HCA Healthcare
HCA Healthcare, Inc. is an American for-profit operator of health care facilities that was founded in 1968. It is based in Nashville, Tennessee, and, as of May 2020, owned and operated 186 hospitals and approximately 2,000 sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics in 21 states and the United Kingdom.[6] As of 2023, HCA Healthcare is ranked #66 on the Fortune 500 rankings of the largest United States corporations by total revenue.[7]
Formerly
HCA Holdings, Inc.
1968
Nashville, Tennessee, U.S.
186 hospitals, approximately 2,000 sites of care located in 21 states and the United Kingdom[1]
United States and the United Kingdom
US$60.23 billion (2022)[3]
US$3.759 billion (2020)[4]
235,000 (2021)[5]
The company engaged in illegal accounting and other crimes in the 1990s that resulted in the payment of more than $2 billion in federal fines and other penalties, and the dismissal of the CEO Rick Scott by the board of directors.[8]
Facilities[edit]
United States[edit]
As of 2020, HCA reports it operates 185 hospitals and more than 2,000 sites of care, including surgery centers, freestanding ERs, urgent care centers, and physician clinics located in 21 U.S. states and in the United Kingdom.[31] A significant portion of those hospitals are situated in Florida and Texas. As of 2022, HCA had 47 hospitals and 31 surgery centers in Florida,[32] and 45 hospitals and 632 affiliated sites of care in Texas.[33] In 2021, it announced plans to build 3 new hospitals in Florida.[34] In 2022, the Dallas News reported that HCA will build 5 new hospitals in Texas. They also have a strong presence in Tennessee, where it began. HCA had 13 hospitals there as of 2019.[35]
Between 2003 and 2017, HCA did not enter any new markets. However, in July 2007, HCA sold its hospitals in Switzerland.[36]
In 2017, HCA acquired the Memorial University Medical Center in Savannah, Georgia.[37] That same year, they acquired three Houston, Texas, hospitals from Tenet Healthcare.[38]
In 2019 they purchased Mission Health System which operates hospitals in North Carolina.[39]
In January 2020, HCA Healthcare acquired Valify, a healthcare cost-management company.[40][41] In May 2020, HCA acquired 49-bed Shands Starke (Fla.) Regional Medical Center and 25-bed Shands Live Oak (Fla.) Regional Medical Center from CHS. HCA is operating the two facilities as off-campus emergency departments of Lake City (Fla.) Medical Center and North Florida Regional Medical Center in Gainesville.[42] Later that year, it signed an agreement to sell Garden Park Medical Center to Singing River Health System.[43]
In 2021, HCA sold Redmond Regional Medical Center to AdventHealth for $635M,[44] and four other Georgia hospitals to Piedmont Healthcare for $950 million.[45] They also announced the acquisition of Meadows Regional Medical Center.[46]
It opened urgent care walk-in centres at London Bridge Hospital and the Portland Hospital in March 2018. It claims that patients, on average, wait just seven minutes to see a nurse and 17 minutes to see a doctor.[48] In February 2022,[49] outsourced cleaning staff at London Bridge Hospital reported a lack of PPE, no access to sick pay, a lack of training and no prior warning about which rooms may be contaminated with the virus through the COVID-19 pandemic.
The Princess Grace Hospital specializes in breast cancer and surgery, aided by Kefah Mokbel and Nick Perry who, in 2005, founded The London Breast Institute.
The company intends to open The Harborne Hospital, a new-built private hospital located close to the Queen Elizabeth Hospital, Birmingham, in January 2024.[50]
Significant areas of operation[edit]
Medical education[edit]
In recent years, HCA Healthcare has become a significant provider of clinical and medical education. It is the largest sponsor of graduate medical education programs in the U.S., with 56 teaching hospitals in 14 states, primarily in regions with a deficit of physician training programs. The company includes Research College of Nursing and Mercy School of Nursing, and has several advanced nursing simulation training centers.[51] In early 2020, it completed the purchase of a majority stake in Galen College of Nursing,[52] which operates five campuses and offers Bachelor of Science and Associate of Science nursing degrees.[53]
Controversies[edit]
Medicare billing practices lawsuit[edit]
In 1993, lawsuits were filed against HCA by former employees who alleged that the company had engaged in questionable Medicare billing practices.[8] In 1997, with a federal investigation by the FBI, the IRS and the Department of Health and Human Services in its early stages, the Columbia/HCA board of directors forced Rick Scott to resign as chairman and CEO amid growing evidence that the company "had kept two sets of books, one to show the government and one with actual expenses listed."[8] Thomas Frist, a co-founder of HCA and brother of U.S. Senator Bill Frist, returned to the company as CEO in 1997[8] and called on longtime friend and colleague Jack O. Bovender, Jr. to help him turn the company around.[54]
The federal probe culminated in 2003 with "the government receiving a total of over $2 billion in criminal fines and civil penalties for systematically defrauding federal health care programs."[55] Columbia/HCA pleaded guilty to 14 felonies and admitted to systematically overcharging the government. The federal probe has been referred to as the longest and costliest investigation for health-care fraud in U.S. history.[54]
2005 insider trading suit[edit]
In July 2005, U.S. Senator Bill Frist sold all of his HCA shares, which were held in a blind trust, two weeks before disappointing earnings sent the stock on a 9-point plunge. At the time, Frist was considering a run for president and said that he had sold his shares to avoid the appearance of a conflict of interest.[56] When the company disclosed that other executives had also sold their shares during that same time, shareholders alleged that the company had made false claims about its profits to drive up the price, which then fell when the company reported disappointing financial results. Eleven of HCA's senior officers were sued for accounting fraud and insider trading.[57] HCA settled the lawsuit in August 2007, agreeing to pay $20 million to the shareholders but admitting no wrongdoing, and no charges were brought.[58]
COVID-19 PPE[edit]
During the COVID-19 pandemic in the United States, HCA hospital nurses and other workers spoke out about the lack of PPE.[59] In April 2020,[60] there was an outcry against HCA following the deaths of two nurses Celia Yap-Banago and Rosa Luna who worked at HCA hospitals in Kansas City and California and had contracted coronavirus, despite the alarm having been raised about the lack of PPE at work.[61]
Mission Hospital Acquisition Complaints[edit]
On December 14, 2023, the North Carolina Attorney General sued HCA for violating the terms of an agreement that allowed HCA to purchase Mission Health. [62][63][64]
On February 13, 2024, HCA Healthcare denied the allegations and asked a judge to dismiss the lawsuit by the Attorney General.[65][66][67] And in return the hospital network filed a counterclaim against the Attorney General.[66]
