—			—			—
Termination of management agreement		181			—			—			—			—
		26,121			25,804			24,774			23,795			22,330
Income before income taxes		3,561			2,231			2,002			1,170			1,398
Provision for income taxes		719			658			627			268			316
Net income		2,842			1,573			1,375			902			1,082
Net income attributable to noncontrolling interests		377			366			321			229			208
Net income attributable to HCA Holdings, Inc.	$	2,465		$	1,207		$	1,054		$	673		$	874
Per common share data:
Basic earnings per share	$	5.17		$	2.83		$	2.48		$	1.59		$	2.07
Diluted earnings per share	$	4.97		$	2.76		$	2.44			1.56			2.03
Cash dividends declared per share		—		$	9.43			—			—			—
Financial Position:
Assets	$	26,898		$	23,852		$	24,131		$	24,280		$	24,025
Working capital		1,679			2,650			2,264			2,391			2,356
Long-term debt, including amounts due within one year		27,052			28,225			25,670			26,989			27,308
Equity securities with contingent redemption rights		—			141			147			155			164
Noncontrolling interests		1,244			1,132			1,008			995			938
Stockholders’ deficit		(7,014	)		(10,794	)		(7,978	)		(9,260	)		(9,600	)
Cash Flow Data:
Cash provided by operating activities	$	3,933		$	3,085		$	2,747		$	1,990		$	1,564
Cash used in investing activities		(2,995	)		(1,039	)		(1,035	)		(1,467	)		(479	)
Capital expenditures		(1,679	)		(1,325	)		(1,317	)		(1,600	)		(1,444	)
Cash used in financing activities		(976	)		(1,947	)		(1,865	)		(451	)		(1,326	)

58

	2011			2010			2009			2008			2007
Operating Data:
Number of hospitals at end of period(a)		163			156			155			158			161
Number of freestanding outpatient surgical centers at end of period(b)		108			97			97			97			99
Number of licensed beds at end of period(c)		41,594			38,827			38,839			38,504			38,405
Weighted average licensed beds(d)		39,735			38,655			38,825			38,422			39,065
Admissions(e)		1,620,400			1,554,400			1,556,500			1,541,800			1,552,700
Equivalent admissions(f)		2,595,900			2,468,400			2,439,000			2,363,600			2,352,400
Average length of stay (days)(g)		4.8			4.8			4.8			4.9			4.9
Average daily census(h)		21,123			20,523			20,650			20,795			21,049
Occupancy(i)		53	%		53	%		53	%		54	%		54	%
Emergency room visits(j)		6,143,500			5,706,200			5,593,500			5,246,400			5,116,100
Outpatient surgeries(k)		799,200			783,600			794,600			797,400			804,900
Inpatient surgeries(l)		484,500			487,100			494,500			493,100			516,500
Days revenues in accounts receivable(m)		53			50			50			55			60
Gross patient revenues(n)	$	141,516		$	125,640		$	115,682		$	102,843		$	92,429
Outpatient revenues as a % of patient revenues(o)		37	%		36	%		39	%		39	%		39	%

(a) Excludes eight facilities in 2010, 2009, 2008 and 2007 that were not consolidated (accounted for using the equity method) for financial reporting purposes.

(b) Excludes one facility in 2011, nine facilities in 2010 and 2007 and eight facilities in 2009 and 2008 that were not consolidated (accounted for using the equity method) for financial reporting purposes.

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

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

(e) 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.

(f) 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.

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

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

(i) 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.

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

(k) 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.

(l) 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.

(m) Revenues per day is calculated by dividing the revenues for the period by the days in the period. Days revenues in accounts receivable is then calculated as accounts receivable, net of the allowance for doubtful accounts, at the end of the period divided by revenues per day. With our adoption of ASU 2011-07, “revenues” used in this computation are net of the provision for doubtful accounts and the computations for all prior periods presented have been restated.

(n) Gross patient revenues are based upon our standard charge listing. Gross charges/revenues typically do not reflect what our hospital facilities are paid. Gross charges/revenues are reduced by the provision for doubtful accounts, contractual adjustments, discounts and charity care to determine reported revenues.

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

59

HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS

Item 7.    Management’s Discussion and Analysis of Financial Condition and Results of Operations

The selected financial data and the accompanying consolidated financial statements present certain information with respect to the financial position, results of operations and cash flows of HCA Holdings, Inc. which should be read in conjunction with the following discussion and analysis. The terms “HCA,” “Company,” “we,” “our,” or “us,” as used herein, refer HCA Inc. and our affiliates prior to the Corporate Reorganization and to HCA Holdings, Inc. and our affiliates after the Corporate Reorganization unless otherwise stated or indicated by context. The term “affiliates” means direct and indirect subsidiaries of HCA Holdings, Inc. and partnerships and joint ventures in which such subsidiaries are partners.

Forward-Looking Statements

This annual report on Form 10-K includes certain disclosures which contain “forward-looking statements.” Forward-looking statements include all 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) the impact of our substantial indebtedness and the ability to refinance such indebtedness on acceptable terms, (2) the effects related to the enactment and implementation of the Budget Control Act of 2011 (“BCA”) and the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act (collectively, the “Health Reform Law”), the possible enactment of additional federal or state health care reforms and possible changes to the Health Reform Law and other federal, state or local laws or regulations affecting the health care industry, (3) increases in the amount and risk of collectibility of uninsured accounts and deductibles and copayment amounts for insured accounts, (4) the ability to achieve operating and financial targets, and attain expected levels of patient volumes and control the costs of providing services, (5) possible changes in the Medicare, Medicaid and other state programs, including Medicaid upper payment limit programs or Waiver Programs, that may impact reimbursements to health care providers and insurers, (6) the highly competitive nature of the health care business, (7) changes in service mix and revenue mix, including potential declines in the population covered under managed care agreements and the ability to enter into and renew managed care provider agreements on acceptable terms, (8) the efforts of insurers, health care providers and others to contain health care costs, (9) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (10) increases in wages and the ability to attract and retain qualified management and personnel, including affiliated physicians, nurses and medical and technical support personnel, (11) the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities, (12) changes in accounting practices, (13) changes in general economic conditions nationally and regionally in our markets, (14) future divestitures which may result in charges and possible impairments of long-lived assets, (15) changes in business strategy or development plans, (16) delays in receiving payments for services provided, (17) the outcome of pending and any future tax audits, appeals and litigation associated with our tax positions, (18) potential adverse impact of known and unknown government investigations, litigation and other claims that may be made against us, (19) our ongoing ability to demonstrate meaningful use of certified electronic health record technology and recognize income for the related Medicare or Medicaid incentive payments, and (20) other risk factors described in this annual report on Form 10-K. 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.

60

HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

2011 Operations Summary

Net income attributable to HCA Holdings, Inc. totaled $2.465 billion, or $4.97 per diluted share, for 2011, compared to $1.207 billion, or $2.76 per diluted share, for 2010. The 2011 results include net gains on sales of facilities of $142 million (pretax), or $0.16 per diluted share, a gain on the acquisition of controlling interest in an equity investment of $1.522 billion (pretax), or $2.87 per diluted share, losses on retirement of debt of $481 million (pretax), or $0.61 per diluted share, and termination of management agreement fees of $181 million (pretax), or $0.30 per diluted share. The 2010 results include net gains on sales of facilities of $4 million (pretax), or $0.01 per diluted share, and impairments of long-lived assets of $123 million (pretax), or $0.18 per diluted share. All “per diluted share” disclosures are based upon amounts net of the applicable income taxes. Shares used for diluted earnings per share were 495.943 million shares and 437.347 million shares for the years ended December 31, 2011 and 2010, respectively. During March 2011, we completed the initial public offering of 87.719 million shares of our common stock, and during September 2011, we repurchased 80.771 million shares of our common stock from affiliates of Bank of America Corporation.

Revenues increased to $29.682 billion for 2011 from $28.035 billion for 2010. Revenues increased 5.9% and 3.3%, respectively, on a consolidated basis and on a same facility basis for 2011, compared to 2010. The consolidated revenues increase can be attributed to the combined impact of a 0.7% increase in revenue per equivalent admission and a 5.2% increase in equivalent admissions. The same facility revenues increase resulted from a 0.3% increase in same facility revenue per equivalent admission and a 3.0% increase in same facility equivalent admissions. We experienced a shift in service mix from more complex surgical cases to less acute medical cases, resulting in lower than anticipated revenue per equivalent admission growth for 2011.

During 2011, consolidated admissions increased 4.2% and same facility admissions increased 2.3%, compared to 2010. Inpatient surgical volumes declined 0.5% on a consolidated basis and declined 1.7% on a same facility basis during 2011, compared to 2010. Outpatient surgical volumes increased 2.0% on a consolidated basis and declined 0.6% on a same facility basis during 2011, compared to 2010. Emergency room visits increased 7.7% on a consolidated basis and increased 6.2% on a same facility basis during 2011, compared to 2010.

For 2011, the provision for doubtful accounts increased $176 million, compared to 2010. The self-pay revenue deductions for charity care and uninsured discounts increased $346 million and $1.066 billion, respectively, for 2011, compared to 2010. The sum of the provision for doubtful accounts, uninsured discounts and charity care, as a percentage of the sum of revenues, the provision for doubtful accounts, uninsured discounts and charity care, was 27.4% for 2011, compared to 25.6% for 2010. Same facility uninsured admissions increased 7.4% and same facility uninsured emergency room visits increased 5.8% for 2011, compared to 2010.

Interest expense totaled $2.037 billion for 2011, compared to $2.097 billion for 2010. The $60 million decline in interest expense for 2011 was due primarily to a decline in the average interest rate.

Cash flows from operating activities increased $848 million, from $3.085 billion for 2010 to $3.933 billion for 2011. The increase in cash flows from operating activities was primarily due to improved cash flows of $885 million related to income taxes.

Business Strategy

We are committed to providing the communities we serve with high quality, cost-effective health care while growing our business, increasing our profitability and creating long-term value for our stockholders. To achieve these objectives, we align our efforts around the following growth agenda:

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HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Business Strategy (Continued)

Grow Our Presence in Existing Markets.    We believe we are well positioned in a number of large and growing markets that will allow us the opportunity to generate long-term, attractive growth through the expansion of our presence in these markets. We plan to continue recruiting and strategically collaborating with the physician community and adding attractive service lines such as cardiology, emergency services, oncology and women’s services. Additional components of our growth strategy include expanding our footprint through developing various outpatient access points, including surgery centers, rural outreach, freestanding emergency departments and walk-in clinics.

Achieve Industry-Leading Performance in Clinical and Satisfaction Measures.    Achieving high levels of patient safety, patient satisfaction and clinical quality are central goals of our business model. To achieve these goals, we have implemented a number of initiatives including infection reduction initiatives, hospitalist programs, advanced health information technology and evidence-based medicine programs. We routinely analyze operational practices from our best-performing hospitals to identify ways to implement organization-wide performance improvements and reduce clinical variation. We believe these initiatives will continue to improve patient care, help us achieve cost efficiencies, grow our revenues and favorably position us in an environment where our constituents are increasingly focused on quality, efficacy and efficiency.

Recruit and Employ Physicians to Meet Need for High Quality Health Services.    We depend on the quality and dedication of the health care providers and other team members who serve at our facilities. We believe a critical component of our growth strategy is our ability to successfully recruit and strategically collaborate with physicians and other professionals to provide high quality care. We attract and retain physicians by providing high quality, convenient facilities with advanced technology, by expanding our specialty services and by building our outpatient operations. We believe our continued investment in the employment, recruitment and retention of physicians will improve the quality of care at our facilities.

Continue to Leverage Our Scale and Market Positions to Enhance Profitability.    We believe there is significant opportunity to continue to grow the profitability of our company by fully leveraging the scale and scope of our franchise. We are currently pursuing next generation performance improvement initiatives such as contracting for services on a multistate basis and expanding our support infrastructure for additional clinical and support functions, such as physician credentialing, medical transcription and electronic medical recordkeeping. We believe our centrally managed business processes and ability to leverage cost-saving practices across our extensive network will enable us to continue to manage costs effectively. We have created a subsidiary, Parallon Business Solutions, to leverage key components of our support infrastructure, including revenue cycle management, healthcare group purchasing, supply chain management and staffing functions and are offering these services to other hospital companies.

Selectively Pursue a Disciplined Development Strategy.    We continue to believe there are significant growth opportunities in our markets. We will continue to provide financial and operational resources to successfully execute on our in-market opportunities. To complement our in-market growth agenda, we intend to focus on selectively developing and acquiring new hospitals, outpatient facilities and other health care service providers. We believe the challenges faced by the hospital industry may spur consolidation and we believe our size, scale, national presence and access to capital will position us well to participate in any such consolidation. We have a strong record of successfully acquiring and integrating hospitals and entering into joint ventures and intend to continue leveraging this experience.

62

HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Critical Accounting Policies and Estimates

The preparation of our consolidated financial statements requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent liabilities and the reported amounts of revenues and expenses. Our estimates are based on historical experience and various other assumptions we believe are reasonable under the circumstances. We evaluate our estimates on an ongoing basis and make changes to the estimates and related disclosures as experience develops or new information becomes known. Actual results may differ from these estimates.

We believe the following critical accounting policies affect our more significant judgments and estimates used in the preparation of our consolidated financial statements.

Revenues

Revenues are recorded during the period the health care services are provided, based upon the estimated amounts due from payers. Estimates of contractual allowances under managed care health plans are based upon the payment terms specified in the related contractual agreements. Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. The estimated reimbursement amounts are made on a payer-specific basis and are recorded based on the best information available regarding management’s interpretation of the applicable laws, regulations and contract terms. 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. We have invested significant resources to refine and improve our computerized billing systems and the information system data used to make contractual allowance estimates. We have developed standardized calculation processes and related training programs to improve the utility of our patient accounting systems.

The Emergency Medical Treatment and Labor Act (“EMTALA”) requires any hospital participating in the Medicare program to conduct an appropriate medical screening examination of every person who presents to the hospital’s emergency room for treatment and, if the individual is suffering from an emergency medical condition, to either stabilize the condition or make an appropriate transfer of the individual to a facility able to handle the condition. The obligation to screen and stabilize emergency medical conditions exists regardless of an individual’s ability to pay for treatment. Federal and state laws and regulations, including but not limited to EMTALA, require, and our commitment to providing quality patient care encourages, the provision of services to patients who are financially unable to pay for the health care services they receive. The Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, the “Health Reform Law”), requires health plans to reimburse hospitals for emergency services provided to enrollees without prior authorization and without regard to whether a participating provider contract is in place. Further, as enacted, the Health Reform Law contains provisions that seek to decrease the number of uninsured individuals, including requirements or incentives, which do not become effective until 2014, for individuals to obtain, and large employers to provide, insurance coverage. These mandates may reduce the financial impact of screening for and stabilizing emergency medical conditions. However, many factors are unknown regarding the impact of the Health Reform Law, including the outcome of court challenges to the constitutionality of the law and Congressional efforts to amend or repeal the law, how many previously uninsured individuals will obtain coverage as a result of the law or the change, if any, in the volume of inpatient and outpatient hospital services that are sought by and provided to previously uninsured individuals and the payer mix.

We do not pursue collection of amounts related to patients who meet our guidelines to qualify as charity care; therefore, they are not reported in revenues. Patients treated at our hospitals for nonelective care, who have income at or below 200% of the federal poverty level, are eligible for charity care. The federal poverty level is established by the federal government and is based on income and family size. We provide discounts from our

63

HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Critical Accounting Policies and Estimates (Continued)

Revenues (Continued)

gross charges to uninsured patients who do not qualify for Medicaid or charity care. These discounts are similar to those provided to many local managed care plans. After the discounts are applied, we are still unable to collect a significant portion of uninsured patients’ accounts, and we record significant provisions for doubtful accounts (based upon our historical collection experience) related to uninsured patients in the period the services are provided.

Due to the complexities involved in the classification and documentation of health care services authorized and provided, the estimation of revenues earned and the related reimbursement are often subject to interpretations that could result in payments that are different from our estimates. Adjustments to estimated Medicare and Medicaid reimbursement amounts and disproportionate-share funds, which resulted in net increases to revenues, related primarily to cost reports filed during the respective year were $40 million, $52 million and $40 million in 2011, 2010 and 2009, respectively. The adjustments to estimated reimbursement amounts, which resulted in net increases to revenues, related primarily to cost reports filed during previous years were $30 million, $50 million and $60 million in 2011, 2010 and 2009, respectively. We expect adjustments during the next 12 months related to Medicare and Medicaid cost report filings and settlements and disproportionate-share funds will result in increases to revenues within generally similar ranges.

Provision for Doubtful Accounts and the Allowance for Doubtful Accounts

The collection of outstanding receivables from Medicare, managed care payers, other third-party payers and patients is our primary source of cash and is critical to our operating performance. The primary collection risks relate to uninsured patient accounts, including patient accounts for which the primary insurance carrier has paid the amounts covered by the applicable agreement, but patient responsibility amounts (deductibles and copayments) remain outstanding. The provision for doubtful accounts and the allowance for doubtful accounts relate primarily to amounts due directly from patients. An estimated allowance for doubtful accounts is recorded for all uninsured accounts, regardless of the aging of those accounts. Accounts are written off when all reasonable internal and external collection efforts have been performed. Our collection policies include a review of all accounts against certain standard collection criteria, upon completion of our internal collection efforts. Accounts determined to possess positive collectibility attributes are forwarded to a secondary external collection agency and the other accounts are written off. The accounts that are not collected by the secondary external collection agency are written off when they are returned to us by the collection agency (usually within 12 months). Writeoffs are based upon specific identification and the writeoff process requires a writeoff adjustment entry to the patient accounting system. We do not pursue collection of amounts related to patients that meet our guidelines to qualify as charity care.

During 2011, we adopted the provisions of Accounting Standards Update No. 2011-07, Presentation and Disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities (“ASU 2011-07”). ASU 2011-07 requires health care entities to change the presentation of the statement of operations by reclassifying the provision for doubtful accounts from an operating expense to a deduction from patient service revenues. All periods presented in this Form 10-K have been reclassified in accordance with ASU 2011-07. The amount of the provision for doubtful accounts is 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 recoveries at facilities that represent a majority of our revenues and accounts receivable (the “hindsight analysis”) as a primary source of information in

64

HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Critical Accounting Policies and Estimates (Continued)

Provision for Doubtful Accounts and the Allowance for Doubtful Accounts (Continued)

estimating the collectibility 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 allowance for doubtful accounts at each of our hospital facilities provide reasonable valuations of our accounts receivable. These routine, quarterly changes in estimates have not resulted in material adjustments to our allowance for doubtful accounts, provision for doubtful accounts or period-to-period comparisons of our results of operations. At December 31, 2011 and 2010, the allowance for doubtful accounts represented approximately 92% and 93%, respectively, of the $4.478 billion and $4.249 billion, respectively, patient due accounts receivable balance. The patient due accounts receivable balance represents the estimated uninsured portion of our accounts receivable. The estimated uninsured portion of Medicaid pending and uninsured discount pending accounts is included in our patient due accounts receivable balance.

The revenue deductions related to uninsured accounts (charity care and uninsured discounts) generally have the inverse effect on the provision for doubtful accounts. To quantify the total impact of and trends related to uninsured accounts, we believe it is beneficial to view these revenue deductions and provision for doubtful accounts in combination, rather than each separately. A summary of these amounts for the years ended December 31, follows (dollars in millions):

	2011		2010		2009
Charity care	$	2,683	$	2,337	$	2,151
Uninsured discounts		5,707		4,641		2,935
Provision for doubtful accounts		2,824		2,648		3,276
Totals	$	11,214	$	9,626	$	8,362

Increases to our uninsured discounts have directly contributed to the declining trend in the provision for doubtful accounts. However, the sum of the provision for doubtful accounts, uninsured discounts and charity care, as a percentage of the sum of revenues, the provision for doubtful accounts, uninsured discounts and charity care increased from 23.8% for 2009 to 25.6% for 2010 and to 27.4% for 2011.

Days revenues in accounts receivable were 53 days, 50 days and 50 days at December 31, 2011, 2010 and 2009, 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, 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.

65

HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Critical Accounting Policies and Estimates (Continued)

Provision for Doubtful Accounts and the Allowance for Doubtful Accounts (Continued)

The approximate breakdown of accounts receivable by payer classification as of December 31, 2011 and 2010 is set forth in the following table:

	% of Accounts Receivable
	Under 91 Days			91—180 Days			Over 180 Days
Accounts receivable aging at December 31, 2011:
Medicare and Medicaid		14	%		1	%		1	%
Managed care and other insurers		22			5			5
Uninsured		15			8			29
Total		51	%		14	%		35	%
Accounts receivable aging at December 31, 2010:
Medicare and Medicaid		14	%		1	%		1	%
Managed care and other insurers		21			4			4
Uninsured		17			8			30
Total		52	%		13	%		35	%

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 wholly-owned insurance subsidiary for losses up to $50 million per occurrence, subject to a $5 million per occurrence self-insured retention. We purchase excess insurance on a claims-made basis for losses in excess of $50 million per occurrence. Our professional liability reserves, net of receivables under reinsurance contracts, do not include amounts for any estimated losses covered by our excess insurance coverage. Provisions for losses related to professional liability risks were $244 million, $222 million and $211 million for the years ended December 31, 2011, 2010 and 2009, respectively.

Reserves for professional liability risks represent the estimated ultimate cost of all reported and unreported losses incurred through the respective consolidated balance sheet dates. The estimated ultimate cost includes estimates of direct expenses and fees paid to outside counsel and experts, but does not include the general overhead costs of our insurance subsidiary or corporate office. Individual case reserves are established based upon the particular circumstances of each reported claim and represent our estimates of the future costs that will be paid on reported claims. Case reserves are reduced as claim payments are made and are adjusted upward or downward as our estimates regarding the amounts of future losses are revised. Once the case reserves for known claims are determined, information is stratified by loss layers and retentions, accident years, reported years, and geographic location of our hospitals. Several actuarial methods are employed to utilize this data to produce estimates of ultimate losses and reserves for incurred but not reported claims, including: paid and incurred extrapolation methods utilizing paid and incurred loss development to estimate ultimate losses; frequency and severity methods utilizing paid and incurred claims development to estimate ultimate average frequency (number of claims) and ultimate average severity (cost per claim); and Bornhuetter-Ferguson methods which add expected development to actual paid or incurred experience to estimate ultimate losses. These methods use our company-specific historical claims data and other information. Company-specific claim reporting and settlement data collected over an approximate 20-year period is used in our reserve estimation process. This company-specific data includes information regarding our business, including historical paid losses and loss adjustment expenses,

66

HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Critical Accounting Policies and Estimates (Continued)

Professional Liability Claims (Continued)

historical and current case loss reserves, actual and projected hospital statistical data, professional liability retentions for each policy year, geographic information and other data.

Reserves and provisions for professional liability risks are based upon actuarially determined estimates. The estimated reserve ranges, net of amounts receivable under reinsurance contracts, were $1.134 billion to $1.354 billion at December 31, 2011 and $1.067 billion to $1.276 billion at December 31, 2010. Our estimated reserves for professional liability claims may change significantly if future claims differ from expected trends. We perform sensitivity analyses which model the volatility of key actuarial assumptions and monitor our reserves for adequacy relative to all our assumptions in the aggregate. Based on our analysis, we believe the estimated professional liability reserve ranges represent the reasonably likely outcomes for ultimate losses. We consider the number and severity of claims to be the most significant assumptions in estimating reserves for professional liabilities. A 2% change in the expected frequency trend could be reasonably likely and would increase the reserve estimate by $18 million or reduce the reserve estimate by $17 million. A 2% change in the expected claim severity trend could be reasonably likely and would increase the reserve estimate by $78 million or reduce the reserve estimate by $71 million. We believe adequate reserves have been recorded for our professional liability claims; however, due to the complexity of the claims, the extended period of time to settle the claims and the wide range of potential outcomes, our ultimate liability for professional liability claims could change by more than the estimated sensitivity amounts and could change materially from our current estimates.

The reserves for professional liability risks cover approximately 2,700 individual claims at both December 31, 2011 and 2010 and estimates for unreported potential claims. The time period required to resolve these claims can vary depending upon the jurisdiction and whether the claim is settled or litigated. The average time period between the occurrence and payment of final settlement for our professional liability claims is approximately five years, although the facts and circumstances of each individual claim can result in an occurrence-to-settlement timeframe that varies from this average. The estimation of the timing of payments beyond a year can vary significantly.

Reserves for professional liability risks were $1.291 billion and $1.262 billion at December 31, 2011 and 2010, respectively. The current portion of these reserves, $298 million and $268 million at December 31, 2011 and 2010, respectively, is included in “other accrued expenses.” Obligations covered by reinsurance contracts are included in the reserves for professional liability risks, as the insurance subsidiary remains liable to the extent reinsurers do not meet their obligations. Reserves for professional liability risks (net of $39 million and $14 million receivable under reinsurance contracts at December 31, 2011 and 2010, respectively) were $1.252 billion and $1.248 billion at December 31, 2011 and 2010, respectively. The estimated total net reserves for professional liability risks at December 31, 2011 and 2010 are comprised of $817 million and $758 million, respectively, of case reserves for known claims and $435 million and $490 million, respectively, of reserves for incurred but not reported claims.

67

HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Critical Accounting Policies and Estimates (Continued)

Professional Liability Claims (Continued)

Changes in our professional liability reserves, net of reinsurance recoverable, for the years ended December 31, are summarized in the following table (dollars in millions):

	2011			2010			2009
Net reserves for professional liability claims, January 1	$	1,248		$	1,269		$	1,330
Provision for current year claims		298			272			258
Favorable development related to prior years’ claims		(54	)		(50	)		(47	)
Total provision		244			222			211
Payments for current year claims		7			7			4
Payments for prior years’ claims		233			236			268
Total claim payments		240			243			272
Net reserves for professional liability claims, December 31	$	1,252		$	1,248		$	1,269

The favorable development related to prior years’ claims resulted from declining claim frequency and moderating claim severity trends. We believe these favorable trends are primarily attributable to tort reforms enacted in key states, particularly Texas, and our risk management and patient safety initiatives, particularly in the area of obstetrics.

Income Taxes

We calculate our provision for income taxes using the asset and liability method, under which deferred tax assets and liabilities are recognized by identifying the temporary differences that arise from the recognition of items in different periods for tax and accounting purposes. Deferred tax assets generally represent the tax effects of amounts expensed in our income statement for which tax deductions will be claimed in future periods.

Although we believe we have properly reported taxable income and paid taxes in accordance with applicable laws, federal, state or international taxing authorities may challenge our tax positions upon audit. Significant judgment is required in determining and assessing the impact of uncertain tax positions. We report a liability for unrecognized tax benefits from uncertain tax positions taken or expected to be taken in our income tax return. During each reporting period, we assess the facts and circumstances related to uncertain tax positions. If the realization of unrecognized tax benefits is deemed probable based upon new facts and circumstances, the estimated liability and the provision for income taxes are reduced in the current period. Final audit results may vary from our estimates.

Results of Operations

Revenue/Volume Trends

Our revenues depend upon inpatient occupancy levels, the ancillary services and therapy programs ordered by physicians and provided to patients, the volume of outpatient procedures and the charge and negotiated payment rates for such services. Gross charges typically do not reflect what our facilities are actually paid. Our facilities have entered into agreements with third-party payers, including government programs and managed care health plans, under which the facilities are paid based upon the cost of providing services, predetermined rates per diagnosis, fixed per diem rates or discounts from gross charges. We do not pursue collection of amounts related to patients who meet our guidelines to qualify for charity care; therefore, they are not reported in

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MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Results of Operations (Continued)

Revenue/Volume Trends (Continued)

revenues. We provide discounts to uninsured patients who do not qualify for Medicaid or charity care that are similar to the discounts provided to many local managed care plans.

Revenues increased 5.9% to $29.682 billion for 2011 from $28.035 billion for 2010 and increased 4.7% for 2010 from $26.776 billion for 2009. The increase in revenues in 2011 can be primarily attributed to the combined impact of a 0.7% increase in revenue per equivalent admission and a 5.2% increase in equivalent admissions compared to the prior year. The increase in revenues in 2010 can be primarily attributed to the combined impact of a 3.5% increase in revenue per equivalent admission and a 1.2% increase in equivalent admissions compared to 2009.

Consolidated admissions increased 4.2% in 2011 compared to 2010 and declined 0.1% in 2010 compared to 2009. Consolidated inpatient surgeries declined 0.5% and consolidated outpatient surgeries increased 2.0% during 2011 compared to 2010. Consolidated inpatient surgeries declined 1.5% and consolidated outpatient surgeries declined 1.4% during 2010 compared to 2009. Consolidated emergency room visits increased 7.7% during 2011 compared to 2010 and increased 2.0% during 2010 compared to 2009.

Same facility revenues increased 3.3% for the year ended December 31, 2011 compared to the year ended December 31, 2010 and increased 4.6% for the year ended December 31, 2010 compared to the year ended December 31, 2009. The 3.3% increase for 2011 can be primarily attributed to the combined impact of a 0.3% increase in same facility revenue per equivalent admission and a 3.0% increase in same facility equivalent admissions. The 4.6% increase for 2010 can be primarily attributed to the combined impact of a 3.2% increase in same facility revenue per equivalent admission and a 1.4% increase in same facility equivalent admissions.

Same facility admissions increased 2.3% in 2011 compared to 2010 and increased 0.1% in 2010 compared to 2009. Same facility inpatient surgeries declined 1.7% and same facility outpatient surgeries declined 0.6% during 2011 compared to 2010. Same facility inpatient surgeries declined 1.4% and same facility outpatient surgeries declined 1.2% during 2010 compared to 2009. Same facility emergency room visits increased 6.2% during 2011 compared to 2010 and increased 2.1% during 2010 compared to 2009.

Same facility uninsured emergency room visits increased 5.8% and same facility uninsured admissions increased 7.4% during 2011 compared to 2010. Same facility uninsured emergency room visits increased 1.2% and same facility uninsured admissions increased 5.4% during 2010 compared to 2009.

The approximate percentages of our admissions related to Medicare, managed Medicare, Medicaid, managed Medicaid, managed care and other insurers and the uninsured for the years ended December 31, 2011, 2010 and 2009 are set forth below.

	Years Ended December 31,
	2011			2010			2009
Medicare		34	%		34	%		34	%
Managed Medicare		11			10			10
Medicaid		9			9			9
Managed Medicaid		8			8			7
Managed care and other insurers		31			32			34
Uninsured		7			7			6
		100	%		100	%		100	%

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HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Results of Operations (Continued)

Revenue/Volume Trends (Continued)

The approximate percentages of our inpatient revenues, before provision for doubtful accounts, related to Medicare, managed Medicare, Medicaid, managed Medicaid, managed care plans and other insurers and the uninsured for the years ended December 31, 2011, 2010 and 2009 are set forth below.

	Years Ended December 31,
	2011			2010			2009
Medicare		31	%		31	%		31	%
Managed Medicare		9			9			8
Medicaid		8			9			8
Managed Medicaid		4			4			4
Managed care and other insurers		45			44			44
Uninsured(a)		3			3			5
		100	%		100	%		100	%

(a) Increases in discounts to uninsured revenues have resulted in declines in the percentage of our inpatient revenues related to the uninsured, as the percentage of uninsured admissions compared to total admissions has increased slightly.

At December 31, 2011, we owned and operated 39 hospitals and 31 surgery centers in the state of Florida. Our Florida facilities’ revenues totaled $6.989 billion, $6.538 billion and $6.217 billion for the years ended December 31, 2011, 2010 and 2009, respectively. At December 31, 2011, we owned and operated 36 hospitals and 22 surgery centers in the state of Texas. Our Texas facilities’ revenues totaled $7.829 billion, $7.597 billion and $7.180 billion for the years ended December 31, 2011, 2010 and 2009, respectively. During each year 2011, 2010 and 2009, 57% of our admissions and 50% of our revenues were generated by our Florida and Texas facilities. Uninsured admissions in Florida and Texas represented 63%, 63% and 64% of our uninsured admissions during 2011, 2010 and 2009, respectively.

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. We provide indigent care services in several communities in the state of Texas, in affiliation with other hospitals. The state of Texas has been involved in efforts to increase the indigent care provided by private hospitals. As a result of additional indigent care being provided by private hospitals, public hospital districts or counties in Texas have available funds that were previously devoted to indigent care. The public hospital districts or counties are under no contractual or legal obligation to provide such indigent care. The public hospital districts or counties have elected to transfer some portion of these available funds to the state’s Medicaid program. Such action is at the sole discretion of the public hospital districts or counties. It is anticipated that these contributions to the state will be matched with federal Medicaid funds. The state then may make supplemental payments to hospitals in the state for Medicaid services rendered. Hospitals receiving Medicaid supplemental payments may include those that are providing additional indigent care services. Our Texas Medicaid revenues included $540 million, $657 million and $474 million during 2011, 2010 and 2009, respectively, of Medicaid supplemental payments. 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 the Centers for Medicare & Medicaid Services (“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

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AND RESULTS OF OPERATIONS — (Continued)

Results of Operations (Continued)

Revenue/Volume Trends (Continued)

could result in the payment programs being reduced or eliminated. In December 2011, CMS approved a Medicaid waiver that allows Texas to continue receiving supplemental Medicaid reimbursement while expanding its Medicaid managed care program, thus Texas is operating pursuant to a Waiver Program. However, we cannot predict whether the Texas private supplemental Medicaid reimbursement program will continue or guarantee that revenues recognized for the program will not decline. 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.

Electronic Health Record Incentive Payments

The American Recovery and Reinvestment Act of 2009 provides for Medicare and Medicaid incentive payments beginning in 2011 for eligible hospitals and professionals that adopt and meaningfully use certified electronic health record (“EHR”) technology. We recognize income related to Medicare and Medicaid incentive payments using a gain contingency model that is based upon when our eligible hospitals have demonstrated meaningful use of certified EHR technology for the applicable period and the cost report information for the full cost report year that will determine the final calculation of the incentive payment is available.

Medicaid EHR incentive calculations and related payment amounts are based upon prior period cost report information available at the time our eligible hospitals adopt, implement or demonstrate meaningful use of certified EHR technology for the applicable period, and are not subject to revision for cost report data filed for a subsequent period. Thus, incentive income recognition occurs at the point our eligible hospitals adopt, implement or demonstrate meaningful use of certified EHR technology for the applicable period, as the cost report information for the full cost report year that will determine the final calculation of the incentive payment is known at that time.

Medicare EHR incentive calculations and related initial payment amounts are based upon the most current filed cost report information available at the time our eligible hospitals demonstrate meaningful use of certified EHR technology for the applicable period. However, unlike Medicaid, this initial payment amount will be adjusted based upon an updated calculation using the annual cost report information for the cost report period that began during the applicable payment year. Thus, incentive income recognition occurs at the point our eligible hospitals demonstrate meaningful use of certified EHR technology for the applicable period and the cost report information for the full cost report year that will determine the final calculation of the incentive payment is available.

We recognized $210 million of electronic health record incentive income related to Medicaid ($87 million) and Medicare ($123 million) incentive programs during 2011. At December 31, 2011, we have $134 million of deferred EHR incentive income, which represents initial incentive payments received for which EHR incentive income has not been recognized. Actual incentive payments could vary from these estimates due to certain factors such as availability of federal funding for both Medicare and Medicaid incentive payments, timing of the approval of state Medicaid incentive payment plans by CMS and our ability to continue to demonstrate meaningful use of certified EHR technology. We have incurred and will continue to incur both capital costs and operating expenses in order to implement our certified EHR technology and meet meaningful use requirements. These expenses are ongoing and are projected to continue over all stages of implementation of meaningful use. The timing of recognizing the expenses may not correlate with the receipt of the incentive payments and the recognition of revenues. For 2011, we incurred $77 million of operating expenses to implement our certified EHR technology and meet meaningful use.

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MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Results of Operations (Continued)

Electronic Health Record Incentive Payments (Continued)

For 2012, we estimate EHR incentive income will be recognized in the range of $325 million to $350 million and that related EHR operating expenses will be in the range of $140 million to $160 million. Actual EHR incentive income and EHR operating expenses could vary from these estimates. There can be no assurance that we will be able to continue to demonstrate meaningful use of certified EHR technology, and the failure to do so could have a material, adverse effect on our results of operations.

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AND RESULTS OF OPERATIONS — (Continued)

Results of Operations (Continued)

Operating Results Summary

The following are comparative summaries of operating results for the years ended December 31, 2011, 2010 and 2009 (dollars in millions):

	2011						2010						2009
	Amount			Ratio			Amount			Ratio			Amount			Ratio
Revenues before provision for doubtful accounts	$	32,506					$	30,683					$	30,052
Provision for doubtful accounts		2,824						2,648						3,276
Revenues		29,682			100.0			28,035			100.0			26,776			100.0
Salaries and benefits		13,440			45.3			12,484			44.5			11,958			44.7
Supplies		5,179			17.4			4,961			17.7			4,868			18.2
Other operating expenses		5,470			18.5			5,004			17.9			4,724			17.6
Electronic health record incentive income		(210	)		(0.7	)		—			—			—			—
Equity in earnings of affiliates		(258	)		(0.9	)		(282	)		(1.0	)		(246	)		(0.9	)
Depreciation and amortization		1,465			4.9			1,421			5.0			1,425			5.2
Interest expense		2,037			6.9			2,097			7.5			1,987			7.4
Losses (gains) on sales of facilities		(142	)		(0.5	)		(4	)		—			15			0.1
Gain on acquisition of controlling interest in equity investment		(1,522	)		(5.1	)		—			—			—			—
Impairments of long-lived assets		—			—			123			0.4			43			0.2
Losses on retirement of debt		481			1.6			—			—			—			—
Termination of management agreement		181			0.6			—			—			—			—
		26,121			88.0			25,804			92.0			24,774			92.5
Income before income taxes		3,561			12.0			2,231			8.0			2,002			7.5
Provision for income taxes		719			2.4			658			2.4			627			2.4
Net income		2,842			9.6			1,573			5.6			1,375			5.1
Net income attributable to noncontrolling interests		377			1.3			366			1.3			321			1.2
Net income attributable to HCA Holdings, Inc.	$	2,465			8.3		$	1,207			4.3		$	1,054			3.9
% changes from prior year:
Revenues		5.9	%					4.7	%					7.2	%
Income before income taxes		59.6						11.5						71.1
Net income attributable to HCA Holdings, Inc.		104.3						14.5						56.7
Admissions(a)		4.2						(0.1	)					1.0
Equivalent admissions(b)		5.2						1.2						3.2
Revenue per equivalent admission		0.7						3.5						3.9
Same facility % changes from prior year(c):
Revenues		3.3						4.6						7.5
Admissions(a)		2.3						0.1						1.2
Equivalent admissions(b)		3.0						1.4						3.4
Revenue per equivalent admission		0.3						3.2						4.0

(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.

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MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Results of Operations (Continued)

Years Ended December 31, 2011 and 2010

Net income attributable to HCA Holdings, Inc. totaled $2.465 billion, or $4.97 per diluted share, for the year ended December 31, 2011 compared to $1.207 billion, or $2.76 per diluted share, for the year ended December 31, 2010. Financial results for 2011 include net gains on sales of facilities of $142 million (pretax), or $0.16 per diluted share, a gain on the acquisition of controlling interest in an equity investment of $1.522 billion (pretax), or $2.87 per diluted share, losses on retirement of debt of $481 million (pretax), or $0.61 per diluted share, and termination of management agreement fees of $181 million (pretax), or $0.30 per diluted share. Financial results for 2010 include net gains on sales of facilities of $4 million (pretax), or $0.01 per diluted share, and asset impairment charges of $123 million (pretax), or $0.18 per diluted share. All “per diluted share” disclosures are based upon amounts net of the applicable income taxes. Shares used for diluted earnings per share were 495.943 million shares and 437.347 million shares for the years ended December 31, 2011 and 2010, respectively. During March 2011, we completed the initial public offering of 87.719 million shares of our common stock, and during September 2011, we repurchased 80.771 million shares of our common stock from affiliates of Bank of America Corporation.

During 2011, consolidated admissions increased 4.2% and same facility admissions increased 2.3% for 2011, compared to 2010. Consolidated inpatient surgical volumes declined 0.5%, and same facility inpatient surgeries declined 1.7% during 2011 compared to 2010. Consolidated outpatient surgical volumes increased 2.0%, and same facility outpatient surgeries declined 0.6% during 2011 compared to 2010. Emergency room visits increased 7.7% on a consolidated basis and increased 6.2% on a same facility basis during 2011 compared to 2010.

Revenues before provision for doubtful accounts increased 5.9% to $32.506 billion for 2011 from $30.683 billion for 2010. Provision for doubtful accounts increased $176 million from $2.648 billion in 2010 to $2.824 billion in 2011. With our adoption of ASU 2011-07, the provision for doubtful accounts has been reclassified from an operating expense to a deduction from patient service revenues. The provision for doubtful accounts and the allowance for doubtful accounts relate primarily to uninsured amounts due directly from patients, including copayment and deductible amounts for patients who have health care coverage. The self-pay revenue deductions for charity care and uninsured discounts increased $346 million and $1.066 billion, respectively, during 2011 compared to 2010. The sum of the provision for doubtful accounts, uninsured discounts and charity care, as a percentage of the sum of revenues, the provision for doubtful accounts, uninsured discounts and charity care, was 27.4% for 2011 compared to 25.6% for 2010. At December 31, 2011, our allowance for doubtful accounts represented approximately 92% of the $4.478 billion total patient due accounts receivable balance, including accounts, net of estimated contractual discounts, related to patients for which eligibility for Medicaid coverage or uninsured discounts was being evaluated.

Revenues increased 5.9% to $29.682 billion for 2011 from $28.035 billion for 2010. The increase in revenues was due primarily to the combined impact of a 0.7% increase in revenue per equivalent admission and a 5.2% increase in equivalent admissions compared to 2010. Same facility revenues increased 3.3% due primarily to the combined impact of a 0.3% increase in same facility revenue per equivalent admission and a 3.0% increase in same facility equivalent admissions compared to 2010.

Salaries and benefits, as a percentage of revenues, were 45.3% in 2011 and 44.5% in 2010. Salaries and benefits per equivalent admission increased 2.4% in 2011 compared to 2010. Same facility labor rate increases averaged 2.3% for 2011 compared to 2010.

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MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Results of Operations (Continued)

Years Ended December 31, 2011 and 2010 (Continued)

Supplies, as a percentage of revenues, were 17.4% in 2011 and 17.7% in 2010. Supply costs per equivalent admission declined 0.7% in 2011 compared to 2010. Supply costs per equivalent admission declined 3.0% for medical devices, 1.5% for pharmacy supplies and 1.7% for blood products, and increased 3.1% for general medical and surgical items in 2011 compared to 2010.

Other operating expenses, as a percentage of revenues, increased to 18.5% in 2011 from 17.9% in 2010. Other operating expenses are primarily comprised of contract services, professional fees, repairs and maintenance, rents and leases, utilities, insurance (including professional liability insurance) and nonincome taxes. Each of contract services and professional fees increased 20 basis points in 2011 compared to 2010. Other operating expenses include $317 million and $354 million of indigent care costs in certain Texas markets during 2011 and 2010, respectively. Provisions for losses related to professional liability risks were $244 million and $222 million for 2011 and 2010, respectively.

We recognized $210 million of electronic health record incentive income related to Medicaid ($87 million) and Medicare ($123 million) incentive programs during 2011. We recognize income related to Medicare and Medicaid incentive payments using a gain contingency model that is based upon when our eligible hospitals have demonstrated meaningful use of certified EHR technology for the applicable period and the cost report information for the full cost report year that will determine the final calculation of the incentive payment is available.

Equity in earnings of affiliates declined from $282 million for 2010 to $258 million for 2011. Equity in earnings of affiliates relates primarily to our Denver, Colorado market joint venture, which effective November 1, 2011, we began consolidating due to our acquisition of the approximate 40% remaining ownership interest.

Depreciation and amortization declined, as a percentage of revenues, to 4.9% in 2011 from 5.0% in 2010. Depreciation expense was $1.461 billion for 2011 and $1.416 billion for 2010.

Interest expense declined to $2.037 billion for 2011 from $2.097 billion for 2010. The decline in interest expense was due primarily to a decline in the average interest rate. Our average debt balance was $26.588 billion for 2011 compared to $26.751 billion for 2010. The average interest rate for our long-term debt declined from 7.8% for 2010 to 7.7% for 2011.

Net gains on sales of facilities were $142 million for 2011 and primarily related to the sale of a hospital facility and other health care entity investments. Net gains on sales of facilities were $4 million for 2010 and were related to sales of real estate and other health care entity investments.

During October 2011, we completed our acquisition of the Colorado Health Foundation’s (“Foundation”) approximate 40% remaining ownership interest in the HCA-HealthONE LLC (“HealthONE”) joint venture for $1.450 billion. We recorded a gain on the acquisition of a controlling interest in an equity investment of $1.522 billion related to the remeasurement of our previous equity investment in HealthONE based upon our acquisition of the Foundation’s ownership interest and the resulting consolidation of the entire enterprise at estimated fair value.

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MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Results of Operations (Continued)

Years Ended December 31, 2011 and 2010 (Continued)

Impairments of long-lived assets were $123 million for 2010 and included $74 million related to two hospital facilities and $49 million related to other health care entity investments, which includes $35 million for the writeoff of capitalized engineering and design costs related to certain building safety requirements (California earthquake standards) that have been revised. There were no impairments of long-lived assets in 2011.

During 2011, we recorded losses on retirement of debt of $481 million related to the redemptions of all $1.000 billion aggregate principal amount of our 9 ¹/8% Senior Secured Notes due 2014, at a redemption price of 104.563% of the principal amount; $108 million aggregate principal amount of our 9 ⁷/8% Senior Secured Notes due 2017, at a redemption price of 109.875% of the principal amount; all of our outstanding $1.578 billion 9 ⁵/8%/10  ³/8% second lien toggle notes due 2016, at a redemption price of 106.783% of the principal amount and all of our outstanding $3.200 billion 9 ¹/4% second lien notes due 2016, at a redemption price of 106.513% of the principal amount. There were no losses on retirement of debt during the 2010.

Our Investors have provided management and advisory services to the Company, pursuant to a management agreement among HCA and the Investors executed in connection with the Investors’ acquisition of HCA in November 2006. In March 2011, the management agreement was terminated pursuant to its terms upon completion of the initial public offering of our common stock, and the Investors were paid a final fee of $181 million.

The effective tax rate was 22.6% and 35.3% for 2011 and 2010, respectively. The effective tax rate computations exclude net income attributable to noncontrolling interests as it relates to consolidated partnerships. Our income before income taxes for 2011 included $1.255 billion of nontaxable gain related to the reported gain on the acquisition of a controlling interest in an equity investment. Our provision for income taxes for 2010 was reduced by $44 million related to reductions in interest expense related to taxing authority examinations. Excluding the effect of these adjustments, the effective tax rate for 2011 and 2010 would have been 37.3% and 37.6%, respectively.

Net income attributable to noncontrolling interests increased from $366 million for 2010 to $377 million for 2011. The increase in net income attributable to noncontrolling interests related primarily to growth in operating results of certain surgery center joint ventures.

Years Ended December 31, 2010 and 2009

Net income attributable to HCA Holdings, Inc. totaled $1.207 billion, or $2.76 per diluted share, for the year ended December 31, 2010 compared to $1.054 billion, or $2.44 per diluted share, for the year ended December 31, 2009. Financial results for 2010 include net gains on sales of facilities of $4 million (pretax), or $0.01 per diluted share, and asset impairment charges of $123 million (pretax), or $0.18 per diluted share. Financial results for 2009 include net losses on sales of facilities of $15 million (pretax), or $0.02 per diluted share, and asset impairment charges of $43 million (pretax), or $0.08 per diluted share. All “per diluted share” disclosures are based upon amounts net of the applicable income taxes. Shares used for diluted earnings per share were 437.347 million shares and 432.227 million shares for the years ended December 31, 2010 and 2009, respectively.

During 2010, consolidated admissions declined 0.1% and same facility admissions increased 0.1% for 2010, compared to 2009. Consolidated inpatient surgical volumes declined 1.5%, and same facility inpatient surgeries

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AND RESULTS OF OPERATIONS — (Continued)

Results of Operations (Continued)

Years Ended December 31, 2010 and 2009 (Continued)

declined 1.4% during 2010 compared to 2009. Consolidated outpatient surgical volumes declined 1.4%, and same facility outpatient surgeries declined 1.2% during 2010 compared to 2009. Emergency room visits increased 2.0% on a consolidated basis and increased 2.1% on a same facility basis during 2010 compared to 2009.

Revenues before provision for doubtful accounts increased 2.1% to $30.683 billion for 2010 from $30.052 billion for 2009. Provision for doubtful accounts declined $628 million from $3.276 billion in 2009 to $2.648 billion in 2010. With our adoption of ASU 2011-07, the provision for doubtful accounts has been reclassified from an operating expense to a deduction from patient service revenues. The provision for doubtful accounts and the allowance for doubtful accounts relate primarily to uninsured amounts due directly from patients, including copayment and deductible amounts for patients who have health care coverage. The decline in the provision for doubtful accounts can be attributed to the $1.892 billion increase in the combined self-pay revenue deductions for charity care and uninsured discounts during 2010, compared to 2009. The self-pay revenue deductions for charity care and uninsured discounts increased $186 million and $1.706 billion, respectively, during 2010 compared to 2009. The sum of the provision for doubtful accounts, uninsured discounts and charity care, as a percentage of the sum of revenues, the provision for doubtful accounts, uninsured discounts and charity care, was 25.6% for 2010 compared to 23.8% for 2009. At December 31, 2010, our allowance for doubtful accounts represented approximately 93% of the $4.249 billion total patient due accounts receivable balance, including accounts, net of estimated contractual discounts, related to patients for which eligibility for Medicaid coverage or uninsured discounts was being evaluated.

Revenues increased 4.7% to $28.035 billion for 2010 from $26.776 billion for 2009. The increase in revenues was due primarily to the combined impact of a 3.5% increase in revenue per equivalent admission and a 1.2% increase in equivalent admissions compared to 2009. Same facility revenues increased 4.6% due primarily to the combined impact of a 3.2% increase in same facility revenue per equivalent admission and a 1.4% increase in same facility equivalent admissions compared to 2009.

Salaries and benefits, as a percentage of revenues, were 44.5% in 2010 and 44.7% in 2009. Salaries and benefits per equivalent admission increased 3.2% in 2010 compared to 2009. Same facility labor rate increases averaged 2.7% for 2010 compared to 2009.

Supplies, as a percentage of revenues, were 17.7% in 2010 and 18.2% in 2009. Supply costs per equivalent admission increased 0.7% in 2010 compared to 2009. Supply costs per equivalent admission increased 2.4% for medical devices, 0.8% for blood products, and 2.9% for general medical and surgical items, and declined 0.7% for pharmacy supplies in 2010 compared to 2009.

Other operating expenses, as a percentage of revenues, increased to 17.9% in 2010 from 17.6% in 2009. Other operating expenses are primarily comprised of contract services, professional fees, repairs and maintenance, rents and leases, utilities, insurance (including professional liability insurance) and nonincome taxes. The major component of the increase in other operating expenses, as a percentage of revenues, was related to indigent care costs in certain Texas markets which increased to $354 million for 2010 from $248 million for 2009. Provisions for losses related to professional liability risks were $222 million and $211 million for 2010 and 2009, respectively.

Equity in earnings of affiliates increased from $246 million for 2009 to $282 million for 2010. Equity in earnings of affiliates related primarily to our Denver, Colorado market joint venture.

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MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Results of Operations (Continued)

Years Ended December 31, 2010 and 2009 (Continued)

Depreciation and amortization declined, as a percentage of revenues, to 5.0% in 2010 from 5.2% in 2009. Depreciation expense was $1.416 billion for 2010 and $1.419 billion for 2009.

Interest expense increased to $2.097 billion for 2010 from $1.987 billion for 2009. The increase in interest expense was due primarily to an increase in the average interest rate. Our average debt balance was $26.751 billion for 2010 compared to $26.267 billion for 2009. The average interest rate for our long-term debt increased from 7.6% for 2009 to 7.8% for 2010.

Net gains on sales of facilities were $4 million for 2010 and were related to sales of real estate and other health care entity investments. Net losses on sales of facilities were $15 million for 2009 and included $8 million of net losses on the sales of three hospital facilities and $7 million of net losses on sales of real estate and other health care entity investments.

Impairments of long-lived assets were $123 million for 2010 and included $74 million related to two hospital facilities and $49 million related to other health care entity investments, which includes $35 million for the writeoff of capitalized engineering and design costs related to certain building safety requirements (California earthquake standards) that have been revised. Impairments of long-lived assets were $43 million for 2009 and included $19 million related to goodwill and $24 million related to property and equipment.

The effective tax rate was 35.3% and 37.3% for 2010 and 2009, 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 2010 and 2009 were reduced by $44 million and $12 million, respectively, related to reductions in interest expense related to taxing authority examinations. Excluding the effect of these adjustments, the effective tax rate for 2010 and 2009 would have been 37.6% and 38.0%, respectively.

Net income attributable to noncontrolling interests increased from $321 million for 2009 to $366 million for 2010. The increase in net income attributable to noncontrolling interests related primarily to growth in operating results of hospital joint ventures in two Texas markets.

Liquidity and Capital Resources

Our primary cash requirements are paying our operating expenses, servicing our debt, capital expenditures on our existing properties, acquisitions of hospitals and other health care entities, repurchases of our common stock, distributions to stockholders and distributions to noncontrolling interests. Our primary cash sources are cash flows from operating activities, issuances of debt and equity securities and dispositions of hospitals and other health care entities.

Cash provided by operating activities totaled $3.933 billion in 2011 compared to $3.085 billion in 2010 and $2.747 billion in 2009. Working capital totaled $1.679 billion at December 31, 2011 and $2.650 billion at December 31, 2010. The decline in working capital is primarily related to an increase in our long-term debt due within one year. The $848 million increase in cash provided by operating activities for 2011, compared to 2010, was primarily related to $885 million improvement from lower income tax payments. The $338 million increase in cash provided by operating activities for 2010, compared to 2009, was primarily comprised of the net impact of the $198 million increase in net income, a $547 million improvement from lower income tax payments and a

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HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Liquidity and Capital Resources (Continued)

$384 million decline from changes in operating assets and liabilities and the provision for doubtful accounts. Cash payments for interest and income taxes declined $780 million for 2011 compared to 2010 and declined $387 million for 2010 compared to 2009.

Cash used in investing activities was $2.995 billion, $1.039 billion and $1.035 billion in 2011, 2010 and 2009, respectively. Excluding acquisitions, capital expenditures were $1.679 billion in 2011, $1.325 billion in 2010 and $1.317 billion in 2009. We expended $1.682 billion, $233 million and $61 million for acquisitions of hospitals and health care entities during 2011, 2010 and 2009, respectively. Expenditures for acquisitions in 2011 included eight hospital facilities, seven of which were related to the acquisition of the remaining interests in our joint venture in the Denver market. Expenditures for acquisitions in 2010 included two hospital facilities and in 2009 were generally comprised of outpatient and ancillary services entities. Planned capital expenditures are expected to approximate $1.9 billion in 2012. At December 31, 2011, there were projects under construction which had an estimated additional cost to complete and equip over the next five years of approximately $1.5 billion. We expect to finance capital expenditures with internally generated and borrowed funds.

During 2011, we received cash of $281 million from sales of one hospital, other health care entities and real estate investments. We also received net cash proceeds of $80 million related to net changes in our investments. During 2010, we received cash proceeds of $37 million from sales of other health care entities and real estate investments. We also received net cash proceeds of $472 million related to net changes in our investments. During 2009, we received cash proceeds of $41 million from dispositions of three hospitals and sales of other health care entities and real estate investments. We also received net cash proceeds of $303 million related to net changes in our investments.

Cash used in financing activities totaled $976 million in 2011, $1.947 billion in 2010 and $1.865 billion in 2009. During 2011, we received cash of $2.506 billion related to the issuance of common stock in conjunction with our initial public offering; we used cash of $1.503 billion for repurchases of common stock; and we used cash proceeds from issuance of common stock and available cash provided by operations to make net debt repayments of $1.589 billion. During 2010, we received net proceeds of $2.533 billion from our debt issuance and debt repayment activities. During 2009, we used cash proceeds from sales of facilities and available cash provided by operations to make net debt repayments of $1.459 billion. During 2011 and 2010, we paid $31 million and $4.257 billion, respectively, in distributions to our stockholders. During 2010, we received contributions from noncontrolling interests of $57 million. During 2011, 2010 and 2009, we made distributions to noncontrolling interests of $378 million, $342 million and $330 million, respectively. We paid debt issuance costs of $92 million, $50 million and $70 million for 2011, 2010 and 2009, respectively. During 2011 and 2010, we received income tax benefits of $63 million and $114 million, respectively, for certain items (primarily the cash distributions to holders of our stock options and exercises of stock options) that were deductible expenses for tax purposes, but were recognized as adjustments to stockholders’ deficit for financial reporting purposes. We or our affiliates, including affiliates of the Sponsors, may in the future repurchase portions of our debt or equity securities, subject to certain limitations, from time to time in either the open market or through privately negotiated transactions, in accordance with applicable SEC and other legal requirements. The timing, prices, and sizes of purchases depend upon prevailing trading prices, general economic and market conditions, and other factors, including applicable securities laws. Funds for the repurchase of debt or equity securities have, and are expected to, come primarily from cash generated from operations and borrowed funds.

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HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Liquidity and Capital Resources (Continued)

In addition to cash flows from operations, available sources of capital include amounts available under our senior secured credit facilities ($2.137 billion as of December 31, 2011 and $2.070 billion as of January 31, 2012) and anticipated access to public and private debt and equity markets.

During 2010, our Board of Directors declared three distributions to our stockholders and holders of stock options. The distributions totaled $9.43 per share and vested stock option, or $4.332 billion in the aggregate. The distributions were funded using funds available under our existing senior secured credit facilities, proceeds from the November 2010 issuance of $1.525 billion aggregate principal amount of 7 ³/4% senior unsecured notes due 2021 and cash on hand.

On February 3, 2012, our Board of Directors declared a distribution to the Company’s existing stockholders and holders of vested stock awards. The distribution declared was $2.00 per share and vested stock award, or approximately $975 million in the aggregate.

Investments of our professional liability insurance subsidiaries, to maintain statutory equity and pay claims, totaled $628 million and $742 million at December 31, 2011 and 2010, respectively. The insurance subsidiary maintained net reserves for professional liability risks of $410 million and $452 million at December 31, 2011 and 2010, respectively. Our facilities are insured by our wholly-owned insurance subsidiary for losses up to $50 million per occurrence; however, this coverage is subject to a $5 million per occurrence self-insured retention. Net reserves for the self-insured professional liability risks retained were $842 million and $796 million at December 31, 2011 and 2010, respectively. Claims payments, net of reinsurance recoveries, during the next 12 months are expected to approximate $285 million. We estimate that approximately $205 million of the expected net claim payments during the next 12 months will relate to claims subject to the self-insured retention.

Financing Activities

We are a highly leveraged company with significant debt service requirements. Our debt totaled $27.052 billion and $28.225 billion at December 31, 2011 and 2010, respectively. Our interest expense was $2.037 billion for 2011 and $2.097 billion for 2010.

During March 2010, we issued $1.400 billion aggregate principal amount of 7 ¹/4% senior secured first lien notes due 2020 at a price of 99.095% of their face value, resulting in $1.387 billion of gross proceeds. After the payment of related fees and expenses, we used the proceeds to repay outstanding indebtedness under our senior secured term loan facilities. During November 2010, we issued $1.525 billion aggregate principal amount of 7 ³/4% senior unsecured notes due 2021 at a price of 100% of their face value. After the payment of related fees and expenses, we used the proceeds to make a distribution to our stockholders and optionholders.

During June 2011, we redeemed all $1.000 billion aggregate principal amount of our 9 ¹/8% senior secured notes due 2014, at a redemption price of 104.563% of the principal amount, and $108 million aggregate principal amount of our 9 ⁷/8% senior secured notes due 2017, at a redemption price of 109.875% of the principal amount.

During August 2011, we issued $5.000 billion aggregate principal amount of notes, comprised of $3.000 billion of 6.50% senior secured first lien notes due 2020 and $2.000 billion of 7.50% senior unsecured notes due 2022. After the payment of related fees and expenses, we used the net proceeds from these debt issuances to redeem all of our outstanding $1.578 billion 9 ⁵/8%/10 ³/8% second lien toggle notes due 2016, at a redemption price of 106.783% of the principal amount, and all of our outstanding $3.200 billion 9 ¹/4% second lien notes due 2016, at a redemption price of 106.513% of the principal amount.

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HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Liquidity and Capital Resources (Continued)

Financing Activities (Continued)

On September 21, 2011, we repurchased 80,771,143 shares of our common stock beneficially owned by affiliates of Bank of America Corporation at a purchase price of $18.61 per share, the closing price of the Company’s common stock on the New York Stock Exchange on September 14, 2011. The repurchase was financed using a combination of cash on hand and borrowings under available credit facilities. The shares repurchased represented approximately 15.6% of our total shares outstanding.

During October 2011, we issued $500 million aggregate principal amount of 8.00% senior unsecured notes due 2018. After the payment of related fees and expenses, we used the net proceeds for general corporate purposes, which included funding a portion of the acquisition of the Colorado Health Foundation’s approximate 40% remaining ownership interest in the HCA-HealthONE LLC joint venture, which was purchased during October 2011 for $1.450 billion.

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 twelve months.

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HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Contractual Obligations and Off-Balance Sheet Arrangements

As of December 31, 2011, maturities of contractual obligations and other commercial commitments are presented in the table below (dollars in millions):

	Payments Due by Period
Contractual Obligations(a)	Total		Current		2-3 Years		4-5 Years		After 5 Years
Long-term debt including interest, excluding the senior secured credit facilities(b)	$	28,545	$	2,248	$	4,089	$	4,063	$	18,145
Loans outstanding under the senior secured credit facilities, including interest(b)		11,560		860		2,931		3,384		4,385
Operating leases(c)		1,934		280		482		302		870
Purchase and other obligations(c)		27		19		8		—		—
Total contractual obligations	$	42,066	$	3,407	$	7,510	$	7,749	$	23,400

	Commitment Expiration by Period
Other Commercial Commitments Not Recorded on the Consolidated Balance Sheet	Total		Current		2-3 Years		4-5 Years		After 5 Years
Surety bonds(d)	$	52	$	51	$	1	$	—	$	—
Letters of credit(e)		65		7		15		43		—
Physician commitments(f)		24		17		7		—		—
Guarantees(g)		2		—		—		—		2
Total commercial commitments	$	143	$	75	$	23	$	43	$	2

(a) We have not included obligations to pay net estimated professional liability claims ($1.252 billion at December 31, 2011, including net reserves of $410 million relating to the wholly-owned insurance subsidiary) in this table. The estimated professional liability claims, which occurred prior to 2007, are expected to be funded by the designated investment securities that are restricted for this purpose ($628 million at December 31, 2011). We also have not included obligations related to unrecognized tax benefits of $494 million at December 31, 2011, as we cannot reasonably estimate the timing or amounts of cash payments, if any, at this time.

(b) Estimates of interest payments assume that interest rates, borrowing spreads and foreign currency exchange rates at December 31, 2011, remain constant during the period presented.

(c) Amounts relate to future operating lease obligations, purchase obligations and other obligations and are not recorded in our consolidated balance sheet. Amounts also include physician commitments that are recorded in our consolidated balance sheet.

(d) Amounts relate primarily to instances in which we have agreed to indemnify various commercial insurers who have provided surety bonds to cover self-insured workers’ compensation claims, utility deposits and damages for malpractice cases which were awarded to plaintiffs by the courts. These cases are currently under appeal and the bonds will not be released by the courts until the cases are closed.

(e) Amounts relate primarily to various insurance programs and employee benefit plan obligations for which we have letters of credit outstanding.

(f) In consideration for physicians relocating to the communities in which our hospitals are located and agreeing to engage in private practice for the benefit of the respective communities, we make advances to physicians, normally over a period of one year, to assist in establishing the physicians’ practices. The actual amount of these commitments to be advanced often depends upon the financial results of the physicians’ private practice during the recruitment agreement payment period. The physician commitments reflected were based on our maximum exposure on effective agreements at December 31, 2011.

(g) We have entered into guarantee agreements related to certain leases.

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HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Market Risk

We are exposed to market risk related to changes in market values of securities. The investments in debt and equity securities of our wholly-owned insurance subsidiaries were $621 million and $7 million, respectively, at December 31, 2011. These investments are carried at fair value, with changes in unrealized gains and losses being recorded as adjustments to other comprehensive income. At December 31, 2011, we had a net unrealized gain of $11 million on the insurance subsidiaries’ investment securities.

We are exposed to market risk related to market illiquidity. Investments in debt and equity securities of our wholly-owned insurance subsidiaries could be impaired by the inability to access the capital markets. Should the wholly-owned 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. At December 31, 2011, our wholly-owned insurance subsidiaries had invested $131 million ($139 million par value) in tax-exempt student loan auction rate securities that continue to experience market illiquidity. It is uncertain if auction-related market liquidity will resume for these securities. We may be required to recognize other-than-temporary impairments on these long-term investments 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, and changes in the fair value of derivatives which have not been designated as hedges are recorded in operations.

With respect to our interest-bearing liabilities, approximately $5.082 billion of long-term debt at December 31, 2011 was subject to variable rates of interest, while the remaining balance in long-term debt of $21.970 billion at December 31, 2011 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% and (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 declined from 7.8% for 2010 to 7.7% for 2011.

On November 8, 2010, an amended and restated joinder agreement was entered into with respect to the cash flow credit facility to establish a new replacement revolving credit series, which will mature on November 17, 2015.

On May 4, 2011, we completed amendments to our senior secured credit agreement and senior secured asset-based revolving credit agreement, as well as extensions of certain of our term loans. The amendments extend $594 million of our term loan A facility with a final maturity of November 2012 to a final maturity of May 2016 and $2.373 billion of our term loan A and term loan B-1 facilities with final maturities of November 2012 and November 2013, respectively, to a final maturity of May 2018.

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HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Market Risk (Continued)

On September 30, 2011, we refinanced our $2.000 billion asset-based revolving credit facility maturing on November 16, 2012 to increase the total capacity to $2.500 billion and extend the maturity to 2016.

The estimated fair value of our total long-term debt was $27.199 billion at December 31, 2011. 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 interest rates, the potential annualized reduction to future pretax earnings would be approximately $51 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.

Our international operations and the European term loan expose us to market risks associated with foreign currencies. In order to mitigate the currency exposure related to debt service obligations through December 31, 2011 under the European term loan, we have entered into cross currency swap agreements. A cross currency swap is an agreement between two parties to exchange a stream of principal and interest payments in one currency for a stream of principal and interest payments in another currency over a specified period.

Financial Instruments

Derivative financial instruments are employed to manage risks, including foreign currency and interest rate exposures, and are not used for trading or speculative purposes. We recognize derivative instruments, such as interest rate swap agreements and foreign exchange contracts, in the consolidated balance sheets at fair value. Changes in the fair value of derivatives are recognized periodically either in earnings or in stockholders’ equity, as a component of other comprehensive income, depending on whether the derivative financial instrument qualifies for hedge accounting, and if so, whether it qualifies as a fair value hedge or a cash flow hedge. Gains and losses on derivatives designated as cash flow hedges, to the extent they are effective, are recorded in other comprehensive income, and subsequently reclassified to earnings to offset the impact of the hedged items when they occur. Changes in the fair value of derivatives not qualifying as hedges, and for any portion of a hedge that is ineffective, are reported in earnings.

The net interest paid or received on interest rate swaps is recognized as interest expense. Gains and losses resulting from the early termination of interest rate swap agreements are deferred and amortized as adjustments to expense over the remaining period of the debt originally covered by the terminated swap.

Effects of Inflation and Changing Prices

Various federal, state and local laws have been enacted that, in certain cases, limit our ability to increase prices. Revenues for general, acute care hospital services rendered to Medicare patients are established under the federal government’s prospective payment system. Total fee-for-service Medicare revenues were 25.8%, 25.7% and 25.6% of our revenues for 2011, 2010 an 2009, respectively.

Management believes hospital industry operating margins have been, and may continue to be, under significant pressure because of changes in payer and service mix and growth in operating expenses in excess of the increase in prospective payments under the Medicare program. In addition, as a result of increasing regulatory and competitive pressures, our ability to maintain operating margins through price increases to non-Medicare patients is limited.

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HCA HOLDINGS, INC.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

AND RESULTS OF OPERATIONS — (Continued)

Effects of Inflation and Changing Prices (Continued)

IRS Disputes

We are contesting, before the IRS Appeals Division, certain claimed deficiencies and adjustments proposed by the IRS Examination Division in connection with its audit of HCA Inc.’s 2005 and 2006 federal income tax returns. The disputed items include the timing of recognition of certain patient service revenues, the deductibility of certain debt retirement costs and our method for calculating the tax allowance for doubtful accounts. The IRS Examination Division began an audit of HCA Inc.’s 2007, 2008 and 2009 federal income tax returns in 2010.

Management believes HCA Holdings, Inc., its predecessors and affiliates properly reported taxable income and paid taxes in accordance with applicable laws and agreements established with the IRS and final resolution of these disputes will not have a material, adverse effect on our results of operations or financial position. However, if payments due upon final resolution of these issues exceed our recorded estimates, such resolutions could have a material, adverse effect on our results of operations or financial position.

Item 7A.    Quantitative and Qualitative Disclosures about Market Risk

Information with respect to this Item is provided under the caption “Market Risk” under Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations.”

Item 8.    Financial Statements and Supplementary Data

Information with respect to this Item is contained in our consolidated financial statements indicated in the Index to Consolidated Financial Statements on Page F-1 of this annual report on Form 10-K.

Item 9.    Changes in and Disagreements with Accountants on Accounting and Financial Disclosure

None.

Item 9A.    Controls and Procedures

1. Conclusion Regarding the Effectiveness of Disclosure Controls and Procedures

Under the supervision and with the participation of our management, including our principal executive officer and principal financial officer, we conducted an evaluation of our disclosure controls and procedures, as such term is defined under Rule 13a-15(e) promulgated under the Securities Exchange Act of 1934, as amended (the “Exchange Act”). Based on this evaluation, our principal executive officer and our principal financial officer concluded that our disclosure controls and procedures were effective as of the end of the period covered by this annual report.

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2. Internal Control Over Financial Reporting

(a) Management’s Report on Internal Control Over Financial Reporting

Our management is responsible for establishing and maintaining effective internal control over financial reporting, as such term is defined in Exchange Act Rule 13a-15(f). Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Therefore, even those systems determined to be effective, can provide only reasonable assurance with respect to financial statement preparation and presentation.

Under the supervision and with the participation of our management, including our principal executive officer and principal financial officer, we conducted an assessment of the effectiveness of our internal control over financial reporting based on the framework in Internal Control — Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission. Based on our assessment under the framework in Internal Control — Integrated Framework, our management concluded that our internal control over financial reporting was effective as of December 31, 2011.

Ernst & Young, LLP, the independent registered public accounting firm that audited our consolidated financial statements included in this Form 10-K, has issued a report on our internal control over financial reporting, which is included herein.

(b) Attestation Report of the Independent Registered Public Accounting Firm

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Report of Independent Registered Public Accounting Firm

The Board of Directors and Stockholders

HCA Holdings, Inc.

We have audited HCA Holdings, Inc.’s internal control over financial reporting as of December 31, 2011, based on criteria established in Internal Control — Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission (the COSO criteria). HCA Holdings, Inc.’s management is responsible for maintaining effective internal control over financial reporting, and for its assessment of the effectiveness of internal control over financial reporting included in the accompanying Management’s Report on Internal Control Over Financial Reporting. Our responsibility is to express an opinion on the company’s internal control over financial reporting based on our audit.

We conducted our audit in accordance with the standards of the Public Company Accounting Oversight Board (United States). Those standards require that we plan and perform the audit to obtain reasonable assurance about whether effective internal control over financial reporting was maintained in all material respects. Our audit included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, testing and evaluating the design and operating effectiveness of internal control based on the assessed risk, and performing such other procedures as we considered necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion.

A company’s internal control over financial reporting is a process designed 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. A company’s internal control over financial reporting includes those policies and procedures that (1) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and (3) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial statements.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.

In our opinion, HCA Holdings, Inc. maintained, in all material respects, effective internal control over financial reporting as of December 31, 2011, based on the COSO criteria.

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), the consolidated balance sheets of HCA Holdings, Inc. as of December 31, 2011 and 2010, and the related consolidated statements of income, stockholders’ deficit, and cash flows for each of the three years in the period ended December 31, 2011 and our report dated February 23, 2012 expressed an unqualified opinion thereon.

/s/ Ernst & Young LLP

Nashville, Tennessee

February 23, 2012

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(c)    Changes in Internal Control Over Financial Reporting

During the fourth quarter of 2011, 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.

Item 9B. Other Information

On February 22, 2012, the Compensation Committee of the Board of Directors approved a one-time cash payment of approximately $1.3 million to Beverly B. Wallace, formerly President–Parallon Business Solutions, to be paid upon her retirement from the Company, effective February 29, 2012. This payment will be in addition to any other payments made to Ms. Wallace in connection with her retirement as set forth in her employment agreement and the Company’s other benefit plans in which she participates.

PART III

Item 10.    Directors, Executive Officers and Corporate Governance

The information required by this Item regarding the identity and business experience of our directors and executive officers is set forth under the heading “Election of Directors” in the definitive proxy materials of HCA to be filed in connection with our 2012 Annual Meeting of Stockholders with respect to our directors and is set forth in Item 1 of Part I of this annual report on Form 10-K with respect to our executive officers. The information required by this Item contained in such definitive proxy materials is incorporated herein by reference.

Information on the beneficial ownership reporting for our directors and executive officers required by this Item is contained under the caption “Section 16(a) Beneficial Ownership Reporting Compliance” in the definitive proxy materials to be filed in connection with our 2012 Annual Meeting of Stockholders and is incorporated herein by reference.

Information on our Audit and Compliance Committee and Audit Committee Financial Experts required by this Item is contained under the caption “Corporate Governance” in the definitive proxy materials to be filed in connection with our 2012 Annual Meeting of Stockholders and is incorporated herein by reference.

We have a Code of Conduct which is applicable to all our directors, officers and employees (the “Code of Conduct”). The Code of Conduct is available on the Ethics and Compliance and Corporate Governance pages of our website at www.hcahealthcare.com. To the extent required pursuant to applicable SEC regulations, we intend to post amendments to or waivers from our Code of Conduct (to the extent applicable to our chief executive officer, principal financial officer or principal accounting officer) at this location on our website or report the same on a Current Report on Form 8-K. Our Code of Conduct is available free of charge upon request to our Corporate Secretary, HCA Holdings, Inc., One Park Plaza, Nashville, TN 37203.

Item 11.    Executive Compensation

The information required by this Item is set forth under the headings “Executive Compensation” and “Compensation Committee Interlocks and Insider Participation” in the definitive proxy materials to be filed in connection with our 2012 Annual Meeting of Stockholders, which information is incorporated herein by reference.

Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters

Information about security ownership of certain beneficial owners required by this Item is set forth under the heading “Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters” in the definitive proxy materials to be filed in connection with our 2012 Annual Meeting of Stockholders, which information is incorporated herein by reference.

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This table provides certain information as of December 31, 2011 with respect to our equity compensation plans:

EQUITY COMPENSATION PLAN INFORMATION

	(a)		(b)		(c)
	Number of securities to be issued upon exercise of outstanding options, warrants and rights		Weighted-average exercise price of outstanding options, warrants  and rights		Number of securities  remaining available for future issuance under equity compensation plans (excluding securities reflected in column(a) )
Equity compensation plans approved by security holders		46,311,800	$	9.26		42,099,900
Equity compensation plans not approved by security holders		—		—		—
Total		46,311,800	$	9.26		42,099,900

* For additional information concerning our equity compensation plans, see the discussion in Note 2 — Share-Based Compensation in the notes to the consolidated financial statements.

Item 13.    Certain Relationships and Related Transactions, and Director Independence

The information required by this Item is set forth under the headings “Certain Relationships and Related Party Transactions” and “Corporate Governance” in the definitive proxy materials to be filed in connection with our 2012 Annual Meeting of Stockholders, which information is incorporated herein by reference.

Item 14.    Principal Accountant Fees and Services

The information required by this Item is set forth under the heading “Principal Accountant Fees and Services” in the definitive proxy materials to be filed in connection with our 2012 Annual Meeting of Stockholders, which information is incorporated herein by reference.

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PART IV

Item 15. Exhibits and Financial Statement Schedules

(a) Documents filed as part of the report:

1. Financial Statements. The accompanying Index to Consolidated Financial Statements on page F-1 of this annual report on Form 10-K is provided in response to this item.

2. List of Financial Statement Schedules. All schedules are omitted because the required information is either not present, not present in material amounts or presented within the consolidated financial statements.

3. List of Exhibits

2.1	—	Agreement and Plan of Merger, dated July 24, 2006, by and among HCA Inc., Hercules Holding II, LLC and Hercules Acquisition Corporation (filed as Exhibit 2.1 to the Company’s Current Report on Form 8-K filed July 25, 2006, and incorporated herein by reference).
2.2	—	Merger Agreement, dated November 22, 2010, by and among HCA Inc., HCA Holdings, Inc., and HCA Merger Sub LLC (filed as Exhibit 2.1 to the Company’s Current Report on Form 8-K filed November 24, 2010, and incorporated herein by reference).
2.3	—	Membership Interest Purchase Agreement by and between HealthONE, D/B/A The Colorado Health Foundation, and HealthONE of Denver, Inc., dated August 2, 2011 (Registrant agrees to furnish supplementally a copy of any omitted schedule to the Securities and Exchange Commission upon request) (filed as Exhibit 2.1 to the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30, 2011, and incorporated herein by reference).
3.1	—	Amended and Restated Certificate of Incorporation of the Company (filed as Exhibit 3.1 to the Company’s Registration Statement on Form S-1 (File No. 333-171369), and incorporated herein by reference).
3.2	—	Amended and Restated Bylaws of the Company (filed as Exhibit 3.2 to the Company’s Registration Statement on Form S-1 (File No. 333-171369), and incorporated herein by reference).
4.1	—	Specimen Certificate for shares of Common Stock, par value $0.01 per share, of the Company. (filed as Exhibit 4.1 to the Company’s Registration Statement on Form S-1 (File No. 333-171369), and incorporated herein by reference).
4.2	—	Security Agreement, dated as of November 17, 2006, among HCA Inc., the subsidiary grantors party thereto and The Bank of New York, as collateral agent (filed as Exhibit 4.2 to the Company’s Current Report on Form 8-K filed November 24, 2006, and incorporated herein by reference).
4.3	—	Pledge Agreement, dated as of November 17, 2006, among HCA Inc., the subsidiary pledgors party thereto and The Bank of New York, as collateral agent (filed as Exhibit 4.3 to the Company’s Current Report of Form 8-K filed November 24, 2006, and incorporated herein by reference).
4.4	—	Indenture, dated February 19, 2009, among HCA Inc, the guarantors party thereto, The Bank of New York Mellon, as collateral agent and The Bank of New York Mellon Trust Company, N.A., as trustee (filed as Exhibit 4.1 to the Company’s Current Report on Form 8-K filed February 25, 2009, and incorporated herein by reference).
4.5	—	Form of 9 7/8% Senior Secured Notes due 2017 (included in Exhibit 4.6).

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4.6(a)	—	$13,550,000,000 — €1,000,000,000 Credit Agreement, dated as of November 17, 2006, among HCA Inc., HCA UK Capital Limited, the lending institutions from time to time parties thereto, Banc of America Securities LLC, J.P. Morgan Securities Inc., Citigroup Global Markets Inc. and Merrill Lynch, Pierce, Fenner & Smith Incorporated, as joint lead arrangers and joint bookrunners, Bank of America, N.A., as administrative agent, JPMorgan Chase Bank, N.A. and Citicorp North America, Inc., as co-syndication agents and Merrill Lynch Capital Corporation, as documentation agent (filed as Exhibit 4.8 to the Company’s Current Report on Form 8-K filed November 24, 2006, and incorporated herein by reference).
4.6(b)	—	Amendment No. 1 to the Credit Agreement, dated as of February 16, 2007, among HCA Inc., HCA UK Capital Limited, the lending institutions from time to time parties thereto, Bank of America, N.A., as administrative agent, JPMorgan Chase Bank, N.A., and Citicorp North America, Inc., as Co-Syndication Agents, Banc of America Securities, LLC, J.P. Morgan Securities Inc., Citigroup Global Markets Inc. and Merrill Lynch, Pierce, Fenner & Smith Incorporated, as joint lead arrangers and bookrunners, Deutsche Bank Securities and Wachovia Capital Markets LLC, as joint bookrunners and Merrill Lynch Capital Corporation, as documentation agent (filed as Exhibit 4.7(b) to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2006, and incorporated herein by reference).
4.6(c)	—	Amendment No. 2 to the Credit Agreement, dated as of March 2, 2009, among HCA Inc., HCA UK Capital Limited, the lending institutions from time to time parties thereto, Bank of America, N.A., as administrative agent, JPMorgan Chase Bank, N.A., and Citicorp North America, Inc., as Co-Syndication Agents, Banc of America Securities, LLC, J.P. Morgan Securities Inc., Citigroup Global Markets Inc. and Merrill Lynch, Pierce, Fenner & Smith Incorporated, as joint lead arrangers and bookrunners, Deutsche Bank Securities and Wachovia Capital Markets LLC, as joint bookrunners and Merrill Lynch Capital Corporation, as documentation agent (filed as exhibit 4.8(c) to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2008, and incorporated herein by reference).
4.6(d)	—	Amendment No. 3 to the Credit Agreement, dated as of June 18, 2009, among HCA Inc., HCA UK Capital Limited, the lending institutions from time to time parties thereto, Bank of America, N.A., as administrative agent, JPMorgan Chase Bank, N.A., and Citicorp North America, Inc., as Co-Syndication Agents, Banc of America Securities, LLC, J.P. Morgan Securities Inc., Citigroup Global Markets Inc. and Merrill Lynch, Pierce, Fenner & Smith Incorporated, as joint lead arrangers and bookrunners, Deutsche Bank Securities and Wachovia Capital Markets LLC, as joint bookrunners and Merrill Lynch Capital Corporation, as documentation agent (filed as Exhibit 4.1 to the Company’s Current Report on Form 8-K filed June 22, 2009, and incorporated herein by reference).
4.6(e)	—	Extension Amendment No. 1 to the Credit Agreement, dated as of April 6, 2010, among HCA Inc., HCA UK Capital Limited, the lending institutions from time to time parties thereto, Bank of America, N.A., as administrative agent and collateral agent (filed as Exhibit 10.1 to the Company’s Current Report on Form 8-K filed April 8, 2010, and incorporated herein by reference).
4.6(f)	—	Amended and Restated Joinder Agreement No. 1, dated as of November 8, 2010, by and among each of the financial institutions listed as a “Replacement-1 Revolving Credit Lender” on Schedule A thereto, HCA Inc., Bank of America, N.A., as Administrative Agent and as Collateral Agent, and the other parties listed on the signature pages thereto (filed as Exhibit 4.1 to the Company’s Quarterly Report on Form 10-Q filed November 9, 2010, and incorporated herein by reference).
4.6(g)	—	Restatement Agreement, dated as of May 4, 2011, by and among HCA Inc., HCA UK Capital Limited, the lenders party thereto and Bank of America, N.A., as administrative agent and collateral agent to the Credit Agreement, dated as of November 17, 2006, as amended on February 16, 2007, March 2, 2009, June 18, 2009, April 6, 2010 and November 8, 2010 (filed as Exhibit 10.1 to the Company’s Current Report on Form 8-K filed May 9, 2011, and incorporated herein by reference).

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4.7	—	U.S. Guarantee, dated November 17, 2006, among HCA Inc., the subsidiary guarantors party thereto and Bank of America, N.A., as administrative agent (filed as Exhibit 4.9 to the Company’s Current Report on Form 8-K filed November 24, 2006, and incorporated herein by reference).
4.8	—	Indenture, dated as of April 22, 2009, among HCA Inc., the guarantors party thereto, Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent, and Law Debenture Trust Company of New York, as trustee (filed as Exhibit 4.1 to the Company’s Current Report on Form 8-K filed April 28, 2009, and incorporated herein by reference).
4.9	—	Security Agreement, dated as November 17, 2006, and amended and restated as of March 2, 2009, among the Company, the Subsidiary Grantors named therein and Bank of America, N.A., as Collateral Agent (filed as exhibit 4.10 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2008, and incorporated herein by reference).
4.10	—	Pledge Agreement, dated as of November 17, 2006, and amended and restated as of March 2, 2009, among the Company, the Subsidiary Pledgors named therein and Bank of America, N.A., as Collateral Agent (filed as exhibit 4.11 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2008, and incorporated herein by reference).
4.11	—	Form of 8 1/2% Senior Secured Notes due 2019 (included in Exhibit 4.10).
4.12	—	Indenture, dated as of August 11, 2009, among HCA Inc., the guarantors party thereto, Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent, and Law Debenture Trust Company of New York, as trustee (filed as Exhibit 4.1 to the Company’s Current Report on Form 8-K filed August 17, 2009, and incorporated herein by reference).
4.13	—	Form of 7 7/8% Senior Secured Notes due 2020 (included in Exhibit 4.14).
4.14	—	Indenture, dated as of March 10, 2010, among HCA Inc., the guarantors party thereto, Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent, and Law Debenture Trust Company of New York, as trustee (filed as Exhibit 4.1 to the Company’s Current Report on Form 8-K filed March 12, 2010, and incorporated herein by reference).
4.15	—	Form of 7 1/4% Senior Secured Notes due 2020 (included in Exhibit 4.16).
4.16	—	$2,500,000,000 Credit Agreement, dated as of September 30, 2011, by and among HCA Inc., the subsidiary borrowers party thereto, the lenders from time to time party thereto and Bank of America, N.A., as administrative agent (filed as Exhibit 4.4 to the Company’s Current Report on Form 8-K filed October 3, 2011, and incorporated herein by reference).
4.17	—	Security Agreement, dated as of September 30, 2011, by and among HCA Inc., the subsidiary borrowers party thereto and Bank of America, N.A., as collateral agent (filed as Exhibit 4.5 to the Company’s Current Report on Form 8-K filed October 3, 2011, and incorporated herein by reference).
4.18(a)	—	General Intercreditor Agreement, dated as of November 17, 2006, between Bank of America, N.A., as First Lien Collateral Agent, and The Bank of New York, as Junior Lien Collateral Agent (filed as Exhibit 4.13(a) to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.18(b)	—	Additional General Intercreditor Agreement, dated as of April 22, 2009, by and among Bank of America, N.A., in its capacity as First Lien Collateral Agent, The Bank of New York Mellon, in its capacity as Junior Lien Collateral Agent and in its capacity as 2006 Second Lien Trustee and The Bank of New York Mellon Trust Company, N.A., in its capacity as 2009 Second Lien Trustee (filed as Exhibit 4.6 to the Company’s Current Report on Form 8-K filed April 28, 2009, and incorporated herein by reference).

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4.18(c)	—	Additional General Intercreditor Agreement, dated as of August 11, 2009, by and among Bank of America, N.A., in its capacity as First Lien Collateral Agent, The Bank of New York Mellon, in its capacity as Junior Lien Collateral Agent and in its capacity as trustee for the Second Lien Notes issued on November 17, 2006, and The Bank of New York Mellon Trust Company, N.A., in its capacity as trustee for the Second Lien Notes issued on February 19, 2009 (filed as Exhibit 4.6 to the Company’s Current Report on Form 8-K filed August 17, 2009, and incorporated herein by reference).
4.18(d)	—	Receivables Intercreditor Agreement, dated as of November 17, 2006, among Bank of America, N.A., as ABL Collateral Agent, Bank of America, N.A., as CF Collateral Agent and The Bank of New York, as Bonds Collateral Agent (filed as Exhibit 4.13(b) to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.18(e)	—	Additional Receivables Intercreditor Agreement, dated as of April 22, 2009, by and between Bank of America, N.A. as ABL Collateral Agent, and Bank of America, N.A. as New First Lien Collateral Agent (filed as Exhibit 4.7 to the Company’s Current Report on Form 8-K filed April 28, 2009, and incorporated herein by reference).
4.18(f)	—	Additional Receivables Intercreditor Agreement, dated as of August 11, 2009, by and between Bank of America, N.A., as ABL Collateral Agent, and Bank of America, N.A., as New First Lien Collateral Agent (filed as Exhibit 4.7 to the Company’s Current Report on Form 8-K filed August 17, 2009, and incorporated herein by reference).
4.18(g)	—	First Lien Intercreditor Agreement, dated as of April 22, 2009, among Bank of America, N.A. as Collateral Agent, Bank of America, N.A. as Authorized Representative under the Credit Agreement and Law Debenture Trust Company of New York as the Initial Additional Authorized Representative (filed as Exhibit 4.5 to the Company’s Current Report on Form 8-K filed April 28, 2009, and incorporated herein by reference).
4.18(h)	—	Additional General Intercreditor Agreement, dated as of August 1, 2011, by and among Bank of America, N.A., in its capacity as First Lien Collateral Agent, The Bank of New York Mellon, in its capacity as Junior Lien Collateral Agent and in its capacity as trustee for the Second Lien Notes issued on November 17, 2006, and The Bank of New York Mellon Trust Company, N.A., in its capacity as trustee for the Second Lien Notes issued on February 19, 2009 (filed as Exhibit 4.9 to the Company’s Current Report on Form 8-K filed August 1, 2011, and incorporated herein by reference).
4.18(i)	—	Additional Receivables Intercreditor Agreement, dated as of August 1, 2011 by and between Bank of America, N.A., as ABL Collateral Agent, and Bank of America, N.A., as New First Lien Collateral Agent (filed as Exhibit 4.1 to the Company’s Current Report on Form 8-K filed October 3, 2011, and incorporated herein by reference).
4.18(j)	—	Additional General Intercreditor Agreement, dated as of February 16, 2012, by and among Bank of America, N.A., in its capacity as First Lien Collateral Agent, The Bank of New York Mellon, in its capacity as Junior Lien Collateral Agent and in its capacity as trustee for the Second Lien Notes issued on November 17, 2006, and The Bank of New York Mellon Trust Company, N.A., in its capacity as trustee for the Second Lien Notes issued on February 19, 2009 (filed as Exhibit 4.9 to the Company’s Current Report on Form 8-K filed February 16, 2012, and incorporated herein by reference).
4.18(k)	—	Additional Receivables Intercreditor Agreement, dated as of February 16, 2012, by and between Bank of America, N.A., as ABL Collateral Agent, and Bank of America, N.A., as New First Lien Collateral Agent (filed as Exhibit 4.10 to the Company’s Current Report on Form 8-K filed February 16, 2012, and incorporated herein by reference).
4.19	—	Registration Rights Agreement, dated as of November 22, 2010, among HCA Holdings, Inc., Hercules Holding II, LLC and certain other parties thereto (filed as Exhibit 4.4 to the Company’s Current Report on Form 8-K filed November 24, 2010, and incorporated herein by reference).

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4.20	—	Registration Rights Agreement, dated as of March 16, 1989, by and among HCA-Hospital Corporation of America and the persons listed on the signature pages thereto (filed as Exhibit 4.14 to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.21	—	Assignment and Assumption Agreement, dated as of February 10, 1994, between HCA-Hospital Corporation of America and the Company relating to the Registration Rights Agreement, as amended (filed as Exhibit 4.15 to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.22(a)	—	Indenture, dated as of December 16, 1993 between the Company and The First National Bank of Chicago, as Trustee (filed as Exhibit 4.16(a) to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.22(b)	—	First Supplemental Indenture, dated as of May 25, 2000 between the Company and Bank One Trust Company, N.A., as Trustee (filed as Exhibit 4.16(b) to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.22(c)	—	Second Supplemental Indenture, dated as of July 1, 2001 between the Company and Bank One Trust Company, N.A., as Trustee (filed as Exhibit 4.16(c) to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.22(d)	—	Third Supplemental Indenture, dated as of December 5, 2001 between the Company and The Bank of New York, as Trustee (filed as Exhibit 4.16(d) to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.22(e)	—	Fourth Supplemental Indenture, dated as of November 14, 2006, between the Company and The Bank of New York, as Trustee (filed as Exhibit 4.1 to the Company’s Current Report on Form 8-K filed November 16, 2006, and incorporated herein by reference).
4.23	—	Form of 7.5% Debentures due 2023 (filed as Exhibit 4.17 to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.24	—	Form of 8.36% Debenture due 2024 (filed as Exhibit 4.18 to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.25	—	Form of Fixed Rate Global Medium-Term Note (filed as Exhibit 4.19 to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.26	—	Form of Floating Rate Global Medium-Term Note (filed as Exhibit 4.20 to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.27	—	Form of 7.69% Note due 2025 (filed as Exhibit 4.10 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2004 (File No. 001-11239), and incorporated herein by reference).
4.28	—	Form of 7.19% Debenture due 2015 (filed as Exhibit 4.22 to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.29	—	Form of 7.50% Debenture due 2095 (filed as Exhibit 4.23 to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.30	—	Form of 7.05% Debenture due 2027 (filed as Exhibit 4.24 to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.31(a)	—	6.95% Note due 2012 in the principal amount of $400,000,000 (filed as Exhibit 4.29(a) to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).

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4.31(b)	—	6.95% Note due 2012 in the principal amount of $100,000,000 (filed as Exhibit 4.29(b) to the Company’s Registration Statement on Form S-4 (File No. 333-145054), and incorporated herein by reference).
4.32(a)	—	6.30% Note due 2012 in the principal amount of $400,000,000 (filed as Exhibit 4.1 to the Company’s Current Report on Form 8-K dated September 18, 2002 (File No. 001-11239), and incorporated herein by reference).
4.32(b)	—	6.30% Note due 2012 in the principal amount of $100,000,000 (filed as Exhibit 4.2 to the Company’s Current Report on Form 8-K dated September 18, 2002 (File No. 001-11239), and incorporated herein by reference).
4.33(a)	—	6.25% Note due 2013 in the principal amount of $400,000,000 (filed as Exhibit 4.1 to the Company’s Current Report on Form 8-K dated February 5, 2003 (File No. 001-11239), and incorporated herein by reference).
4.33(b)	—	6 3/4% Note due 2013 in the principal amount of $100,000,000 (filed as Exhibit 4.2 to the Company’s Current Report on Form 8-K dated February 5, 2003 (File No. 001-11239), and incorporated herein by reference).
4.34(a)	—	6 3/4% Note due 2013 in the principal amount of $400,000,000 (filed as Exhibit 4.1 to the Company’s Current Report on Form 8-K dated July 23, 2003 (File No. 001-11239), and incorporated herein by reference).
4.34(b)	—	6 3/4% Note due 2013 in the principal amount of $100,000,000 (filed as Exhibit 4.2 to the Company’s Current Report on Form 8-K dated July 23, 2003 (File No. 001-11239), and incorporated herein by reference).
4.35	—	7.50% Note due 2033 in the principal amount of $250,000,000 (filed as Exhibit 4.2 to the Company’s Current Report on Form 8-K dated November 6, 2003 (File No. 001-11239), and incorporated herein by reference).
4.36	—	5.75% Note due 2014 in the principal amount of $500,000,000 (filed as Exhibit 4.1 to the Company’s Current Report on Form 8-K dated March 8, 2004 (File No. 001-11239), and incorporated herein by reference).
4.37(a)	—	6.375% Note due 2015 in the principal amount of $500,000,000 (filed as Exhibit 4.2 to the Company’s Current Report on Form 8-K dated November 16, 2004 (File No. 001-11239), and incorporated herein by reference).
4.37(b)	—	6.375% Note due 2015 in the principal amount of $250,000,000 (filed as Exhibit 4.3 to the Company’s Current Report on Form 8-K dated November 16, 2004 (File No. 001-11239), and incorporated herein by reference).
4.38(a)	—	6.500% Note due 2016 in the principal amount of $500,000,000 (filed as Exhibit 4.1 to the Company’s Current Report on Form 8-K filed on February 8, 2006, and incorporated herein by reference).
4.38(b)	—	6.500% Note due 2016 in the principal amount of $500,000,000 (filed as Exhibit 4.2 to the Company’s Current Report on Form 8-K filed on February 8, 2006, and incorporated herein by reference).
4.39	—	Indenture, dated as of November 23, 2010, among HCA Holdings, Inc., Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent, and Law Debenture Trust Company of New York, as trustee (filed as Exhibit 4.1 to the Company’s Current Report on Form 8-K filed November 24, 2010, and incorporated herein by reference).
4.40	—	Form of 7 3/4% Senior Notes due 2021 (included in Exhibit 4.39).

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4.41	—	Form of Indenture of HCA Inc. (filed as Exhibit 4.2 to the Registrant’s Registration Statement on Form S-3 (File No. 333-175791), and incorporated herein by reference).
4.42	—	Supplemental Indenture No. 1, dated as of August 1, 2011, among HCA Inc., HCA Holdings, Inc., Law Debenture Trust Company of New York, as trustee, and Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent (filed as Exhibit 4.2 to the Company’s Current Report on Form 8-K filed August 1, 2011, and incorporated herein by reference).
4.43	—	Supplemental Indenture No. 2, dated as of August 1, 2011, among HCA Inc., HCA Holdings, Inc., the subsidiary guarantors named therein, Law Debenture Trust Company of New York, as trustee, and Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent (filed as Exhibit 4.3 to the Company’s Current Report on Form 8-K filed August 1, 2011, and incorporated herein by reference).
4.44	—	Form of 7.50% Senior Notes Due 2022 (included in Exhibit 4.42).
4.45	—	Form of 6.50% Senior Secured Notes Due 2020 (included in Exhibit 4.43).
4.46	—	Supplemental Indenture No. 3, dated as of October 3, 2011, among HCA Inc., HCA Holdings, Inc., Law Debenture Trust Company of New York, as trustee, and Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent (filed as Exhibit 4.2 to the Company’s Current Report on Form 8-K filed October 3, 2011, and incorporated herein by reference).
4.47	—	Form of 8.00% Senior Notes Due 2018 (included in Exhibit 4.46).
4.48	—	Supplemental Indenture No. 4, dated as of February 16, 2012, among HCA Inc., HCA Holdings, Inc., the subsidiary guarantors named therein, Law Debenture Trust Company of New York, as trustee, and Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent (filed as Exhibit 4.2 to the Company’s Current Report on Form 8-K filed February 16, 2012, and incorporated herein by reference).
4.49	—	Form of 5.875% Senior Secured Notes due 2022 (included in Exhibit 4.48).
10.1	—	HCA-Hospital Corporation of America Nonqualified Initial Option Plan (filed as Exhibit 4.6 to the Company’s Registration Statement on Form S-3 (File No. 33-52379), and incorporated herein by reference).*
10.2	—	Form of Indemnity Agreement with certain officers and directors (filed as Exhibit 10.3 to the Company’s Registration Statement on Form S-4 (File No. 333-145054) and incorporated herein by reference).
10.3	—	Columbia/HCA Healthcare Corporation 2000 Equity Incentive Plan (filed as Exhibit A to the Company’s Proxy Statement for the Annual Meeting of Stockholders on May 25, 2000, and incorporated herein by reference).*
10.4	—	Form of Non-Qualified Stock Option Award Agreement (Officers) (filed as Exhibit 99.2 to the Company’s Current Report on Form 8-K dated February 2, 2005 (File No. 001-11239), and incorporated herein by reference).*
10.5	—	HCA 2005 Equity Incentive Plan (filed as Exhibit B to the Company’s Proxy Statement for the Annual Meeting of Shareholders on May 26, 2005, and incorporated herein by reference).*
10.6	—	Form of 2005 Non-Qualified Stock Option Agreement (Officers) (filed as Exhibit 99.2 to the Company’s Current Report on Form 8-K dated October 6, 2005, and incorporated herein by reference).*
10.7	—	Form of 2006 Non-Qualified Stock Option Award Agreement (Officers) (filed as Exhibit 10.2 to the Company’s Current Report on Form 8-K dated February 1, 2006, and incorporated herein by reference).*

96

10.8(a)	—	2006 Stock Incentive Plan for Key Employees of HCA Holdings, Inc. and its Affiliates as Amended and Restated (filed as Exhibit 10.11(b) to the Company’s Registration Statement on Form S-1 (File No. 333-171369), and incorporated herein by reference).*
10.8(b)	—	First Amendment to 2006 Stock Incentive Plan for Key Employees of HCA Holdings, Inc. and its Affiliates, as amended and restated (filed as Exhibit 10.1 to the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30, 2011, and incorporated herein by reference).*
10.9(a)	—	Management Stockholder’s Agreement dated November 17, 2006 (filed as Exhibit 10.12 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2006, and incorporated herein by reference).
10.9(b)	—	Form of Omnibus Amendment to HCA Holdings, Inc’s Management Stockholder’s Agreements (filed as Exhibit 10.39 to the Company’s Registration Statement on Form S-1 (File No. 333-171369), and incorporated herein by reference).*
10.10	—	Form of Option Rollover Agreement (filed as Exhibit 10.14 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2006, and incorporated herein by reference).*
10.11	—	Form of Stock Option Agreement (2007) (filed as Exhibit 10.15 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2006, and incorporated herein by reference).*
10.12	—	Form of Stock Option Agreement (2008) (filed as Exhibit 10.16 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2007, and incorporated herein by reference).*
10.13	—	Form of Stock Option Agreement (2009) (filed as Exhibit 10.17 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2008, and incorporated herein by reference).*
10.14	—	Form of Stock Option Agreement (2010) (filed as Exhibit 10.20 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2009, and incorporated herein by reference).*
10.15	—	Form of 2x Time Stock Option Agreement (filed as Exhibit 10.2 to the Company’s Quarterly Report on Form 10-Q for the quarterly period ended September 30, 2009, and incorporated herein by reference).
10.16	—	Form Stock Option Agreement (2011) (filed as Exhibit 10.1 to the Company’s Quarterly Report on Form 10-Q for the quarter ended September 30, 2011, and incorporated herein by reference).*
10.17	—	Form of Stock Appreciation Right Award Agreement Under the 2006 Stock Incentive Plan for Key Employees of HCA Holdings, Inc. and its Affiliates, as Amended and Restated (filed as Exhibit 10.1 to the Company’s Current Report on Form 8-K filed February 14, 2012, and incorporated herein by reference).*
10.18	—	Form of Director Restricted Share Unit Agreement (Initial Award) Under the 2006 Stock Incentive Plan for Key Employees of HCA Holdings, Inc. and its Affiliates, as Amended and Restated (filed as Exhibit 10.2 to the Company’s Current Report on Form 8-K filed February 14, 2012, and incorporated herein by reference).*
10.19	—	Form of Director Restricted Share Unit Agreement (Annual Award) Under the 2006 Stock Incentive Plan for Key Employees of HCA Holdings, Inc. and its Affiliates, as Amended and Restated (filed as Exhibit 10.3 to the Company’s Current Report on Form 8-K filed February 14, 2012, and incorporated herein by reference).*
10.20	—	Exchange and Purchase Agreement (filed as Exhibit 10.16 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2006, and incorporated herein by reference).
10.21	—	Civil and Administrative Settlement Agreement, dated December 14, 2000 between the Company, the United States Department of Justice and others (filed as Exhibit 99.2 to the Company’s Current Report on Form 8-K dated December 20, 2000 (File No. 001-11239), and incorporated herein by reference).

97

10.22	—	Plea Agreement, dated December 14, 2000 between the Company, Columbia Homecare Group, Inc., Columbia Management Companies, Inc. and the United States Department of Justice (filed as Exhibit 99.3 to the Company’s Current Report on Form 8-K dated December 20, 2000 (File No. 001-11239), and incorporated herein by reference).
10.23	—	Corporate Integrity Agreement, dated December 14, 2000 between the Company and the Office of Inspector General of the United States Department of Health and Human Services (filed as Exhibit 99.4 to the Company’s Current Report on Form 8-K dated December 20, 2000 (File No. 001-11239), and incorporated herein by reference).
10.24	—	Management Agreement, dated November 17, 2006, among HCA Inc., Bain Capital Partners, LLC, Kohlberg Kravis Roberts & Co. L.P., Dr. Thomas F. Frist, Jr., Patricia F. Elcan, William R. Frist and Thomas F. Frist III, and Merrill Lynch Global Partners, Inc. (filed as Exhibit 10.20 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2006, and incorporated herein by reference).
10.25	—	Retirement Agreement between the Company and Thomas F. Frist, Jr., M.D. dated as of January 1, 2002 (filed as Exhibit 10.30 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2001 (File No. 001-11239), and incorporated herein by reference).*
10.26	—	Amended and Restated HCA Supplemental Executive Retirement Plan, effective December 22, 2010, except as provided therein (filed as Exhibit 10.26 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2010, and incorporated herein by reference).*
10.27	—	Amended and Restated HCA Restoration Plan, effective December 22, 2010 (filed as Exhibit 10.27 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2010, and incorporated herein by reference).*
10.28(a)	—	HCA Inc. 2008-2009 Senior Officer Performance Excellence Program (filed as Exhibit 10.27 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2007, and incorporated herein by reference).*
10.28(b)	—	HCA Inc. Amendment No. 1 to the 2008-2009 Senior Officer Performance Excellence Program (filed as Exhibit 10.28(b) to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2008, and incorporated herein by reference).*
10.29(a)	—	Employment Agreement dated November 16, 2006 (Richard M. Bracken) (filed as Exhibit 10.27(b) to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2006, and incorporated herein by reference).*
10.29(b)	—	Employment Agreement dated November 16, 2006 (R. Milton Johnson) (filed as Exhibit 10.27(c) to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2006, and incorporated herein by reference).*
10.29(c)	—	Employment Agreement dated November 16, 2006 (Samuel N. Hazen) (filed as Exhibit 10.27(d) to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2006, and incorporated herein by reference).*
10.29(d)	—	Employment Agreement dated November 16, 2006 (William P. Rutledge) (filed as Exhibit 10.27(e) to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2006, and incorporated herein by reference).*
10.29(e)	—	Employment Agreement dated November 16, 2006 (Beverly B. Wallace) (filed as Exhibit 10.28(e) to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2007, and incorporated herein by reference).*
10.29(f)	—	Amended and Restated Employment Agreement dated October 27, 2008 (Jack O. Bovender, Jr.) (filed as Exhibit 10.29(f) to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2008, and incorporated herein by reference).*

98

10.29(g)	—	Amendment to Employment Agreement effective January 1, 2009 (Richard M. Bracken) (filed as Exhibit 10.29(g) to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2008, and incorporated herein by reference).*
10.29(h)	—	Amendment No. 2 to Employment Agreement effective February 9, 2011 (Richard M. Bracken) (filed as Exhibit 10.29(h) to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2010, and incorporated herein by reference).*
10.29(i)	—	Amendment to Employment Agreement effective February 9, 2011 (R. Milton Johnson) (filed as Exhibit 10.29(i) to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2010, and incorporated herein by reference).*
10.29(j)	—	Amendment to Employment Agreement effective February 9, 2011 (Samuel N. Hazen) (filed as Exhibit 10.29(j) to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2010, and incorporated herein by reference).*
10.29(k)	—	Amendment to Employment Agreement effective February 9, 2011 (Beverly B. Wallace) (filed as Exhibit 10.29(k) to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2010, and incorporated herein by reference).*
10.30	—	Administrative Settlement Agreement dated June 25, 2003 by and between the United States Department of Health and Human Services, acting through the Centers for Medicare and Medicaid Services, and the Company (filed as Exhibit 10.1 to the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30, 2003 (File No. 001-11239), and incorporated herein by reference).
10.31	—	Civil Settlement Agreement by and among the United States of America, acting through the United States Department of Justice and on behalf of the Office of Inspector General of the Department of Health and Human Services, the TRICARE Management Activity (filed as Exhibit 10.2 to the Company’s Quarterly Report of Form 10-Q for the quarter ended June 30, 2003 (File No. 001-11239), and incorporated herein by reference).
10.32(a)	—	Form of Amended and Restated Limited Liability Company Agreement of Hercules Holding II, LLC dated as of November 17, 2006, among Hercules Holding II, LLC and certain other parties thereto (filed as Exhibit 10.3 to the Company’s Registration Statement on Form 8-A, filed April 29, 2008 (File No. 000-18406) and incorporated herein by reference).
10.32(b)	—	Form of Amendment to the Amended and Restated Limited Liability Company Agreement of Hercules Holding II, LLC (filed as Exhibit 10.32(a) to the Company’s Registration Statement on Form S-1 (File No. 333-171369), and incorporated herein by reference).
10.33	—	Indemnification Priority and Information Sharing Agreement, dated as of November 1, 2009, between HCA Inc. and certain other parties thereto (filed as Exhibit 10.35 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2009 (File No. 001-11239), and incorporated herein by reference).
10.34	—	HCA Inc. 2010 Senior Officer Performance Excellence Program (filed as Exhibit 10.1 to the Company’s Current Report on Form 8-K dated April 6, 2010, and incorporated herein by reference).*
10.35	—	Form of Restricted Share Unit Agreement (Officers) (filed as Exhibit 10.2 to the Company’s Current Report on Form 8-K dated April 6, 2010, and incorporated herein by reference).*
10.36	—	Assignment and Assumption Agreement, dated November 22, 2010, by and among HCA Inc., HCA Holdings, Inc. and HCA Merger Sub LLC (filed as Exhibit 10.1 to the Company’s Current Report on Form 8-K filed November 24, 2010, and incorporated herein by reference).

99

10.37	—	Omnibus Amendment to Various Stock and Option Plans and the Management Stockholders’ Agreement, dated November 22, 2010 (filed as Exhibit 10.2 to the Company’s Current Report on Form 8-K filed November 24, 2010, and incorporated herein by reference).*
10.38	—	Omnibus Amendment to Stock Option Agreements Issued Under the 2006 Stock Incentive Plan for Key Employees of HCA Holdings, Inc. and its Affiliates, as amended, effective February 16, 2011 (filed as Exhibit 10.38 to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2010, and incorporated herein by reference).*
10.39	—	Stockholders’ Agreement, dated as of March 9, 2011, by and among the Company, Hercules Holding II, LLC and the other signatories thereto (filed as Exhibit 10.1 to the Company’s Current Report on Form 8-K filed March 16, 2011, and incorporated herein by reference).
10.40	—	Amendment, dated as of September 21, 2011, to the Stockholders’ Agreement, dated as of March 9, 2011 (filed as Exhibit 10.2 to the Company’s Current Report on Form 8-K filed September 21, 2011, and incorporated herein by reference).
10.41	—	HCA Holdings, Inc. 2011 Senior Officer Performance Excellence Program (filed as Exhibit 10.1 to the Company’s Current Report on Form 8-K filed April 5, 2011, and incorporated herein by reference).*
10.42	—	Form of 2011 PEP Restricted Share Unit Agreement (Officers) (filed as Exhibit 10.2 to the Company’s Current Report on Form 8-K filed April 5, 2011, and incorporated herein by reference).*
10.43	—	Form of Director Restricted Share Unit Agreement Under the 2006 Stock Incentive Plan for Key Employees of HCA Holdings, Inc. and its Affiliates, as Amended and Restated (filed as Exhibit 10.5 to the Company’s Quarterly Report on Form 10-Q for the quarter ended March 31, 2011, and incorporated herein by reference).*
10.44	—	Share Repurchase Agreement, dated September 15, 2011, between HCA Holdings, Inc. and ML Global Private Equity Fund, L.P. and ML HCA Co-Invest, L.P. (filed as Exhibit 10.1 to the Company’s Current Report on Form 8-K filed September 21, 2011, and incorporated herein by reference).
21	—	List of Subsidiaries.
23	—	Consent of Ernst & Young LLP.
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 annual report on Form 10-K for the year ended December 31, 2011, filed with the SEC on February 23, 2012, formatted in Extensible Business Reporting Language (XBRL): (i) the consolidated balance sheets at December 31, 2011 and 2010, (ii) the consolidated income statements for the years ended December 31, 2011, 2010 and 2009, (iii) the consolidated comprehensive income statements for the years ended December 31, 2011, 2010 and 2009, (iv) the consolidated statements of stockholders’ deficit for the years ended December 31, 2011, 2010 and 2009, (v) the consolidated statements of cash flows for the years ended December 31, 2011, 2010 and 2009, and (vi) the notes to consolidated financial statements.(1)

(1) The XBRL related information in Exhibit 101 to this annual report on Form 10-K shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, or otherwise subject to liability of that section and shall not be incorporated by reference into any filing or other document pursuant to the Securities Act of 1933, as amended, except as shall be expressly set forth by specific reference in such filing or document.

* Management compensatory plan or arrangement.

100

SIGNATURES

Pursuant to the requirements of Section 13 or 15(d) 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 HOLDINGS, INC.
By:	/S/    RICHARD M. BRACKEN
	Richard M. Bracken
	Chairman of the Board and Chief Executive Officer

Dated: February 23, 2012

Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the following persons on behalf of the registrant and in the capacities and on the dates indicated.

Signature	Title	Date
/S/    RICHARD M. BRACKEN         Richard M. Bracken	Chairman of the Board and Chief Executive Officer (Principal Executive Officer)	February 23, 2012
/S/    R. MILTON JOHNSON         R. Milton Johnson	President, Chief Financial Officer and Director (Principal Financial Officer and Principal Accounting Officer)	February 23, 2012
/S/    JOHN P. CONNAUGHTON         John P. Connaughton	Director	February 23, 2012
/S/    KENNETH W. FREEMAN         Kenneth W. Freeman	Director	February 23, 2012
/S/    THOMAS F. FRIST III         Thomas F. Frist III	Director	February 23, 2012
/S/    WILLIAM R. FRIST         William R. Frist	Director	February 23, 2012

101

Signature	Title	Date
/S/    CHRISTOPHER R. GORDON         Christopher R. Gordon	Director	February 23, 2012
/S/    JAY O. LIGHT         Jay O. Light	Director	February 23, 2012
/S/    MICHAEL W. MICHELSON         Michael W. Michelson	Director	February 23, 2012
/S/    JAMES C. MOMTAZEE         James C. Momtazee	Director	February 23, 2012
/S/    GEOFFREY G. MEYERS         Geoffrey G. Meyers	Director	February 23, 2012
/S/    STEPHEN G. PAGLIUCA         Stephen G. Pagliuca	Director	February 23, 2012
/S/    WAYNE J. RILEY         Wayne J. Riley	Director	February 23, 2012

102

HCA HOLDINGS, INC.

INDEX TO CONSOLIDATED FINANCIAL STATEMENTS

	Page
Report of Independent Registered Public Accounting Firm		F-2
Consolidated Financial Statements:
Consolidated Income Statements for the years ended December 31, 2011, 2010 and 2009		F-3
Consolidated Comprehensive Income Statements for the years ended December 31, 2011, 2010 and 2009		F-4
Consolidated Balance Sheets, December 31, 2011 and 2010		F-5
Consolidated Statements of Stockholders’ Deficit for the years ended December  31, 2011, 2010 and 2009		F-6
Consolidated Statements of Cash Flows for the years ended December 31, 2011, 2010 and 2009		F-7
Notes to Consolidated Financial Statements		F-8
Quarterly Consolidated Financial Information (Unaudited)		F-49

F-1

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

The Board of Directors and Stockholders

HCA Holdings, Inc.

We have audited the accompanying consolidated balance sheets of HCA Holdings, Inc. as of December 31, 2011 and 2010, and the related consolidated statements of income, comprehensive income, stockholders’ deficit, and cash flows for each of the three years in the period ended December 31, 2011. These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on these financial statements based on our audits.

We conducted our audits in accordance with the standards of the Public Company Accounting Oversight Board (United States). Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion.

In our opinion, the financial statements referred to above present fairly, in all material respects, the consolidated financial position of HCA Holdings, Inc. at December 31, 2011 and 2010, and the consolidated results of its operations and its cash flows for each of the three years in the period ended December 31, 2011, in conformity with U.S. generally accepted accounting principles.

As discussed in Note 1 to the consolidated financial statements, the Company changed its presentation of revenues and provision for doubtful accounts as a result of the adoption of the amendments to the FASB Accounting Standards Codification resulting from Accounting Standards Update No. 2011-07, Presentation and Disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Healthcare Entities.

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), HCA Holdings, Inc.’s internal control over financial reporting as of December 31, 2011, based on criteria established in Internal Control — Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission and our report dated February 23, 2012 expressed an unqualified opinion thereon.

/s/ Ernst & Young LLP

Nashville, Tennessee

February 23, 2012

F-2

HCA HOLDINGS, INC.

CONSOLIDATED INCOME STATEMENTS

FOR THE YEARS ENDED DECEMBER 31, 2011, 2010 AND 2009

(Dollars in millions, except per share amounts)

	2011			2010			2009
Revenues before the provision for doubtful accounts	$	32,506		$	30,683		$	30,052
Provision for doubtful accounts		2,824			2,648			3,276
Revenues		29,682			28,035			26,776
Salaries and benefits		13,440			12,484			11,958
Supplies		5,179			4,961			4,868
Other operating expenses		5,470			5,004			4,724
Electronic health record incentive income		(210	)		—			—
Equity in earnings of affiliates		(258	)		(282	)		(246	)
Depreciation and amortization		1,465			1,421			1,425
Interest expense		2,037			2,097			1,987
Losses (gains) on sales of facilities		(142	)		(4	)		15
Gain on acquisition of controlling interest in equity investment		(1,522	)		—			—
Impairments of long-lived assets		—			123			43
Losses on retirement of debt		481			—			—
Termination of management agreement		181			—			—
		26,121			25,804			24,774
Income before income taxes		3,561			2,231			2,002
Provision for income taxes		719			658			627
Net income		2,842			1,573			1,375
Net income attributable to noncontrolling interests		377			366			321
Net income attributable to HCA Holdings, Inc.	$	2,465		$	1,207		$	1,054
Per share data:
Basic earnings per share	$	5.17		$	2.83		$	2.48
Diluted earnings per share	$	4.97		$	2.76		$	2.44
Shares used in earnings per share calculations (in thousands):
Basic		476,609			426,424			425,567
Diluted		495,943			437,347			432,227

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

F-3

HCA HOLDINGS, INC.

CONSOLIDATED COMPREHENSIVE INCOME STATEMENTS

FOR THE YEARS ENDED DECEMBER 31, 2011, 2010 AND 2009

(Dollars in millions)

	2011			2010			2009
Net income	$	2,842		$	1,573		$	1,375
Other comprehensive income (loss) before taxes:
Foreign currency translation		(9	)		(25	)		39
Unrealized gains on available-for-sale securities		2			2			69
Less: gains included in other operating expenses		—			(13	)		—
		2			(11	)		69
Defined benefit plans		(67	)		(76	)		(18	)
Less: pension costs included in salaries and benefits		25			18			16
		(42	)		(58	)		(2	)
Change in fair value of derivative financial instruments		(311	)		(255	)		(209	)
Less: interest costs included in interest expense		341			384			345
		30			129			136
Other comprehensive income (loss) before taxes		(19	)		35			242
Income taxes (benefits) related to other comprehensive income items		(7	)		13			88
Other comprehensive income (loss)		(12	)		22			154
Comprehensive income		2,830			1,595			1,529
Comprehensive income attributable to noncontrolling interests		377			366			321
Comprehensive income attributable to HCA Holdings, Inc.	$	2,453		$	1,229		$	1,208

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

F-4

HCA HOLDINGS, INC.

CONSOLIDATED BALANCE SHEETS

DECEMBER 31, 2011 AND 2010

(Dollars in millions)

	2011			2010
ASSETS
Current assets:
Cash and cash equivalents	$	373		$	411
Accounts receivable, less allowance for doubtful accounts of $4,106 and $3,939		4,533			3,832
Inventories		1,054			897
Deferred income taxes		594			931
Other		679			848
		7,233			6,919
Property and equipment, at cost:
Land		1,416			1,215
Buildings		10,231			9,438
Equipment		15,431			14,310
Construction in progress		997			678
		28,075			25,641
Accumulated depreciation		(15,241	)		(14,289	)
		12,834			11,352
Investments of insurance subsidiaries		548			642
Investments in and advances to affiliates		101			869
Goodwill and other intangible assets		5,251			2,693
Deferred loan costs		290			374
Other		641			1,003
	$	26,898		$	23,852
LIABILITIES AND STOCKHOLDERS’ DEFICIT
Current liabilities:
Accounts payable	$	1,597		$	1,537
Accrued salaries		965			895
Other accrued expenses		1,585			1,245
Long-term debt due within one year		1,407			592
		5,554			4,269
Long-term debt		25,645			27,633
Professional liability risks		993			995
Income taxes and other liabilities		1,720			1,608
Equity securities with contingent redemption rights		—			141
Stockholders’ deficit:
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 437,477,900 shares — 2011 and 427,458,800 shares — 2010		4			4
Capital in excess of par value		1,601			386
Accumulated other comprehensive loss		(440	)		(428	)
Retained deficit		(9,423	)		(11,888	)
Stockholders’ deficit attributable to HCA Holdings, Inc.		(8,258	)		(11,926	)
Noncontrolling interests		1,244			1,132
		(7,014	)		(10,794	)
	$	26,898		$	23,852

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

F-5

HCA HOLDINGS, INC.

CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ DEFICIT

FOR THE YEARS ENDED DECEMBER 31, 2011, 2010 AND 2009

(Dollars in millions)

	Equity (Deficit) Attributable to HCA Holdings, Inc.
	Common Stock						Capital in Excess of Par Value			Accumulated Other Comprehensive Loss			Retained Deficit			Equity Attributable to Noncontrolling Interests
	Shares (000)			Par Value															Total
Balances, December 31, 2008		425,125		$	4		$	162		$	(604	)	$	(9,817	)	$	995		$	(9,260	)
Comprehensive income											154			1,054			321			1,529
Share-based benefit plans		1,216						47												47
Distributions																	(330	)		(330	)
Other								14									22			36
Balances, December 31, 2009		426,341			4			223			(450	)		(8,763	)		1,008			(7,978	)
Comprehensive income											22			1,207			366			1,595
Share-based benefit plans		1,118						43												43
Distributions														(4,332	)		(342	)		(4,674	)
Contributions																	57			57
Other								120									43			163
Balances, December 31, 2010		427,459			4			386			(428	)		(11,888	)		1,132			(10,794	)
Comprehensive income											(12	)		2,465			377			2,830
Issuance of common stock		87,719			1			2,505												2,506
Repurchase of common stock		(80,771	)		(1	)		(1,502	)											(1,503	)
Share-based benefit plans		3,071						35												35
Distributions																	(378	)		(378	)
Consolidation of acquired controlling interest in equity investment																	93			93
Reclassification of equity securities with contingent redemption rights								141												141
Other								36									20			56
Balances, December 31, 2011		437,478		$	4		$	1,601		$	(440	)	$	(9,423	)	$	1,244		$	(7,014	)

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

F-6

HCA HOLDINGS, INC.

CONSOLIDATED STATEMENTS OF CASH FLOWS

FOR THE YEARS ENDED DECEMBER 31, 2011, 2010 AND 2009

(Dollars in millions)

	2011			2010			2009
Cash flows from operating activities:
Net income	$	2,842		$	1,573		$	1,375
Adjustments to reconcile net income to net cash provided by operating activities:
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable		(3,248	)		(2,789	)		(3,180	)
Inventories and other assets		(18	)		(287	)		(191	)
Accounts payable and accrued expenses		313			229			280
Provision for doubtful accounts		2,824			2,648			3,276
Depreciation and amortization		1,465			1,421			1,425
Income taxes		912			27			(520	)
Losses (gains) on sales of facilities		(142	)		(4	)		15
Gain on acquisition of controlling interest in equity investment		(1,522	)		—			—
Impairments of long-lived assets		—			123			43
Losses on retirement of debt		481			—			—
Amortization of deferred loan costs		70			81			80
Share-based compensation		26			32			40
Pay-in-kind interest		(78	)		—			58
Other		8			31			46
Net cash provided by operating activities		3,933			3,085			2,747
Cash flows from investing activities:
Purchase of property and equipment		(1,679	)		(1,325	)		(1,317	)
Acquisition of hospitals and health care entities		(1,682	)		(233	)		(61	)
Disposal of hospitals and health care entities		281			37			41
Change in investments		80			472			303
Other		5			10			(1	)
Net cash used in investing activities		(2,995	)		(1,039	)		(1,035	)
Cash flows from financing activities:
Issuances of long-term debt		5,500			2,912			2,979
Net change in revolving bank credit facilities		(449	)		1,889			(1,335	)
Repayment of long-term debt		(6,640	)		(2,268	)		(3,103	)
Distributions to noncontrolling interests		(378	)		(342	)		(330	)
Contributions from noncontrolling interests		—			57			—
Payment of debt issuance costs		(92	)		(50	)		(70	)
Issuance of common stock		2,506			—			—
Repurchase of common stock		(1,503	)		—			—
Distributions to stockholders		(31	)		(4,257	)		—
Income tax benefits		63			114			—
Other		48			(2	)		(6	)
Net cash used in financing activities		(976	)		(1,947	)		(1,865	)
Change in cash and cash equivalents		(38	)		99			(153	)
Cash and cash equivalents at beginning of period		411			312			465
Cash and cash equivalents at end of period	$	373		$	411		$	312
Interest payments	$	1,987		$	1,994		$	1,751
Income tax (refunds) payments, net	$	(256	)	$	517		$	1,147

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

F-7

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

NOTE 1 — ACCOUNTING POLICIES

Reporting Entity and Corporate Reorganization

On November 17, 2006, HCA Inc. was acquired by a private investor group, including affiliates of or funds sponsored by Bain Capital Partners, LLC, Kohlberg Kravis Roberts & Co., BAML Capital Partners and HCA founder, Dr. Thomas F. Frist Jr. (collectively, the “Investors”) and by members of management and certain other investors. The transaction was accounted for as a recapitalization in our financial statements, with no adjustments to the historical basis of our assets and liabilities.

On November 22, 2010, HCA Inc. reorganized by creating a new holding company structure (the “Corporate Reorganization”). HCA Holdings, Inc. became the new parent company, and HCA Inc. became HCA Holdings, Inc.’s wholly-owned direct subsidiary. As part of the Corporate Reorganization, HCA Inc.’s outstanding shares of common stock were automatically converted, on a share for share basis, into identical shares of HCA Holdings, Inc.’s common stock. As a result of the Corporate Reorganization, HCA Holdings, Inc. was deemed the successor registrant to HCA Inc. under the Exchange Act.

During February 2011, our Board of Directors approved an increase in the number of our authorized shares to 1,800,000,000 shares of common stock and a 4.505-to-one split of our issued and outstanding common shares. All common share and per common share amounts in these consolidated financial statements and notes to consolidated financial statements reflect the 4.505-to-one split. During March 2011, we completed the initial public offering of 87,719,300 shares of our common stock at a price of $30.00 per share (before deducting underwriter discounts, commissions and other related offering expenses). Certain of our stockholders also sold 57,410,700 shares of our common stock in this offering. We did not receive any proceeds from the shares sold by the selling stockholders. Our common stock is now traded on the New York Stock Exchange (symbol “HCA”).

HCA Holdings, 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 Holdings, Inc. and partnerships and joint ventures in which such subsidiaries are partners. At December 31, 2011, these affiliates owned and operated 163 hospitals, 108 freestanding surgery centers and provided extensive outpatient and ancillary services. HCA Holdings, 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 Inc. and its affiliates prior to the Corporate Reorganization and to HCA Holdings, Inc. and its affiliates after the Corporate Reorganization. The term “facilities” or “hospitals” refer to entities owned and operated by affiliates of HCA and the term “employees” refers to employees of affiliates of HCA.

F-8

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 1 — ACCOUNTING POLICIES (Continued)

Basis of Presentation

The preparation of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. Actual results could differ from those estimates.

The consolidated financial statements include all subsidiaries and entities controlled by HCA. We generally define “control” as ownership of a majority of the voting interest of an entity. The consolidated financial statements include entities in which we absorb a majority of the entity’s expected losses, receive a majority of the entity’s expected residual returns, or both, as a result of ownership, contractual or other financial interests in the entity. Significant intercompany transactions have been eliminated. Investments in entities we do not control, but in which we have a substantial ownership interest and can exercise significant influence, are accounted for using the equity method.

We have completed various acquisitions and joint venture transactions. The accounts of these entities have been included in our consolidated financial statements for periods subsequent to our acquisition of controlling interests. The majority of our expenses are “cost of revenue” items. Costs that could be classified as general and administrative include our corporate office costs, which were $228 million, $182 million and $164 million for the years ended December 31, 2011, 2010 and 2009, respectively.

Revenues

In 2011, we adopted the provisions of Accounting Standards Update No. 2011-07, Presentation and Disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities (“ASU 2011-07”). ASU 2011-07 requires health care entities to change the presentation of the statement of operations by reclassifying the provision for doubtful accounts from an operating expense to a deduction from patient service revenues. All periods presented in these consolidated financial statements and notes to consolidated financial statements have been reclassified in accordance with ASU 2011-07.

F-9

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 1 — ACCOUNTING POLICIES (Continued)

Revenues (Continued)

Revenues consist primarily of net patient service revenues that are recorded based upon established billing rates less allowances for contractual adjustments. Revenues are recorded during the period the health care services are provided, based upon the estimated amounts due from the patients and third-party payers. Third-party payers include federal and state agencies (under the Medicare and Medicaid programs), managed care health plans, commercial insurance companies and employers. Estimates of contractual allowances under managed care health plans are based upon the payment terms specified in the related contractual agreements. Contractual payment terms in managed care agreements are generally based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates. Revenues related to uninsured patients and copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record a provision for doubtful accounts (based primarily on historical collection experience) related to these uninsured accounts to record the net self pay accounts receivable at the estimated amounts we expect to collect. Our revenues from third party payers and the uninsured for the years ended December 31, are summarized in the following table (dollars in millions):

	2011			Ratio			2010			Ratio			2009			Ratio
Medicare	$	7,653			25.8	%	$	7,203			25.7	%	$	6,866			25.6	%
Managed Medicare		2,442			8.2			2,162			7.7			2,006			7.5
Medicaid		1,845			6.2			1,962			7.0			1,691			6.3
Managed Medicaid		1,265			4.3			1,165			4.2			1,113			4.2
Managed care and other insurers		15,703			52.9			14,762			52.7			14,323			53.5
International (managed care and other insurers)		938			3.2			784			2.8			702			2.6
		29,846			100.6			28,038			100.1			26,701			99.7
Uninsured		1,846			6.2			1,732			6.2			2,350			8.8
Other		814			2.7			913			3.3			1,001			3.7
Revenues before provision for doubtful accounts		32,506			109.5			30,683			109.6			30,052			112.2
Provision for doubtful accounts		(2,824	)		(9.5	)		(2,648	)		(9.6	)		(3,276	)		(12.2	)
Revenues	$	29,682			100.0	%	$	28,035			100.0	%	$	26,776			100.0	%

Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility recorded estimates will change by a material amount. Estimated reimbursement amounts are adjusted in subsequent periods as cost reports are prepared and filed and as final settlements are determined (in relation to certain government programs, primarily Medicare, this is generally referred to as the “cost report” filing and settlement process). The adjustments to estimated Medicare and Medicaid reimbursement amounts and disproportionate-share funds, which resulted in net increases to revenues, related primarily to cost reports filed during the respective year were $40 million, $52 million and $40 million in 2011, 2010 and 2009, respectively. The adjustments to estimated reimbursement amounts, which resulted in net increases to revenues, related primarily to cost reports filed during previous years were $30 million, $50 million and $60 million in 2011, 2010 and 2009, respectively.

The Emergency Medical Treatment and Labor Act (“EMTALA”) requires any hospital participating in the Medicare program to conduct an appropriate medical screening examination of every person who presents to the hospital’s emergency room for treatment and, if the individual is suffering from an emergency medical condition,

F-10

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 1 — ACCOUNTING POLICIES (Continued)

Revenues (Continued)

to either stabilize the condition or make an appropriate transfer of the individual to a facility able to handle the condition. The obligation to screen and stabilize emergency medical conditions exists regardless of an individual’s ability to pay for treatment. Federal and state laws and regulations, including but not limited to EMTALA, require, and our commitment to providing quality patient care encourages, us to provide services to patients who are financially unable to pay for the health care services they receive. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues. Patients treated at hospitals for nonelective care, who have income at or below 200% of the federal poverty level, are eligible for charity care. The federal poverty level is established by the federal government and is based on income and family size. We provide discounts to uninsured patients who do not qualify for Medicaid or charity care. These discounts are similar to those provided to many local managed care plans. In implementing the discount policy, we first attempt to qualify uninsured patients for Medicaid, other federal or state assistance or charity care. If an uninsured patient does not qualify for these programs, the uninsured discount is applied.

The revenue deductions related to uninsured accounts (charity care and uninsured discounts) generally have the inverse impact on the provision for doubtful accounts. To quantify the total impact of and trends related to uninsured accounts, we believe it is beneficial to view charity care, uninsured discounts and the provision for doubtful accounts in combination, rather than each separately. A summary of these amounts for the years ended December 31, follows (dollars in millions):

	2011		Ratio			2010		Ratio			2009		Ratio
Charity care	$	2,683		24	%	$	2,337		24	%	$	2,151		26	%
Uninsured discounts		5,707		51			4,641		48			2,935		35
Provision for doubtful accounts		2,824		25			2,648		28			3,276		39
Total uncompensated care	$	11,214		100	%	$	9,626		100	%	$	8,362		100	%

A summary of the estimated cost of total uncompensated care for the years ended December 31, follows (dollars in millions):

	2011			2010			2009
Gross patient charges	$	141,516		$	125,640		$	115,682
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)		25,554			23,870			22,975
Cost-to-charges ratio		18.1	%		19.0	%		19.9	%
Total uncompensated care	$	11,214		$	9,626		$	8,362
Multiplied by the cost-to-charges ratio		18.1	%		19.0	%		19.9	%
Estimated cost of total uncompensated care	$	2,030		$	1,829		$	1,664

The sum of charity care, uninsured discounts and the provision for doubtful accounts, as a percentage of the sum of revenues, charity care, uninsured discounts and the provision for doubtful accounts increased from 23.8% for 2009, to 25.6% for 2010 and to 27.4% for 2011. The trend of the three components of uncompensated care indicates that increases to our uninsured discounts have resulted in the provision for doubtful accounts declining from 39% of total uncompensated care for 2009 to 25% of total uncompensated care for 2011, and uninsured discounts increasing from 35% of total uncompensated care for 2009 to 51% of total uncompensated care for 2011.

F-11

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 1 — ACCOUNTING POLICIES (Continued)

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 estimated professional liability claims during the next twelve months are not included in cash and cash equivalents as these funds are not available for general corporate purposes. Carrying values of cash and cash equivalents approximate fair value due to the short-term nature of these instruments.

Our cash management system provides for daily investment of available balances and the funding of outstanding checks when presented for payment. Outstanding, but unpresented, checks totaling $382 million and $384 million at December 31, 2011 and 2010, respectively, have been included in “accounts payable” in the consolidated balance sheets. Upon presentation for payment, these checks are funded through available cash balances or our credit facility.

Accounts Receivable

We receive payments for services rendered from federal and state agencies (under the Medicare and Medicaid programs), managed care health plans, commercial insurance companies, employers and patients. We recognize that revenues and receivables from government agencies are significant to our operations, but do not believe there are significant credit risks associated with these government agencies. We do not believe there are any other significant concentrations of revenues from any particular payer that would subject us to any significant credit risks in the collection of our accounts receivable.

Additions to the allowance for doubtful accounts are made by means of the provision for doubtful accounts. Accounts written off as uncollectible are deducted from the allowance for doubtful accounts and subsequent recoveries are added. The amount of the provision for doubtful accounts is based upon management’s assessment of historical and expected net collections, business and economic conditions, trends in federal, state and private employer health care coverage and other collection indicators. The provision for doubtful accounts and the allowance for doubtful accounts relate to “uninsured” amounts (including copayment and deductible amounts from patients who have health care coverage) due directly from patients. Accounts are written off when all reasonable internal and external collection efforts have been performed. We consider the return of an account from the secondary external collection agency to be the culmination of our reasonable collection efforts and the timing basis for writing off the account balance. Writeoffs are based upon specific identification and the writeoff process requires a writeoff adjustment entry to the patient accounting system. Management relies on the results of detailed reviews of historical writeoffs and recoveries at facilities that represent a majority of our revenues and accounts receivable (the “hindsight analysis”) as a primary source of information to utilize in estimating the collectibility of our accounts receivable. We perform the hindsight analysis quarterly, utilizing rolling twelve-months accounts receivable collection and writeoff data. At December 31, 2011 and 2010, the allowance for doubtful accounts represented approximately 92% and 93%, respectively, of the $4.478 billion and $4.249 billion, respectively, patient due accounts receivable balance. The patient due accounts receivable balance represents the estimated uninsured portion of our accounts receivable. The estimated uninsured portion of Medicaid pending and uninsured discount pending accounts is included in our patient due accounts receivable balance. Days revenues in accounts receivable were 53 days, 50 days and 50 days at December 31, 2011, 2010 and 2009, respectively. Adverse changes in general economic conditions, patient accounting service center operations, payer mix or trends in federal or state governmental health care coverage could affect our collection of accounts receivable, cash flows and results of operations.

F-12

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 1 — ACCOUNTING POLICIES (Continued)

Inventories

Inventories are stated at the lower of cost (first-in, first-out) or market.

Property and Equipment

Depreciation expense, computed using the straight-line method, was $1.461 billion in 2011, $1.416 billion in 2010 and $1.419 billion in 2009. Buildings and improvements are depreciated over estimated useful lives ranging generally from 10 to 40 years. Estimated useful lives of equipment vary generally from four to 10 years.

When events, circumstances or operating results indicate the carrying values of certain long-lived assets expected to be held and used, might be impaired, we prepare projections of the undiscounted future cash flows expected to result from the use of the assets and their eventual disposition. If the projections indicate the recorded amounts are not expected to be recoverable, such amounts are reduced to estimated fair value. Fair value may be estimated based upon internal evaluations that include quantitative analyses of revenues and cash flows, reviews of recent sales of similar facilities and independent appraisals.

Long-lived assets to be disposed of are reported at the lower of their carrying amounts or fair value less costs to sell or close. The estimates of fair value are usually based upon recent sales of similar assets and market responses based upon discussions with and offers received from potential buyers.

Investments of Insurance Subsidiaries

At December 31, 2011 and 2010, the investments of our wholly-owned insurance subsidiaries were classified as “available-for-sale” as defined in Accounting Standards Codification (“ASC”) No. 320, Investments — Debt and Equity Securities and are recorded at fair value. The investment securities are held for the purpose of providing the funding source to pay professional liability claims covered by the insurance subsidiaries. We perform a quarterly assessment of individual investment securities to determine whether declines in market value are temporary or other-than-temporary. Our investment securities evaluation process involves multiple subjective judgments, often involves estimating the outcome of future events, and requires a significant level of professional judgment in determining whether an impairment has occurred. We evaluate, among other things, the financial position and near term prospects of the issuer, conditions in the issuer’s industry, liquidity of the investment, changes in the amount or timing of expected future cash flows from the investment, and recent downgrades of the issuer by a rating agency, to determine if, and when, a decline in the fair value of an investment below amortized cost is considered other-than-temporary. The length of time and extent to which the fair value of the investment is less than amortized cost and our ability and intent to retain the investment, to allow for any anticipated recovery of the investment’s fair value, are important components of our investment securities evaluation process.

Goodwill and Other Intangible Assets

Goodwill is not amortized but is subject to annual impairment tests. In addition to the annual impairment review, impairment reviews are performed whenever circumstances indicate a possible impairment may exist. Impairment testing for goodwill is done at the reporting unit level. Reporting units are one level below the business segment level, and our impairment testing is performed at the operating division or market level. We compare the fair value of the reporting unit assets to the carrying amount, on at least an annual basis, to

F-13

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 1 — ACCOUNTING POLICIES (Continued)

Goodwill and Other Intangible Assets (Continued)

determine if there is potential impairment. If the fair value of the reporting unit assets is less than their carrying value, we compare the fair value of the goodwill to its carrying value. If the fair value of the goodwill is less than its carrying value, an impairment loss is recognized. Fair value of goodwill is estimated based upon internal evaluations of the related long-lived assets for each reporting unit that include quantitative analyses of revenues and cash flows and reviews of recent sales of similar facilities. No goodwill impairments were recognized during 2011, and we recognized goodwill impairments of $14 million and $19 million during 2010 and 2009, respectively.

During 2011, goodwill increased by $2.329 billion related to acquisitions, declined by $24 million related to facility sales, and declined by $16 million related to foreign currency translation and other adjustments. During 2010, goodwill increased by $125 million related to acquisitions, declined by $14 million related to impairments and increased by $5 million related to foreign currency translation and other adjustments.

Since January 1, 2000, we have recognized total goodwill impairments of $102 million in the aggregate. None of the goodwill impairments related to evaluations of goodwill at the reporting unit level, as all recognized goodwill impairments during this period related to goodwill allocated to asset disposal groups.

During 2011, other intangible assets increased by $269 million. Other intangible assets are not amortized but are subject to annual impairment tests.

Deferred Loan Costs

Debt issuance costs are amortized based upon the terms of the respective debt obligations. The gross carrying amount of deferred loan costs at December 31, 2011 and 2010 was $638 million and $712 million, respectively, and accumulated amortization was $348 million and $338 million, respectively. Amortization of deferred loan costs is included in interest expense and was $70 million, $81 million and $80 million for 2011, 2010 and 2009, respectively.

Physician Recruiting Agreements

In order to recruit physicians to meet the needs of our hospitals and the communities they serve, we enter into minimum revenue guarantee arrangements to assist the recruited physicians during the period they are relocating and establishing their practices. A guarantor is required to recognize, at the inception of a guarantee, a liability for the fair value of the stand-ready obligation undertaken in issuing the guarantee. We expense the total estimated guarantee liability amount at the time the physician recruiting agreement becomes effective as we are not able to justify recording a contract-based asset based upon our analysis of the related control, regulatory and legal considerations.

The physician recruiting liability amount of $15 million at both December 31, 2011 and 2010 represents the amount of expense recognized in excess of payments made through December 31, 2011 and 2010. At December 31, 2011 the maximum amount we could have to pay under all effective minimum revenue guarantees was $39 million.

F-14

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 1 — ACCOUNTING POLICIES (Continued)

Professional Liability Claims

Reserves for professional liability risks were $1.291 billion and $1.262 billion at December 31, 2011 and 2010, respectively. The current portion of the reserves, $298 million and $268 million at December 31, 2011 and 2010, respectively, is included in “other accrued expenses” in the consolidated balance sheets. Provisions for losses related to professional liability risks were $244 million, $222 million and $211 million for 2011, 2010 and 2009, respectively, and are included in “other operating expenses” in our consolidated income statements. Provisions for losses related to professional liability risks are based upon actuarially determined estimates. Loss and loss expense reserves represent the estimated ultimate net cost of all reported and unreported losses incurred through the respective consolidated balance sheet dates. The reserves for unpaid losses and loss expenses are estimated using individual case-basis valuations and actuarial analyses. Those estimates are subject to the effects of trends in loss severity and frequency. The estimates are continually reviewed and adjustments are recorded as experience develops or new information becomes known. Adjustments to the estimated reserve amounts are included in current operating results. The reserves for professional liability risks cover approximately 2,700 individual claims at both December 31, 2011 and 2010 and estimates for unreported potential claims. The time period required to resolve these claims can vary depending upon the jurisdiction and whether the claim is settled or litigated. During 2011 and 2010, $240 million and $243 million, respectively, of net payments were made for professional and general liability claims. The estimation of the timing of payments beyond a year can vary significantly. Although considerable variability is inherent in professional liability reserve estimates, we believe the reserves for losses and loss expenses are adequate; however, there can be no assurance the ultimate liability will not exceed our estimates.

A portion of our professional liability risks is insured through a wholly-owned insurance subsidiary. Subject to a $5 million per occurrence self-insured retention, our facilities are insured by our wholly-owned insurance subsidiary for losses up to $50 million per occurrence. The insurance subsidiary has obtained reinsurance for professional liability risks generally above a retention level of $15 million per occurrence. We also maintain professional liability insurance with unrelated commercial carriers for losses in excess of amounts insured by our insurance subsidiary.

The obligations covered by reinsurance contracts are included in the reserves for professional liability risks, as the insurance subsidiary remains liable to the extent the reinsurers do not meet their obligations under the reinsurance contracts. The amounts receivable under the reinsurance contracts include $25 million and $11 million at December 31, 2011 and 2010, respectively, recorded in “other assets” and $14 million and $3 million at December 31, 2011 and 2010, respectively, recorded in “other current assets”.

Financial Instruments

Derivative financial instruments are employed to manage risks, including interest rate and foreign currency exposures, and are not used for trading or speculative purposes. We recognize derivative instruments, such as interest rate swap agreements and foreign exchange contracts, in the consolidated balance sheets at fair value. Changes in the fair value of derivatives are recognized periodically either in earnings or in stockholders’ equity, as a component of other comprehensive income (loss), depending on whether the derivative financial instrument qualifies for hedge accounting, and if so, whether it qualifies as a fair value hedge or a cash flow hedge. Generally, changes in fair values of derivatives accounted for as fair value hedges are recorded in earnings, along with the changes in the fair value of the hedged items related to the hedged risk. Gains and losses on derivatives designated as cash flow hedges, to the extent they are effective, are recorded in other comprehensive income

F-15

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 1 — ACCOUNTING POLICIES (Continued)

Financial Instruments (Continued)

(loss), and subsequently reclassified to earnings to offset the impact of the forecasted transactions when they occur. In the event the forecasted transaction to which a cash flow hedge relates is no longer likely, the amount in other comprehensive income (loss) is recognized in earnings and generally the derivative is terminated. Changes in the fair value of derivatives not qualifying as hedges, and for any portion of a hedge that is ineffective, are reported in earnings.

The net interest paid or received on interest rate swaps is recognized as interest expense. Gains and losses resulting from the early termination of interest rate swap agreements are deferred and amortized as adjustments to interest expense over the remaining term of the debt originally associated with the terminated swap.

Electronic Health Record Incentive Payments

The American Recovery and Reinvestment Act of 2009 provides for Medicare and Medicaid incentive payments beginning in 2011 for eligible hospitals and professionals that adopt and meaningfully use certified electronic health record (“EHR”) technology. We recognize income related to Medicare and Medicaid incentive payments using a gain contingency model that is based upon when our eligible hospitals have demonstrated meaningful use of certified EHR technology for the applicable period and the cost report information for the full cost report year that will determine the final calculation of the incentive payment is available.

Medicaid EHR incentive calculations and related payment amounts are based upon prior period cost report information available at the time our eligible hospitals adopt, implement or demonstrate meaningful use of certified EHR technology for the applicable period, and are not subject to revision for cost report data filed for a subsequent period. Thus, incentive income recognition occurs at the point our eligible hospitals adopt, implement or demonstrate meaningful use of certified EHR technology for the applicable period, as the cost report information for the full cost report year that will determine the final calculation of the incentive payment is known at that time.

Medicare EHR incentive calculations and related initial payment amounts are based upon the most current filed cost report information available at the time our eligible hospitals demonstrate meaningful use of certified EHR technology for the applicable period. However, unlike Medicaid, this initial payment amount will be adjusted based upon an updated calculation using the annual cost report information for the cost report period that began during the applicable payment year. Thus, incentive income recognition occurs at the point our eligible hospitals demonstrate meaningful use of certified EHR technology for the applicable period and the cost report information for the full cost report year that will determine the final calculation of the incentive payment is available.

We recognized $210 million of electronic health record incentive income related to Medicaid ($87 million) and Medicare ($123 million) incentive programs during the year ended December 31, 2011. At December 31, 2011, we have $134 million of deferred EHR incentive income, which represents initial incentive payments received for which EHR incentive income has not been recognized. We previously reported $39 million of Medicaid EHR incentives and $51 million ($34 million of Medicaid EHR incentives and $17 million of Medicare EHR incentives) for the quarters ended June 30, 2011 and September 30, 2011, respectively, in the line item “Revenues” in our consolidated income statements. These amounts have been reclassified and are now included in the line item “Electronic health record incentive income” in our consolidated income statement for the year ended December 31, 2011.

F-16

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 1 — ACCOUNTING POLICIES (Continued)

Noncontrolling Interests in Consolidated Entities

The consolidated financial statements include all assets, liabilities, revenues and expenses of less than 100% owned entities that we control. Accordingly, we have recorded noncontrolling interests in the earnings and equity of such entities.

Related Party Transactions — Management Agreement

The Investors have provided management and advisory services to the Company pursuant to a management agreement among HCA Inc. and the Investors executed in connection with the Investors’ acquisition of HCA Inc. in November 2006. The management agreement was terminated pursuant to its terms upon completion of the initial public offering of our common stock during March 2011, and the Company paid the Investors a final fee of $181 million. The management agreement also provided that the Company pay a 1% fee in connection with certain financing, acquisition, divestiture and change of control transactions. The Company paid the Investors a fee of $26 million related to the initial public offering of our common stock, and this fee was recorded as a cost of the stock offering. The annual management fee was $18 million for 2010 and $15 million for 2009.

Reclassifications

Certain prior year amounts have been reclassified to conform to the 2011 presentation.

NOTE 2 — SHARE-BASED COMPENSATION

Stock Incentive Plan

The 2006 Stock Incentive Plan for Key Employees of HCA Holdings Inc. and its Affiliates, as Amended and Restated (the “Stock Incentive Plan”) is designed to promote the long term financial interests and growth of the Company and its subsidiaries by attracting and retaining management and other personnel and key service providers and to motivate management personnel by means of incentives to achieve long range goals and further the alignment of interests of participants with those of our stockholders through opportunities for increased stock, or stock-based, ownership in the Company. During 2011, our Board of Directors approved certain amendments to the Stock Incentive Plan that became effective upon the initial public offering of our common stock. The amendments included an increase to the number of shares available for issuance under the plan by 40,000,000 shares. A portion of the options under the Stock Incentive Plan vests solely based upon continued employment over a specific period of time, and a portion of the options vests based both upon continued employment over a specific period of time and upon the achievement of predetermined financial and Investor return targets over time. We granted 1,288,000 and 964,000 options under the Stock Incentive Plan during 2011 and 2010, respectively. As of December 31, 2011, 35,090,800 options granted under the Stock Incentive Plan have vested, of which 30,723,400 are outstanding and exercisable, and there were 42,099,900 shares available for future grants under the Stock Incentive Plan.

Rollover Options

Certain management holders of outstanding prerecapitalization HCA stock options retained certain of their stock options (the “Rollover Options”). The Rollover Options remain outstanding in accordance with the terms of the governing stock incentive plans and grant agreements pursuant to which the holder originally received the

F-17

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 2 — SHARE-BASED COMPENSATION (Continued)

Rollover Options (Continued)

stock option grants. Pursuant to the rollover option agreement, 49,408,100 prerecapitalization HCA stock options were converted into 10,294,500 Rollover Options, of which 2,825,100 are outstanding and exercisable at December 31, 2011.

Stock Option Activity

The fair value of each stock option award is estimated on the grant date, using option valuation models and the weighted average assumptions indicated in the following table. Awards under the Stock Incentive Plan generally vest based on continued employment and based upon achievement of certain financial and Investor return targets. Each grant is valued as a single award with an expected term equal to the average expected term of the component vesting tranches. We use historical option exercise behavior data and other factors to estimate the expected term of the options. The expected term of the option is limited by the contractual term, and employee post-vesting termination behavior is incorporated in the historical option exercise behavior data. Compensation cost is recognized on the straight-line attribution method. The straight-line attribution method requires that total compensation expense recognized must at least equal the vested portion of the grant-date fair value. The expected volatility is derived using historical stock price information of certain peer group companies for a period of time equal to the expected option term. The risk-free interest rate is the approximate yield on United States Treasury Strips having a life equal to the expected option life on the date of grant. The expected life is an estimate of the number of years an option will be held before it is exercised.

	2011			2010			2009
Risk-free interest rate		0.89	%		2.07	%		1.45	%
Expected volatility		41	%		35	%		35	%
Expected life, in years		5			5			5
Expected dividend yield		—			—			—

Information regarding stock option activity during 2011, 2010 and 2009 is summarized below (share amounts in thousands):

	Stock Options			Weighted Average Exercise Price		Weighted Average Remaining Contractual Term		Aggregate Intrinsic  Value (dollars in millions)
Options outstanding, December 31, 2008		47,906		$	9.99
Granted		8,045			19.70
Exercised		(2,278	)		3.81
Cancelled		(1,756	)		11.56
Options outstanding, December 31, 2009		51,917			11.72
Granted		964			15.73
Exercised		(1,726	)		4.06
Cancelled		(629	)		7.96
Options outstanding, December 31, 2010		50,526			8.58
Granted		1,288			23.35
Exercised		(5,044	)		6.31
Cancelled		(458	)		5.88
Options outstanding, December 31, 2011		46,312			9.26		5.6 years	$	595
Options exercisable, December 31, 2011		33,548		$	9.74		5.4 years	$	414

F-18

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 2 — SHARE-BASED COMPENSATION (Continued)

Stock Option Activity (Continued)

During 2010, our Board of Directors declared three distributions to the Company’s stockholders and holders of stock options. The distributions totaled $9.43 per share and vested stock option. Pursuant to the terms of our stock option plans, the holders of nonvested stock options received $9.43 per share reductions (subject to certain tax related limitations for certain stock options that resulted in deferred distributions for a portion of the declared distribution, which will be paid upon the vesting of the applicable stock options) to the exercise price of the share-based awards.

The weighted average fair values of stock options granted during 2011, 2010 and 2009 were $8.53, $7.13 and $3.54 per share, respectively. The total intrinsic value of stock options exercised in the year ended December 31, 2011 was $121 million. As of December 31, 2011, the unrecognized compensation cost related to nonvested awards was $23 million.

NOTE 3 — ACQUISITIONS AND DISPOSITIONS

HealthONE Acquisition

During October 2011, we completed the acquisition of the Colorado Health Foundation’s (“Foundation”) approximate 40% remaining ownership interest in the HCA-HealthONE LLC (“HealthONE”) joint venture for $1.450 billion. HealthONE’s assets include seven hospitals and 12 freestanding surgery centers in the Denver area. We accounted for our investment in HealthONE using the equity method through October 2011 with our share of their operations all recorded in the line item “Equity in earnings of affiliates” in our consolidated income statements, and we began consolidating HealthONE’s operations in our consolidated income statements beginning November 2011.

The total cost of the HealthONE acquisition has been allocated to the assets acquired and liabilities assumed based upon their respective fair values in accordance with ASC No. 805, Business Combinations. The purchase price represented a premium over the fair value of the net tangible and identifiable intangible assets acquired for reasons such as expected cash flows and HealthONE’s assembled workforce.

Based on our purchase price allocation as of December 31, 2011, we identified and analyzed the acquired fixed assets, contracts, contractual commitments and legal contingencies to record the fair value of all assets acquired and liabilities assumed, resulting in goodwill of $2.261 billion being recorded. The amount of goodwill expected to be tax deductible is approximately $894 million. We also recorded a gain of $1.522 billion related to this acquisition due to the remeasurement of our previous equity investment in HealthONE, based upon our acquisition of the Foundation’s ownership interest and the resulting consolidation of the entire enterprise at estimated fair value. Adjustments to the December 31, 2011 purchase price allocation are not expected to be material.

A summary of the purchase price allocation, including assumed liabilities, follows (in millions):

Current assets	$	400
Property and equipment		1,040
Identifiable intangible asset (trade name)		269
Goodwill		2,261
Other assets		7
Liabilities		152
Noncontrolling interests		93

F-19

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 3 — ACQUISITIONS AND DISPOSITIONS (Continued)

HealthONE Acquisition (Continued)

The acquired HealthONE operating results have been included in the consolidated income statements since the acquisition date. The revenues and net income attributable to HCA Holdings, Inc. related to the acquired HealthONE operations for the period from November 1, 2011 through December 31, 2011 were $347 million and $15 million, respectively. The unaudited pro forma combined summary of our operations gives effect to including the acquired HealthONE operating results as if the acquisition had occurred as of January 1, 2010, follows (in millions):

	Years Ended December 31,
	2011		2010
Pro forma revenues	$	31,383	$	29,925
Pro forma net income attributable to HCA Holdings, Inc.		2,507		1,257

Pro forma adjustments to net income attributable to HCA Holdings, Inc. include adjustments to record HealthONE’s operating results on a consolidated basis and eliminate the equity method operating results, to record depreciation expense based on the estimated fair value assigned to the long-lived assets acquired, to record interest expense assuming the increase in long-term debt used to fund the acquisition had occurred as of January 1, 2010 and to record the related tax effects. These pro forma results are not necessarily indicative of the actual results of operations that would have occurred if the acquisition had occurred on January 1, 2010.

Other Acquisitions and Dispositions

During 2011, we paid $136 million to acquire a hospital and $96 million to acquire other nonhospital health care entities. During 2010, we paid $163 million to acquire two hospitals and $70 million to acquire other health care entities. During 2009, we paid $61 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. The purchase price paid in excess of the fair value of identifiable net assets of these acquired entities aggregated $68 million, $125 million and $5 million in 2011, 2010 and 2009, respectively. 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 2011, we received proceeds of $281 million and recognized a net pretax gain of $142 million ($80 million after tax) related to the sales of a hospital facility and our investment in a hospital joint venture. During 2010, we received proceeds of $37 million and recognized a net pretax gain of $4 million ($2 million after tax) from sales of nonhospital health care entities and real estate investments. During 2009, we received proceeds of $3 million and recognized a net pretax loss of $8 million ($5 million after tax) on the sales of three hospitals. We also received proceeds of $38 million and recognized a net pretax loss of $7 million ($4 million after tax) from sales of other health care entities and real estate investments.

F-20

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 4 — IMPAIRMENTS OF LONG-LIVED ASSETS

There were no impairments of long-lived assets for 2011. During 2010, we recorded pretax charges of $123 million to reduce the carrying value of identified assets to estimated fair value. The $123 million asset impairment includes $57 million related to a hospital facility in our Central Group, $5 million related to other health care entity investments in our National Group, $17 million related to a hospital facility in our Southwest Group and $44 million related to Corporate and other, which includes $35 million for the writeoff of capitalized engineering and design costs related to certain building safety requirements (California earthquake standards) that have been revised. During 2009, we recorded pretax charges of $43 million to reduce the carrying value of identified assets to estimated fair value. The $43 million asset impairment includes $15 million related to certain hospital facilities and other health care entity investments in our Central Group, $16 million related to other health care entity investments in our National Group and $12 million related to certain hospital facilities in our Southwest Group.

The asset impairment charges did not have a significant impact on our operations or cash flows and are not expected to significantly impact cash flows for future periods. The impairment charges affected our property and equipment asset category by $109 million and $24 million in 2010 and 2009, respectively.

NOTE 5 — INCOME TAXES

The provision for income taxes consists of the following (dollars in millions):

	2011			2010		2009
Current:
Federal	$	(119	)	$	401	$	809
State		(12	)		26		75
Foreign		44			33		21
Deferred:
Federal		714			161		(274	)
State		71			17		(37	)
Foreign		21			20		33
	$	719		$	658	$	627

The provision for income taxes reflects $100 million, $69 million and $18 million ($63 million, $44 million and $12 million net of tax, respectively) reductions in interest related to taxing authority examinations for the years ended December 31, 2011, 2010 and 2009, respectively.

A reconciliation of the federal statutory rate to the effective income tax rate follows:

	2011			2010			2009
Federal statutory rate		35.0	%		35.0	%		35.0	%
State income taxes, net of federal tax benefit		2.0			2.7			3.2
Change in liability for uncertain tax positions		1.0			0.3			(0.2	)
Nontaxable gain on acquisition of controlling interest in equity investment		(13.8	)		—			—
Tax exempt interest income		(0.2	)		(0.4	)		(0.8	)
Income attributable to noncontrolling interests from consolidated partnerships		(2.4	)		(5.8	)		(6.0	)
Other items, net		(1.4	)		(2.3	)		0.1
Effective income tax rate		20.2	%		29.5	%		31.3	%

F-21

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 5 — INCOME TAXES (Continued)

A summary of the items comprising the deferred tax assets and liabilities at December 31 follows (dollars in millions):

	2011				2010
	Assets		Liabilities		Assets		Liabilities
Depreciation and fixed asset basis differences	$	—	$	402	$	—	$	211
Allowances for professional liability and other risks		337		—		329		—
Accounts receivable		706		—		1,011		—
Compensation		216		—		202		—
Other		698		511		776		400
	$	1,957	$	913	$	2,318	$	611

At December 31, 2011, state net operating loss carryforwards (expiring in years 2012 through 2031) available to offset future taxable income approximated $34 million. Utilization of net operating loss carryforwards in any one year may be limited and, in certain cases, result in an adjustment to intangible assets. Net deferred tax assets related to such carryforwards are not significant.

At December 31, 2011, we were contesting, before the IRS Appeals Division, certain claimed deficiencies and adjustments proposed by the IRS Examination Division in connection with its audit of HCA Inc.’s 2005 and 2006 federal income tax returns. The disputed items include the timing of recognition of certain patient service revenues, the deductibility of certain debt retirement costs and our method for calculating the tax allowance for doubtful accounts. The IRS Examination Division began an audit of HCA Inc.’s 2007, 2008 and 2009 federal income tax returns in 2010.

The following table summarizes the activity related to our unrecognized tax benefits (dollars in millions):

	2011			2010
Balance at January 1	$	313		$	485
Additions (reductions) based on tax positions related to the current year		83			(18	)
Additions for tax positions of prior years		73			61
Reductions for tax positions of prior years		(15	)		(78	)
Settlements		—			(134	)
Lapse of applicable statutes of limitations		(9	)		(3	)
Balance at December 31	$	445		$	313

During 2011, we finalized settlements with the IRS Examination Division resolving all outstanding issues for our 1997 through 2004 tax years. During 2010, we finalized settlements with the Appeals Division of the IRS resolving the deductibility of our 2003 government settlement payment, the timing of certain patient service revenues for 2003 and 2004 and the method for calculating the tax allowance for doubtful accounts for certain affiliated partnerships for 2003 and 2004.

Our liability for unrecognized tax benefits was $494 million, including accrued interest of $62 million and excluding $13 million that was recorded as reductions of the related deferred tax assets, as of December 31, 2011 ($413 million, $115 million and $15 million, respectively, as of December 31, 2010). Unrecognized tax benefits of $173 million ($190 million as of December 31, 2010) would affect the effective rate, if recognized. The

F-22

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 5 — INCOME TAXES (Continued)

liability for unrecognized tax benefits does not reflect deferred tax assets of $45 million ($63 million as of December 31, 2010) related to deductible interest and state income taxes or a refundable deposit of $19 million ($82 million as of December 31, 2010), which is recorded in noncurrent assets.

Depending on the resolution of the IRS disputes, the completion of examinations by federal, state or international 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 6 — 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 stock options, computed using the treasury stock method. The following table sets forth the computations of basic and diluted earnings per share for the years ended December 31, 2011, 2010 and 2009 (dollars in millions, except per share amounts, and shares in thousands):

	2011		2010		2009
Net income attributable to HCA Holdings, Inc	$	2,465	$	1,207	$	1,054
Weighted average common shares outstanding		476,609		426,424		425,567
Effect of dilutive stock options		19,334		10,923		6,660
Shares used for diluted earnings per share		495,943		437,347		432,227
Earnings per share:
Basic earnings per share	$	5.17	$	2.83	$	2.48
Diluted earnings per share	$	4.97	$	2.76	$	2.44

NOTE 7 — INVESTMENTS OF INSURANCE SUBSIDIARIES

A summary of the insurance subsidiaries’ investments at December 31 follows (dollars in millions):

	2011
	Amortized Cost		Unrealized Amounts					Fair Value
			Gains		Losses
Debt securities:
States and municipalities	$	398	$	19	$	—		$	417
Auction rate securities		139		—		(8	)		131
Asset-backed securities		20		—		—			20
Money market funds		53		—		—			53
		610		19		(8	)		621
Equity securities		7		1		(1	)		7
	$	617	$	20	$	(9	)		628
Amounts classified as current assets									(80	)
Investment carrying value								$	548

F-23

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 7 — INVESTMENTS OF INSURANCE SUBSIDIARIES (Continued)

	2010
	Amortized Cost		Unrealized Amounts					Fair Value
			Gains		Losses
Debt securities:
States and municipalities	$	312	$	12	$	(1	)	$	323
Auction rate securities		251		—		(1	)		250
Asset-backed securities		26		1		(1	)		26
Money market funds		135		—		—			135
		724		13		(3	)		734
Equity securities		8		1		(1	)		8
	$	732	$	14	$	(4	)		742
Amounts classified as current assets									(100	)
Investment carrying value								$	642

At December 31, 2011 and 2010 the investments of our insurance subsidiaries were classified as “available-for-sale.” Changes in temporary unrealized gains and losses are recorded as adjustments to other comprehensive income (loss). At December 31, 2011 and 2010, $19 million and $92 million, respectively, of our investments were subject to the restrictions included in insurance bond collateralization and assumed reinsurance contracts.

Scheduled maturities of investments in debt securities at December 31, 2011 were as follows (dollars in millions):

	Amortized Cost		Fair Value
Due in one year or less	$	101	$	102
Due after one year through five years		112		119
Due after five years through ten years		143		151
Due after ten years		95		98
		451		470
Auction rate securities		139		131
Asset-backed securities		20		20
	$	610	$	621

The average expected maturity of the investments in debt securities at December 31, 2011 was 4.4 years, compared to the average scheduled maturity of 10.8 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. The average expected maturities for our auction rate and asset-backed securities were derived from valuation models of expected cash flows and involved management’s judgment. The average expected maturities for our auction rate and asset-backed securities at December 31, 2011 were 4.9 years and 4.8 years, respectively, compared to average scheduled maturities of 24.9 years and 24.8 years, respectively.

F-24

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 7 — INVESTMENTS OF INSURANCE SUBSIDIARIES (Continued)

The cost of securities sold is based on the specific identification method. Sales of securities for the years ended December 31 are summarized below (dollars in millions):

	2011		2010		2009
Debt securities:
Cash proceeds	$	—	$	329	$	141
Gross realized gains		—		14		—
Gross realized losses		—		1		1
Equity securities:
Cash proceeds	$	—	$	—	$	3
Gross realized gains		—		—		1
Gross realized losses		—		—		—

NOTE 8 — 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 two parties based on common notional principal amounts and maturity dates. Pay-fixed interest rate swaps effectively convert LIBOR indexed variable rate obligations to fixed interest rate obligations. The interest payments under these agreements are settled on a net basis. The net interest payments, based on the notional amounts in these agreements, generally match the timing of the related liabilities, for the interest rate swap agreements which have been designated as cash flow hedges. The notional amounts of the swap agreements represent amounts used to calculate the exchange of cash flows and are not our assets or liabilities. Our credit risk related to these agreements is considered low because the swap agreements are with creditworthy financial institutions.

The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at December 31, 2011 (dollars in millions):

	Notional Amount		Maturity Date		Fair Value
Pay-fixed interest rate swaps	$	500		December 2014	$	(7	)
Pay-fixed interest rate swaps		3,000		December 2016		(339	)
Pay-fixed interest rate swaps		1,000		December 2017		(53	)

During the next 12 months, we estimate $110 million will be reclassified from other comprehensive income (“OCI”) to interest expense.

Cross Currency Swaps

The Company and certain subsidiaries have incurred obligations and entered into various intercompany transactions where such obligations are denominated in currencies, other than the functional currencies of the parties executing the trade. In order to mitigate the currency exposure risks and better match the cash flows of our obligations and intercompany transactions with cash flows from operations, we enter into various cross currency swaps. Our credit risk related to these agreements is considered low because the swap agreements are with creditworthy financial institutions.

F-25

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 8 — FINANCIAL INSTRUMENTS (Continued)

Cross Currency Swaps (Continued)

Our cross currency swap is not designated as a hedge, and changes in fair value are recognized in results of operations. The following table sets forth our cross currency swap agreement at December 31, 2011 (amounts in millions):

	Notional Amount		Maturity Date		Fair Value
Euro — United States Dollar Currency Swap		291 Euro		November 2013	$	(16	)

Derivatives — Results of Operations

The following tables present the effect of our interest rate and cross currency swaps on our results of operations for the year ended December 31, 2011 (dollars in millions):

Derivatives in Cash Flow Hedging Relationships	Amount of Loss Recognized  in OCI on Derivatives, Net of Tax		Location of  Loss Reclassified from Accumulated  OCI into Operations		Amount of  Loss Reclassified from Accumulated  OCI into Operations
Interest rate swaps	$	197		Interest expense	$	341

Derivatives Not Designated as Hedging Instruments	Location of Loss Recognized in Operations on Derivatives		Amount of Loss Recognized in Operations on Derivatives
Interest rate swaps		Other operating expenses	$	1
Cross currency swap		Other operating expenses		54

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 December 31, 2011, we have not been required to post any collateral related to these agreements. If we had breached these provisions at December 31, 2011, we would have been required to settle our obligations under the agreements at their aggregate, estimated termination value of $452 million.

NOTE 9 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE

Accounting Standards Codification 820, Fair Value Measurements and Disclosures (“ASC 820”) defines fair value, establishes a framework for measuring fair value, and expands disclosures about fair value measurements. ASC 820 applies to reported balances that are required or permitted to be measured at fair value under existing accounting pronouncements.

ASC 820 emphasizes fair value is a market-based measurement, not an entity-specific measurement. Therefore, a fair value measurement should be determined based on the assumptions market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, ASC 820 establishes 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).

F-26

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 9 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE (Continued)

Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates, and yield curves observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market activity. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input significant to the fair value measurement in its entirety. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment, and considers factors specific to the asset or liability.

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. Certain types of cash traded instruments are classified within Level 3 of the fair value hierarchy because they trade infrequently and therefore have little or no price transparency. Such instruments include auction rate securities (“ARS”) and limited partnership investments. The transaction price is initially used as the best estimate of fair value.

Our wholly-owned insurance subsidiaries had investments in tax-exempt ARS, which are backed by student loans substantially guaranteed by the federal government, of $131 million ($139 million par value) at December 31, 2011. We do not currently intend to attempt to sell the ARS as the liquidity needs of our insurance subsidiaries are expected to be met by other investments in their investment portfolios. During 2011 and 2010, certain issuers and their broker/dealers redeemed or repurchased $112 million and $150 million, respectively, of our ARS at par value. The valuation of these securities involved management’s judgment, after consideration of market factors and the absence of market transparency, market liquidity and observable inputs. Our valuation models derived a fair market value compared to tax-equivalent yields of other student loan backed variable rate securities of similar credit worthiness and similar effective maturities.

Derivative Financial Instruments

We have entered into interest rate and cross currency swap agreements to manage our exposure to fluctuations in interest rates and foreign currency risks. 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, foreign exchange rates and implied volatilities. To comply with the provisions of ASC 820, we incorporate credit valuation adjustments to reflect both our own nonperformance risk and the respective counterparty’s nonperformance risk in the fair value measurements.

Although we determined the majority of the inputs used to value our derivatives fall within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with our derivatives utilize Level 3 inputs, such as estimates of current credit spreads to evaluate the likelihood of default by us and our counterparties. We assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our derivative positions and at December 31, 2011 and 2010, we determined the credit valuation adjustments were not significant to the overall valuation of our derivatives.

F-27

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 9 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE (Continued)

The following table summarizes our assets and liabilities measured at fair value on a recurring basis as of December 31, 2011 and 2010, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions):

	December 31, 2011
				Fair Value Measurements Using
	Fair Value			Quoted Prices in Active  Markets for Identical Assets and Liabilities (Level 1)			Significant Other Observable  Inputs (Level 2)			Significant Unobservable  Inputs (Level 3)
Assets:
Investments of insurance subsidiaries:
Debt securities:
States and municipalities	$	417		$	—		$	417		$	—
Auction rate securities		131			—			—			131
Asset-backed securities		20			—			20			—
Money market funds		53			53			—			—
		621			53			437			131
Equity securities		7			1			5			1
Investments of insurance subsidiaries		628			54			442			132
Less amounts classified as current assets		(80	)		(54	)		(26	)		—
	$	548		$	—		$	416		$	132
Liabilities:
Cross currency swap (Income taxes and other liabilities)	$	16		$	—		$	16		$	—
Interest rate swaps (Income taxes and other liabilities)		399			—			399			—

F-28

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 9 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE (Continued)

	December 31, 2010
				Fair Value Measurements Using
	Fair Value			Quoted Prices in Active  Markets for Identical Assets and Liabilities (Level 1)			Significant Other Observable  Inputs (Level 2)		Significant Unobservable  Inputs (Level 3)
Assets:
Investments of insurance subsidiaries:
Debt securities:
States and municipalities	$	323		$	—		$	323	$	—
Auction rate securities		250			—			—		250
Asset-backed securities		26			—			26		—
Money market funds		135			135			—		—
		734			135			349		250
Equity securities		8			2			5		1
Investments of insurance subsidiaries		742			137			354		251
Less amounts classified as current assets		(100	)		(100	)		—		—
	$	642		$	37		$	354	$	251
Cross currency swap (Other assets)	$	39		$	—		$	39	$	—
Liabilities:
Interest rate swaps (Income taxes and other liabilities)	$	426		$	—		$	426	$	—

The following table summarizes the activity related to the auction rate and equity securities investments of our insurance subsidiaries which have fair value measurements based on significant unobservable inputs (Level 3) during the year ended December 31, 2011 (dollars in millions):

Asset balances at December 31, 2010	$	251
Unrealized losses included in other comprehensive income		(7	)
Settlements		(112	)
Asset balances at December 31, 2011	$	132

The estimated fair value of our long-term debt was $27.199 billion and $28.738 billion at December 31, 2011 and 2010, respectively, compared to carrying amounts aggregating $27.052 billion and $28.225 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.

F-29

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 10 — LONG-TERM DEBT

A summary of long-term debt at December 31, including related interest rates at December 31, 2011, follows (dollars in millions):

	2011		2010
Senior secured asset-based revolving credit facility (effective interest rate of 1.8%)	$	2,155	$	1,875
Senior secured revolving credit facility		—		729
Senior secured term loan facilities (effective interest rate of 4.8%)		7,425		7,530
Senior secured first lien notes (effective interest rate of 7.7%)		7,081		4,075
Other senior secured debt (effective interest rate of 6.8%)		350		322
First lien debt		17,011		14,531
Senior secured second lien notes (effective interest rate of 11.0%)		197		4,501
Senior secured toggle notes		—		1,578
Second lien debt		197		6,079
Senior unsecured notes (effective interest rate of 7.3%)		9,844		7,615
Total debt (average life of 6.9 years, rates averaging 6.3%)		27,052		28,225
Less amounts due within one year		1,407		592
	$	25,645	$	27,633

2011 Activity

During May 2011, we completed amendments to our senior secured credit agreement and senior secured asset-based revolving credit agreement, as well as extensions of certain of our term loans. The amendments extended $594 million ($572 million outstanding at December 31, 2011) of our term loan A facility with a final maturity of November 2012 to a final maturity of May 2016 and $2.373 billion of our term loan A and term loan B-1 facilities with final maturities of November 2012 and November 2013, respectively, to a final maturity of May 2018.

During June 2011, we redeemed all $1.000 billion aggregate principal amount of our 9 ¹/8% senior secured notes due 2014, at a redemption price of 104.563% of the principal amount, and $108 million aggregate principal amount of our 9 ⁷/8% senior secured notes due 2017, at a redemption price of 109.875% of the principal amount. The pretax loss on retirement of debt related to these redemptions was $75 million.

During August 2011, we issued $5.000 billion aggregate principal amount of notes, comprised of $3.000 billion of 6.50% senior secured first lien notes due 2020 and $2.000 billion of 7.50% senior unsecured notes due 2022. We used the net proceeds from these debt issuances to redeem all of our outstanding $1.578 billion 9 ⁵/8%/10 ³/8% second lien toggle notes due 2016, at a redemption price of 106.783% of the principal amount, and all of our outstanding $3.200 billion 9 ¹/4% second lien notes due 2016, at a redemption price of 106.513% of the principal amount. The pretax loss on retirement of debt related to these redemptions was $406 million.

During September 2011, we refinanced our $2.000 billion asset-based revolving credit facility maturing on November 16, 2012 to increase the total capacity to $2.500 billion and extend the maturity to 2016.

During October 2011, we issued $500 million aggregate principal amount of 8.00% senior unsecured notes due 2018. We used the net proceed for general corporate purposes, which included funding a portion of the acquisition of the remaining interest in HealthONE.

F-30

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 10 — LONG-TERM DEBT (Continued)

Senior Secured Credit Facilities And Other First Lien Debt

We have entered into the following senior secured credit facilities: (i) a $2.500 billion asset-based revolving credit facility maturing on September 30, 2016 with a borrowing base of 85% of eligible accounts receivable, subject to customary reserves and eligibility criteria ($2.155 billion outstanding at December 31, 2011) (the “ABL credit facility”); (ii) a $2.000 billion senior secured revolving credit facility maturing on November 17, 2015 (none outstanding at December 31, 2011 without giving effect to certain outstanding letters of credit); (iii) a $414 million senior secured term loan A-1 facility maturing on November 17, 2012; (iv) a $572 million senior secured term loan A-2 facility maturing on May 2, 2016; (v) a $1.689 billion senior secured term loan B-1 facility maturing on November 17, 2013; (vi) a $2.000 billion senior secured term loan B-2 facility maturing on March 31, 2017; (vii) a $2.373 billion senior secured term loan B-3 facility maturing on May 1, 2018; and (viii) a €291 million, or $377 million-equivalent, senior secured European term loan facility maturing on November 17, 2013. We refer to the facilities described under (ii) through (viii) above, collectively, as the “cash flow credit facility” and, together with the ABL credit facility, the “senior secured credit facilities.”

Borrowings under the senior secured credit facilities bear interest at a rate equal to, 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, plus, in each case, an applicable margin. The applicable margin for borrowings under the senior secured credit facilities may be reduced subject to attaining certain leverage ratios.

The senior secured credit facilities contain a number of covenants that restrict, subject to certain exceptions, our (and some or all of our subsidiaries’) ability to incur additional indebtedness, repay subordinated indebtedness, create liens on assets, sell assets, make investments, loans or advances, engage in certain transactions with affiliates, pay dividends and distributions, and enter into sale and leaseback transactions. In addition, we are required to satisfy and maintain a maximum total leverage ratio covenant under the cash flow credit facility and, in certain situations under the ABL credit facility, a minimum interest coverage ratio covenant.

Senior secured first lien notes consist of (i) $1.500 billion aggregate principal amount of 8 ¹/2% senior secured first lien notes due 2019; (ii) $1.250 billion aggregate principal amount of 7 ⁷/8% senior secured first lien notes due 2020; (iii) $1.400 billion aggregate principal amount of 7 ¹/4% senior secured first lien notes due 2020; (iv) $3.000 billion aggregate principal amount of 6.50% senior secured first lien notes due 2020; and (v) $69 million of unamortized debt discounts that reduces the senior secured first lien indebtedness. Capital leases and other secured debt totaled $350 million at December 31, 2011.

We use interest rate swap agreements to manage the variable rate exposure of our debt portfolio. At December 31, 2011, we had entered into effective interest rate swap agreements, in a total notional amount of $4.500 billion, in order to hedge a portion of our exposure to variable rate interest payments associated with the senior secured credit facility. The effect of the interest rate swaps is reflected in the effective interest rates for the senior secured credit facilities.

Senior Secured Second Lien Notes

Senior secured second lien notes is comprised of $202 million aggregate principal amount of 9 ⁷/8% senior secured second lien notes due 2017 and $5 million of unamortized debt discounts that reduces the senior secured second lien indebtedness.

F-31

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 10 — LONG-TERM DEBT (Continued)

Senior Unsecured Notes

Senior unsecured notes consist of (i) $7.194 billion aggregate principal amount of senior notes with maturities ranging from 2012 to 2033; (ii) an aggregate principal amount of $246 million medium-term notes with maturities ranging from 2014 to 2025; (iii) an aggregate principal amount of $886 million debentures with maturities ranging from 2015 to 2095; (iv) an aggregate principal amount of $1.525 billion senior notes due 2021 issued by HCA Holdings, Inc. (the “2021 Notes”); and (v) $7 million of unamortized debt discounts that reduce the indebtedness.

General Debt Information

The senior secured credit facilities and senior secured notes are fully and unconditionally guaranteed by substantially all existing and future, direct and indirect, wholly-owned material domestic subsidiaries that are “Unrestricted Subsidiaries” under our Indenture (the “1993 Indenture”) dated December 16, 1993 (except for certain special purpose subsidiaries that only guarantee and pledge their assets under our ABL credit facility). In addition, borrowings under the European term loan are guaranteed by all material, wholly-owned European subsidiaries.

All obligations under the ABL credit facility, and the guarantees of those obligations, are secured, subject to permitted liens and other exceptions, by a first-priority lien on substantially all of the receivables of the borrowers and each guarantor under such ABL credit facility (the “Receivables Collateral”).

All obligations under the cash flow credit facility and the guarantees of such obligations are secured, subject to permitted liens and other exceptions, by:

• a first-priority lien on the capital stock owned by HCA Inc., or by any U.S. guarantor, in each of their respective first-tier subsidiaries;

• a first-priority lien on substantially all present and future assets of HCA Inc. and of each U.S. guarantor other than (i) “Principal Properties” (as defined in the 1993 Indenture), (ii) certain other real properties and (iii) deposit accounts, other bank or securities accounts, cash, leaseholds, motor-vehicles and certain other exceptions; and

• a second-priority lien on certain of the Receivables Collateral.

Our senior secured first lien notes and the related guarantees are secured by first-priority liens, subject to permitted liens, on our and our subsidiary guarantors’ assets, subject to certain exceptions, that secure our cash flow credit facility on a first-priority basis and are secured by second priority liens, subject to permitted liens, on our and our subsidiary guarantors’ assets that secure our ABL credit facility on a first priority basis and our other cash flow credit facility on a second-priority basis.

Our second lien debt and the related guarantees are secured by second-priority liens, subject to permitted liens, on our and our subsidiary guarantors’ assets, subject to certain exceptions, that secure our cash flow credit facility on a first-priority basis and are secured by third-priority liens, subject to permitted liens, on our and our subsidiary guarantors’ assets that secure our asset-based revolving credit facility on a first priority basis and our other cash flow credit facility on a second-priority basis.

Maturities of long-term debt in years 2013 through 2016, excluding amounts under the ABL credit facility, are $3.167 billion, $751 million, $1.020 billion and $1.537 billion, respectively.

F-32

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 11 — 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. The resolution of any such lawsuits, claims or legal and regulatory proceedings could have a material, adverse effect on our results of operations or financial position.

Health care companies are subject to numerous 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 government inquiries from federal and state agencies and our facilities may receive such inquiries in future periods. 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 or financial position.

We are 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. It is management’s opinion that the ultimate resolution of these pending claims and legal proceedings will not have a material, adverse effect on our results of operations or financial position.

The Civil Division of the Department of Justice (“DOJ”) has contacted the Company in connection with its nationwide review of whether, in certain cases, hospital charges to the federal government relating to implantable cardio-defibrillators (“ICDs”) met the Centers for Medicare & Medicaid Services criteria. In connection with this nationwide review, the DOJ has indicated that it will be reviewing certain ICD billing and medical records at 95 HCA hospitals; the review covers the period from October 2003 to the present. The review could potentially give rise to claims against the Company under the federal False Claims Act or other statutes, regulations or laws. At this time, we cannot predict what effect, if any, this review or any resulting claims could have on the Company.

On October 28, 2011, a shareholder action was filed in the United States District Court for the Middle District of Tennessee. The case seeks to include as a class all persons who acquired the Company’s stock pursuant or traceable to the Company’s Registration Statement and Prospectus issued in connection with the March 9, 2011 initial public offering. The lawsuit asserts a claim under Section 11 of the Securities Act of 1933 against the Company, certain members of the board of directors, and certain underwriters in the offering. It further asserts a claim under Section 15 of the Securities Act of 1933 against the same members of the board of directors. The action alleges deficiencies in the Company’s disclosures in the Registration Statement relating to: (1) accounting for its 2006 recapitalization and 2010 reorganization; (2) the Company’s failure to maintain effective internal controls relating to its accounting for such transactions; and (3) the Company’s revenue growth rate. Subsequently, two additional class action complaints setting forth substantially similar claims were filed in the same federal court. All three of the cases have been consolidated.

F-33

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 12 — LEASES

We lease medical office buildings and certain equipment under operating lease agreements. Commitments relating to noncancellable operating leases for each of the next five years and thereafter are as follows (dollars in millions):

For the Year Ended December 31,
2012	$	280
2013		264
2014		218
2015		171
2016		131
Thereafter		870
		1,934
Less sublease income		(51	)
	$	1,883

NOTE 13 — CAPITAL STOCK

The amended and restated certificate of incorporation authorizes the Company to issue up to 1,800,000,000 shares of common stock, and our amended and restated by-laws set the number of directors constituting the board of directors of the Company at not less than one nor more than 15. During February 2011, our Board of Directors approved a 4.505-to-one split of our issued and outstanding common shares. All common share and per common share amounts in these consolidated financial statements and notes to consolidated financial statements reflect the 4.505-to-one stock split. During March 2011, we completed the initial public offering of 87,719,300 shares of our common stock at a price of $30.00 per share and realized net proceeds (after costs of the offering) of $2.506 billion.

On September 21, 2011, we repurchased 80,771,143 shares of our common stock beneficially owned by affiliates of Bank of America Corporation at a purchase price of $18.61 per share, the closing price of the Company’s common stock on the New York Stock Exchange on September 14, 2011. The repurchase was financed using a combination of cash on hand and borrowings under available credit facilities. The shares repurchased represented approximately 15.6% of our total shares outstanding at the time of the repurchase.

Distributions

During 2010, our Board of Directors declared three distributions to the Company’s stockholders and holders of stock options. The distributions totaled $9.43 per share and vested stock option, or $4.332 billion in the aggregate. The distributions were funded using funds available under our senior secured credit facilities, proceeds from the 2021 Notes offering and cash on hand. Pursuant to the terms of our stock option plans, the holders of nonvested stock options received $9.43 per share reductions (subject to certain tax related limitations for certain stock options that resulted in deferred distributions for a portion of the declared distribution, which will be paid upon the vesting of the applicable stock options) to the exercise price of the share-based awards. There were no distributions declared during 2011.

F-34

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 13 — CAPITAL STOCK (Continued)

Stockholder Agreements and Equity Securities with Contingent Redemption Rights

Prior to the consummation of the initial public offering of our common stock, certain employees could elect to have the Company redeem their common stock and vested options in the event of death or permanent disability, pursuant to the terms of their management stockholder agreements. The consummation of the initial public offering of our common stock effectively terminated the contingent redemption rights and the applicable amounts have been reclassified back to stockholders’ equity.

NOTE 14 — EMPLOYEE BENEFIT PLANS

We maintain contributory, defined contribution benefit plans that are available to employees who meet certain minimum requirements. Certain of the plans require that we match specified percentages of participant contributions up to certain maximum levels (generally, 100% of the first 3% to 9%, depending upon years of vesting service, of compensation deferred by participants). The cost of these plans totaled $321 million for 2011, $307 million for 2010 and $283 million for 2009. Our contributions are funded periodically during each year.

We maintain the noncontributory, nonqualified Restoration Plan to provide certain retirement benefits for eligible employees. Eligibility for the Restoration Plan is based upon earning eligible compensation in excess of the Social Security Wage Base and attaining 1,000 or more hours of service during the plan year. Company credits to participants’ account balances (the Restoration Plan is not funded) depend upon participants’ compensation, years of vesting service and certain IRS limitations related to the HCA 401(k) plan. Benefits expense under this plan was $25 million for 2011, $19 million for 2010 and $26 million for 2009. Accrued benefits liabilities under this plan totaled $105 million at December 31, 2011 and $84 million at December 31, 2010.

We maintain a Supplemental Executive Retirement Plan (“SERP”) for certain executives. The plan is designed to ensure that upon retirement the participant receives the value of a prescribed life annuity from the combination of the SERP and our other benefit plans. Benefits expense under the plan was $33 million for 2011, $27 million for 2010 and $24 million for 2009. Accrued benefits liabilities under this plan totaled $237 million at December 31, 2011 and $197 million at December 31, 2010.

We maintain defined benefit pension plans which resulted from certain hospital acquisitions in prior years. Benefits expense under these plans was $37 million for 2011, $30 million for 2010, and $39 million for 2009. Accrued benefits liabilities under these plans totaled $147 million at December 31, 2011 and $131 million at December 31, 2010.

NOTE 15 — SEGMENT AND GEOGRAPHIC INFORMATION

We operate in one line of business, which is operating hospitals and related health care entities. Our operations are structured into three geographically organized groups: the National, Southwest and Central Groups. During February 2011, we reorganized our operational groups and have restated the prior period amounts to reflect this reorganization. At December 31, 2011, the National Group includes 64 hospitals located in Florida, South Carolina, southern Georgia, Alaska, California, Nevada, Utah and Idaho, the Southwest Group includes 46 hospitals located in Colorado, Texas, Oklahoma and the Wichita, Kansas market, and the Central Group includes 47 hospitals located in Louisiana, Indiana, Kentucky, Tennessee, Virginia, New Hampshire, northern Georgia and the Kansas City market. We also operate six hospitals in England, and these facilities are included in the Corporate and other group.

F-35

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 15 — SEGMENT AND GEOGRAPHIC INFORMATION (Continued)

Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, losses (gains) on sales of facilities, gain on acquisition of controlling interest in equity investment, impairments of long-lived assets, losses on retirement of debt, termination of management agreement, 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, depreciation and amortization, assets and goodwill and other intangible assets are summarized in the following table (dollars in millions):

	For the Years Ended December 31,
	2011			2010			2009
Revenues:
National Group	$	12,224		$	11,624		$	11,047
Southwest Group		9,311			8,700			8,282
Central Group		6,982			6,727			6,570
Corporate and other		1,165			984			877
	$	29,682		$	28,035		$	26,776
Equity in earnings of affiliates:
National Group	$	(7	)	$	(4	)	$	(4	)
Southwest Group		(251	)		(277	)		(240	)
Central Group		—			(1	)		(2	)
Corporate and other		—			—			—
	$	(258	)	$	(282	)	$	(246	)
Adjusted segment EBITDA:
National Group	$	2,531		$	2,431		$	2,250
Southwest Group		2,370			2,254			2,089
Central Group		1,285			1,272			1,325
Corporate and other		(125	)		(89	)		(192	)
	$	6,061		$	5,868		$	5,472
Depreciation and amortization:
National Group	$	512		$	508		$	516
Southwest Group		464			427			426
Central Group		347			352			352
Corporate and other		142			134			131
	$	1,465		$	1,421		$	1,425

F-36

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 15 — SEGMENT AND GEOGRAPHIC INFORMATION (Continued)

	For the Years Ended December 31,
	2011			2010			2009
Adjusted segment EBITDA	$	6,061		$	5,868		$	5,472
Depreciation and amortization		1,465			1,421			1,425
Interest expense		2,037			2,097			1,987
Losses (gains) on sales of facilities		(142	)		(4	)		15
Gain on acquisition of controlling interest in equity investment		(1,522	)		—			—
Impairments of long-lived assets		—			123			43
Losses on retirement of debt		481			—			—
Termination of management agreement		181			—			—
Income before income taxes	$	3,561		$	2,231		$	2,002

	As of December 31,
	2011		2010
Assets:
National Group	$	7,827	$	7,345
Southwest Group		9,908		6,747
Central Group		5,187		5,271
Corporate and other		3,976		4,489
	$	26,898	$	23,852

	National Group			Southwest Group			Central Group		Corporate and Other			Total
Goodwill and other intangible assets:
Balance at December 31, 2010	$	787		$	636		$	1,019	$	251		$	2,693
Acquisitions		32			2,533			—		33			2,598
Dispositions		(19	)		(5	)		—		—			(24	)
Foreign currency translation and other		—			(4	)		—		(12	)		(16	)
Balance at December 31, 2011	$	800		$	3,160		$	1,019	$	272		$	5,251

F-37

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 16 — OTHER COMPREHENSIVE LOSS

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

	Unrealized Gains (Losses) on Available-for-Sale Securities			Foreign Currency Translation Adjustments			Defined Benefit Plans			Change in Fair Value of Derivative Instruments			Total
Balances at December 31, 2008	$	(30	)	$	(28	)	$	(106	)	$	(440	)	$	(604	)
Unrealized gains on available-for-sale securities, net of $25 of income taxes		44			—			—			—			44
Foreign currency translation adjustments, net of $14 of income taxes		—			25			—			—			25
Defined benefit plans, net of $8 income tax benefit		—			—			(10	)		—			(10	)
Change in fair value of derivative instruments, net of $76 income tax benefit		—			—			—			(133	)		(133	)
Expense reclassified into operations from other comprehensive income, net of $6 and $127, respectively, income tax benefits		—			—			10			218			228
Balances at December 31, 2009		14			(3	)		(106	)		(355	)		(450	)
Unrealized gains on available-for-sale securities, net of $1 of income taxes		1			—			—			—			1
Foreign currency translation adjustments, net of $9 income tax benefit		—			(16	)		—			—			(16	)
Defined benefit plans, net of $28 income tax benefit		—			—			(48	)		—			(48	)
Change in fair value of derivative instruments, net of $94 income tax benefit		—			—			—			(161	)		(161	)
(Income) expense reclassified into operations from other comprehensive income, net of $(4), $7 and $140, respectively, income (taxes) benefits		(9	)		—			11			244			246
Balances at December 31, 2010		6			(19	)		(143	)		(272	)		(428	)
Unrealized gains on available-for-sale securities, net of $1 of income taxes		1			—			—			—			1
Foreign currency translation adjustments, net of $3 income tax benefit		—			(6	)		—			—			(6	)
Defined benefit plans, net of $25 income tax benefit		—			—			(42	)		—			(42	)
Change in fair value of derivative instruments, net of $114 income tax benefit		—			—			—			(197	)		(197	)
Expense reclassified into operations from other comprehensive income, net of $9 and $125, respectively, income tax benefits		—			—			16			216			232
Balances at December 31, 2011	$	7		$	(25	)	$	(169	)	$	(253	)	$	(440	)

F-38

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 17 — ACCRUED EXPENSES AND ALLOWANCE FOR DOUBTFUL ACCOUNTS

A summary of other accrued expenses at December 31 follows (dollars in millions):

	2011		2010
Professional liability risks	$	298	$	268
Interest		383		309
Taxes other than income		232		197
Other		672		471
	$	1,585	$	1,245

A summary of activity for the allowance of doubtful accounts follows (dollars in millions):

	Balance at Beginning of Year		Provision for Doubtful Accounts		Accounts Written off, Net of Recoveries			Balance at End of Year
Allowance for doubtful accounts:
Year ended December 31, 2009	$	4,741	$	3,276	$	(3,157	)	$	4,860
Year ended December 31, 2010		4,860		2,648		(3,569	)		3,939
Year ended December 31, 2011		3,939		2,824		(2,657	)		4,106

NOTE 18 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION

On November 22, 2010, HCA Inc. reorganized by creating a new holding company structure. HCA Holdings, Inc. became the new parent company, and HCA Inc. is now HCA Holdings, Inc.’s wholly-owned direct subsidiary. On November 23, 2010, HCA Holdings, Inc. issued the 2021 Notes. These notes are senior unsecured obligations and are not guaranteed by any of our subsidiaries.

The senior secured credit facilities and senior secured notes described in Note 10 are fully and unconditionally guaranteed by substantially all existing and future, direct and indirect, wholly-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 ABL credit facility).

Our condensed consolidating balance sheets at December 31, 2011 and 2010 and condensed consolidating statements of income and cash flows for each of the three years in the period ended December 31, 2011, segregating HCA Holdings, Inc. issuer, HCA Inc. issuer, the subsidiary guarantors, the subsidiary non-guarantors and eliminations, follow.

F-39

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 18 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued)

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING INCOME STATEMENT

For The Year Ended December 31, 2011

(Dollars in millions)

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Revenues before provision for doubtful accounts	$	—		$	—		$	18,126		$	14,380		$	—		$	32,506
Provision for doubtful accounts		—			—			1,644			1,180			—			2,824
Revenues		—			—			16,482			13,200			—			29,682
Salaries and benefits		—			—			7,584			5,856			—			13,440
Supplies		—			—			2,851			2,328			—			5,179
Other operating expenses		—			4			2,741			2,725			—			5,470
Electronic health record incentive income		—			—			(126	)		(84	)		—			(210	)
Equity in earnings of affiliates		(2,543	)		—			(86	)		(172	)		2,543			(258	)
Depreciation and amortization		—			—			777			688			—			1,465
Interest expense		120			2,390			(342	)		(131	)		—			2,037
Gains on sales of facilities		—			—			(127	)		(15	)		—			(142	)
Gain on acquisition of controlling interest in equity investment		—			—			—			(1,522	)		—			(1,522	)
Losses on retirement of debt		—			481			—			—			—			481
Termination of management agreement		—			181			—			—			—			181
Management fees		—			—			(491	)		491			—			—
		(2,423	)		3,056			12,781			10,164			2,543			26,121
Income (loss) before income taxes		2,423			(3,056	)		3,701			3,036			(2,543	)		3,561
Provision (benefit) for income taxes		(42	)		(1,068	)		1,271			558			—			719
Net income (loss)		2,465			(1,988	)		2,430			2,478			(2,543	)		2,842
Net income attributable to noncontrolling interests		—			—			63			314			—			377
Net income (loss) attributable to HCA Holdings, Inc.	$	2,465		$	(1,988	)	$	2,367		$	2,164		$	(2,543	)	$	2,465

F-40

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 18 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued)

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING INCOME STATEMENT

For The Year Ended December 31, 2010

(Dollars in millions)

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Revenues before provision for doubtful accounts	$	—		$	—		$	17,647		$	13,036		$	—		$	30,683
Provision for doubtful accounts		—			—			1,632			1,016			—			2,648
Revenues		—			—			16,015			12,020			—			28,035
Salaries and benefits		—			—			7,315			5,169			—			12,484
Supplies		—			—			2,825			2,136			—			4,961
Other operating expenses		—			5			2,634			2,365			—			5,004
Equity in earnings of affiliates		(1,215	)		—			(107	)		(175	)		1,215			(282	)
Depreciation and amortization		—			—			782			639			—			1,421
Interest expense		12			2,700			(761	)		146			—			2,097
Gains on sales of facilities		—			—			—			(4	)		—			(4	)
Impairments of long-lived assets		—			—			58			65			—			123
Management fees		—			—			(454	)		454			—			—
		(1,203	)		2,705			12,292			10,795			1,215			25,804
Income (loss) before income taxes		1,203			(2,705	)		3,723			1,225			(1,215	)		2,231
Provision (benefit) for income taxes		(4	)		(955	)		1,299			318			—			658
Net income (loss)		1,207			(1,750	)		2,424			907			(1,215	)		1,573
Net income attributable to noncontrolling interests		—			—			44			322			—			366
Net income (loss) attributable to HCA Holdings, Inc.	$	1,207		$	(1,750	)	$	2,380		$	585		$	(1,215	)	$	1,207

F-41

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 18 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued)

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING INCOME STATEMENT

For The Year Ended December 31, 2009

(Dollars in millions)

	HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Revenues before provision for doubtful accounts	$	—		$	17,584		$	12,468		$	—		$	30,052
Provision for doubtful accounts		—			2,043			1,233			—			3,276
Revenues		—			15,541			11,235			—			26,776
Salaries and benefits		—			7,149			4,809			—			11,958
Supplies		—			2,846			2,022			—			4,868
Other operating expenses		14			2,497			2,213			—			4,724
Equity in earnings of affiliates		(2,540	)		(95	)		(151	)		2,540			(246	)
Depreciation and amortization		—			787			638			—			1,425
Interest expense		2,356			(500	)		131			—			1,987
Losses (gains) on sales of facilities		—			17			(2	)		—			15
Impairments of long-lived assets		—			34			9			—			43
Management fees		—			(443	)		443			—			—
		(170	)		12,292			10,112			2,540			24,774
Income before income taxes		170			3,249			1,123			(2,540	)		2,002
Provision (benefit) for income taxes		(884	)		1,189			322			—			627
Net income		1,054			2,060			801			(2,540	)		1,375
Net income attributable to noncontrolling interests		—			61			260			—			321
Net income attributable to HCA Holdings, Inc.	$	1,054		$	1,999		$	541		$	(2,540	)	$	1,054

F-42

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 18 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued)

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING BALANCE SHEET

DECEMBER 31, 2011

(Dollars in millions)

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors		Eliminations			Condensed Consolidated
ASSETS
Current assets:
Cash and cash equivalents	$	—		$	—		$	115		$	258	$	—		$	373
Accounts receivable, net		—			—			2,429			2,104		—			4,533
Inventories		—			—			602			452		—			1,054
Deferred income taxes		594			—			—			—		—			594
Other		50			—			184			445		—			679
		644			—			3,330			3,259		—			7,233
Property and equipment, net		—			—			7,088			5,746		—			12,834
Investments of insurance subsidiaries		—			—			—			548		—			548
Investments in and advances to affiliates		—			—			15			86		—			101
Goodwill and other intangible assets		—			—			1,605			3,646		—			5,251
Deferred loan costs		22			268			—			—		—			290
Investments in and advances to subsidiaries		16,825			—			—			—		(16,825	)		—
Other		450			—			21			170		—			641
	$	17,941		$	268		$	12,059		$	13,455	$	(16,825	)	$	26,898
LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY
Current liabilities:
Accounts payable	$	—		$	—		$	899		$	698	$	—		$	1,597
Accrued salaries		—			—			568			397		—			965
Other accrued expenses		15			367			449			754		—			1,585
Long-term debt due within one year		—			1,347			28			32		—			1,407
		15			1,714			1,944			1,881		—			5,554
Long-term debt		1,525			23,454			110			556		—			25,645
Intercompany balances		24,121			(12,814	)		(15,183	)		3,876		—			—
Professional liability risks		—			—			—			993		—			993
Income taxes and other liabilities		538			415			556			211		—			1,720
		26,199			12,769			(12,573	)		7,517		—			33,912
Stockholders’ (deficit) equity attributable to HCA Holdings, Inc.		(8,258	)		(12,501	)		24,534			4,792		(16,825	)		(8,258	)
Noncontrolling interests		—			—			98			1,146		—			1,244
		(8,258	)		(12,501	)		24,632			5,938		(16,825	)		(7,014	)
	$	17,941		$	268		$	12,059		$	13,455	$	(16,825	)	$	26,898

F-43

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 18 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued)

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING BALANCE SHEET

DECEMBER 31, 2010

(Dollars in millions)

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors		Eliminations			Condensed Consolidated
ASSETS
Current assets:
Cash and cash equivalents	$	6		$	—		$	156		$	249	$	—		$	411
Accounts receivable, net		—			—			2,214			1,618		—			3,832
Inventories		—			—			547			350		—			897
Deferred income taxes		931			—			—			—		—			931
Other		202			—			223			423		—			848
		1,139			—			3,140			2,640		—			6,919
Property and equipment, net		—			—			6,817			4,535		—			11,352
Investments of insurance subsidiaries		—			—			—			642		—			642
Investments in and advances to affiliates		—			—			248			621		—			869
Goodwill and other intangible assets		—			—			1,635			1,058		—			2,693
Deferred loan costs		23			351			—			—		—			374
Investments in and advances to subsidiaries		14,282			—			—			—		(14,282	)		—
Other		776			39			21			167		—			1,003
	$	16,220		$	390		$	11,861		$	9,663	$	(14,282	)	$	23,852
LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY
Current liabilities:
Accounts payable	$	—		$	—		$	919		$	618	$	—		$	1,537
Accrued salaries		—			—			556			339		—			895
Other accrued expenses		12			296			328			609		—			1,245
Long-term debt due within one year		—			554			12			26		—			592
		12			850			1,815			1,592		—			4,269
Long-term debt		1,525			25,758			95			255		—			27,633
Intercompany balances		25,985			(16,130	)		(12,833	)		2,978		—			—
Professional liability risks		—			—			—			995		—			995
Income taxes and other liabilities		483			425			505			195		—			1,608
		28,005			10,903			(10,418	)		6,015		—			34,505
Equity securities with contingent redemption rights		141			—			—			—		—			141
Stockholders’ (deficit) equity attributable to HCA Holdings, Inc.		(11,926	)		(10,513	)		22,167			2,628		(14,282	)		(11,926	)
Noncontrolling interests		—			—			112			1,020		—			1,132
		(11,926	)		(10,513	)		22,279			3,648		(14,282	)		(10,794	)
	$	16,220		$	390		$	11,861		$	9,663	$	(14,282	)	$	23,852

F-44

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 18 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued)

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS

For The Year Ended December 31, 2011

(Dollars in millions)

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Cash flows from operating activities:
Net income (loss)	$	2,465		$	(1,988	)	$	2,430		$	2,478		$	(2,543	)	$	2,842
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Change in operating assets and liabilities		6			71			(1,755	)		(1,275	)		—			(2,953	)
Provision for doubtful accounts		—			—			1,644			1,180			—			2,824
Depreciation and amortization		—			—			777			688			—			1,465
Income taxes		912			—			—			—			—			912
Gains on sales of facilities		—			—			(127	)		(15	)		—			(142	)
Gain on acquisition of controlling interest in equity investment		—			—			—			(1,522	)		—			(1,522	)
Losses on retirement of debt		—			481			—			—			—			481
Amortization of deferred loan costs		—			70			—			—			—			70
Share-based compensation		26			—			—			—			—			26
Pay-in-kind interest		—			(78	)		—			—			—			(78	)
Equity in earnings of affiliates		(2,543	)		—			—			—			2,543			—
Other		—			9			—			(1	)		—			8
Net cash provided by (used in) operating activities		866			(1,435	)		2,969			1,533			—			3,933
Cash flows from investing activities:
Purchase of property and equipment		—			—			(910	)		(769	)		—			(1,679	)
Acquisition of hospitals and health care entities		—			—			(142	)		(1,540	)		—			(1,682	)
Disposal of hospitals and health care entities		—			—			200			81			—			281
Change in investments		—			—			34			46			—			80
Other		—			—			—			5			—			5
Net cash used in investing activities		—			—			(818	)		(2,177	)		—			(2,995	)
Cash flows from financing activities:
Issuances of long-term debt		—			5,500			—			—			—			5,500
Net change in revolving bank credit facilities		—			(449	)		—			—			—			(449	)
Repayment of long-term debt		—			(6,577	)		(17	)		(46	)		—			(6,640	)
Distributions to noncontrolling interests		—			—			(77	)		(301	)		—			(378	)
Payment of debt issuance costs		—			(92	)		—			—			—			(92	)
Issuance of common stock		2,506			—			—			—			—			2,506
Repurchase of common stock		(1,503	)		—			—			—			—			(1,503	)
Distributions to stockholders		(31	)		—			—			—			—			(31	)
Income tax benefits		63			—			—			—			—			63
Changes in intercompany balances with affiliates, net		(1,918	)		3,053			(2,098	)		963			—			—
Other		11			—			—			37			—			48
Net cash provided by (used in) financing activities		(872	)		1,435			(2,192	)		653			—			(976	)
Change in cash and cash equivalents		(6	)		—			(41	)		9			—			(38	)
Cash and cash equivalents at beginning of period		6			—			156			249			—			411
Cash and cash equivalents at end of period	$	—		$	—		$	115		$	258		$	—		$	373

F-45

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 18 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued)

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS

For The Year Ended December 31, 2010

(Dollars in millions)

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Cash flows from operating activities:
Net income (loss)	$	1,207		$	(1,750	)	$	2,424		$	907		$	(1,215	)	$	1,573
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Change in operating assets and liabilities		12			13			(1,759	)		(1,113	)		—			(2,847	)
Provision for doubtful accounts		—			—			1,632			1,016			—			2,648
Depreciation and amortization		—			—			782			639			—			1,421
Income taxes		27			—			—			—			—			27
Gains on sales of facilities		—			—			—			(4	)		—			(4	)
Impairments of long-lived assets		—			—			58			65			—			123
Amortization of deferred loan costs		—			81			—			—			—			81
Share-based compensation		32			—			—			—			—			32
Equity in earnings of affiliates		(1,215	)		—			—			—			1,215			—
Other		—			31			—			—			—			31
Net cash provided by (used in) operating activities		63			(1,625	)		3,137			1,510			—			3,085
Cash flows from investing activities:
Purchase of property and equipment		—			—			(602	)		(723	)		—			(1,325	)
Acquisition of hospitals and health care entities		—			—			(21	)		(212	)		—			(233	)
Disposal of hospitals and health care entities		—			—			29			8			—			37
Change in investments		—			—			1			471			—			472
Other		—			—			(3	)		13			—			10
Net cash used in investing activities		—			—			(596	)		(443	)		—			(1,039	)
Cash flows from financing activities:
Issuances of long-term debt		1,525			1,387			—			—			—			2,912
Net change in revolving bank credit facilities		—			1,889			—			—			—			1,889
Repayment of long-term debt		—			(2,164	)		(32	)		(72	)		—			(2,268	)
Distributions to noncontrolling interests		—			—			(61	)		(281	)		—			(342	)
Contributions from noncontrolling interests		—			—			—			57			—			57
Payment of debt issuance costs		(23	)		(27	)		—			—			—			(50	)
Distributions to stockholders		(4,257	)		—			—			—			—			(4,257	)
Income tax benefits		114			—			—			—			—			114
Changes in intercompany balances with affiliates, net		2,590			556			(2,387	)		(759	)		—			—
Other		(6	)		(16	)		—			20			—			(2	)
Net cash provided by (used in) financing activities		(57	)		1,625			(2,480	)		(1,035	)		—			(1,947	)
Change in cash and cash equivalents		6			—			61			32			—			99
Cash and cash equivalents at beginning of period		—			—			95			217			—			312
Cash and cash equivalents at end of period	$	6		$	—		$	156		$	249		$	—		$	411

F-46

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 18 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued)

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS

For The Year Ended December 31, 2009

(Dollars in millions)

	HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Cash flows from operating activities:
Net income	$	1,054		$	2,060		$	801		$	(2,540	)	$	1,375
Adjustments to reconcile net income to net cash provided by (used in) operating activities:
Change in operating assets and liabilities		90			(1,882	)		(1,299	)		—			(3,091	)
Provision for doubtful accounts		—			2,043			1,233			—			3,276
Depreciation and amortization		—			787			638			—			1,425
Income taxes		(520	)		—			—			—			(520	)
Losses (gains) on sales of facilities		—			17			(2	)		—			15
Impairments of long-lived assets		—			34			9			—			43
Amortization of deferred loan costs		80			—			—			—			80
Share-based compensation		40			—			—			—			40
Pay-in-kind interest		58			—			—			—			58
Equity in earnings of affiliates		(2,540	)		—			—			2,540			—
Other		50			(2	)		(2	)		—			46
Net cash provided by (used in) operating activities		(1,688	)		3,057			1,378			—			2,747
Cash flows from investing activities:
Purchase of property and equipment		—			(720	)		(597	)		—			(1,317	)
Acquisition of hospitals and health care entities		—			(38	)		(23	)		—			(61	)
Disposal of hospitals and health care entities		—			21			20			—			41
Change in investments		—			(7	)		310			—			303
Other		—			—			(1	)		—			(1	)
Net cash used in investing activities		—			(744	)		(291	)		—			(1,035	)
Cash flows from financing activities:
Issuances of long-term debt		2,979			—			—			—			2,979
Net change in revolving bank credit facilities		(1,335	)		—			—			—			(1,335	)
Repayment of long-term debt		(2,972	)		(7	)		(124	)		—			(3,103	)
Distributions to noncontrolling interests		—			(70	)		(260	)		—			(330	)
Payment of debt issuance costs		(70	)		—			—			—			(70	)
Changes in intercompany balances with affiliates, net		3,107			(2,275	)		(832	)		—			—
Other		(21	)		—			15			—			(6	)
Net cash provided by (used in) financing activities		1,688			(2,352	)		(1,201	)		—			(1,865	)
Change in cash and cash equivalents		—			(39	)		(114	)		—			(153	)
Cash and cash equivalents at beginning of period		—			134			331			—			465
Cash and cash equivalents at end of period	$	—		$	95		$	217		$	—		$	312

F-47

HCA HOLDINGS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

NOTE 18 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION (Continued)

Healthtrust, Inc. — The Hospital Company (“Healthtrust”) is the first-tier subsidiary of HCA Inc. The common stock of Healthtrust has been pledged as collateral for the senior secured credit facilities and senior secured notes described in Note 10. Rule 3-16 of Regulation S-X under the Securities Act requires the filing of separate financial statements for any affiliate of the registrant whose securities constitute a substantial portion of the collateral for any class of securities registered or being registered. We believe the separate financial statements requirement applies to Healthtrust due to the pledge of its common stock as collateral for the senior secured notes. Due to the corporate structure relationship of HCA and Healthtrust, HCA’s operating subsidiaries are also the operating subsidiaries of Healthtrust. The corporate structure relationship, combined with the application of push-down accounting in Healthtrust’s consolidated financial statements related to HCA’s debt and financial instruments, results in the consolidated financial statements of Healthtrust being substantially identical to the consolidated financial statements of HCA. The consolidated financial statements of HCA and Healthtrust present the identical amounts for revenues, expenses, net income, assets, liabilities, total stockholders’ deficit, net cash provided by operating activities, net cash used in investing activities and net cash used in financing activities. Certain individual line items in the HCA consolidated statements of stockholders’ deficit are combined into one line item in the Healthtrust consolidated statements of stockholder’s deficit.

Reconciliations of the HCA Holdings, Inc. Consolidated Statements of Stockholders’ Deficit presentation to the Healthtrust, Inc. — The Hospital Company Consolidated Statements of Stockholder’s Deficit presentation for the years ended December 31, 2011, 2010 and 2009 are as follows (dollars in millions):

	2011		2010		2009
Presentation in HCA Holdings, Inc. Consolidated Statements of Stockholders’ Deficit:
Share-based benefit plans	$	35	$	43	$	47
Reclassification of certain equity securities with contingent redemption rights		141		—		—
Other		36		120		14
Presentation in Healthtrust, Inc. — The Hospital Company Consolidated Statements of Stockholder’s Deficit:
Distributions from HCA Holdings, Inc., net of contributions to HCA Holdings, Inc.	$	212	$	163	$	61

Due to the consolidated financial statements of Healthtrust being substantially identical to the consolidated financial statements of HCA, except for the items presented in the tables above, the separate consolidated financial statements of Healthtrust are not presented.

NOTE 19 — SUBSEQUENT EVENT

On February 3, 2012, our Board of Directors declared a distribution to the Company’s stockholders and holders of vested stock awards. The distribution will be $2.00 per share and vested stock award, or approximately $975 million in the aggregate. The distribution is expected to be paid on February 29, 2012 to holders of record on February 16, 2012. The distribution is expected to be funded using funds available under our existing senior secured credit facilities. Pursuant to the terms of our stock award plans, the holders of nonvested stock options and stock appreciation rights will receive a $2.00 per share reduction (subject to certain tax related limitations for certain stock awards that resulted in deferred distributions for a portion of the declared distribution, which will be paid upon the vesting of the applicable stock award) to the exercise price of their share-based awards. The holders of any nonvested restricted share units will be paid $2.00 per unit upon the vesting of the applicable restricted share units.

F-48

HCA HOLDINGS, INC.

QUARTERLY CONSOLIDATED FINANCIAL INFORMATION

(UNAUDITED)

(Dollars in millions)

	2011
	First			Second			Third			Fourth
Revenues(i)	$	7,406		$	7,249		$	7,258		$	7,769
Net income	$	334	(a)	$	320	(b)	$	146	(c)	$	2,042	(d)
Net income attributable to HCA Holdings, Inc.	$	240	(a)	$	229	(b)	$	61	(c)	$	1,935	(d)
Basic earnings per share	$	0.54		$	0.44		$	0.12		$	4.43
Diluted earnings per share	$	0.52		$	0.43		$	0.11		$	4.25

	2010
	First			Second			Third			Fourth
Revenues(i)	$	6,980		$	6,968		$	6,926		$	7,161
Net income	$	476	(e)	$	378	(f)	$	325	(g)	$	394	(h)
Net income attributable to HCA Holdings, Inc.	$	388	(e)	$	293	(f)	$	243	(g)	$	283	(h)
Basic earnings per share	$	0.91		$	0.69		$	0.57		$	0.66
Diluted earnings per share	$	0.89		$	0.67		$	0.55		$	0.65

(a) First quarter results include $2 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $149 million of costs related to the termination of management agreement (See NOTE 1 of the notes to consolidated financial statements).

(b) Second quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $47 million of losses on retirement of debt (See NOTE 10 of the notes to consolidated financial statements).

(c) Third quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $256 million of losses on retirement of debt (See NOTE 10 of the notes to consolidated financial statements).

(d) Fourth quarter results include $84 million of gains on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $1.424 billion of gain on acquisition of controlling interest in equity investment (See NOTE 3 of the notes to consolidated financial statements).

(e) First quarter results include $12 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

(f) Second quarter results include $57 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

(g) Third quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $6 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

(h) Fourth quarter results include $3 million of gains on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $2 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

(i) The “Revenues” presented for each quarter of 2010 and the first and second quarters of 2011 have been reduced by the provision for doubtful accounts for each quarter in accordance with our adoption of ASU 2011-07 in the third quarter of 2011. The “Revenues” presented for the second and third quarters of 2011 have been reduced for the reclassification of “Electronic health record incentive income” as a separate line item in our consolidated income statements (See NOTE 1 of the notes to consolidated financial statements).

F-49

EX-21

Exhibit 21

ALABAMA

CareOne Home Health Services, Inc.

Four Rivers Medical Center PHO, Inc.

Selma Medical Center Hospital, Inc.

ALASKA

Chugach PT, Inc.

Columbia Behavioral Healthcare, Inc.

Columbia North Alaska Healthcare, Inc.

ARKANSAS

Columbia Health System of Arkansas, Inc.

BERMUDA

Parthenon Insurance Company, Limited

CALIFORNIA

Center for Advanced Imaging, LLC

CFC Investments, Inc.

CH Systems

Chino Community Hospital Corporation, Inc.

Columbia ASC Management, L.P.

Columbia Riverside, Inc.

Columbia/HCA San Clemente, Inc.

Encino Hospital Corporation, Inc.

Far West Division, Inc.

Galen-Soch, Inc.

Good Samaritan Surgery Center, L.P.

HCA Health Services of California, Inc.

Healdsburg General Hospital, Inc.

L E Corporation

Las Encinas Hospital

Los Gatos Surgical Center, a California Limited Partnership

Los Gatos Surgical Center

Los Robles Regional Medical Center

Los Robles Hospital & Medical Center

Los Robles SurgiCenter, LLC

Los Robles SurgiCenter

MCA Investment Company

Mission Bay Memorial Hospital, Inc.

Neuro Affiliates Company

Riverside Healthcare System, L.P.

Riverside Community Hospital

Riverside Holdings, Inc.

Riverside Surgicenter, L.P.

San Joaquin Surgical Center, Inc.

San Jose Pathology Outreach, LLC

Southwest Surgical Clinic, Inc.

Surgicare of Good Samaritan, LLC

Surgicare of Los Gatos, Inc.

Surgicare of Los Robles, LLC

Surgicare of Riverside, LLC

Surgicare of West Hills, Inc.

West Hills Hospital

West Hills Hospital & Medical Center

West Hills Surgical Center, Ltd.

West Hills Surgical Center

West Los Angeles Physicians’ Hospital, Inc.

Westminster Community Hospital

CAYMAN ISLANDS

Health Midwest Insurance Company, Ltd.

COLORADO

Altitude Mid Level Providers, LLC

Centrum Surgery Center, Ltd.

Centrum Surgical Center

Clear Creek Surgery Center, LLC

Clear Creek Surgery Center

Colorado Health Systems, Inc.

Columbine Psychiatric Center, Inc.

Continental Division I, Inc.

Denver Mid-Town Surgery Center, Ltd.

Midtown Surgical Center

Diagnostic Mammography Services, G.P.

Galen of Aurora, Inc.

HCA-HealthONE LLC

North Suburban Medical Center

Presbyterian/St. Luke’s Medical Center

Rose Medical Center

Sky Ridge Medical Center

Swedish Medical Center

The Medical Center of Aurora

Health Care Indemnity, Inc.

HealthONE at Breckenridge, LLC

HealthONE Aurora Investment, LLC

HealthONE Clear Creek, LLC

HealthONE Clinic Services - Bariatric Medicine, LLC

HealthONE Clinic Services - Behavioral Health, LLC

HealthONE Clinic Services - Cancer Specialties, LLC

HealthONE Clinic Services - Cardiovascular, LLC

HealthONE Clinic Services - Medical Specialties, LLC

HealthONE Clinic Services - Neurosciences, LLC

HealthONE Clinic Services - Obstetrics and Gynecology, LLC

HealthONE Clinic Services - Occupational Medicine, LLC

HealthONE Clinic Services - Oncology Hematology, LLC

HealthONE Clinic Services - Orthopedic Specialists, LLC

HealthONE Clinic Services - Otolaryngology Specialists, LLC

HealthONE Clinic Services - Pediatric Cardiovascular Surgery, LLC

HealthONE Clinic Services - Pediatric Specialties, LLC

HealthONE Clinic Services - Primary Care, LLC

HealthONE Clinic Services - Spine Surgeons LLC

HealthONE Clinic Services - Surgery Neurological, LLC

HealthONE Clinic Services - Surgical Specialties, LLC

HealthONE Clinic Services - Youth Rehabilitation LLC

HealthONE Clinic Services LLC

HealthONE High Street Primary Care Center, LLC

HealthONE Institutes for Clinical Research, LLC

HealthOne Lincoln Investment, LLC

HealthONE Lowry, LLC

HealthONE of Denver, Inc.

HealthONE Radiation Therapy at Red Rocks, LLC

HealthONE Radiation Therapy at Thornton, LLC

HealthONE Ridge View Endoscopy Center, LLC

Ridge View Endoscopy Center

HealthONE Surgicare of Ridge View, LLC

HealthONE Urologic, LLC

HealthOne Westside Investment, LLC

Hospital-Based CRNA Services, Inc.

Lakewood Outpatient Surgical Center, Ltd.

Lakewood Surgicare, Inc.

Lincoln Surgery Center, LLC

Lincoln Surgery Center

Lowry Surgery Center, LLC

Lowry Surgery Center

Medical Care America Colorado, LLC

Medical Imaging of Colorado LLC

Mountain View MRI Associates, Ltd.

MOVCO, Inc.

New Rose Holding Company, Inc.

North Suburban Medical Group

North Suburban Spine Center, L.P.

Musculoskeletal Surgery Center

North Suburban Surgery Center, L.P.

North Suburban Surgery Center

Outpatient Surgery Center of Lakewood, L.P.

P/SL Hyperbaric Partnership

Proaxis Therapy HealthOne LLC

Red Rocks Surgery Center, LLC

Red Rocks Surgery Center

Rocky Mountain Pediatric Hematology Oncology, LLC

Rocky Mountain Surgery Center, LLC

Rocky Mountain Surgery Center

Rose Ambulatory Surgery Center, L.P.

Rose Surgical Center

Rose Health Partners, LLC

Rose Medical Plaza, Ltd.

Rose POB, Inc.

Sky Ridge Spine Manager, LLC

Sky Ridge Surgery Center, L.P.

Sky Ridge Surgical Center

Sky Ridge Total Joint Manager, LLC

Southwest Medpro, Ltd.

Surgery Center of the Rockies, LLC

Surgicare of Denver Mid-Town, Inc.

Surgicare of North Suburban, LLC

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 II, Inc.

Swedish MOB III, Inc.

Swedish MOB IV, Inc.

Swedish MOB, LLC

Urology Surgery Center of Colorado, LLC

Urology Surgery Center

DELAWARE

AC Med, LLC

Aligned Business Consortium Group, L.P.

Alpharetta Imaging Services, LLC

Alternaco, LLC

American Medicorp Development Co.

Ami-Point GA, LLC

AOGN, LLC

Appledore Medical Group, Inc.

AR Holding 1, LLC

AR Holding 2, LLC

AR Holding 3, 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

Arkansas Medical Park, LLC

ASD Shared Services, LLC

Atlanta Healthcare Management, L.P.

Atlanta Market GP, Inc.

Atlanta Orthopaedic Surgical Center, Inc.

Aventura Cancer Center Manager, LLC

Bayshore Partner, LLC

Belton Family Practice Clinic, LLC

Boca Raton Open Imaging Center, LLC

Boynton Beach EFL Imaging Center, LLC

Bradenton Outpatient Services, LLC

Brandon Imaging Manager, LLC

Brandon Regional Cancer Center, LLC

Brandon SRS Management Services, LLC

C/HCA Capital, Inc.

C/HCA, Inc.

California Imaging Center Manager, LLC

Cancer Centers of North Florida, LLC

Cancer Services of Aventura, LLC

Carolina Forest Imaging Manager, LLC

Centennial CyberKnife Center, LLC

Centennial CyberKnife Manager, LLC

Centerpoint Medical Center of Independence, LLC

Centerpoint Medical Center

Central Florida Diagnostic Cardiology Center, LLC

Central Florida Imaging Services, LLC

Central Health Holding Company, Inc.

Central Health Services Hospice, Inc.

Chattanooga ASC, LLC

CHC Finance Co.

CHC Payroll Agent, Inc.

CHCA Bayshore, L.P.

Bayshore Medical Center

CHCA Clear Lake, L.P.

Clear Lake Regional Medical Center

Mainland Medical Center, a campus of Clear Lake Regional Medical Center

CHCA Conroe, L.P.

Conroe Regional Medical Center

CHCA Hospital LP, Inc.

CHCA Mainland, L.P.

Mainland Medical Center

CHCA Palmyra Partner, Inc.

CHCA West Houston, L.P.

West Houston Medical Center

CHCA Woman’s Hospital, L.P.

Woman’s Hospital of Texas

Cheray and Samuels, LLC

Clear Lake Cardiac Catheterization Center, L.P.

Clear Lake Cardiac GP, LLC

Clear Lake Merger, LLC

Clear Lake Regional Partner, LLC

ClinicServ, LLC

Clipper Cardiovascular Associates, Inc.

Coastal Bend Hospital, Inc.

Coastal Healthcare Services, Inc.

Cobb Imaging Services, LLC

Coliseum Health Group, LLC

Coliseum Medical Center, LLC

Coliseum Medical Centers

Coliseum Psychiatric Center, LLC

Coliseum Center for Behavioral Health

Coliseum Surgery Center, L.L.C.

Columbia Behavioral Health, LLC

Columbia Hospital (Palm Beaches) Limited Partnership

Columbia Hospital

Columbia Hospital Corporation of Fort Worth

Columbia Hospital Corporation of Houston

Columbia Hospital Corporation-Delaware

Columbia Palm Beach GP, LLC

Columbia Rio Grande Healthcare, L.P.

Rio Grande Regional Hospital

Columbia Valley Healthcare System, L.P.

Valley Regional Medical Center

Columbia Westbank Healthcare, L.P.

Columbia/HCA Middle East Management Company

Columbia-SDH Holdings, Inc.

Columbus Cath Lab, Inc.

Columbus Cath Lab, LLC

Concept EFL Imaging Center, LLC

Concept West EFL Imaging Center, LLC

Conroe Partner, LLC

CoralStone Management, Inc.

COSCORP, LLC

CPS TN Processor 1, Inc.

CRMC-M, LLC

Dallas/Ft. Worth Physician, LLC

Delray EFL Imaging Center, LLC

Delta Division, Inc.

Doctors Hospital of Augusta, LLC

Doctors Hospital

Douglasville Imaging Services, LLC

Drake Management Company

East Florida Imaging Holdings, LLC

EMMC, LLC

EP Health, LLC

EP Holdco, LLC

EPIC Development, Inc.

EPIC Diagnostic Centers, Inc.

EPIC Healthcare Management Company

EPIC Surgery Centers, Inc.

Extendicare Properties, Inc.

Fairview Park GP, LLC

Fairview Partner, LLC

Family Care of E. Jackson County, LLC

FHAL, LLC

Forest Park Surgery Pavilion, Inc.

Forest Park Surgery Pavilion, L.P.

Fort Bend Hospital, Inc.

Galen (Kansas) Merger, LLC

Galen BH, Inc.

Galen Finance, LLC

Galen Global Finance, Inc.

Galen GOK, LLC

Galen Holdco, LLC

Galen Hospital Alaska, Inc.

Alaska Regional Hospital

Galen International Capital, Inc.

Galen International Holdings, Inc.

Galen KY, LLC

Galen LA, LLC

Galen MCS, LLC

Galen Medical Corporation

Galen MRMC, LLC

Galen NMC, LLC

Galen NSH, LLC

Galen SOM, LLC

Galen SSH, LLC

Galendeco, Inc.

GalTex, LLC

Garden Park Community Hospital Limited Partnership

Gardens EFL Imaging Center, LLC

Georgia Health Holdings, Inc.

Georgia, L.P.

GHC-Galen Health Care, LLC

Good Samaritan Hospital, L.P.

Good Samaritan Hospital

Good Samaritan Hospital, LLC

Goppert-Trinity Family Care, LLC

GPCH-GP, Inc.

Garden Park Medical Center

Grand Strand Regional Medical Center, LLC

Grand Strand Regional Medical Center

Grandview Health Care Clinic, LLC

H.H.U.K., Inc.

HCA - IT&S Field Operations, Inc.

HCA - IT&S Inventory Management, Inc.

HCA - IT&S TN Field Operations, Inc.

HCA Health Services of Midwest, Inc.

HCA Holdco, LLC

HCA Imaging Services of North Florida, Inc.

HCA Inc.

HCA International Finance LLP

HCA Management Services, L.P.

HCA Outpatient Imaging Services Group, Inc.

HCA Property GP, LLC

HCA Psychiatric Company

HCA Squared, LLC

HCA Wesley Rehabilitation Hospital, Inc.

HCA-Access Healthcare Holdings, LLC

HCA-Access Healthcare Partner, Inc.

HCA-EmCare Holdings, LLC

HCA-EMS Holdings, LLC

HCAPS Anesthesia Manager, LLC

Health Insight Capital, LLC

Health Services (Delaware), Inc.

Health Services Merger, Inc.

Healthcare Technology Assessment Corporation

Healthco, LLC

Healthnet of Kentucky, LLC

Healthserv Acquisition, LLC

Healthtrust MOB Tennessee, LLC

Healthtrust Purchasing Group, L.P.

Healthtrust, Inc. - The Hospital Company

Hearthstone Home Health, Inc.

Heathrow Imaging, LLC

Hendersonville ODC, LLC

Henrico Doctors Hospital - Forest Campus Property, LLC

HHNC, LLC

Highway 50 Real Estate, LLC

hInsight - Nasolux Holdings, LLC

hInsight-Airstrip Holdings, LLC

HM OMCOS, LLC

Hospital Corp., LLC

Hospital Development Properties, Inc.

Hospital Partners Merger, LLC

Houston Healthcare Holdings, Inc.

Houston Woman’s Hospital Partner, LLC

HPG Enterprises, LLC

HPG Solutions, LLC

HSS Holdco, LLC

HSS Systems, LLC

HTI Hospital Holdings, Inc.

HTI MOB, LLC

Imaging Services of Appomattox, LLC

Imaging Services of Jacksonville, LLC

Imaging Services of Louisiana Manager, LLC

Imaging Services of Louisiana, LLC

Imaging Services of Orlando, LLC

Imaging Services of Richmond, LLC

Imaging Services of Roanoke, LLC

Imaging Services of West Boynton, LLC

IMX Holdings, LLC

Independence Regional Medical Group, LLC

Indian Path, LLC

Indianapolis Hospital Partner, LLC

Integrated Regional Laboratories, LLP

InterMedHx, LLC

Jackson County Medical Group, LLC

JCSH, LLC

JCSHLP, LLC

JFK Medical Center Limited Partnership

JFK Medical Center

Jupiter EFL Imaging Center, LLC

JV Investor, LLC

Kansas Healthserv, LLC

Katy Medical Center, Inc.

Kendall Regional Medical Center, LLC

Lake City Imaging, LLC

Lakeland Medical Center, LLC

Lakeside Radiology, LLC

Lakeview Medical Center, LLC

Lakeview Regional Medical Center

Laredo Medco, LLC

Lee’s Summit Family Care, LLC

Lewis-Gale Medical Center, LLC

Lewis-Gale Medical Center

Low Country Health Services, Inc. of the Southeast

Macon Healthcare, LLC

Macon Northside Health Group, LLC

Macon Northside Hospital, LLC

Coliseum Northside Hospital

Management Services Holdings, Inc.

Mayhill Cancer Center, LLC

Medical Arts Hospital of Texarkana, Inc.

Medical Care America, LLC

Medical Care Financial Services Corp.

Medical Care Real Estate Finance, Inc.

Medical Center of Plano Partner, LLC

Medical Centers of Oklahoma, LLC

Medical City Dallas Partner, LLC

Medical Corporation of America

Medical Office Buildings of Kansas, LLC

Medical Specialties, Inc.

MediStone Healthcare Ventures, Inc.

MediVision of Mecklenburg County, Inc.

MediVision of Tampa, Inc.

MediVision, Inc.

Miami Beach EFL Imaging Center, LLC

MidAmerica Oncology, LLC

Mid-Continent Health Services, Inc.

Middle Georgia Hospital, LLC

Midtown Diagnostics, LLC

Midwest Division - ACH, LLC

Allen County Hospital

Midwest Division - CMC, LLC

Midwest Division - LRHC, LLC

Lafayette Regional Health Center

Midwest Division - LSH, LLC

Lee’s Summit Medical Center

Midwest Division - MCI, LLC

Midwest Division - MII, LLC

Midwest Division - MMC, LLC

Menorah Medical Center

Midwest Division - OPRMC, LLC

Overland Park Regional Medical Center

Midwest Division - PFC, LLC

Midwest Division - RMC, LLC

Research Medical Center

Midwest Division - RPC, LLC

Research Psychiatric Center

Midwest Division - TLM, LLC

Midwest Holdings, Inc.

Midwest Medicine Associates, LLC

Midwest Metropolitan Physicians Group, LLC

Mira Healthcare, LLC

Mobile Corps., Inc.

MRT&C, Inc.

Nashville Shared Services General Partnership

North Augusta Imaging Management, LLC

North Augusta Imaging Services, LLC

North Brandon Imaging, LLC

North Florida Cancer Center Lake City, LLC

North Florida Cancer Center Live Oak, LLC

North Florida Cancer Center Tallahassee, LLC

North Florida Radiation Oncology, LLC

North Miami Beach Surgery Center Limited Partnership

North Miami Beach Surgical Center

North Miami Beach Surgical Center, LLC

North Tampa Imaging, LLC

North Texas Medical Center, Inc.

Northeast Florida Cancer Services, LLC

Northwest Fla. Home Health Agency, Inc.

Notami Hospitals, LLC

Notami, LLC

Notco, LLC

NTGP, LLC

NTMC Ambulatory Surgery Center, L.P.

NTMC Management Company

NTMC Venture, Inc.

Ocala Stereotactic Radiosurgery Partner, LLC

Ocala Stereotactic Radiosurgery, LLC

Ogden Tomotherapy Manager, LLC

Ogden Tomotherapy, LLC

OHH Imaging Services, LLC

Oncology Services of Corpus Christi Manager, LLC

Oncology Services of Corpus Christi, LLC

Orlando Outpatient Surgical Center, Inc.

Outpatient Cardiovascular Center of Central Florida, LLC

Outpatient GP, LLC

Outpatient LP, LLC

Outpatient Services - LAD, LLC

Outpatient Services Holdings, Inc.

Palm Beach EFL Imaging Center, LLC

Palms West Hospital Limited Partnership

Palms West Hospital

Palmyra Park GP, Inc.

Paragon SDS, Inc.

Paragon WSC, Inc.

Parallon Holdings, LLC

Parkland Physician Services, Inc.

Parkway Hospital, Inc.

Pearland Partner, LLC

Pinellas Medical, LLC

Pioneer Medical, LLC

Plano Heart Institute, L.P.

Plano Heart Management, LLC

Plantation General Hospital, L.P.

Mercy Hospital, a Campus of Plantation General Hospital

Plantation General Hospital

PMM, Inc.

POH Holdings, LLC

Portsmouth Regional Ambulatory Surgery Center, LLC

Portsmouth Regional Ambulatory Surgery Center

Preferred Works WC, LLC

Primary Care Acquisition, Inc.

Primary Medical Management, Inc.

Radiation Oncology Manager, LLC

RCH, LLC

Red Rock at Maryland Parkway, LLC

Red Rock at Smoke Ranch, LLC

Red Rock Holdco, LLC

Reston Hospital Center, LLC

Reston Hospital Center

RHA MSO, LLC

Riverside CyberKnife Manager, LLC

Riverside CyberKnife, LLC

Riverside Hospital, Inc.

Riverside Imaging, LLC

RMC HBP, LLC

Round Rock Hospital, Inc.

Samaritan, LLC

San Bernardino Imaging, LLC

San Jose Healthcare System, LP

Regional Medical Center of San Jose

San Jose Hospital, L.P.

San Jose Medical Center, LLC

San Jose, LLC

Sarah Cannon Research Institute, LLC

SCRI Holdings, LLC

Sino American Healthcare Consulting, LLC

SJMC, LLC

SMCH, LLC

South Bay Imaging, LLC

South Brandon Imaging, LLC

South Valley Hospital, L.P.

Southtown Women’s Clinic, LLC

Spalding Rehabilitation L.L.C.

Spalding Rehabilitation Hospital

Spring Hill Imaging, LLC

Springview KY, LLC

Stereotactic Radiosurgery Systems of Brandon, LLC

Stiles Road Imaging LLC

Stones River Hospital, LLC

Suburban Medical Center at Hoffman Estates, Inc.

Summit General Partner, Inc.

Summit Medical Assoc., LLC

Summit Outpatient Diagnostic Center, LLC

Sun Bay Medical Office Building, Inc.

Sun City Imaging, LLC

Sun-Med, LLC

Sunrise Hospital and Medical Center, LLC

Sunrise Hospital & Medical Center

Surgicare of Denton, Inc.

Surgicare of Plano, Inc.

Surgico, LLC

Swedish MOB Acquisition, Inc.

TBHI Outpatient Services, LLC

Terre Haute Hospital GP, Inc.

Terre Haute Hospital Holdings, Inc.

Terre Haute Regional Hospital, L.P.

Terre Haute Regional Hospital

The Medical Group of Kansas City, LLC

Total Imaging - Parsons, LLC

Town Plaza Family Practice, LLC

Trident Medical Center, LLC

Trident Medical Center

Tuckahoe Surgery Center, LP

Parham Surgery Center

Ultra Imaging Management Services, LLC

Ultra Imaging of Tampa, LLC

Utah Medco, LLC

Value Health Management, Inc.

VHSC Plantation, LLC

Vicksburg Diagnostic Services, L.P.

Washington Holdco, LLC

Wesley Cath Lab, LLC

Wesley Manager, LLC

Wesley Medical Center, LLC

Wesley Medical Center

West Boynton Beach Open Imaging Center, LLC

West Florida Imaging Services, LLC

West Florida PET Services, LLC

West Houston, LLC

Westbury Hospital, Inc.

WHG Medical, LLC

WJHC, LLC

Woman’s Hospital Merger, LLC

Women’s Hospital Indianapolis GP, Inc.

Women’s Hospital Indianapolis, L.P.

FLORIDA

Access 2 Health Care Physicians, LLC

Access Health Care Physicians, LLC

Access Management Co., LLC

Ace Leasing II, LLC

All About Staffing, Inc.

Ambulatory Laser Associates, GP

Ambulatory Surgery Center Group, Ltd.

Ambulatory Surgery Center

Atlantis Surgicare, LLC

Aventura Comprehensive Cancer Research Group of Florida, Inc.

Aventura Healthcare Specialists LLC

Aventura Neurosurgery, LLC

BAMI Property, LLC

Bannerman Family Care, LLC

Bay Hospital, Inc.

Gulf Coast Medical Center

Bayonet Point Surgery Center, Ltd.

Bayonet Point Surgery and Endoscopy Center

Bayside Ambulatory Center, LLC

Beach Primary Care, LLC

Behavioral Health Sciences of West Florida, LLC

Belleair Surgery Center, Ltd.

Belleair Surgery Center

Big Cypress Medical Center, Inc.

Bonita Bay Surgery Center, Inc.

Bonita Bay Surgery Center, Ltd.

Bradenton Cardiology Physician Network, LLC

Brandon Surgi-Center, Ltd.

Brandon Surgery Center

Broward Cardiovascular Surgeons, LLC

Broward Healthcare System, Inc.

Broward Neurosurgeons, LLC

Cape Coral Surgery Center, Inc.

Cape Coral Surgery Center, Ltd.

Capital Regional Healthcare, LLC

CCH-GP, Inc.

Cedarcare, Inc.

Cedars BTW Program, Inc.

Cedars Gastroenterologists, LLC

Cedars Healthcare Group, Ltd.

Cedars International Cardiology Consultants, LLC

Cedars Medical Center Hospitalists, LLC

Central Florida Cardiology Interpretations, LLC

Central Florida Division Practice, Inc.

Central Florida Obstetrics & Gynecology Associates, LLC

Central Florida Physician Network, LLC

Central Florida Regional Hospital, Inc.

Central Florida Regional Hospital

Collier County Home Health Agency, Inc.

Columbia Behavioral Health, Ltd.

Columbia Behavioral Healthcare of South Florida, Inc.

Columbia Central Florida Division, Inc.

Columbia Development of Florida, Inc.

Columbia Eye and Specialty Surgery Center, Ltd.

Tampa Eye & Specialty Surgery Center

Columbia Florida Group, Inc.

Columbia Hospital Corporation of Central Miami

Columbia Hospital Corporation of Kendall

Columbia Hospital Corporation of Miami

Columbia Hospital Corporation of Miami Beach

Columbia Hospital Corporation of North Miami Beach

Columbia Hospital Corporation of South Broward

Westside Regional Medical Center

Columbia Hospital Corporation of South Dade

Columbia Hospital Corporation of South Florida

Columbia Hospital Corporation of South Miami

Columbia Hospital Corporation of Tamarac

Columbia Hospital Corporation-SMM

Columbia Jacksonville Healthcare System, Inc.

Columbia Lake Worth Surgical Center Limited Partnership

Columbia Midtown Joint Venture

Columbia North Central Florida Health System Limited Partnership

Columbia North Florida Regional Medical Center Limited Partnership

Columbia Ocala Regional Medical Center Physician Group, Inc.

Columbia Palm Beach Healthcare System Limited Partnership

Columbia Park Healthcare System, Inc.

Columbia Park Medical Center, Inc.

Columbia Physician Services - Florida Group, Inc.

Columbia Primary Care, LLC

Columbia Resource Network, Inc.

Columbia Tampa Bay Division, Inc.

Columbia-Osceola Imaging Center, Inc.

Community Hospital Family Practice, LLC

Coral Springs Surgi-Center, Ltd.

Surgery Center at Coral Springs

Countryside Surgery Center, Ltd.

Countryside Surgery Center

Daytona Medical Center, Inc.

Diagnostic Breast Center, Inc.

Doctors Osteopathic Medical Center, Inc.

Doctors Same Day Surgery Center, Inc.

Doctors Same Day Surgery Center, Ltd.

Doctors Same Day Surgery Center

DOMC Property, LLC

East Florida Behavioral Health Network, LLC

East Florida Division, Inc.

East Florida Emergency Physician Group, LLC

East Florida Hospitalists, LLC

East Florida Primary Care, LLC

East Pointe Hospital, Inc.

Edward White Hospital, Inc.

Edward White Hospital

Emergency Providers Group LLC

Englewood Community Hospital, Inc.

Englewood Community Hospital

Family Care Partners, LLC

Fawcett Memorial Hospital, Inc.

Fawcett Memorial Hospital

Florida Home Health Services-Private Care, Inc.

Florida Outpatient Surgery Center, Ltd.

Florida Surgery Center

Fort Myers Market, Inc.

Fort Pierce Immediate Care Center, Inc.

Fort Pierce Orthopaedics, LLC

Fort Pierce Surgery Center, Ltd.

Fort Walton Beach Medical Center, Inc.

Fort Walton Beach Medical Center

Freeport Family Medicine, LLC

Ft. Pierce Surgicare, LLC

Ft. Walton Beach Anesthesia Services, LLC

Gainesville GYN Oncology of North Florida Regional Medical Center, LLC

Gainesville Physicians, LLC

Galen Diagnostic Multicenter, Ltd.

Galen Hospital-Pembroke Pines, Inc.

Galen of Florida, Inc.

St. Petersburg General Hospital

Galencare, Inc.

Brandon Regional Hospital

Northside Hospital

Grant Center Hospital of Ocala, Inc.

Gulf Coast Inpatient Specialists, LLC

Gulf Coast Medical Center Primary Care, LLC

Gulf Coast Multispecialty Services, LLC

Hamilton Memorial Hospital, Inc.

HCA - Viera ALF, LLC

HCA - WHS Progressive, LLC

HCA - WHS Services, LLC

HCA Family Care Center, Inc.

HCA Health Services of Florida, Inc.

Blake Medical Center

Oak Hill Hospital

Regional Medical Center Bayonet Point

St. Lucie Medical Center

HCA Health Services of Miami, Inc.

HCA Outpatient Clinic Services of Miami, Inc.

HD&S Corp. Successor, Inc.

HealthCoast Physician Group, LLC

Heathrow Internal Medicine, LLC

Heritage Family Care, LLC

Homecare North, Inc.

Hospital Corporation of Lake Worth

ICC Healthcare, LLC

Integrated Regional Lab, LLC

Integrated Regional Laboratories Pathology Services, LLC

Intensive Care Consortium, Inc.

Internal Medicine Services of Osceola, LLC

Jacksonville Multispecialty Services, LLC

Jacksonville Specialists, LLC

Jacksonville Surgery Center, Ltd.

Jacksonville Surgery Center

JFK Internal Medicine Faculty Practice, LLC

JFK Occupational Medicine, LLC

JFK Real Properties, Ltd.

Kendall Healthcare Group, Ltd.

Kendall Regional Medical Center

Kendall Vascular Surgery, LLC

Kingsley Family Care, LLC

Kissimmee Surgicare, Ltd.

Kissimmee Surgery Center

LAD Imaging, LLC

Lake City Regional Medical Group, LLC

Lake Nona Hospital, Inc.

Largo Cardiology, LLC

Largo Medical Center, Inc.

Largo Medical Center

Largo Medical Center - Indian Rocks

Largo Physician Group, LLC

Laurel Grove Surgery Center, LLC

Lawnwood Cardiovascular Surgery, LLC

Lawnwood Healthcare Specialists, LLC

Lawnwood Medical Center, Inc.

Lawnwood Regional Medical Center & Heart Institute

Lawnwood Pavilion Physician Services, LLC

Live Oak Immediate Care Center, LLC

M & M of Ocala, Inc.

Manatee Surgicare, Ltd.

Gulf Coast Surgery Center

Marion Community Hospital, Inc.

Ocala Regional Medical Center

Medical Associates of Ocala, LLC

Medical Center of Port St. Lucie, Inc.

Medical Center of Santa Rosa, Inc.

Medical Imaging Center of Ocala [General Partnership]

Medical Partners of North Florida, LLC

Memorial Family Practice Associates, LLC

Memorial Health Primary Care at St. Johns Bluff, LLC

Memorial Healthcare Group, Inc.

Memorial Hospital Jacksonville

Specialty Hospital

Memorial Neurosurgery Group, LLC

Memorial Surgicare, Ltd.

Plaza Surgery Center II

Mercy ASC, LLC

MHS Partnership Holdings JSC, Inc.

MHS Partnership Holdings SDS, Inc.

Miami Beach Healthcare Group, Ltd.

Aventura Hospital and Medical Center

Miami Lakes Surgery Center, Ltd.

Miami Lakes Surgery Center

Navarre Family Care, LLC

Network MS of Florida, Inc.

New Port Richey Hospital, Inc.

Community Hospital

New Port Richey Surgery Center, Ltd.

New Port Richey Surgery Center

Niceville Family Practice, LLC

North Central Florida Health System, Inc.

North Florida Division I, Inc.

North Florida Division Practice, Inc.

North Florida GI Center GP, Inc.

North Florida GI Center, Ltd.

North Florida Endoscopy Center

North Florida Immediate Care Center, Inc.

North Florida Neurosurgery, LLC

North Florida Outpatient Imaging Center, Ltd.

North Florida Physician Services, Inc.

North Florida Physicians, LLC

North Florida Regional Medical Center, Inc.

North Florida Regional Medical Center

North Florida Regional Medical Center, Inc.

North Florida Regional Otolaryngology, LLC

North Florida Rehab Investments, LLC

North Florida Surgical Associates, LLC

North Palm Beach County Surgery Center, LLC

North County Surgicenter

North River Physician Network, LLC

North Transfer Center, LLC

Northside MRI, Inc.

Northwest Florida Cardiology, LLC

Northwest Florida Healthcare Systems, Inc.

Northwest Florida Multispecialty Physicians, LLC

Northwest Florida Primary Care, LLC

Northwest Medical Center, Inc.

Northwest Medical Center

Notami Hospitals of Florida, Inc.

Lake City Medical Center

Oak Hill Acquisition, Inc.

Oak Hill Family Care, LLC

Oak Hill Hospitalists, LLC

Ocala Health Imaging Services, LLC

Ocala Health Primary Care, LLC

Ocala Health Surgical Group, LLC

Ocala Regional Outpatient Services, Inc.

Okaloosa Hospital, Inc.

Twin Cities Hospital

Okeechobee Hospital, Inc.

Raulerson Hospital

Orange Park Hospitalists, LLC

Orange Park Medical Center, Inc.

Orange Park Medical Center

Orlando Surgicare, Ltd.

Same Day Surgicenter of Orlando

Osceola Neurological Associates, LLC

Osceola Physician Network, LLC

Osceola Regional Hospital, Inc.

Osceola Regional Medical Center

Osceola Regional Hospitalists, LLC

Osceola Surgical Associates, LLC

Outpatient Surgical Services, Ltd.

Outpatient Surgical Services

P&L Associates

Palm Beach General Surgery, LLC

Palm Beach Healthcare System, Inc.

Palm Beach Hospitalists Program, LLC

Palms West Gastroenterology, LLC

Palms West Pediatric Neurosurgery, Inc.

Palms West Surgery Center, Ltd.

Palms West Surgicenter

Park South Imaging Center, Ltd.

Pediatric Intensivist Group, LLC

Pensacola Primary Care, Inc.

Pinellas Surgery Center, Ltd.

Center for Special Surgery

Pinnacle Physician Network, LLC

Port St. Lucie Surgery Center, Ltd.

St. Lucie Surgery Center

Premier Medical Management, Ltd.

Primary Care Medical Associates, Inc.

Pulmonary Renal Intensivist Group, LLC

Putnam Hospital, Inc.

Raulerson Gastroenterology, LLC

Raulerson GYN, LLC

Raulerson Primary Care, LLC

Sarasota Doctors Hospital, Inc.

Doctors Hospital of Sarasota

South Broward Practices, Inc.

South Florida Division Practice, Inc.

South Transfer Center, LLC

Southwest Florida Health System, Inc.

Southwest Florida Regional Medical Center, Inc.

Space Coast Surgical Center, Ltd.

Merritt Island Surgery Center

Specialty Hospitalists at Ft. Walton Beach, LLC

Spinal Disorder and Pain Treatment Institute, LLC

St. Lucie Hospitalists, LLC

St. Lucie Medical Center Hyperbarics, LLC

St. Lucie Medical Center Walk-In Clinic, LLC

St. Lucie Medical Specialists, LLC

St. Lucie West Primary Care, LLC

St. Petersburg General Surgery, LLC

Sun City Hospital, Inc.

South Bay Hospital

Surgery Center of Atlantis, LLC

Atlantis Outpatient Center

Surgery Center of Aventura, Ltd.

Surgery Center of Aventura

Surgery Center of Ft. Pierce, Ltd

Surgery Center of Port Charlotte, Ltd.

Gulf Pointe Surgery Center

Surgical Park Center, Ltd.

Surgical Park Center

Surgicare America - Winter Park, Inc.

Surgicare of Altamonte Springs, Inc.

Surgicare of Aventura, LLC

Surgicare of Bayonet Point, Inc.

Surgicare of Bayside, LLC

Surgicare of Brandon, Inc.

Surgicare of Central Florida, Inc.

Surgicare of Countryside, Inc.

Surgicare of Florida, Inc.

Surgicare of Ft. Pierce, Inc.

Surgicare of Kissimmee, Inc.

Surgicare of Laurel Grove, LLC

Surgicare of Manatee, Inc.

Surgicare of Merritt Island, Inc.

Surgicare of Miami Lakes, LLC

Surgicare of New Port Richey, Inc.

Surgicare of Orange Park, Inc.

Surgicare of Orange Park, Ltd.

Orange Park Surgery Center

Surgicare of Orlando, Inc.

Surgicare of Palms West, LLC

Surgicare of Pinellas, Inc.

Surgicare of Plantation, Inc.

Surgicare of Port Charlotte, LLC

Surgicare of Port St. Lucie, Inc.

Surgicare of St. Andrews, Inc.

Surgicare of St. Andrews, Ltd.

Surgery Center at St. Andrews

Surgicare of Stuart, Inc.

Surgicare of Tallahassee, Inc.

Tallahassee Community Network, Inc.

Tallahassee Medical Center, Inc.

Capital Regional Medical Center

Tallahassee Orthopedic Surgery Partners, Ltd.

Tallahassee Outpatient Surgery Center

Tampa Bay Health System, Inc.

Tampa Surgi-Centre, Inc.

The Neurohealth Sciences Center, LLC

Total Imaging - Hudson, LLC

Total Imaging - North St. Petersburg, LLC

Travel Medicine and Infections, LLC

University Healthcare Specialists, LLC

University Hospital, Ltd.

University Hospital and Medical Center

Venture Ambulatory Surgery Center, LLC

Venture Ambulatory Surgery Center

Venture Medical Management, LLC

West Florida Behavioral Health, Inc.

West Florida Cardiology Network, LLC

West Florida Division, Inc.

West Florida Gulf Coast Primary Care, LLC

West Florida HealthWorks, LLC

West Florida Internal Medicine, LLC

West Florida Physician Network, LLC

West Florida Regional Medical Center, Inc.

West Florida Hospital

West Florida Specialty Physicians, LLC

West Florida Trauma Network, LLC

West Jacksonville Medical Center, Inc.

Westside Surgery Center, Ltd.

Parkside Surgery Center

Wildwood Medical Center, Inc.

Women’s Health Center of Central Florida, LLC

GEORGIA

Acworth Immediate Care, LLC

Albany Family Practice, LLC

Albany Neurosurgery Center, LLC

AOSC Sports Medicine, Inc.

Atlanta Home Care, L.P.

Atlanta Outpatient Surgery Center, Inc.

Atlanta Surgery Center, Ltd.

Atlanta Outpatient Peachtree Dunwoody Center

Atlanta Outpatient Surgery Center

Pediatric Surgery Center at Atlanta Outpatient

Augusta Inpatient Services, LLC

Augusta Multispecialty Services, LLC

Augusta Primary Care Services, LLC

Augusta Specialty Hospitalists, LLC

Buckhead Surgical Services, L.P.

Byron Family Practice, LLC

Cartersville Medical Center, LLC

Cartersville Medical Center

Cartersville Occupational Medicine Center, LLC

Cartersville Physician Practice I, LLC

Cartersville Urgent Care, LLC

CCBH Psychiatric Hospitalists, LLC

Center for Colorectal Care, LLC

Chatsworth Hospital Corp.

Church Street Partners

Coliseum Health Group, Inc.

Coliseum Park Hospital, Inc.

Coliseum Primary Care Services, LLC

Coliseum Primary Healthcare - Macon, LLC

Coliseum Primary Healthcare - Riverside, LLC

Coliseum Professional Associates, LLC

Coliseum Same Day Surgery Center, L.P.

Coliseum Same Day Surgery Center

Columbia Coliseum Same Day Surgery Center, Inc.

Columbia Polk General Hospital, Inc.

Polk Medical Center

Columbia Surgicare of Augusta, Ltd.

Augusta Surgical Center

Columbia-Georgia PT, Inc.

Columbus Cardiology, Inc.

Columbus Doctors Hospital, Inc.

Diagnostic Services, G.P.

Doctors Hospital Center for Occupational Medicine, LLC

Doctors Hospital Columbus GA-Joint Venture

Doctors Hospital of Augusta Neurology, LLC

Doctors Hospital Surgery Center, L.P.

Evans Surgery Center

Doctors-I, Inc.

Doctors-II, Inc.

Doctors-III, Inc.

Doctors-IV, Inc.

Doctors-IX, Inc.

Doctors-V, Inc.

Doctors-VI, Inc.

Doctors-VII, Inc.

Doctors-VIII, Inc.

Doctors-X, Inc.

Dublin Community Hospital, LLC

Dublin Heart Specialists, LLC

Dublin Multispecialty, LLC

Dunwoody Physician Practice Network, Inc.

Eastside General Surgery, LLC

Eastside Medical Center, LLC

Eastside Medical Center

Eastside Surgery Center, LLC

EHCA Diagnostics, LLC

EHCA Eastside Occupational Medicine Center, LLC

EHCA Metropolitan, LLC

EHCA Parkway, LLC

EHCA Peachtree, LLC

EHCA West Paces, LLC

EHCA, LLC

Fairview Medical Services, LLC

Fairview Park, Limited Partnership

Fairview Park Hospital

Georgia Psychiatric Company, Inc.

Grace Family Practice, LLC

Grayson Primary Care, LLC

Greater Gwinnett Internal Medicine Associates, LLC

Greater Gwinnett Physician Corporation

Gwinnett Community Hospital, Inc.

HCA Health Services of Georgia, Inc.

HCOL, Inc.

Heritage Medical Care, LLC

Hospitalists at Fairview Park, LLC

Hughston Hospital Services, LLC

Infectious Diseases Consultants of Southwest Georgia, LLC

Johns Creek Physician Services Corporation

Marietta Outpatient Medical Building, Inc.

Marietta Outpatient Surgery, Ltd.

Marietta Surgical Center

Marietta Surgical Center, Inc.

Med Corp., Inc.

MedFirst, Inc.

Medical Center - West, Inc.

Medical Oncology Associates, LLC

MOSC Sports Medicine, Inc.

North Georgia Primary Care Group, LLC

Northlake Medical Center, LLC

Northlake MultiSpecialty Associates, LLC

Northlake Physician Practice Network, Inc.

Northlake Surgical Center, L.P.

Northlake Surgical Center

Northlake Surgicare, Inc.

Orthopaedic Specialty Associates, L.P.

Orthopaedic Sports Specialty Associates, Inc.

Palmyra Brain & Spine Center, LLC

Palmyra Park Hospital, LLC

Palmyra Professional Fees, LLC

Redmond Anesthesia Services, LLC

Redmond Hospital Services, LLC

Redmond Neurosurgery, LLC

Redmond Park Health Services, Inc.

Redmond Park Hospital, LLC

Redmond Regional Medical Center

Redmond Physician Practice Company

Redmond Physician Practice Company II

Redmond Physician Practice Company III

Redmond Physician Practice XI, LLC

Rockbridge Primary Care, LLC

Rome Imaging Center Limited Partnership

Surgery Center of Rome, L.P.

The Surgery Center of Rome

Surgicare of Augusta, Inc.

Surgicare of Buckhead, LLC

Surgicare of Eastside, LLC

Surgicare of Evans, Inc.

Surgicare of Rome, Inc.

The Rankin Foundation

Urology Center of North Georgia, LLC

West Paces Services, Inc.

IDAHO

East Falls Cardiovascular and Thoracic Surgery, LLC

East Falls OBGYN, LLC

East Falls Plastic Surgery, LLC

Eastern Idaho Health Services, Inc.

Eastern Idaho Regional Medical Center

Eastern Idaho Regional Medical Center Physician Services, LLC

EIRMC Hospitalist Services, LLC

Idaho Physician Services, Inc.

Patients First Neonatology, LLC

Patients First Neurology, LLC

West Valley Medical Center, Inc.

West Valley Medical Center

West Valley Medical Group, LLC

West Valley Professional Fee Billing, LLC

West Valley Therapy Services, LLC

ILLINOIS

Chicago Grant Hospital, Inc.

Columbia Chicago Division, Inc.

Columbia LaGrange Hospital, Inc.

Columbia Surgicare - North Michigan Ave., L.P.

Galen of Illinois, Inc.

Illinois Psychiatric Hospital Company, Inc.

Smith Laboratories, Inc.

INDIA

All About Staffing (India) Private Limited

INDIANA

Advanced Neurosurgery, LLC

Advanced Orthopedics, LLC

Advanced Plastic Surgery Center of Terre Haute, LLC

Advanced Radiation Oncology Care, LLC

Basic American Medical, Inc.

Family Medicine of Terre Haute, LLC

Hospitalists of the Wabash Valley, LLC

Jeffersonville MediVision, Inc.

Regional Hospital Healthcare Partners, LLC

Surgicare of Indianapolis, Inc.

Surgicare of Terre Haute, LLC

Terre Haute Heart Lung Vascular Associates, LLC

Terre Haute MOB, L.P.

Terre Haute Obstetrics and Gynecology, LLC

Wabash Cardiology Associates, LLC

Wabash Valley Hospitalists, LLC

KANSAS

Care for Women, LLC

Family Health Medical Group of Overland Park, LLC

Galichia Anesthesia Services, LLC

Galichia Emergency Physicians, LLC

Heartland Women’s Group at Wesley, LLC

Johnson County Neurology, LLC

Johnson County Surgery Center, L.P.

Surgicenter of Johnson County

Johnson County Surgicenter, L.L.C.

Kansas Pulmonary and Sleep Specialists, LLC

Kansas Trauma and Critical Care Specialists, LLC

Menorah Medical Group, LLC

Menorah Urgent Care, LLC

Mid-America Surgery Center, LLC

Mid-America Surgery Institute, LLC

Mid-America Surgery Institute

Midwest Cardiology Specialists, LLC

Midwest Cardiovascular and Thoracic Surgeons of Kansas, LLC

Midwest Division, Inc.

Midwest Oncology Associates, LLC

Mill Creek Outpatient Services, LLC

MMC Sleep Lab Management, LLC

Neurology Associates of Kansas, LLC

Neuroscience Associates of Kansas City, LLC

OPRMC-HBP, LLC

Overland Park Cardiovascular, Inc.

Overland Park Medical Specialists, LLC

Overland Park Orthopedics, LLC

Overland Park Surgical Specialties, LLC

Paragyn Surgical, LLC

Pediatric Specialty Clinic LLC

Physician Associates of Corporate Woods, LLC

Quivira Internal Medicine, Inc.

Statland Medical Group, LLC

Surgery Center of Overland Park, L.P.

Overland Park Surgery Center

Surgicare of Overland Park, LLC

Surgicare of Wichita, Inc.

Surgicare of Wichita, LLC

Surgicare of Wichita

Surgicenter of Johnson County, Ltd.

Wesley Physician Services, LLC

Wesley Physicians - Anesthesiologist, LLC

Wesley Physicians - Cardiovascular, LLC

Wesley Physicians - Medical Specialties LLC

Wesley Physicians - Obstetrics and Gynecology LLC

Wesley Physicians - Primary Care LLC

Wesley Physicians - Surgical Specialties LLC

KENTUCKY

CHCK, Inc.

Commonwealth Specialists of Kentucky, LLC

Frankfort Hospital, Inc.

Frankfort Orthopedics, LLC

Frankfort Wound Care, LLC

Galen of Kentucky, Inc.

Greenview Hospital, Inc.

Greenview Regional Hospital

Greenview PrimeCare, LLC

Hospitalists at Greenview Regional Hospital, LLC

Kentucky Cardiopulmonary Interpretation Services, LLC

Southern Kentucky Medicine Associates, LLC

Southern Kentucky Neurosurgical Associates, LLC

Southern Kentucky Urology, LLC

Surgery Center of Greenview, L.P.

Surgicare of Greenview, Inc.

Tri-County Community Hospital, Inc.

Western Kentucky Gastroenterology, LLC

LOUISIANA

Acadiana Care Center, Inc.

Acadiana Practice Management, Inc.

Acadiana Regional Pharmacy, Inc.

Avoyelles Family Care (A Medical Limited Liability Company)

Center for Digestive Diseases, LLC

Children’s Multi-Specialty Group, LLC

CLASC Manager, LLC

Columbia Healthcare System of Louisiana, Inc.

Columbia West Bank Hospital, Inc.

Columbia/HCA Healthcare Corporation of Central Louisiana, Inc.

Columbia/HCA of Baton Rouge, Inc.

Columbia/HCA of New Orleans, Inc.

Dauterive Hospital Corporation

Dauterive Hospital

Dauterive Physicians, LLC

Doctors Hospital of Opelousas Limited Partnership

HCA Health Services of Louisiana, Inc.

Lafayette OB Hospitalists, LLC

Lafayette Pediatric Neurology Center, LLC

Lafayette Surgery Center Limited Partnership

Lafayette Surgicare

Lafayette Surgicare, Inc.

Lafayette Urogynecology & Urology Center, LLC

Lakeside Women’s Services, LLC

Lakeview Multispecialty Group, LLC

Louisiana Psychiatric Company, Inc.

Medical Center of Baton Rouge, Inc.

Metairie Primary Care Associates, LLC

Notami (Opelousas), Inc.

Notami Hospitals of Louisiana, Inc.

Rapides Healthcare System, L.L.C.

Rapides Regional Medical Center

Rapides Regional Physician Group Primary Care, LLC

Rapides Regional Physician Group Specialty Care, LLC

Rapides Regional Physician Group, LLC

Rapides Surgery Center, LLC

RMCA Professionals Mgmt, LLC

Southwest Medical Center Family Practice, LLC

Southwest Medical Center Multi-Specialty Group, LLC

Southwest Medical Center Surgical Group, LLC

Surgicare Merger Company of Louisiana

Surgicare of Lakeview, Inc.

Surgicare Outpatient Center of Baton Rouge, Inc.

Surgicenter of East Jefferson, Inc.

The Regional Health System of Acadiana, LLC

The Regional Medical Center of Acadiana

Women’s & Children’s Hospital, a Campus of The Regional Medical Center of Acadiana

TUHC Anesthesiology Group, LLC

TUHC Hospitalist Group, LLC

TUHC Physician Group, LLC

TUHC Primary Care and Pediatrics Group, LLC

TUHC Radiology Group, LLC

Tulane Clinic, LLC

Tulane Professionals Management, L.L.C.

University Healthcare System, L.C.

Tulane University Hospital and Clinic

Uptown Primary Care Associates, LLC

WGH, Inc.

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

Women’s & Children’s Pediatric Orthopedic Center, LLC

Women’s & Children’s Pulmonology Clinic, LLC

Women’s and Children’s Professional Management, L.L.C.

Women’s Multi-Specialty Group, LLC

LUXEMBOURG

HCA Luxembourg 1 Sarl

HCA Luxembourg 2 Sarl

MASSACHUSETTS

Columbia Hospital Corporation of Massachusetts, Inc.

Orlando Outpatient Surgical Center, Ltd.

MISSISSIPPI

Brookwood Medical Center of Gulfport, Inc.

Coastal Imaging Center of Gulfport, Inc.

Coastal Imaging Center, L.P.

Galen of Mississippi, Inc.

Garden Park Hospitalist Program, LLC

Garden Park Investments, L.P.

Garden Park Physician Services Corporation

Gulf Coast Medical Ventures, Inc.

HTI Health Services, Inc.

Orange Grove Surgical Associates, LLC

Southern Urology Associates, LLC

VIP, Inc.

MISSOURI

AB TIC Investments, LLC

Bone & Joint Specialists Physician Group, LLC

Cardiology Associates Medical Group, LLC

Cedar Creek Medical Group, LLC

Centerpoint Cardiology Services, LLC

Centerpoint Clinic of Blue Springs, LLC

Centerpoint Hospital Based Physicians, LLC

Centerpoint Medical Specialists, LLC

Centerpoint Orthopedics, LLC

Centerpoint Physicians Group, LLC

Centerpoint Women’s Services, LLC

Clinishare, Inc.

Endocrinology Associates of Lee’s Summit, LLC

Eye Care Surgicare, Ltd.

Eye Surgicare of Independence, LLC

Family Care at Arbor Walk, LLC

Family Health Specialists of Lee’s Summit, LLC

Foot & Ankle Specialty Services, LLC

Harrisonville Family Medicine Group, LLC

HCA Midwest Comprehensive Care, Inc.

Health Midwest Medical Group, Inc.

Health Midwest Office Facilities Corporation

Health Midwest Ventures Group, Inc.

HEI Missouri, Inc.

HM Acquisition, LLC

Independence Neurosurgery Services, LLC

Independence Surgicare, Inc.

Kansas City Neurology Associates, LLC

Kansas City Perfusion Services, Inc.

Kansas City Pulmonology Practice, LLC

Kansas City Vascular & General Surgery Group, LLC

Lee’s Summit Urgent Care, LLC

Medical Center Imaging, Inc.

Metropolitan Multispecialty Physicians Group, Inc.

Mid-States Financial Services, Inc.

Midwest Cardiovascular & Thoracic Surgery, LLC

Midwest Division - RBH, LLC

Research Belton Hospital

Midwest Division Spine Care, LLC

Midwest Doctor’s Group, LLC

Midwest Infectious Disease Specialists, LLC

Midwest Specialty Care - Lee’s Summit, LLC

Midwest Trauma Services, LLC

Midwest Women’s Healthcare Specialists, LLC

Missouri Healthcare System, L.P.

National Association of Senior Friends

Notami Hospitals of Missouri, Inc.

Nuclear Diagnosis, Inc.

Ozarks Medical Services, Inc.

Precise Imaging, Inc.

Raymore Medical Group, LLC

Research Cardiology Associates, LLC

Research Family Physicians, LLC

Research Internal Medicine, LLC

Research Multi-Specialty Physicians Group, LLC

Research Neurology Associates, LLC

Research Neuroscience Institute, LLC

Research Psychiatric - 1500, LLC

RMC - Pulmonary, LLC

RMC Transplant Physicians, LLC

Surgery Center of Independence, L.P.

Centerpoint Ambulatory Surgery Center

Surgical Care Medical Group, LLC

Surgicare of Kansas City, LLC

Surgicenter of Kansas City, L.L.C.

Surgicenter of Kansas City

Women’s Center at Brookside, LLC

NEVADA

CHC Holdings, Inc.

CHC Venture Co.

CIS Holdings, Inc.

Columbia Hospital Corporation of West Houston

Fremont Women’s Health, LLC

Health Service Partners, Inc.

Las Vegas ASC, LLC

Las Vegas Physical Therapy, Inc.

Las Vegas Surgical Center, a Nevada limited partnership

Las Vegas Surgicare, Inc.

Las Vegas Surgicare, Ltd.

Las Vegas Surgery Center

Nevada Surgery Center of Southern Hills, L.P.

Nevada Surgicare of Southern Hills, LLC

Rhodes Limited-Liability Company

Sahara Outpatient Surgery Center, Ltd.

Sahara Surgery Center

Southern Hills Medical Center, LLC

Southern Hills Hospital & Medical Center

Specialty Surgicare of Las Vegas, LP

Specialty Surgery Center

Sunrise Flamingo Surgery Center, Limited Partnership

Flamingo Surgery Center

Sunrise Mountainview Hospital, Inc.

MountainView Hospital

Sunrise Neuro Sciences, LLC

Sunrise Outpatient Services, Inc.

Sunrise Physician Services, LLC

Sunrise Trauma Services, LLC

Surgicare of Las Vegas, Inc.

Value Health Holdings, Inc.

VH Holdco, Inc.

VH Holdings, Inc.

Western Plains Capital, Inc.

NEW HAMPSHIRE

Appledore Medical Group II, Inc.

Derry ASC, Inc.

HCA Health Services of New Hampshire, Inc.

Parkland Medical Center

Portsmouth Regional Ambulatory Surgery Center

Med-Point of New Hampshire, Inc.

Occupational Health Services of PRH, LLC

Parkland Hospitalists Program, LLC

Parkland Oncology, LLC

Salem Surgery Center, Limited Partnership

Salem Surgery Center

Surgicare of Salem, LLC

NORTH CAROLINA

Brunswick Anesthesia, LLC

CareOne Home Health Services, Inc.

Cumberland Medical Center, Inc.

HCA - Raleigh Community Hospital, Inc.

Heritage Hospital, Inc.

HTI Health Services of North Carolina, Inc.

Mecklenburg Surgical Land Development, Ltd.

Raleigh Community Medical Office Building, Ltd.

Wake Psychiatric Hospital, Inc.

OHIO

Columbia/HCA Healthcare Corporation of Northern Ohio

Columbia-CSA/HS Greater Canton Area Healthcare System, L.P.

Columbia-CSA/HS Greater Cleveland Area Healthcare System, L.P.

Lorain County Surgery Center, Ltd.

Surgicare of Lorain County, Inc.

Surgicare of Westlake, Inc.

Westlake Surgicare, L.P.

OKLAHOMA

Columbia Doctors Hospital of Tulsa, Inc.

Columbia Oklahoma Division, Inc.

Edmond General Surgery, LLC

Edmond Hospitalists, LLC

Edmond Intensivists, LLC

Edmond Physician Hospital Organization, Inc.

Edmond Physician Services, LLC

Edmond Podiatry Associates, LLC

Edmond Spine and Orthopedic Services, LLC

Family Medicine Associates of Edmond, LLC

HCA Health Services of Oklahoma, Inc.

OU Medical Center

OU Medical Center Edmond

Healthcare Oklahoma, Inc.

Medi Flight of Oklahoma, LLC

Medical Imaging, Inc.

Millenium Health Care of Oklahoma, Inc.

Oklahoma Outpatient Surgery Limited Partnership

Oklahoma Surgicare

Oklahoma Physicians - Medical Specialties LLC

Oklahoma Physicians - Obstetrics and Gynecology LLC

Oklahoma Physicians - Primary Care LLC

Oklahoma Physicians - Surgical Specialties LLC

Oklahoma Surgicare, Inc.

Oklahoma Transplant Physicians, LLC

Plains Healthcare System, Inc.

Stephenson Laser Center, L.L.C.

Surgicare of Northwest Oklahoma Limited Partnership

Surgicare of Tulsa, Inc.

SWMC, Inc.

PHILIPPINES

All About Staffing Philippines, Inc.

Career Staffing U.S.A.

SOUTH CAROLINA

C/HCA Development, Inc.

Carolina Regional Surgery Center, Inc.

Carolina Regional Surgery Center, Ltd.

Grande Dunes Surgery Center

Coastal Carolina Home Care, Inc.

Coastal Carolina Multispecialty Associates, LLC

Coastal Carolina Primary Care, LLC

Coastal Inpatient Physicians, LLC

Colleton Ambulatory Care, LLC

Colleton Ambulatory Surgery Center

Colleton Diagnostic Center, LLC

Colleton Medical Anesthesia, LLC

Colleton Medical Hospitalists, LLC

Colleton Neurology Associates, LLC

Colleton Otolaryngology, Head and Neck Surgery, LLC

Columbia/HCA Healthcare Corporation of South Carolina

Columbia-CSA/HS Greater Columbia Area Healthcare System, L.P.

Doctors Hospital North Augusta Imaging Center, LLC

Doctor’s Memorial Hospital of Spartanburg, L.P.

Edisto Multispecialty Associates, Inc.

Grand Strand Senior Health Center, LLC

Grand Strand Specialty Associates, LLC

Grand Strand Surgical Specialists, LLC

North Augusta Rehab Health Center, LLC

North Charleston Diagnostic Imaging Center, LLC

South Atlantic Division, Inc.

South Carolina Imaging Employer Corp.

Tri-County Surgical Specialists, LLC

Trident Behavioral Health Services, LLC

Trident Eye Surgery Center, L.P.

Trident Eye Surgery Center

Trident Medical Services, Inc.

Trident Neonatology Services, LLC

Walterboro Community Hospital, Inc.

Colleton Medical Center

SWITZERLAND

Glemm SA

HCA Switzerland Finance Sarl

HCA Switzerland Holding Sarl

TENNESSEE

Arthritis Specialists of Nashville, Inc.

Athens Community Hospital, Inc.

Atrium Surgery Center, Ltd.

Centennial Cardiovascular Consultants, LLC

Centennial Heart, LLC

Centennial Neuroscience, LLC

Centennial Primary Care, LLC

Centennial Psychiatric Associates, LLC

Centennial Surgery Center, L.P.

Centennial Surgery Center

Centennial Surgical Associates, LLC

Centennial Surgical Clinic, LLC

Central Tennessee Hospital Corporation

Horizon Medical Center

Chattanooga Diagnostic Associates, LLC

Chattanooga Healthcare Network Partner, Inc.

Chattanooga Healthcare Network, L.P.

Columbia Integrated Health Systems, Inc.

Columbia Medical Group - Centennial, Inc.

Columbia Medical Group - Daystar, Inc.

Columbia Medical Group - Parkridge, Inc.

Columbia Medical Group - Southern Hills, Inc.

Columbia Medical Group - The Frist Clinic, Inc.

Dickson Corporate Health Services, LLC

Dickson Surgery Center, L.P.

Frist Clinic Express, LLC

Gastroenterology Specialists of Middle Tennessee, LLC

H2U Wellness Centers, LLC

HCA - Information Technology & Services, Inc.

HCA - IT&S PBS Field Operations, Inc.

HCA ASD Financial Operations, LLC

HCA ASD Sales Services, LLC

HCA Central Group, Inc.

HCA Chattanooga Market, Inc.

HCA Development Company, Inc.

HCA Eastern Group, Inc.

HCA Health Services of Tennessee, Inc.

Centennial Medical Center

Centennial Medical Center at Ashland City

Southern Hills Medical Center

StoneCrest Medical Center

Summit Medical Center

HCA Long Term Health Services of Miami, Inc.

Sister Emmanuel Hospital

HCA Medical Services, Inc.

HCA Physician Services, Inc.

HCA Realty, Inc.

Health to You, LLC

Healthcare Sales National Management Services Group, LLC

Healthtrust, Inc. - The Hospital Company

Hendersonville Hospital Corporation

Hendersonville Medical Center

Hendersonville Hospitalist Services, Inc.

Hendersonville OB/GYN, LLC

Hendersonville Primary Care, LLC

Hermitage Primary Care, LLC

Holly Hill/Charter Behavioral Health System, L.L.C.

Hometrust Management Services, Inc.

Horizon Orthopedics, LLC

Horizon Surgical, LLC

Hospital Corporation of Tennessee

Hospital Realty Corporation

Hospitalists at Centennial Medical Center, LLC

Hospitalists at Horizon Medical Center, LLC

Hospitalists at Parkridge, LLC

Hospitalists at StoneCrest, LLC

HTI Memorial Hospital Corporation

Skyline Madison Campus

Skyline Medical Center

Indian Path Hospital, Inc.

Indian Path Rehabilitation Center, Inc.

Internal Medicine Associates of Southern Hills, LLC

Lookout Valley Medical Center, LLC

Madison Behavioral Health, LLC

Madison Internal Medicine, LLC

McMinnville Cardiology, LLC

Med Group - Southern Hills Hospitalists, LLC

Medical Group - Dickson, Inc.

Medical Group - Southern Hills of Brentwood, LLC

Medical Group - Southern Hills of Nolensville, LLC

Medical Group - Stonecrest FP, Inc.

Medical Group - Stonecrest Pulmonology, LLC

Medical Group - StoneCrest, Inc.

Medical Group - Summit, Inc.

Medical Plaza Ambulatory Surgery Center Associates, L.P.

Plaza Day Surgery

Medical Plaza MRI, L.P.

Middle Tennessee Neurology LLC

Mid-State Physicians, LLC

Nashville Psychiatric Company, Inc.

Natchez Surgery Center, LLC

Network Management Services, Inc.

Neurology Associates of Hendersonville, LLC

North Florida Regional Freestanding Surgery Center, L.P.

North Florida Surgical Pavilion

North Nashville Family Health Center, LLC

NPAS Affiliate, Inc.

NPAS Solutions, LLC

NPAS, Inc.

Old Fort Village, LLC

OneSourceMed, Inc.

Palmer Medical Center, LLC

Parallon Business Solutions, LLC

Parallon Credentialing Solutions, LLC

Parallon Employer, LLC

Parallon Health Information Solutions, LLC

Parallon Payroll Solutions, LLC

Parallon Physician Services, LLC

Parallon Workforce Management Solutions, LLC

Park View Insurance Company

Parkridge East Specialty Associates, LLC

Parkridge Hospitalists, Inc.

Parkridge Medical Associates, LLC

Parkridge Medical Center, Inc.

Parkridge East Hospital

Parkridge Medical Center

Parkridge Valley Hospital

Parkridge Professionals, Inc.

Parkside Surgery Center, Inc.

Plano Ambulatory Surgery Associates, L.P.

Surgery Center of Plano

Portland Primary Care, LLC

Portland Surgical, LLC

Premier ASC, LLC

Pulmonary Medicine of Dickson, LLC

Rio Grande Surgery Center Associates, L.P.

Rio Grande Surgery Center

SCRI Services, LLC

Shelbyville Cardiology, LLC

Signal Mountain Primary Care, LLC

Skyline Medical Group, LLC

Skyline Neuroscience Associates, LLC

Skyline Primary Care, LLC

Skyline Rehab Associates, LLC

Skyline Riverside Medical Group, LLC

Southeast Surgical Solutions, LLC

Southern Hills Neurology Consultants, LLC

Southern Hills Orthopaedic Consultants, LLC

Specialist Group at Centennial, LLC

Spring Hill Hospital, Inc.

Spring Hill Physicians, LLC

SRS Acquisition, Inc.

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

St. Mark’s Outpatient Surgery Center

Sterling Primary Care Associates, LLC

Stonecrest Medical Group - Family Practice of Murfreesboro, LLC

Stonecrest Medical Group - SC Murfreesboro Family Practice, LLC

Sullins Surgical Center, Inc.

Summit Convenient Care at Lebanon, LLC

Summit Heart, LLC

Summit Research Solutions, LLC

Summit Surgery Center, L.P.

Summit Surgery Center

Summit Surgical Associates, LLC

Summit Walk-in Clinic, LLC

Surgery Center of Chattanooga, L.P.

Surgery Center of Chattanooga

Surgicare of Chattanooga, LLC

Surgicare of Dickson, LLC

Surgicare of Madison, Inc.

Surgicare of Natchez, LLC

Surgicare of Premier Orthopaedic, LLC

Surgicare of Southern Hills, Inc.

Surgicare of Wilson County, LLC

Surgicare Outpatient Center of Jackson, Inc.

Sycamore Shoals Hospital, Inc.

TCMC Madison-Portland, Inc.

Tennessee Healthcare Management, Inc.

Tennessee Valley Outpatient Diagnostic Center, LLC

The Charter Cypress Behavioral Health System, L.L.C.

Trident Ambulatory Surgery Center, L.P.

Trident Ambulatory Surgery Center

TriStar Cardiovascular Surgery, LLC

TriStar Health System, Inc.

TriStar Medical Group - Centennial Primary Care, LLC

TriStar OB/GYN, LLC

Vascular and Endovascular Specialists, LLC

Vision Holdings, LLC

Wilson County Outpatient Surgery Center, L.P.

TEXAS

Administrative Physicians of North Texas, PLLC

All About Staffing of Texas, Inc.

Ambulatory Endoscopy Clinic of Dallas, Ltd.

Ambulatory Endoscopy Clinic of Dallas

Arlington Diagnostic South, Inc.

Arlington Neurosurgeons, PLLC

Arlington Primary Care, PLLC

Arlington Primary Medicine, PLLC

Arlington Vascular Surgery, PLLC

Austin Heart Cardiology MSO, LLC

Austin Heart, PLLC

Austin Medical Center, Inc.

Austin Physicians Management, LLC

Austin Urogynecology, PLLC

Bailey Square Ambulatory Surgical Center, Ltd.

Bailey Square Surgery Center

Bailey Square Outpatient Surgical Center, Inc.

Barrow Medical Center CT Services, Ltd.

Bay Area Healthcare Group, Ltd.

Corpus Christi Medical Center

Bay Area Surgical Center Investors, Ltd.

Bay Area Surgicare Center, Inc.

Bayshore Occupational and Family Medicine, PLLC

Bayshore Surgery Center, Ltd.

Bedford-Northeast Community Hospital, Inc.

Bellaire Imaging, Inc.

Brownsville Specialists of Texas, PLLC

Brownsville Surgical Specialists, PLLC

Brownsville-Valley Regional Medical Center, Inc.

C. Medrano, M.D., PLLC

Calder Urgent Care, PLLC

Calloway Creek Surgery Center, L.P.

Calloway Creek Surgicare, LLC

Capital Area Cardiology

Capital Area Occupational Medicine, PLLC

Capital Area Primary Care, PLLC

Capital Area Providers

Capital Area Specialists, PLLC

Capital Area Surgeons, PLLC

Cardio Vascular Surgeons of North Texas, PLLC

Cardiology Specialists of North Texas, PLLC

Central San Antonio Surgical Center Investors, Ltd.

Central Texas Cardiac Arrhythmia Physicians, PLLC

CHC Management, Ltd.

CHC Payroll Company

CHC Realty Company

CHCA Pearland, L.P.

CHC-El Paso Corp.

CHC-Miami Corp.

Christina Cano-Gonzalez, M.D., PLLC

Clear Lake Family Physicians, PLLC

Clear Lake Multi-Specialty Group, PLLC

Clear Lake Regional Medical Center, Inc.

Clear Lake Surgicare, Ltd.

Bay Area Surgicare Center

Coastal Bend Hospital CT Services, Ltd.

Collin County Diagnostic Associates, PLLC

COL-NAMC Holdings, Inc.

Columbia Ambulatory Surgery Division, Inc.

Columbia Bay Area Realty, Ltd.

Columbia Call Center, Inc.

Columbia Central Group, Inc.

Columbia Champions Treatment Center, Inc.

Columbia GP of Mesquite, Inc.

Columbia Greater Houston Division Healthcare Network, Inc.

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

Medical City Dallas Hospital

Columbia Hospital Corporation at the Medical Center

Columbia Hospital Corporation of Arlington

Columbia Hospital Corporation of Bay Area

Columbia Hospital Corporation of Corpus Christi

Columbia Hospital-El Paso, Ltd.

Columbia Medical Arts Hospital Subsidiary, L.P.

Columbia Medical Center at Lancaster Subsidiary, L.P.

Columbia Medical Center Dallas Southwest Subsidiary, L.P.

Columbia Medical Center of Arlington Subsidiary, L.P.

Medical Center of Arlington

Columbia Medical Center of Denton Subsidiary, L.P.

Denton Regional Medical Center

Columbia Medical Center of Las Colinas, Inc.

Las Colinas Medical Center

Columbia Medical Center of Lewisville Subsidiary, L.P.

Medical Center of Lewisville

Columbia Medical Center of McKinney Subsidiary, L.P.

Medical Center of McKinney

Columbia Medical Center of Plano Subsidiary, L.P.

Medical Center of Plano

Columbia North Hills Hospital Subsidiary, L.P.

North Hills Hospital

Columbia North Texas Healthcare System, L.P.

Columbia North Texas Subsidiary GP, LLC

Columbia North Texas Surgery Center Subsidiary, L.P.

Columbia Northwest Medical Center Partners, Ltd.

Columbia Northwest Medical Center, Inc.

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

Plaza Medical Center of Fort Worth

Columbia Psychiatric Management Co.

Columbia South Texas Division, Inc.

Columbia Specialty Hospital of Dallas Subsidiary, L.P.

Columbia Specialty Hospitals, Inc.

Columbia Surgery Group, Inc.

Columbia/HCA Healthcare Corporation of Central Texas

Columbia/HCA Heartcare of Corpus Christi, Inc.

Columbia/HCA International Group, Inc.

Columbia/HCA of Houston, Inc.

Columbia/HCA of North Texas, Inc.

Columbia/HCA Physician Hospital Organization Medical Center Hospital

Columbia-Quantum, Inc.

Comprehensive Radiology Management Services, Ltd.

Congenital Heart Surgery Center, PLLC

Conroe Hospital Corporation

Conroe Orthopedic Specialists, PLLC

Conroe Specialists of Texas, PLLC

Corpus Christi Healthcare Group, Ltd.

Corpus Christi Primary Care Associates, PLLC

Corpus Christi Radiation Oncology, PLLC

Corpus Christi Surgery Center, L.P.

Corpus Christi Surgery, Ltd.

Corpus Surgicare, Inc.

CP Surgery Center, LLC

Dallas Cardiology Specialists, PLLC

Dallas CardioThoracic Surgery Consultants, PLLC

Dallas Hand Surgery Center, PLLC

Dallas Neuro-Stroke Affiliates, PLLC

Deep Purple Investments, LLC

Denton Cancer Center, PLLC

Denton County Hospitalist Program, PLLC

Denton Pediatric Physicians, PLLC

Denton Primary Care, PLLC

Denton Regional Ambulatory Surgery Center, L.P.

Day Surgery Center at Denton Regional Medical Center

DFW Physicians Group, PLLC

Doctors Bay Area Physician Hospital Organization

Doctors Hospital (Conroe), Inc.

E.P. Physical Therapy Centers, Inc.

East Houston Specialists, PLLC

El Paso Healthcare Provider Network

El Paso Healthcare System Physician Services, LLC

El Paso Healthcare System, Ltd.

Las Palmas Del Sol Healthcare

El Paso Nurses Unlimited, Inc.

El Paso Primary Care, PLLC

El Paso Surgery Centers, L.P.

East El Paso Surgery Center

Surgical Center of El Paso

El Paso Surgicenter, Inc.

Eldridge Family Practitioners, PLLC

Elite Family Health of Plano, PLLC

Elite OB-GYN Services of El Paso, PLLC

Elite Orthopaedics of El Paso, PLLC

Elite Orthopaedics of Irving, PLLC

Elite Orthopaedics of Plano, PLLC

Emergency Psychiatric Medicine, PLLC

Endoscopy Clinic of Dallas, Inc.

Endoscopy of Plano, L.P.

Endoscopy of Plano

Endoscopy Surgicare of Plano, LLC

EPIC Properties, Inc.

EPSC, L.P.

Family First Medicine in Brownsville, PLLC

Family Practitioners of Montgomery, PLLC

Family Practitioners of Pearland, PLLC

Flower Mound Surgery Center, Ltd.

Fort Worth Investments, Inc.

Frisco Warren Parkway 91, Inc.

G. Rowe, M.D. , PLLC

G. Schnider, M.D., PLLC

Galen Hospital of Baytown, Inc.

General and Cardiovascular Surgeons of Conroe, PLLC

General Surgeons of Houston, PLLC

General Surgeons of North Richland Hills, PLLC

General Surgeons of Pasadena, PLLC

GI Associates of Denton, PLLC

Gramercy Surgery Center, Ltd.

Gramercy Outpatient Surgery Center

Greater Houston Preferred Provider Option, Inc.

Green Oaks Hospital Subsidiary, L.P.

Green Oaks Hospital

Gulf Coast Division, Inc.

Gulf Coast Physician Administrators, Inc.

H2U Wellness Centers - PISD, PLLC

H2U Wellness Centers - San Benito CISD, PLLC

HCA Central/West Texas Physicians Management, LLC

HCA Health Services of Texas, Inc.

HCA Pearland GP, Inc.

HCA Plano Imaging, Inc.

HCA Western Group, Inc.

HCAPS Conroe Affiliation, Inc.

Heart Specialist of North Texas, PLLC

Heartcare of Texas, Ltd.

Hidalgo County Family Practitioners, PLLC

Hidden Lakes Health Center, PLLC

Hip & Joint Specialists of North Texas, PLLC

Houston Northwest Surgical Partners, Inc.

Houston Pediatric Specialty Group, PLLC

HPG Energy, L.P.

HPG GP, LLC

HTI Gulf Coast, Inc.

HWCA, PLLC

Internal Medicine Associates of Huntsville, PLLC

J. M. Garcia, M.D., PLLC

Kathy L. Summers, M.D., PLLC

Kennedale Primary Care PLLC

Kingwood Multi-Specialty Group, PLLC

Kingwood Surgery Center, LLC

Humble Kingwood Endoscopy Center

KPH-Consolidation, Inc.

Kingwood Medical Center

Kyle Primary Care, PLLC

Las Colinas Primary Care, PLLC

Las Colinas Surgery Center, Ltd.

Las Colinas Surgery Center

Leadership Healthcare Holdings II L.P., L.L.P.

Leadership Healthcare Holdings L.P., L.L.P.

Leslie Cohan, M.D., PLLC

Longview Regional Physician Hospital Organization, Inc.

M. Jamshidi, D.O., PLLC

Mainland Family Medicine, PLLC

Mainland Multi-Specialty Group, PLLC

Mainland Primary Care Physicians, PLLC

Mark Gottesman, M.D., PLLC

Mary Alice Cowan, M.D., PLLC

Maternal Fetal Medicine Specialists of Corpus Christi, PLLC

McKinney Surgeons, PLLC

MEC Endoscopy, LLC

Med City Dallas Outpatient Surgery Center, L.P.

Medical City Dallas Ambulatory Surgery Center

Med-Center Hosp./Houston, Inc.

Medical Care Surgery Center, Inc.

Medical City Dallas Hospital, Inc.

MediPurchase, Inc.

Methodist Healthcare System of San Antonio, Ltd., L.L.P.

Methodist Ambulatory Surgery Hospital - Northwest

Methodist Hospital

Methodist Specialty and Transplant Hospital

Methodist Stone Oak Hospital

Methodist Texsan Hospital, a Methodist Hospital facility

Metropolitan Methodist Hospital

Northeast Methodist Hospital

Methodist Medical Center ASC, L.P.

Methodist Ambulatory Surgery Center - Medical Center

Metroplex Surgicenters, Inc.

MGH Medical, Inc.

MHS SC Partner, L.L.C.

MHS Surgery Centers, L.P.

Mid-Cities Surgi-Center, Inc.

Movement Disorders of North Texas, PLLC

National Patient Account Services, Inc.

Navarro Memorial Hospital, Inc.

Neuro Texas, PLLC

Neuro-Hospitalist of Clear Lake, PLLC

Neurological Eye Specialists of North Texas, PLLC

Neurological Specialists of McKinney, PLLC

Neurological Specialists, PLLC

Neurosurgical Specialists of El Paso, PLLC

Neurosurgical Specialists of North Texas, PLLC

North Austin Maternal Fetal Medicine, PLLC

North Austin Plastic Surgery Associates, PLLC

North Austin Surgery Center, L.P.

North Austin Surgery Center

North Central Methodist ASC, L.P.

Methodist Ambulatory Surgery Center - North Central

North Hills Cardiac Catheterization Center, L.P.

North Hills Catheterization Lab, LLC

North Hills Primary Care, PLLC

North Hills Surgicare, L.P.

Texas Pediatric Surgery Center

North Shore Specialists of Texas, PLLC

North Texas Cardiology, PLLC

North Texas Craniofacial Fellowship Program, PLLC

North Texas Division, Inc.

North Texas General, L.P.

North Texas Geriatrics, PLLC

North Texas Heart Surgery Center, PLLC

North Texas Internal Medicine Specialists, PLLC

North Texas Neuro Stroke OP, PLLC

North Texas of Hope, PLLC

North Texas Pulmonary Critical Care, PLLC

North Texas Sports and Orthopedics Center, PLLC

North Texas Stroke Center, PLLC

Northeast Methodist Surgicare, Ltd.

Northeast PHO, Inc.

Oakwood Surgery Center, Ltd., LLP

Oakwood Surgery Center

OB Hospitalists of Woman’s Hospital, PLLC

OB/Gyn Associates of Denton, PLLC

OB/GYN of Brownsville, PLLC

Occupational and Family Medicine of South Texas

Orthopedic Hospital, Ltd.

Texas Orthopedic Hospital

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

Fannin Surgicare

Paragon of Texas Health Properties, Inc.

Paragon Physicians Hospital Organization of South Texas, Inc.

Paragon Surgery Centers of Texas, Inc.

Park Central Surgical Center, Ltd.

Park Central Surgical Center

Parkway Cardiac Center, Ltd.

Parkway Surgery Services, Ltd.

Pasadena Bayshore Hospital, Inc.

Pediatric Cardiac Intensivists of North Texas, PLLC

Pediatric Hospitalists of Conroe, PLLC

Pediatric Intensivists of El Paso, PLLC

Pediatric Specialists of Clear Lake, PLLC

Pediatric Surgicare, Inc.

Physicians Ambulatory Surgery Center, LLC

Physicians Endoscopy Center

Plano Surgery Center - GP, LLC

Plano Urology, PLLC

Plaza Primary Care, PLLC

Plaza Transplant Center, PLLC

Primary Care Plano, PLLC

Primary Care South, PLLC

Primary Care West, PLLC

Primary Health Network of South Texas

Quantum/Bellaire Imaging, Ltd.

Rim Building Partners, L.P.

Rio Grande Healthcare MSO, Inc.

Rio Grande NP, Inc.

Rio Grande Regional Hospital, Inc.

Rio Grande Regional Investments, Inc.

Rio Grande Valley Cardiology, PLLC

Rosewood Medical Center, Inc.

Rosewood Professional Building, Ltd.

Royal Oaks Surgery Center, L.P.

S. Faro, M.D. & C. Faro, M.D., PLLC

S.A. Medical Center, Inc.

San Antonio Division, Inc.

San Antonio Regional Hospital, Inc.

Sante Fe Family Practitioners, PLLC

SAPN, LLC

South Austin Surgery Center, Ltd.

Surgicare of South Austin

South Texas Surgicare, Inc.

Southern Texas Physicians’ Network

Specialty Associates of West Houston, PLLC

Spring Branch Family Practitioners, PLLC

Spring Branch Medical Center, Inc.

St. David’s Healthcare Partnership, L.P., LLP

Heart Hospital of Austin

North Austin Medical Center

Round Rock Medical Center

St. David’s Georgetown Hospital

St. David’s Medical Center

St. David’s South Austin Medical Center

St. David’s Cardiology, PLLC

St. David’s Neurology, PLLC

St. David’s OB Hospitalist, PLLC

STPN Manager, LLC

Sugar Land Surgery Center, Ltd.

Sugar Land Surgery Center

Sun Towers/Vista Hills Holding Co.

Surgical Center of Irving, Inc.

Surgical Facility of West Houston, L.P.

Surgical Specialists of Clear Lake, PLLC

Surgical Specialists of Corpus Christi, PLLC

Surgicare of Arlington, LLC

Surgicare of Central Park Surgery Center, LLC

Surgicare of Central San Antonio, Inc.

Surgicare of Flower Mound, Inc.

Surgicare of Fort Worth Co-GP, LLC

Surgicare of Fort Worth, Inc.

Surgicare of Gramercy, Inc.

Surgicare of Houston Women’s, Inc.

Surgicare of Kingwood, LLC

Surgicare of McKinney, Inc.

Surgicare of Medical City Dallas, LLC

Surgicare of Memorial Endoscopy, LLC

Surgicare of North Austin, LLC

Surgicare of North San Antonio, Inc.

Surgicare of Northeast San Antonio, Inc.

Surgicare of Pasadena, Inc.

Surgicare of Round Rock, Inc.

Surgicare of Royal Oaks, LLC

Surgicare of South Austin, Inc.

Surgicare of Southwest Houston, LLC

Surgicare of Sugar Land, Inc.

Surgicare of Travis Center, Inc.

Tarrant County Surgery Center, L.P.

Trinity Park Surgery Center

Texas Psychiatric Company, Inc.

The West Texas Division of Columbia, Inc.

THN Physicians Association, Inc.

Travis Surgery Center, L.P.

Tuscan Imaging Center at Las Colinas, LLC

Urological Specialists of Arlington, PLLC

Urology Services of El Paso, PLLC

Village Oaks Medical Center, Inc.

W & C Hospital, Inc.

West Houston ASC, Inc.

West Houston Healthcare Group, Ltd.

West Houston Internal Specialists, PLLC

West Houston Outpatient Medical Facility, Inc.

West Houston Surgicare, Inc.

West LPN Fort Worth Oncology, PLLC

West LPN, Inc.

West McKinney Imaging Services, LLC

West Park Surgery Center, L.P.

McKinney Surgery Center

WHMC, Inc.

Woman’s Health Group, PLLC

Woman’s Hospital of Texas, Incorporated

Women Practitioners of Houston, PLLC

Women Specialists of Bayshore, PLLC

Women Specialists of Mainland, PLLC

Women’s Link Specialty Obstetrical Referral Clinic, PLLC

Women’sLink Center of Wylie - A Medical Center of Plano Facility, LLC

UNITED KINGDOM

All About Staffing (UK) Limited

Carriford Management Limited

Chelsea Outpatient Centre LLP

Enhancecorp Limited

Galen Health Partners Limited

Hamsard 3160 Limited

Hamsard 3214 LLP

Harley Street Clinic @ The Groves LLP

HCA Finance, LP

HCA International Holdings Limited

HCA International Limited

Princess Grace Hospital

The Harley Street Clinic

The Portland Hospital for Women and Children

The Wellington Hospital

HCA Luxembourg Finance Limited

HCA Purchasing Limited

HCA Staffing Limited

HCA UK Capital Limited

HCA UK Holdings Limited

HCA UK Investments Limited

HCA UK Limited

HCA UK Services, Ltd.

Healthtrust-Europe Company Limited

Healthtrust-Europe LLP

Indemed Managed Services Limited

La Tour Finance Limited Partnership

Leaders in Oncology Care Limited

Leaders in Oncology Care Network Limited

LOC @ The Christie LLP

LOC @ The London Bridge Hospital LLP

LOC @ The Wellington Hospital LLP

Platinum Medical Centre

LOC Partnership LLP

London Back Limited

London Radiography & Radiotherapy Services Limited

PET CT LLP

Robotic Radiosurgery LLP

Roodlane Medical Limited

Sarah Cannon Research UK Limited

SCRI Global Services Limited

St. Martins Healthcare Limited

Lister Hospital

London Bridge Hospital

St. Martins Ltd.

St. Martins Medical Services Limited

The Christie Clinic LLP

The Harley Street Cancer Clinic Limited

The London Stone Centre Limited

Twenty Seven Welbeck Street Limited

Wellington Diagnostic Services LLP

UTAH

Alta Internal Medicine, LLC

Bountiful Surgery Center, LLC

Lakeview Endoscopy Center

Brigham City Community Hospital Physician Services, LLC

Brigham City Community Hospital, Inc.

Brigham City Community Hospital

Brigham City Health Plan, Inc.

Columbia Ogden Medical Center, Inc.

Ogden Regional Medical Center

East Layton Internal Medicine, LLC

General Hospitals of Galen, Inc.

Gynecology Specialists of Utah, LLC

Healthtrust Utah Management Services, Inc.

Hospital Corporation of Utah

Lakeview Hospital

HTI Physician Services of Utah, Inc.

Jordan Family Health, L.L.C.

Lakeview Hospital Physician Services, LLC

Lakeview Internal Medicine, LLC

Lakeview Neurosurgery Clinic, LLC

Lakeview Professional Billing, LLC

Lakeview Urology & General Surgery, LLC

Layton Family Practice, LLC

Lone Peak General Surgery, LLC

Lone Peak Hospital, Inc.

Maternal Fetal Services of Utah, LLC

Mountain Division, Inc.

Mountain View Hospital, Inc.

Mountain View Hospital

Mountain View Medical Office Building, Ltd.

Mountain West Surgery Center, LLC

Mountain West Surgery Center

MountainStar Brigham General Surgery, LLC

Mountainstar Brigham OBGYN, LLC

MountainStar Canyon Surgical Clinic, LLC

MountainStar Cardiology Ogden Regional, LLC

MountainStar Cardiology St. Marks, LLC

Mountainstar Cardiovascular Services, LLC

MountainStar Medical Group - Brigham City Community Hospital, LLC

MountainStar Medical Group - Ogden Regional Medical Center, LLC

MountainStar Medical Group - St. Mark’s Hospital, LLC

MountainStar Medical Group Neurosurgery - St. Mark’s, LLC

Mountainstar Ogden Pediatrics, LLC

MVH Professional Services, LLC

Northern Utah Healthcare Corporation

St. Mark’s Hospital

Northern Utah Healthcare Imaging Holdco, LLC

Northern Utah Imaging, LLC

Ogden Imaging, LLC

Ogden Internal Medicine & Urology, LLC

Ogden Regional Health Plan, Inc.

Ogden Regional Medical Center Professional Billing, LLC

Ogden Senior Center, LLC

Salt Lake City Surgicare, Inc.

Shadow Mountain Family Medicine, LLC

St. Mark’s Gynecology Oncology Care, LLC

St. Mark’s Investments, Inc.

St. Mark’s Physicians, Inc.

St. Mark’s Professional Services, LLC

St. Mark’s South Jordan Family Practice, LLC

Surgicare of Bountiful, LLC

Surgicare of Mountain West, LLC

Surgicare of Utah, LLC

Surgicare of Wasatch Front, LLC

The Wasatch Endoscopy Center, Ltd.

Wasatch Endoscopy Center

Timpanogos Pain Specialists, LLC

Timpanogos Professional Services, LLC

Timpanogos Regional Medical Services, Inc.

Timpanogos Regional Hospital

Utah Imaging GP, LLC

Utah Surgery Center, L.P.

South Towne Surgery Center

Wasatch Front Surgery Center, LLC

Utah Surgical Center

West Jordan Hospital Corporation

West Valley Imaging, LLC

VIRGINIA

Alleghany General and Bariatric Services, LLC

Alleghany Hospitalists, LLC

Alleghany Primary Care, Inc.

Alleghany Specialists, LLC

Ambulatory Services Management Corporation of Chesterfield County, Inc.

Appomattox Imaging, LLC

Arlington Surgery Center, L.P.

Arlington Surgicare, LLC

Ashburn ASC, LLC

Ashburn Imaging, LLC

Atrium Surgery Center, L.P.

Atrium Surgicare, LLC

Blacksburg Family Care, LLC

Buford Road Imaging, L.L.C.

Capital Anesthesia Services, LLC

Capital Division, Inc.

Cardiac Surgical Associates, LLC

Cardiothoracic Surgeons of Roanoke Valley, LLC

Carlin Springs Urgent Care, LLC

Central Shared Services, LLC

Chesterfield Imaging, LLC

Chippenham & Johnston-Willis Hospitals, Inc.

CJW Medical Center

Chippenham & Johnston-Willis Sports Medicine, LLC

Chippenham Ambulatory Surgery Center, LLC

Chippenham Pediatric Specialists, LLC

Christiansburg Family Medicine, LLC

Christiansburg Internal Medicine, LLC

CJW Infectious Disease, LLC

CJW Wound Healing Center, LLC

Colonial Heights Ambulatory Surgery Center, L.P.

Colonial Heights Surgery Center

Colonial Heights Surgicare, LLC

Columbia Arlington Healthcare System, L.L.C.

Columbia Healthcare of Central Virginia, Inc.

Columbia Medical Group - Southwest Virginia, Inc.

Columbia Pentagon City Hospital, L.L.C.

Columbia/Alleghany Regional Hospital, Incorporated

LewisGale Hospital Alleghany

Columbia/HCA John Randolph, Inc.

John Randolph Medical Center

Commonwealth Perinatal Services, LLC

Crewe Outpatient Imaging, LLC

CVMC Property, LLC

Daleville Imaging Manager, LLC

Daleville Imaging, L.P.

Dominion Hospital Physicians’ Group, LLC

Fairfax Surgical Center, L.P.

Fairfax Surgical Center

Family Medicine of Blacksburg, LLC

Family Practice at Forest Hill, LLC

Family Practice at Retreat, LLC

Fort Chiswell Family Practice, LLC

Galen of Virginia, Inc.

Galen Property, LLC

Galen Virginia Hospital Corporation

Generations Family Practice, Inc.

GYN-Oncology of Southwest Virginia, LLC

Hanover Outpatient Surgery Center, L.P.

Hanover Outpatient Surgery Center

HCA Health Services of Virginia, Inc.

Henrico Doctors’ Hospital

Henrico Doctors’ Hospital-Forest Campus

Parham Doctors’ Hospital - A Campus of Henrico Doctors’ Hospital

Retreat Doctors’ Hospital - A Campus of Henrico Doctors’ Hospital

HCA Richmond Division, Inc.

HDH Thoracic Surgeons, LLC

Henrico Doctors’ Family Medicine, LLC

Henrico Doctors’ Neurology Associates, LLC

Henrico Doctor’s OB GYN Specialists, LLC

Henrico Radiation Oncology, LLC

Henrico Surgical Specialists, LLC

HSS Virginia, L.P.

Institute of Advanced ENT Surgery, LLC

Internal Medicine of Blacksburg, LLC

James River Internists, LLC

John Randolph Family Practice, LLC

John Randolph OB/GYN, LLC

John Randolph Surgeons, LLC

Lewis Gale Physicians Specialists, LLC

Lewis-Gale Hospital, Incorporated

Lewis-Gale Physicians, LLC

LGMC Ambulatory Surgery Center, LLC

Loudoun Surgery Center, L.P.

Loudoun Surgery Center, LLC

Management Services of the Virginias, Inc.

Mechanicsville Imaging, LLC

Montgomery Cancer Center, LLC

Montgomery Hospitalists, LLC

Montgomery Regional Hospital, Inc.

LewisGale Hospital Montgomery

Montgomery Surgery Associates, LLC

Northern Virginia Community Hospital, LLC

Northern Virginia Hospital Corporation

Orthopedics Specialists, LLC

Pediatric Specialists for CJW, LLC

Preferred Hospitals, Inc.

Primary Care of West End, LLC

Primary Health Group, Inc.

Pulaski Community Hospital, Inc.

LewisGale Hospital Pulaski

Pulaski Radiologists, LLC

Pulaski Urology, LLC

Quick Care Centers, LLC

Radford Family Medicine, LLC

Reston Hospitalists, LLC

Reston Surgery Center, L.P.

Reston Surgery Center

Retreat Cardiology, LLC

Retreat Hospital, LLC

Retreat Internal Medicine, LLC

Retreat Surgical Associates, LLC

Richmond Imaging Employer Corp.

Richmond Multi-Specialty, LLC

Richmond Pediatric Surgeon’s, LLC

Roanoke Imaging, LLC

Roanoke Neurosurgery, LLC

Roanoke Surgery Center, L.P.

Blue Ridge Surgery Center

Roanoke Valley Gynecology, LLC

Salem Hospitalists, LLC

Short Pump Imaging, LLC

Southwest Virginia Fertility Center, LLC

Southwest Virginia Orthopedics and Spine, LLC

Specialty Physicians of Northern Virginia, LLC

Spotsylvania Condominium Property, LLC

Spotsylvania Medical Center, Inc.

Spotsylvania Regional Medical Center

Spotsylvania Multi-Specialty Group, LLC

Spotsylvania Regional Surgery Center, LLC

Stafford Imaging, LLC

Surgical Associates of Southwest Virginia, LLC

Surgical Associates of the New River Valley, LLC

Surgicare of Ashburn, LLC

Surgicare of Chippenham, LLC

Surgicare of Fairfax, Inc.

Surgicare of Hanover, Inc.

Surgicare of Reston, Inc.

Surgicare of Roanoke, LLC

Surgicare of Spotsylvania, LLC

Surgicare of Tuckahoe, Inc.

Tri-City Multi-Specialty, LLC

Urology Specialists of Richmond, LLC

Virginia Gynecologic Oncology, LLC

Virginia Hematology & Oncology Associates, Inc.

Virginia Hospitalists, Inc.

Virginia Psychiatric Company, Inc.

Dominion Hospital

West Creek Ambulatory Surgery Center, LLC

West Creek Medical Center, Inc.

Women’s & Children’s Center, LLC

Women’s Health Center of SWVA, LLC

WASHINGTON

ACH, Inc.

Capital Network Services, Inc.

WEST VIRGINIA

Columbia Parkersburg Healthcare System, LLC

Galen of West Virginia, Inc.

HCA Health Services of West Virginia, Inc.

Hospital Corporation of America

Parkersburg SJ Holdings, Inc.

Teays Valley Health Services, LLC

Tri Cities Health Services Corp.

EX-23

Exhibit 23

Consent of Independent Registered Public Accounting Firm

We consent to the incorporation by reference in the following Registration Statements:

(1) Registration Statement (Form S-8 No. 333-173866) pertaining to the HCA-Hospital Corporation of America Nonqualified Initial Option Plan, HCA, Inc. 2000 Equity Incentive Plan and HCA 2005 Equity Incentive Plan,

(2) Registration Statement (Form S-8 No. 333-172887) pertaining to the 2006 Stock Incentive Plan for Key Employees of HCA Holdings, Inc. and its Affiliates, as Amended and Restated of HCA Holdings, Inc.,

(3) Registration Statement (Form S-8 No. 333-150714) pertaining to the 2006 Stock Incentive Plan for Key Employees of HCA Inc. and its Affiliates, and

(4) Registration Statement (Form S-3 No. 333-175791) of HCA Holdings, Inc.;

of our reports dated February 23, 2012, with respect to the consolidated financial statements of HCA Holdings, Inc. and the effectiveness of internal control over financial reporting of HCA Holdings, Inc., included in this Annual Report (Form 10-K) of HCA Holdings, Inc. for the year ended December 31, 2011.

/s/ Ernst & Young LLP

Nashville, Tennessee

February 23, 2012

EX-31.1

EXHIBIT 31.1

CERTIFICATIONS

I, Richard M. Bracken, certify that:

1. I have reviewed this annual report on Form 10-K of HCA Holdings, Inc.;

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

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

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

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

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

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

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

5. The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit and compliance 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/ RICHARD M. BRACKEN
	Richard M. Bracken Chairman of the Board and Chief Executive Officer

Date: February 23, 2012

EX-31.2

EXHIBIT 31.2

CERTIFICATIONS

I, R. Milton Johnson, certify that:

1. I have reviewed this annual report of Form 10-K of HCA Holdings, Inc.;

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

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

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

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

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

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

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

5. The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit and compliance 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/ R. MILTON JOHNSON
	R. Milton Johnson President and Chief Financial Officer

Date: February 23, 2012

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 Annual Report of HCA Holdings, Inc. (the “Company”) on Form 10-K for the year ended December 31, 2011, 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/ RICHARD M. BRACKEN
	Richard M. Bracken Chairman of the Board and Chief Executive Officer

February 23, 2012

By:	/S/ R. MILTON JOHNSON
	R. Milton Johnson President and Chief Financial Officer

February 23, 2012

XML

Segment And Geographic Information (Tables)

12 Months Ended

Dec. 31, 2011

Segment And Geographic Information [Abstract]

Schedule Of Geographic Distributions Of Revenues, Equity In Earnings Of Affiliates, Adjusted Segment EBITDA, Depreciation And Amortization, Assets And Goodwill

	For the Years Ended December 31,
	2011			2010			2009
Revenues:
National Group	$	12,224		$	11,624		$	11,047
Southwest Group		9,311			8,700			8,282
Central Group		6,982			6,727			6,570
Corporate and other		1,165			984			877
	$	29,682		$	28,035		$	26,776
Equity in earnings of affiliates:
National Group	$	(7	)	$	(4	)	$	(4	)
Southwest Group		(251	)		(277	)		(240	)
Central Group		—			(1	)		(2	)
Corporate and other		—			—			—
	$	(258	)	$	(282	)	$	(246	)
Adjusted segment EBITDA:
National Group	$	2,531		$	2,431		$	2,250
Southwest Group		2,370			2,254			2,089
Central Group		1,285			1,272			1,325
Corporate and other		(125	)		(89	)		(192	)
	$	6,061		$	5,868		$	5,472
Depreciation and amortization:
National Group	$	512		$	508		$	516
Southwest Group		464			427			426
Central Group		347			352			352
Corporate and other		142			134			131
	$	1,465		$	1,421		$	1,425
Adjusted segment EBITDA	$	6,061		$	5,868		$	5,472
Depreciation and amortization		1,465			1,421			1,425
Interest expense		2,037			2,097			1,987
Losses (gains) on sales of facilities		(142	)		(4	)		15
Gain on acquisition of controlling interest in equity investment		(1,522	)		—			—
Impairments of long-lived assets		—			123			43
Losses on retirement of debt		481			—			—
Termination of management agreement		181			—			—
Income before income taxes	$	3,561		$	2,231		$	2,002

	As of December 31,
	2011		2010
Assets:
National Group	$	7,827	$	7,345
Southwest Group		9,908		6,747
Central Group		5,187		5,271
Corporate and other		3,976		4,489
	$	26,898	$	23,852

	National Group			Southwest Group			Central Group		Corporate and Other			Total
Goodwill and other intangible assets:
Balance at December 31, 2010	$	787		$	636		$	1,019	$	251		$	2,693
Acquisitions		32			2,533			—		33			2,598
Dispositions		(19	)		(5	)		—		—			(24	)
Foreign currency translation and other					(4	)		—		(12	)		(16	)
Balance at December 31, 2011	$	800		$	3,160		$	1,019	$	272		$	5,251

XML

Impairments Of Long-Lived Assets (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2010	Dec. 31, 2009
Impaired Long-Lived Assets Held and Used [Line Items]
Asset impairment charges	$ 123	$ 43
Write-off of capitalized engineering and design costs	35
Central Group [Member]
Impaired Long-Lived Assets Held and Used [Line Items]
Asset impairment charges	57	15
National Group [Member]
Impaired Long-Lived Assets Held and Used [Line Items]
Asset impairment charges	5	16
Southwest Group [Member]
Impaired Long-Lived Assets Held and Used [Line Items]
Asset impairment charges	17	12
Corporate And Other Group [Member]
Impaired Long-Lived Assets Held and Used [Line Items]
Asset impairment charges	44
Property And Equipment Asset [Member]
Impaired Long-Lived Assets Held and Used [Line Items]
Asset impairment charges	$ 109	$ 24

XML

Share-Based Compensation (Narrative) (Details) (USD $)	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Stock options outstanding and exercisable	33,548,000
Options granted	1,288,000	964,000	8,045,000
Shares available for future grants	40,000,000
Stock and vested options, distributions per share		$ 9.43
Nonvested stock options, reductions per share		9.43
Weighted average fair value of stock options granted	$ 8.53	$ 7.13	$ 3.54
Total intrinsic value of stock options	121,000,000
Unrecognized compensation cost related to nonvested awards	23,000,000
Rollover Options [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Stock options converted to rollover options	10,294,500
Prerecapitalization of stock option	49,408,100
Stock options outstanding and exercisable	2,825,100
2006 Plan [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Stock options outstanding and exercisable	30,723,400
Options granted	1,288,000	964,000
Vested options	$ 35,090,800
Shares available for future grants	42,099,900

XML

Assets And Liabilities Measured At Fair Value (Schedule Of Assets And Liabilities Measured At Fair Value On A Recurring Basis) (Details) (USD $) In Millions, unless otherwise specified	Dec. 31, 2011	Dec. 31, 2010
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	$ 628	$ 742
Less amounts classified as current assets	(80)	(100)
Investments of insurance subsidiaries, noncurrent	548	642
Fair Value [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value		642
Investments of insurance subsidiaries, Debt and Equity securities, Fair Value	628	742
Less amounts classified as current assets	(80)	(100)
Investments of insurance subsidiaries, noncurrent	548
Quoted Prices In Active Markets For Identical Assets And Liabilities (Level1) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value		37
Investments of insurance subsidiaries, Debt and Equity securities, Fair Value	54	137
Less amounts classified as current assets	(54)	(100)
Significant Other Observable Inputs (Level 2) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value		354
Investments of insurance subsidiaries, Debt and Equity securities, Fair Value	442	354
Less amounts classified as current assets	(26)
Investments of insurance subsidiaries, noncurrent	416
Significant Unobservable Inputs (Level 3) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value		251
Investments of insurance subsidiaries, Debt and Equity securities, Fair Value	132	251
Investments of insurance subsidiaries, noncurrent	132
Auction Rate Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	131
Cross Currency Swap (Other Assets) [Member] | Fair Value [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value		39
Cross Currency Swap (Other Assets) [Member] | Significant Other Observable Inputs (Level 2) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value		39
Cross Currency Swap (Income Taxes And Other Liabilities) [Member] | Fair Value [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	16
Cross Currency Swap (Income Taxes And Other Liabilities) [Member] | Significant Other Observable Inputs (Level 2) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	16
Interest Rate Swaps [Member] | Fair Value [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	399	426
Interest Rate Swaps [Member] | Significant Other Observable Inputs (Level 2) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	399	426
Debt Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	621	734
Debt Securities [Member] | Fair Value [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	621	734
Debt Securities [Member] | Quoted Prices In Active Markets For Identical Assets And Liabilities (Level1) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	53	135
Debt Securities [Member] | Significant Other Observable Inputs (Level 2) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	437	349
Debt Securities [Member] | Significant Unobservable Inputs (Level 3) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	131	250
Debt Securities [Member] | States And Municipalities [Member] | Fair Value [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	417	323
Debt Securities [Member] | States And Municipalities [Member] | Significant Other Observable Inputs (Level 2) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	417	323
Debt Securities [Member] | Auction Rate Securities [Member] | Fair Value [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	131	250
Debt Securities [Member] | Auction Rate Securities [Member] | Significant Unobservable Inputs (Level 3) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	131	250
Debt Securities [Member] | Asset-Backed Securities [Member] | Fair Value [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	20	26
Debt Securities [Member] | Asset-Backed Securities [Member] | Significant Other Observable Inputs (Level 2) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	20	26
Debt Securities [Member] | Money Market Funds [Member] | Fair Value [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	53	135
Debt Securities [Member] | Money Market Funds [Member] | Quoted Prices In Active Markets For Identical Assets And Liabilities (Level1) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	53	135
Equity Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	7	8
Equity Securities [Member] | Fair Value [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	7	8
Equity Securities [Member] | Quoted Prices In Active Markets For Identical Assets And Liabilities (Level1) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	1	2
Equity Securities [Member] | Significant Other Observable Inputs (Level 2) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	5	5
Equity Securities [Member] | Significant Unobservable Inputs (Level 3) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	$ 1	$ 1

XML

Income Taxes (Narrative) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Income Taxes [Line Items]
Reductions in interest related to taxing authority examinations	$ 100	$ 69	$ 18
Reductions in interest related to taxing authority examinations, net of tax	63	44	12
State net operating loss carryforwards	34
Liability for unrecognized tax benefits	494	413
Unrecognized tax benefits, accrued interest	62	115
Deferred tax assets, reductions	13	15
Unrecognized tax benefits that would impact effective tax rate	173	190
Liability for unrecognized tax benefits does not reflect deferred tax assets	45	63
Unrecognized tax benefits, refundable deposit	$ 19	$ 82
Maximum [Member] | State And Local Jurisdiction [Member]
Income Taxes [Line Items]
Net operating loss carryforwards, expiration date	2031
Minimum [Member] | State And Local Jurisdiction [Member]
Income Taxes [Line Items]
Net operating loss carryforwards, expiration date	2012

XML

Employee Benefit Plans (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Defined Contribution Benefit Plans [Member]
Defined Benefit Plan Disclosure [Line Items]
Cost of defined benefit plans	$ 321	$ 307	$ 283
Restoration Plan [Member]
Defined Benefit Plan Disclosure [Line Items]
Number of hours of service required to qualify for the plan	1,000 or more hours
Noncontributory and nonqualified plan, benefit expense	25	19	26
Noncontributory and nonqualified plan, accrued benefits liabilities	105	84
Supplemental Executive Retirement Plan [Member]
Defined Benefit Plan Disclosure [Line Items]
Benefits expense	33	27	24
Accrued benefits liabilities	237	197
Defined Benefit Pension Plans [Member]
Defined Benefit Plan Disclosure [Line Items]
Benefits expense	37	30	39
Accrued benefits liabilities	$ 147	$ 131
Subsequent To March 31, 2008 [Member] | Defined Contribution Benefit Plans [Member]
Defined Benefit Plan Disclosure [Line Items]
Percentage of employer contribution to match participant contribution in defined contribution plan, net	100.00%
Subsequent To March 31, 2008 [Member] | Minimum [Member] | Defined Contribution Benefit Plans [Member]
Defined Benefit Plan Disclosure [Line Items]
Percentage of employer contribution to match participant contribution in defined contribution plan	3.00%
Subsequent To March 31, 2008 [Member] | Maximum [Member] | Defined Contribution Benefit Plans [Member]
Defined Benefit Plan Disclosure [Line Items]
Percentage of employer contribution to match participant contribution in defined contribution plan	9.00%

XML

Accounting Policies (Schedule Of Revenue Deductions Related To Uninsured Accounts) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Accounting Policies [Abstract]
Charity care	$ 2,683	$ 2,337	$ 2,151
Uninsured discounts	5,707	4,641	2,935
Provision for doubtful accounts	2,824	2,648	3,276
Total uncompensated care	$ 11,214	$ 9,626	$ 8,362
Charity care Ratio	24.00%	24.00%	26.00%
Uninsured discounts Ratio	51.00%	48.00%	35.00%
Provision for doubtful accounts Ratio	25.00%	28.00%	39.00%
Total uncompensated care Ratio	100.00%	100.00%	100.00%

XML

Earnings Per Share (Tables)

12 Months Ended

Dec. 31, 2011

Earnings Per Share [Abstract]

Schedule Of Computations Of Basic And Diluted Earnings Per Share

	2011		2010		2009
Net income attributable to HCA Holdings, Inc	$	2,465	$	1,207	$	1,054
Weighted average common shares outstanding		476,609		426,424		425,567
Effect of dilutive stock options		19,334		10,923		6,660
Shares used for diluted earnings per share		495,943		437,347		432,227
Earnings per share:
Basic earnings per share	$	5.17	$	2.83	$	2.48
Diluted earnings per share	$	4.97	$	2.76	$	2.44

XML

Segment And Geographic Information (Details) (USD $) In Millions, unless otherwise specified	0 Months Ended	3 Months Ended																12 Months Ended
	Jan. 01, 2000	Dec. 31, 2011		Sep. 30, 2011		Jun. 30, 2011		Mar. 31, 2011		Dec. 31, 2010		Sep. 30, 2010		Jun. 30, 2010		Mar. 31, 2010		Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Segment Reporting Information [Line Items]
Number of owned and operated hospitals																		163
Revenues		$ 7,769	[1]	$ 7,258	[1]	$ 7,249	[1]	$ 7,406	[1]	$ 7,161	[1]	$ 6,926	[1]	$ 6,968	[1]	$ 6,980	[1]	$ 29,682	$ 28,035	$ 26,776
Equity in earnings of affiliates																		(258)	(282)	(246)
Adjusted segment EBITDA																		6,061	5,868	5,472
Depreciation and amortization																		1,465	1,421	1,425
Interest expense																		2,037	2,097	1,987
Losses (gains) on sales of facilities		(84)		1		(1)		2		(3)		1						(142)	(4)	15
Gain on acquisition of controlling interest in equity investment		(1,424)																(1,522)
Impairments of long-lived assets										2		6		57		12			123	43
Losses on retirement of debt				256		47												481
Termination of management agreement								149										181
Income before income taxes																		3,561	2,231	2,002
Assets		26,898								23,852								26,898	23,852
Balance at December 31, 2010								2,693										2,693
Goodwill, Acquisitions																		2,598
Goodwill, Impairments	(102)																	(24)	(14)	(19)
Goodwill, Foreign currency translation and other																		(16)	5
Balance at December 31, 2011		5,251								2,693								5,251	2,693
National Group [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals																		64
Revenues																		12,224	11,624	11,047
Equity in earnings of affiliates																		(7)	(4)	(4)
Adjusted segment EBITDA																		2,531	2,431	2,250
Depreciation and amortization																		512	508	516
Assets		7,827								7,345								7,827	7,345
Balance at December 31, 2010								787										787
Goodwill, Acquisitions																		32
Goodwill, Impairments																		(19)
Balance at December 31, 2011		800								787								800	787
Southwest Group [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals																		46
Revenues																		9,311	8,700	8,282
Equity in earnings of affiliates																		(251)	(277)	(240)
Adjusted segment EBITDA																		2,370	2,254	2,089
Depreciation and amortization																		464	427	426
Assets		9,908								6,747								9,908	6,747
Balance at December 31, 2010								636										636
Goodwill, Acquisitions																		2,533
Goodwill, Impairments																		(5)
Goodwill, Foreign currency translation and other																		(4)
Balance at December 31, 2011		3,160								636								3,160	636
Central Group [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals																		47
Revenues																		6,982	6,727	6,570
Equity in earnings of affiliates																			1	2
Adjusted segment EBITDA																		1,285	1,272	1,325
Depreciation and amortization																		347	352	352
Assets		5,187								5,271								5,187	5,271
Balance at December 31, 2010								1,019										1,019
Balance at December 31, 2011		1,019								1,019								1,019	1,019
Corporate And Other [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals																		6
Revenues																		1,165	984	877
Adjusted segment EBITDA																		(125)	(89)	(192)
Depreciation and amortization																		142	134	131
Assets		3,976								4,489								3,976	4,489
Balance at December 31, 2010								251										251
Goodwill, Acquisitions																		33
Goodwill, Foreign currency translation and other																		(12)
Balance at December 31, 2011		$ 272								$ 251								$ 272	$ 251

[1] The "Revenues" presented for each quarter of 2010 and the first and second quarters of 2011 have been reduced by the provision for doubtful accounts for each quarter in accordance with our adoption of ASU 2011-07 in the third quarter of 2011. The "Revenues" presented for the second and third quarters of 2011 have been reduced for the reclassification of "Electronic health record incentive income" as a separate line item in our consolidated income statements (See NOTE 1 of the notes to consolidated financial statements).

XML

Long-Term Debt (Senior Secured Second Lien Notes) (Details) (USD $) In Millions, unless otherwise specified						12 Months Ended
	Dec. 31, 2011 Senior Secured Second Lien Notes [Member]	Feb. 28, 2009 Senior Secured Second Lien Notes [Member]	Nov. 30, 2006 Senior Secured Second Lien Notes Due 2014 [Member]	Nov. 30, 2006 Senior Secured Second Lien Notes Due 2016 [Member]	Nov. 30, 2010 Senior Unsecured Notes Due 2021 [Member]	Dec. 31, 2011 Maturities Ranging 2014 To 2025 [Member]	Dec. 31, 2011 Maturities Ranging 2015 To 2095 [Member]	Dec. 31, 2011 Maturities Ranging 2012 To 2033 [Member]	Dec. 31, 2011 Senior Unsecured Notes Unamortized Debt Discounts [Member]
Line of Credit Facility [Line Items]
Debt instrument, stated interest		9.875%	9.125%	9.25%	7.75%
Medium-term notes						$ 246
Debentures, principal amount							886
Debt instrument, maturities range, start						2014	2015	2012
Debt instrument, maturities range, end						2025	2095	2033
Senior unsecured notes					1,525
Debt instrument, unamortized discount	$ 5								$ 7

XML

Income Taxes (Schedule Of Reconciliation Of The Federal Statutory Rate To The Effective Income Tax Rate) (Details)	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Income Taxes [Abstract]
Federal statutory rate	35.00%	35.00%	35.00%
State income taxes, net of federal tax benefit	2.00%	2.70%	3.20%
Change in liability for uncertain tax positions	1.00%	0.30%	(0.20%)
Nontaxable gain on acquisition of controlling interest in equity investment	(13.80%)
Tax exempt interest income	(0.20%)	(0.40%)	(0.80%)
Income attributable to noncontrolling interests from consolidated partnerships	(2.40%)	(5.80%)	(6.00%)
Other items, net	(1.40%)	(2.30%)	0.10%
Effective income tax rate	20.20%	29.50%	31.30%

XML

Leases (Schedule Of Commitments Relating To Noncancellable Operating Leases) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011
Leases [Abstract]
2012	$ 280
2013	264
2014	218
2015	171
2016	131
Thereafter	870
Operating leases future minimum payments due, gross	1,934
Less sublease income	(51)
Commitments relating to noncancellable operating leases	$ 1,883

XML

Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information (Schedule Of Consolidated Statements of Stockholder's Deficit) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Share-based benefit plans	$ 35	$ 43	$ 47
Reclassification of equity securities with contingent redemption rights	141
Other	56	163	36
Healthtrust, Inc. [Member]
Share-based benefit plans	35	43	47
Reclassification of equity securities with contingent redemption rights	141
Other	36	120	14
Distributions from HCA Holdings, Inc., net of contributions to HCA Holdings, Inc.	$ 212	$ 163	$ 61

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Accrued Expenses And Allowance For Doubtful Accounts (Summary Of Other Accrued Expenses) (Details) (USD $) In Millions, unless otherwise specified	Dec. 31, 2011	Dec. 31, 2010
Accrued Expenses And Allowance For Doubtful Accounts [Abstract]
Prrofessional liability risks	$ 298	$ 268
Interest	383	309
Taxes other than income	232	197
Other	672	471
Other accrued expenses	$ 1,585	$ 1,245

XML

Subsequent Event (Details) (USD $) In Millions, except Per Share data, unless otherwise specified	0 Months Ended
	Feb. 16, 2012	Feb. 03, 2012
Subsequent Event [Abstract]
Dividend payment		$ 975
Date of dividend payment	Feb. 29, 2012
Dividend per share		$ 2.00
Reduction Per Share		$ 2.00

XML

Capital Stock (Details) (USD $)	0 Months Ended	1 Months Ended			3 Months Ended	12 Months Ended		12 Months Ended
	Sep. 21, 2011	Sep. 21, 2011	Mar. 31, 2011	Feb. 28, 2011	Mar. 31, 2011	Dec. 31, 2010	Dec. 31, 2011	Dec. 31, 2011 Maximum [Member]	Dec. 31, 2011 Minimum [Member]
Capital Stock [Line Items]
Common stock, shares authorized				1,800,000,000		1,800,000,000	1,800,000,000
Split ratio for issued and outstanding common shares				4.505
Number of directors as per the amended and restated by-laws								15	1
Proceeds from issuance of initial public offering			$ 2,506,000,000
Initial public offering of shares common stock			87,719,300		87,719,300
Initial public offering of shares of common stock, price per share			$ 30.00		$ 30.00
Repurchase of common stock	80,771,143
Repurchase of common stock, per share		$ 18.61
Shares repurchased as percentage of total shares outstanding		15.60%
Value of distribution						$ 4,332,000,000
Value of distribution per share						$ 9.43
Reduction of non vested stock options on exercise price of share-based awards						$ 9.43

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Assets And Liabilities Measured At Fair Value (Schedule Related To The Auction Rate And Equity Securities Investments Of Insurance Subsidiaries At Fair Value) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011
Assets And Liabilities Measured At Fair Value [Abstract]
Asset balances at December 31, 2010	$ 251
Unrealized losses included in other comprehensive income	(7)
Settlements	(112)
Asset balances at December 31, 2011	$ 132

XML

Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information

12 Months Ended

Dec. 31, 2011

Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Abstract]

Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information

NOTE 18 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION AND OTHER COLLATERAL-RELATED INFORMATION

On November 22, 2010, HCA Inc. reorganized by creating a new holding company structure. HCA Holdings, Inc. became the new parent company, and HCA Inc. is now HCA Holdings, Inc.'s wholly-owned direct subsidiary. On November 23, 2010, HCA Holdings, Inc. issued the 2021 Notes. These notes are senior unsecured obligations and are not guaranteed by any of our subsidiaries.

The senior secured credit facilities and senior secured notes described in Note 10 are fully and unconditionally guaranteed by substantially all existing and future, direct and indirect, wholly-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 ABL credit facility).

Our condensed consolidating balance sheets at December 31, 2011 and 2010 and condensed consolidating statements of income and cash flows for each of the three years in the period ended December 31, 2011, segregating HCA Holdings, Inc. issuer, HCA Inc. issuer, the subsidiary guarantors, the subsidiary non-guarantors and eliminations, follow.

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING INCOME STATEMENT

For The Year Ended December 31, 2011

(Dollars in millions)

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Revenues before provision for doubtful accounts	$	—		$	—		$	18,126		$	14,380		$	—		$	32,506
Provision for doubtful accounts		—			—			1,644			1,180			—			2,824
Revenues		—			—			16,482			13,200		$	—			29,682
Salaries and benefits		—			—			7,584			5,856			—			13,440
Supplies		—			—			2,851			2,328			—			5,179
Other operating expenses		—			4			2,741			2,725			—			5,470
Electronic health record incentive income		—			—			(126	)		(84	)		—			(210	)
Equity in earnings of affiliates		(2,543	)		—			(86	)		(172	)		2,543			(258	)
Depreciation and amortization		—			—			777			688			—			1,465
Interest expense		120			2,390			(342	)		(131	)		—			2,037
Gains on sales of facilities		—			—			(127	)		(15	)		—			(142	)
Gain on acquisition of controlling interest in equity investment		—			—			—			(1,522	)		—			(1,522	)
Losses on retirement of debt		—			481			—			—			—			481
Termination of management agreement		—			181			—			—			—			181
Management fees		—			—			(491	)		491			—			—
		(2,423	)		3,056			12,781			10,164			2,543			26,121
Income (loss) before income taxes		2,423			(3,056	)		3,701			3,036			(2,543	)		3,561
Provision (benefit) for income taxes		(42	)		(1,068	)		1,271			558			—			719
Net income (loss)		2,465			(1,988	)		2,430			2,478			(2,543	)		2,842
Net income attributable to noncontrolling interests		—			—			63			314			—			377
Net income (loss) attributable to HCA Holdings, Inc.	$	2,465		$	(1,988	)	$	2,367		$	2,164		$	(2,543	)	$	2,465

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING INCOME STATEMENT

For The Year Ended December 31, 2010

(Dollars in millions)

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Revenues before provision for doubtful accounts	$	—		$	—		$	17,647		$	13,036		$	—		$	30,683
Provision for doubtful accounts		—			—			1,632			1,016			—			2,648
Revenues		—			—			16,015			12,020		$	—			28,035
Salaries and benefits		—			—			7,315			5,169			—			12,484
Supplies		—			—			2,825			2,136			—			4,961
Other operating expenses		—			5			2,634			2,365			—			5,004
Equity in earnings of affiliates		(1,215	)		—			(107	)		(175	)		1,215			(282	)
Depreciation and amortization		—			—			782			639			—			1,421
Interest expense		12			2,700			(761	)		146			—			2,097
Gains on sales of facilities		—			—			—			(4	)		—			(4	)
Impairments of long-lived assets		—			—			58			65			—			123
Management fees		—			—			(454	)		454			—			—
		(1,203	)		2,705			12,292			10,795			1,215			25,804
Income (loss) before income taxes		1,203			(2,705	)		3,723			1,225			(1,215	)		2,231
Provision (benefi) for income taxes		(4	)		(955	)		1,299			318			—			658
Net income (loss)		1,207			(1,750	)		2,424			907			(1,215	)		1,573
Net income attributable to noncontrolling interests		—			—			44			322			—			366
Net income (loss) attributable to HCA Holdings, Inc.	$	1,207		$	(1,750	)	$	2,380		$	585		$	(1,215	)	$	1,207

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING INCOME STATEMENT

For The Year Ended December 31, 2009

(Dollars in millions)

	HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Revenues before provision for doubtful accounts	$	—		$	17,584		$	12,468		$	—		$	30,052
Provision for doubtful accounts		—			2,043			1,233			—			3,276
Revenues		—			15,541			11,235			—			26,776
Salaries and benefits		—			7,149			4,809			—			11,958
Supplies		—			2,846			2,022			—			4,868
Other operating expenses		14			2,497			2,213			—			4,724
Equity in earnings of affiliates		(2,540	)		(95	)		(151	)		2,540			(246	)
Depreciation and amortization		—			787			638			—			1,425
Interest expense		2,356			(500	)		131			—			1,987
Losses (gains) on sales of facilities		—			17			(2	)		—			15
Impairments of long-lived assets		—			34			9			—			43
Management fees		—			(443	)		443			—			—
		(170	)		12,292			10,112			2,540			24,774
Income before income taxes		170			3,249			1,123			(2,540	)		2,002
Provision (benefi) for income taxes		(884	)		1,189			322			—			627
Net income		1,054			2,060			801			(2,540	)		1,375
Net income attributable to noncontrolling interests		—			61			260			—			321
Net income attributable to HCA Holdings, Inc.	$	1,054		$	1,999		$	541		$	(2,540	)	$	1,054

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING BALANCE SHEET

DECEMBER 31, 2011

(Dollars in millions)

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors		Eliminations			Condensed Consolidated
ASSETS
Current assets:
Cash and cash equivalents	$	—		$	—		$	115		$	258	$	—		$	373
Accounts receivable, net		—			—			2,429			2,104		—			4,533
Inventories		—			—			602			452		—			1,054
Deferred income taxes		594			—			—			—		—			594
Other		50			—			184			445		—			679
		644			—			3,330			3,259		—			7,233
Property and equipment, net		—			—			7,088			5,746		—			12,834
Investments of insurance subsidiaries		—			—			—			548		—			548
Investments in and advances to affiliates		—			—			15			86		—			101
Goodwill and other intangible assets		—			—			1,605			3,646		—			5,251
Deferred loan costs		22			268			—			—		—			290
Investments in and advances to subsidiaries		16,825			—			—			—		(16,825	)		—
Other		450			—			21			170		—			641
	$	17,941		$	268		$	12,059		$	13,455	$	(16,825	)	$	26,898
LIABILITIES AND STOCKHOLDERS' (DEFICIT) EQUITY
Current liabilities:
Accounts payable	$	—		$	—		$	899		$	698	$	—		$	1,597
Accrued salaries		—			—			568			397		—			965
Other accrued expenses		15			367			449			754		—			1,585
Long-term debt due within one year		—			1,347			28			32		—			1,407
		15			1,714			1,944			1,881		—			5,554
Long-term debt		1,525			23,454			110			556		—			25,645
Intercompany balances		24,121			(12,814	)		(15,183	)		3,876		—			—
Professional liability risks		—			—			—			993		—			993
Income taxes and other liabilities		538			415			556			211		—			1,720
		26,199			12,769			(12,573	)		7,517		—			33,912
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.		(8,258	)		(12,501	)		24,534			4,792		(16,825	)		(8,258	)
Noncontrolling interests		—			—			98			1,146		—			1,244
		(8,258	)		(12,501	)		24,632			5,938		(16,825	)		(7,014	)
	$	17,941		$	268		$	12,059		$	13,455	$	(16,825	)	$	26,898

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING BALANCE SHEET

DECEMBER 31, 2010

(Dollars in millions)

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors		Eliminations			Condensed Consolidated
ASSETS
Current assets:
Cash and cash equivalents	$	6		$	—		$	156		$	249	$	—		$	411
Accounts receivable, net		—			—			2,214			1,618		—			3,832
Inventories		—			—			547			350		—			897
Deferred income taxes		931			—			—			—		—			931
Other		202			—			223			423		—			848
		1,139			—			3,140			2,640		—			6,919
Property and equipment, net		—			—			6,817			4,535		—			11,352
Investments of insurance subsidiaries		—			—			—			642		—			642
Investments in and advances to affiliates		—			—			248			621		—			869
Goodwill and other intangible assets		—			—			1,635			1,058		—			2,693
Deferred loan costs		23			351			—			—		—			374
Investments in and advances to subsidiaries		14,282			—			—			—		(14,282	)		—
Other		776			39			21			167		—			1,003
	$	16,220		$	390		$	11,861		$	9,663	$	(14,282	)	$	23,852
LIABILITIES AND STOCKHOLDERS' (DEFICIT) EQUITY
Current liabilities:
Accounts payable	$	—		$	—		$	919		$	618	$	—		$	1,537
Accrued salaries		—			—			556			339		—			895
Other accrued expenses		12			296			328			609		—			1,245
Long-term debt due within one year		—			554			12			26		—			592
		12			850			1,815			1,592		—			4,269
Long-term debt		1,525			25,758			95			255		—			27,633
Intercompany balances		25,985			(16,130	)		(12,833	)		2,978		—			—
Professional liability risks		—			—			—			995		—			995
Income taxes and other liabilities		483			425			505			195		—			1,608
		28,005			10,903			(10,418	)		6,015		—			34,505
Equity securities with contingent redemption rights		141			—			—			—		—			141
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.		(11,926	)		(10,513	)		22,167			2,628		(14,282	)		(11,926	)
Noncontrolling interests		—			—			112			1,020		—			1,132
		(11,926	)		(10,513	)		22,279			3,648		(14,282	)		(10,794	)
	$	16,220		$	390		$	11,861		$	9,663	$	(14,282	)	$	23,852

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS

For The Year Ended December 31, 2011

(Dollars in millions)

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Cash flows from operating activities:
Net income (loss)	$	2,465		$	(1,988	)	$	2,430		$	2,478		$	(2,543	)	$	2,842
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Change in operating assets and liabilities		6			71			(1,755	)		(1,275	)		—			(2,953	)
Provision for doubtful accounts		—			—			1,644			1,180			—			2,824
Depreciation and amortization		—			—			777			688			—			1,465
Income taxes		912			—			—			—			—			912
Gains on sales of facilities		—			—			(127	)		(15	)		—			(142	)
Gain on acquisition of controlling interest in equity investment		—			—			—			(1,522	)		—			(1,522	)
Losses on retirement of debt		—			481			—			—			—			481
Amortization of deferred loan costs		—			70			—			—			—			70
Share-based compensation		26			—			—			—			—			26
Pay-in-kind interest		—			(78	)		—			—			—			(78	)
Equity in earnings of affiliates		(2,543	)		—			—			—			2,543			—
Other		—			9			—			(1	)		—			8
Net cash provided by (used in) operating activities		866			(1,435	)		2,969			1,533			—			3,933
Cash flows from investing activities:
Purchase of property and equipment		—			—			(910	)		(769	)		—			(1,679	)
Acquisition of hospitals and health care entities		—			—			(142	)		(1,540	)		—			(1,682	)
Disposal of hospitals and health care entities		—			—			200			81			—			281
Change in investments		—			—			34			46			—			80
Other		—			—			—			5			—			5
Net cash used in investing activities		—			—			(818	)		(2,177	)		—			(2,995	)
Cash flows from financing activities:
Issuances of long-term debt		—			5,500			—			—			—			5,500
Net change in revolving bank credit facilities		—			(449	)		—			—			—			(449	)
Repayment of long-term debt		—			(6,577	)		(17	)		(46	)		—			(6,640	)
Distributions to noncontrolling interests		—			—			(77	)		(301	)		—			(378	)
Payment of debt issuance costs		—			(92	)		—			—			—			(92	)
Issuance of common stock		2,506			—			—			—			—			2,506
Repurchase of common stock		(1,503	)		—			—			—			—			(1,503	)
Distributions to stockholders		(31	)		—			—			—			—			(31	)
Income tax benefits		63			—			—			—			—			63
Changes in intercompany balances with affiliates, net		(1,918	)		3,053			(2,098	)		963			—			—
Other		11			—			—			37			—			48
Net cash provided by (used in) financing activities		(872	)		1,435			(2,192	)		653			—			(976	)
Change in cash and cash equivalents		(6	)		—			(41	)		9			—			(38	)
Cash and cash equivalents at beginning of period		6			—			156			249			—			411
Cash and cash equivalents at end of period	$	—		$	—		$	115		$	258		$	—		$	373

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS

For The Year Ended December 31, 2010

(Dollars in millions)

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Cash flows from operating activities:
Net income	$	1,207		$	(1,750	)	$	2,424		$	907		$	(1,215	)	$	1,573
Adjustments to reconcile net income to net cash provided by (used in) operating activities:
Change in operating assets and liabilities		12			13			(1,759	)		(1,113	)		—			(2,847	)
Provision for doubtful accounts		—			—			1,632			1,016			—			2,648
Depreciation and amortization		—			—			782			639			—			1,421
Income taxes		27			—			—			—			—			27
Gains on sales of facilities		—			—			—			(4	)		—			(4	)
Impairments of long-lived assets		—			—			58			65			—			123
Amortization of deferred loan costs		—			81			—			—			—			81
Share-based compensation		32			—			—			—			—			32
Equity in earnings of affiliates		(1,215	)		—			—			—			1,215			—
Other		—			31			—			—			—			31
Net cash provided by (used in) operating activities		63			(1,625	)		3,137			1,510			—			3,085
Cash flows from investing activities:
Purchase of property and equipment		—			—			(602	)		(723	)		—			(1,325	)
Acquisition of hospitals and health care entities		—			—			(21	)		(212	)		—			(233	)
Disposal of hospitals and health care entities		—			—			29			8			—			37
Change in investments		—			—			1			471			—			472
Other		—			—			(3	)		13			—			10
Net cash used in investing activities		—			—			(596	)		(443	)		—			(1,039	)
Cash flows from financing activities:
Issuances of long-term debt		1,525			1,387			—			—			—			2,912
Net change in revolving bank credit facilities		—			1,889			—			—			—			1,889
Repayment of long-term debt		—			(2,164	)		(32	)		(72	)		—			(2,268	)
Distributions to noncontrolling interests		—			—			(61	)		(281	)		—			(342	)
Contributions from noncontrolling interests		—			—			—			57			—			57
Payment of debt issuance costs		(23	)		(27	)		—			—			—			(50	)
Distributions to stockholders		(4,257	)		—			—			—			—			(4,257	)
Income tax benefits		114			—			—			—			—			114
Changes in intercompany balances with affiliates, net		2,590			556			(2,387	)		(759	)		—			—
Other		(6	)		(16	)		—			20			—			(2	)
Net cash provided by (used in) financing activities		(57	)		1,625			(2,480	)		(1,035	)		—			(1,947	)
Change in cash and cash equivalents		6			—			61			32			—			99
Cash and cash equivalents at beginning of period		—			—			95			217			—			312
Cash and cash equivalents at end of period	$	6		$	—		$	156		$	249		$	—		$	411

HCA HOLDINGS, INC.

CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS

For The Year Ended December 31, 2009

(Dollars in millions)

	HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Cash flows from operating activities:
Net income	$	1,054		$	2,060		$	801		$	(2,540	)	$	1,375
Adjustments to reconcile net income to net cash provided by (used in) operating activities:
Change in operating assets and liabilities		90			(1,882	)		(1,299	)		—			(3,091	)
Provision for doubtful accounts		—			2,043			1,233			—			3,276
Depreciation and amortization		—			787			638			—			1,425
Income taxes		(520	)		—			—			—			(520	)
Losses (gains) on sales of facilities		—			17			(2	)		—			15
Impairments of long-lived assets		—			34			9			—			43
Amortization of deferred loan costs		80			—			—			—			80
Share-based compensation		40			—			—			—			40
Pay-in-kind interest		58			—			—			—			58
Equity in earnings of affiliates		(2,540	)		—			—			2,540			—
Other		50			(2	)		(2	)		—			46
Net cash provided by (used in) operating activities		(1,688	)		3,057			1,378			—			2,747
Cash flows from investing activities:
Purchase of property and equipment		—			(720	)		(597	)		—			(1,317	)
Acquisition of hospitals and health care entities		—			(38	)		(23	)		—			(61	)
Disposal of hospitals and health care entities		—			21			20			—			41
Change in investments		—			(7	)		310			—			303
Other		—			—			(1	)		—			(1	)
Net cash used in investing activities		—			(744	)		(291	)		—			(1,035	)
Cash flows from financing activities:
Issuances of long-term debt		2,979			—			—			—			2,979
Net change in revolving bank credit facilities		(1,335	)		—			—			—			(1,335	)
Repayment of long-term debt		(2,972	)		(7	)		(124	)		—			(3,103	)
Distributions to noncontrolling interests		—			(70	)		(260	)		—			(330	)
Payment of debt issuance costs		(70	)		—			—			—			(70	)
Changes in intercompany balances with affiliates, net		3,107			(2,275	)		(832	)		—			—
Other		(21	)		—			15			—			(6	)
Net cash provided by (used in) financing activities		1,688			(2,352	)		(1,201	)		—			(1,865	)
Change in cash and cash equivalents		—			(39	)		(114	)		—			(153	)
Cash and cash equivalents at beginning of period		—			134			331			—			465
Cash and cash equivalents at end of period	$	—		$	95		$	217		$	—		$	312

Healthtrust, Inc. — The Hospital Company ("Healthtrust") is the first-tier subsidiary of HCA Inc. The common stock of Healthtrust has been pledged as collateral for the senior secured credit facilities and senior secured notes described in Note 10. Rule 3-16 of Regulation S-X under the Securities Act requires the filing of separate financial statements for any affiliate of the registrant whose securities constitute a substantial portion of the collateral for any class of securities registered or being registered. We believe the separate financial statements requirement applies to Healthtrust due to the pledge of its common stock as collateral for the senior secured notes. Due to the corporate structure relationship of HCA and Healthtrust, HCA's operating subsidiaries are also the operating subsidiaries of Healthtrust. The corporate structure relationship, combined with the application of push-down accounting in Healthtrust's consolidated financial statements related to HCA's debt and financial instruments, results in the consolidated financial statements of Healthtrust being substantially identical to the consolidated financial statements of HCA. The consolidated financial statements of HCA and Healthtrust present the identical amounts for revenues, expenses, net income, assets, liabilities, total stockholders' deficit, net cash provided by operating activities, net cash used in investing activities and net cash used in financing activities. Certain individual line items in the HCA consolidated statements of stockholders' deficit are combined into one line item in the Healthtrust consolidated statements of stockholder's deficit.

Reconciliations of the HCA Holdings, Inc. Consolidated Statements of Stockholders' Deficit presentation to the Healthtrust, Inc. — The Hospital Company Consolidated Statements of Stockholder's Deficit presentation for the years ended December 31, 2011, 2010 and 2009 are as follows (dollars in millions):

	2011		2010		2009
Presentation in HCA Holdings, Inc. Consolidated Statements of Stockholders' Deficit:
Share-based benefit plans	$	35	$	43	$	47
Reclassification of certain equity securities with contingent redemption rights		141		—		—
Other		36		120		14
Presentation in Healthtrust, Inc. — The Hospital Company Consolidated Statements of Stockholder's Deficit:
Distributions from HCA Holdings, Inc., net of contributions to HCA Holdings, Inc.	$	212	$	163	$	61

Due to the consolidated financial statements of Healthtrust being substantially identical to the consolidated financial statements of HCA, except for the items presented in the tables above, the separate consolidated financial statements of Healthtrust are not presented.

XML

Share-Based Compensation (Schedule Of Stock Option Activity) (Details) (USD $) In Millions, except Share data in Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2011 years	Dec. 31, 2010	Dec. 31, 2009
Share-Based Compensation [Abstract]
Stock Options outstanding, Beginning balance	50,526	51,917	47,906
Stock Options outstanding, Weighted Average Exercise Price, Beginning Balance	$ 8.58	$ 11.72	$ 9.99
Granted, Stock Options	1,288	964	8,045
Granted, Weighted Average Exercise Price	$ 23.35	$ 15.73	$ 19.70
Exercised, Stock Options	(5,044)	(1,726)	(2,278)
Exercised, Weighted Average Exercise Price	$ 6.31	$ 4.06	$ 3.81
Cancelled, Stock Options	(458)	(629)	(1,756)
Cancelled, Weighted Average Exercise Price	$ 5.88	$ 7.96	$ 11.56
Stock Options outstanding, Ending Balance	46,312	50,526	51,917
Stock Options outstanding, Weighted Average Exercise Price, Ending Balance	$ 9.26	$ 8.58	$ 11.72
Options outstanding, Weighted Average Remaining Contractual Term	5.6
Options outstanding, Aggregate Intrinsic Value	$ 595
Options exercisable, Stock Options	33,548
Options exercisable, Weighted Average Exercise Price	$ 9.74
Options exercisable, Weighted Average Remaining Contractual Term	5.4
Options exercisable, Aggregate Intrinsic Value	$ 414

XML

Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information (Tables)

12 Months Ended

Dec. 31, 2011

Dec. 31, 2010

Dec. 31, 2009

Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Abstract]

Schedule Of Condensed Consolidating Income Statement

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Revenues before provision for doubtful accounts	$	—		$	—		$	18,126		$	14,380		$	—		$	32,506
Provision for doubtful accounts		—			—			1,644			1,180			—			2,824
Revenues		—			—			16,482			13,200		$	—			29,682
Salaries and benefits		—			—			7,584			5,856			—			13,440
Supplies		—			—			2,851			2,328			—			5,179
Other operating expenses		—			4			2,741			2,725			—			5,470
Electronic health record incentive income		—			—			(126	)		(84	)		—			(210	)
Equity in earnings of affiliates		(2,543	)		—			(86	)		(172	)		2,543			(258	)
Depreciation and amortization		—			—			777			688			—			1,465
Interest expense		120			2,390			(342	)		(131	)		—			2,037
Gains on sales of facilities		—			—			(127	)		(15	)		—			(142	)
Gain on acquisition of controlling interest in equity investment		—			—			—			(1,522	)		—			(1,522	)
Losses on retirement of debt		—			481			—			—			—			481
Termination of management agreement		—			181			—			—			—			181
Management fees		—			—			(491	)		491			—			—
		(2,423	)		3,056			12,781			10,164			2,543			26,121
Income (loss) before income taxes		2,423			(3,056	)		3,701			3,036			(2,543	)		3,561
Provision (benefit) for income taxes		(42	)		(1,068	)		1,271			558			—			719
Net income (loss)		2,465			(1,988	)		2,430			2,478			(2,543	)		2,842
Net income attributable to noncontrolling interests		—			—			63			314			—			377
Net income (loss) attributable to HCA Holdings, Inc.	$	2,465		$	(1,988	)	$	2,367		$	2,164		$	(2,543	)	$	2,465

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Revenues before provision for doubtful accounts	$	—		$	—		$	17,647		$	13,036		$	—		$	30,683
Provision for doubtful accounts		—			—			1,632			1,016			—			2,648
Revenues		—			—			16,015			12,020		$	—			28,035
Salaries and benefits		—			—			7,315			5,169			—			12,484
Supplies		—			—			2,825			2,136			—			4,961
Other operating expenses		—			5			2,634			2,365			—			5,004
Equity in earnings of affiliates		(1,215	)		—			(107	)		(175	)		1,215			(282	)
Depreciation and amortization		—			—			782			639			—			1,421
Interest expense		12			2,700			(761	)		146			—			2,097
Gains on sales of facilities		—			—			—			(4	)		—			(4	)
Impairments of long-lived assets		—			—			58			65			—			123
Management fees		—			—			(454	)		454			—			—
		(1,203	)		2,705			12,292			10,795			1,215			25,804
Income (loss) before income taxes		1,203			(2,705	)		3,723			1,225			(1,215	)		2,231
Provision (benefi) for income taxes		(4	)		(955	)		1,299			318			—			658
Net income (loss)		1,207			(1,750	)		2,424			907			(1,215	)		1,573
Net income attributable to noncontrolling interests		—			—			44			322			—			366
Net income (loss) attributable to HCA Holdings, Inc.	$	1,207		$	(1,750	)	$	2,380		$	585		$	(1,215	)	$	1,207

	HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Revenues before provision for doubtful accounts	$	—		$	17,584		$	12,468		$	—		$	30,052
Provision for doubtful accounts		—			2,043			1,233			—			3,276
Revenues		—			15,541			11,235			—			26,776
Salaries and benefits		—			7,149			4,809			—			11,958
Supplies		—			2,846			2,022			—			4,868
Other operating expenses		14			2,497			2,213			—			4,724
Equity in earnings of affiliates		(2,540	)		(95	)		(151	)		2,540			(246	)
Depreciation and amortization		—			787			638			—			1,425
Interest expense		2,356			(500	)		131			—			1,987
Losses (gains) on sales of facilities		—			17			(2	)		—			15
Impairments of long-lived assets		—			34			9			—			43
Management fees		—			(443	)		443			—			—
		(170	)		12,292			10,112			2,540			24,774
Income before income taxes		170			3,249			1,123			(2,540	)		2,002
Provision (benefi) for income taxes		(884	)		1,189			322			—			627
Net income		1,054			2,060			801			(2,540	)		1,375
Net income attributable to noncontrolling interests		—			61			260			—			321
Net income attributable to HCA Holdings, Inc.	$	1,054		$	1,999		$	541		$	(2,540	)	$	1,054

Schedule Of Condensed Consolidating Balance Sheet

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors		Eliminations			Condensed Consolidated
ASSETS
Current assets:
Cash and cash equivalents	$	—		$	—		$	115		$	258	$	—		$	373
Accounts receivable, net		—			—			2,429			2,104		—			4,533
Inventories		—			—			602			452		—			1,054
Deferred income taxes		594			—			—			—		—			594
Other		50			—			184			445		—			679
		644			—			3,330			3,259		—			7,233
Property and equipment, net		—			—			7,088			5,746		—			12,834
Investments of insurance subsidiaries		—			—			—			548		—			548
Investments in and advances to affiliates		—			—			15			86		—			101
Goodwill and other intangible assets		—			—			1,605			3,646		—			5,251
Deferred loan costs		22			268			—			—		—			290
Investments in and advances to subsidiaries		16,825			—			—			—		(16,825	)		—
Other		450			—			21			170		—			641
	$	17,941		$	268		$	12,059		$	13,455	$	(16,825	)	$	26,898
LIABILITIES AND STOCKHOLDERS' (DEFICIT) EQUITY
Current liabilities:
Accounts payable	$	—		$	—		$	899		$	698	$	—		$	1,597
Accrued salaries		—			—			568			397		—			965
Other accrued expenses		15			367			449			754		—			1,585
Long-term debt due within one year		—			1,347			28			32		—			1,407
		15			1,714			1,944			1,881		—			5,554
Long-term debt		1,525			23,454			110			556		—			25,645
Intercompany balances		24,121			(12,814	)		(15,183	)		3,876		—			—
Professional liability risks		—			—			—			993		—			993
Income taxes and other liabilities		538			415			556			211		—			1,720
		26,199			12,769			(12,573	)		7,517		—			33,912
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.		(8,258	)		(12,501	)		24,534			4,792		(16,825	)		(8,258	)
Noncontrolling interests		—			—			98			1,146		—			1,244
		(8,258	)		(12,501	)		24,632			5,938		(16,825	)		(7,014	)
	$	17,941		$	268		$	12,059		$	13,455	$	(16,825	)	$	26,898

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors		Eliminations			Condensed Consolidated
ASSETS
Current assets:
Cash and cash equivalents	$	6		$	—		$	156		$	249	$	—		$	411
Accounts receivable, net		—			—			2,214			1,618		—			3,832
Inventories		—			—			547			350		—			897
Deferred income taxes		931			—			—			—		—			931
Other		202			—			223			423		—			848
		1,139			—			3,140			2,640		—			6,919
Property and equipment, net		—			—			6,817			4,535		—			11,352
Investments of insurance subsidiaries		—			—			—			642		—			642
Investments in and advances to affiliates		—			—			248			621		—			869
Goodwill and other intangible assets		—			—			1,635			1,058		—			2,693
Deferred loan costs		23			351			—			—		—			374
Investments in and advances to subsidiaries		14,282			—			—			—		(14,282	)		—
Other		776			39			21			167		—			1,003
	$	16,220		$	390		$	11,861		$	9,663	$	(14,282	)	$	23,852
LIABILITIES AND STOCKHOLDERS' (DEFICIT) EQUITY
Current liabilities:
Accounts payable	$	—		$	—		$	919		$	618	$	—		$	1,537
Accrued salaries		—			—			556			339		—			895
Other accrued expenses		12			296			328			609		—			1,245
Long-term debt due within one year		—			554			12			26		—			592
		12			850			1,815			1,592		—			4,269
Long-term debt		1,525			25,758			95			255		—			27,633
Intercompany balances		25,985			(16,130	)		(12,833	)		2,978		—			—
Professional liability risks		—			—			—			995		—			995
Income taxes and other liabilities		483			425			505			195		—			1,608
		28,005			10,903			(10,418	)		6,015		—			34,505
Equity securities with contingent redemption rights		141			—			—			—		—			141
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.		(11,926	)		(10,513	)		22,167			2,628		(14,282	)		(11,926	)
Noncontrolling interests		—			—			112			1,020		—			1,132
		(11,926	)		(10,513	)		22,279			3,648		(14,282	)		(10,794	)
	$	16,220		$	390		$	11,861		$	9,663	$	(14,282	)	$	23,852

Schedule Of Condensed Consolidating Statement Of Cash Flows

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Cash flows from operating activities:
Net income (loss)	$	2,465		$	(1,988	)	$	2,430		$	2,478		$	(2,543	)	$	2,842
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Change in operating assets and liabilities		6			71			(1,755	)		(1,275	)		—			(2,953	)
Provision for doubtful accounts		—			—			1,644			1,180			—			2,824
Depreciation and amortization		—			—			777			688			—			1,465
Income taxes		912			—			—			—			—			912
Gains on sales of facilities		—			—			(127	)		(15	)		—			(142	)
Gain on acquisition of controlling interest in equity investment		—			—			—			(1,522	)		—			(1,522	)
Losses on retirement of debt		—			481			—			—			—			481
Amortization of deferred loan costs		—			70			—			—			—			70
Share-based compensation		26			—			—			—			—			26
Pay-in-kind interest		—			(78	)		—			—			—			(78	)
Equity in earnings of affiliates		(2,543	)		—			—			—			2,543			—
Other		—			9			—			(1	)		—			8
Net cash provided by (used in) operating activities		866			(1,435	)		2,969			1,533			—			3,933
Cash flows from investing activities:
Purchase of property and equipment		—			—			(910	)		(769	)		—			(1,679	)
Acquisition of hospitals and health care entities		—			—			(142	)		(1,540	)		—			(1,682	)
Disposal of hospitals and health care entities		—			—			200			81			—			281
Change in investments		—			—			34			46			—			80
Other		—			—			—			5			—			5
Net cash used in investing activities		—			—			(818	)		(2,177	)		—			(2,995	)
Cash flows from financing activities:
Issuances of long-term debt		—			5,500			—			—			—			5,500
Net change in revolving bank credit facilities		—			(449	)		—			—			—			(449	)
Repayment of long-term debt		—			(6,577	)		(17	)		(46	)		—			(6,640	)
Distributions to noncontrolling interests		—			—			(77	)		(301	)		—			(378	)
Payment of debt issuance costs		—			(92	)		—			—			—			(92	)
Issuance of common stock		2,506			—			—			—			—			2,506
Repurchase of common stock		(1,503	)		—			—			—			—			(1,503	)
Distributions to stockholders		(31	)		—			—			—			—			(31	)
Income tax benefits		63			—			—			—			—			63
Changes in intercompany balances with affiliates, net		(1,918	)		3,053			(2,098	)		963			—			—
Other		11			—			—			37			—			48
Net cash provided by (used in) financing activities		(872	)		1,435			(2,192	)		653			—			(976	)
Change in cash and cash equivalents		(6	)		—			(41	)		9			—			(38	)
Cash and cash equivalents at beginning of period		6			—			156			249			—			411
Cash and cash equivalents at end of period	$	—		$	—		$	115		$	258		$	—		$	373

	HCA Holdings, Inc. Issuer			HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Cash flows from operating activities:
Net income	$	1,207		$	(1,750	)	$	2,424		$	907		$	(1,215	)	$	1,573
Adjustments to reconcile net income to net cash provided by (used in) operating activities:
Change in operating assets and liabilities		12			13			(1,759	)		(1,113	)		—			(2,847	)
Provision for doubtful accounts		—			—			1,632			1,016			—			2,648
Depreciation and amortization		—			—			782			639			—			1,421
Income taxes		27			—			—			—			—			27
Gains on sales of facilities		—			—			—			(4	)		—			(4	)
Impairments of long-lived assets		—			—			58			65			—			123
Amortization of deferred loan costs		—			81			—			—			—			81
Share-based compensation		32			—			—			—			—			32
Equity in earnings of affiliates		(1,215	)		—			—			—			1,215			—
Other		—			31			—			—			—			31
Net cash provided by (used in) operating activities		63			(1,625	)		3,137			1,510			—			3,085
Cash flows from investing activities:
Purchase of property and equipment		—			—			(602	)		(723	)		—			(1,325	)
Acquisition of hospitals and health care entities		—			—			(21	)		(212	)		—			(233	)
Disposal of hospitals and health care entities		—			—			29			8			—			37
Change in investments		—			—			1			471			—			472
Other		—			—			(3	)		13			—			10
Net cash used in investing activities		—			—			(596	)		(443	)		—			(1,039	)
Cash flows from financing activities:
Issuances of long-term debt		1,525			1,387			—			—			—			2,912
Net change in revolving bank credit facilities		—			1,889			—			—			—			1,889
Repayment of long-term debt		—			(2,164	)		(32	)		(72	)		—			(2,268	)
Distributions to noncontrolling interests		—			—			(61	)		(281	)		—			(342	)
Contributions from noncontrolling interests		—			—			—			57			—			57
Payment of debt issuance costs		(23	)		(27	)		—			—			—			(50	)
Distributions to stockholders		(4,257	)		—			—			—			—			(4,257	)
Income tax benefits		114			—			—			—			—			114
Changes in intercompany balances with affiliates, net		2,590			556			(2,387	)		(759	)		—			—
Other		(6	)		(16	)		—			20			—			(2	)
Net cash provided by (used in) financing activities		(57	)		1,625			(2,480	)		(1,035	)		—			(1,947	)
Change in cash and cash equivalents		6			—			61			32			—			99
Cash and cash equivalents at beginning of period		—			—			95			217			—			312
Cash and cash equivalents at end of period	$	6		$	—		$	156		$	249		$	—		$	411

	HCA Inc. Issuer			Subsidiary Guarantors			Subsidiary Non- Guarantors			Eliminations			Condensed Consolidated
Cash flows from operating activities:
Net income	$	1,054		$	2,060		$	801		$	(2,540	)	$	1,375
Adjustments to reconcile net income to net cash provided by (used in) operating activities:
Change in operating assets and liabilities		90			(1,882	)		(1,299	)		—			(3,091	)
Provision for doubtful accounts		—			2,043			1,233			—			3,276
Depreciation and amortization		—			787			638			—			1,425
Income taxes		(520	)		—			—			—			(520	)
Losses (gains) on sales of facilities		—			17			(2	)		—			15
Impairments of long-lived assets		—			34			9			—			43
Amortization of deferred loan costs		80			—			—			—			80
Share-based compensation		40			—			—			—			40
Pay-in-kind interest		58			—			—			—			58
Equity in earnings of affiliates		(2,540	)		—			—			2,540			—
Other		50			(2	)		(2	)		—			46
Net cash provided by (used in) operating activities		(1,688	)		3,057			1,378			—			2,747
Cash flows from investing activities:
Purchase of property and equipment		—			(720	)		(597	)		—			(1,317	)
Acquisition of hospitals and health care entities		—			(38	)		(23	)		—			(61	)
Disposal of hospitals and health care entities		—			21			20			—			41
Change in investments		—			(7	)		310			—			303
Other		—			—			(1	)		—			(1	)
Net cash used in investing activities		—			(744	)		(291	)		—			(1,035	)
Cash flows from financing activities:
Issuances of long-term debt		2,979			—			—			—			2,979
Net change in revolving bank credit facilities		(1,335	)		—			—			—			(1,335	)
Repayment of long-term debt		(2,972	)		(7	)		(124	)		—			(3,103	)
Distributions to noncontrolling interests		—			(70	)		(260	)		—			(330	)
Payment of debt issuance costs		(70	)		—			—			—			(70	)
Changes in intercompany balances with affiliates, net		3,107			(2,275	)		(832	)		—			—
Other		(21	)		—			15			—			(6	)
Net cash provided by (used in) financing activities		1,688			(2,352	)		(1,201	)		—			(1,865	)
Change in cash and cash equivalents		—			(39	)		(114	)		—			(153	)
Cash and cash equivalents at beginning of period		—			134			331			—			465
Cash and cash equivalents at end of period	$	—		$	95		$	217		$	—		$	312

Schedule Of Consolidated Statements of Stockholder's Deficit

	2011		2010		2009
Presentation in HCA Holdings, Inc. Consolidated Statements of Stockholders' Deficit:
Share-based benefit plans	$	35	$	43	$	47
Reclassification of certain equity securities with contingent redemption rights		141		—		—
Other		36		120		14
Presentation in Healthtrust, Inc. — The Hospital Company Consolidated Statements of Stockholder's Deficit:
Distributions from HCA Holdings, Inc., net of contributions to HCA Holdings, Inc.	$	212	$	163	$	61

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Long-Term Debt (Schedule Of Long-Term Debt) (Details) (USD $) In Millions, unless otherwise specified	Dec. 31, 2011 years	Dec. 31, 2010
Debt Instrument [Line Items]
First lien debt	$ 17,011	$ 14,531
Senior secured toggle notes		1,578
Second lien debt	197	6,079
Total debt	27,052	28,225
Long-term debt due within one year	1,407	592
Long-term debt	25,645	27,633
Long-term debt average rate	6.30%
Long-term debt average term	6.9
1.5% Senior Secured Asset Based Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Long-term line of credit	2,155	1,875
1.8% Senior Secured Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Long-term line of credit		729
Effective interest rate	1.80%
6.9% Senior Secured Term Loan Facilities [Member]
Debt Instrument [Line Items]
Long-term line of credit	7,425	7,530
Effective interest rate	4.80%
8.4% Senior Secured First Lien Notes [Member]
Debt Instrument [Line Items]
Senior secured first lien notes	7,081	4,075
Effective interest rate	7.70%
7.1% Other Senior Secured Debt [Member]
Debt Instrument [Line Items]
Other senior secured debt	350	322
Effective interest rate	6.80%
9.7% Senior Secured Notes [Member]
Debt Instrument [Line Items]
Senior secured first lien notes	197	4,501
Effective interest rate	11.00%
7.1% Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes	$ 9,844	$ 7,615
Effective interest rate	7.30%

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Long-Term Debt (Tables)

12 Months Ended

Dec. 31, 2011

Long-Term Debt [Abstract]

Schedule Of Long-Term Debt

	2011		2010
Senior secured asset-based revolving credit facility (effective interest rate of 1.8%)	$	2,155	$	1,875
Senior secured revolving credit facility		—		729
Senior secured term loan facilities (effective interest rate of 4.8%)		7,425		7,530
Senior secured first lien notes (effective interest rate of 7.7%)		7,081		4,075
Other senior secured debt (effective interest rate of 6.8%)		350		322
First lien debt		17,011		14,531
Senior secured second lien notes (effective interest rate of 11.0%)		197		4,501
Senior secured toggle notes		—		1,578
Second lien debt		197		6,079
Senior unsecured notes (effective interest rate of 7.3%)		9,844		7,615
Total debt (average life of 6.9 years, rates averaging 6.3%)		27,052		28,225
Less amounts due within one year		1,407		592
	$	25,645	$	27,633

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Acquisitions And Dispositions (Schedule Of Allocation Of The Purchase Price, Including Assumed Liabilities) (Details) (USD $) In Millions, unless otherwise specified	Dec. 31, 2011	Dec. 31, 2010
Goodwill	$ 2,261
Noncontrolling interests	1,244	1,132
HealthONE [Member]
Current assets	400
Property and equipment	1,040
Identifiable intangible asset (trade name)	269
Goodwill	2,261
Other assets	7
Liabilities	152
Noncontrolling interests	$ 93

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Financial Instruments (Schedule Of Cross Currency Swap Agreement Not Designated As Hedge) (Details) In Millions, unless otherwise specified	Dec. 31, 2011 EUR (€)	Dec. 31, 2011 Maturity Date, 2011 [Member] Euro - United States Dollar Currency Swap [Member] USD ($)
Derivative Instruments, Gain (Loss) [Line Items]
Notinal amount of for curency derivates	€ 291
Fair Value		$ (16)

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Investments Of Insurance Subsidiaries (Narrative) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010
Investments Of Insurance Subsidiaries [Line Items]
Investments subject to restrictions	$ 19	$ 92
Available for sale securities expected maturity of debt securities (in years)	4.4
Available for sale securities average scheduled maturity (in years)	10.8
Asset-Backed Securities [Member]
Investments Of Insurance Subsidiaries [Line Items]
Available for sale securities expected maturity of debt securities (in years)	4.8
Available for sale securities average scheduled maturity (in years)	24.8
Auction Rate Securities [Member]
Investments Of Insurance Subsidiaries [Line Items]
Available for sale securities expected maturity of debt securities (in years)	4.9
Available for sale securities average scheduled maturity (in years)	24.9

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Accounting Policies (Schedule Of Estimated Costs Of Uncompensated Care) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Accounting Policies [Abstract]
Gross patient charges	$ 141,516	$ 125,640	$ 115,682
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)	25,554	23,870	22,975
Cost-to-charges ratio	18.10%	19.00%	19.90%
Total uncompensated care	11,214	9,626	8,362
Multiplied by the cost-to-charges ratio	18.10%	19.00%	19.90%
Estimated cost of total uncompensated care	$ 2,030	$ 1,829	$ 1,664

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Share-Based Compensation

12 Months Ended

Dec. 31, 2011

Share-Based Compensation [Abstract]

Share-Based Compensation

NOTE 2 — SHARE-BASED COMPENSATION

Stock Incentive Plan

The 2006 Stock Incentive Plan for Key Employees of HCA Holdings Inc. and its Affiliates, as Amended and Restated (the "Stock Incentive Plan") is designed to promote the long term financial interests and growth of the Company and its subsidiaries by attracting and retaining management and other personnel and key service providers and to motivate management personnel by means of incentives to achieve long range goals and further the alignment of interests of participants with those of our stockholders through opportunities for increased stock, or stock-based, ownership in the Company. During 2011, our Board of Directors approved certain amendments to the Stock Incentive Plan that became effective upon the initial public offering of our common stock. The amendments included an increase to the number of shares available for issuance under the plan by 40,000,000 shares. A portion of the options under the Stock Incentive Plan vests solely based upon continued employment over a specific period of time, and a portion of the options vests based both upon continued employment over a specific period of time and upon the achievement of predetermined financial and Investor return targets over time. We granted 1,288,000 and 964,000 options under the Stock Incentive Plan during 2011 and 2010, respectively. As of December 31, 2011, 35,090,800 options granted under the Stock Incentive Plan have vested, of which 30,723,400 are outstanding and exercisable, and there were 42,099,900 shares available for future grants under the Stock Incentive Plan.

Rollover Options

Certain management holders of outstanding prerecapitalization HCA stock options retained certain of their stock options (the "Rollover Options"). The Rollover Options remain outstanding in accordance with the terms of the governing stock incentive plans and grant agreements pursuant to which the holder originally received the stock option grants. Pursuant to the rollover option agreement, 49,408,100 prerecapitalization HCA stock options were converted into 10,294,500 Rollover Options, of which 2,825,100 are outstanding and exercisable at December 31, 2011.

Stock Option Activity

The fair value of each stock option award is estimated on the grant date, using option valuation models and the weighted average assumptions indicated in the following table. Awards under the Stock Incentive Plan generally vest based on continued employment and based upon achievement of certain financial and Investor return targets. Each grant is valued as a single award with an expected term equal to the average expected term of the component vesting tranches. We use historical option exercise behavior data and other factors to estimate the expected term of the options. The expected term of the option is limited by the contractual term, and employee post-vesting termination behavior is incorporated in the historical option exercise behavior data. Compensation cost is recognized on the straight-line attribution method. The straight-line attribution method requires that total compensation expense recognized must at least equal the vested portion of the grant-date fair value. The expected volatility is derived using historical stock price information of certain peer group companies for a period of time equal to the expected option term. The risk-free interest rate is the approximate yield on United States Treasury Strips having a life equal to the expected option life on the date of grant. The expected life is an estimate of the number of years an option will be held before it is exercised.

	2011			2010			2009
Risk-free interest rate		0.89	%		2.07	%		1.45	%
Expected volatility		41	%		35	%		35	%
Expected life, in years		5			5			5
Expected dividend yield		—			—			—

Information regarding stock option activity during 2011, 2010 and 2009 is summarized below (share amounts in thousands):

	Stock Options			Weighted Average Exercise Price		Weighted Average Remaining Contractual Term		Aggregate Intrinsic  Value (dollars in millions)
Options outstanding, December 31, 2008		47,906		$	9.99
Granted		8,045			19.70
Exercised		(2,278	)		3.81
Cancelled		(1,756	)		11.56
Options outstanding, December 31, 2009		51,917			11.72
Granted		964			15.73
Exercised		(1,726	)		4.06
Cancelled		(629	)		7.96
Options outstanding, December 31, 2010		50,526			8.58
Granted		1,288			23.35
Exercised		(5,044	)		6.31
Cancelled		(458	)		5.88
Options outstanding, December 31, 2011		46,312			9.26		5.6 years	$	595
Options exercisable, December 31, 2011		33,548		$	9.74		5.4 years	$	414

During 2010, our Board of Directors declared three distributions to the Company's stockholders and holders of stock options. The distributions totaled $9.43 per share and vested stock option. Pursuant to the terms of our stock option plans, the holders of nonvested stock options received $9.43 per share reductions (subject to certain tax related limitations for certain stock options that resulted in deferred distributions for a portion of the declared distribution, which will be paid upon the vesting of the applicable stock options) to the exercise price of the share-based awards.

The weighted average fair values of stock options granted during 2011, 2010 and 2009 were $8.53, $7.13 and $3.54 per share, respectively. The total intrinsic value of stock options exercised in the year ended December 31, 2011 was $121 million. As of December 31, 2011, the unrecognized compensation cost related to nonvested awards was $23 million.

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Investments Of Insurance Subsidiaries (Schedule Of Investments) (USD $) In Millions, unless otherwise specified	Dec. 31, 2011	Dec. 31, 2010
Schedule of Available-for-sale Securities [Line Items]
Amortized Cost	$ 617	$ 732
Unrealized Amounts, Gains	20	14
Unrealized Amounts, Losses	(9)	(4)
Fair Value	628	742
Less amounts classified as current assets	(80)	(100)
Investment carrying value	548	642
Debt Securities [Member]
Schedule of Available-for-sale Securities [Line Items]
Amortized Cost	610	724
Unrealized Amounts, Gains	19	13
Unrealized Amounts, Losses	(8)	(3)
Fair Value	621	734
Equity Securities [Member]
Schedule of Available-for-sale Securities [Line Items]
Amortized Cost	7	8
Unrealized Amounts, Gains	1	1
Unrealized Amounts, Losses	(1)	(1)
Fair Value	7	8
States And Municipalities [Member] | Debt Securities [Member]
Schedule of Available-for-sale Securities [Line Items]
Amortized Cost	398	312
Unrealized Amounts, Gains	19	12
Unrealized Amounts, Losses		(1)
Fair Value	417	323
Auction Rate Securities [Member] | Debt Securities [Member]
Schedule of Available-for-sale Securities [Line Items]
Amortized Cost	139	251
Unrealized Amounts, Losses	(8)	(1)
Fair Value	131	250
Asset-Backed Securities [Member] | Debt Securities [Member]
Schedule of Available-for-sale Securities [Line Items]
Amortized Cost	20	26
Unrealized Amounts, Gains		1
Unrealized Amounts, Losses		(1)
Fair Value	20	26
Money Market Funds [Member] | Debt Securities [Member]
Schedule of Available-for-sale Securities [Line Items]
Amortized Cost	53	135
Fair Value	$ 53	$ 135

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Quarterly Consolidated Financial Information (Tables)

12 Months Ended

Dec. 31, 2011

Quarterly Consolidated Financial Information [Abstract]

Schedule Of Quarterly Consolidated Financial Information

HCA HOLDINGS, INC.

QUARTERLY CONSOLIDATED FINANCIAL INFORMATION

(UNAUDITED)

(Dollars in millions)

	2011
	First			Second			Third			Fourth
Revenues(i)	$	7,406		$	7,249		$	7,258		$	7,769
Net income	$	334	(a)	$	320	(b)	$	146	(c)	$	2,042	(d)
Net income attributable to HCA Holdings, Inc.	$	240	(a)	$	229	(b)	$	61	(c)	$	1,935	(d)
Basic earnings per share	$	0.54		$	0.44		$	0.12		$	4.43
Diluted earnings per share	$	0.52		$	0.43		$	0.11		$	4.25

	2010
	First			Second			Third			Fourth
Revenues(i)	$	6,980		$	6,968		$	6,926		$	7,161
Net income	$	476	(e)	$	378	(f)	$	325	(g)	$	394	(h)
Net income attributable to HCA Holdings, Inc.	$	388	(e)	$	293	(f)	$	243	(g)	$	283	(h)
Basic earnings per share	$	0.91		$	0.69		$	0.57		$	0.66
Diluted earnings per share	$	0.89		$	0.67		$	0.55		$	0.65

(a) First quarter results include $2 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $149 million of costs related to the termination of management agreement (See NOTE 1 of the notes to consolidated financial statements).

(b) Second quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $47 million of losses on retirement of debt (See NOTE 10 of the notes to consolidated financial statements).

(c) Third quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $256 million of losses on retirement of debt (See NOTE 10 of the notes to consolidated financial statements).

(d) Fourth quarter results include $84 million of gains on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $1.424 billion of gain on acquisition of controlling interest in equity investment (See NOTE 3 of the notes to consolidated financial statements).

(e) First quarter results include $12 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

(f) Second quarter results include $57 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

(g) Third quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $6 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

(h) Fourth quarter results include $3 million of gains on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $2 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

(i) The "Revenues" presented for each quarter of 2010 and the first and second quarters of 2011 have been reduced by the provision for doubtful accounts for each quarter in accordance with our adoption of ASU 2011-07 in the third quarter of 2011. The "Revenues" presented for the second and third quarters of 2011 have been reduced for the reclassification of "Electronic health record incentive income" as a separate line item in our consolidated income statements (See NOTE 1 of the notes to consolidated financial statements).

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Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2011

Accounting Policies [Abstract]

Schedule Of Revenues From Third Party Payers And Uninsured

	2011			Ratio			2010			Ratio			2009			Ratio
Medicare	$	7,653			25.8	%	$	7,203			25.7	%	$	6,866			25.6	%
Managed Medicare		2,442			8.2			2,162			7.7			2,006			7.5
Medicaid		1,845			6.2			1,962			7.0			1,691			6.3
Managed Medicaid		1,265			4.3			1,165			4.2			1,113			4.2
Managed care and other insurers		15,703			52.9			14,762			52.7			14,323			53.5
International (managed care and other insurers)		938			3.2			784			2.8			702			2.6
		29,846			100.6			28,038			100.1			26,701			99.7
Uninsured		1,846			6.2			1,732			6.2			2,350			8.8
Other		814			2.7			913			3.3			1,001			3.7
Revenues before provision for doubtful accounts		32,506			109.5			30,683			109.6			30,052			112.2
Provision for doubtful accounts		(2,824	)		(9.5	)		(2,648	)		(9.6	)		(3,276	)		(12.2	)
Revenues	$	29,682			100.0	%	$	28,035			100.0	%	$	26,776			100.0	%

Schedule Of Revenue Deductions Related To Uninsured Accounts

	2011		Ratio			2010		Ratio			2009		Ratio
Charity care	$	2,683		24	%	$	2,337		24	%	$	2,151		26	%
Uninsured discounts		5,707		51			4,641		48			2,935		35
Provision for doubtful accounts		2,824		25			2,648		28			3,276		39
Total uncompensated care	$	11,214		100	%	$	9,626		100	%	$	8,362		100	%

Schedule Of Estimated Costs Of Uncompensated Care

	2011			2010			2009
Gross patient charges	$	141,516		$	125,640		$	115,682
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)		25,554			23,870			22,975
Cost-to-charges ratio		18.1	%		19.0	%		19.9	%
Total uncompensated care	$	11,214		$	9,626		$	8,362
Multiplied by the cost-to-charges ratio		18.1	%		19.0	%		19.9	%
Estimated cost of total uncompensated care	$	2,030		$	1,829		$	1,664

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Accounting Policies (Policy)

12 Months Ended

Dec. 31, 2011

Accounting Policies [Abstract]

Basis Of Presentation

Basis of Presentation

The preparation of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. Actual results could differ from those estimates.

The consolidated financial statements include all subsidiaries and entities controlled by HCA. We generally define "control" as ownership of a majority of the voting interest of an entity. The consolidated financial statements include entities in which we absorb a majority of the entity's expected losses, receive a majority of the entity's expected residual returns, or both, as a result of ownership, contractual or other financial interests in the entity. Significant intercompany transactions have been eliminated. Investments in entities we do not control, but in which we have a substantial ownership interest and can exercise significant influence, are accounted for using the equity method.

We have completed various acquisitions and joint venture transactions. The accounts of these entities have been included in our consolidated financial statements for periods subsequent to our acquisition of controlling interests. The majority of our expenses are "cost of revenue" items. Costs that could be classified as general and administrative include our corporate office costs, which were $228 million, $182 million and $164 million for the years ended December 31, 2011, 2010 and 2009, respectively.

Revenues

In 2011, we adopted the provisions of Accounting Standards Update No. 2011-07, Presentation and Disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities ("ASU 2011-07"). ASU 2011-07 requires health care entities to change the presentation of the statement of operations by reclassifying the provision for doubtful accounts from an operating expense to a deduction from patient service revenues. All periods presented in these consolidated financial statements and notes to consolidated financial statements have been reclassified in accordance with ASU 2011-07.

Revenues consist primarily of net patient service revenues that are recorded based upon established billing rates less allowances for contractual adjustments. Revenues are recorded during the period the health care services are provided, based upon the estimated amounts due from the patients and third-party payers. Third-party payers include federal and state agencies (under the Medicare and Medicaid programs), managed care health plans, commercial insurance companies and employers. Estimates of contractual allowances under managed care health plans are based upon the payment terms specified in the related contractual agreements. Contractual payment terms in managed care agreements are generally based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates. Revenues related to uninsured patients and copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record a provision for doubtful accounts (based primarily on historical collection experience) related to these uninsured accounts to record the net self pay accounts receivable at the estimated amounts we expect to collect. Our revenues from third party payers and the uninsured for the years ended December 31, are summarized in the following table (dollars in millions):

	2011			Ratio			2010			Ratio			2009			Ratio
Medicare	$	7,653			25.8	%	$	7,203			25.7	%	$	6,866			25.6	%
Managed Medicare		2,442			8.2			2,162			7.7			2,006			7.5
Medicaid		1,845			6.2			1,962			7.0			1,691			6.3
Managed Medicaid		1,265			4.3			1,165			4.2			1,113			4.2
Managed care and other insurers		15,703			52.9			14,762			52.7			14,323			53.5
International (managed care and other insurers)		938			3.2			784			2.8			702			2.6
		29,846			100.6			28,038			100.1			26,701			99.7
Uninsured		1,846			6.2			1,732			6.2			2,350			8.8
Other		814			2.7			913			3.3			1,001			3.7
Revenues before provision for doubtful accounts		32,506			109.5			30,683			109.6			30,052			112.2
Provision for doubtful accounts		(2,824	)		(9.5	)		(2,648	)		(9.6	)		(3,276	)		(12.2	)
Revenues	$	29,682			100.0	%	$	28,035			100.0	%	$	26,776			100.0	%

Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility recorded estimates will change by a material amount. Estimated reimbursement amounts are adjusted in subsequent periods as cost reports are prepared and filed and as final settlements are determined (in relation to certain government programs, primarily Medicare, this is generally referred to as the "cost report" filing and settlement process). The adjustments to estimated Medicare and Medicaid reimbursement amounts and disproportionate-share funds, which resulted in net increases to revenues, related primarily to cost reports filed during the respective year were $40 million, $52 million and $40 million in 2011, 2010 and 2009, respectively. The adjustments to estimated reimbursement amounts, which resulted in net increases to revenues, related primarily to cost reports filed during previous years were $30 million, $50 million and $60 million in 2011, 2010 and 2009, respectively.

The Emergency Medical Treatment and Labor Act ("EMTALA") requires any hospital participating in the Medicare program to conduct an appropriate medical screening examination of every person who presents to the hospital's emergency room for treatment and, if the individual is suffering from an emergency medical condition, to either stabilize the condition or make an appropriate transfer of the individual to a facility able to handle the condition. The obligation to screen and stabilize emergency medical conditions exists regardless of an individual's ability to pay for treatment. Federal and state laws and regulations, including but not limited to EMTALA, require, and our commitment to providing quality patient care encourages, us to provide services to patients who are financially unable to pay for the health care services they receive. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues. Patients treated at hospitals for nonelective care, who have income at or below 200% of the federal poverty level, are eligible for charity care. The federal poverty level is established by the federal government and is based on income and family size. We provide discounts to uninsured patients who do not qualify for Medicaid or charity care. These discounts are similar to those provided to many local managed care plans. In implementing the discount policy, we first attempt to qualify uninsured patients for Medicaid, other federal or state assistance or charity care. If an uninsured patient does not qualify for these programs, the uninsured discount is applied.

The revenue deductions related to uninsured accounts (charity care and uninsured discounts) generally have the inverse impact on the provision for doubtful accounts. To quantify the total impact of and trends related to uninsured accounts, we believe it is beneficial to view charity care, uninsured discounts and the provision for doubtful accounts in combination, rather than each separately. A summary of these amounts for the years ended December 31, follows (dollars in millions):

	2011		Ratio			2010		Ratio			2009		Ratio
Charity care	$	2,683		24	%	$	2,337		24	%	$	2,151		26	%
Uninsured discounts		5,707		51			4,641		48			2,935		35
Provision for doubtful accounts		2,824		25			2,648		28			3,276		39
Total uncompensated care	$	11,214		100	%	$	9,626		100	%	$	8,362		100	%

A summary of the estimated cost of total uncompensated care for the years ended December 31, follows (dollars in millions):

	2011			2010			2009
Gross patient charges	$	141,516		$	125,640		$	115,682
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)		25,554			23,870			22,975
Cost-to-charges ratio		18.1	%		19.0	%		19.9	%
Total uncompensated care	$	11,214		$	9,626		$	8,362
Multiplied by the cost-to-charges ratio		18.1	%		19.0	%		19.9	%
Estimated cost of total uncompensated care	$	2,030		$	1,829		$	1,664

The sum of charity care, uninsured discounts and the provision for doubtful accounts, as a percentage of the sum of revenues, charity care, uninsured discounts and the provision for doubtful accounts increased from 23.8% for 2009, to 25.6% for 2010 and to 27.4% for 2011. The trend of the three components of uncompensated care indicates that increases to our uninsured discounts have resulted in the provision for doubtful accounts declining from 39% of total uncompensated care for 2009 to 25% of total uncompensated care for 2011, and uninsured discounts increasing from 35% of total uncompensated care for 2009 to 51% of total uncompensated care for 2011.

Cash And Cash Equivalents

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 estimated professional liability claims during the next twelve months are not included in cash and cash equivalents as these funds are not available for general corporate purposes. Carrying values of cash and cash equivalents approximate fair value due to the short-term nature of these instruments.

Our cash management system provides for daily investment of available balances and the funding of outstanding checks when presented for payment. Outstanding, but unpresented, checks totaling $382 million and $384 million at December 31, 2011 and 2010, respectively, have been included in "accounts payable" in the consolidated balance sheets. Upon presentation for payment, these checks are funded through available cash balances or our credit facility.

Accounts Receivable

Accounts Receivable

We receive payments for services rendered from federal and state agencies (under the Medicare and Medicaid programs), managed care health plans, commercial insurance companies, employers and patients. We recognize that revenues and receivables from government agencies are significant to our operations, but do not believe there are significant credit risks associated with these government agencies. We do not believe there are any other significant concentrations of revenues from any particular payer that would subject us to any significant credit risks in the collection of our accounts receivable.

Additions to the allowance for doubtful accounts are made by means of the provision for doubtful accounts. Accounts written off as uncollectible are deducted from the allowance for doubtful accounts and subsequent recoveries are added. The amount of the provision for doubtful accounts is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in federal, state and private employer health care coverage and other collection indicators. The provision for doubtful accounts and the allowance for doubtful accounts relate to "uninsured" amounts (including copayment and deductible amounts from patients who have health care coverage) due directly from patients. Accounts are written off when all reasonable internal and external collection efforts have been performed. We consider the return of an account from the secondary external collection agency to be the culmination of our reasonable collection efforts and the timing basis for writing off the account balance. Writeoffs are based upon specific identification and the writeoff process requires a writeoff adjustment entry to the patient accounting system. Management relies on the results of detailed reviews of historical writeoffs and recoveries at facilities that represent a majority of our revenues and accounts receivable (the "hindsight analysis") as a primary source of information to utilize in estimating the collectibility of our accounts receivable. We perform the hindsight analysis quarterly, utilizing rolling twelve-months accounts receivable collection and writeoff data. At December 31, 2011 and 2010, the allowance for doubtful accounts represented approximately 92% and 93%, respectively, of the $4.478 billion and $4.249 billion, respectively, patient due accounts receivable balance. The patient due accounts receivable balance represents the estimated uninsured portion of our accounts receivable. The estimated uninsured portion of Medicaid pending and uninsured discount pending accounts is included in our patient due accounts receivable balance. Days revenues in accounts receivable were 53 days, 50 days and 50 days at December 31, 2011, 2010 and 2009, respectively. Adverse changes in general economic conditions, patient accounting service center operations, payer mix or trends in federal or state governmental health care coverage could affect our collection of accounts receivable, cash flows and results of operations.

Inventories

.Inventories

Inventories are stated at the lower of cost (first-in, first-out) or market.

Property And Equipment

Property and Equipment

Depreciation expense, computed using the straight-line method, was $1.461 billion in 2011, $1.416 billion in 2010 and $1.419 billion in 2009. Buildings and improvements are depreciated over estimated useful lives ranging generally from 10 to 40 years. Estimated useful lives of equipment vary generally from four to 10 years.

When events, circumstances or operating results indicate the carrying values of certain long-lived assets expected to be held and used, might be impaired, we prepare projections of the undiscounted future cash flows expected to result from the use of the assets and their eventual disposition. If the projections indicate the recorded amounts are not expected to be recoverable, such amounts are reduced to estimated fair value. Fair value may be estimated based upon internal evaluations that include quantitative analyses of revenues and cash flows, reviews of recent sales of similar facilities and independent appraisals.

Long-lived assets to be disposed of are reported at the lower of their carrying amounts or fair value less costs to sell or close. The estimates of fair value are usually based upon recent sales of similar assets and market responses based upon discussions with and offers received from potential buyers.

Investments Of Insurance Subsidiaries

Investments of Insurance Subsidiaries

At December 31, 2011 and 2010, the investments of our wholly-owned insurance subsidiaries were classified as "available-for-sale" as defined in Accounting Standards Codification ("ASC") No. 320, Investments — Debt and Equity Securities and are recorded at fair value. The investment securities are held for the purpose of providing the funding source to pay professional liability claims covered by the insurance subsidiaries. We perform a quarterly assessment of individual investment securities to determine whether declines in market value are temporary or other-than-temporary. Our investment securities evaluation process involves multiple subjective judgments, often involves estimating the outcome of future events, and requires a significant level of professional judgment in determining whether an impairment has occurred. We evaluate, among other things, the financial position and near term prospects of the issuer, conditions in the issuer's industry, liquidity of the investment, changes in the amount or timing of expected future cash flows from the investment, and recent downgrades of the issuer by a rating agency, to determine if, and when, a decline in the fair value of an investment below amortized cost is considered other-than-temporary. The length of time and extent to which the fair value of the investment is less than amortized cost and our ability and intent to retain the investment, to allow for any anticipated recovery of the investment's fair value, are important components of our investment securities evaluation process.

Goodwill And Other Intangible Assets

Goodwill and Other Intangible Assets

Goodwill is not amortized but is subject to annual impairment tests. In addition to the annual impairment review, impairment reviews are performed whenever circumstances indicate a possible impairment may exist. Impairment testing for goodwill is done at the reporting unit level. Reporting units are one level below the business segment level, and our impairment testing is performed at the operating division or market level. We compare the fair value of the reporting unit assets to the carrying amount, on at least an annual basis, to determine if there is potential impairment. If the fair value of the reporting unit assets is less than their carrying value, we compare the fair value of the goodwill to its carrying value. If the fair value of the goodwill is less than its carrying value, an impairment loss is recognized. Fair value of goodwill is estimated based upon internal evaluations of the related long-lived assets for each reporting unit that include quantitative analyses of revenues and cash flows and reviews of recent sales of similar facilities. No goodwill impairments were recognized during 2011, and we recognized goodwill impairments of $14 million and $19 million during 2010 and 2009, respectively.

During 2011, goodwill increased by $2.329 billion related to acquisitions, declined by $24 million related to facility sales, and declined by $16 million related to foreign currency translation and other adjustments. During 2010, goodwill increased by $125 million related to acquisitions, declined by $14 million related to impairments and increased by $5 million related to foreign currency translation and other adjustments.

Since January 1, 2000, we have recognized total goodwill impairments of $102 million in the aggregate. None of the goodwill impairments related to evaluations of goodwill at the reporting unit level, as all recognized goodwill impairments during this period related to goodwill allocated to asset disposal groups.

During 2011, other intangible assets increased by $269 million. Other intangible assets are not amortized but are subject to annual impairment tests.

Deferred Loan Costs

Deferred Loan Costs

Debt issuance costs are amortized based upon the terms of the respective debt obligations. The gross carrying amount of deferred loan costs at December 31, 2011 and 2010 was $638 million and $712 million, respectively, and accumulated amortization was $348 million and $338 million, respectively. Amortization of deferred loan costs is included in interest expense and was $70 million, $81 million and $80 million for 2011, 2010 and 2009, respectively.

Physician Recruiting Agreements

Physician Recruiting Agreements

In order to recruit physicians to meet the needs of our hospitals and the communities they serve, we enter into minimum revenue guarantee arrangements to assist the recruited physicians during the period they are relocating and establishing their practices. A guarantor is required to recognize, at the inception of a guarantee, a liability for the fair value of the stand-ready obligation undertaken in issuing the guarantee. We expense the total estimated guarantee liability amount at the time the physician recruiting agreement becomes effective as we are not able to justify recording a contract-based asset based upon our analysis of the related control, regulatory and legal considerations.

The physician recruiting liability amount of $15 million at both December 31, 2011 and 2010 represents the amount of expense recognized in excess of payments made through December 31, 2011 and 2010. At December 31, 2011 the maximum amount we could have to pay under all effective minimum revenue guarantees was $39 million.

Professional Liability Claims

Reserves for professional liability risks were $1.291 billion and $1.262 billion at December 31, 2011 and 2010, respectively. The current portion of the reserves, $298 million and $268 million at December 31, 2011 and 2010, respectively, is included in "other accrued expenses" in the consolidated balance sheets. Provisions for losses related to professional liability risks were $244 million, $222 million and $211 million for 2011, 2010 and 2009, respectively, and are included in "other operating expenses" in our consolidated income statements. Provisions for losses related to professional liability risks are based upon actuarially determined estimates. Loss and loss expense reserves represent the estimated ultimate net cost of all reported and unreported losses incurred through the respective consolidated balance sheet dates. The reserves for unpaid losses and loss expenses are estimated using individual case-basis valuations and actuarial analyses. Those estimates are subject to the effects of trends in loss severity and frequency. The estimates are continually reviewed and adjustments are recorded as experience develops or new information becomes known. Adjustments to the estimated reserve amounts are included in current operating results. The reserves for professional liability risks cover approximately 2,700 individual claims at both December 31, 2011 and 2010 and estimates for unreported potential claims. The time period required to resolve these claims can vary depending upon the jurisdiction and whether the claim is settled or litigated. During 2011 and 2010, $240 million and $243 million, respectively, of net payments were made for professional and general liability claims. The estimation of the timing of payments beyond a year can vary significantly. Although considerable variability is inherent in professional liability reserve estimates, we believe the reserves for losses and loss expenses are adequate; however, there can be no assurance the ultimate liability will not exceed our estimates.

A portion of our professional liability risks is insured through a wholly-owned insurance subsidiary. Subject to a $5 million per occurrence self-insured retention, our facilities are insured by our wholly-owned insurance subsidiary for losses up to $50 million per occurrence. The insurance subsidiary has obtained reinsurance for professional liability risks generally above a retention level of $15 million per occurrence. We also maintain professional liability insurance with unrelated commercial carriers for losses in excess of amounts insured by our insurance subsidiary.

The obligations covered by reinsurance contracts are included in the reserves for professional liability risks, as the insurance subsidiary remains liable to the extent the reinsurers do not meet their obligations under the reinsurance contracts. The amounts receivable under the reinsurance contracts include $25 million and $11 million at December 31, 2011 and 2010, respectively, recorded in "other assets" and $14 million and $3 million at December 31, 2011 and 2010, respectively, recorded in "other current assets".

Financial Instruments

Financial Instruments

Derivative financial instruments are employed to manage risks, including interest rate and foreign currency exposures, and are not used for trading or speculative purposes. We recognize derivative instruments, such as interest rate swap agreements and foreign exchange contracts, in the consolidated balance sheets at fair value. Changes in the fair value of derivatives are recognized periodically either in earnings or in stockholders' equity, as a component of other comprehensive income (loss), depending on whether the derivative financial instrument qualifies for hedge accounting, and if so, whether it qualifies as a fair value hedge or a cash flow hedge. Generally, changes in fair values of derivatives accounted for as fair value hedges are recorded in earnings, along with the changes in the fair value of the hedged items related to the hedged risk. Gains and losses on derivatives designated as cash flow hedges, to the extent they are effective, are recorded in other comprehensive income (loss), and subsequently reclassified to earnings to offset the impact of the forecasted transactions when they occur. In the event the forecasted transaction to which a cash flow hedge relates is no longer likely, the amount in other comprehensive income (loss) is recognized in earnings and generally the derivative is terminated. Changes in the fair value of derivatives not qualifying as hedges, and for any portion of a hedge that is ineffective, are reported in earnings.

The net interest paid or received on interest rate swaps is recognized as interest expense. Gains and losses resulting from the early termination of interest rate swap agreements are deferred and amortized as adjustments to interest expense over the remaining term of the debt originally associated with the terminated swap.

Electronic Health Record Incentive Payments

Electronic Health Record Incentive Payments

The American Recovery and Reinvestment Act of 2009 provides for Medicare and Medicaid incentive payments beginning in 2011 for eligible hospitals and professionals that adopt and meaningfully use certified electronic health record ("EHR") technology. We recognize income related to Medicare and Medicaid incentive payments using a gain contingency model that is based upon when our eligible hospitals have demonstrated meaningful use of certified EHR technology for the applicable period and the cost report information for the full cost report year that will determine the final calculation of the incentive payment is available.

Medicaid EHR incentive calculations and related payment amounts are based upon prior period cost report information available at the time our eligible hospitals adopt, implement or demonstrate meaningful use of certified EHR technology for the applicable period, and are not subject to revision for cost report data filed for a subsequent period. Thus, incentive income recognition occurs at the point our eligible hospitals adopt, implement or demonstrate meaningful use of certified EHR technology for the applicable period, as the cost report information for the full cost report year that will determine the final calculation of the incentive payment is known at that time.

Medicare EHR incentive calculations and related initial payment amounts are based upon the most current filed cost report information available at the time our eligible hospitals demonstrate meaningful use of certified EHR technology for the applicable period. However, unlike Medicaid, this initial payment amount will be adjusted based upon an updated calculation using the annual cost report information for the cost report period that began during the applicable payment year. Thus, incentive income recognition occurs at the point our eligible hospitals demonstrate meaningful use of certified EHR technology for the applicable period and the cost report information for the full cost report year that will determine the final calculation of the incentive payment is available.

We recognized $210 million of electronic health record incentive income related to Medicaid ($87 million) and Medicare ($123 million) incentive programs during the year ended December 31, 2011. At December 31, 2011, we have $134 million of deferred EHR incentive income, which represents initial incentive payments received for which EHR incentive income has not been recognized. We previously reported $39 million of Medicaid EHR incentives and $51 million ($34 million of Medicaid EHR incentives and $17 million of Medicare EHR incentives) for the quarters ended June 30, 2011 and September 30, 2011, respectively, in the line item "Revenues" in our consolidated income statements. These amounts have been reclassified and are now included in the line item "Electronic health record incentive income" in our consolidated income statement for the year ended December 31, 2011.

Noncontrolling Interests In Consolidated Entities

Noncontrolling Interests in Consolidated Entities

The consolidated financial statements include all assets, liabilities, revenues and expenses of less than 100% owned entities that we control. Accordingly, we have recorded noncontrolling interests in the earnings and equity of such entities.

Related Party Transactions - Management Agreement

Related Party Transactions — Management Agreement

The Investors have provided management and advisory services to the Company pursuant to a management agreement among HCA Inc. and the Investors executed in connection with the Investors' acquisition of HCA Inc. in November 2006. The management agreement was terminated pursuant to its terms upon completion of the initial public offering of our common stock during March 2011, and the Company paid the Investors a final fee of $181 million. The management agreement also provided that the Company pay a 1% fee in connection with certain financing, acquisition, divestiture and change of control transactions. The Company paid the Investors a fee of $26 million related to the initial public offering of our common stock, and this fee was recorded as a cost of the stock offering. The annual management fee was $18 million for 2010 and $15 million for 2009.

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Income Taxes (Schedule Of Provision For Income Taxes) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Income Taxes [Abstract]
Current, Federal	$ (119)	$ 401	$ 809
Current, State	(12)	26	75
Current, Foreign	44	33	21
Deferred, Federal	714	161	(274)
Deferred, State	71	17	(37)
Deferred, Foreign	21	20	33
Provision for income taxes	$ 719	$ 658	$ 627

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Accounting Policies (Narrative) (Details) (USD $)	0 Months Ended	1 Months Ended		3 Months Ended			12 Months Ended
	Jan. 01, 2000	Mar. 31, 2011	Feb. 28, 2011	Sep. 30, 2011	Jun. 30, 2011	Mar. 31, 2011	Dec. 31, 2011 days	Dec. 31, 2010	Dec. 31, 2009 days
Accounting Policies [Line Items]
Number of common stock shares authorized			1,800,000,000				1,800,000,000	1,800,000,000
Initial public offering of shares common stock		$ 87,719,300				$ 87,719,300
Initial public offering of shares of common stock, price per share		$ 30.00				$ 30.00
Split ratio for issued and outstanding common shares			4.505
Stock holders sold common stock in offering						57,410,700
Number of owned and operated hospitals							163
Number of freestanding surgery centers							108
Number of facilities located							20
General and administrative expense							228,000,000	182,000,000	164,000,000
Adjustments to estimated reimbursement filed during respective year							40,000,000	52,000,000	40,000,000
Adjustments to estimated reimbursement filed during previous years							30,000,000	50,000,000	60,000,000
Percentage of income of federal poverty level eligible for charity care							200.00%
Percentage of the sum of revenues, uninsured discounts and charity care							27.40%	25.60%	23.80%
Percentage of provision for doubtful accounts							25.00%	28.00%	39.00%
Percentage of uninsured discounts							51.00%	48.00%	35.00%
Outstanding checks unpresented for payment							382,000,000	384,000,000
Allowance for doubtful accounts percentage of accounts receivable							92.00%	93.00%
Allowance for doubtful accounts							4,478,000,000	4,249,000,000
Days revenues in accounts receivable							53	50	50
Depreciation expense							1,461,000,000	1,416,000,000	1,419,000,000
Amortization of deferred loan costs							70,000,000	81,000,000	80,000,000
Goodwill impairments	102,000,000						24,000,000	14,000,000	19,000,000
Goodwill increased related to acquisitions							2,329,000,000	125,000,000
Goodwill increased related to foreign currency translation and other adjustments							16,000,000	(5,000,000)
Other intangible assets							269,000,000
Deferred loan costs							638,000,000	712,000,000
Deferred loan costs, accumulated amortization							348,000,000	338,000,000
Physician recruiting liability amounts							15,000,000	15,000,000
Maximum amount pay under effective minimum revenue guarantees							39,000,000
Reserves for professional liability risks							1,291,000,000	1,262,000,000
Current portion of professional liability risks reserves							298,000,000	268,000,000
Provisions for losses related to professional liability risks							244,000,000	222,000,000	211,000,000
Reserves for professional liability risks cover individual claims							2,700	2,700
Net payments of professional and general liability claims							240,000,000	243,000,000
Self insured retention amount per occurrence							5,000,000
Maximum amount losses per occurrence							50,000,000
Reinsurance for professional liability risks retention level of amount per occurrence							15,000,000
Amounts receivable under reinsurance contracts recorded in other assets							25,000,000	11,000,000
Amounts receivable under reinsurance contracts recorded in other current assets							14,000,000	3,000,000
Investor final fee upon completion of initial public offering of common stock		181,000,000					181,000,000
Electronic health record incentive income					51,000,000		210,000,000
Percentage of fee							1.00%
Incentive income, medicaid				34,000,000	39,000,000		87,000,000
Incentive income, medicare				17,000,000			123,000,000
Electronic health record deferred incentive income							134,000,000
Investors fee related to the initial public offering of common stock, recorded as cost of stock offering							26,000,000
Annual management fee								$ 18,000,000	$ 15,000,000
Provision for doubtful accounts Ratio							25.00%	28.00%	39.00%
Provision For Doubtful Accounts Under Uninsured Accounts Ratio							25.00%	28.00%	39.00%
Building And Improvements [Member]
Accounting Policies [Line Items]
Estimated useful lives in years, minimum							10
Estimated useful lives in years, maximum							40
Equipment [Member]
Accounting Policies [Line Items]
Estimated useful lives in years, minimum							4
Estimated useful lives in years, maximum							10

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Share-Based Compensation (Tables)

12 Months Ended

Dec. 31, 2011

Share-Based Compensation [Abstract]

Schedule Of Fair Value Of Each Stock Option Award Is Estimated On The Grant Date, Using Option Valuation Models

	2011			2010			2009
Risk-free interest rate		0.89	%		2.07	%		1.45	%
Expected volatility		41	%		35	%		35	%
Expected life, in years		5			5			5
Expected dividend yield		—			—			—

Schedule Of Stock Option Activity

	Stock Options			Weighted Average Exercise Price		Weighted Average Remaining Contractual Term		Aggregate Intrinsic  Value (dollars in millions)
Options outstanding, December 31, 2008		47,906		$	9.99
Granted		8,045			19.70
Exercised		(2,278	)		3.81
Cancelled		(1,756	)		11.56
Options outstanding, December 31, 2009		51,917			11.72
Granted		964			15.73
Exercised		(1,726	)		4.06
Cancelled		(629	)		7.96
Options outstanding, December 31, 2010		50,526			8.58
Granted		1,288			23.35
Exercised		(5,044	)		6.31
Cancelled		(458	)		5.88
Options outstanding, December 31, 2011		46,312			9.26		5.6 years	$	595
Options exercisable, December 31, 2011		33,548		$	9.74		5.4 years	$	414

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Acquisitions And Dispositions (Tables)

12 Months Ended

Dec. 31, 2011

Acquisitions And Dispositions [Abstract]

Schedule Of Allocation Of The Purchase Price, Including Assumed Liabilities

Current assets	$	400
Property and equipment		1,040
Identifiable intangible asset (trade name)		269
Goodwill		2,261
Other assets		7
Liabilities		152
Noncontrolling interests		93

Schedule Of Pro Forma Summary Of Operations

	Years Ended December 31,
	2011		2010
Pro forma revenues	$	31,383	$	29,925
Pro forma net income attributable to HCA Holdings, Inc.		2,507		1,257

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Accounting Policies

12 Months Ended

Dec. 31, 2011

Accounting Policies [Abstract]

Accounting Policies

NOTE 1 — ACCOUNTING POLICIES

Reporting Entity and Corporate Reorganization

On November 17, 2006, HCA Inc. was acquired by a private investor group, including affiliates of or funds sponsored by Bain Capital Partners, LLC, Kohlberg Kravis Roberts & Co., BAML Capital Partners and HCA founder, Dr. Thomas F. Frist Jr. (collectively, the "Investors") and by members of management and certain other investors. The transaction was accounted for as a recapitalization in our financial statements, with no adjustments to the historical basis of our assets and liabilities.

On November 22, 2010, HCA Inc. reorganized by creating a new holding company structure (the "Corporate Reorganization"). HCA Holdings, Inc. became the new parent company, and HCA Inc. became HCA Holdings, Inc.'s wholly-owned direct subsidiary. As part of the Corporate Reorganization, HCA Inc.'s outstanding shares of common stock were automatically converted, on a share for share basis, into identical shares of HCA Holdings, Inc.'s common stock. As a result of the Corporate Reorganization, HCA Holdings, Inc. was deemed the successor registrant to HCA Inc. under the Exchange Act.

During February 2011, our Board of Directors approved an increase in the number of our authorized shares to 1,800,000,000 shares of common stock and a 4.505-to-one split of our issued and outstanding common shares. All common share and per common share amounts in these consolidated financial statements and notes to consolidated financial statements reflect the 4.505-to-one split. During March 2011, we completed the initial public offering of 87,719,300 shares of our common stock at a price of $30.00 per share (before deducting underwriter discounts, commissions and other related offering expenses). Certain of our stockholders also sold 57,410,700 shares of our common stock in this offering. We did not receive any proceeds from the shares sold by the selling stockholders. Our common stock is now traded on the New York Stock Exchange (symbol "HCA").

HCA Holdings, 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 Holdings, Inc. and partnerships and joint ventures in which such subsidiaries are partners. At December 31, 2011, these affiliates owned and operated 163 hospitals, 108 freestanding surgery centers and provided extensive outpatient and ancillary services. HCA Holdings, 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 Inc. and its affiliates prior to the Corporate Reorganization and to HCA Holdings, Inc. and its affiliates after the Corporate Reorganization. The term "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 preparation of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. Actual results could differ from those estimates.

The consolidated financial statements include all subsidiaries and entities controlled by HCA. We generally define "control" as ownership of a majority of the voting interest of an entity. The consolidated financial statements include entities in which we absorb a majority of the entity's expected losses, receive a majority of the entity's expected residual returns, or both, as a result of ownership, contractual or other financial interests in the entity. Significant intercompany transactions have been eliminated. Investments in entities we do not control, but in which we have a substantial ownership interest and can exercise significant influence, are accounted for using the equity method.

We have completed various acquisitions and joint venture transactions. The accounts of these entities have been included in our consolidated financial statements for periods subsequent to our acquisition of controlling interests. The majority of our expenses are "cost of revenue" items. Costs that could be classified as general and administrative include our corporate office costs, which were $228 million, $182 million and $164 million for the years ended December 31, 2011, 2010 and 2009, respectively.

 

Revenues

In 2011, we adopted the provisions of Accounting Standards Update No. 2011-07, Presentation and Disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities ("ASU 2011-07"). ASU 2011-07 requires health care entities to change the presentation of the statement of operations by reclassifying the provision for doubtful accounts from an operating expense to a deduction from patient service revenues. All periods presented in these consolidated financial statements and notes to consolidated financial statements have been reclassified in accordance with ASU 2011-07.

Revenues consist primarily of net patient service revenues that are recorded based upon established billing rates less allowances for contractual adjustments. Revenues are recorded during the period the health care services are provided, based upon the estimated amounts due from the patients and third-party payers. Third-party payers include federal and state agencies (under the Medicare and Medicaid programs), managed care health plans, commercial insurance companies and employers. Estimates of contractual allowances under managed care health plans are based upon the payment terms specified in the related contractual agreements. Contractual payment terms in managed care agreements are generally based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates. Revenues related to uninsured patients and copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record a provision for doubtful accounts (based primarily on historical collection experience) related to these uninsured accounts to record the net self pay accounts receivable at the estimated amounts we expect to collect. Our revenues from third party payers and the uninsured for the years ended December 31, are summarized in the following table (dollars in millions):

	2011			Ratio			2010			Ratio			2009			Ratio
Medicare	$	7,653			25.8	%	$	7,203			25.7	%	$	6,866			25.6	%
Managed Medicare		2,442			8.2			2,162			7.7			2,006			7.5
Medicaid		1,845			6.2			1,962			7.0			1,691			6.3
Managed Medicaid		1,265			4.3			1,165			4.2			1,113			4.2
Managed care and other insurers		15,703			52.9			14,762			52.7			14,323			53.5
International (managed care and other insurers)		938			3.2			784			2.8			702			2.6
		29,846			100.6			28,038			100.1			26,701			99.7
Uninsured		1,846			6.2			1,732			6.2			2,350			8.8
Other		814			2.7			913			3.3			1,001			3.7
Revenues before provision for doubtful accounts		32,506			109.5			30,683			109.6			30,052			112.2
Provision for doubtful accounts		(2,824	)		(9.5	)		(2,648	)		(9.6	)		(3,276	)		(12.2	)
Revenues	$	29,682			100.0	%	$	28,035			100.0	%	$	26,776			100.0	%

Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility recorded estimates will change by a material amount. Estimated reimbursement amounts are adjusted in subsequent periods as cost reports are prepared and filed and as final settlements are determined (in relation to certain government programs, primarily Medicare, this is generally referred to as the "cost report" filing and settlement process). The adjustments to estimated Medicare and Medicaid reimbursement amounts and disproportionate-share funds, which resulted in net increases to revenues, related primarily to cost reports filed during the respective year were $40 million, $52 million and $40 million in 2011, 2010 and 2009, respectively. The adjustments to estimated reimbursement amounts, which resulted in net increases to revenues, related primarily to cost reports filed during previous years were $30 million, $50 million and $60 million in 2011, 2010 and 2009, respectively.

The Emergency Medical Treatment and Labor Act ("EMTALA") requires any hospital participating in the Medicare program to conduct an appropriate medical screening examination of every person who presents to the hospital's emergency room for treatment and, if the individual is suffering from an emergency medical condition, to either stabilize the condition or make an appropriate transfer of the individual to a facility able to handle the condition. The obligation to screen and stabilize emergency medical conditions exists regardless of an individual's ability to pay for treatment. Federal and state laws and regulations, including but not limited to EMTALA, require, and our commitment to providing quality patient care encourages, us to provide services to patients who are financially unable to pay for the health care services they receive. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues. Patients treated at hospitals for nonelective care, who have income at or below 200% of the federal poverty level, are eligible for charity care. The federal poverty level is established by the federal government and is based on income and family size. We provide discounts to uninsured patients who do not qualify for Medicaid or charity care. These discounts are similar to those provided to many local managed care plans. In implementing the discount policy, we first attempt to qualify uninsured patients for Medicaid, other federal or state assistance or charity care. If an uninsured patient does not qualify for these programs, the uninsured discount is applied.

The revenue deductions related to uninsured accounts (charity care and uninsured discounts) generally have the inverse impact on the provision for doubtful accounts. To quantify the total impact of and trends related to uninsured accounts, we believe it is beneficial to view charity care, uninsured discounts and the provision for doubtful accounts in combination, rather than each separately. A summary of these amounts for the years ended December 31, follows (dollars in millions):

	2011		Ratio			2010		Ratio			2009		Ratio
Charity care	$	2,683		24	%	$	2,337		24	%	$	2,151		26	%
Uninsured discounts		5,707		51			4,641		48			2,935		35
Provision for doubtful accounts		2,824		25			2,648		28			3,276		39
Total uncompensated care	$	11,214		100	%	$	9,626		100	%	$	8,362		100	%

A summary of the estimated cost of total uncompensated care for the years ended December 31, follows (dollars in millions):

	2011			2010			2009
Gross patient charges	$	141,516		$	125,640		$	115,682
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)		25,554			23,870			22,975
Cost-to-charges ratio		18.1	%		19.0	%		19.9	%
Total uncompensated care	$	11,214		$	9,626		$	8,362
Multiplied by the cost-to-charges ratio		18.1	%		19.0	%		19.9	%
Estimated cost of total uncompensated care	$	2,030		$	1,829		$	1,664

The sum of charity care, uninsured discounts and the provision for doubtful accounts, as a percentage of the sum of revenues, charity care, uninsured discounts and the provision for doubtful accounts increased from 23.8% for 2009, to 25.6% for 2010 and to 27.4% for 2011. The trend of the three components of uncompensated care indicates that increases to our uninsured discounts have resulted in the provision for doubtful accounts declining from 39% of total uncompensated care for 2009 to 25% of total uncompensated care for 2011, and uninsured discounts increasing from 35% of total uncompensated care for 2009 to 51% of total uncompensated care for 2011.

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 estimated professional liability claims during the next twelve months are not included in cash and cash equivalents as these funds are not available for general corporate purposes. Carrying values of cash and cash equivalents approximate fair value due to the short-term nature of these instruments.

Our cash management system provides for daily investment of available balances and the funding of outstanding checks when presented for payment. Outstanding, but unpresented, checks totaling $382 million and $384 million at December 31, 2011 and 2010, respectively, have been included in "accounts payable" in the consolidated balance sheets. Upon presentation for payment, these checks are funded through available cash balances or our credit facility.

Accounts Receivable

We receive payments for services rendered from federal and state agencies (under the Medicare and Medicaid programs), managed care health plans, commercial insurance companies, employers and patients. We recognize that revenues and receivables from government agencies are significant to our operations, but do not believe there are significant credit risks associated with these government agencies. We do not believe there are any other significant concentrations of revenues from any particular payer that would subject us to any significant credit risks in the collection of our accounts receivable.

Additions to the allowance for doubtful accounts are made by means of the provision for doubtful accounts. Accounts written off as uncollectible are deducted from the allowance for doubtful accounts and subsequent recoveries are added. The amount of the provision for doubtful accounts is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in federal, state and private employer health care coverage and other collection indicators. The provision for doubtful accounts and the allowance for doubtful accounts relate to "uninsured" amounts (including copayment and deductible amounts from patients who have health care coverage) due directly from patients. Accounts are written off when all reasonable internal and external collection efforts have been performed. We consider the return of an account from the secondary external collection agency to be the culmination of our reasonable collection efforts and the timing basis for writing off the account balance. Writeoffs are based upon specific identification and the writeoff process requires a writeoff adjustment entry to the patient accounting system. Management relies on the results of detailed reviews of historical writeoffs and recoveries at facilities that represent a majority of our revenues and accounts receivable (the "hindsight analysis") as a primary source of information to utilize in estimating the collectibility of our accounts receivable. We perform the hindsight analysis quarterly, utilizing rolling twelve-months accounts receivable collection and writeoff data. At December 31, 2011 and 2010, the allowance for doubtful accounts represented approximately 92% and 93%, respectively, of the $4.478 billion and $4.249 billion, respectively, patient due accounts receivable balance. The patient due accounts receivable balance represents the estimated uninsured portion of our accounts receivable. The estimated uninsured portion of Medicaid pending and uninsured discount pending accounts is included in our patient due accounts receivable balance. Days revenues in accounts receivable were 53 days, 50 days and 50 days at December 31, 2011, 2010 and 2009, respectively. Adverse changes in general economic conditions, patient accounting service center operations, payer mix or trends in federal or state governmental health care coverage could affect our collection of accounts receivable, cash flows and results of operations.

.Inventories

Inventories are stated at the lower of cost (first-in, first-out) or market.

Property and Equipment

Depreciation expense, computed using the straight-line method, was $1.461 billion in 2011, $1.416 billion in 2010 and $1.419 billion in 2009. Buildings and improvements are depreciated over estimated useful lives ranging generally from 10 to 40 years. Estimated useful lives of equipment vary generally from four to 10 years.

When events, circumstances or operating results indicate the carrying values of certain long-lived assets expected to be held and used, might be impaired, we prepare projections of the undiscounted future cash flows expected to result from the use of the assets and their eventual disposition. If the projections indicate the recorded amounts are not expected to be recoverable, such amounts are reduced to estimated fair value. Fair value may be estimated based upon internal evaluations that include quantitative analyses of revenues and cash flows, reviews of recent sales of similar facilities and independent appraisals.

Long-lived assets to be disposed of are reported at the lower of their carrying amounts or fair value less costs to sell or close. The estimates of fair value are usually based upon recent sales of similar assets and market responses based upon discussions with and offers received from potential buyers.

Investments of Insurance Subsidiaries

At December 31, 2011 and 2010, the investments of our wholly-owned insurance subsidiaries were classified as "available-for-sale" as defined in Accounting Standards Codification ("ASC") No. 320, Investments — Debt and Equity Securities and are recorded at fair value. The investment securities are held for the purpose of providing the funding source to pay professional liability claims covered by the insurance subsidiaries. We perform a quarterly assessment of individual investment securities to determine whether declines in market value are temporary or other-than-temporary. Our investment securities evaluation process involves multiple subjective judgments, often involves estimating the outcome of future events, and requires a significant level of professional judgment in determining whether an impairment has occurred. We evaluate, among other things, the financial position and near term prospects of the issuer, conditions in the issuer's industry, liquidity of the investment, changes in the amount or timing of expected future cash flows from the investment, and recent downgrades of the issuer by a rating agency, to determine if, and when, a decline in the fair value of an investment below amortized cost is considered other-than-temporary. The length of time and extent to which the fair value of the investment is less than amortized cost and our ability and intent to retain the investment, to allow for any anticipated recovery of the investment's fair value, are important components of our investment securities evaluation process.

Goodwill and Other Intangible Assets

Goodwill is not amortized but is subject to annual impairment tests. In addition to the annual impairment review, impairment reviews are performed whenever circumstances indicate a possible impairment may exist. Impairment testing for goodwill is done at the reporting unit level. Reporting units are one level below the business segment level, and our impairment testing is performed at the operating division or market level. We compare the fair value of the reporting unit assets to the carrying amount, on at least an annual basis, to determine if there is potential impairment. If the fair value of the reporting unit assets is less than their carrying value, we compare the fair value of the goodwill to its carrying value. If the fair value of the goodwill is less than its carrying value, an impairment loss is recognized. Fair value of goodwill is estimated based upon internal evaluations of the related long-lived assets for each reporting unit that include quantitative analyses of revenues and cash flows and reviews of recent sales of similar facilities. No goodwill impairments were recognized during 2011, and we recognized goodwill impairments of $14 million and $19 million during 2010 and 2009, respectively.

During 2011, goodwill increased by $2.329 billion related to acquisitions, declined by $24 million related to facility sales, and declined by $16 million related to foreign currency translation and other adjustments. During 2010, goodwill increased by $125 million related to acquisitions, declined by $14 million related to impairments and increased by $5 million related to foreign currency translation and other adjustments.

Since January 1, 2000, we have recognized total goodwill impairments of $102 million in the aggregate. None of the goodwill impairments related to evaluations of goodwill at the reporting unit level, as all recognized goodwill impairments during this period related to goodwill allocated to asset disposal groups.

During 2011, other intangible assets increased by $269 million. Other intangible assets are not amortized but are subject to annual impairment tests.

Deferred Loan Costs

Debt issuance costs are amortized based upon the terms of the respective debt obligations. The gross carrying amount of deferred loan costs at December 31, 2011 and 2010 was $638 million and $712 million, respectively, and accumulated amortization was $348 million and $338 million, respectively. Amortization of deferred loan costs is included in interest expense and was $70 million, $81 million and $80 million for 2011, 2010 and 2009, respectively.

Physician Recruiting Agreements

In order to recruit physicians to meet the needs of our hospitals and the communities they serve, we enter into minimum revenue guarantee arrangements to assist the recruited physicians during the period they are relocating and establishing their practices. A guarantor is required to recognize, at the inception of a guarantee, a liability for the fair value of the stand-ready obligation undertaken in issuing the guarantee. We expense the total estimated guarantee liability amount at the time the physician recruiting agreement becomes effective as we are not able to justify recording a contract-based asset based upon our analysis of the related control, regulatory and legal considerations.

The physician recruiting liability amount of $15 million at both December 31, 2011 and 2010 represents the amount of expense recognized in excess of payments made through December 31, 2011 and 2010. At December 31, 2011 the maximum amount we could have to pay under all effective minimum revenue guarantees was $39 million.

  Professional Liability Claims

Reserves for professional liability risks were $1.291 billion and $1.262 billion at December 31, 2011 and 2010, respectively. The current portion of the reserves, $298 million and $268 million at December 31, 2011 and 2010, respectively, is included in "other accrued expenses" in the consolidated balance sheets. Provisions for losses related to professional liability risks were $244 million, $222 million and $211 million for 2011, 2010 and 2009, respectively, and are included in "other operating expenses" in our consolidated income statements. Provisions for losses related to professional liability risks are based upon actuarially determined estimates. Loss and loss expense reserves represent the estimated ultimate net cost of all reported and unreported losses incurred through the respective consolidated balance sheet dates. The reserves for unpaid losses and loss expenses are estimated using individual case-basis valuations and actuarial analyses. Those estimates are subject to the effects of trends in loss severity and frequency. The estimates are continually reviewed and adjustments are recorded as experience develops or new information becomes known. Adjustments to the estimated reserve amounts are included in current operating results. The reserves for professional liability risks cover approximately 2,700 individual claims at both December 31, 2011 and 2010 and estimates for unreported potential claims. The time period required to resolve these claims can vary depending upon the jurisdiction and whether the claim is settled or litigated. During 2011 and 2010, $240 million and $243 million, respectively, of net payments were made for professional and general liability claims. The estimation of the timing of payments beyond a year can vary significantly. Although considerable variability is inherent in professional liability reserve estimates, we believe the reserves for losses and loss expenses are adequate; however, there can be no assurance the ultimate liability will not exceed our estimates.

A portion of our professional liability risks is insured through a wholly-owned insurance subsidiary. Subject to a $5 million per occurrence self-insured retention, our facilities are insured by our wholly-owned insurance subsidiary for losses up to $50 million per occurrence. The insurance subsidiary has obtained reinsurance for professional liability risks generally above a retention level of $15 million per occurrence. We also maintain professional liability insurance with unrelated commercial carriers for losses in excess of amounts insured by our insurance subsidiary.

The obligations covered by reinsurance contracts are included in the reserves for professional liability risks, as the insurance subsidiary remains liable to the extent the reinsurers do not meet their obligations under the reinsurance contracts. The amounts receivable under the reinsurance contracts include $25 million and $11 million at December 31, 2011 and 2010, respectively, recorded in "other assets" and $14 million and $3 million at December 31, 2011 and 2010, respectively, recorded in "other current assets".

Financial Instruments

Derivative financial instruments are employed to manage risks, including interest rate and foreign currency exposures, and are not used for trading or speculative purposes. We recognize derivative instruments, such as interest rate swap agreements and foreign exchange contracts, in the consolidated balance sheets at fair value. Changes in the fair value of derivatives are recognized periodically either in earnings or in stockholders' equity, as a component of other comprehensive income (loss), depending on whether the derivative financial instrument qualifies for hedge accounting, and if so, whether it qualifies as a fair value hedge or a cash flow hedge. Generally, changes in fair values of derivatives accounted for as fair value hedges are recorded in earnings, along with the changes in the fair value of the hedged items related to the hedged risk. Gains and losses on derivatives designated as cash flow hedges, to the extent they are effective, are recorded in other comprehensive income (loss), and subsequently reclassified to earnings to offset the impact of the forecasted transactions when they occur. In the event the forecasted transaction to which a cash flow hedge relates is no longer likely, the amount in other comprehensive income (loss) is recognized in earnings and generally the derivative is terminated. Changes in the fair value of derivatives not qualifying as hedges, and for any portion of a hedge that is ineffective, are reported in earnings.

The net interest paid or received on interest rate swaps is recognized as interest expense. Gains and losses resulting from the early termination of interest rate swap agreements are deferred and amortized as adjustments to interest expense over the remaining term of the debt originally associated with the terminated swap.

 

Electronic Health Record Incentive Payments

The American Recovery and Reinvestment Act of 2009 provides for Medicare and Medicaid incentive payments beginning in 2011 for eligible hospitals and professionals that adopt and meaningfully use certified electronic health record ("EHR") technology. We recognize income related to Medicare and Medicaid incentive payments using a gain contingency model that is based upon when our eligible hospitals have demonstrated meaningful use of certified EHR technology for the applicable period and the cost report information for the full cost report year that will determine the final calculation of the incentive payment is available.

Medicaid EHR incentive calculations and related payment amounts are based upon prior period cost report information available at the time our eligible hospitals adopt, implement or demonstrate meaningful use of certified EHR technology for the applicable period, and are not subject to revision for cost report data filed for a subsequent period. Thus, incentive income recognition occurs at the point our eligible hospitals adopt, implement or demonstrate meaningful use of certified EHR technology for the applicable period, as the cost report information for the full cost report year that will determine the final calculation of the incentive payment is known at that time.

Medicare EHR incentive calculations and related initial payment amounts are based upon the most current filed cost report information available at the time our eligible hospitals demonstrate meaningful use of certified EHR technology for the applicable period. However, unlike Medicaid, this initial payment amount will be adjusted based upon an updated calculation using the annual cost report information for the cost report period that began during the applicable payment year. Thus, incentive income recognition occurs at the point our eligible hospitals demonstrate meaningful use of certified EHR technology for the applicable period and the cost report information for the full cost report year that will determine the final calculation of the incentive payment is available.

We recognized $210 million of electronic health record incentive income related to Medicaid ($87 million) and Medicare ($123 million) incentive programs during the year ended December 31, 2011. At December 31, 2011, we have $134 million of deferred EHR incentive income, which represents initial incentive payments received for which EHR incentive income has not been recognized. We previously reported $39 million of Medicaid EHR incentives and $51 million ($34 million of Medicaid EHR incentives and $17 million of Medicare EHR incentives) for the quarters ended June 30, 2011 and September 30, 2011, respectively, in the line item "Revenues" in our consolidated income statements. These amounts have been reclassified and are now included in the line item "Electronic health record incentive income" in our consolidated income statement for the year ended December 31, 2011.

Noncontrolling Interests in Consolidated Entities

The consolidated financial statements include all assets, liabilities, revenues and expenses of less than 100% owned entities that we control. Accordingly, we have recorded noncontrolling interests in the earnings and equity of such entities.

Related Party Transactions — Management Agreement

The Investors have provided management and advisory services to the Company pursuant to a management agreement among HCA Inc. and the Investors executed in connection with the Investors' acquisition of HCA Inc. in November 2006. The management agreement was terminated pursuant to its terms upon completion of the initial public offering of our common stock during March 2011, and the Company paid the Investors a final fee of $181 million. The management agreement also provided that the Company pay a 1% fee in connection with certain financing, acquisition, divestiture and change of control transactions. The Company paid the Investors a fee of $26 million related to the initial public offering of our common stock, and this fee was recorded as a cost of the stock offering. The annual management fee was $18 million for 2010 and $15 million for 2009.

Reclassifications

Certain prior year amounts have been reclassified to conform to the 2011 presentation.

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Income Taxes (Tables)

12 Months Ended

Dec. 31, 2011

Income Taxes [Abstract]

Schedule Of Provision For Income Taxes

	2011			2010		2009
Current:
Federal	$	(119	)	$	401	$	809
State		(12	)		26		75
Foreign		44			33		21
Deferred:
Federal		714			161		(274	)
State		71			17		(37	)
Foreign		21			20		33
	$	719		$	658	$	627

Schedule Of Reconciliation Of The Federal Statutory Rate To The Effective Income Tax Rate

	2011			2010			2009
Federal statutory rate		35.0	%		35.0	%		35.0	%
State income taxes, net of federal tax benefit		2.0			2.7			3.2
Change in liability for uncertain tax positions		1.0			0.3			(0.2	)
Nontaxable gain on acquisition of controlling interest in equity investment		(13.8	)		—			—
Tax exempt interest income		(0.2	)		(0.4	)		(0.8	)
Income attributable to noncontrolling interests from consolidated partnerships		(2.4	)		(5.8	)		(6.0	)
Other items, net		(1.4	)		(2.3	)		0.1
Effective income tax rate		20.2	%		29.5	%		31.3	%

Schedule Of Deferred Tax Assets And Liabilities

	2011				2010
	Assets		Liabilities		Assets		Liabilities
Depreciation and fixed asset basis differences	$	—	$	402	$	—	$	211
Allowances for professional liability and other risks		337		—		329		—
Accounts receivable		706		—		1,011		—
Compensation		216		—		202		—
Other		698		511		776		400
	$	1,957	$	913	$	2,318	$	611

Schedule Of Activity Related To Unrecognized Tax Benefits

	2011			2010
Balance at January 1	$	313		$	485
Additions (reductions) based on tax positions related to the current year		83			(18	)
Additions for tax positions of prior years		73			61
Reductions for tax positions of prior years		(15	)		(78	)
Settlements		—			(134	)
Lapse of applicable statutes of limitations		(9	)		(3	)
Balance at December 31	$	445		$	313

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Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information (Schedule Of Condensed Consolidating Income Statement) (Details) (USD $) In Millions, unless otherwise specified	3 Months Ended																12 Months Ended
	Dec. 31, 2011		Sep. 30, 2011		Jun. 30, 2011		Mar. 31, 2011		Dec. 31, 2010		Sep. 30, 2010		Jun. 30, 2010		Mar. 31, 2010		Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Issuance of common stock	$ 2,506																$ 2,506
Repurchase of common stock																	(1,503)
Revenues before the provision for doubtful accounts																	32,506	30,683	30,052
Provision for doubtful accounts																	2,824	2,648	3,276
Revenues	7,769	[1]	7,258	[1]	7,249	[1]	7,406	[1]	7,161	[1]	6,926	[1]	6,968	[1]	6,980	[1]	29,682	28,035	26,776
Salaries and benefits																	13,440	12,484	11,958
Supplies																	5,179	4,961	4,868
Other operating expenses																	5,470	5,004	4,724
Equity in earnings of affiliates																	(258)	(282)	(246)
Depreciation and amortization																	1,465	1,421	1,425
Interest expense																	2,037	2,097	1,987
Losses (gains) on sales of facilities	(84)		1		(1)		2		(3)		1						(142)	(4)	15
Gain on acquisition of controlling interest in equity investment	(1,424)																(1,522)
Losses on retirement of debt			256		47												481
Impairments of long-lived assets									2		6		57		12			123	43
Management fees																		18	15
Total expenses including equity in earnings of affiliates																	26,121	25,804	24,774
Income (loss) before income taxes																	3,561	2,231	2,002
Provision for income taxes																	719	658	627
Net income	2,042	[2]	146	[3]	320	[4]	334	[5]	394	[6]	325	[3]	378	[7]	476	[8]	2,842	1,573	1,375
Net income attributable to noncontrolling interests																	377	366	321
Net income attributable to HCA Holdings, Inc.	1,935	[2]	61	[3]	229	[4]	240	[5]	283	[6]	243	[3]	293	[7]	388	[8]	2,465	1,207	1,054
Parent Company [Member]
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Issuance of common stock	2,506																2,506
Repurchase of common stock																	(1,503)
Equity in earnings of affiliates																	(2,543)	(1,215)
Interest expense																	120	12
Total expenses including equity in earnings of affiliates																	(2,423)	(1,203)
Income (loss) before income taxes																	2,423	1,203
Provision for income taxes																	(42)	(4)
Net income																	2,465	1,207
Net income attributable to HCA Holdings, Inc.																	2,465	1,207
HCA Inc. Issuer [Member]
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Other operating expenses																	4	5	14
Equity in earnings of affiliates																			(2,540)
Interest expense																	2,390	2,700	2,356
Losses on retirement of debt																	481
Total expenses including equity in earnings of affiliates																	3,056	2,705	(170)
Income (loss) before income taxes																	(3,056)	(2,705)	170
Provision for income taxes																	(1,068)	(955)	(884)
Net income																	(1,988)	(1,750)	1,054
Net income attributable to HCA Holdings, Inc.																	(1,988)	(1,750)	1,054
Subsidiary Guarantors [Member]
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Revenues before the provision for doubtful accounts																	18,126	17,647	17,584
Provision for doubtful accounts																	1,644	1,632	2,043
Revenues																	16,482	16,015	15,541
Salaries and benefits																	7,584	7,315	7,149
Supplies																	2,851	2,825	2,846
Other operating expenses																	2,741	2,634	2,497
Equity in earnings of affiliates																	(86)	(107)	(95)
Depreciation and amortization																	777	782	787
Interest expense																	(342)	(761)	(500)
Losses (gains) on sales of facilities																	(127)		17
Impairments of long-lived assets																		58	34
Management fees																	(491)	(454)	(443)
Total expenses including equity in earnings of affiliates																	12,781	12,292	12,292
Income (loss) before income taxes																	3,701	3,723	3,249
Provision for income taxes																	1,271	1,299	1,189
Net income																	2,430	2,424	2,060
Net income attributable to noncontrolling interests																	63	44	61
Net income attributable to HCA Holdings, Inc.																	2,367	2,380	1,999
Subsidiary Non-Guarantors [Member]
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Revenues before the provision for doubtful accounts																	14,380	13,036	12,468
Provision for doubtful accounts																	1,180	1,016	1,233
Revenues																	13,200	12,020	11,235
Salaries and benefits																	5,856	5,169	4,809
Supplies																	2,328	2,136	2,022
Other operating expenses																	2,725	2,365	2,213
Equity in earnings of affiliates																	(172)	(175)	(151)
Depreciation and amortization																	688	639	638
Interest expense																	(131)	146	131
Losses (gains) on sales of facilities																	(15)	(4)	(2)
Gain on acquisition of controlling interest in equity investment																	(1,522)
Impairments of long-lived assets																		65	9
Management fees																	491	454	443
Total expenses including equity in earnings of affiliates																	10,164	10,795	10,112
Income (loss) before income taxes																	3,036	1,225	1,123
Provision for income taxes																	558	318	322
Net income																	2,478	907	801
Net income attributable to noncontrolling interests																	314	322	260
Net income attributable to HCA Holdings, Inc.																	2,164	585	541
Eliminations [Member]
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Equity in earnings of affiliates																	2,543	1,215	2,540
Total expenses including equity in earnings of affiliates																	2,543	1,215	2,540
Income (loss) before income taxes																	(2,543)	(1,215)	(2,540)
Net income																	(2,543)	(1,215)	(2,540)
Net income attributable to HCA Holdings, Inc.																	$ (2,543)	$ (1,215)	$ (2,540)

[1] The "Revenues" presented for each quarter of 2010 and the first and second quarters of 2011 have been reduced by the provision for doubtful accounts for each quarter in accordance with our adoption of ASU 2011-07 in the third quarter of 2011. The "Revenues" presented for the second and third quarters of 2011 have been reduced for the reclassification of "Electronic health record incentive income" as a separate line item in our consolidated income statements (See NOTE 1 of the notes to consolidated financial statements).

[2] Fourth quarter results include $84 million of gains on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $1.424 billion of gain on acquisition of controlling interest in equity investment (See NOTE 3 of the notes to consolidated financial statements).

[3] Third quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $256 million of losses on retirement of debt (See NOTE 10 of the notes to consolidated financial statements).

[4] Second quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $47 million of losses on retirement of debt (See NOTE 10 of the notes to consolidated financial statements).

[5] First quarter results include $2 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $149 million of costs related to the termination of management agreement (See NOTE 1 of the notes to consolidated financial statements).

[6] Fourth quarter results include $3 million of gains on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $2 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

[7] Second quarter results include $57 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

[8] First quarter results include $12 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

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Other Comprehensive Loss (Tables)

12 Months Ended

Dec. 31, 2011

Other Comprehensive Loss [Abstract]

Components Of Accumulated Other Comprehensive Loss

	Unrealized Gains (Losses) on Available-for-Sale Securities			Foreign Currency Translation Adjustments			Defined Benefit Plans			Change in Fair Value of Derivative Instruments			Total
Balances at December 31, 2008	$	(30	)	$	(28	)	$	(106	)	$	(440	)	$	(604	)
Unrealized gains on available-for-sale securities, net of $25 of income taxes		44			—			—			—			44
Foreign currency translation adjustments, net of $14 of income taxes		—			25			—			—			25
Defined benefit plans, net of $8 income tax benefit		—			—			(10	)		—			(10	)
Change in fair value of derivative instruments, net of $76 income tax benefit		—			—			—			(133	)		(133	)
Expense reclassified into operations from other comprehensive income, net of $6 and $127, respectively, income tax benefits		—			—			10			218			228
Balances at December 31, 2009		14			(3	)		(106	)		(355	)		(450	)
Unrealized gains on available-for-sale securities, net of $1 of income taxes		1			—			—			—			1
Foreign currency translation adjustments, net of $9  income tax benefit		—			(16	)		—			—			(16	)
Defined benefit plans, net of $28 income tax benefit		—			—			(48	)		—			(48	)
Change in fair value of derivative instruments, net of $94 income tax benefit		—			—			—			(161	)		(161	)
(Income) expense reclassified into operations from other comprehensive income, net of $(4), $7 and $140, respectively, income (taxes) benefits		(9	)		—			11			244			246
Balances at December 31, 2010		6			(19	)		(143	)		(272	)		(428	)
Unrealized gains on available-for-sale securities, net of $1 of income taxes		1			—			—			—			1
Foreign currency translation adjustments, net of $3 income tax benefit		—			(6	)		—			—			(6	)
Defined benefit plans, net of $25 income tax benefit		—			—			(42	)		—			(42	)
Change in fair value of derivative instruments, net of $114 income tax benefit		—			—			—			(197	)		(197	)
Expense reclassified into operations from other comprehensive income, net of $9 and $125, respectively, income tax benefits		—			—			16			216			232
Balances at December 31, 2011	$	7		$	(25	)	$	(169	)	$	(253	)	$	(440	)

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Acquisitions And Dispositions (Schedule Of Pro Forma Summary Of Operations) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010
Acquisitions And Dispositions [Abstract]
Pro forma revenues	$ 31,383	$ 29,925
Pro forma net income attributable to HCA Holdings, Inc.	$ 2,507	$ 1,257

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Long-Term Debt (2011 Activity) (Details)	1 Months Ended					12 Months Ended					12 Months Ended												12 Months Ended	1 Months Ended		12 Months Ended		1 Months Ended				1 Months Ended				12 Months Ended	1 Months Ended
	Aug. 31, 2011 USD ($)	Jun. 30, 2011 USD ($)	Dec. 31, 2011 USD ($)	Sep. 30, 2011 USD ($)	Dec. 31, 2010 USD ($)	Dec. 31, 2011 Asset Based Revolving Credit Facility Maturing On September 30, 2016 [Member] USD ($)	Dec. 31, 2011 Senior Secured Revolving Credit Facility Maturing On November 17, 2015 [Member] USD ($)	Dec. 31, 2011 Senior Secured Term Loan A-One Facility Maturing On November 17, 2012 [Member] USD ($)	Dec. 31, 2011 Senior Secured Term Loan A-One Facility Maturing From November, 2012 To May, 2016 [Member] USD ($)	Dec. 31, 2011 Senior Secured Term Loan B-One Facility Maturing On November 17, 2013 [Member] USD ($)	Dec. 31, 2011 Senior Secured Term Loan B-Two Facility Maturing On March 31, 2017 [Member] USD ($)	Dec. 31, 2011 Senior Secured Term Loan B-Three Facility Maturing On May 1, 2018 [Member] USD ($)	Dec. 31, 2011 Senior Secured European Term Loan Facility Maturing On November 17, 2013 [Member] USD ($)	Dec. 31, 2011 Senior Secured European Term Loan Facility Maturing On November 17, 2013 [Member] EUR (€)	Oct. 31, 2011 Senior Secured First Lien Notes Due 2018 [Member] USD ($)	Apr. 30, 2009 Senior Secured First Lien Notes Due 2019 [Member] USD ($)	Dec. 31, 2011 Senior Secured First Lien Notes Due 2020 [Member] USD ($)	Mar. 31, 2010 Senior Secured First Lien Notes Due 2020 [Member] USD ($)	Aug. 31, 2009 Senior Secured First Lien Notes Due 2020 [Member] USD ($)	Dec. 31, 2011 Senior Secured Credit Facilities And Other First Lien Debt Unamortized Debt Discount [Member] USD ($)	Aug. 31, 2011 Other Activity Senior Secured First Lien Notes Due 2012 [Member] USD ($)	Aug. 31, 2011 Other Activity Aggregate Principal Amount Of Notes [Member] USD ($)	Dec. 31, 2011 Final Maturity Of May 2018 [Member]	Sep. 30, 2011 Other Activity Asset Based Revolving Credit Facility Maturing On November 16, 2012 [Member] USD ($)	Aug. 31, 2011 Senior Unsecured Notes Due 2022 [Member] USD ($)	Dec. 31, 2011 Term Loan A And Term Loan B-1 Facilities With Final Maturity Of November 2012 [Member] USD ($)	Dec. 31, 2011 Term Loan A Facility With Final Maturity Of November 2012 [Member] USD ($)	Aug. 31, 2011 Other Activity Second Lien Toggle Notes Due 2016 [Member] USD ($)	Nov. 30, 2006 Senior Secured Second Lien Notes Due 2016 [Member] USD ($)	Jun. 30, 2011 Senior Secured Notes Due 2014 [Member] USD ($)	Jun. 02, 2011 Senior Secured Notes Due 2014 [Member]	Jun. 30, 2011 Senior Secured Notes Due 2017 [Member] USD ($)	Jun. 02, 2011 Senior Secured Notes Due 2017 [Member]	Dec. 31, 2011 Senior Secured Second Lien Notes [Member] USD ($)	Feb. 28, 2009 Senior Secured Second Lien Notes [Member]	Dec. 31, 2011 Maturities Ranging 2012 To 2033 [Member] USD ($)	Aug. 31, 2011 Second Lien Notes Due 2016 [Member] USD ($)	Aug. 26, 2011 Second Lien Notes Due 2016 [Member]
Line of Credit Facility [Line Items]
Senior notes																																					$ 3,200,000,000
Senior Secured Toggle Notes					1,578,000,000																							1,578,000,000
Redemption of aggregate principal amount																														1,000,000,000		108,000,000
Percentage of redemption price of principal amount																												106.783		104.563		109.875					106.513
Pretax loss on retirement of debt	406,000,000	75,000,000
Line of credit, total borrowing capacity				2,500,000,000
Debt instrument, maturities range, start																								November 16, 2012												2012
Debt instrument, maturities range, end																								2016		November 2013	May 2016									2033
Percentage of senior secured credit facility over eligible accounts receivable			85.00%
Line of credit outstanding			2,155,000,000				572,000,000
Debt instrument maturity date						Sep. 30, 2016	Nov. 17, 2015				Mar. 31, 2017												May 01, 2018
Long-term line of credit						2,500,000,000	2,000,000,000	414,000,000	572,000,000	1,689,000,000	2,000,000,000	2,373,000,000	377,000,000	291,000,000										2,000,000,000		2,373,000,000	594,000,000
Debt instrument basis spread			0.50%
Debt instrument, principal amount															500,000,000	1,500,000,000	3,000,000,000	1,400,000,000	1,250,000,000		3,000,000,000	5,000,000,000			2,000,000,000									202,000,000		7,194,000,000
Debt instrument, stated interest															8.00%	8.50%	6.50%	7.25%	7.875%		6.50%				7.50%				9.25%		9.125%		9.875%		9.875%			9.25%
Debt instrument, unamortized discount																				69,000,000														5,000,000
Capital leases and other secured debt			350,000,000
Notional amount, total			4,500,000,000
Debt Instrument Stated Interest In Cash																												9.625	9.625
Debt Instrument Stated Interest In Kind																												$ 10.375	$ 10.375

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Consolidated Income Statements (USD $) In Millions, except Share data in Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Consolidated Income Statements [Abstract]
Revenues before the provision for doubtful accounts	$ 32,506	$ 30,683	$ 30,052
Provision for doubtful accounts	2,824	2,648	3,276
Revenues	29,682	28,035	26,776
Salaries and benefits	13,440	12,484	11,958
Supplies	5,179	4,961	4,868
Other operating expenses	5,470	5,004	4,724
Electronic health record incentive income	(210)
Equity in earnings of affiliates	(258)	(282)	(246)
Depreciation and amortization	1,465	1,421	1,425
Interest expense	2,037	2,097	1,987
Losses (gains) on sales of facilities	(142)	(4)	15
Gain on acquisition of controlling interest in equity investment	(1,522)
Impairments of long-lived assets		123	43
Losses on retirement of debt	481
Termination of management agreement	181
Total expenses including equity in earnings of affiliates	26,121	25,804	24,774
Income before income taxes	3,561	2,231	2,002
Provision for income taxes	719	658	627
Net income	2,842	1,573	1,375
Net income attributable to noncontrolling interests	377	366	321
Net income attributable to HCA Holdings, Inc.	$ 2,465	$ 1,207	$ 1,054
Per share data:
Basic earnings per share	$ 5.17	$ 2.83	$ 2.48
Diluted earnings per share	$ 4.97	$ 2.76	$ 2.44
Shares used in earnings per share calculations (in thousands):
Basic	476,609	426,424	425,567
Diluted	495,943	437,347	432,227

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Accounting Policies (Schedule Of Revenues From Third Party Payers And Uninsured) (Details) (USD $) In Millions, unless otherwise specified	3 Months Ended																12 Months Ended
	Dec. 31, 2011		Sep. 30, 2011		Jun. 30, 2011		Mar. 31, 2011		Dec. 31, 2010		Sep. 30, 2010		Jun. 30, 2010		Mar. 31, 2010		Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Accounting Policies [Line Items]
Revenues from third party payers																	$ 29,846	$ 28,038	$ 26,701
Uninsured																	1,846	1,732	2,350
Other																	814	913	1,001
Revenues before the provision for doubtful accounts																	32,506	30,683	30,052
Provision for doubtful accounts																	(2,824)	(2,648)	(3,276)
Revenues	7,769	[1]	7,258	[1]	7,249	[1]	7,406	[1]	7,161	[1]	6,926	[1]	6,968	[1]	6,980	[1]	29,682	28,035	26,776
Revenues from third party payers Ratio																	100.60%	100.10%	99.70%
Uninsured Ratio																	6.20%	6.20%	8.80%
Other Ratio																	2.70%	3.30%	3.70%
Revenues before provision for doubtful accounts Ratio																	109.50%	109.60%	112.20%
Provision for doubtful accounts Ratio																	(9.50%)	(9.60%)	(12.20%)
Revenues ratio from third party payers																	100.00%	100.00%	100.00%
Medicare [Member]
Accounting Policies [Line Items]
Revenues from third party payers																	7,653	7,203	6,866
Revenues from third party payers Ratio																	25.80%	25.70%	25.60%
Managed Medicare [Member]
Accounting Policies [Line Items]
Revenues from third party payers																	2,442	2,162	2,006
Revenues from third party payers Ratio																	8.20%	7.70%	7.50%
Medicaid [Member]
Accounting Policies [Line Items]
Revenues from third party payers																	1,845	1,962	1,691
Revenues from third party payers Ratio																	6.20%	7.00%	6.30%
Managed Medicaid [Member]
Accounting Policies [Line Items]
Revenues from third party payers																	1,265	1,165	1,113
Revenues from third party payers Ratio																	4.30%	4.20%	4.20%
Managed Care And Other Insurers [Member]
Accounting Policies [Line Items]
Revenues from third party payers																	15,703	14,762	14,323
Revenues from third party payers Ratio																	52.90%	52.70%	53.50%
International (managed care and other insurers) [Member]
Accounting Policies [Line Items]
Revenues from third party payers																	$ 938	$ 784	$ 702
Revenues from third party payers Ratio																	3.20%	2.80%	2.60%

[1] The "Revenues" presented for each quarter of 2010 and the first and second quarters of 2011 have been reduced by the provision for doubtful accounts for each quarter in accordance with our adoption of ASU 2011-07 in the third quarter of 2011. The "Revenues" presented for the second and third quarters of 2011 have been reduced for the reclassification of "Electronic health record incentive income" as a separate line item in our consolidated income statements (See NOTE 1 of the notes to consolidated financial statements).

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Consolidated Statements Of Stockholders' Deficit (USD $) In Millions, except Share data	Common Stock [Member]	Capital in Excess of Par Value [Member]	Accumulated Other Comprehensive Loss [Member]	Retained Deficit [Member]	Equity Attributable To Noncontrolling Interests [Member]	Total
Balance at Dec. 31, 2008	$ 4	$ 162	$ (604)	$ (9,817)	$ 995	$ (9,260)
Balance, shares at Dec. 31, 2008	425,125,000
Comprehensive income			154	1,054	321	1,529
Share-based benefit plans		47				47
Share-based benefit plans, shares	1,216,000
Distributions					(330)	(330)
Other		14			22	36
Balance at Dec. 31, 2009	4	223	(450)	(8,763)	1,008	(7,978)
Balance, shares at Dec. 31, 2009	426,341,000
Comprehensive income			22	1,207	366	1,595
Share-based benefit plans		43				43
Share-based benefit plans, shares	1,118,000
Distributions				(4,332)	(342)	(4,674)
Contributions					57	57
Other		120			43	163
Balance at Dec. 31, 2010	4	386	(428)	(11,888)	1,132	(10,794)
Balance, shares at Dec. 31, 2010	427,459,000
Comprehensive income			(12)	2,465	377	2,830
Issuance of common stock	1	2,505				2,506
Issuance of common stock, shares	87,719,000
Repurchase of common stock	(1)	(1,502)				(1,503)
Repurchase of common stock, shares	(80,771,000)
Share-based benefit plans		35				35
Share-based benefit plans, shares	3,071,000
Distributions					(378)	(378)
Consolidation of acquired controlling interest in equity investment					93	93
Reclassification of equity securities with contingent redemption rights		141				141
Other		36			20	56
Balance at Dec. 31, 2011	$ 4	$ 1,601	$ (440)	$ (9,423)	$ 1,244	$ (7,014)
Balance, shares at Dec. 31, 2011	437,478,000

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Income Taxes (Schedule Of Activity Related To Unrecognized Tax Benefits) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010
Income Taxes [Abstract]
Balance at January 1	$ 313	$ 485
Additions (reductions) based on tax positions related to the current year	83	(18)
Additions for tax positions of prior years	73	61
Reductions for tax positions of prior years	(15)	(78)
Settlements		(134)
Lapse of applicable statutes of limitations	(9)	(3)
Balance at December 31	$ 445	$ 313

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Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2011

Financial Instruments [Abstract]

Schedule Of Interest Rate Swap Agreements Designated As Cash Flow Hedges

	Notional Amount		Maturity Date		Fair Value
Pay-fixed interest rate swaps	$	500		December 2014	$	(7	)
Pay-fixed interest rate swaps		3,000		December 2016		(339	)
Pay-fixed interest rate swaps		1,000		December 2017		(53	)

Effect Of Interest Rate Swaps Included On Results Of Operations

Derivatives in Cash Flow Hedging Relationships	Amount of Loss Recognized  in OCI on Derivatives, Net of Tax		Location of  Loss Reclassified from Accumulated  OCI into Operations		Amount of  Loss Reclassified from Accumulated  OCI into Operations
Interest rate swaps	$	197		Interest expense	$	341

Derivatives Not Designated as Hedging Instruments	Location of Loss Recognized in Operations on Derivatives		Amount of Loss Recognized in Operations on Derivatives
Interest rate swaps		Other operating expenses	$	1
Cross currency swap		Other operating expenses		54

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Financial Instruments (Narrative) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011
Financial Instruments [Abstract]
Estimated amount reclassified from other comprehensive income to interest expense	$ 110
Estimated termination value if there is breach of provision related to derivative agreement	$ 452

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Segment And Geographic Information

12 Months Ended

Dec. 31, 2011

Segment And Geographic Information [Abstract]

Segment And Geographic Information

NOTE 15 — SEGMENT AND GEOGRAPHIC INFORMATION

We operate in one line of business, which is operating hospitals and related health care entities. Our operations are structured into three geographically organized groups: the National, Southwest and Central Groups. During February 2011, we reorganized our operational groups and have restated the prior period amounts to reflect this reorganization. At December 31, 2011, the National Group includes 64 hospitals located in Florida, South Carolina, southern Georgia, Alaska, California, Nevada, Utah and Idaho, the Southwest Group includes 46 hospitals located in Colorado, Texas, Oklahoma and the Wichita, Kansas market, and the Central Group includes 47 hospitals located in Louisiana, Indiana, Kentucky, Tennessee, Virginia, New Hampshire, northern Georgia and the Kansas City market. We also operate six hospitals in England, and these facilities are included in the Corporate and other group.

Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, losses (gains) on sales of facilities, gain on acquisition of controlling interest in equity investment, impairments of long-lived assets, losses on retirement of debt, termination of management agreement, 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, depreciation and amortization, assets and goodwill and other intangible assets are summarized in the following table (dollars in millions):

	For the Years Ended December 31,
	2011			2010			2009
Revenues:
National Group	$	12,224		$	11,624		$	11,047
Southwest Group		9,311			8,700			8,282
Central Group		6,982			6,727			6,570
Corporate and other		1,165			984			877
	$	29,682		$	28,035		$	26,776
Equity in earnings of affiliates:
National Group	$	(7	)	$	(4	)	$	(4	)
Southwest Group		(251	)		(277	)		(240	)
Central Group		—			(1	)		(2	)
Corporate and other		—			—			—
	$	(258	)	$	(282	)	$	(246	)
Adjusted segment EBITDA:
National Group	$	2,531		$	2,431		$	2,250
Southwest Group		2,370			2,254			2,089
Central Group		1,285			1,272			1,325
Corporate and other		(125	)		(89	)		(192	)
	$	6,061		$	5,868		$	5,472
Depreciation and amortization:
National Group	$	512		$	508		$	516
Southwest Group		464			427			426
Central Group		347			352			352
Corporate and other		142			134			131
	$	1,465		$	1,421		$	1,425
Adjusted segment EBITDA	$	6,061		$	5,868		$	5,472
Depreciation and amortization		1,465			1,421			1,425
Interest expense		2,037			2,097			1,987
Losses (gains) on sales of facilities		(142	)		(4	)		15
Gain on acquisition of controlling interest in equity investment		(1,522	)		—			—
Impairments of long-lived assets		—			123			43
Losses on retirement of debt		481			—			—
Termination of management agreement		181			—			—
Income before income taxes	$	3,561		$	2,231		$	2,002

	As of December 31,
	2011		2010
Assets:
National Group	$	7,827	$	7,345
Southwest Group		9,908		6,747
Central Group		5,187		5,271
Corporate and other		3,976		4,489
	$	26,898	$	23,852

	National Group			Southwest Group			Central Group		Corporate and Other			Total
Goodwill and other intangible assets:
Balance at December 31, 2010	$	787		$	636		$	1,019	$	251		$	2,693
Acquisitions		32			2,533			—		33			2,598
Dispositions		(19	)		(5	)		—		—			(24	)
Foreign currency translation and other					(4	)		—		(12	)		(16	)
Balance at December 31, 2011	$	800		$	3,160		$	1,019	$	272		$	5,251

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Assets And Liabilities Measured At Fair Value (Tables)

12 Months Ended

Dec. 31, 2011

Dec. 31, 2010

Assets And Liabilities Measured At Fair Value [Abstract]

Schedule Of Assets And Liabilities Measured At Fair Value On A Recurring Basis

	December 31, 2011
				Fair Value Measurements Using
	Fair Value			Quoted Prices in Active  Markets for Identical Assets and Liabilities (Level 1)			Significant Other Observable  Inputs (Level 2)			Significant Unobservable  Inputs (Level 3)
Assets:
Investments of insurance subsidiaries:
Debt securities:
States and municipalities	$	417		$	—		$	417		$	—
Auction rate securities		131			—			—			131
Asset-backed securities		20			—			20			—
Money market funds		53			53			—			—
		621			53			437			131
Equity securities		7			1			5			1
Investments of insurance subsidiaries		628			54			442			132
Less amounts classified as current assets		(80	)		(54	)		(26	)		—
	$	548		$	—		$	416		$	132
Liabilities:
Cross currency swap (Income taxes and other liabilities)	$	16		$	—		$	16		$	—
Interest rate swaps (Income taxes and other liabilities)		399			—			399			—

	December 31, 2010
				Fair Value Measurements Using
	Fair Value			Quoted Prices in Active  Markets for Identical Assets and Liabilities (Level 1)			Significant Other Observable  Inputs (Level 2)		Significant Unobservable  Inputs (Level 3)
Assets:
Investments of insurance subsidiaries:
Debt securities:
States and municipalities	$	323		$	—		$	323	$	—
Auction rate securities		250			—			—		250
Asset-backed securities		26			—			26		—
Money market funds		135			135			—		—
		734			135			349		250
Equity securities		8			2			5		1
Investments of insurance subsidiaries		742			137			354		251
Less amounts classified as current assets		(100	)		(100	)		—		—
	$	642		$	37		$	354	$	251
Cross currency swap (Other assets)	$	39		$	—		$	39	$	—
Liabilities:
Interest rate swaps (Income taxes and other liabilities)	$	426		$	—		$	426	$	—

Schedule Related To The Auction Rate And Equity Securities Investments Of Insurance Subsidiaries At Fair Value

Asset balances at December 31, 2010	$	251
Unrealized losses included in other comprehensive income		(7	)
Settlements		(112	)
Asset balances at December 31, 2011	$	132

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Accrued Expenses And Allowance For Doubtful Accounts

12 Months Ended

Dec. 31, 2011

Accrued Expenses And Allowance For Doubtful Accounts [Abstract]

Accrued Expenses And Allowance For Doubtful Accounts

NOTE 17 — ACCRUED EXPENSES AND ALLOWANCE FOR DOUBTFUL ACCOUNTS

A summary of other accrued expenses at December 31 follows (dollars in millions):

	2011		2010
Professional liability risks	$	298	$	268
Interest		383		309
Taxes other than income		232		197
Other		672		471
	$	1,585	$	1,245

A summary of activity for the allowance of doubtful accounts follows (dollars in millions):

	Balance at Beginning of Year		Provision for Doubtful Accounts		Accounts Written off, Net of Recoveries			Balance at End of Year
Allowance for doubtful accounts:
Year ended December 31, 2009	$	4,741	$	3,276	$	(3,157	)	$	4,860
Year ended December 31, 2010		4,860		2,648		(3,569	)		3,939
Year ended December 31, 2011		3,939		2,824		(2,657	)		4,106

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Financial Instruments (Effect Of Interest Rate Swaps Included On Result Of Operations) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011
Interest Rate Swaps [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Loss (Gain) Recognized in OCI on Derivatives , Net of Tax	$ 197
Interest Expense [Member] | Interest Rate Swaps [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Loss Reclassified from Accumulated OCI into Operations	341
Other Operating Expenses [Member] | Interest Rate Swaps [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Loss Recognized in Operations on Derivatives	1
Other Operating Expenses [Member] | Cross Currency Swap (Other Assets) [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Loss Recognized in Operations on Derivatives	$ 54

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Consolidated Statements Of Cash Flows (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Cash flows from operating activities:
Net income	$ 2,842	$ 1,573	$ 1,375
Adjustments to reconcile net income to net cash provided by operating activities:
Accounts receivable	(3,248)	(2,789)	(3,180)
Inventories and other assets	(18)	(287)	(191)
Accounts payable and accrued expenses	313	229	280
Provision for doubtful accounts	2,824	2,648	3,276
Depreciation and amortization	1,465	1,421	1,425
Income taxes	912	27	(520)
Losses (gains) on sales of facilities	(142)	(4)	15
Gain on acquisition of controlling interest in equity investment	(1,522)
Impairments of long-lived assets		123	43
Losses on retirement of debt	481
Amortization of deferred loan costs	70	81	80
Share-based compensation	26	32	40
Pay-in-kind interest	(78)		58
Other	8	31	46
Net cash provided by (used in) operating activities	3,933	3,085	2,747
Cash flows from investing activities:
Purchase of property and equipment	(1,679)	(1,325)	(1,317)
Acquisition of hospitals and health care entities	(1,682)	(233)	(61)
Disposal of hospitals and health care entities	281	37	41
Change in investments	80	472	303
Other	5	10	(1)
Net cash used in investing activities	(2,995)	(1,039)	(1,035)
Cash flows from financing activities:
Issuances of long-term debt	5,500	2,912	2,979
Net change in revolving bank credit facilities	(449)	1,889	(1,335)
Repayment of long-term debt	(6,640)	(2,268)	(3,103)
Distributions to noncontrolling interests	(378)	(342)	(330)
Contributions from noncontrolling interests		57
Payment of debt issuance costs	(92)	(50)	(70)
Issuance of common stock	2,506
Repurchase of common stock	(1,503)
Distributions to stockholders	(31)	(4,257)
Income tax benefits	63	114
Other	48	(2)	(6)
Net cash provided by (used in) financing activities	(976)	(1,947)	(1,865)
Change in cash and cash equivalents	(38)	99	(153)
Cash and cash equivalents at beginning of period	411	312	465
Cash and cash equivalents at end of period	373	411	312
Interest payments	1,987	1,994	1,751
Income tax (refunds) payments, net	$ (256)	$ 517	$ 1,147

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Consolidated Comprehensive Income Statements (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Consolidated Comprehensive Income Statements [Abstract]
Net income	$ 2,842	$ 1,573	$ 1,375
Other comprehensive income (loss) before taxes:
Foreign currency translation	(9)	(25)	39
Unrealized gains on available-for-sale securities	2	2	69
Less: gains included in other operating expenses		(13)
Total unrealized gains (losses) on available-for-sale securities	2	(11)	69
Defined benefit plans	(67)	(76)	(18)
Less: pension costs included in salaries and benefits	25	18	16
Total defined benefit plans	(42)	(58)	(2)
Change in fair value of derivative financial instruments	(311)	(255)	(209)
Less: interest costs included in interest expense	341	384	345
Total change in fair value of derivative financial instruments	30	129	136
Other comprehensive income (loss) before taxes	(19)	35	242
Income taxes (benefits) related to other comprehensive income items	(7)	13	88
Other comprehensive income (loss)	(12)	22	154
Comprehensive income	2,830	1,595	1,529
Comprehensive income attributable to noncontrolling interests	377	366	321
Comprehensive income attributable to HCA Holdings, Inc.	$ 2,453	$ 1,229	$ 1,208

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Long-Term Debt

12 Months Ended

Dec. 31, 2011

Long-Term Debt [Abstract]

Long-Term Debt

NOTE 10 — LONG-TERM DEBT

A summary of long-term debt at December 31, including related interest rates at December 31, 2011, follows (dollars in millions):

	2011		2010
Senior secured asset-based revolving credit facility (effective interest rate of 1.8%)	$	2,155	$	1,875
Senior secured revolving credit facility		—		729
Senior secured term loan facilities (effective interest rate of 4.8%)		7,425		7,530
Senior secured first lien notes (effective interest rate of 7.7%)		7,081		4,075
Other senior secured debt (effective interest rate of 6.8%)		350		322
First lien debt		17,011		14,531
Senior secured second lien notes (effective interest rate of 11.0%)		197		4,501
Senior secured toggle notes		—		1,578
Second lien debt		197		6,079
Senior unsecured notes (effective interest rate of 7.3%)		9,844		7,615
Total debt (average life of 6.9 years, rates averaging 6.3%)		27,052		28,225
Less amounts due within one year		1,407		592
	$	25,645	$	27,633

2011 Activity

During May 2011, we completed amendments to our senior secured credit agreement and senior secured asset-based revolving credit agreement, as well as extensions of certain of our term loans. The amendments extended $594 million ($572 million outstanding at December 31, 2011) of our term loan A facility with a final maturity of November 2012 to a final maturity of May 2016 and $2.373 billion of our term loan A and term loan B-1 facilities with final maturities of November 2012 and November 2013, respectively, to a final maturity of May 2018.

During June 2011, we redeemed all $1.000 billion aggregate principal amount of our 9 ¹/8% senior secured notes due 2014, at a redemption price of 104.563% of the principal amount, and $108 million aggregate principal amount of our 9 ⁷/8% senior secured notes due 2017, at a redemption price of 109.875% of the principal amount. The pretax loss on retirement of debt related to these redemptions was $75 million.

During August 2011, we issued $5.000 billion aggregate principal amount of notes, comprised of $3.000 billion of 6.50% senior secured first lien notes due 2020 and $2.000 billion of 7.50% senior unsecured notes due 2022. We used the net proceeds from these debt issuances to redeem all of our outstanding $1.578 billion 9 ⁵/8%/10 ³/8% second lien toggle notes due 2016, at a redemption price of 106.783% of the principal amount, and all of our outstanding $3.200 billion 9 ¹/4% second lien notes due 2016, at a redemption price of 106.513% of the principal amount. The pretax loss on retirement of debt related to these redemptions was $406 million.

During September 2011, we refinanced our $2.000 billion asset-based revolving credit facility maturing on November 16, 2012 to increase the total capacity to $2.500 billion and extend the maturity to 2016.

During October 2011, we issued $500 million aggregate principal amount of 8.00% senior unsecured notes due 2018. We used the net proceed for general corporate purposes, which included funding a portion of the acquisition of the remaining interest in HealthONE.

We have entered into the following senior secured credit facilities: (i) a $2.500 billion asset-based revolving credit facility maturing on September 30, 2016 with a borrowing base of 85% of eligible accounts receivable, subject to customary reserves and eligibility criteria ($2.155 billion outstanding at December 31, 2011) (the "ABL credit facility"); (ii) a $2.000 billion senior secured revolving credit facility maturing on November 17, 2015 (none outstanding at December 31, 2011 without giving effect to certain outstanding letters of credit); (iii) a $414 million senior secured term loan A-1 facility maturing on November 17, 2012; (iv) a $572 million senior secured term loan A-2 facility maturing on May 2, 2016; (v) a $1.689 billion senior secured term loan B-1 facility maturing on November 17, 2013; (vi) a $2.000 billion senior secured term loan B-2 facility maturing on March 31, 2017; (vii) a $2.373 billion senior secured term loan B-3 facility maturing on May 1, 2018; and (viii) a €291 million, or $377 million-equivalent, senior secured European term loan facility maturing on November 17, 2013. We refer to the facilities described under (ii) through (viii) above, collectively, as the "cash flow credit facility" and, together with the ABL credit facility, the "senior secured credit facilities."

Borrowings under the senior secured credit facilities bear interest at a rate equal to, 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, plus, in each case, an applicable margin. The applicable margin for borrowings under the senior secured credit facilities may be reduced subject to attaining certain leverage ratios.

The senior secured credit facilities contain a number of covenants that restrict, subject to certain exceptions, our (and some or all of our subsidiaries') ability to incur additional indebtedness, repay subordinated indebtedness, create liens on assets, sell assets, make investments, loans or advances, engage in certain transactions with affiliates, pay dividends and distributions, and enter into sale and leaseback transactions. In addition, we are required to satisfy and maintain a maximum total leverage ratio covenant under the cash flow credit facility and, in certain situations under the ABL credit facility, a minimum interest coverage ratio covenant.

Senior secured first lien notes consist of (i) $1.500 billion aggregate principal amount of 8 ¹/2% senior secured first lien notes due 2019; (ii) $1.250 billion aggregate principal amount of 7 ⁷/8% senior secured first lien notes due 2020; (iii) $1.400 billion aggregate principal amount of 7 ¹/4% senior secured first lien notes due 2020; (iv) $3.000 billion aggregate principal amount of 6.50% senior secured first lien notes due 2020; and (v) $69 million of unamortized debt discounts that reduces the senior secured first lien indebtedness. Capital leases and other secured debt totaled $350 million at December 31, 2011.

We use interest rate swap agreements to manage the variable rate exposure of our debt portfolio. At December 31, 2011, we had entered into effective interest rate swap agreements, in a total notional amount of $4.500 billion, in order to hedge a portion of our exposure to variable rate interest payments associated with the senior secured credit facility. The effect of the interest rate swaps is reflected in the effective interest rates for the senior secured credit facilities.

Senior Secured Second Lien Notes

Senior secured second lien notes is comprised of $202 million aggregate principal amount of 9 ⁷/8% senior secured second lien notes due 2017 and $5 million of unamortized debt discounts that reduces the senior secured second lien indebtedness.

Senior unsecured notes consist of (i) $7.194 billion aggregate principal amount of senior notes with maturities ranging from 2012 to 2033; (ii) an aggregate principal amount of $246 million medium-term notes with maturities ranging from 2014 to 2025; (iii) an aggregate principal amount of $886 million debentures with maturities ranging from 2015 to 2095; (iv) an aggregate principal amount of $1.525 billion senior notes due 2021 issued by HCA Holdings, Inc. (the "2021 Notes"); and (v) $7 million of unamortized debt discounts that reduce the indebtedness.

General Debt Information

The senior secured credit facilities and senior secured notes are fully and unconditionally guaranteed by substantially all existing and future, direct and indirect, wholly-owned material domestic subsidiaries that are "Unrestricted Subsidiaries" under our Indenture (the "1993 Indenture") dated December 16, 1993 (except for certain special purpose subsidiaries that only guarantee and pledge their assets under our ABL credit facility). In addition, borrowings under the European term loan are guaranteed by all material, wholly-owned European subsidiaries.

All obligations under the ABL credit facility, and the guarantees of those obligations, are secured, subject to permitted liens and other exceptions, by a first-priority lien on substantially all of the receivables of the borrowers and each guarantor under such ABL credit facility (the "Receivables Collateral").

All obligations under the cash flow credit facility and the guarantees of such obligations are secured, subject to permitted liens and other exceptions, by:

• a first-priority lien on the capital stock owned by HCA Inc., or by any U.S. guarantor, in each of their respective first-tier subsidiaries;

• a first-priority lien on substantially all present and future assets of HCA Inc. and of each U.S. guarantor other than (i) "Principal Properties" (as defined in the 1993 Indenture), (ii) certain other real properties and (iii) deposit accounts, other bank or securities accounts, cash, leaseholds, motor-vehicles and certain other exceptions; and

• a second-priority lien on certain of the Receivables Collateral.

Our senior secured first lien notes and the related guarantees are secured by first-priority liens, subject to permitted liens, on our and our subsidiary guarantors' assets, subject to certain exceptions, that secure our cash flow credit facility on a first-priority basis and are secured by second priority liens, subject to permitted liens, on our and our subsidiary guarantors' assets that secure our ABL credit facility on a first priority basis and our other cash flow credit facility on a second-priority basis.

Our second lien debt and the related guarantees are secured by second-priority liens, subject to permitted liens, on our and our subsidiary guarantors' assets, subject to certain exceptions, that secure our cash flow credit facility on a first-priority basis and are secured by third-priority liens, subject to permitted liens, on our and our subsidiary guarantors' assets that secure our asset-based revolving credit facility on a first priority basis and our other cash flow credit facility on a second-priority basis.

Maturities of long-term debt in years 2013 through 2016, excluding amounts under the ABL credit facility, are $3.167 billion, $751 million, $1.020 billion and $1.537 billion, respectively.

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Document And Entity Information (USD $) In Millions, except Share data, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Jan. 31, 2012	Jun. 30, 2011
Document And Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2011
Document Fiscal Period Focus	FY
Document Fiscal Year Focus	2011
Entity Registrant Name	HCA Holdings, Inc.
Entity Central Index Key	0000860730
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		437,618,000
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Public Float			$ 5,186

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Contingencies

12 Months Ended

Dec. 31, 2011

Contingencies [Abstract]

Contingencies

NOTE 11 — 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. The resolution of any such lawsuits, claims or legal and regulatory proceedings could have a material, adverse effect on our results of operations or financial position.

Health care companies are subject to numerous 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 government inquiries from federal and state agencies and our facilities may receive such inquiries in future periods. 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 or financial position.

We are 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. It is management's opinion that the ultimate resolution of these pending claims and legal proceedings will not have a material, adverse effect on our results of operations or financial position.

The Civil Division of the Department of Justice ("DOJ") has contacted the Company in connection with its nationwide review of whether, in certain cases, hospital charges to the federal government relating to implantable cardio-defibrillators ("ICDs") met the Centers for Medicare & Medicaid Services criteria. In connection with this nationwide review, the DOJ has indicated that it will be reviewing certain ICD billing and medical records at 95 HCA hospitals; the review covers the period from October 2003 to the present. The review could potentially give rise to claims against the Company under the federal False Claims Act or other statutes, regulations or laws. At this time, we cannot predict what effect, if any, this review or any resulting claims could have on the Company.

On October 28, 2011, a shareholder action was filed in the United States District Court for the Middle District of Tennessee. The case seeks to include as a class all persons who acquired the Company's stock pursuant or traceable to the Company's Registration Statement and Prospectus issued in connection with the March 9, 2011 initial public offering. The lawsuit asserts a claim under Section 11 of the Securities Act of 1933 against the Company, certain members of the board of directors, and certain underwriters in the offering. It further asserts a claim under Section 15 of the Securities Act of 1933 against the same members of the board of directors. The action alleges deficiencies in the Company's disclosures in the Registration Statement relating to: (1) accounting for its 2006 recapitalization and 2010 reorganization; (2) the Company's failure to maintain effective internal controls relating to its accounting for such transactions; and (3) the Company's revenue growth rate. Subsequently, two additional class action complaints setting forth substantially similar claims were filed in the same federal court. All three of the cases have been consolidated.

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Other Comprehensive Loss (Components Of Accumulated Other Comprehensive Loss) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009	Dec. 31, 2011
Other Comprehensive Loss [Abstract]
Unrealized Gain (Losses) on Available-for-Sale Securities, Beginning balance	$ 6	$ 14	$ (30)	$ 7
Foreign Currency Translation Adjustments, Beginning balance	(19)	(3)	(28)
Defined Benefit Plans, Beginning balance	(143)	(106)	(106)
Change in fair value of derivative instruments, Beginning balance	(272)	(355)	(440)
Accumulated other comprehensive income (loss), net of tax, beginning balance	(428)	(450)	(604)
Unrealized Gains (Losses) on Available-for-Sale Securities	1		44
Foreign Currency Translation Adjustments	(6)	(16)	25
Defined Benefit Plans	(42)	(48)	(10)
Change in fair value of derivative instruments, net of income tax benefit	(197)	(161)	(133)
Unrealized Gains (Losses) on Available-for-Sale Securities, (Income) expense reclassified into operations from other comprehensive income		(9)
Defined Benefit Plans, (Income) expense reclassified into operations from other comprehensive income	16	11	10
Change in Fair Value of Derivatives Instruments, (Income) expense reclassified into operations from other comprehensive income	216	244	218
Foreign Currency Translation Adjustments, Ending balance	(25)	(19)	(3)
Defined Benefit Plans, Ending Balance	(169)	(143)	(106)
Change in fair value of derivatives instruments, Ending balance	(253)	(272)	(355)
Accumulated other comprehensive income (loss), net of tax, Ending balance	(440)	(428)	(450)
(Income) expense reclassified into operations from other comprehensive income, Total	232	246	228
Unrealized Gain (Losses) on Available-for-Sale Securities, Tax portion	1	1	25
Foreign Currency Translation Adjustments, income (taxes)	3	9	14
Defined benefit plans, income tax benefit	25	28	8
Change in fair value of derivatives instruments, income tax benefit	114	94	76
Unrealized Gain (Losses) on Available-for-Sale Securities,(Income) expense reclassified into operations from other comprehensive income, Tax Portion		(4)
Defined Benefit Plans, (Income) expense reclassified into operations from other comprehensive income, Tax Portion	9	7	6
Change in Fair Value of Derivatives Instruments, (Income) expense reclassified into operations from other comprehensive income, Tax Portion	$ 125	$ 140	$ 127

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Consolidated Balance Sheets (USD $) In Millions, unless otherwise specified	Dec. 31, 2011	Dec. 31, 2010
ASSETS
Cash and cash equivalents	$ 373	$ 411
Accounts receivable, less allowance for doubtful accounts of $4,106 and $3,939	4,533	3,832
Inventories	1,054	897
Deferred income taxes	594	931
Other	679	848
Total current assets	7,233	6,919
Land	1,416	1,215
Buildings	10,231	9,438
Equipment	15,431	14,310
Construction in progress	997	678
Property and equipment, gross	28,075	25,641
Accumulated depreciation	(15,241)	(14,289)
Property and equipment, net	12,834	11,352
Investments of insurance subsidiaries	548	642
Investments in and advances to affiliates	101	869
Goodwill and other intangible assets	5,251	2,693
Deferred loan costs	290	374
Other	641	1,003
Total assets	26,898	23,852
LIABILITIES AND STOCKHOLDERS' DEFICIT
Accounts payable	1,597	1,537
Accrued salaries	965	895
Other accrued expenses	1,585	1,245
Long-term debt due within one year	1,407	592
Total current liabilities	5,554	4,269
Long-term debt	25,645	27,633
Professional liability risks	993	995
Income taxes and other liabilities	1,720	1,608
Equity securities with contingent redemption rights		141
Stockholders' deficit:
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 437,477,900 shares - 2011 and 427,458,800 shares - 2010	4	4
Capital in excess of par value	1,601	386
Accumulated other comprehensive loss	(440)	(428)
Retained deficit	(9,423)	(11,888)
Stockholders' deficit attributable to HCA Holdings, Inc.	(8,258)	(11,926)
Noncontrolling interests	1,244	1,132
Total stockholders' deficit	(7,014)	(10,794)
Total liabilities and stockholders' deficit	$ 26,898	$ 23,852

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Income Taxes

12 Months Ended

Dec. 31, 2011

Income Taxes [Abstract]

Income Taxes

NOTE 5 — INCOME TAXES

The provision for income taxes consists of the following (dollars in millions):

	2011			2010		2009
Current:
Federal	$	(119	)	$	401	$	809
State		(12	)		26		75
Foreign		44			33		21
Deferred:
Federal		714			161		(274	)
State		71			17		(37	)
Foreign		21			20		33
	$	719		$	658	$	627

The provision for income taxes reflects $100 million, $69 million and $18 million ($63 million, $44 million and $12 million net of tax, respectively) reductions in interest related to taxing authority examinations for the years ended December 31, 2011, 2010 and 2009, respectively.

A reconciliation of the federal statutory rate to the effective income tax rate follows:

	2011			2010			2009
Federal statutory rate		35.0	%		35.0	%		35.0	%
State income taxes, net of federal tax benefit		2.0			2.7			3.2
Change in liability for uncertain tax positions		1.0			0.3			(0.2	)
Nontaxable gain on acquisition of controlling interest in equity investment		(13.8	)		—			—
Tax exempt interest income		(0.2	)		(0.4	)		(0.8	)
Income attributable to noncontrolling interests from consolidated partnerships		(2.4	)		(5.8	)		(6.0	)
Other items, net		(1.4	)		(2.3	)		0.1
Effective income tax rate		20.2	%		29.5	%		31.3	%

A summary of the items comprising the deferred tax assets and liabilities at December 31 follows (dollars in millions):

	2011				2010
	Assets		Liabilities		Assets		Liabilities
Depreciation and fixed asset basis differences	$	—	$	402	$	—	$	211
Allowances for professional liability and other risks		337		—		329		—
Accounts receivable		706		—		1,011		—
Compensation		216		—		202		—
Other		698		511		776		400
	$	1,957	$	913	$	2,318	$	611

At December 31, 2011, state net operating loss carryforwards (expiring in years 2012 through 2031) available to offset future taxable income approximated $34 million. Utilization of net operating loss carryforwards in any one year may be limited and, in certain cases, result in an adjustment to intangible assets. Net deferred tax assets related to such carryforwards are not significant.

At December 31, 2011, we were contesting, before the IRS Appeals Division, certain claimed deficiencies and adjustments proposed by the IRS Examination Division in connection with its audit of HCA Inc.'s 2005 and 2006 federal income tax returns. The disputed items include the timing of recognition of certain patient service revenues, the deductibility of certain debt retirement costs and our method for calculating the tax allowance for doubtful accounts. The IRS Examination Division began an audit of HCA Inc.'s 2007, 2008 and 2009 federal income tax returns in 2010.

The following table summarizes the activity related to our unrecognized tax benefits (dollars in millions):

	2011			2010
Balance at January 1	$	313		$	485
Additions (reductions) based on tax positions related to the current year		83			(18	)
Additions for tax positions of prior years		73			61
Reductions for tax positions of prior years		(15	)		(78	)
Settlements		—			(134	)
Lapse of applicable statutes of limitations		(9	)		(3	)
Balance at December 31	$	445		$	313

During 2011, we finalized settlements with the IRS Examination Division resolving all outstanding issues for our 1997 through 2004 tax years. During 2010, we finalized settlements with the Appeals Division of the IRS resolving the deductibility of our 2003 government settlement payment, the timing of certain patient service revenues for 2003 and 2004 and the method for calculating the tax allowance for doubtful accounts for certain affiliated partnerships for 2003 and 2004.

Our liability for unrecognized tax benefits was $494 million, including accrued interest of $62 million and excluding $13 million that was recorded as reductions of the related deferred tax assets, as of December 31, 2011 ($413 million, $115 million and $15 million, respectively, as of December 31, 2010). Unrecognized tax benefits of $173 million ($190 million as of December 31, 2010) would affect the effective rate, if recognized. The liability for unrecognized tax benefits does not reflect deferred tax assets of $45 million ($63 million as of December 31, 2010) related to deductible interest and state income taxes or a refundable deposit of $19 million ($82 million as of December 31, 2010), which is recorded in noncurrent assets.

Depending on the resolution of the IRS disputes, the completion of examinations by federal, state or international taxing authorities, or the expiration of statutes of limitation for specific taxing jurisdictions, we believe it is reasonably possible that our liability for unrecognized tax benefits may significantly increase or decrease within the next 12 months. However, we are currently unable to estimate the range of any possible change.

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Impairments Of Long-Lived Assets

12 Months Ended

Dec. 31, 2011

Impairments Of Long-Lived Assets [Abstract]

Impairments Of Long-Lived Assets

NOTE 4 — IMPAIRMENTS OF LONG-LIVED ASSETS

There were no impairments of long-lived assets for 2011. During 2010, we recorded pretax charges of $123 million to reduce the carrying value of identified assets to estimated fair value. The $123 million asset impairment includes $57 million related to a hospital facility in our Central Group, $5 million related to other health care entity investments in our National Group, $17 million related to a hospital facility in our Southwest Group and $44 million related to Corporate and other, which includes $35 million for the writeoff of capitalized engineering and design costs related to certain building safety requirements (California earthquake standards) that have been revised. During 2009, we recorded pretax charges of $43 million to reduce the carrying value of identified assets to estimated fair value. The $43 million asset impairment includes $15 million related to certain hospital facilities and other health care entity investments in our Central Group, $16 million related to other health care entity investments in our National Group and $12 million related to certain hospital facilities in our Southwest Group.

The asset impairment charges did not have a significant impact on our operations or cash flows and are not expected to significantly impact cash flows for future periods. The impairment charges affected our property and equipment asset category by $109 million and $24 million in 2010 and 2009, respectively.

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Other Comprehensive Loss

12 Months Ended

Dec. 31, 2011

Other Comprehensive Loss [Abstract]

Other Comprehensive Loss

NOTE 16 — OTHER COMPREHENSIVE LOSS

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

	Unrealized Gains (Losses) on Available-for-Sale Securities			Foreign Currency Translation Adjustments			Defined Benefit Plans			Change in Fair Value of Derivative Instruments			Total
Balances at December 31, 2008	$	(30	)	$	(28	)	$	(106	)	$	(440	)	$	(604	)
Unrealized gains on available-for-sale securities, net of $25 of income taxes		44			—			—			—			44
Foreign currency translation adjustments, net of $14 of income taxes		—			25			—			—			25
Defined benefit plans, net of $8 income tax benefit		—			—			(10	)		—			(10	)
Change in fair value of derivative instruments, net of $76 income tax benefit		—			—			—			(133	)		(133	)
Expense reclassified into operations from other comprehensive income, net of $6 and $127, respectively, income tax benefits		—			—			10			218			228
Balances at December 31, 2009		14			(3	)		(106	)		(355	)		(450	)
Unrealized gains on available-for-sale securities, net of $1 of income taxes		1			—			—			—			1
Foreign currency translation adjustments, net of $9  income tax benefit		—			(16	)		—			—			(16	)
Defined benefit plans, net of $28 income tax benefit		—			—			(48	)		—			(48	)
Change in fair value of derivative instruments, net of $94 income tax benefit		—			—			—			(161	)		(161	)
(Income) expense reclassified into operations from other comprehensive income, net of $(4), $7 and $140, respectively, income (taxes) benefits		(9	)		—			11			244			246
Balances at December 31, 2010		6			(19	)		(143	)		(272	)		(428	)
Unrealized gains on available-for-sale securities, net of $1 of income taxes		1			—			—			—			1
Foreign currency translation adjustments, net of $3 income tax benefit		—			(6	)		—			—			(6	)
Defined benefit plans, net of $25 income tax benefit		—			—			(42	)		—			(42	)
Change in fair value of derivative instruments, net of $114 income tax benefit		—			—			—			(197	)		(197	)
Expense reclassified into operations from other comprehensive income, net of $9 and $125, respectively, income tax benefits		—			—			16			216			232
Balances at December 31, 2011	$	7		$	(25	)	$	(169	)	$	(253	)	$	(440	)

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Leases

12 Months Ended

Dec. 31, 2011

Leases [Abstract]

Leases

NOTE 12 — LEASES

We lease medical office buildings and certain equipment under operating lease agreements. Commitments relating to noncancellable operating leases for each of the next five years and thereafter are as follows (dollars in millions):

For the Year Ended December 31,
2012	$	280
2013		264
2014		218
2015		171
2016		131
Thereafter		870
		1,934
Less sublease income		(51	)
	$	1,883

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Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information (Schedule Of Condensed Consolidating Balance Sheet) (Details) (USD $) In Millions, unless otherwise specified	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009	Dec. 31, 2008
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Cash and cash equivalents	$ 373	$ 411	$ 312	$ 465
Accounts receivable, net	4,533	3,832
Inventories	1,054	897
Deferred income taxes	594	931
Other	679	848
Total current assets	7,233	6,919
Property and equipment, net	12,834	11,352
Investments of insurance subsidiaries	548	642
Investments in and advances to affiliates	101	869
Goodwill	5,251	2,693
Deferred loan costs	290	374
Other	641	1,003
Total assets	26,898	23,852
Accounts payable	1,597	1,537
Accrued salaries	965	895
Other accrued expenses	1,585	1,245
Long-term debt due within one year	1,407	592
Total current liabilities	5,554	4,269
Long-term debt	25,645	27,633
Professional liability risks	993	995
Income taxes and other liabilities	1,720	1,608
Total liabilities	33,912	34,505
Equity securities with contingent redemption rights		141
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	(8,258)	(11,926)
Noncontrolling Interests	1,244	1,132
Total stockholders' deficit	(7,014)	(10,794)	(7,978)	(9,260)
Total liabilities and stockholders' deficit	26,898	23,852
Parent Company [Member]
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Cash and cash equivalents		6
Deferred income taxes	594	931
Other	50	202
Total current assets	644	1,139
Deferred loan costs	22	23
Investments in and advances to subsidiaries	16,825	14,282
Other	450	776
Total assets	17,941	16,220
Other accrued expenses	15	12
Total current liabilities	15	12
Long-term debt	1,525	1,525
Intercompany balances	24,121	25,985
Income taxes and other liabilities	538	483
Total liabilities	26,199	28,005
Equity securities with contingent redemption rights		141
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	(8,258)	(11,926)
Total stockholders' deficit	(8,258)	(11,926)
Total liabilities and stockholders' deficit	17,941	16,220
HCA Inc. Issuer [Member]
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Deferred loan costs	268	351
Other		39
Total assets	268	390
Other accrued expenses	367	296
Long-term debt due within one year	1,347	554
Total current liabilities	1,714	850
Long-term debt	23,454	25,758
Intercompany balances	(12,814)	(16,130)
Income taxes and other liabilities	415	425
Total liabilities	12,769	10,903
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	(12,501)	(10,513)
Total stockholders' deficit	(12,501)	(10,513)
Total liabilities and stockholders' deficit	268	390
Subsidiary Guarantors [Member]
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Cash and cash equivalents	115	156	95	134
Accounts receivable, net	2,429	2,214
Inventories	602	547
Other	184	223
Total current assets	3,330	3,140
Property and equipment, net	7,088	6,817
Investments in and advances to affiliates	15	248
Goodwill	1,605	1,635
Other	21	21
Total assets	12,059	11,861
Accounts payable	899	919
Accrued salaries	568	556
Other accrued expenses	449	328
Long-term debt due within one year	28	12
Total current liabilities	1,944	1,815
Long-term debt	110	95
Intercompany balances	(15,183)	(12,833)
Income taxes and other liabilities	556	505
Total liabilities	(12,573)	(10,418)
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	24,534	22,167
Noncontrolling Interests	98	112
Total stockholders' deficit	24,632	22,279
Total liabilities and stockholders' deficit	12,059	11,861
Subsidiary Non-Guarantors [Member]
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Cash and cash equivalents	258	249	217	331
Accounts receivable, net	2,104	1,618
Inventories	452	350
Other	445	423
Total current assets	3,259	2,640
Property and equipment, net	5,746	4,535
Investments of insurance subsidiaries	548	642
Investments in and advances to affiliates	86	621
Goodwill	3,646	1,058
Other	170	167
Total assets	13,455	9,663
Accounts payable	698	618
Accrued salaries	397	339
Other accrued expenses	754	609
Long-term debt due within one year	32	26
Total current liabilities	1,881	1,592
Long-term debt	556	255
Intercompany balances	3,876	2,978
Professional liability risks	993	995
Income taxes and other liabilities	211	195
Total liabilities	7,517	6,015
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	4,792	2,628
Noncontrolling Interests	1,146	1,020
Total stockholders' deficit	5,938	3,648
Total liabilities and stockholders' deficit	13,455	9,663
Eliminations [Member]
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Investments in and advances to subsidiaries	(16,825)	(14,282)
Total assets	(16,825)	(14,282)
Stockholders' (deficit) equity attributable to HCA Holdings, Inc.	(16,825)	(14,282)
Total stockholders' deficit	(16,825)	(14,282)
Total liabilities and stockholders' deficit	$ (16,825)	$ (14,282)

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Financial Instruments

12 Months Ended

Dec. 31, 2011

Financial Instruments [Abstract]

Financial Instruments

NOTE 8 — 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 two parties based on common notional principal amounts and maturity dates. Pay-fixed interest rate swaps effectively convert LIBOR indexed variable rate obligations to fixed interest rate obligations. The interest payments under these agreements are settled on a net basis. The net interest payments, based on the notional amounts in these agreements, generally match the timing of the related liabilities, for the interest rate swap agreements which have been designated as cash flow hedges. The notional amounts of the swap agreements represent amounts used to calculate the exchange of cash flows and are not our assets or liabilities. Our credit risk related to these agreements is considered low because the swap agreements are with creditworthy financial institutions.

The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at December 31, 2011 (dollars in millions):

	Notional Amount		Maturity Date		Fair Value
Pay-fixed interest rate swaps	$	500		December 2014	$	(7	)
Pay-fixed interest rate swaps		3,000		December 2016		(339	)
Pay-fixed interest rate swaps		1,000		December 2017		(53	)

During the next 12 months, we estimate $110 million will be reclassified from other comprehensive income ("OCI") to interest expense.

Cross Currency Swaps

The Company and certain subsidiaries have incurred obligations and entered into various intercompany transactions where such obligations are denominated in currencies, other than the functional currencies of the parties executing the trade. In order to mitigate the currency exposure risks and better match the cash flows of our obligations and intercompany transactions with cash flows from operations, we enter into various cross currency swaps. Our credit risk related to these agreements is considered low because the swap agreements are with creditworthy financial institutions.

Our cross currency swap is not designated as a hedge, and changes in fair value are recognized in results of operations. The following table sets forth our cross currency swap agreement at December 31, 2011 (amounts in millions):

	Notional Amount		Maturity Date		Fair Value
Euro — United States Dollar Currency Swap		291 Euro		November 2013	$	(16	)

Derivatives — Results of Operations

The following tables present the effect of our interest rate and cross currency swaps on our results of operations for the year ended December 31, 2011 (dollars in millions):

Derivatives in Cash Flow Hedging Relationships	Amount of Loss Recognized  in OCI on Derivatives, Net of Tax		Location of  Loss Reclassified from Accumulated  OCI into Operations		Amount of  Loss Reclassified from Accumulated  OCI into Operations
Interest rate swaps	$	197		Interest expense	$	341

Derivatives Not Designated as Hedging Instruments	Location of Loss Recognized in Operations on Derivatives		Amount of Loss Recognized in Operations on Derivatives
Interest rate swaps		Other operating expenses	$	1
Cross currency swap		Other operating expenses		54

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 December 31, 2011, we have not been required to post any collateral related to these agreements. If we had breached these provisions at December 31, 2011, we would have been required to settle our obligations under the agreements at their aggregate, estimated termination value of $452 million.

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Earnings Per Share (Schedule Of Computations Of Basic And Diluted Earnings Per Share) (Details) (USD $) In Millions, except Share data, unless otherwise specified	3 Months Ended																12 Months Ended
	Dec. 31, 2011		Sep. 30, 2011		Jun. 30, 2011		Mar. 31, 2011		Dec. 31, 2010		Sep. 30, 2010		Jun. 30, 2010		Mar. 31, 2010		Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Earnings Per Share [Abstract]
Net income attributable to HCA Holdings, Inc.	$ 1,935	[1]	$ 61	[2]	$ 229	[3]	$ 240	[4]	$ 283	[5]	$ 243	[2]	$ 293	[6]	$ 388	[7]	$ 2,465	$ 1,207	$ 1,054
Weighted average common shares outstanding																	476,609,000	426,424,000	425,567,000
Effect of dilutive stock options																	19,334,000,000	10,923,000,000	6,660,000,000
Shares used for diluted earnings per share																	495,943,000	437,347,000	432,227,000
Basic earnings per share	$ 4.43		$ 0.12		$ 0.44		$ 0.54		$ 0.66		$ 0.57		$ 0.69		$ 0.91		$ 5.17	$ 2.83	$ 2.48
Diluted earnings per share	$ 4.25		$ 0.11		$ 0.43		$ 0.52		$ 0.65		$ 0.55		$ 0.67		$ 0.89		$ 4.97	$ 2.76	$ 2.44

[1] Fourth quarter results include $84 million of gains on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $1.424 billion of gain on acquisition of controlling interest in equity investment (See NOTE 3 of the notes to consolidated financial statements).

[2] Third quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $256 million of losses on retirement of debt (See NOTE 10 of the notes to consolidated financial statements).

[3] Second quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $47 million of losses on retirement of debt (See NOTE 10 of the notes to consolidated financial statements).

[4] First quarter results include $2 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $149 million of costs related to the termination of management agreement (See NOTE 1 of the notes to consolidated financial statements).

[5] Fourth quarter results include $3 million of gains on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $2 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

[6] Second quarter results include $57 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

[7] First quarter results include $12 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

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Earnings Per Share

12 Months Ended

Dec. 31, 2011

Earnings Per Share [Abstract]

Earnings Per Share

NOTE 6 — 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 stock options, computed using the treasury stock method. The following table sets forth the computations of basic and diluted earnings per share for the years ended December 31, 2011, 2010 and 2009 (dollars in millions, except per share amounts, and shares in thousands):

	2011		2010		2009
Net income attributable to HCA Holdings, Inc	$	2,465	$	1,207	$	1,054
Weighted average common shares outstanding		476,609		426,424		425,567
Effect of dilutive stock options		19,334		10,923		6,660
Shares used for diluted earnings per share		495,943		437,347		432,227
Earnings per share:
Basic earnings per share	$	5.17	$	2.83	$	2.48
Diluted earnings per share	$	4.97	$	2.76	$	2.44

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Investments Of Insurance Subsidiaries

12 Months Ended

Dec. 31, 2011

Investments Of Insurance Subsidiaries [Abstract]

Investments Of Insurance Subsidiaries

NOTE 7 — INVESTMENTS OF INSURANCE SUBSIDIARIES

A summary of the insurance subsidiaries' investments at December 31 follows (dollars in millions):

	2011
	Amortized Cost		Unrealized Amounts					Fair Value
			Gains		Losses
Debt securities:
States and municipalities	$	398	$	19	$	—		$	417
Auction rate securities		139		—		(8	)		131
Asset-backed securities		20		—		—			20
Money market funds		53		—		—			53
		610		19		(8	)		621
Equity securities		7		1		(1	)		7
	$	617	$	20	$	(9	)		628
Amounts classified as current assets									(80	)
Investment carrying value								$	548
	2010
	Amortized Cost		Unrealized Amounts					Fair Value
			Gains		Losses
Debt securities:
States and municipalities	$	312	$	12	$	(1	)	$	323
Auction rate securities		251		—		(1	)		250
Asset-backed securities		26		1		(1	)		26
Money market funds		135		—		—			135
		724		13		(3	)		734
Equity securities		8		1		(1	)		8
	$	732	$	14	$	(4	)		742
Amounts classified as current assets									(100	)
Investment carrying value								$	642

At December 31, 2011 and 2010 the investments of our insurance subsidiaries were classified as "available-for-sale." Changes in temporary unrealized gains and losses are recorded as adjustments to other comprehensive income (loss). At December 31, 2011 and 2010, $19 million and $92 million, respectively, of our investments were subject to the restrictions included in insurance bond collateralization and assumed reinsurance contracts.

Scheduled maturities of investments in debt securities at December 31, 2011 were as follows (dollars in millions):

	Amortized Cost		Fair Value
Due in one year or less	$	101	$	102
Due after one year through five years		112		119
Due after five years through ten years		143		151
Due after ten years		95		98
		451		470
Auction rate securities		139		131
Asset-backed securities		20		20
	$	610	$	621

The average expected maturity of the investments in debt securities at December 31, 2011 was 4.4 years, compared to the average scheduled maturity of 10.8 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. The average expected maturities for our auction rate and asset-backed securities were derived from valuation models of expected cash flows and involved management's judgment. The average expected maturities for our auction rate and asset-backed securities at December 31, 2011 were 4.9 years and 4.8 years, respectively, compared to average scheduled maturities of 24.9 years and 24.8 years, respectively.

The cost of securities sold is based on the specific identification method. Sales of securities for the years ended December 31 are summarized below (dollars in millions):

	2011		2010		2009
Debt securities:
Cash proceeds	$	—	$	329	$	141
Gross realized gains		—		14		—
Gross realized losses		—		1		1
Equity securities:
Cash proceeds	$	—	$	—	$	3
Gross realized gains		—		—		1
Gross realized losses		—		—		—

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Assets And Liabilities Measured At Fair Value

12 Months Ended

Dec. 31, 2011

Assets And Liabilities Measured At Fair Value [Abstract]

Assets And Liabilities Measured At Fair Value

NOTE 9 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE

Accounting Standards Codification 820, Fair Value Measurements and Disclosures ("ASC 820") defines fair value, establishes a framework for measuring fair value, and expands disclosures about fair value measurements. ASC 820 applies to reported balances that are required or permitted to be measured at fair value under existing accounting pronouncements.

ASC 820 emphasizes fair value is a market-based measurement, not an entity-specific measurement. Therefore, a fair value measurement should be determined based on the assumptions market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, ASC 820 establishes a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs classified within Levels 1 and 2 of the hierarchy) and the reporting entity's own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy).

Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates, and yield curves observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity's own assumptions, as there is little, if any, related market activity. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input significant to the fair value measurement in its entirety. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment, and considers factors specific to the asset or liability.

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. Certain types of cash traded instruments are classified within Level 3 of the fair value hierarchy because they trade infrequently and therefore have little or no price transparency. Such instruments include auction rate securities ("ARS") and limited partnership investments. The transaction price is initially used as the best estimate of fair value.

Our wholly-owned insurance subsidiaries had investments in tax-exempt ARS, which are backed by student loans substantially guaranteed by the federal government, of $131 million ($139 million par value) at December 31, 2011. We do not currently intend to attempt to sell the ARS as the liquidity needs of our insurance subsidiaries are expected to be met by other investments in their investment portfolios. During 2011 and 2010, certain issuers and their broker/dealers redeemed or repurchased $112 million and $150 million, respectively, of our ARS at par value. The valuation of these securities involved management's judgment, after consideration of market factors and the absence of market transparency, market liquidity and observable inputs. Our valuation models derived a fair market value compared to tax-equivalent yields of other student loan backed variable rate securities of similar credit worthiness and similar effective maturities.

Derivative Financial Instruments

We have entered into interest rate and cross currency swap agreements to manage our exposure to fluctuations in interest rates and foreign currency risks. 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, foreign exchange rates and implied volatilities. To comply with the provisions of ASC 820, we incorporate credit valuation adjustments to reflect both our own nonperformance risk and the respective counterparty's nonperformance risk in the fair value measurements.

Although we determined the majority of the inputs used to value our derivatives fall within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with our derivatives utilize Level 3 inputs, such as estimates of current credit spreads to evaluate the likelihood of default by us and our counterparties. We assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our derivative positions and at December 31, 2011 and 2010, we determined the credit valuation adjustments were not significant to the overall valuation of our derivatives.

The following table summarizes our assets and liabilities measured at fair value on a recurring basis as of December 31, 2011 and 2010, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions):

	December 31, 2011
				Fair Value Measurements Using
	Fair Value			Quoted Prices in Active  Markets for Identical Assets and Liabilities (Level 1)			Significant Other Observable  Inputs (Level 2)			Significant Unobservable  Inputs (Level 3)
Assets:
Investments of insurance subsidiaries:
Debt securities:
States and municipalities	$	417		$	—		$	417		$	—
Auction rate securities		131			—			—			131
Asset-backed securities		20			—			20			—
Money market funds		53			53			—			—
		621			53			437			131
Equity securities		7			1			5			1
Investments of insurance subsidiaries		628			54			442			132
Less amounts classified as current assets		(80	)		(54	)		(26	)		—
	$	548		$	—		$	416		$	132
Liabilities:
Cross currency swap (Income taxes and other liabilities)	$	16		$	—		$	16		$	—
Interest rate swaps (Income taxes and other liabilities)		399			—			399			—

	December 31, 2010
				Fair Value Measurements Using
	Fair Value			Quoted Prices in Active  Markets for Identical Assets and Liabilities (Level 1)			Significant Other Observable  Inputs (Level 2)		Significant Unobservable  Inputs (Level 3)
Assets:
Investments of insurance subsidiaries:
Debt securities:
States and municipalities	$	323		$	—		$	323	$	—
Auction rate securities		250			—			—		250
Asset-backed securities		26			—			26		—
Money market funds		135			135			—		—
		734			135			349		250
Equity securities		8			2			5		1
Investments of insurance subsidiaries		742			137			354		251
Less amounts classified as current assets		(100	)		(100	)		—		—
	$	642		$	37		$	354	$	251
Cross currency swap (Other assets)	$	39		$	—		$	39	$	—
Liabilities:
Interest rate swaps (Income taxes and other liabilities)	$	426		$	—		$	426	$	—

The following table summarizes the activity related to the auction rate and equity securities investments of our insurance subsidiaries which have fair value measurements based on significant unobservable inputs (Level 3) during the year ended December 31, 2011 (dollars in millions):

Asset balances at December 31, 2010	$	251
Unrealized losses included in other comprehensive income		(7	)
Settlements		(112	)
Asset balances at December 31, 2011	$	132

The estimated fair value of our long-term debt was $27.199 billion and $28.738 billion at December 31, 2011 and 2010, respectively, compared to carrying amounts aggregating $27.052 billion and $28.225 billion, respectively. The estimates of fair value are generally based upon the quoted market prices or quoted market prices for similar issues of long-term debt with the same maturities.

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Investments Of Insurance Subsidiaries (Schedule Of Cost Of Securities Sold) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Debt Securities [Member]
Cash proceeds		$ 329	$ 141
Gross realized gains		14
Gross realized losses		1	1
Equity Securities [Member]
Cash proceeds			3
Gross realized gains			1
Gross realized losses

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Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information (Schedule Of Condensed Consolidating Statement Of Cash Flows) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Net income	$ 2,842	$ 1,573	$ 1,375
Changes in operating assets and liabilities	(2,953)	(2,847)	(3,091)
Provision for doubtful accounts	2,824	2,648	3,276
Depreciation and amortization	1,465	1,421	1,425
Income taxes	912	27	(520)
Losses (gains) on sales of facilities	(142)	(4)	15
Gain on acquisition of controlling interest in equity investment	(1,522)
Impairments of long-lived assets		123	43
Losses on retirement of debt	481
Amortization of deferred loan costs	70	81	80
Share-based compensation	26	32	40
Pay-in-kind interest	(78)		58
Equity in earnings of affiliates	(258)	(282)	(246)
Other	8	31	46
Net cash provided by (used in) operating activities	3,933	3,085	2,747
Purchase of property and equipment	(1,679)	(1,325)	(1,317)
Acquisition of hospitals and health care entities	(1,682)	(233)	(61)
Disposal of hospitals and health care entities	281	37	41
Change in investments	80	472	303
Other	5	10	(1)
Net cash used in investing activities	(2,995)	(1,039)	(1,035)
Issuance of long-term debt	5,500	2,912	2,979
Net change in revolving credit facilities	(449)	1,889	(1,335)
Repayment of long-term debt	(6,640)	(2,268)	(3,103)
Distributions to noncontrolling interests	(378)	(342)	(330)
Contributions from noncontrolling interests		57
Payment of debt issuance costs	(92)	(50)	(70)
Repurchase of common stock	(1,503)
Issuance of common stock	2,506
Distributions to stockholders	(31)	(4,257)
Income tax benefits	63	114
Other	48	(2)	(6)
Net cash provided by (used in) financing activities	(976)	(1,947)	(1,865)
Change in cash and cash equivalents	(38)	99	(153)
Cash and cash equivalents at beginning of period	411	312	465
Cash and cash equivalents at end of period	373	411	312
Parent Company [Member]
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Net income	2,465	1,207
Changes in operating assets and liabilities	6	12
Income taxes	912	27
Share-based compensation	26	32
Equity in earnings of affiliates	(2,543)	(1,215)
Net cash provided by (used in) operating activities	866	63
Issuance of long-term debt		1,525
Payment of debt issuance costs		(23)
Distributions to stockholders	(31)	(4,257)
Income tax benefits	63	114
Changes in intercompany balances with affiliates, net	(1,918)	2,590
Other	11	(6)
Net cash provided by (used in) financing activities	(872)	(57)
Change in cash and cash equivalents	(6)	6
Cash and cash equivalents at beginning of period	6
Cash and cash equivalents at end of period		6
HCA Inc. Issuer [Member]
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Net income	(1,988)	(1,750)	1,054
Changes in operating assets and liabilities	71	13	90
Income taxes			(520)
Losses on retirement of debt	481
Amortization of deferred loan costs	70	81	80
Share-based compensation			40
Pay-in-kind interest			58
Equity in earnings of affiliates			(2,540)
Other	9	31	50
Net cash provided by (used in) operating activities	(1,435)	(1,625)	(1,688)
Issuance of long-term debt	5,500	1,387	2,979
Net change in revolving credit facilities	(449)	1,889	(1,335)
Repayment of long-term debt	(6,577)	(2,164)	(2,972)
Payment of debt issuance costs	(92)	(27)	(70)
Changes in intercompany balances with affiliates, net	3,053	556	3,107
Other		(16)	(21)
Net cash provided by (used in) financing activities	1,435	1,625	1,688
Subsidiary Guarantors [Member]
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Net income	2,430	2,424	2,060
Changes in operating assets and liabilities	(1,755)	(1,759)	(1,882)
Provision for doubtful accounts	1,644	1,632	2,043
Depreciation and amortization	777	782	787
Losses (gains) on sales of facilities	(127)		17
Impairments of long-lived assets		58	34
Equity in earnings of affiliates	(86)	(107)	(95)
Other			(2)
Net cash provided by (used in) operating activities	2,969	3,137	3,057
Purchase of property and equipment	(910)	(602)	(720)
Acquisition of hospitals and health care entities	(142)	(21)	(38)
Disposal of hospitals and health care entities	200	29	21
Change in investments	34	1	(7)
Other		(3)
Net cash used in investing activities	(818)	(596)	(744)
Repayment of long-term debt	(17)	(32)	(7)
Distributions to noncontrolling interests	(77)	(61)	(70)
Changes in intercompany balances with affiliates, net	(2,098)	(2,387)	(2,275)
Net cash provided by (used in) financing activities	(2,192)	(2,480)	(2,352)
Change in cash and cash equivalents	(41)	61	(39)
Cash and cash equivalents at beginning of period	156	95	134
Cash and cash equivalents at end of period	115	156	95
Subsidiary Non-Guarantors [Member]
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Net income	2,478	907	801
Changes in operating assets and liabilities	(1,275)	(1,113)	(1,299)
Provision for doubtful accounts	1,180	1,016	1,233
Depreciation and amortization	688	639	638
Losses (gains) on sales of facilities	(15)	(4)	(2)
Gain on acquisition of controlling interest in equity investment	(1,522)
Impairments of long-lived assets		65	9
Equity in earnings of affiliates	(172)	(175)	(151)
Other	(1)		(2)
Net cash provided by (used in) operating activities	1,533	1,510	1,378
Purchase of property and equipment	(769)	(723)	(597)
Acquisition of hospitals and health care entities	(1,540)	(212)	(23)
Disposal of hospitals and health care entities	81	8	20
Change in investments	46	471	310
Other	5	13	(1)
Net cash used in investing activities	(2,177)	(443)	(291)
Repayment of long-term debt	(46)	(72)	(124)
Distributions to noncontrolling interests	(301)	(281)	(260)
Contributions from noncontrolling interests		57
Changes in intercompany balances with affiliates, net	963	(759)	(832)
Other	37	20	15
Net cash provided by (used in) financing activities	653	(1,035)	(1,201)
Change in cash and cash equivalents	9	32	(114)
Cash and cash equivalents at beginning of period	249	217	331
Cash and cash equivalents at end of period	258	249	217
Eliminations [Member]
Supplemental Condensed Consolidating Financial Information And Other Collateral-Related Information [Line Items]
Net income	(2,543)	(1,215)	(2,540)
Equity in earnings of affiliates	$ 2,543	$ 1,215	$ 2,540

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Financial Instruments (Schedule Of Interest Rate Swap Agreements Designated As Cash Flow Hedges) (Details) In Millions, unless otherwise specified	Dec. 31, 2011 EUR (€)	Dec. 31, 2011 Maturity Date, 2014 [Member] Pay-Fixed Interest Rate Swaps [Member] USD ($)	Dec. 31, 2011 Maturity Date, 2014 [Member] Pay-Fixed Interest Rate Swaps [Member] USD ($)	Dec. 31, 2011 Maturity Date, 2016 [Member] Pay-Fixed Interest Rate Swaps [Member] USD ($)
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amounts		$ 500	$ 1,000	$ 3,000
Notinal amount of for curency derivates	291
Fair Value		$ (7)	$ (53)	$ (339)

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Investments Of Insurance Subsidiaries (Schedule Of Maturities Of Investments) (Details) (USD $) In Millions, unless otherwise specified	Dec. 31, 2011	Dec. 31, 2010
Amortized cost, Due in one year or less	$ 101
Amortized cost, Due after one year through five years	112
Amortized cost, Due after five years through ten years	143
Amortized cost, Due after ten years	95
Amortized cost	610
Amortized Cost, Total	451
Fair Value, Due in one year or less	102
Fair Value, Due after one year through five years	119
Fair Value, Due after five years through ten years	151
Fair Value, Due after ten years	98
Fair Value, Total	470
Fair Value, Total	621
Amortized Cost	617	732
Insurance subsidiaries investments, fair value	628	742
Asset-Backed Securities [Member]
Amortized cost	20
Insurance subsidiaries investments, fair value	20
Auction Rate Securities [Member]
Amortized cost	139
Insurance subsidiaries investments, fair value	$ 131

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Investments Of Insurance Subsidiaries (Tables)

12 Months Ended

Dec. 31, 2011

Investments Of Insurance Subsidiaries [Abstract]

Schedule Of Investments

	2011
	Amortized Cost		Unrealized Amounts					Fair Value
			Gains		Losses
Debt securities:
States and municipalities	$	398	$	19	$	—		$	417
Auction rate securities		139		—		(8	)		131
Asset-backed securities		20		—		—			20
Money market funds		53		—		—			53
		610		19		(8	)		621
Equity securities		7		1		(1	)		7
	$	617	$	20	$	(9	)		628
Amounts classified as current assets									(80	)
Investment carrying value								$	548
	2010
	Amortized Cost		Unrealized Amounts					Fair Value
			Gains		Losses
Debt securities:
States and municipalities	$	312	$	12	$	(1	)	$	323
Auction rate securities		251		—		(1	)		250
Asset-backed securities		26		1		(1	)		26
Money market funds		135		—		—			135
		724		13		(3	)		734
Equity securities		8		1		(1	)		8
	$	732	$	14	$	(4	)		742
Amounts classified as current assets									(100	)
Investment carrying value								$	642

Schedule Of Maturities Of Investments

	Amortized Cost		Fair Value
Due in one year or less	$	101	$	102
Due after one year through five years		112		119
Due after five years through ten years		143		151
Due after ten years		95		98
		451		470
Auction rate securities		139		131
Asset-backed securities		20		20
	$	610	$	621

Schedule Of Cost Of Securities Sold

	2011		2010		2009
Debt securities:
Cash proceeds	$	—	$	329	$	141
Gross realized gains		—		14		—
Gross realized losses		—		1		1
Equity securities:
Cash proceeds	$	—	$	—	$	3
Gross realized gains		—		—		1
Gross realized losses		—		—		—

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Acquisitions And Dispositions (Narrative) (Details) (USD $) In Millions, unless otherwise specified	3 Months Ended																12 Months Ended					2 Months Ended	12 Months Ended				12 Months Ended				12 Months Ended						12 Months Ended
	Dec. 31, 2011		Sep. 30, 2011		Jun. 30, 2011		Mar. 31, 2011		Dec. 31, 2010		Sep. 30, 2010		Jun. 30, 2010		Mar. 31, 2010		Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009	Dec. 31, 2011 Parent Company [Member]	Dec. 31, 2010 Parent Company [Member]	Dec. 31, 2011 HealthONE [Member]	Dec. 31, 2011 HealthONE [Member]	Dec. 31, 2011 Other [Member]	Dec. 31, 2010 Other [Member]	Dec. 31, 2009 Other [Member]	Dec. 31, 2009 Hospitals [Member]	Dec. 31, 2011 Hospitals [Member] HealthONE [Member]	Dec. 31, 2010 Hospitals [Member] Other [Member]	Dec. 31, 2011 Hospitals [Member] Other [Member]	Dec. 31, 2011 Other Healthcare Entity [Member]	Dec. 31, 2010 Other Healthcare Entity [Member]	Dec. 31, 2009 Other Healthcare Entity [Member]	Dec. 31, 2011 Other Healthcare Entity [Member] Other [Member]	Dec. 31, 2010 Other Healthcare Entity [Member] Other [Member]	Dec. 31, 2009 Other Healthcare Entity [Member] Other [Member]	Dec. 31, 2011 Freestanding Surgery Centers [Member] HealthONE [Member]
Business Acquisition [Line Items]
Equity interest, ownership percentage by parent																						40.00%	40.00%
Purchase price of acquisition																						$ 1,450	$ 1,450
Number of acquired businesses																												7	2								12
Gain on acquisition of business	1,424																1,522						1,522
Expected tax deductible on the amount of goodwill related to acquisition	894																894
Revenues	7,769	[1]	7,258	[1]	7,249	[1]	7,406	[1]	7,161	[1]	6,926	[1]	6,968	[1]	6,980	[1]	29,682	28,035	26,776			347
Net income	1,935	[2]	61	[3]	229	[4]	240	[5]	283	[6]	243	[3]	293	[7]	388	[8]	2,465	1,207	1,054	2,465	1,207	15
Cash paid for acquisition																													163	136				96	70	61
Fair value of identifiable net assets of acquired entities	2,261																2,261							(68)	125	5
Proceeds from sale of business																											3				281	37	38
Pretax gain (loss) on sale of business																											8				142	4	7
Gain on sale of business after tax																											$ 5				$ 80	$ 2	$ 4

[1] The "Revenues" presented for each quarter of 2010 and the first and second quarters of 2011 have been reduced by the provision for doubtful accounts for each quarter in accordance with our adoption of ASU 2011-07 in the third quarter of 2011. The "Revenues" presented for the second and third quarters of 2011 have been reduced for the reclassification of "Electronic health record incentive income" as a separate line item in our consolidated income statements (See NOTE 1 of the notes to consolidated financial statements).

[2] Fourth quarter results include $84 million of gains on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $1.424 billion of gain on acquisition of controlling interest in equity investment (See NOTE 3 of the notes to consolidated financial statements).

[3] Third quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $256 million of losses on retirement of debt (See NOTE 10 of the notes to consolidated financial statements).

[4] Second quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $47 million of losses on retirement of debt (See NOTE 10 of the notes to consolidated financial statements).

[5] First quarter results include $2 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $149 million of costs related to the termination of management agreement (See NOTE 1 of the notes to consolidated financial statements).

[6] Fourth quarter results include $3 million of gains on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $2 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

[7] Second quarter results include $57 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

[8] First quarter results include $12 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

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Employee Benefit Plans

12 Months Ended

Dec. 31, 2011

Employee Benefit Plans [Abstract]

Employee Benefit Plans

NOTE 14 — EMPLOYEE BENEFIT PLANS

We maintain contributory, defined contribution benefit plans that are available to employees who meet certain minimum requirements. Certain of the plans require that we match specified percentages of participant contributions up to certain maximum levels (generally, 100% of the first 3% to 9%, depending upon years of vesting service, of compensation deferred by participants). The cost of these plans totaled $321 million for 2011, $307 million for 2010 and $283 million for 2009. Our contributions are funded periodically during each year.

We maintain the noncontributory, nonqualified Restoration Plan to provide certain retirement benefits for eligible employees. Eligibility for the Restoration Plan is based upon earning eligible compensation in excess of the Social Security Wage Base and attaining 1,000 or more hours of service during the plan year. Company credits to participants' account balances (the Restoration Plan is not funded) depend upon participants' compensation, years of vesting service and certain IRS limitations related to the HCA 401(k) plan. Benefits expense under this plan was $25 million for 2011, $19 million for 2010 and $26 million for 2009. Accrued benefits liabilities under this plan totaled $105 million at December 31, 2011 and $84 million at December 31, 2010.

We maintain a Supplemental Executive Retirement Plan ("SERP") for certain executives. The plan is designed to ensure that upon retirement the participant receives the value of a prescribed life annuity from the combination of the SERP and our other benefit plans. Benefits expense under the plan was $33 million for 2011, $27 million for 2010 and $24 million for 2009. Accrued benefits liabilities under this plan totaled $237 million at December 31, 2011 and $197 million at December 31, 2010.

We maintain defined benefit pension plans which resulted from certain hospital acquisitions in prior years. Benefits expense under these plans was $37 million for 2011, $30 million for 2010, and $39 million for 2009. Accrued benefits liabilities under these plans totaled $147 million at December 31, 2011 and $131 million at December 31, 2010.

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Subsequent Event

12 Months Ended

Dec. 31, 2011

Subsequent Event [Abstract]

Subsequent Event

NOTE 19 — SUBSEQUENT EVENT

On February 3, 2012, our Board of Directors declared a distribution to the Company's stockholders and holders of vested stock awards. The distribution will be $2.00 per share and vested stock award, or approximately $975 million in the aggregate. The distribution is expected to be paid on February 29, 2012 to holders of record on February 16, 2012. The distribution is expected to be funded using funds available under our existing senior secured credit facilities. Pursuant to the terms of our stock award plans, the holders of nonvested stock options and stock appreciation rights will receive a $2.00 per share reduction (subject to certain tax related limitations for certain stock awards that resulted in deferred distributions for a portion of the declared distribution, which will be paid upon the vesting of the applicable stock award) to the exercise price of their share-based awards. The holders of any nonvested restricted share units will be paid $2.00 per unit upon the vesting of the applicable restricted share units.

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Share-Based Compensation (Schedule Of Fair Value Of Each Stock Option Award Is Estimated On The Grant Date, Using Option Valuation Models) (Details)	12 Months Ended
	Dec. 31, 2011 years	Dec. 31, 2010 years	Dec. 31, 2009 years
Share-Based Compensation [Abstract]
Risk-free interest rate	0.89%	2.07%	1.45%
Expected volatility	41.00%	35.00%	35.00%
Expected life, in years	5	5	5
Expected dividend yield

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Accrued Expenses And Allowance For Doubtful Accounts (Tables)

12 Months Ended

Dec. 31, 2011

Accrued Expenses And Allowance For Doubtful Accounts [Abstract]

Summary Of Other Accrued Expenses

	2011		2010
Professional liability risks	$	298	$	268
Interest		383		309
Taxes other than income		232		197
Other		672		471
	$	1,585	$	1,245

Summary Of Allowance Of Doubtful Accounts

	Balance at Beginning of Year		Provision for Doubtful Accounts		Accounts Written off, Net of Recoveries			Balance at End of Year
Allowance for doubtful accounts:
Year ended December 31, 2009	$	4,741	$	3,276	$	(3,157	)	$	4,860
Year ended December 31, 2010		4,860		2,648		(3,569	)		3,939
Year ended December 31, 2011		3,939		2,824		(2,657	)		4,106

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Consolidated Balance Sheets (Parenthetical) (USD $) In Millions, except Share data, unless otherwise specified	Dec. 31, 2011	Dec. 31, 2010
Consolidated Balance Sheets [Abstract]
Allowance for accounts receivable	$ 4,106	$ 3,939
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	1,800,000,000	1,800,000,000
Common stock, shares outstanding	437,477,900	427,458,800

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Quarterly Consolidated Financial Information (Details) (USD $) In Millions, except Per Share data, unless otherwise specified	3 Months Ended																12 Months Ended
	Dec. 31, 2011		Sep. 30, 2011		Jun. 30, 2011		Mar. 31, 2011		Dec. 31, 2010		Sep. 30, 2010		Jun. 30, 2010		Mar. 31, 2010		Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Revenues	$ 7,769	[1]	$ 7,258	[1]	$ 7,249	[1]	$ 7,406	[1]	$ 7,161	[1]	$ 6,926	[1]	$ 6,968	[1]	$ 6,980	[1]	$ 29,682	$ 28,035	$ 26,776
Net income	2,042	[2]	146	[3]	320	[4]	334	[5]	394	[6]	325	[3]	378	[7]	476	[8]	2,842	1,573	1,375
Net income attributable to HCA Holdings, Inc.	1,935	[2]	61	[3]	229	[4]	240	[5]	283	[6]	243	[3]	293	[7]	388	[8]	2,465	1,207	1,054
Basic earnings per share	$ 4.43		$ 0.12		$ 0.44		$ 0.54		$ 0.66		$ 0.57		$ 0.69		$ 0.91		$ 5.17	$ 2.83	$ 2.48
Diluted earnings per share	$ 4.25		$ 0.11		$ 0.43		$ 0.52		$ 0.65		$ 0.55		$ 0.67		$ 0.89		$ 4.97	$ 2.76	$ 2.44
Losses (gains) on sales of facilities	(84)		1		(1)		2		(3)		1						(142)	(4)	15
Gain on purchase of facilities	1,424																1,522
Termination of management agreement							149										181
Losses on retirement of debt			256		47												481
Impairments of long-lived assets									2		6		57		12			123	43
Parent Company [Member]
Net income																	2,465	1,207
Net income attributable to HCA Holdings, Inc.																	$ 2,465	$ 1,207

[1] The "Revenues" presented for each quarter of 2010 and the first and second quarters of 2011 have been reduced by the provision for doubtful accounts for each quarter in accordance with our adoption of ASU 2011-07 in the third quarter of 2011. The "Revenues" presented for the second and third quarters of 2011 have been reduced for the reclassification of "Electronic health record incentive income" as a separate line item in our consolidated income statements (See NOTE 1 of the notes to consolidated financial statements).

[2] Fourth quarter results include $84 million of gains on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $1.424 billion of gain on acquisition of controlling interest in equity investment (See NOTE 3 of the notes to consolidated financial statements).

[3] Third quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $256 million of losses on retirement of debt (See NOTE 10 of the notes to consolidated financial statements).

[4] Second quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $47 million of losses on retirement of debt (See NOTE 10 of the notes to consolidated financial statements).

[5] First quarter results include $2 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $149 million of costs related to the termination of management agreement (See NOTE 1 of the notes to consolidated financial statements).

[6] Fourth quarter results include $3 million of gains on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $2 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

[7] Second quarter results include $57 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

[8] First quarter results include $12 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

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Acquisitions And Dispositions

12 Months Ended

Dec. 31, 2011

Acquisitions And Dispositions [Abstract]

Acquisitions And Dispositions

NOTE 3 — ACQUISITIONS AND DISPOSITIONS

HealthONE Acquisition

During October 2011, we completed the acquisition of the Colorado Health Foundation's ("Foundation") approximate 40% remaining ownership interest in the HCA-HealthONE LLC ("HealthONE") joint venture for $1.450 billion. HealthONE's assets include seven hospitals and 12 freestanding surgery centers in the Denver area. We accounted for our investment in HealthONE using the equity method through October 2011 with our share of their operations all recorded in the line item "Equity in earnings of affiliates" in our consolidated income statements, and we began consolidating HealthONE's operations in our consolidated income statements beginning November 2011.

The total cost of the HealthONE acquisition has been allocated to the assets acquired and liabilities assumed based upon their respective fair values in accordance with ASC No. 805, Business Combinations. The purchase price represented a premium over the fair value of the net tangible and identifiable intangible assets acquired for reasons such as expected cash flows and HealthONE's assembled workforce.

Based on our purchase price allocation as of December 31, 2011, we identified and analyzed the acquired fixed assets, contracts, contractual commitments and legal contingencies to record the fair value of all assets acquired and liabilities assumed, resulting in goodwill of $2.261 billion being recorded. The amount of goodwill expected to be tax deductible is approximately $894 million. We also recorded a gain of $1.522 billion related to this acquisition due to the remeasurement of our previous equity investment in HealthONE, based upon our acquisition of the Foundation's ownership interest and the resulting consolidation of the entire enterprise at estimated fair value. Adjustments to the December 31, 2011 purchase price allocation are not expected to be material.

A summary of the purchase price allocation, including assumed liabilities, follows (in millions):

Current assets	$	400
Property and equipment		1,040
Identifiable intangible asset (trade name)		269
Goodwill		2,261
Other assets		7
Liabilities		152
Noncontrolling interests		93

The acquired HealthONE operating results have been included in the consolidated income statements since the acquisition date. The revenues and net income attributable to HCA Holdings, Inc. related to the acquired HealthONE operations for the period from November 1, 2011 through December 31, 2011 were $347 million and $15 million, respectively. The unaudited pro forma combined summary of our operations gives effect to including the acquired HealthONE operating results as if the acquisition had occurred as of January 1, 2010, follows (in millions):

	Years Ended December 31,
	2011		2010
Pro forma revenues	$	31,383	$	29,925
Pro forma net income attributable to HCA Holdings, Inc.		2,507		1,257

Pro forma adjustments to net income attributable to HCA Holdings, Inc. include adjustments to record HealthONE's operating results on a consolidated basis and eliminate the equity method operating results, to record depreciation expense based on the estimated fair value assigned to the long-lived assets acquired, to record interest expense assuming the increase in long-term debt used to fund the acquisition had occurred as of January 1, 2010 and to record the related tax effects. These pro forma results are not necessarily indicative of the actual results of operations that would have occurred if the acquisition had occurred on January 1, 2010.

Other Acquisitions and Dispositions

         During 2011, we paid $136 million to acquire a hospital and $96 million to acquire other nonhospital health care entities. During 2010, we paid $163 million to acquire two hospitals and $70 million to acquire other health care entities. During 2009, we paid $61 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. The purchase price paid in excess of the fair value of identifiable net assets of these acquired entities aggregated $68 million, $125 million and $5 million in 2011, 2010 and 2009, respectively. 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 2011, we received proceeds of $281 million and recognized a net pretax gain of $142 million ($80 million after tax) related to the sales of a hospital facility and our investment in a hospital joint venture. During 2010, we received proceeds of $37 million and recognized a net pretax gain of $4 million ($2 million after tax) from sales of nonhospital health care entities and real estate investments. During 2009, we received proceeds of $3 million and recognized a net pretax loss of $8 million ($5 million after tax) on the sales of three hospitals. We also received proceeds of $38 million and recognized a net pretax loss of $7 million ($4 million after tax) from sales of other health care entities and real estate investments.

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Income Taxes (Schedule Of Deferred Tax Assets And Liabilities) (Details) (USD $) In Millions, unless otherwise specified	Dec. 31, 2011	Dec. 31, 2010
Income Taxes [Abstract]
Depreciation and fixed asset basis differences, Liabilities	$ 402	$ 211
Allowances for professional liability and other risks, Assets	337	329
Accounts receivable, Assets	706	1,011
Compensation, Assets	216	202
Other, Assets	698	776
Other, Liabilities	511	400
Deferred tax assets	1,957	2,318
Deferred tax liabilities	$ 913	$ 611

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Accrued Expenses And Allowance For Doubtful Accounts (Summary Of Allowance Of Doubtful Accounts) (Details) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Accrued Expenses And Allowance For Doubtful Accounts [Abstract]
Balance at Beginning of Year	$ 3,939	$ 4,860	$ 4,741
Provision for Doubtful Accounts	2,824	2,648	3,276
Accounts Written off, Net of Recoveries	(2,657)	(3,569)	(3,157)
Balance at End of Year	$ 4,106	$ 3,939	$ 4,860

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Assets And Liabilities Measured At Fair Value (Narrative) (Details) (USD $) In Millions, unless otherwise specified	Dec. 31, 2011	Dec. 31, 2010
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Insurance subsidiaries investments, fair value	$ 628	$ 742
Investments of insurance subsidiaries	548	642
Estimated fair value of long-term debt	27,199	28,738
Carrying amounts of long-term debt	27,052	28,225
Auction Rate Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Insurance subsidiaries investments, fair value	131
Investments in tax-exempt ARS at par value	139
Redeemed or repurchased of ARS at par value	$ 112	$ 150

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Quarterly Consolidated Financial Information

12 Months Ended

Dec. 31, 2011

Quarterly Consolidated Financial Information [Abstract]

Quarterly Consolidated Financial Information

HCA HOLDINGS, INC.

QUARTERLY CONSOLIDATED FINANCIAL INFORMATION

(UNAUDITED)

(Dollars in millions)

	2011
	First			Second			Third			Fourth
Revenues(i)	$	7,406		$	7,249		$	7,258		$	7,769
Net income	$	334	(a)	$	320	(b)	$	146	(c)	$	2,042	(d)
Net income attributable to HCA Holdings, Inc.	$	240	(a)	$	229	(b)	$	61	(c)	$	1,935	(d)
Basic earnings per share	$	0.54		$	0.44		$	0.12		$	4.43
Diluted earnings per share	$	0.52		$	0.43		$	0.11		$	4.25

	2010
	First			Second			Third			Fourth
Revenues(i)	$	6,980		$	6,968		$	6,926		$	7,161
Net income	$	476	(e)	$	378	(f)	$	325	(g)	$	394	(h)
Net income attributable to HCA Holdings, Inc.	$	388	(e)	$	293	(f)	$	243	(g)	$	283	(h)
Basic earnings per share	$	0.91		$	0.69		$	0.57		$	0.66
Diluted earnings per share	$	0.89		$	0.67		$	0.55		$	0.65

(a) First quarter results include $2 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $149 million of costs related to the termination of management agreement (See NOTE 1 of the notes to consolidated financial statements).

(b) Second quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $47 million of losses on retirement of debt (See NOTE 10 of the notes to consolidated financial statements).

(c) Third quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $256 million of losses on retirement of debt (See NOTE 10 of the notes to consolidated financial statements).

(d) Fourth quarter results include $84 million of gains on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $1.424 billion of gain on acquisition of controlling interest in equity investment (See NOTE 3 of the notes to consolidated financial statements).

(e) First quarter results include $12 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

(f) Second quarter results include $57 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

(g) Third quarter results include $1 million of losses on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $6 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

(h) Fourth quarter results include $3 million of gains on sales of facilities (See NOTE 3 of the notes to consolidated financial statements) and $2 million of costs related to the impairments of long-lived assets (See NOTE 4 of the notes to consolidated financial statements).

(i) The "Revenues" presented for each quarter of 2010 and the first and second quarters of 2011 have been reduced by the provision for doubtful accounts for each quarter in accordance with our adoption of ASU 2011-07 in the third quarter of 2011. The "Revenues" presented for the second and third quarters of 2011 have been reduced for the reclassification of "Electronic health record incentive income" as a separate line item in our consolidated income statements (See NOTE 1 of the notes to consolidated financial statements).

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Long-Term Debt (General Debt Information) (Details) (USD $) In Millions, unless otherwise specified		12 Months Ended			1 Months Ended
	Dec. 31, 2011	Dec. 31, 2011 Term Loan A Facility With Final Maturity Of November 2012 [Member]	Dec. 31, 2011 Term Loan A And Term Loan B-1 Facilities With Final Maturity Of November 2012 [Member]	Dec. 31, 2011 Maturities Ranging 2013 Through 2016 [Member]	Sep. 30, 2011 Other Activity Asset Based Revolving Credit Facility Maturing On November 16, 2012 [Member]
Line of Credit Facility [Line Items]
Debt instrument, maturities range, start				2013	November 16, 2012
Debt instrument, maturities range, end		May 2016	November 2013	2016	2016
Maturity of long term debt in year one	$ 3,167
Maturity of long term debt in year two	751,000
Maturity of long term debt in year three	1,020
Maturity of long term debt in year four	$ 1,537

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Leases (Tables)

12 Months Ended

Dec. 31, 2011

Leases [Abstract]

Schedule Of Commitments Relating To Noncancellable Operating Leases

For the Year Ended December 31,
2012	$	280
2013		264
2014		218
2015		171
2016		131
Thereafter		870
		1,934
Less sublease income		(51	)
	$	1,883

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Capital Stock

12 Months Ended

Dec. 31, 2011

Capital Stock [Abstract]

Capital Stock

NOTE 13 — CAPITAL STOCK

           The amended and restated certificate of incorporation authorizes the Company to issue up to 1,800,000,000 shares of common stock, and our amended and restated by-laws set the number of directors constituting the board of directors of the Company at not less than one nor more than 15. During February 2011, our Board of Directors approved a 4.505-to-one split of our issued and outstanding common shares. All common share and per common share amounts in these consolidated financial statements and notes to consolidated financial statements reflect the 4.505-to-one stock split. During March 2011, we completed the initial public offering of 87,719,300 shares of our common stock at a price of $30.00 per share and realized net proceeds (after costs of the offering) of $2.506 billion.

On September 21, 2011, we repurchased 80,771,143 shares of our common stock beneficially owned by affiliates of Bank of America Corporation at a purchase price of $18.61 per share, the closing price of the Company's common stock on the New York Stock Exchange on September 14, 2011. The repurchase was financed using a combination of cash on hand and borrowings under available credit facilities. The shares repurchased represented approximately 15.6% of our total shares outstanding at the time of the repurchase.

Distributions

During 2010, our Board of Directors declared three distributions to the Company's stockholders and holders of stock options. The distributions totaled $9.43 per share and vested stock option, or $4.332 billion in the aggregate. The distributions were funded using funds available under our senior secured credit facilities, proceeds from the 2021 Notes offering and cash on hand. Pursuant to the terms of our stock option plans, the holders of nonvested stock options received $9.43 per share reductions (subject to certain tax related limitations for certain stock options that resulted in deferred distributions for a portion of the declared distribution, which will be paid upon the vesting of the applicable stock options) to the exercise price of the share-based awards. There were no distributions declared during 2011.

Stockholder Agreements and Equity Securities with Contingent Redemption Rights

Prior to the consummation of the initial public offering of our common stock, certain employees could elect to have the Company redeem their common stock and vested options in the event of death or permanent disability, pursuant to the terms of their management stockholder agreements. The consummation of the initial public offering of our common stock effectively terminated the contingent redemption rights and the applicable amounts have been reclassified back to stockholders' equity.