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Week One Writing Assignment: short 3-page memo for quick instructor feedback

Read the HCA 10-Ks Business section (first 30 pages). Summarize the important

issues for your CEO, assuming you work for a similar organization

Table of Contents We receive payments for patient services from the federal goverment under the Medi o gram, state governments under theit respective Medicaid or similar programs, managed care plans (includes plans offered through the health insurance wachanges, beginning in 2014), private insurers and directly from patients. Our revenues from third-party payers and the uninsured for the years ended December 31, 2014, 2013 and 2012 are summarized in the following table (dollars in millions): 2013 Rata 25.196 Medicare Managed Medicare Medicaid Managed Medicaid Managed care and other insurers Interational (managed care and other insurers) 8.9 43 2014 8.354 3.614 1.848 1,923 20.066 1.311 37.116 1,494 1.477 40.087 (3.169) $36,918 Faded December 31 Rate $7.951 23.395 3.279 9.6 1.480 1,570 4,6 18,654 54.6 1.175 3.4 34,109 99.8 2,677 78 1.254 38,040 1113 6,858) (113) $34.182 100.0% 2012 $ 8,292 2.954 1,464 1.504 17.998 1.060 33,272 2.580 931 36,783 3.770) 33.013 4.4 4.5 54.5 3.2 100.7 100.6 78 Uninsured Other Revenues before provision for doubtful accounts Provision for doubtful accounts Revenues 108.6 (8.6) 1113 (113) 100.096 100.0% 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 eligible to participate in 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 plan including plans offered through the American Health Benefit Exchanges (Exchanges). These discount programs genera 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 consumance continues to increase. Collection of amounts due from individuals is typically more difficult than from go uninsured patients who do not qualify for Medicaid or charity care under our charity care policy. In implementing the uninsured 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 quality for these programs, the uninsured discount is applied Medicare In addition to the reimbursement reductions and adjustments discussed below, the Budget Control Act of 2011 (the "BCA) requires automatic spending reductions to reduce the federal deficit, including Medicare spending reductions of up to 256 per fiscal year with a uniform percentage reduction across all Medicare programs. These automatic spending reductions began on March 1, 2013, with CMS imposing a reduction on Medicare claims beginning on April 1, 2013. These reductions have been extended through 2024 Table of Contents achieve industry-leading performance in clinical and satisfaction measures: recruit and employ physicians to meet the need for high quality health 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. At December 31, 2014, we owned and operated 162 general, acute care hospitals with 42,860 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 goveming board, made up of members of the local 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 intems and residents and other education programs. At December 31, 2014, we operated three psychiatric hospitals with 396 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 ("ASC"), 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 member 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, govermental reimbursement assistance, construction planning and coordination, information technology systems and solutions, legal counsel, human resources services and intemal 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 nites for inpatient services vary significantly depending on the type of payer, the type of service (0.8, 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. 4/225 PARTI Item 1. Business General HCA Holdings, Inc. is one of the leading health care services companies in the United States. At December 31, 2014, we operated 166 hospitals, comprised of 162 general, acute care hospitals, three psychiatric hospitals, and one rehabilitation hospital. In addition, we operated 113 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 Holdings, Inc., and its affiliates. 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 gencral, 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, freestanding emergency care facilities, diagnostic centers and rehabilitation facilities. Our psychiatric hospitals provide a full range of mental health care services through inpatient, partial hospitalization and outpatient seg Our common stock is 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. 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 SECs 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 Intemet site at http://www.sec.goy 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 For 10-0. 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 Table of Contents We receive payments for patient services from the federal goverment under the Medi o gram, state governments under theit respective Medicaid or similar programs, managed care plans (includes plans offered through the health insurance wachanges, beginning in 2014), private insurers and directly from patients. Our revenues from third-party payers and the uninsured for the years ended December 31, 2014, 2013 and 2012 are summarized in the following table (dollars in millions): 2013 Rata 25.196 Medicare Managed Medicare Medicaid Managed Medicaid Managed care and other insurers Interational (managed care and other insurers) 8.9 43 2014 8.354 3.614 1.848 1,923 20.066 1.311 37.116 1,494 1.477 40.087 (3.169) $36,918 Faded December 31 Rate $7.951 23.395 3.279 9.6 1.480 1,570 4,6 18,654 54.6 1.175 3.4 34,109 99.8 2,677 78 1.254 38,040 1113 6,858) (113) $34.182 100.0% 2012 $ 8,292 2.954 1,464 1.504 17.998 1.060 33,272 2.580 931 36,783 3.770) 33.013 4.4 4.5 54.5 3.2 100.7 100.6 78 Uninsured Other Revenues before provision for doubtful accounts Provision for doubtful accounts Revenues 108.6 (8.6) 1113 (113) 100.096 100.0% 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 eligible to participate in 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 plan including plans offered through the American Health Benefit Exchanges (Exchanges). These discount programs genera 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 consumance continues to increase. Collection of amounts due from individuals is typically more difficult than from go uninsured patients who do not qualify for Medicaid or charity care under our charity care policy. In implementing the uninsured 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 quality for these programs, the uninsured discount is applied Medicare In addition to the reimbursement reductions and adjustments discussed below, the Budget Control Act of 2011 (the "BCA) requires automatic spending reductions to reduce the federal deficit, including Medicare spending reductions of up to 256 per fiscal year with a uniform percentage reduction across all Medicare programs. These automatic spending reductions began on March 1, 2013, with CMS imposing a reduction on Medicare claims beginning on April 1, 2013. These reductions have been extended through 2024 Table of Contents achieve industry-leading performance in clinical and satisfaction measures: recruit and employ physicians to meet the need for high quality health 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. At December 31, 2014, we owned and operated 162 general, acute care hospitals with 42,860 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 goveming board, made up of members of the local 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 intems and residents and other education programs. At December 31, 2014, we operated three psychiatric hospitals with 396 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 ("ASC"), 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 member 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, govermental reimbursement assistance, construction planning and coordination, information technology systems and solutions, legal counsel, human resources services and intemal 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 nites for inpatient services vary significantly depending on the type of payer, the type of service (0.8, 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. 4/225 PARTI Item 1. Business General HCA Holdings, Inc. is one of the leading health care services companies in the United States. At December 31, 2014, we operated 166 hospitals, comprised of 162 general, acute care hospitals, three psychiatric hospitals, and one rehabilitation hospital. In addition, we operated 113 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 Holdings, Inc., and its affiliates. 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 gencral, 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, freestanding emergency care facilities, diagnostic centers and rehabilitation facilities. Our psychiatric hospitals provide a full range of mental health care services through inpatient, partial hospitalization and outpatient seg Our common stock is 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. 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 SECs 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 Intemet site at http://www.sec.goy 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 For 10-0. 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

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