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HCA · HCA Healthcare, Inc.

546 filings

HCA SEC Filings

HCA Healthcare, Inc. - 546 total filings

Filing record · 2016–202610-K1110-Q328-K144

HCA filed 11 annual reports (10-K), 32 quarterly reports (10-Q) and 144 current reports (8-K) between 2016 and 2026.

  1. Material agreement8-K · Jun ’17Jun ’17
  2. Material agreement8-K · Oct ’19Oct ’19
  3. Leadership change8-K · Oct ’21Oct ’21
  4. Leadership change8-K · Jul ’25Jul ’25
Showing 1–50 of 546 filings
8-K

HCA Healthcare, Inc. 8-K Report, Financial Obligation (Jul 29, 2026)

HCA Healthcare, Inc. (HCA) announced via an 8-K filing on July 29, 2026, a significant expansion of its commercial paper program. The company's subsidiary, HCA Inc., has increased the maximum aggregate principal amount of unsecured commercial paper notes that can be outstanding at any time from $4.0 billion to $8.0 billion. This move provides HCA with substantially enhanced financial flexibility and access to short-term funding. The expansion is guaranteed by the parent company, HCA Healthcare, Inc., reinforcing the creditworthiness of the issued notes.

Jul 29, 2026
10-Q

HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2026

HCA Healthcare's second quarter of 2026 showed solid top-line growth, with revenues rising 8.7% year over year to $20.230 billion and net income attributable to HCA of $1.699 billion, or $7.62 per diluted share, versus $6.83 a year earlier. A large part of the revenue gain is non-recurring in nature: the quarter includes $1.372 billion of incremental revenue and $829 million of other operating expenses tied to the Florida state directed payment program, of which roughly $980 million of revenue and $557 million of expense relate to periods before 2026. Management also cited about $400 million of incremental net benefit from Medicaid supplemental payment programs. Excluding these items, underlying growth in revenue per equivalent admission and volumes was more modest, and the quarter's operating margin pressure from other operating expenses (24.9% of revenue versus 20.4%) is substantially tied to the same program. Cash generation weakened sharply. Operating cash flow fell to $2.335 billion in the quarter from $4.210 billion, driven by about $1.4 billion of unfavorable working capital changes, mainly higher accounts receivable linked to Medicaid directed payment programs, and a $594 million increase in income taxes paid. For the first half, operating cash flow was $4.349 billion versus $5.861 billion. Uninsured admissions rose 23.3% in the quarter, reflecting the expiration of enhanced Exchange premium tax credits at the end of 2025, and accounts receivable grew to $12.281 billion. Days revenue in receivables rose to 55 from 51 a year earlier. Balance sheet and capital allocation remain active. Total debt reached $49.718 billion, up from $46.492 billion at year-end, as the company issued $3.0 billion of senior notes and relied on commercial paper, which stood at $3.890 billion. The company repurchased $3.635 billion of stock in the first half and 4.75 million shares in the second quarter, leaving $7.210 billion of authorization available. Stockholders' deficit widened to $(3.209) billion including noncontrolling interests. Management reports that the Medicaid directed payment and provider tax changes under the 2025 Federal Budget Act remain a key uncertainty, and management is projecting 2026 capital expenditures of $5.0 to $5.5 billion.

Jul 28, 2026
8-K

HCA Healthcare, Inc. 8-K Report, Financial Results (Jul 24, 2026)

HCA Healthcare reported second-quarter 2026 results that beat on the top line and grew Adjusted EBITDA 4.6% to $4.027 billion, but the quality of that growth is mixed. Revenue rose 8.7% to $20.230 billion and diluted EPS rose 11.6% to $7.62. However, the results were helped by roughly $400 million of incremental net benefit from Medicaid Supplemental Payment Programs, primarily Florida, including a one-time $1.372 billion revenue catch-up tied to periods back to October 2024. Against that, management estimates an unfavorable payer mix shift from uninsured volume tied to exchange coverage losses of about $400 million in the quarter, and surgical volumes declined (inpatient surgeries down 2.3%, outpatient down 3.4%). The most important change for investors is the revised 2026 guidance. Net income attributable to HCA was cut to $6.300-$6.700 billion from $6.495-$7.035 billion, and EPS guidance was lowered to $28.70-$30.50 from $29.10-$31.50. Adjusted EBITDA guidance fell to $15.400-$16.100 billion. The exchange-related headwind estimate was widened to ($1.0)-($1.2) billion from ($600)-($900) million, while the Medicaid supplemental payment benefit was raised to $300-$500 million from a ($50)-($250) million range. Revenue guidance was narrowed to $77.0-$79.5 billion. Management characterized the Q2 results as consistent with its July 14 preview, which suggests the cut was already anticipated by the market. Capital allocation remains shareholder-friendly but leverage is rising. HCA repurchased 4.752 million shares for $2.064 billion in the quarter, leaving $7.210 billion of authorization, and declared a quarterly dividend of $0.78 per share payable September 30, 2026. Total debt reached $49.718 billion against cash of $1.013 billion, and operating cash flow fell sharply to $2.335 billion from $4.210 billion a year earlier. Investors should weigh the strong earnings headline against lower cash generation, the reliance on one-time supplemental payment catch-ups, and a meaningful deterioration in the exchange-driven payer mix outlook.

Jul 24, 2026
8-K

HCA Healthcare, Inc. 8-K Report, Financial Results (Jul 14, 2026)

HCA Healthcare previewed preliminary second-quarter 2026 results and revised its full-year 2026 guidance. Revenue for Q2 2026 is expected to be about $20.23 billion, up from $18.605 billion a year earlier (roughly 8.7% growth). Net income attributable to HCA is expected at about $1.699 billion, or $7.62 per diluted share, versus $6.83 in Q2 2025. Adjusted EBITDA is expected at about $4.027 billion, up from $3.849 billion, though the adjusted EBITDA margin contracted to 19.9% from 20.7%. These figures are preliminary, unaudited, and subject to the completion of the quarter-end close. The quarter was shaped by two offsetting forces. Uninsured volume rose as patients lost coverage on the health insurance exchanges, an unfavorable payer mix shift that management estimates reduced pre-tax income by about $400 million, including a roughly $75 million increase to its prior first-quarter exchange estimate. Partly offsetting this, HCA recognized about $400 million of incremental net Medicaid supplemental payment benefit, primarily from Florida's state directed payment program approved by CMS during the quarter. Volume trends were mixed: admissions and emergency room visits grew, while inpatient and outpatient surgeries declined. HCA lowered its 2026 guidance. Revenue is now expected at $77.0 to $79.5 billion (previously $76.5 to $80.0 billion), net income at $6.3 to $6.7 billion (previously $6.495 to $7.035 billion), adjusted EBITDA at $15.4 to $16.1 billion (previously $15.55 to $16.45 billion), and diluted EPS at $28.70 to $30.50 (previously $29.10 to $31.50). The estimated exchange headwind widened to $1.0 to $1.2 billion from $600 to $900 million, while the Medicaid supplemental payment benefit moved to a $300 to $500 million tailwind from a net headwind of $50 to $250 million. Capital expenditure guidance of $5.0 to $5.5 billion is unchanged. Management will discuss results on a July 24, 2026 earnings call.

Jul 14, 2026
8-K

HCA Healthcare, Inc. 8-K Report, Executive Changes (Jun 18, 2026)

HCA Healthcare, Inc. has announced a significant leadership change with the upcoming departure of Dr. Michael Cuffe from his role as Executive Vice President and Chief Clinical Officer. This transition is effective August 31, 2026, after which Dr. Cuffe will remain with the company in a transitional capacity until February 2027. This move signifies a shift in the company's executive team, and investors will want to monitor the strategic implications and the appointment of a successor to this critical clinical leadership position.

Jun 18, 2026
8-K

HCA Healthcare, Inc. 8-K Report, Material Agreement (Apr 30, 2026)

HCA Healthcare, Inc. (HCA) announced through its subsidiary, HCA Inc., the successful completion of a public offering of $3 billion in aggregate principal amount of senior unsecured notes. The offering is comprised of three tranches: $1 billion of 4.700% Senior Notes due 2031, $750 million of 5.000% Senior Notes due 2033, and $1.25 billion of 5.300% Senior Notes due 2036. These notes are guaranteed on a senior unsecured basis by the Parent Guarantor, HCA Healthcare, Inc. This significant debt issuance, registered under a shelf registration statement, will increase HCA's leverage but provides substantial capital. Investors should note the varying interest rates and maturity dates, which reflect market conditions and the company's long-term financing strategy. The company has entered into an underwriting agreement with several major investment banks for this offering, and detailed terms, including covenants, optional redemption, and change of control provisions, are outlined in the respective indentures filed with the SEC.

Apr 30, 2026
10-Q

HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2026

HCA Healthcare's first quarter 2026 revenue rose 4.3% to $19.109 billion, driven by a 3.1% increase in revenue per equivalent admission and a 1.1% rise in equivalent admissions. Diluted EPS increased 10.9% to $7.15, but this was largely a function of a roughly 9% reduction in diluted share count (226.7 million versus 249.4 million) from ongoing buybacks. Net income attributable to HCA grew only 0.6% to $1.620 billion, and pre-tax income fell 1.7% to $2.287 billion as interest expense rose 6.8% to $584 million and depreciation and amortization rose 8.1%. The lower effective tax rate (21.0% versus 23.8%) was supported by a $103 million tax benefit from employee equity award settlements, which flatters the current quarter's earnings quality. The filing highlights a payer-mix shift that investors should monitor. Managed care and insurer revenue as a share of total revenue fell to 47.5% from 49.4%, reflecting the expiration of enhanced Exchange premium tax credits at the end of 2025. Uninsured admissions rose 15.6% on a consolidated basis, and charity care rose to $5.513 billion from $3.644 billion. Estimated uncompensated care costs increased to $1.252 billion from $1.055 billion. Respiratory-related admissions fell 42% against a weak seasonal comparison, which weighed on volumes. Outpatient surgeries declined 2.7%. Balance sheet and liquidity require attention. Total debt was $48.0 billion, and short-term debt and current maturities climbed to $8.5 billion, including $3.65 billion of commercial paper. Working capital was negative $3.2 billion, although management states that excluding commercial paper it would have been positive $444 million and that the company can refinance commercial paper under its senior unsecured credit facility. Operating cash flow improved to $2.014 billion from $1.651 billion, but capital expenditures of $1.119 billion and share repurchases of $1.571 billion were funded in part by net borrowings of $1.4 billion. Stockholders' deficit widened to $(2.978) billion. Management reiterated 2026 capital expenditure guidance of $5.0 to $5.5 billion and declared a $0.78 quarterly dividend.

Apr 29, 2026
8-K

HCA Healthcare, Inc. 8-K Report, Shareholder Vote Results (Apr 28, 2026)

HCA Healthcare, Inc. (HCA) filed an 8-K on April 28, 2026, detailing the results of its Annual Meeting of Stockholders held on April 23, 2026. The meeting saw strong participation, with over 209 million shares represented. A key outcome was the overwhelming election of all nine director nominees to the Board of Directors, indicating robust shareholder confidence in the current leadership and governance structure. Furthermore, the Company's appointment of Ernst & Young LLP as its independent registered public accounting firm for 2026 received broad ratification, underscoring shareholder trust in the auditing process. Shareholder approval was also given to the advisory resolution on executive compensation, suggesting alignment between management's pay practices and investor sentiment. However, two shareholder proposals, one concerning healthcare consequences reporting and another on shareholders' right to act by written consent, failed to gain majority support.

Apr 28, 2026
8-K

HCA Healthcare, Inc. 8-K Report, Corporate Update (Apr 27, 2026)

HCA Healthcare, Inc. (NYSE: HCA) announced on April 27, 2026 that its wholly owned subsidiary, HCA Inc. (the Issuer), is launching a proposed public offering of senior unsecured notes. The final size, maturity, and coupon will depend on market conditions at pricing. Citigroup, Barclays, BofA Securities, and J.P. Morgan are joint book-running managers, and the offering is being made under an effective shelf registration statement. The filing does not state a final offering size, so investors should treat the amount as undetermined until pricing. The company says net proceeds are intended for general corporate purposes, including repaying borrowings under its $4.000 billion commercial paper program (which can be reborrowed), and potentially funding redemptions of its 5.250% senior notes due June 2026 ($1.500 billion) and 5.375% senior notes due September 2026 ($1.000 billion). The Issuer has elected to redeem both series on May 27, 2026, conditioned on receipt of offering proceeds before that date. The redemption is effectively a refinancing of near-term maturities, which would reduce 2026 debt maturities and extend the company's debt profile if completed. For investors, the filing is primarily a financing and liability-management event rather than an operating update, and it contains no new financial results or guidance. Key items to monitor are the pricing terms (coupon and tenor), the final principal amount relative to the $2.500 billion of notes being redeemed, and whether the conditional redemption closes on schedule. The filing refers to the Form 10-K filed February 10, 2026 for risk factors.

Apr 27, 2026
8-K

HCA Healthcare, Inc. 8-K Report, Financial Results (Apr 24, 2026)

HCA Healthcare reported first quarter 2026 results that were mixed beneath a headline EPS gain. Revenue rose 4.3% to $19.109 billion, and diluted EPS increased 10.9% to $7.15, but that EPS growth was driven largely by a sharply lower share count (226.7 million diluted shares versus 249.4 million a year earlier, reflecting about $1.57 billion of buybacks). Net income attributable to HCA grew only 0.6% to $1.620 billion, and Adjusted EBITDA rose just 1.9% to $3.802 billion, with the Adjusted EBITDA margin contracting from 20.4% to 19.9%. Operating volumes were soft. Same facility admissions rose 0.9% and equivalent admissions rose 1.3%, but inpatient surgeries fell 0.3%, outpatient surgeries fell 1.7%, and the company did not see its typical seasonal first-quarter volume increase. Respiratory-related admissions fell 42% year over year, and a January winter storm also weighed on volumes. Management said these headwinds were mostly offset by recognition of Medicaid supplemental program revenue that was not in its initial 2026 guidance. Pricing was the main growth driver, with same facility revenue per equivalent admission up 3.1%. Salaries and benefits and other operating expenses grew faster than revenue, which compressed margins. Cash generation and capital return were strong. Operating cash flow rose 22.0% to $2.014 billion, and the company repurchased $1.571 billion of stock. Total debt stood at $48.0 billion, with $8.5 billion of short-term borrowings and debt due within one year, up from $4.9 billion at year-end. The company reaffirmed its 2026 guidance of $76.5–80.0 billion in revenue, $15.55–16.45 billion in Adjusted EBITDA, and $29.10–31.50 in diluted EPS, and declared a quarterly dividend of $0.78 per share payable June 30, 2026.

Apr 24, 2026
8-K

HCA Healthcare, Inc. 8-K Report, Executive Changes (Feb 25, 2026)

HCA Healthcare, Inc. (HCA) announced the adoption of its 2026 Executive Officer Performance Excellence Program (Executive Officer PEP) on February 24, 2026. This program outlines how the company's executive officers will be eligible to earn performance-based cash awards. The compensation structure is heavily weighted towards financial performance, with 80% of awards tied to EBITDA targets and 20% linked to quality metrics. This emphasis signals a continued focus on profitability while also incorporating critical patient care and experience indicators. Investors should note the specific award opportunities, which range from 175% of base salary for the CEO down to 100% for other named executive officers. The program details tiered payouts for EBITDA performance, with potential for awards to double the target amount at maximum performance. The quality metrics component is also subject to tiered payouts and can be forfeited entirely if EBITDA falls below 90% of target, reinforcing the primacy of financial results. The Compensation Committee retains discretion over adjustments and clawbacks, providing flexibility and risk mitigation.

Feb 25, 2026
10-K

HCA Healthcare, Inc. Annual Report, Year Ended Dec 31, 2025

HCA Healthcare reported a strong 2025, with revenues rising 7.1% to $75.6 billion and net income attributable to HCA of $6.784 billion, or $28.33 per diluted share, up from $22.00 in 2024. Growth was driven by a 2.9% increase in equivalent admissions and a 4.0% increase in revenue per equivalent admission. Operating cash flow rose to $12.6 billion, funding $4.9 billion of capital expenditures and $10.1 billion of share repurchases. Same-facility revenue grew 6.6%, and Medicaid state directed and supplemental payments contributed about $6.2 billion. Balance sheet leverage increased. Total debt rose to $46.5 billion from $43.0 billion, and interest expense climbed 9% to $2.25 billion. Stockholders' deficit widened to $(2.8) billion, a consequence of heavy buybacks and retained deficits rather than operating weakness. Working capital turned negative, partly because of $2.2 billion of commercial paper, and the company established a $4.0 billion commercial paper program. The outlook carries meaningful policy risk. Management expects SDP revenues to decline in 2026 absent new approvals, and it cites the expiration of enhanced ACA premium tax credits, the 2025 Federal Budget Act (FBA) Medicaid and provider-tax changes, and Medicare site-neutral and inpatient-only list phase-outs as headwinds. Florida and Texas account for 51% of revenues, and the company is implementing a new EHR platform. Planned 2026 capex is $5.0 to $5.5 billion, and the quarterly dividend was raised to $0.78.

Feb 10, 2026
8-K

HCA Healthcare, Inc. 8-K Report, Financial Results (Jan 27, 2026)

HCA Healthcare reported fourth-quarter 2025 results on January 27, 2026 that beat its own trajectory on the bottom line. Q4 revenue rose 6.7% to $19.513 billion, GAAP net income attributable to HCA grew 30.6% to $1.878 billion, and diluted EPS rose 44.6% to $8.14. Excluding facility gains and losses, EPS, as adjusted, rose 28.8% to $8.01, and Adjusted EBITDA grew 10.8% to $4.114 billion (21.1% margin). Operating volumes were solid: same facility admissions rose 2.4%, same facility equivalent admissions rose 2.5%, and revenue per equivalent admission rose 2.9%. Comparisons are flattered by roughly $200 million (about $0.60 per share) of Hurricane Helene and Milton impacts in Q4 2024, and Q4 2024 also carried a $195 million facility loss. Full-year 2025 revenue was $75.6 billion, net income attributable to HCA was $6.784 billion ($28.33 diluted EPS), and Adjusted EBITDA was $15.566 billion. Cash generation and capital allocation are the key points for investors. Q4 operating cash flow fell to $2.359 billion from $2.559 billion, but that figure was depressed by about $1.3 billion of tax payments deferred into Q4 because of IRS relief tied to April 2025 Tennessee severe weather. Full-year operating cash flow was $12.636 billion, and capex was $4.944 billion. HCA repurchased $10.067 billion of stock during 2025, including $2.558 billion in Q4. The Board authorized a new $10 billion repurchase program with no time limit, and declared a $0.78 quarterly dividend payable March 31, 2026. Total debt was $46.492 billion at year end, against cash of $1.040 billion. Leverage is high relative to the equity base, since stockholders' deficit attributable to HCA widened to $(6.027) billion. For 2026, management guided to revenue of $76.5 to $80.0 billion, Adjusted EBITDA of $15.55 to $16.45 billion, and diluted EPS of $29.10 to $31.50 on about 223.5 million shares. Capex is expected at $5.0 to $5.5 billion. The guidance assumes a mostly stable operating environment and excludes facility gains and losses, debt retirement losses, legal claim costs, and impairments. It also reflects headwinds from the expiration of enhanced ACA marketplace premium tax credits at year end 2025, the OBBBA, tariffs, and uncertain Medicaid supplemental payments. The guided EPS midpoint of about $30.30 implies modest growth over 2025's $28.33, helped by a lower share count.

Jan 27, 2026
8-K

HCA Healthcare, Inc. 8-K Report, Material Agreement (Oct 31, 2025)

HCA Healthcare, Inc. (HCA) announced the successful completion of a significant public offering of senior notes, raising a total of $3.25 billion. The offering was structured across four tranches with varying maturities and coupon rates: $500 million of 4.300% Senior Notes due 2030, $1 billion of 4.600% Senior Notes due 2032, $1 billion of 4.900% Senior Notes due 2035, and $750 million of 5.700% Senior Notes due 2055. These notes are guaranteed by the parent company, HCA Healthcare, Inc., and represent senior unsecured obligations of the subsidiary issuer. The proceeds from this offering will likely be used to fund general corporate purposes or existing debt refinancing, though specific use of proceeds is not detailed in this filing. The company has also entered into an underwriting agreement with several prominent financial institutions to facilitate this issuance. This move indicates HCA's ongoing strategy to manage its capital structure and potentially fund future growth or operational needs.

Oct 31, 2025
10-Q

HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2025

HCA Healthcare's third-quarter 2025 results were strong on the top and bottom lines. Revenues rose 9.6% to $19.161 billion (same-facility revenues up 9.2%), driven by a 6.1% increase in revenue per equivalent admission and a 3.2% increase in equivalent admissions. Net income attributable to HCA rose 29.4% to $1.643 billion, or $6.96 per diluted share, versus $4.88 a year earlier. Part of the margin improvement came from lower salaries and benefits as a share of revenue (43.6% vs. 45.0%) and a 23.9% effective tax rate. Management attributed the revenue-per-admission gain partly to higher state supplemental Medicaid revenue from newly approved programs, a source of revenue the filing flags as exposed to federal policy changes. Cash flow and capital allocation were the main focus of the nine-month period. Operating cash flow rose to $10.277 billion from $7.955 billion, but this was helped by a $1.259 billion decline in income taxes paid, related to an IRS deferral for Tennessee-based taxpayers until Q4 2025. Management spent $7.509 billion on share repurchases (21.3 million shares at an average of $352.40) and $3.455 billion on capital expenditures, against planned 2025 capex of about $5.0 billion. Cash fell to $997 million, and working capital turned negative at $(2.611) billion. Total debt rose to $44.511 billion, with $6.110 billion due within one year, including $1.910 billion of commercial paper. Shareholders' deficit widened to $(2.159) billion. The filing also flags policy risks for 2026. The One Big Beautiful Bill Act is expected to reduce Medicaid spending and coverage, and sequestration could cut Medicare reimbursement by up to 4% in early 2026 absent congressional action. Medicaid DSH reductions of $8.0 billion per year began October 1, 2025, and the expiration of enhanced ACA premium tax credits after December 31, 2025 could raise uninsured volumes. Management states that cash flows and its credit facilities should be sufficient for liquidity needs.

Oct 30, 2025
8-K

HCA Healthcare, Inc. 8-K Report, Corporate Update (Oct 27, 2025)

On October 27, 2025, HCA Healthcare, Inc. disclosed via Form 8-K that its wholly owned subsidiary, HCA Inc. (the Issuer), is launching a proposed public offering of senior unsecured notes. Final terms, including maturity, interest rate, and principal amount, will depend on market conditions at pricing. The filing is a financing and liability-management event rather than an operating or earnings update, so it contains no new financial results, guidance, or operating metrics. The stated use of proceeds is general corporate purposes, which may include repaying borrowings under HCA's $4.0 billion commercial paper program (which can be reborrowed) and redeeming part or all of HCA Inc.'s $1.5 billion of 5.875% senior notes due 2026. The Issuer has elected to redeem all $1.5 billion of those notes on November 26, 2025, conditioned on receipt of the offering's net proceeds before the redemption date. The 8-K itself is not a formal redemption notice; that is issued separately. For investors, the transaction appears to be a refinancing that extends the maturity profile and shifts short-term or near-term debt into longer-dated fixed-rate notes. Its net effect on leverage and interest expense depends on final pricing and whether the commercial paper is repaid or only refinanced. The offering is made under an effective shelf registration, and the 8-K notes that the forward-looking statements and risk factors in HCA's February 14, 2025 Form 10-K still apply.

Oct 27, 2025
8-K

HCA Healthcare, Inc. 8-K Report, Financial Results (Oct 24, 2025)

HCA Healthcare reported third-quarter 2025 results that beat its own prior trajectory and raised full-year 2025 guidance. Revenue rose 9.6% year over year to $19.161 billion, and net income attributable to HCA grew 29.4% to $1.643 billion, or $6.96 per diluted share (up 42.6%). Adjusted EBITDA increased 18.5% to $3.870 billion, with the margin expanding to 20.2% from 18.7%. Operating volume was steady-to-better: same facility admissions rose 2.1%, same facility equivalent admissions rose 2.4%, and same facility revenue per equivalent admission increased 6.6%. Part of the year-over-year comparison benefits from Q3 2024 being depressed by roughly $50 million (about $0.15 per share) of Hurricane Helene impacts. Management raised 2025 guidance across the board. Revenue is now expected at $75.0 to $76.5 billion (previously $74.0 to $76.0 billion), Adjusted EBITDA at $15.25 to $15.65 billion (previously $14.7 to $15.3 billion), and diluted EPS at $27.00 to $28.00 (previously $25.50 to $27.00). Capital expenditures are estimated at about $5.0 billion. Cash generation was strong, with operating cash flow of $4.416 billion in the quarter. HCA also repurchased 6.514 million shares for $2.498 billion and retains $3.256 billion under its authorization, while the board declared a $0.72 quarterly dividend payable December 29, 2025. The balance sheet carries meaningful leverage: total debt of $44.511 billion against cash of $997 million, and stockholders' deficit attributable to HCA widened to $(5.335) billion. Investors should weigh the strong earnings and buyback-driven per-share growth against this leverage and ongoing policy risks, including the scheduled expiration of enhanced ACA premium tax credits after December 31, 2025, Medicaid funding changes under the One Big Beautiful Bill Act, and sequestration.

Oct 24, 2025
10-Q

HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2025

HCA Healthcare's second quarter 2025 results show continued top-line and earnings growth. Revenues rose 6.4% year over year to $18.605 billion, driven by a 3.9% increase in revenue per equivalent admission and a 2.3% increase in equivalent admissions. Net income attributable to HCA rose 13.1% to $1.653 billion, or $6.83 per diluted share, versus $5.53 a year earlier, helped by a 0.2-point-lower salaries and benefits ratio and a lower effective tax rate (24.1% vs. 27.4%). Adjusted segment EBITDA across the three groups reached $4.201 billion for the quarter, up from $3.805 billion. Share count reduction from buybacks (diluted shares down about 8.7% year over year) amplified per-share gains. Management also repurchased $5.011 billion of stock in the first half of 2025 while maintaining a 2025 capex plan of about $5.0 billion. Balance sheet and liquidity require closer attention. Total debt rose to $44.483 billion from $43.031 billion at year-end 2024, and working capital turned negative at $376 million, largely due to $5.104 billion of debt due within one year and $1.778 billion of commercial paper, a new program established in June 2025. Cash fell to $939 million. Stockholders' deficit attributable to HCA widened to $(4.394) billion, reflecting heavy buybacks that exceed retained earnings growth. Management highlighted that the July 4, 2025 One Big Beautiful Bill Act (OBBBA) is expected to reduce Medicaid coverage and federal spending over time, and that supplemental payment programs and enhanced ACA premium tax credits face expiration or restructuring risk. Management has not quantified the financial impact of these policy changes, so these remain the principal forward-looking uncertainties for investors. Operating cash flow improved substantially to $5.861 billion in the first half of 2025 from $4.440 billion, but about $853 million of the increase reflects a deferral of Tennessee estimated tax payments to the fourth quarter of 2025, which is a timing benefit rather than recurring earnings power. Investors should separate these timing effects from underlying cash generation.

Aug 4, 2025
8-K

HCA Healthcare, Inc. 8-K Report, Financial Results (Jul 25, 2025)

HCA Healthcare reported strong second-quarter 2025 results, with revenues up 6.4% to $18.605 billion and net income attributable to HCA up 13.1% to $1.653 billion. Diluted EPS rose 23.5% to $6.83, and adjusted EBITDA increased 8.4% to $3.849 billion, with the adjusted EBITDA margin expanding to 20.7% from 20.3%. Operating cash flow more than doubled to $4.210 billion from $1.971 billion. EPS growth outpaced net income growth largely because diluted shares fell about 8% year over year, from 264.1 million to 241.9 million, reflecting aggressive buybacks. Same facility admissions grew 1.8%, and same facility revenue per equivalent admission rose 4.0%, so pricing and mix contributed more to growth than volume. Management raised its 2025 guidance across the board. Revenue is now expected at $74.0 to $76.0 billion, adjusted EBITDA at $14.7 to $15.3 billion, and diluted EPS at $25.50 to $27.00, up from $24.05 to $25.85. The midpoint EPS raise is roughly 6%. Capital expenditures are estimated at about $5.0 billion. The Board declared a quarterly dividend of $0.72 per share, payable September 30, 2025 to holders of record on September 16, 2025. Balance sheet leverage remains high. Total debt was $44.5 billion against $939 million of cash, and HCA reported a stockholders' deficit attributable to the company of $4.4 billion, which widened from $2.5 billion at year-end 2024. Short-term debt and current maturities rose to $5.1 billion. Investors should weigh strong cash generation and shareholder returns, including $5.0 billion of repurchases in the first half, against this leverage and the policy and payer uncertainties cited in the forward-looking statements, such as enhanced premium tax credit expirations, Medicaid program changes, and the OBBBA legislation.

Jul 25, 2025
8-K

HCA Healthcare, Inc. 8-K Report, Executive Changes (Jul 11, 2025)

HCA Healthcare, Inc. (NYSE: HCA) filed a Form 8-K on July 11, 2025 to disclose a board change. The Board appointed John W. Chidsey, III as an independent director effective July 15, 2025, expanding the Board from nine to ten members. Mr. Chidsey will serve on the Audit and Compliance, Compensation, and Patient Safety and Quality of Care Committees. The filing is limited to governance information and contains no financial results, guidance, or material operational updates. Mr. Chidsey brings a substantial corporate background. He most recently served as global chief executive officer of Subway, previously led Burger King Holdings as CEO, and held leadership roles at Cendant Corporation and senior financial positions at PepsiCo. He currently sits on the board of Norwegian Cruise Line Holdings and formerly served on the boards of Encompass Health, Burger King Holdings (as chairman), and Brinker International. His financial and strategic expertise may strengthen oversight of HCA's audit and compensation functions. For investors, the appointment is a routine, non-dilutive governance event. The filing states there is no arrangement or related-party transaction requiring disclosure, and Mr. Chidsey will receive the standard non-management director compensation previously described in HCA's April 29, 2025 8-K. The appointment should be viewed as a modest governance enhancement rather than a signal of changed strategy or financial performance.

Jul 11, 2025
8-K

HCA Healthcare, Inc. 8-K Report, Financial Obligation (Jun 10, 2025)

HCA Healthcare, Inc. (HCA) has announced the establishment of a commercial paper program through its direct, wholly-owned subsidiary, HCA Inc. This program allows for the issuance of unsecured commercial paper notes up to a maximum aggregate principal amount of $4.0 billion outstanding at any time. The Parent Guarantor, HCA Healthcare, Inc., is providing an unconditional guarantee for these notes, indicating strong financial backing for this new financing facility. The primary purpose of this commercial paper program is to provide HCA with flexible access to short-term funding for general corporate purposes. The notes will have maturities of up to 397 days and will be sold on customary terms in the U.S. commercial paper market. Investors should note that this is a private placement and the securities are not registered under the Securities Act of 1933, meaning they are subject to specific exemptions from registration requirements. This move suggests a proactive approach by HCA to manage its liquidity and working capital needs.

Jun 10, 2025
10-Q

HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2025

HCA Healthcare's first quarter 2025 results showed solid top-line growth and earnings expansion. Revenues rose 5.7% to $18.321 billion from $17.339 billion, driven by a 3.1% increase in equivalent admissions and a 2.5% increase in revenue per equivalent admission. Net income attributable to HCA rose 1.2% to $1.610 billion, or $6.45 per diluted share, versus $5.93 a year earlier. The comparison is flattered by the prior-year quarter, which included $201 million of facility sale gains ($0.57 per diluted share), so underlying earnings growth was stronger than the headline suggests. Pretax income increased 3.5%, and diluted share count fell about 7% (249.4 million vs. 268.0 million) due to heavy buybacks, which helped per-share results. Cash generation weakened meaningfully. Operating cash flow fell $818 million to $1.651 billion, driven by a $1.157 billion negative swing in working capital, with accounts receivable rising to $11.1 billion and days revenue in receivables at 54. Capital spending was $991 million, and HCA repurchased $2.5 billion of stock in the quarter, funded in part by new borrowings. Total debt increased to $44.6 billion, though the company refinanced its 2025 maturities and terminated several secured facilities in favor of an $8 billion unsecured revolver, with $7.8 billion available at quarter-end. Stockholders' deficit widened to $(438) million, a result of buybacks exceeding retained earnings, which is typical for a leveraged repurchaser but worth monitoring. Management flagged several risks going forward, including possible restructuring or elimination of state Medicaid supplemental payment programs, expiration of enhanced ACA premium tax credits at the end of 2025, rising uninsured volumes in Texas and Florida, and inflation in other operating expenses. Planned 2025 capex of $5.0 to $5.2 billion and the $8.3 billion remaining buyback authorization signal continued capital deployment.

May 1, 2025
8-K

HCA Healthcare, Inc. 8-K Report, Executive Changes (Apr 29, 2025)

HCA Healthcare, Inc. filed an 8-K on April 28, 2025, detailing key corporate governance updates approved at their Annual Meeting on April 24, 2025. The most significant information for investors pertains to changes in Board of Directors compensation and an expansion of the company's stock incentive plan. The Board approved a new compensation program for non-management directors, which includes revised annual retainers for various committee roles and the Chairmanship, along with a significant annual equity award valued at $220,000 in restricted stock units. This reflects an alignment with attracting and retaining experienced leadership. Furthermore, HCA stockholders overwhelmingly approved an amendment to the 2020 Stock Incentive Plan, increasing the share pool by 13,150,000 shares and extending its term to 2035. This provides the company with substantial equity to incentivize future performance and employee retention. Additionally, an amendment to the Certificate of Incorporation to exculpate officers was approved, offering further protection to management. The filing also confirms the election of all nine director nominees and the ratification of Ernst & Young LLP as the independent auditor.

Apr 29, 2025
8-K

HCA Healthcare, Inc. 8-K Report, Financial Results (Apr 25, 2025)

HCA Healthcare reported first quarter 2025 results (quarter ended March 31, 2025) with revenues of $18.321 billion, up from $17.339 billion a year earlier, and net income attributable to HCA of $1.610 billion, or $6.45 per diluted share, versus $5.93 in the prior-year quarter. The prior-year figure included $201 million in facility sale gains ($0.57 per share), so on an adjusted basis EPS grew from $5.36 to $6.45, roughly 20 percent. Adjusted EBITDA rose to $3.733 billion from $3.353 billion, with the margin expanding to 20.4 percent from 19.3 percent. Volume trends were solid: same facility admissions rose 2.6 percent, same facility equivalent admissions rose 2.8 percent, emergency room visits rose 4.0 percent, and same facility revenue per equivalent admission increased 2.9 percent. Outpatient surgery cases declined 2.1 percent on a same facility basis, a soft spot in the quarter. Cash generation weakened in the quarter. Operating cash flow fell to $1.651 billion from $2.469 billion, driven largely by a $1.000 billion outflow from accounts payable and accrued expenses. Capital expenditures were $991 million. HCA returned substantial capital to shareholders, repurchasing 7.762 million shares for $2.506 billion, leaving $8.259 billion under its authorization. Total debt stood at $44.576 billion against cash of $1.060 billion, and stockholders' deficit widened to $(3.519) billion attributable to HCA. Leverage and the buyback pace relative to free cash flow are the key watch items for investors. Management reaffirmed 2025 guidance issued in January: revenues of $72.8 to $75.8 billion, Adjusted EBITDA of $14.3 to $15.1 billion, and diluted EPS of $24.05 to $25.85. The board declared a quarterly dividend of $0.72 per share, payable June 30, 2025 to holders of record on June 16, 2025. Guidance assumes a mostly stable operating environment and flags risks including tariffs, Medicaid and Medicare policy changes, expiring enhanced ACA premium tax credits, and lingering impacts from the 2024 hurricanes.

Apr 25, 2025
8-K

HCA Healthcare, Inc. 8-K Report, Executive Changes (Feb 24, 2025)

HCA Healthcare, Inc. (HCA) has filed an 8-K report detailing its 2025 Executive Officer Performance Excellence Program (Executive Officer PEP). This new program outlines the performance-based compensation structure for the company's executive officers, aiming to align their incentives with key financial and operational goals. The program emphasizes achievement of EBITDA targets, which represent 80% of the award opportunity, and quality metrics, accounting for the remaining 20%. This structure suggests a strong focus on profitability and operational efficiency, while also incorporating critical quality of care indicators as defined by the company. For investors, the most significant aspect is the direct link between executive compensation and the achievement of specific financial and quality benchmarks. The program details the potential payout percentages based on performance levels, ranging from threshold to maximum achievement, with specific award opportunities tied to base salary for the CEO, CFO, and COO. The inclusion of stringent conditions, such as a minimum EBITDA performance being required for any quality-based payout, underscores the company's commitment to balancing financial success with patient care excellence. The filing also notes the retirement of a Board member, Meg G. Crofton, effective at the upcoming annual meeting.

Feb 24, 2025
8-K

HCA Healthcare, Inc. 8-K Report, Material Agreement (Feb 21, 2025)

HCA Healthcare, Inc. (HCA) has announced the completion of a significant debt offering, raising $5.25 billion in aggregate principal amount of senior notes through its wholly owned subsidiary, HCA Inc. This offering comprises six tranches with varying maturities and interest rates, including senior notes due 2028, 2030, 2032, 2035, and 2055, as well as floating rate senior notes due 2028. These notes are guaranteed on a senior unsecured basis by HCA Healthcare, Inc. and are intended to provide additional financial flexibility for the company. The issuance was completed on February 21, 2025, under the company's existing shelf registration statement and pursuant to multiple supplemental indentures. The specific terms, including interest rates and payment dates, are detailed for each tranche. The notes rank senior to subordinated debt and equally to other senior indebtedness of the Issuer, but are effectively subordinated to secured debt and structurally subordinated to the debt of HCA's subsidiaries. Covenants within the indentures place limitations on liens, sale-leaseback transactions, and asset disposals. Additionally, provisions for optional redemption, change of control triggers with a repurchase price of 101%, and events of default are outlined.

Feb 21, 2025
8-K

HCA Healthcare, Inc. 8-K Report, Material Agreement (Feb 20, 2025)

HCA Healthcare, Inc. (HCA) announced through its subsidiary, HCA Inc., the entry into a new, larger senior unsecured revolving credit facility totaling $8.0 billion. This new facility has a five-year term and replaces the company's previous senior secured credit facilities, which included a $3.5 billion revolving credit facility and a $1.238 billion term loan. The company repaid all outstanding obligations under the terminated senior secured facilities immediately prior to entering the new agreement. The refinancing is intended to provide HCA with enhanced financial flexibility for general corporate purposes.

Feb 20, 2025
8-K

HCA Healthcare, Inc. 8-K Report, Corporate Update (Feb 18, 2025)

HCA Healthcare's wholly owned subsidiary, HCA Inc. (the Issuer), announced a proposed public offering of senior unsecured notes on February 18, 2025. The filing describes a refinancing package rather than a new growth initiative. As of February 14, 2025, the Issuer had borrowed $2.950 billion under its ABL credit facility, part of which was used to repay at maturity the full $2.600 billion of 5.375% Senior Notes due 2025. The Issuer intends to terminate its existing secured Cash Flow and ABL credit facilities, which mature June 30, 2026 absent termination, and replace them with an $8.000 billion, five-year senior unsecured revolving credit facility. The Cash Flow facility carried $1.238 billion of term loan A outstanding at December 31, 2024. For investors, the key changes are a shift from secured to unsecured debt and a move away from guarantees. The new facility will not be guaranteed by HCA Healthcare or any subsidiary of the Issuer, and it will carry a quarterly maximum leverage covenant of 4.50x, which can step up to 5.00x for certain periods after a material acquisition. Initial pricing is expected at Term SOFR plus 1.25% plus a 0.10% credit spread adjustment, with the margin tied to the Issuer's credit rating going forward. Net proceeds from the notes are earmarked for general corporate purposes, including repaying borrowings under the new facility, or under the ABL facility if the refinancing is not completed. Final notes terms, including maturity, coupon, and principal amount, will depend on market conditions at pricing and were not disclosed in this filing. Overall, the transaction is primarily a liability management and maturity-extension exercise. It addresses the 2025 notes maturity and the 2026 secured facility maturities, and it gives HCA more flexible unsecured funding. The filing does not disclose new earnings, cash flow, or operating results, and the terms of the offering remain subject to market conditions.

Feb 18, 2025
10-K

HCA Healthcare, Inc. Annual Report, Year Ended Dec 31, 2024

HCA Healthcare's 2024 10-K shows a company with strong top-line growth and cash generation, but a balance sheet that is heavily levered and a shareholder-return program funded largely by debt. Revenues rose 8.7% to $70.603 billion, driven by a 5.3% increase in equivalent admissions and a 3.2% increase in revenue per equivalent admission. Net income attributable to HCA was $5.760 billion, or $22.00 per diluted share, up from $18.97 in 2023. Operating cash flow reached $10.514 billion, up $1.083 billion, and capital expenditures were $4.875 billion. Management plans $5.0 to $5.2 billion of capex in 2025. The balance sheet is the main investor concern. Total debt rose to $43.031 billion from $39.593 billion, and interest expense climbed to $2.061 billion. Stockholders' equity attributable to HCA is negative at $(2.499) billion. Management repurchased $6.042 billion of stock in 2024 and paid $690 million in dividends, funded in part by $4.5 billion of new senior notes and $3.0 billion of further issuance. The board authorized a new $10 billion repurchase program in January 2025, and the quarterly dividend was raised to $0.72 from $0.66. Risk factors center on payer mix and government policy. Medicare and Medicaid together provided about 44.5% of 2024 revenues. Florida and Texas generated 52% of revenues, and the company is exposed to hurricanes, as Helene and Milton cost roughly $250 million in 2024. Other watch items include the expiration of enhanced ACA premium tax credits after 2025, a rising uninsured emergency room volume (up 13.8%), and Medicaid supplemental payment programs that reached about $4.9 billion in 2024 but face federal rule changes.

Feb 14, 2025
8-K

HCA Healthcare, Inc. 8-K Report, Financial Results (Jan 24, 2025)

HCA Healthcare reported fourth-quarter 2024 revenues of $18.285 billion, up from $17.303 billion a year earlier, and net income attributable to HCA of $1.438 billion, or $5.63 per diluted share, versus $5.93 in 4Q 2023. The GAAP decline is driven largely by a $195 million ($0.59 per share) loss on sales of facilities, primarily tied to the pending sale of a California hospital, and an estimated $0.60 per share hit from Hurricanes Helene and Milton. Adjusted EBITDA rose 2.6% to $3.712 billion, though the margin contracted to 20.3% from 20.9%. Operating volumes were solid: same facility admissions grew 3.0% and same facility equivalent admissions grew 3.1%, while outpatient surgeries fell 1.3%. For full-year 2024, revenue reached $70.603 billion, GAAP diluted EPS was $22.00, and Adjusted EBITDA was $13.882 billion. Capital return is a major theme. HCA repurchased $1.700 billion of stock in the fourth quarter, full-year repurchases totaled $6.042 billion, and the Board authorized a new $10 billion buyback with no time limit. The quarterly dividend was set at $0.72 per share, payable March 31, 2025. Balance sheet leverage remains substantial, with total debt of $43.031 billion against cash of $1.933 billion, and the company held $7.986 billion of credit facility availability. For 2025, management guided to revenue of $72.8 to $75.8 billion, Adjusted EBITDA of $14.3 to $15.1 billion, and diluted EPS of $24.05 to $25.85 on 243 million shares. Capital expenditures are expected at $5.0 to $5.2 billion. The guidance assumes a mostly stable operating environment and excludes gains or losses on facility sales, debt retirement costs, legal claims, and impairments. Investors should weigh the strong cash generation and buyback capacity against heavy debt, regulatory exposure (including Medicaid supplemental payments and expiring enhanced premium tax credits), and continued hurricane-related costs.

Jan 24, 2025
10-Q

HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2024

HCA Healthcare's third quarter 2024 results showed strong top-line and earnings growth. Revenues rose 7.9% year over year to $17.487 billion, driven by a 5.0% increase in equivalent admissions and a 2.8% increase in revenue per equivalent admission. Net income attributable to HCA rose 17.7% to $1.270 billion, or $4.88 per diluted share (versus $3.91). Income before taxes grew 17.0% to $1.906 billion, with salaries and benefits falling to 45.0% of revenue from 46.6%, helped by a 17.8% decline in contract labor. Offsetting this, supplies, other operating expenses and interest expense were higher as a share of revenue or in absolute terms, and the quarter absorbed about $50 million (about $0.15 per diluted share) of Hurricane Helene costs. For the first nine months, revenues increased 9.8% to $52.318 billion and diluted EPS reached $16.37, up from $13.07. Operating cash flow improved to $7.955 billion from $6.757 billion, while capital expenditures held near $3.6 billion with about $5 billion planned for 2024. Share repurchases were significant at $4.342 billion year to date, and the company retired about 13 million shares, reducing the share count by roughly 6% year over year. Management expects Hurricane Helene and Hurricane Milton to cost $200 million to $300 million ($0.60 to $0.90 per diluted share) in the fourth quarter, before any insurance recoveries. Balance sheet leverage rose modestly. Total debt reached $42.965 billion, up from $39.593 billion at year-end 2023, following $7.5 billion of new senior notes issued in 2024 to refinance the asset-based revolver and fund the maturity of $2.0 billion of 2024 notes. Stockholders' deficit attributable to HCA widened to $(2.182) billion, a function of the buybacks and dividends exceeding retained earnings. Liquidity remains solid, with $7.986 billion available under senior secured credit facilities and $2.888 billion of cash. The company also disclosed that its Florida and Texas hospitals represent 59% of admissions and 51% of revenue, concentrating exposure in two states.

Oct 31, 2024
8-K

HCA Healthcare, Inc. 8-K Report, Financial Results (Oct 25, 2024)

HCA Healthcare's third quarter 2024 results (reported October 25, 2024) showed strong top-line and earnings growth. Revenues rose to $17.487 billion from $16.213 billion (about 7.9%), and net income attributable to HCA reached $1.270 billion, or $4.88 per diluted share, versus $3.91 a year earlier. Adjusted EBITDA increased to $3.267 billion from $2.880 billion, with the margin expanding to 18.7% from 17.8%. Volume growth was healthy, with same facility admissions up 4.5% and emergency room visits up 4.6%, while revenue per equivalent admission rose 2.5%. Outpatient surgeries declined 2.0%, a softer spot in the mix. Note that the prior-year quarter included a roughly $397 million Florida directed payment benefit, so the year-over-year comparison is flattered by a non-recurring item in the base period. The main near-term headwind is Hurricanes Helene and Milton. HCA estimated a $50 million (about $0.15 per share) hit in Q3 and expects a further $200 to $300 million (about $0.60 to $0.90 per share) impact in Q4, before any insurance recoveries. Despite this, management reaffirmed 2024 guidance but now expects results in the lower half of the ranges. Guidance calls for Adjusted EBITDA of $13.75 to $14.25 billion and diluted EPS of $21.60 to $22.80. Capital expenditures were raised to about $5 billion. Management also gave early 2025 commentary, suggesting diluted EPS and Adjusted EBITDA growth near or slightly above the upper end of its long-term ranges. Capital allocation remained shareholder-friendly. HCA repurchased 4.948 million shares for $1.795 billion in the quarter, with $2.433 billion left on its authorization, and declared a quarterly dividend of $0.66 per share payable December 27, 2024. Leverage is elevated, however: total debt was $42.965 billion against cash of $2.888 billion, and the balance sheet shows a stockholders' deficit attributable to HCA of $(2.182) billion. Operating cash flow was strong at $3.515 billion in the quarter, up from $2.479 billion a year earlier.

Oct 25, 2024
8-K

HCA Healthcare, Inc. 8-K Report, Material Agreement (Aug 12, 2024)

HCA Healthcare, Inc. (HCA) has filed an 8-K report on August 12, 2024, detailing the completion of a significant public offering of senior notes totaling $3,000,000,000 in aggregate principal amount. This offering consists of three tranches: $750,000,000 of 5.450% Senior Notes due 2031 (New 2031 Notes), $1,250,000,000 of 5.450% Senior Notes due 2034 (2034 Notes), and $1,000,000,000 of 5.950% Senior Notes due 2054 (2054 Notes). These notes are senior unsecured obligations of HCA Inc., guaranteed on a senior unsecured basis by the Parent Guarantor, HCA Healthcare, Inc. The issuance of these notes is a material event for investors as it impacts the company's capital structure and long-term financing. The proceeds from this offering will be used to refinance existing debt and for general corporate purposes, though specific use of proceeds beyond that is not detailed in this filing. The tiered interest rates and maturity dates reflect market conditions and the company's debt management strategy. Investors should note the covenants and change of control provisions detailed in the Indentures, which offer certain protections.

Aug 12, 2024
8-K

HCA Healthcare, Inc. 8-K Report, Corporate Update (Aug 8, 2024)

HCA Healthcare, Inc. (HCA) announced on August 7, 2024, through an 8-K filing, that it has entered into an Underwriting Agreement to issue and sell $3.0 billion in aggregate principal amount of senior notes. This debt offering consists of three tranches: $750 million of 5.450% Senior Notes due 2031, $1.25 billion of 5.450% Senior Notes due 2034, and $1.0 billion of 5.950% Senior Notes due 2054. These notes will be guaranteed on a senior unsecured basis by the Parent Guarantor, HCA Healthcare, Inc., and are being issued under the company's existing Form S-3 registration statement.

Aug 8, 2024
10-Q

HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2024

HCA Healthcare's second quarter 2024 results showed continued top-line momentum. Revenues rose 10.3% year over year to $17.492 billion, driven by a 6.0% increase in equivalent admissions and a 4.1% increase in revenue per equivalent admission. Net income attributable to HCA grew 22.5% to $1.461 billion, and diluted EPS rose to $5.53 from $4.29. Results were helped by a $12 million gain on facility sales in the quarter, while the six-month period included a larger $213 million gain, primarily from the sale of a California hospital. Operating margin pressure is visible in the cost lines: other operating expenses rose to 20.7% of revenue from 19.2%, driven by professional fees and state provider fees, while salaries and benefits improved to 43.9% of revenue from 45.9%, helped by a 25.7% decline in contract labor. Cash generation and balance sheet items warrant attention. Operating cash flow for the quarter fell $504 million year over year to $1.971 billion, mainly because of a $824 million negative swing in working capital, chiefly higher accounts receivable and lower accounts payable. Total debt rose to $40.880 billion, and the current portion of long-term debt jumped to $4.574 billion, which pushed working capital down to $872 million from $2.272 billion at year-end 2023. HCA issued $4.5 billion of senior notes in February 2024 and repaid a $2.0 billion maturity in March. Capital spending remains heavy, with planned 2024 capex of $5.1 to $5.3 billion. Management also returned significant capital to shareholders, repurchasing $2.547 billion of stock in the first half and declaring a $0.66 quarterly dividend, while shares outstanding fell to 259.2 million from 265.5 million at year-end 2023. Overall, the filing reflects strong earnings growth supported by volume gains and labor cost relief, offset by rising non-labor costs, weaker working capital conversion, and a larger debt load. Investors would likely focus on whether accounts receivable trends normalize and whether the company can sustain margin improvement while funding elevated capital spending and buybacks.

Jul 29, 2024
8-K

HCA Healthcare, Inc. 8-K Report, Financial Results (Jul 23, 2024)

HCA Healthcare reported strong second-quarter 2024 results, with revenues of $17.492 billion (up from $15.861 billion, roughly 10%), net income attributable to HCA of $1.461 billion, or $5.53 per diluted share (versus $4.29 a year earlier), and Adjusted EBITDA of $3.550 billion, a 20.3% margin versus 19.3% in 2Q 2023. Volume trends were healthy: same facility admissions rose 5.8%, same facility equivalent admissions rose 5.2%, and same facility revenue per equivalent admission increased 4.4%. Emergency room visits grew 5.5%, inpatient surgeries rose 2.6%, and outpatient surgeries declined 2.1%. Management characterized demand as strong and raised its full-year 2024 guidance across all key metrics. The revised guidance is the central investor takeaway. Revenue guidance moved to $69.75–$71.75 billion from $67.75–$70.25 billion, net income attributable to HCA to $5.675–$5.975 billion from $5.200–$5.600 billion, Adjusted EBITDA to $13.75–$14.25 billion from $12.85–$13.55 billion, and diluted EPS to $21.60–$22.80 from $19.70–$21.20. Capital expenditures are expected at $5.1–$5.3 billion. Share repurchases remain significant: HCA bought back 4.217 million shares for $1.367 billion in the quarter and had $4.228 billion left under its authorization. Diluted share count fell to 264.1 million from 278.2 million a year earlier, which amplifies per-share earnings growth. Balance sheet and cash generation warrant monitoring. Total debt was $40.880 billion at June 30, 2024, against cash of $831 million, and $4.574 billion of long-term debt comes due within one year. Operating cash flow in the quarter fell to $1.971 billion from $2.475 billion a year earlier, a notable decline that the release does not explain in detail. Liquidity was $7.137 billion of credit facility availability. The Board declared a quarterly dividend of $0.66 per share, payable September 30, 2024 to holders of record on September 16, 2024. Note that the filing's operating cash flow figure for the quarter differs from the six-month figure in the cash flow statement, which is presented separately; investors should rely on the source reconciliation.

Jul 23, 2024
10-Q

HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2024

HCA Healthcare's first quarter 2024 results showed strong top-line and earnings growth. Revenues rose 11.2% to $17.339 billion from $15.591 billion, driven by a 7.1% increase in equivalent admissions and a 3.9% rise in revenue per equivalent admission (same facility revenues up 8.8%). Net income attributable to HCA Healthcare rose 16.7% to $1.591 billion, or $5.93 per diluted share, versus $4.85 a year earlier. The quarter was helped by a $201 million pretax gain on sales of facilities (primarily a California hospital sale, worth $0.57 per diluted share), while the prior-year quarter included a $145 million one-time revenue benefit from resolving disputed payer claims. Excluding these items, underlying growth was still solid, though operating cost pressure was evident: other operating expenses rose to 20.9% of revenues from 18.7%, driven by professional fees and state provider fees, while salaries and benefits improved to 44.4% of revenues from 45.4%. Cash generation and capital allocation were robust. Operating cash flow increased to $2.469 billion from $1.803 billion, helped by working capital changes. HCA issued $4.5 billion of senior notes in February 2024 and used proceeds to repay its asset-based revolver, then repaid $2.0 billion of 2024 maturities. Total debt was $40.191 billion at quarter end, and the company repurchased 3.894 million shares for about $1.18 billion. Management reiterated planned 2024 capital expenditures of $5.1 to $5.3 billion and declared a $0.66 quarterly dividend. Investors should weigh the high leverage and rising debt-service costs, with interest expense up 6.9% to $512 million, against the strong volume growth, favorable pricing, and disciplined capital returns.

May 2, 2024
8-K

HCA Healthcare, Inc. 8-K Report, Executive Changes (Apr 30, 2024)

HCA Healthcare, Inc. (HCA) filed an 8-K report on April 29, 2024, detailing key events from its Annual Meeting of Stockholders held on April 25, 2024, and a CFO transition. The report announced the retirement of Executive Vice President and CFO William B. Rutherford, effective May 1, 2024, with Christopher F. Wyatt appointed as the new principal accounting officer while continuing his role as Senior Vice President and Controller. This transition appears smooth with no immediate concerns indicated regarding Mr. Wyatt's appointment. The Annual Meeting saw strong stockholder support for the re-election of all ten director nominees and the ratification of Ernst & Young LLP as the independent registered public accounting firm. Furthermore, stockholders approved a non-binding advisory resolution to hold annual say-on-pay votes, aligning with the board's determination to conduct these votes yearly. Conversely, several stockholder proposals concerning risk mitigation for state restrictions on emergency abortions, patient feedback on care quality, and maternal health outcomes were not approved.

Apr 30, 2024
8-K

HCA Healthcare, Inc. 8-K Report, Financial Results (Apr 26, 2024)

HCA Healthcare reported first quarter 2024 results (quarter ended March 31, 2024) that were driven primarily by broad-based volume growth. Revenues rose 11.2% to $17.339 billion from $15.591 billion, and net income attributable to HCA Healthcare was $1.591 billion, or $5.93 per diluted share, versus $4.85 a year earlier. The headline EPS figure was helped by a $201 million pre-tax gain on facility sales (about $0.57 per diluted share), primarily from the sale of a California hospital. Excluding facility gains and losses, net income attributable to HCA, as adjusted, was $1.437 billion, or $5.36 per diluted share, compared with $4.93 a year earlier, a gain of roughly 9%. Adjusted EBITDA rose 5.7% to $3.353 billion, although the margin contracted to 19.3% from 20.3%, reflecting higher other operating expenses. Operating volumes were strong. Same facility admissions grew 6.2%, same facility equivalent admissions grew 5.2%, and same facility emergency room visits grew 7.2%. Same facility revenue per equivalent admission rose 3.5%. Inpatient surgeries grew 1.7%, while outpatient surgeries declined 2.1%. Operating cash flow was $2.469 billion, up from $1.803 billion. Management reaffirmed its 2024 guidance, which calls for revenues of $67.75 billion to $70.25 billion, net income attributable to HCA of $5.2 billion to $5.6 billion, Adjusted EBITDA of $12.85 billion to $13.55 billion, and diluted EPS of $19.70 to $21.20. Guidance excludes facility gains and losses, debt retirement losses, legal claim costs, and impairments. Capital allocation remained shareholder-focused. HCA repurchased 3.894 million shares for $1.180 billion, leaving $5.595 billion under its authorization, and declared a quarterly dividend of $0.66 per share payable June 28, 2024 to holders of record on June 14, 2024. Total debt was $40.191 billion at quarter end, and HCA issued $4.483 billion of long-term debt during the quarter while repaying $2.066 billion. Liquidity included $1.284 billion of cash and $7.987 billion of credit facility availability. Investors should note the substantial leverage, the thinner adjusted margin, and the reliance on volume growth and continued buybacks.

Apr 26, 2024
8-K

HCA Healthcare, Inc. 8-K Report, Executive Changes (Feb 26, 2024)

HCA Healthcare, Inc. (HCA) filed an 8-K on February 26, 2024, detailing its 2024 Executive Officer Performance Excellence Program (Executive Officer PEP). This program establishes performance-based compensation for the company's executive officers, with awards weighted 80% on EBITDA targets and 20% on quality metrics. Specific EBITDA targets will be set for the company overall and for key operating groups, while quality metrics will focus on Healthcare-Associated Infections and Sepsis, Complication and Mortality, and Care Experience. Furthermore, the filing announces an adjustment to the compensation for Michael R. McAlevey, who will transition to Executive Vice President – Chief Legal and Administrative Officer on April 1, 2024. This transition includes a base salary increase and a significant long-term equity incentive award. Notably, William B. Rutherford, Executive Vice President and Chief Financial Officer, will retire on May 1, 2024, and will not participate in the Executive Officer PEP.

Feb 26, 2024
8-K

HCA Healthcare, Inc. 8-K/A Report, Executive Changes (Feb 26, 2024)

This 8-K/A filing from HCA Healthcare, Inc. serves as an amendment to a previous 8-K announcing the appointment of Michael A. Marks as Executive Vice President and Chief Financial Officer, effective May 1, 2024. The primary purpose of this amendment is to disclose material changes to Mr. Marks' compensation arrangements related to his new role, which were not finalized at the time of the initial filing. Key details of the compensation changes include the establishment of the 2024 Executive Officer Performance Excellence Program (Executive Officer PEP). Under this program, Mr. Marks' performance awards will be weighted 80% towards EBITDA targets and 20% towards specific quality metrics. These quality metrics encompass Healthcare-Associated Infections and Sepsis, Complication and Mortality, and Care Experience. His award opportunity will increase from 65% of base salary to 110% of base salary upon assuming the CFO role.

Feb 26, 2024
8-K

HCA Healthcare, Inc. 8-K Report, Material Agreement (Feb 23, 2024)

HCA Healthcare, Inc. (HCA) has filed an 8-K report detailing a significant financing transaction. On February 23, 2024, the company, through its subsidiary HCA Inc., successfully completed the public offering of $4.5 billion in aggregate principal amount of senior unsecured notes. These notes are structured across various maturity dates and interest rates, including $1.0 billion of 5.450% notes due 2031, $1.3 billion of 5.600% notes due 2034, $1.5 billion of 6.000% notes due 2054, and $0.7 billion of 6.100% notes due 2064. The parent company, HCA Healthcare, Inc., fully and unconditionally guarantees these notes. This substantial debt issuance, registered under a Form S-3 shelf registration statement, provides HCA with significant capital. The proceeds are intended to fund general corporate purposes, which may include capital expenditures, debt repayment, or acquisitions, although specific use of proceeds is not detailed in this filing. The indenture governing these notes includes standard covenants related to liens, sale and lease-back transactions, and asset disposals, as well as provisions for optional redemption and a change of control repurchase right for noteholders under specific conditions. Investors should note that while these notes are senior unsecured obligations of the issuer, they are effectively subordinated to secured debt and structurally subordinated to the debt and liabilities of HCA's subsidiaries.

Feb 23, 2024
8-K

HCA Healthcare, Inc. 8-K Report, Corporate Update (Feb 21, 2024)

HCA Healthcare, Inc. (HCA) announced on February 20, 2024, the execution of an underwriting agreement for the issuance and sale of $4.5 billion in aggregate principal amount of senior notes. This significant debt financing is structured across four tranches with varying maturity dates and interest rates, ranging from 5.450% due in 2031 to 6.100% due in 2064. The notes will be guaranteed on a senior unsecured basis by the parent company, HCA Healthcare, Inc., and are being issued under the company's existing Form S-3 registration statement. This debt offering is a material event for investors as it provides insight into HCA's capital structure management and financing strategy. The substantial capital raised may be intended for various corporate purposes, such as funding operations, acquisitions, refinancing existing debt, or general corporate expenditures. Investors should monitor how these funds are deployed and assess the impact on the company's leverage ratios and overall financial health. The specific terms of the notes, including their coupon rates and maturity profiles, reflect current market conditions and HCA's credit standing.

Feb 21, 2024
10-K

HCA Healthcare, Inc. Annual Report, Year Ended Dec 31, 2023

HCA Healthcare's FY2023 10-K shows a company with strong top-line growth but lower bottom-line earnings. Revenue rose 7.9% to $64.968 billion, driven by a 4.9% increase in equivalent admissions and a 2.8% increase in revenue per equivalent admission. Net income attributable to HCA fell 7.1% to $5.242 billion, or $18.97 per diluted share, versus $19.15 in 2022. The decline reflects the absence of 2022's $1.301 billion in facility sale gains, along with higher salaries, other operating expenses (up to 19.8% of revenue from 18.5%), and interest expense ($1.938 billion, up from $1.741 billion). Operating cash flow improved to $9.431 billion, and the company returned capital through $3.811 billion in buybacks and $661 million in dividends. Balance sheet leverage remains the central investor consideration. Total debt was $39.593 billion at year-end 2023, with the average effective interest rate on long-term debt rising to 5.0% from 4.7%. Management plans capital expenditures of $5.1 to $5.3 billion in 2024, and a new $6 billion buyback authorization was approved in January 2024 alongside a raised quarterly dividend of $0.66. Key risks include heavy concentration in Florida and Texas (51% of revenue), reliance on Medicare and Medicaid (44.1% of revenue), exposure to a July 2023 cybersecurity incident affecting about 11 million patients, and ongoing staffing pressures and regulatory uncertainty around Medicaid supplemental payments. Overall, HCA combined solid volume growth and pricing with rising costs and interest burden. Investors are weighing sustained cash generation and shareholder returns against a large debt load, reimbursement exposure, and margin pressure from labor and operating expenses.

Feb 16, 2024
8-K

HCA Healthcare, Inc. 8-K Report, Financial Results (Jan 30, 2024)

HCA Healthcare reported fourth-quarter 2023 revenues of $17.303 billion, up from $15.497 billion a year earlier, with net income attributable to HCA of $1.607 billion, or $5.93 per diluted share, versus $7.28 in 4Q 2022. The comparison is distorted by a $1.326 billion gain on facility sales in 4Q 2022 (worth $2.64 per share); excluding gains and losses on facility sales and debt retirement, 4Q 2023 EPS was $5.90 versus $4.64 a year earlier, a sizable improvement. Adjusted EBITDA rose about 14% to $3.618 billion, with the margin widening to 20.9% from 20.5%. Volume and pricing both contributed: same facility admissions rose 3.1% and revenue per equivalent admission rose 6.9%, reflecting strong demand and improved cost trends. For full-year 2023, revenues were $64.968 billion, Adjusted EBITDA was $12.726 billion, and diluted EPS was $18.97, compared with $19.15 in 2022 (which included large facility-sale gains). The company guided to 2024 revenues of $67.75 to $70.25 billion, Adjusted EBITDA of $12.85 to $13.55 billion, and diluted EPS of $19.70 to $21.20. Capital expenditures are expected at $5.1 to $5.3 billion. The guidance midpoint implies modest EBITDA growth but a higher capital spending burden. Capital allocation remains shareholder-friendly: the Board authorized an additional $6 billion buyback, on top of $775 million remaining at year-end, and declared a $0.66 quarterly dividend. Balance sheet leverage is significant, with total debt of $39.593 billion against cash of $935 million, though the company had $6.107 billion of credit facility availability. Leadership is also changing. CFO Bill Rutherford retires effective May 1, 2024, after ten years as CFO and 34 years with the company. He will be succeeded by Michael A. Marks, a 34-year HCA veteran who is currently Senior Vice President, Finance. Marks's compensation includes a $900,000 base salary and a $2 million target long-term equity award, split between stock appreciation rights and performance share units tied to a three-year cumulative EPS goal. The transition is orderly, with an internal successor who has worked closely with the outgoing CFO, which should reassure investors about continuity.

Jan 30, 2024
8-K

HCA Healthcare, Inc. 8-K Report, Regulation FD Disclosure (Nov 9, 2023)

HCA Healthcare filed this 8-K on November 9, 2023 under Regulation FD to furnish a press release issued ahead of its 2023 Investor Day. The company disclosed its strategic long-term financial targets for the next five years: Adjusted EBITDA growth of 4% to 6% annually and diluted earnings per share growth of 8% to 12% annually. These are presented as composite targets, and management cautioned that results in any single year may fall outside these ranges. Management also gave an early, preliminary view of 2024. CEO Sam Hazen said that while the 2024 planning process was not complete, the company currently believes its 2024 expectations will fall within the long-term target ranges. That view explicitly takes into account the resolution of disputed claims with a commercial payer recorded in the first quarter of 2023, so investors should consider that one-time item when comparing 2024 to prior periods. Detailed 2024 guidance is deferred to the year-end earnings call in January. The filing is largely informational and the material content is forward-looking. Investors should weigh the targets against the risk factors listed in the release, which include payer mix shifts, uninsured patient growth, labor and supply costs, Medicaid and Medicare policy changes, indebtedness, and cybersecurity risk, including the data security incident disclosed in July 2023. The information furnished under Item 7.01 is not deemed filed for Section 18 purposes.

Nov 9, 2023
10-Q

HCA Healthcare, Inc. Quarterly Report for Q3 Ended Sep 30, 2023

HCA Healthcare's third quarter 2023 10-Q shows continued top-line growth driven mainly by pricing and volume, but margin pressure and rising leverage-related costs are weighing on profitability. Revenue rose 8.3% year over year to $16.213 billion in the quarter, with revenue per equivalent admission up 3.6% and equivalent admissions up 4.5%. Net income attributable to HCA fell 4.9% to $1.079 billion, and diluted EPS held flat at $3.91 because of a 5% reduction in diluted share count from buybacks. Nine-month revenue grew 6.5% to $47.665 billion, while pretax income rose only 1.6%, reflecting higher other operating expenses (19.5% of revenue versus 18.6%), including directed payment program costs, and higher interest expense of $1.447 billion versus $1.288 billion. Balance sheet and cash flow trends warrant attention. Total debt was $39.346 billion at September 30, 2023, and the company describes itself as highly leveraged. Operating cash flow for the nine months rose to $6.757 billion, but capital expenditures of $3.585 billion, buybacks of $2.901 billion, dividends and noncontrolling distributions left cash essentially flat at $891 million. Management plans roughly $4.7 billion of capex for 2023 and has $6.455 billion of revolver availability. Shareholder returns have been funded in part by new borrowing, and the company's own financing activity shows net debt additions of about $1.1 billion year to date. Investors should also note a $105 million pretax loss from a hospital-based physician staffing joint venture in Q3, a July 2023 data security incident referenced in the forward-looking statements, and an ongoing qui tam False Claims Act lawsuit related to the Texas Medicaid program in Harris County. Management reports no material changes to risk factors versus the 2022 10-K, and the uncertain outcome of supplemental payment program reviews remains a key policy risk given Medicaid and Medicare exposure.

Oct 26, 2023
8-K

HCA Healthcare, Inc. 8-K Report, Financial Results (Oct 24, 2023)

HCA Healthcare reported third-quarter 2023 revenue of $16.213 billion, up about 8.3% from $14.971 billion a year earlier, driven by solid demand and same-facility growth (admissions up 3.4%, equivalent admissions up 4.1%, revenue per equivalent admission up 3.6%). Profitability was weaker than the top line. Adjusted EBITDA was $2.880 billion versus $2.902 billion, and the Adjusted EBITDA margin fell to 17.8% from 19.4%. Management attributed the shortfall mainly to its Valesco physician staffing joint venture, which underperformed expectations. The quarter also included $397 million of revenue and $195 million of operating expenses tied to the Florida directed payment program year that ended September 30, 2023. Diluted EPS was flat at $3.91, but that figure benefited from a sharp reduction in share count (275.4 million diluted shares versus 289.9 million), as the company repurchased 4.2 million shares for $1.140 billion during the quarter. HCA revised its 2023 guidance. Revenue was narrowed to $63.5–$64.5 billion (from $63.25–$64.75 billion), and net income attributable to HCA was set at $4.940–$5.130 billion (from $4.900–$5.255 billion). Adjusted EBITDA guidance was narrowed to $12.3–$12.6 billion, down from a top end of $12.8 billion, and diluted EPS guidance was narrowed to $17.80–$18.50 (from $17.70–$18.90). The top end of the EBITDA and EPS ranges was lowered, signaling a more cautious outlook for the remainder of the year. The company also declared a quarterly dividend of $0.60 per share, payable December 28, 2023, to holders of record on December 14, 2023. Balance sheet and cash flow metrics were mixed. Third-quarter operating cash flow was $2.479 billion, down from $3.020 billion a year earlier. Capital expenditures were $1.147 billion. Total debt was $39.346 billion against cash of $891 million, and the company had $6.455 billion of credit facility availability. The filing also references a data security incident disclosed in July 2023 among its forward-looking risk factors.

Oct 24, 2023
10-Q

HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2023

HCA Healthcare's second quarter 2023 results showed continued top-line growth and solid profitability. Revenues rose 7.0% year over year to $15.861 billion, driven by a 4.0% increase in equivalent admissions and a 2.9% increase in revenue per equivalent admission. Same facility revenues grew 6.2%. Net income attributable to HCA was $1.193 billion, or $4.29 per diluted share, up from $3.90 a year earlier, helped by lower share count after buybacks (diluted shares fell to 278.2 million from 296.1 million). Adjusted segment EBITDA was $3.056 billion, roughly flat with the prior year's $3.042 billion, and operating margin pressure came mainly from other operating expenses, which rose to 19.2% of revenue from 18.3%, led by a 70 basis point increase in professional fees. Cash generation improved meaningfully. Operating cash flow for the first half of 2023 was $4.278 billion, up 44% from $2.975 billion, largely from working capital improvement, particularly lower accounts receivable. Capital spending increased to $2.438 billion for the first half, and management plans roughly $4.7 billion of capital expenditures for 2023. HCA continues to carry heavy leverage, with total debt of $38.932 billion, and interest expense rose 14.5% to $964 million for the six months as the average effective rate climbed to 5.0%. The company issued $3.25 billion of senior notes in May 2023 to repay its asset-based revolver, extending maturities into 2028, 2033 and 2053. Investors should also note the July 2023 data security incident, which HCA says may involve information for about 11 million patients. It contains no clinical or financial account data, and management does not expect a material impact, though multiple class action lawsuits have been filed. Other items to monitor include the qui tam lawsuit tied to the Texas Medicaid program, ongoing IRS examinations, and continued uncertainty around state supplemental payment programs.

Aug 2, 2023
8-K

HCA Healthcare, Inc. 8-K Report, Financial Results (Jul 27, 2023)

HCA Healthcare reported second-quarter 2023 revenues of $15.861 billion, up about 7.0% from $14.820 billion a year earlier. Net income attributable to HCA rose to $1.193 billion, or $4.29 per diluted share, versus $3.90 in 2Q 2022. The EPS increase is helped by the absence of the prior-year losses on facility sales ($0.11) and debt retirement ($0.20), and by a diluted share count that fell to 278.2 million from 296.1 million after buybacks. Excluding those prior-year items, EPS grew from $4.21 to $4.29. Adjusted EBITDA was $3.056 billion, roughly flat with $3.042 billion, and the Adjusted EBITDA margin contracted to 19.3% from 20.5%. That margin compression reflects the cost pressures visible in the income statement: salaries and benefits, supplies, and other operating expenses all grew faster than revenue as a share of sales. Volume trends were solid. Same-facility admissions rose 2.2%, same-facility equivalent admissions rose 3.7%, and same-facility emergency room visits rose 3.7%. Same-facility revenue per equivalent admission increased 2.4%. Operating cash flow was strong at $2.475 billion in the quarter, compared with $1.630 billion a year earlier. HCA repurchased 3.3 million shares for $915 million in the quarter, with $2.825 billion left under its authorization, and declared a $0.60 quarterly dividend payable September 29, 2023. Total debt stood at $38.932 billion at quarter-end, so leverage remains the key balance sheet consideration. Management raised full-year 2023 guidance. Revenue is now expected at $63.25 to $64.75 billion (from $62.5 to $64.5 billion), Adjusted EBITDA at $12.3 to $12.8 billion (from $12.1 to $12.7 billion), and diluted EPS at $17.70 to $18.90 (from $17.25 to $18.55). Capital expenditures are now estimated at about $4.7 billion, up from $4.6 billion. The forward-looking statements also reference a data security incident disclosed in July 2023, which investors should monitor for any financial or operational impact.

Jul 27, 2023