Annual

Impact
Report

March 2022
Due to increased travel precautions and our
ongoing commitment to protecting patients
and colleagues throughout the pandemic,
several of the individuals pictured throughout
this report are from our MidAmerica Division.

It is important to note that our collective

impact reflects the hard work of all of our
283,000+ dedicated and compassionate
Vanessa McAnally, APRN, FNP-C,
colleagues throughout the U.S. and U.K.
Nurse Practitioner, CareNow State Line Road
We show up.
“We show up” isn’t just something we say, it’s something we do
each day, no matter the circumstance. The past two years have
delivered immense challenges for our nation — especially for the
healthcare industry and frontline caregivers. However, through it
all, we have grown stronger and discovered new and innovative
ways to uplift our mission.

This annual Impact Report recognizes the teamwork, sacrifices,

and commitment of our physicians, nurses, and colleagues;
the many ways we show up for our patients and communities;
and the innovative work we’re doing to advance the practice of
medicine for years to come.

In 2021, HCA Healthcare colleagues demonstrated incredible

compassion and resilience while continuing to respond to the
ever-changing pandemic. We’re proud to have accelerated
COVID-19 research while treating more COVID-19 inpatients than
any other health system in the country. We remained committed
to advancing patient care and scaling innovations; supporting
our colleagues and their families with expanded benefits and
programs; making progress on our diversity, equity, and inclusion
initiatives; practicing environmental stewardship; and discovering
new ways to improve more lives in more ways.

We’re also proud to present our 2022 nursing strategy, which

focuses on advocacy and leadership, staffing and care team
support, education and academic partnerships, and professional
practice. Nurses are the cornerstone of patient care, and
HCA Healthcare is committed to investing in and advancing
nurses while addressing staffing challenges.

I am confident that the results presented and stories shared

will demonstrate how our integrated HCA Healthcare network
creates more resources, more solutions, and more possibilities
for everyone who walks through our doors.

Samuel N. Hazen
Chief Executive Officer

HCA Healthcare Annual Impact Report | 3

Contents

10 24 44
Dedication to Innovations for Investing in and
our patients care and research advancing clinicians
We are committed to delivering As a learning health system, HCA Healthcare educational programs
exceptional care to every patient. research and innovation are at the and partnerships help ensure a strong
Our millions of patient encounters forefront of how we seek to raise pipeline of nurses and physicians.
allow us to develop and share best the bar for healthcare everywhere. We’re also committed to listening to
practices to improve patient care our clinicians and providing the tools
and save lives. they need.

19 31 57
Protecting Supporting our Caring for our
our patients colleagues communities
We remain focused on protecting We offer a variety of programs and Whether through volunteering our
our patients in our facilities by benefits to support our colleagues, time, making charitable donations or
supporting safety initiatives and whether they decide to transition partnering with other organizations,
sharing best practices across our into a leadership role or pursue a at HCA Healthcare, we are committed
sites of care. new degree. to creating healthier tomorrows for
our communities.

4 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 5
 Our integrated HCA Healthcare's

network of care 182

hospitals

are supported by more than

2,300 ambulatory sites of
care, including:

238
urgent care clinics

123
freestanding
emergency rooms

1,480
physician practices
*Hospital locations as of Dec. 31, 2021

In this year’s annual Impact Report, we

Economic impact in 2021 services
102
reflect on the past year and the positive behavioral
impact we create for all we are privileged to our communities by the numbers health programs
serve and with whom we collaborate. Our
impact is made possible by our incredible
colleagues, communities and strategic
partners who embrace HCA Healthcare’s $26.7B+ 35M+ ~1M 82
mission and values. Every day, we seek to in payroll patient encounters telehealth encounters home health and
raise the bar higher, not just for ourselves, and benefits hospice agencies
but for healthcare everywhere.

$5.5B 217K+ 8.4M+ 125

federal, state and local babies delivered emergency
taxes incurred in 2021 room visits surgery centers

$3.5B+ 160K+
*As of Dec. 31, 2021

in capital COVID-19
6 | HCA Healthcare Annual Impact Report investment inpatients treated
Our affiliated lines
of business

HealthTrust is a healthcare Galen College of Nursing joined

performance improvement company HCA Healthcare in 2020, bringing
committed to strengthening provider together two leading nursing
outcomes and clinical excellence organizations and creating the country’s
by leveraging scale, innovation and largest academic practice partnership.
operator expertise. Since 1999, This partnership has increased access
HealthTrust has been the supply chain to education and provided nursing
engine supporting the career development opportunities
HCA Healthcare enterprise. that we believe will positively impact
patient care. Through this partnership,
we launched three new nursing school
locations in 2021.

Parallon, one of the largest premier

revenue cycle partners in the country, Healthcare at Home
serves hundreds of hospitals and Hospice & Family Care
thousands of physician practices by
providing deep operational knowledge, Brookdale Health Care Services joined
industry expertise and proven revenue HCA Healthcare in July 2021, when
cycle solutions. we completed the purchase of a
majority stake in the company from
Brookdale Senior Living, Inc. This joint
venture expands HCA Healthcare’s
ability to serve patients beyond our
network of hospitals, surgery centers
Sarah Cannon, the Cancer Institute and freestanding ERs, and creates
of HCA Healthcare, offers integrated seamless transitions to post-acute care
cancer treatments with convenient – specifically home health, hospice and
access to cutting-edge therapies for outpatient therapy services.
those facing cancer. Through its services,
Sarah Cannon provides advanced
cancer care close to home for hundreds
of thousands of patients, a number
unmatched by any single cancer center.

Pictured left: Galen College of Nursing

students take part in a clinical simulation
HCA Healthcare Annual Impact Report | 9
Dedication to
our patients
We are committed to delivering exceptional care
to every patient. From our patient encounters,
we develop and share best practices to improve
patient care and save lives.
Quality, Reducing opioid misuse and
improving surgical outcomes
Providing faster stroke care

patient-centered care
Our network of providers uses a proven rapid
HCA Healthcare’s Enhanced Surgical assessment approach to swiftly assess and
Recovery (ESR) program helps improve treat stroke patients.
surgical recovery, patient length of stay
(LOS) and overall complications. The As of December 2021, HCA Healthcare
program focuses on acute care level facilities achieved a median door-to-needle
We strive to deliver superior care to our From treating suspected and positive
interventions which are shown to have the time of 35 minutes for stroke care, which
patients during every interaction. Our COVID-19 cases, we share our learnings
most clinical validation. In 2021, the ESR is 42% faster than the national stroke
approach to ensuring high-quality care is with research institutions to improve
program helped decrease complication rates treatment goal of 60 minutes (American
rooted in our belief of always doing what treatments, outcomes and care.
by 20% compared to those surgeries not Heart Association/American Stroke
is right for our patients. Since the beginning of the pandemic,
using ESR. In addition, ESR has resulted in Association). This performance is recognized
HCA Healthcare has conducted various
the following improvements: by payers and accreditors, who recognize
From our more than 35 million annual COVID-19 related research projects and
numerous HCA Healthcare facilities as
patient encounters, we develop and share worked to spearhead COVID-19 literature
centers of excellence.
best practices across our enterprise that to accelerate the understanding and
help continuously improve patient care, treatment of the coronavirus.
using evidence-based guidance, tools,
measurement, advanced analytics and data As of December 2021, HCA Healthcare has
science to support safe, effective, efficient, nearly 50 clinical publications in print, in
Enhanced Surgical Recovery Awards and
compassionate care. press, under review or in late preparation. (ESR) patient outcomes recognition for
Improving COVID-19 care To learn more about how we’re quality of care
improving COVID-19 care, visit
We continue to support and care for HCAhealthcareImpact.com.
up to a HCA Healthcare’s Continental Division,
patients during the COVID-19 pandemic.
38%
which includes HealthONE, was named to
IBM Watson Health’s 15 Top Health Systems
list for the second consecutive year

In addition, 16 of the best performing

hospitals in the nation are part of
decrease in opioid usage
HCA Healthcare, according to the 2021
compared to those surgeries
Fortune/IBM Watson Health 100 Top
not using ESR
Hospitals list

Five of these hospitals also received the

Everest Award, an additional honor for
those who ranked among the top for current

36%
performance and had the highest rates of
improvement during a five-year period

Newsweek magazine recognized 18

HCA Healthcare facilities as America’s Best
Physical Rehab Centers in 2021
decrease in 30-day
readmissions compared to In February 2021, 14 HCA Healthcare
those surgeries not using ESR hospitals were recognized among the
‘250 Best Hospitals’ by Healthgrades

Shannita Khemraj-Beharry, RDCS, Mission Hospital, an HCA Healthcare

Cardiac Sonographer, Research Medical Center affiliated hospital, was listed as one of the
‘50 Best Hospitals’ by Healthgrades
 Equity of Care Data collection
Our Health Equity Council analyzes
data to address disparities and
"To build a culture of health
equity, we must first ensure
everyone has the basics to be
improve patient outcomes, and
data from our more than 35 million
healthy. And when it comes
HCA Healthcare is committed to providing equitable
access to high-quality care for our patients and fostering annual patient encounters helps to expanding opportunities
a diverse and inclusive workplace for our colleagues. We provide insights to advance health for health, thinking the same
equity nationwide.
have signed a national Equity of Care pledge, through the approach will work universally
American Hospital Association Institute for Diversity and
is like expecting everyone to
Health Equity, to reinforce this commitment. Our Equity of
Cultural competence be able to ride the same bike.
Care program provides compassionate and patient-focused
solutions and resources through the following focus areas: More than 182,000 HCA Healthcare The key is to remember there
colleagues have completed our
equity of care education course,
is no ‘off-the-shelf’ solution.
which was created to advance our It takes time, ingenuity,
colleagues’ cultural competence. patience and compassion to
fully understand their needs
Pastoral and spiritual care and to truly help them heal."
HCA Healthcare maintains a large
network of professionally certified Dean Beasley, Equity of Care Coordinator
and accredited chaplains and at Doctors Hospital of Augusta
qualified pastoral and spiritual
care providers who provide
spiritual care for our patients, their
companions, and colleagues and
the communities we serve.

Language services
Our facilities deliver healthcare
services in more than 170 languages
and dialects.

Access to services
More than 1,000 Equity of Care
Coordinators (ECCs) across the
HCA Healthcare enterprise advance
health equity for patients and their
loved ones by ensuring equitable
access to high-quality healthcare
services for individuals who are deaf
or hard of hearing, are blind or have
low vision, utilize service animals or
are limited English proficient (LEP).

*As of Dec. 31, 2021

14 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 15
 Health
As part of our continued commitment
to providing equitable access to care,
HCA Healthcare formed the Health Equity

Equity
Council in January 2021 to help identify
and address health disparities within and
outside of our hospitals, as well as to

Council
develop strategies that advance health
equity. This cross-functional group of senior
leaders — co-led by our chief clinical officer
and chief diversity officer — analyzes race,
ethnicity and language (REaL) data, sexual
orientation and gender identity (SOGI) data Cynthia Turner, RN Coordinator,
MidAmerica Division Transfer Center
and other socio-demographic characteristics
to address disparities and improve patient
quality, safety and satisfaction outcomes
for diverse populations.

Financial
The findings from our annual equitable
In 2021, HCA Healthcare
outcomes analysis have been used to
contributed an estimated
shape the focus of initiatives undertaken
$3.3B+ for the delivery

support
by the council, including partnerships with
of charity care, uninsured
community organizations and industry
discounts and other
partners to address specific opportunities
uncompensated care.
related to cardiovascular health, cancer
screenings and navigation services, and
maternal health for communities of color.
To support the goal of monitoring and At HCA Healthcare, we work to ease the Through our Patient Benefit
reporting health equity data on a regular stress that the healthcare insurance and Advisor hotline, which
cadence, a health equity dashboard has billing process can bring. Serving both operated from the beginning
been developed to provide insight into uninsured and underinsured patients, of the pandemic through
potential disparities in care outcomes HCA Healthcare applies a sliding scale March 2021, we assisted
on a quarterly basis. discount on patient amounts due based nearly 11,000 patients who
on federal poverty guidelines (FPG) experienced unemployment
For more information, visit and household income. We provide one and/or loss of health
HCAhealthcareImpact.com. of the most generous patient financial insurance during the
assistance programs in the country. height of the pandemic.
Our programs and resources include
pricing information, financial counseling,
patient-friendly billing practices and
financial assistance programs for
uninsured and underinsured patients.

16 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 17
 Protecting
our patients
“The great hospitals will always put the
patient and the patient’s family first, and
the really great institutions will provide
care with warmth, compassion and dignity
for the individual.”

Dr. Thomas Frist Sr.

HCA Healthcare co-founder

Angela Simms, MSPT, Physical Therapist,

Research Medical Center
18 | HCA Healthcare Annual Impact Report
 COVID-19
160K+
response COVID-19 inpatients
treated in 2021

HCA Healthcare continues to respond to the

Safety
1.2B+
ongoing COVID-19 pandemic, treating more

protocols
than 160,000 COVID-19 inpatients in 2021
and over 271,000 total from February 2020
to December 2021 — more than any other total items of PPE
health system in the country. Throughout the distributed in 2021
pandemic, we have remained committed to
the safety of everyone within our facilities by We remain focused on the safety of our
implementing precautionary measures such and coordination of these was centrally patients in our facilities by supporting
as masking policies, screening processes, organized through the EEOC’s Emergency safety initiatives and sharing best
social distancing guidelines and modified Medical Services Operations practices across our facilities. We engineer
visitor policies as needed. We continue Center (EMSOC), located in Nashville, safety into our system by design, and
to follow the guidance of the Centers for Tennessee. Overall, nearly 1,000 patients our Patient Safety and Care Experience
Disease Control and Prevention (CDC), were safely discharged or transferred to teams are responsible for managing
professional society recommendations and help create immediate bed capacity our federally-chartered Patient Safety
state-based executive orders. for patients. organization. They oversee Event
Reporting, Patient Experience, Barcode
When the Delta variant resulted in a surge The EEOC also partnered with HealthTrust Medication Administration and Medication
of COVID-19 cases in Florida, and vendors to monitor oxygen levels and Diversion Prevention, among other
HCA Healthcare’s Enterprise Emergency supply across our markets in real time. This programs. They are also responsible for
Operations Center (EEOC) was tasked helped HCA Healthcare maintain safe levels our clinical pharmacy surveillance software,
with supporting the National Group Clinical of oxygen supply at all of our facilities implemented to prevent life-threatening
Operations team in the decompression of when the country was facing a shortage medication errors, improve patient
our hospitals throughout the state. Our of oxygen. outcomes and reduce drug waste.
Enterprise Preparedness and Emergency
Operations (EPEO) Medical Transport Access to personal protective equipment
Division facilitated contracting additional (PPE) continues to be vital for the safety of
EMS and medical transport companies to our colleagues and patients. To diversify our
safely transfer patients as needed. Dispatch supply chain and expand access to PPE,
HCA Healthcare announced Top (left to right): Former Senior Vice President and
Chief Nurse Executive Jane Englebright, Ph.D. and
a joint venture business
Since the start of the with A Plus International
HCA Healthcare colleague Angela Novak

pandemic, HCA Healthcare Inc. to manufacture Middle (left to right): Ian Green, PCT; Kristi Colgan,
has treated more COVID-19 procedural and surgical Speech-Language Pathologist; and Amneet Kaur,
masks in Asheville, North Occupational Therapist, Overland Park Regional
inpatients than any other
Carolina. In addition, Medical Center
health system in the U.S. HCA Healthcare continues Bottom: Surgical Technologist AJ Eisenhart (pictured
to work with partners and left) and Operating Room Supervisor Jill Criner
suppliers to ensure we meet the demand for (pictured right) help prepare a colleague's surgical gown
at Overland Park Regional Medical Center
PPE. Overall, we distributed more than 1.2
billion items of PPE in 2021.

20 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 21
Jeffrey Fletcher, Lead RN
MidAmerica Division Transfer Center

Data protection
Caring for our patients is not limited Through our Code of Conduct and policies
to clinical care and patient safety, but and procedures, HCA Healthcare requires
also includes maintaining their privacy. its workforce members, affiliated covered
Each year, all HCA Healthcare colleagues entities and business associates to subscribe
complete training that covers privacy, to appropriate privacy practices. We reinforce
information security, physical security this message through various educational
and more. and training sessions and the routine
dissemination of regulatory information
The main goal of the Privacy Program is and supplemental guidance to assist in
to ensure our patients’ health information maintaining compliance with patient privacy.
and privacy rights are properly protected.

Ethical Awards and recognition for

patient experience and safety

business In early 2022,

In 2021, 18 HCA Healthcare facilities received

practices
Press Ganey Pinnacle of Excellence or
HCA Healthcare was 100%
Guardian of Excellence awards for patient
recognized for the 12th
experience. The Pinnacle of Excellence
time by Ethisphere, a 84%
Award is presented to Press Ganey
global leader in defining 80%
clients that have maintained high levels of
and advancing the
excellence for three years in one of four
We strive to ensure our actions reflect our mission and standards of ethical
categories: patient experience, employee
dedication to creating healthier tomorrows for our business practices, as 60%
engagement, physician engagement or 58%
patients and communities. Each year, HCA Healthcare one of the World’s Most
clinical quality performance. Clients that
colleagues complete an annual code of conduct training, Ethical Companies.
receive the Guardian of Excellence Award 40%
which details company expectations related to ethics,
have achieved the 95th percentile for one
compliance, security and more. In addition, our Ethics
of those same categories.
Line is available 24/7 for colleague questions and 20%
reporting and addresses 100% of calls received. The Ethics
In its fall 2021 Hospital Safety Grades,
Line allows colleagues to report ethics or compliance
The Leapfrog Group recognized 84% of
concerns without fear of retaliation, while resolving cases
HCA Healthcare hospitals with an U.S. HCA Healthcare
expeditiously and recommending corrective action.
A or B rating, as compared to 58% of hospitals hospitals
hospitals nationally.

22 | HCA Healthcare Annual Impact Report

Innovations
for care and
research
As a learning health system, research
and innovation are at the forefront
of how we seek to raise the bar for
healthcare everywhere.

Elizabeth Catapang, ASCP, Microbiology

Medical Technologist, Research Medical Center
 Care
Setting new Transformation
standards of care and Innovation
through research Since our founding, HCA Healthcare has prioritized and
embraced innovation to constantly address the needs

and innovation
of those we serve and to support our clinicians. In 2021,
we launched a new strategic pillar dedicated to Care
Transformation and Innovation (CT&I). Through the
clinically led integration of technology into care delivery,
CT&I aims to accelerate the organization into the future
of healthcare through bold innovations that address
current and anticipated challenges facing caregivers.
HCA Healthcare utilizes findings from Accelerating COVID-19 research
our more than 35 million annual patient
At the onset of the pandemic, CT&I will integrate innovative ideas from frontline
encounters to identify opportunities to Above: Kasey Kelm, Technical Analyst,
HCA Healthcare, with support from HRI, MidAmerica Division
clinicians and work with colleagues to test, measure and
improve clinical care and support our more
Sarah Cannon Research Institute and its scale solutions. Currently, CT&I is prioritizing changes
than 93,000 nurses and 45,000 active and
precision medicine platform, Genospace, to mitigate frontline burnout, enhance employee well-
affiliated physicians.
created a COVID-19 patient registry to being and deliver high-quality care to our patients and
capture and analyze data from treating communities. This work is supported by a variety of
Through partnerships with GE, Google and
COVID-19 patients. A research study published experts across clinical care, engineering and technology
other leading technology companies,

271K+
in the Journal of Clinical Investigation in groups. Labor and Delivery has been selected as CT&I’s
HCA Healthcare is advancing care delivery
2021 analyzed data from COVID-19 patients first innovative focus area.
within and outside of our hospitals. The
to assess the effectiveness of convalescent
HCA Healthcare Research Institute (HRI)
plasma treatment. To learn more about current and future CT&I initiatives,
is our multispecialty clinical research arm
patients treated by visit HCAhealthcareImpact.com.
focused on advancing therapies for patients
In January 2021, we formed a consortium HCA Healthcare for COVID-19
through our affiliated network of providers
of prominent public and private research from February 2020 to
and care sites. HRI is supported by HCA December 2021, more than
institutions to use our vast data on COVID-19
Healthcare’s oncology research organization, any other health system in
hospital care to improve patient outcomes
Sarah Cannon Research Institute, which the United States.
and public knowledge. The institutions —
focuses on community-based cancer
including the federal Agency for Healthcare
research. Together, we conduct large-
Research and Quality (AHRQ), Johns Hopkins

550+
scale clinical research and collaborate with
University, Duke University, Meharry Medical
institutions including Harvard Pilgrim Health
College, Harvard Pilgrim Health Care Institute
Care Institute and the CDC to unlock insights
and others — have access to the data in a
into real-world data and clinical studies that
research program directed by HRI. As of Dec. first-in-human clinical trials
help lead to scientific breakthroughs and
31, 2021, 12 studies were being conducted or conducted across Sarah
transform patient care.
had been completed using data from more Cannon Research Institute,
than 210,000 patients in the HCA Healthcare 65 of which occurred in 2021.
COVID-19 Registry.

26 | HCA Healthcare Annual Impact Report

 Telehealth
expansion
Throughout our network, our care teams partner with
remote telehealth physicians to deliver around-the-
clock, high-quality care. With more than 1,500 telehealth
programs across our organization, we plan to expand
our footprint in nursing, critical care and
maternal-fetal medicine in 2022.
"Telepsychiatry has provided
advantages for patients by Prior to the pandemic, HCA Healthcare
Hemin Qaradagi, Technical Analyst,
had an average of 3,000 telehealth patient
increasing access to care for those encounters per year. Today, our telehealth
MidAmerica Division

in remote or underserved areas, providers are seeing approximately one

those who need specialty care million patients per year as the numbers
and those in need of culturally have continued to climb.

sensitive care, while decreasing

time and cost of travel."
Telehealth has continued to play an
important role as we care for the mental Google Cloud
partnership
well-being of our patients. In 2021,
Adriana Foster, MD HCA Healthcare emergency rooms
Associate Regional Medical Director experienced a 40% increase in behavioral
Telehealth Provider Plus health cases. Our ER physicians can request
a telehealth consult with one of our
remote psychiatrists to provide important "We are honored to In May 2021, HCA Healthcare and Google Cloud
assessments and help guide the right path announced a multi-year strategic partnership to
of care for our patients. Our telehealth services help
partner with
create a secure and dynamic data analytics platform
connect patients to the right level of care at the most HCA Healthcare on this for HCA Healthcare and enable the development
critical times supporting emergent stroke, neurology unique opportunity to of next generation operational models focused on
and psychiatry cases at more than 175 outreach sites. actionable insights and improved workflows.
be at the forefront of
Our colleagues provide these critical services to
rural, underserved communities to give patients the advancing care through The partnership builds on our innovative use of
specialized care they need and help them avoid lengthy the power of real-time information technology to accelerate the digital
or costly travel to medical appointments. data availability to transformation taking place within our organization
and the healthcare industry. With privacy and security
support clinical and
as guiding principles of our partnership, Google Cloud
operational workflows."
3K 45K 560K does not have any access to patient identifiable data.
average telehealth visits primary care
telehealth Thomas Kurian
in our urgent and specialty
visits per day CEO, Google Cloud
care centers telehealth visits

*As of Dec. 31, 2021

28 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 29
Supporting our
colleagues
HCA Healthcare is proud to offer a variety
of programs and benefits to support our
colleagues, whether they decide to transition
into a leadership role or pursue a new degree.
We’re also committed to strengthening the
diversity of our workforce and investing in the
well-being of our colleagues and their families.

Left to right: Amarachi Uzodimma BSN, RN, NE-BC, Nurse

Manager, Transplant Nephrology; Avery Cunningham, RN,
Staff Nurse, Transplant Nephrology, Research Medical Center
 Investing in our Ken Washington, president
of practice operations for

workforce and
HCA Healthcare’s Physician
Services Group, serves on
HCA Healthcare's Executive

strengthening
DEI Council, the Black
Senior Leadership Council
and he is the executive

the diversity of
sponsor for
HCA Healthcare's
enterprise-wide Black

our leadership
Colleague Network.

"I love the way Better leaders help provide better patient
experiences. HCA Healthcare’s Leadership
HCA Healthcare wraps
Institute advances our vision by building
its arms around new strategic and operational capabilities,
leaders and ensures rapidly deploying best practices and
we are aligned and cultivating leaders who exemplify our values.
Program offerings include the Leadership
equipped for success." Institute Academy for Directors, Leadership
Essentials for Supervisors and Managers,
Leadership Institute and the Nursing Leadership Certificate.
New Leader Signature Series programs, including the
Orientation (NLO) participant Executive Development Program and
Executive Residency Program, focus on
developing high-potential colleagues to help
ensure HCA Healthcare has a robust talent
pipeline of qualified leaders for key roles.

210,200+
hours of training for
over 78,600 participants
delivered by the Leadership
Institute in 2021

32 | HCA Healthcare Annual Impact Report

In 2021, the Leadership Institute delivered In 2020, HCA Healthcare announced
more than 210,200 hours of training for over a variety of diversity, equity and
78,600 participants through both virtual inclusion (DEI) commitments,
and blended offerings. Harvard Spark including the creation of a council
allowed 9,540 colleagues to access more comprised of Black senior leaders
than 211,900 resources on-demand when from across the enterprise to better
and where it was best for them. Our new understand how we can support our
Thrive Forward digital toolkit was developed Black colleagues and communities.
to provide assessments, articles, videos Our Black Senior Leadership Council
and other tools to help leaders and their was established and is led by CEO
teams reduce stress and create healthier Sam Hazen and Chief Diversity
habits for overall well-being. Since its Officer (CDO) Sherri Neal. Based
launch, the Thrive Forward toolkit has been on discussions with this council,
downloaded more than 4,100 times. a sponsorship program will be
launched in early 2022 for a select
HCA Healthcare remains focused on group of Black colleagues to drive
strengthening the diversity of our advancement in leadership. This is
colleagues. In 2021, we hired 35% people of a phased approach that we plan to
color in management and supervision roles, a expand in scope to include a broader
10% increase from the prior year. Executive Development Program
focus on leaders of color and female
Graduating Class of 2021 leaders by the end of 2022.
In addition, we are strengthening the
diversity of our leadership pipeline via several Visit HCAhealthcareImpact.com
executive development programs offered to learn more about our DEI
through the Leadership Institute, including commitments and the progress
the Executive Residency Program. In 2021, we "I learned about biases Launched in early 2020, our conscious we made in 2021.
hired our most diverse Executive Residency inclusion training, developed by our
that I was not aware
Program class yet — 57% people of color and Diversity, Equity and Inclusion and
57% female. Overall, we increased people of of. I appreciate that Leadership & Organizational Development
color and female representation in leadership HCA Healthcare cares teams, equips leaders to recognize and
development programs by 22% in 2021. about this topic and is mitigate different types of unconscious
biases, and prepares them with practical
willing to address and day-to-day skills and resources to engage
encourage inclusion." and support our colleagues. As of Dec. 31,
In 2021, HCA Healthcare hired its most 2021, 78% of our 10,000+ directors and
diverse Executive Residency Program Conscious inclusion above have completed formal conscious
class yet training participant inclusion training. In 2021, all

57 % 57 %
HCA Healthcare colleagues received
education on mitigating bias, a crucial
component of conscious inclusion, as part
Left to right: Suyapa Soto, CST, Surgical Team Member;
of the annual code of conduct training.
Vonika Jack, CST, Surgical Team Member; and Sabrine
People of color Female Semoin, MD, MBA, FACS, General Surgeon,
HCA Florida University Hospital

34 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 35
Education and
development resources
HCA Healthcare is proud to
support the educational goals
$59.2M+
in student loan assistance
of our colleagues and their since 2018
family members through a
variety of programs.

~$40M
Mental wellness
Eligible colleagues can receive $100 (full-time) or in tuition reimbursement
$50 (part-time) per month to help repay student in 2021
loans through our student loan assistance program
(lifetime maximums apply). In 2021, 13,884 colleagues

588
participated in the program. In total, HCA Healthcare
has assisted with more than $59.2 million in student More than ever, healthcare workers are under tremendous pressures to care for their
loan payments (as of Dec. 31, 2021). communities in the midst of greater demands and fewer care providers. We’re here to support
recipients received
our physicians, nurses and other colleagues so they can continue to provide the high-quality,
scholarships through the
Our tuition assistance program provides up to Patricia Frist Memorial patient-centered care our communities deserve. Existing and expanded programs include:
$5,250 in tuition assistance to eligible colleagues Scholarship Program in 2021
each year (lifetime maximums apply). Approximately Nurse Care: This free, confidential, 24/7 Motivation Alliance: HCA Healthcare
$40 million is reimbursed to colleagues annually. support program and counseling service colleagues can access a free custom
gives HCA Healthcare full-time and part- version of this service, which provides
In 2021, the HCA Healthcare Foundation renamed time hospital-based nurses remote access tools for managing stress and anxiety.
the HCA Healthcare Scholars Program to the to licensed psychologists, social workers
Patricia Frist Memorial Scholarship Program and marriage and family therapists. In 2021, Doctor On Demand: Colleagues with an
in honor of the late Patricia Frist, a longtime 24,720 calls were received. eligible HCA Healthcare medical plan can
philanthropist in Nashville, Tennessee, and wife of speak with a board-certified physician any
HCA Healthcare co-founder Dr. Thomas Frist Jr. Optum: This partnership offers colleagues time, day or night, through this telehealth
Through this program, eligible dependents of and members of their immediate household service. Physicians provide care for 90%
HCA Healthcare colleagues can receive merit-based free counseling sessions. Colleagues can of the most common health conditions,
higher education scholarships of up to $5,000 a also access free apps, resources and referral including stress, anxiety and depression.
year. In 2021, 588 recipients received scholarships services to find help with anything from
totaling more than $2 million. home maintenance to legal support.

36 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 37
 HCA Healthcare
Dan Finger, a pharmacist at HCA Healthcare, credits the
HCA Healthcare Hope Fund in helping provide an in-home
chair lift for his 1-year-old granddaughter, Ryllah, who was
born with a rare genetic condition.

Hope Fund Dan Finger’s story

Dan Finger, a pharmacist at
HCA Healthcare, and his wife have custody
The HCA Healthcare Hope Fund is a colleague-run, colleague-supported 501(c)(3)
of their 1-year-old granddaughter, Ryllah.
charity that helps colleagues and their immediate families when faced with financial
Ryllah was born with a rare genetic
hardship due to natural disaster, illness/injury, domestic violence, death of a loved
condition. “It basically affects every aspect
one or other difficult situations.
of her development, including the ability to
walk,” Dan said. Living in a multi-level home,
In 2021, the Hope Fund reached an exciting milestone with more than $75 million in
Dan and his wife had concerns about being
assistance provided to colleagues since its inception in 2005.
able to safely transport Ryllah up and down
the stairs without falling, especially as they
get older and Ryllah continues to grow.
$10.4M+
in assistance distributed in Dan wasn’t sure whether the
2021 to help 4,800+ HCA Healthcare Hope Fund would be able
HCA Healthcare families "Having that chair took to assist in Ryllah’s situation, but decided
to apply. It wasn’t long before Dan received
out all of the anxiety
2,200+ of possibly falling and
notice that his family was approved to
receive help for a chair lift.
HCA Healthcare families hurting ourselves, her
received $3.2 million in “It helped us tremendously,” Dan said.
disaster assistance
or both. It changed
“I was elated, I couldn’t believe it. It allows
things for the better at us to go up and down the stairs while
30,380+ our house." carrying oxygen and carrying her. It is a
big deal.”
colleagues made donations
Dan Finger
to support one another
HCA Healthcare pharmacist With the assistance provided by the Hope
Fund, Dan and his wife are able to continue
$11M providing care for Ryllah, now with more
peace of mind.
donated to the Hope Fund in 2021
$6.8M from colleagues and
other support
$4.2M from HCA Healthcare
matching funds

See how HCA Healthcare colleagues are helping more families in need at
HCAhealthcareImpact.com.

38 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 39
 Vital Voices
Ensuring a positive and inclusive colleague experience starts
by giving each of our more than 283,000 colleagues a chance
to share their thoughts in a confidential format.
HCA Healthcare sends an onboarding pulse survey to
colleagues after 45 and 100 days of employment to receive
feedback on the onboarding and recruitment experience. Vital
Voices engagement pulse surveys are shared throughout the
year to help our teams set goals and make improvements.

Not only does this lead to a better experience for our

colleagues, but also better care for our patients. One example
$50M
is the Investing in Our Colleagues initiative, which includes an additional capital
additional $50 million capital nursing investment that gives our nursing investment from
facilities a portion of funds to enhance patient care as needed. the Investing in Our
This initiative was created because of feedback received from Colleagues initiative
our colleagues through Vital Voices.

Colleague Networks
HCA Healthcare has established enterprise-wide,
virtual networks to give colleagues the chance to meet
Above: Aubree Hosiner, RN; Yvonne Adams, LPN; David Porter, PA; Arian Culp, MD, Med Surg, Research Medical Center and network with peers who have shared experiences and
commonalities. So far, seven Colleague Networks have

An engaged workforce
been created for veterans, Black colleagues, women, young
professionals, LGBTQ+ colleagues, Hispanic/Latinx colleagues,
and Asian and Pacific Islander colleagues (see badges below).
Each network is led by a senior leader who serves as executive
sponsor. In 2022, a new Colleague Network will be launched
supporting colleagues with disabilities and their allies, and
Awards of Distinction spirit and forward thinking of today’s colleagues.
programming will expand to the division level to offer local
The Excellence in Nursing Award recognizes
HCA Healthcare’s annual Awards of Distinction programming and engagement opportunities.
the intrinsic value of nursing in advancing
recognize extraordinary colleagues who
our mission and is given in two categories:
exemplify our culture and values in three
professional mentoring and compassionate
award categories. The Frist Humanitarian
care. Learn more about this year’s Awards of
Award, named in honor of HCA Healthcare
Distinction recipients at
co-founder Dr. Thomas F. Frist Sr., is given to
HCAhealthcareImpact.com. BRAVE Conversations
colleagues who demonstrate commitment
and caring that goes beyond everyday acts Our award-winning BRAVE Conversations program provides
of kindness and who inspire fellow colleagues Colleague Recognition Program colleagues opportunities to discuss complex topics through
with their compassion and dedication. HCA Healthcare expanded its Colleague a safe, immersive dialogue experience. In total, nearly 4,000
These award recipients are examples of Recognition Program to all colleagues in fall colleagues joined our BRAVE conversations in 2021, increasing
the volunteer spirit of all HCA Healthcare 2021. Through the program website, colleagues our attendance from 2020 by 40%. Topics included celebrating
colleagues and the humanitarian principles of can give and receive recognition while earning Asian and Pacific Islander voices, advocating for health equity
our organization’s founders. The Innovators points that can be redeemed for rewards of within the LGBTQ+ community, building bridges with
Award honors our organization’s legacy of their choice. In 2021, there were close to one the deaf and hard-of-hearing community, and honoring
innovation by recognizing the entrepreneurial million recognition touchpoints with colleagues. our veterans.

40 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 41
 Awards and offered a pandemic pay program (70% base pay for Below: The late HCA Healthcare

recognition
those whose hours were reduced). colleague Avery King

~$99M
Quarantine Pay Program total
"My managers and Military awards spend between 2020 and 2021 for
supervisors are very HCA Healthcare has a longstanding connection to the approximately 65K unique recipients
U.S. armed forces, military veterans and their families.
understanding and Since 2012, we have hired more than 40,000 veterans,
effectively support my active-duty personnel and military spouses. Best Employers for Women 2021
military obligations … In 2021, the Military Times named HCA Healthcare
For the second consecutive year, HCA Healthcare
affiliate Parallon was named as one of the country’s
My journey has been a one of the country’s best employers for military- Best Employers for Women by Forbes and Statista, Inc.
complicated one from connected employment programs, benefits For this annual ranking, 50,000 Americans working for
and support.
the start, but I could businesses that employ more than 1,000 people were Supporting veterans’
surveyed about development opportunities, working
always count on them HCA Healthcare has been nationally recognized as organizations
conditions and arrangements, parental leave, family
a military-friendly employer and military-spouse In November 2021,
for anything I needed." friendly employer for 11 consecutive years by VIQTORY.
support and more. Representation at the executive and
HCA Healthcare donated a total of
board levels and initiatives to improve gender equality
were also considered. $150,000 to local veteran support
Karina Banaduc, Army Reserve Sgt. In addition, Employer Support of the Guard and organizations. The donations
and Med-Surg Unit Nurse at
Reserve (ESGR), a Department of Defense program, Parallon is a leading provider of revenue cycle were made in honor of the late
Grand Strand Medical Center
presented HCA Healthcare and affiliate hospital Grand management services, and women make up 88% of its HCA Healthcare colleague and Air
Strand Medical Center in Myrtle Beach, South Carolina, workforce and 74% of its collective leadership team. Force veteran Avery King, who
with a Secretary of Defense Employer Support was instrumental in the creation
Freedom Award. This award was given in recognition of of our Military Affairs Program.
exemplary support for our National Guard and Reserve
2021 LinkedIn Talent Awards Contributions were made to the
colleagues. Karina Banaduc, an Army Reserve Sgt. and HCA Healthcare was named a Diversity Champion at the following organizations:
med-surg unit nurse at Grand Strand Medical Center, 2021 LinkedIn Talent Awards. This recognition is given to
nominated our organization for support she received companies that have initiated and inspired meaningful REBOOT Recovery
while deployed as a combat medic assisting with conversations around diversity, inclusion and equity. A Soldier’s Child
COVID-19 efforts in Newark, New Jersey. Operation Stand Down Tennessee
2021 Human Rights Campaign MTSU Charlie and Hazel Daniels
2021 LinkedIn Top Companies
Corporate Equality Index Veterans and Military Family Center
HCA Healthcare was recognized by LinkedIn as one of
HCA Healthcare achieved a 2021 Human Rights
the 50 best U.S. workplaces for professionals to grow
Campaign Corporate Equality Index score of 85/100,
their careers. This annual list highlights organizations
that invest in employee success, career development,
an increase of 15 points from the previous year. This $150,000
index rates corporations on LGBTQ+ workplace
and equity and inclusion. LinkedIn cited our donated to local
equality based on four criteria: workforce protections,
veteran support
commitment to frontline healthcare workers during inclusive benefits, supporting an inclusive culture
organizations
the COVID-19 pandemic, noting that we had no and corporate social responsibility, and responsible
layoffs as a result of the pandemic, provided 100% citizenship. HCA Healthcare continues to work to
base pay to those who needed to quarantine, and provide an inclusive environment for all colleagues.

42 | HCA Healthcare Annual Impact Report

Investing in
and advancing
clinicians
We believe excellent people make excellence
happen, and we offer a variety of educational
programs and partnerships to ensure a strong
pipeline of nurses and physicians to our
facilities. We’re also committed to listening to
our clinicians and providing the tools they need.

Brandy Tuttle, BSN, RN Charge Nurse, Outpatient Oncology,

Sarah Cannon Cancer Center at Research Medical Center
 Nursing at
HCA Healthcare
Flip the page to
view our 2022
nursing strategy

Nurses have an unwavering commitment to

caring for their patients and supporting each
other. While the COVID-19 pandemic showed
the world how vital our frontline colleagues are,
it re-emphasized another industry-wide issue
?— nursing staffing challenges — that was a

93,000+ concern before the pandemic. In its State of the

World’s Nursing 2020 report, the World Health
registered nurses Organization estimated a global shortage of
5.9 million nurses.

20+ For the past several years, HCA Healthcare’s

strategic vision for nursing was focused
physical nursing academic on investing in nursing through four key
and simulation centers pillars: advocacy and leadership, increasing
performance visibility, consistency in nursing
practice and operations and leveraging scale
to drive performance. In 2022, we are refining
our nursing strategy approach by building on
previous strategic pillars and focusing more
on innovative ways to solve nursing staffing
challenges and enabling nurses to practice at
the top of their license.

Our 2022 nursing strategy was developed

by listening to nurses at all levels of our
organization and will be guided by these four
pillars: advocacy and leadership, staffing and
care team support, education and academic
partnerships, and professional practice. This
emphasis on listening to our colleagues will
continue through dedicated nurse workgroups.

46 | HCA Healthcare Annual Impact Report

2022 nursing
strategy pillars Staff ng and Care Team Support
Create innovative and effective care
delivery models to support care teams
and meet patient needs by:
• Optimizing technology
• Diversifying and optimizing the workforce
• Enhancing nursing communication
• Improving nursing workload and patient safety
Advocacy and Leadership
Develop extraordinary leaders at
every level and provide unparalleled
opportunities for a career for a
lifetime by:
Education and Academic Partnerships
• Recruiting and retaining Access to industry-leading education and career
the workforce development opportunities to positively impact
• Developing nursing patient care by:
leadership
• Gaining nursing market share
• Strengthening new nurse competency
• Expanding access to Centers for
Clinical Advancement

Professional Practice
Ensure ownership of evidence-based
practice to elevate nursing excellence by:
• Improving nurse sensitive
quality indicators

Vickie Estrada, BSN, RN, Staff Nurse Transplant

Nephrology, Research Medical Center
 Below (left to right): Research College of Nursing students (2022)
Angie Lopez Rodriguez, BSN; Ebele Egbuniwe, BSN; Ellan Harder, BSN

Education
opportunities "When I went into my
unit, I was met with a
Galen College of Nursing
team of nurses that was
HCA Healthcare is the majority owner of Galen
College of Nursing, one of the country’s largest just so eager to help me
private nursing colleges. This partnership provides grow as a person, as a
our nursing colleagues with access to more
education and career development opportunities.
nurse and as a leader.
We continue to expand access to quality nursing You go from learning
education by opening new campuses around
something online to
the country.
doing it in simulation
In November, Galen and Fisk University, a lab and then having to
Historically Black University, announced an
articulation agreement that allows Fisk degree perform it on the floor."
coursework credits to transfer to Galen so
students can go directly into Galen’s BSN program. Janie Holmes, MSN, RN, CPN
Students can complete the BSN program in as Nurse Residency Cohort Graduate
little as two years. This will help Fisk students Manager of Pediatric ICU
obtain degrees that can lead to advancement and TriStar Centennial Medical Center
growth, drive diversity in the nursing field, and in
turn make a meaningful impact on the quality of
healthcare in the communities we serve.

HCA Healthcare’s HCA Healthcare invests approximately

tuition assistance
$40 million per year in the tuition Nurse Residency + Centers for Clinical
program includes the
HCA Healthcare-Galen assistance program, which has helped StaRN programs Advancement
College of Nursing about 5,000 colleagues graduate. More Our year-long Nurse Residency Program HCA Healthcare currently has 11 Centers
Grant, which allows includes more than 500 hours of clinical for Clinical Advancement, including a
than 70% of degrees have been in the
direct billing between education both in the classroom and at co-location with Galen College of Nursing.
our two organizations. nursing field. the bedside. Graduate nurses work with a These simulation learning centers across
That means zero out- community of experienced nurses and their the country give our nurses the opportunity
of-pocket tuition costs for colleagues pursuing fellow residents to better prepare for their to continue their clinical education with
an online RN to BSN. Galen offers other unique nursing career. lifelike simulation equipment so they can
programs — both online and at campuses across feel confident and knowledgeable in a
the country — to HCA Healthcare colleagues. Our StaRN (Specialty Training Apprenticeship variety of patient care situations.
for Registered Nurses) Program provides
intensive training for our nursing students.

48 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 49
 Advancing
care through
technology
HCA Healthcare provides technologies to our
care teams to promote the best outcomes for
our patients and improve efficiencies for our
nurses. HCA Healthcare was recognized as a 2021
CIO 100 award winner for Collaborative Nursing
Technology. These awards honor organizations
that are using information technology in
innovative ways.

Our Information Technology Group (ITG)

and Clinical Operations Group (COG) hosted a
Coding for Caregivers event in the spring. Nurses
were asked to submit ideas for improving work
efficiencies at the patient bedside. After more than
5,000 ideas were received, nearly 600 participants
worked together in 29 teams to create solutions,
some of which are currently under development
for our nurses.

The HCA Inspire app, pictured right, allows our

nurses to connect with peers and mentors, grow
professionally, access their schedules and more.

Through iMobile, a secure text messaging system,

our nurses can easily communicate and share
information with other members of the care team,
receive updates on patient status and be alerted
when a patient needs them.

Our Care Team Assignment (CTA) application

serves as the single source for a patient’s care
team information and allows other tools like Sepsis
Prevention and Optimization of Therapy (SPOT) to
identify a patient’s caregiver at any given time. CTA
Bottom right: Valerie Wilen, CRNA, Overland Park Regional Medical Center data also provides insight into staffing acuities for
our inpatient nursing units. At the close of 2021,
91 sites were live across our system.
50 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 51
 Ernesto’s story
The pandemic has been a difficult and
emotional journey, but one that Ernesto
Carnota, director of critical care at
HCA Florida JFK Hospital in West Palm
Beach, Florida, believes has brought new "The whole world got
attention to the nursing profession.
We had to keep going the opportunity to see
“The whole world got the opportunity to In the early days of the pandemic “there what nurses do and how
see what nurses do and how important was an incredible amount of feeling
nurses are,” Ernesto said. “As a profession,
important nurses are.
helpless,” Ernesto recalled. “[But] we
we were challenged in every single aspect couldn’t stop. We had to keep going.” As a profession, we were
where we could be challenged. The Ernesto and his fellow HCA Healthcare challenged in every single
amount of resilience and compassion that nurses navigated the unknown in the
I experienced from my nursing colleagues face of many fears, adapting and drawing aspect where we could be
was something that I never thought I strength from their colleagues. challenged. The amount of
would experience.”
Expanded benefits put into place early on
resilience and compassion
Ernesto decided to become a nurse after helped — pandemic pay for nurses unable that I experienced from
his mother was hospitalized for nearly a to work because of COVID-19, employee
month, drawn to what he calls a career of
my nursing colleagues was
assistance programs to support physical
service. “Nurses have the opportunity to be and emotional well-being, and regular something that I never
present during the gift of life (when babies check-ins. Ernesto recalls leaders at thought I would experience."
are born), and we also have the opportunity HCA Florida JFK Hospital putting in equally
to be there for the last minutes of a long days, and CEOs donning scrubs to
Ernesto Carnota, BSN-RN, CCRN
person’s life. We’re the only profession work alongside nurses.
Director of Critical Care
that can cover the entire lifespan.”
HCA Florida JFK Hospital
“I couldn’t be more proud of being a part
of this profession and a part of this
amazing team of HCA Healthcare nurses,”
Ernesto said.

Above: Ernesto Carnota, BSN-RN, CCRN, Director of Critical Care

at HCA Florida JFK Hospital in West Palm Beach, Florida

52 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 53
 Below: Alosh Madala, MD, Board Certified Urologist, Research Medical Center

Attracting
4,591
exceptional residents

physicians 303
fellows

HCA Healthcare co-founders and physicians

Dr. Thomas Frist Sr. and Dr. Thomas Frist Jr.
218
envisioned creating a healthcare company specialty programs
with the scale, resources and clinical (residencies)
expertise to deliver high-quality care across
the nation. Their original vision continues
to guide our organization today, and we are 81
proud to have fostered a robust sub-specialty programs
(fellowships)

45K+
community of dedicated and
highly skilled caregivers.

active and
Our Physician Services Group
(PSG) and Physician and
299
affiliated physicians Provider Relations (PPR) team graduate medical
honor the autonomy and education programs
expertise of our physicians and
As of Dec. 31, 2021
advanced practice providers. We listen to
and collaborate with them through physician
governance councils, operational and service
line meetings, physician engagement and
patient safety culture surveys and our robust Educating the next generation of physicians
network of physician relationship specialists.
To ensure our physician partners and As the largest sponsor of residency and to guide them through their journey.
advanced practice providers can concentrate fellowship programs across the nation, Our GME team and Diversity, Equity and
on their patients, we offer support for HCA Healthcare’s graduate medical education Inclusion department frequently partner to
various needs, including: (GME) program is leading the industry in provide cultural competence education to
clinical experience. Our programs seek to residents and fellow, including veteran care
• Quality • Marketing inspire tomorrow’s physicians to care for and workshops, conscious inclusion training and
• Technology • Payer relationship improve human life by focusing on patient- transgender care workshops. Our residents
• Informatics
management centered approaches to practicing the latest and fellows produce evidence that drives
• Risk and regulatory evidence-based medicine. future practice by leveraging HCA Healthcare’s
• Supply chain
resources national clinical data warehouse — the
HCA Healthcare residents and fellows heart of our data ecosystem. Learn more at
have access to talented teams of faculty, HCAhealthcareImpact.com.
industry experts and dedicated researchers

54 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 55
Caring for our
communities
Whether through volunteering our time,
making charitable donations or partnering with
other organizations, at HCA Healthcare, we are
committed to creating healthier tomorrows for
our communities.
 Giving and
volunteering
The ongoing COVID-19 pandemic means giving
back and volunteering continued to look a
little different in 2021, but the commitment
and creativity of our colleagues to support our
communities through this new normal Above: Twenty-six HCA Healthcare volunteers, including Spencer Jones and Bev Sears (pictured),
remained intact. spent a day building a Habitat for Humanity home in Columbia, Tennessee.

$41M+ 99,600+
enterprise giving volunteer hours Healthier
Tomorrow Fund
to community
organizations

$17M 5,600+
colleague giving with charitable Since its founding in 1982, the Since its launch, $4.5 million in funding
HCA Healthcare organizations
HCA Healthcare Foundation has awarded has already been allocated to 13 different
matching supported through
donations and more than $231 million in grants. In May 2021, organizations, including the American
volunteering the HCA Healthcare Foundation announced Heart Association, Girl Scouts of the
the Healthier Tomorrow Fund, an $80 USA, Volunteers of America, Central
million community impact fund focused on Texas Allied Health Institute and Educate
Above: HCA Healthcare colleagues
addressing high-priority community needs Texas. Launching the Healthier Tomorrow
Akshay Shinde and Swathi Polepalli
and health equity. The fund provides grants Fund further expands HCA Healthcare’s
to nonprofit organizations in 25 cities philanthropy in the communities where our
where HCA Healthcare has a presence. colleagues live and serve. The foundation
plans to distribute up to $8 million of the
Healthier Tomorrow Fund this year with
goals to expand to additional markets.

58 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 59
 Healthy Food
for Healthier
Tomorrows
During the 2021 holiday season, The 370,000 nutritious
HCA Healthcare helped stock the shelves meals that were
at food banks across the country as part
provided to families
of our organization’s Healthy Food for
in need included:
Healthier Tomorrows Food & Nutrition
Drive. By working with local food banks
to collect and provide nutritious meals for
our communities, HCA Healthcare sought 77,830
to address food insecurity — the lack of meals donated
consistent access to enough food to have by colleagues
an active, healthy lifestyle.

Over the course of 30 days,

HCA Healthcare colleagues across the 52,000
country provided nearly 370,000 nutritious
meals from colleague
meals to food banks in the communities charitable donations
that we serve by donating food or making
financial contributions to help purchase
perishable items such as milk, fruit
and vegetables. 240,000
meals from $60,000 in
grants provided by the
HCA Healthcare Foundation
for the winning facilities and
divisions of a creative food
sculpture contest

Top left: HCA Florida Citrus Hospital's food drive benefited the Community Food Bank of Citrus County. Pictured (left to right):
Jennifer Losse, RN, Employee Health Nurse; Rene Thomas, Human Resources Vice President; and Josh Moore, Chief Operating Officer

Top right: Barrett Blackmon, Regional Vice President, Oncology, Sarah Cannon Cancer Institute at HCA Houston Healthcare,
volunteered at the Houston Food Bank.

Bottom: HCA Florida North Florida Hospital's food drive benefited The Bread of the Mighty Food Bank. Pictured: Mary Piazza, MSN,
RN, AOCNP, Nursing Director, 5 North Oncology Unit

60 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 61
 March of Dimes Supporting mental health
Helping every mom and baby education with EVERFI
get the best possible start HCA Healthcare is committed to
supporting the growing need for mental
HCA Healthcare is proud to deepen our
health education in communities and the
longstanding relationship with March of
mental well-being of kids and adolescents.
Dimes through a new partnership focused
We are proud to partner with EVERFI, an
on improving maternal health outcomes.
international technology company driving
HCA Healthcare is the largest system
social change through education, to launch
for delivering babies in the country and
Mental Wellness Basics, a digital resource
more than 217,000 babies are delivered at
that introduces middle and high school
our hospitals every year. Together, March
students to mental health education.
of Dimes and HCA Healthcare are using
our clinical data, pioneering research and
The course is designed to build awareness
passionate history to deliver healthier
and empathy, reduce stigma, and provide
tomorrows for mothers and babies.
facts about the symptoms and prevalence
of mental health conditions, including
instruction about how to notice when
mental health is at risk and choices that may

Partnering
help in reducing the severity of symptoms.
American Red Cross
A beacon of hope when

with other
disaster strikes

18K +
HCA Healthcare shares a long history of
partnering with the American Red Cross to

community
provide disaster relief. Our partnership means we
are able to stay ready to respond to emergencies middle and high
and support our communities during the school students

leaders
most difficult times, thanks to planning and
reached by the Mental Wellness Basics
preparation drills and full-scale disaster exercises
course since its launch in October 2020
that ensure we can deploy teams and resources
when needed. In 2021, HCA Healthcare made our
third consecutive $500,000 contribution to the
American Red Cross Annual
In 2021, HCA Healthcare made a Disaster Giving Program.
Over the last five years, we’ve
third consecutive contribution of provided more than $4.6
$500,000 to the American Red Cross million in financial support
Annual Disaster Giving Program. to the Red Cross for shared
disaster response capabilities
and relief efforts, including the Texas winter
storms in 2021 and the tornadoes in Kentucky.
We also provide Red Cross leaders with access to
our emergency response information system to
help coordinate their activities.

62 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 63
 A workforce
Advancing our diversity,
equity and inclusion (DEI)
commitments

reflecting the Our Executive Diversity, Equity and Inclusion

Council and Division Diversity, Equity and

communities
Inclusion Councils oversee the deployment of
our DEI strategies and programs across the
enterprise. We are adding new roles in our

we serve
divisions to provide dedicated and local focus
to the DEI agenda.

Additionally, the HCA Healthcare Foundation

collaborated with our Division Diversity,
Equity and Inclusion Councils in investing
"The ongoing Strategic partnerships build diverse up to $300,000 in grants to support
pandemic reminds talent pipeline strengthening partnerships with local
community organizations supporting social
us daily of the HCA Healthcare supports colleagues in the work they
justice and health equity. Grants already
crucial importance do every day, creates opportunities for connection and
distributed to local organizations include the
dialogue, and enables us to better attract, engage and
of providing an Urban League of Broward, RISE Augusta,
develop diverse talent. In May 2021, HCA Healthcare
adequate pipeline the Tampa Bay Healthcare Collaborative,
announced a $10 million investment over the next three
Gentlemen by Choice, Big Brothers Big
of skilled healthcare years to Historically Black Colleges and Universities
Sisters Colorado, Hispanic Unity of Florida
professionals. This (HBCUs) and Hispanic-Serving Institutions (HSIs) across
and Project Access,
our footprint. This commitment supports our goal for a
timely and generous diverse pipeline of future healthcare professionals and
among others.
partnership allows us leaders, ultimately helping us to deliver more equitable,
HCA Healthcare is committed to working with
to train more students culturally competent care. The investment includes a
and investing in diverse businesses, including
$1.5 million partnership with Florida A&M University’s
who will join the those owned and operated by people of
(FAMU) School of Allied Health Sciences. Through
frontlines of those color, women, veterans and members of the
internship stipends and scholarships, the funding will help
LGBTQ+ community. We have partnered with
fighting to protect pave student pathways from undergraduate to graduate
our Capital Deployment team and HealthTrust
America’s health." to management careers in the healthcare industry.
to act on strengthening our relationships
with diverse suppliers. Our Division Diversity,
In January 2021, we established the Market and
Dr. Larry Robinson, Florida Equity and Inclusion Councils are setting goals
Hospital Governance Taskforce to elevate market and
A&M University President for local diversity spending.
hospital governance practices across the enterprise
by developing guidance related to recommended
roles, objectives, operations and composition for our
Top: Tiffany Simpson, MD, Neonatologist, Overland Park
market and hospital boards of trustees. The guidance
Regional Medical Center
developed by the taskforce includes best practices
Middle left: Raymar Yapmoreno, BSN, RN, Transplant
for advancing board diversity and quantifiable board
Nephrology Staff Nurse, Research Medical Center
composition targets to ensure our market and hospital
boards of trustees reflect the unique diversity of the Middle right (left to right): Abigail Frye, PCT; Saarah Arif,
PCT, Medical Surgical (Med Surg) at Overland Park Regional
communities we serve.
Medical Center

Bottom: HCA Healthcare donated $1.5 million to strengthen

FAMU students’ pathways to healthcare careers
64 | HCA Healthcare Annual Impact Report
 Emergency
Operations
Jessica Picanzo, MSN, EMT-P, CFRN,
Whether facing natural disasters or a global CMTE, Director, Enterprise Emergency
Operations and Medical Transport
pandemic, HCA Healthcare’s Enterprise
Emergency Operations Center (EEOC) is ready
to support our more than 2,300 sites of care
every day of the year. The EEOC, based in Caring for evacuees
Nashville, Tennessee, is made up of nearly 200
Delivering on HCA Healthcare’s
leaders who work with experts across the
mission — Above all else, we
enterprise to plan and execute crisis responses
are committed to the care and
and help our facilities and colleagues obtain
improvement of human life — the
the resources they need to continue providing
EEOC supported our Capital
Above (left to right): Aaron Pilant, Bradenton Police Sergeant; Jenna Sorgenfrei, PharmD, MSPS, BCCCP, Clinical Pharmacist; Linh patient-centered care in the midst of
Dang, PharmD, PGY-1 Pharmacy Practice Resident; Boubacar Cherif, PharmD, PGY-1 Pharmacy Practice Resident; and Derek Division in providing urgent care
any emergency.
Vuong, PharmD, BCPS, CPh, Coordinator of Clinical Pharmacy Services, HCA Florida Blake Hospital to 800 individuals evacuated from
Afghanistan in August 2021. To best
In February 2021, devastating winter storms
serve this population,
hit Texas, directly impacting our colleagues
HCA Healthcare partnered with the

Combatting
and sites of care throughout the state. When
As a learning health system, American Red Cross to establish
the municipal water supply was disrupted,
HCA Healthcare is using the science culturally competent care. Our
the EEOC deployed water tanker trucks to
of big data to combat the opioid organization also supported

the opioid
impacted hospitals. Fuel trucks were also
public health crisis and transform pain vaccination efforts when a measles
stationed at hospitals for colleagues, and
management, with initiatives in surgical, outbreak was identified at Dulles
HCA Healthcare helped coordinate repair
emergency and other care settings. International Airport upon evacuees’
services for colleagues whose homes had been

crisis
arrival. In addition, the EEOC worked
damaged. Our hospitals were able to provide
In October 2021, HCA Healthcare with our Central and West Texas
hard-to-find goods like fresh produce and
hosted its third annual “Crush the Division to serve evacuees when a
paper products to colleagues at mini-markets
Crisis” event, collecting a record refugee site was established at a
set up in our hospitals.
15,566 pounds of unused and expired military base outside of El Paso.
medications in support of the Drug
Enforcement Administration’s National

15,500+
Prescription Drug Take Back Day. In
partnership with local law enforcement
agencies, collection sites were hosted 800
pounds of unused and expired at 96 HCA Healthcare facilities at 98 evacuees from
event locations across 17 states. Afghanistan were
medications collected
provided care upon
arrival in the U.S.

66 | HCA Healthcare Annual Impact Report

Before Hurricane Ida made landfall in August facilities safely, calling on HCA Houston Below: Photo by Brandon Bell/Getty Images
2021 as a high-end Category 4 hurricane, the Healthcare’s AIRLife medical transport team
EEOC took action to ensure our Louisiana to assist. Fuel trucks, water tanker trucks,
hospitals had appropriate staff, medications, temporary staffing, remediation teams and
supplies, food, water and generator power. other resources were also supplied to hospitals
Command Centers were opened at after the storm, and colleagues received
HCA Healthcare facilities throughout housing, gas, meals, laundry and other
Louisiana. When Tulane Lakeside Hospital necessary supplies. EEOC leaders secured
lost water pressure, the decision was made local hotels for our colleagues by providing
to evacuate patients out of an abundance generators to power the hotels dedicated
of caution. The EEOC coordinated patient to HCA Healthcare colleagues and families.
transfers to sister hospitals and other nearby

Hurricane Ida

133 43
patients sheltered at patients sheltered at all patients later evacuated from
Tulane Medical Center Tulane Lakeside Hospital Tulane Lakeside Hospital
out of caution

15 650 $1.2M
generators on hotel rooms provided to provided to 1,140
site at peak house 1,000+ individuals HCA Healthcare Hope Fund
recipients

Supporting relief efforts Foundation gave a combined $250,000 to the

American Red Cross and various community
HCA Healthcare, the HCA Healthcare
organizations.
Foundation and our affiliated hospitals are
proud to support charitable organizations
HCA Healthcare and affiliate Tulane Health
that provide food, shelter and other
System gave a combined $225,000 to support
necessities to communities impacted
Hurricane Ida recovery and relief efforts
by disaster.
by United Way of Southeast Louisiana,
Second Harvest Food Bank and Northshore
After the winter storms in Texas,
Community Foundation.
HCA Healthcare announced $250,000 in
contributions on behalf of our organization
After destructive tornadoes impacted
and affiliated hospitals in Texas to support
communities across the South and
relief efforts by charitable organizations
Midwest in December 2021, HCA Healthcare
throughout the state, including the American
contributed $250,000 among the American
Red Cross, North Texas Food Bank, Urban
Red Cross Southern and Midwest Tornadoes
League and United Way Storm Relief Fund.
Relief Fund, United Way of Southern
Kentucky Tornado Crisis and Recovery Fund
In August 2021, after record rainfall and
and Governor Beshear’s Team Western
flooding impacted Middle Tennessee,
Above: Brian Rayl, RN, BSN, CCRN, EMT-P, Flight Paramedic, HCA Houston Healthcare AIRLife Kentucky Tornado Relief Fund.
HCA Healthcare and the HCA Healthcare

68 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 69
 Environmental
stewardship
We are accelerating our efforts and The four key themes of our strategy are:
embracing our role in creating a better • Managing energy and water responsibly,
future for everyone. Our commitment reducing use of energy and water, Our commitment to the care and improvement of human life guides everything we do,
to the care and improvement of human decarbonizing energy and managing including our dedication to being a responsible and concerned citizen in our communities.
life requires that we consider the water quality
impact we have on the environment and • Enhancing our climate resilience,

33.4M+ 18.3M
ensuring HCA Healthcare operations
its role in health and the enjoyment of
and the communities we serve are more 16M+
everyday life. pounds of pounds of gallons of
resilient to climate risks
cardboard, paper, construction water saved
Our environmental strategy enables • Sourcing and consuming efficiently,
aluminum, wood waste recycled
decreasing emissions from purchased
HCA Healthcare to prepare and and rechargeable
goods, sourcing responsibly, reducing
execute short- and long-term consumption and reusing where batteries recycled
sustainability plans and develop a possible
broad ESG narrative that considers our • Greening our capital programs, reducing
stakeholders, the environment and our carbon emissions, waste and other 969,600+ 46.2M 10
future together. environmental impacts from new pounds of devices kWh of energy LEED-certified
construction, retrofits and expansions diverted from landfill reduction facilities
for reprocessing
Our emissions baseline and climate
risk report, aligned with Taskforce for
Climate-Related Financial Disclosures
guidance, will be available in spring 2022
at HCAhealthcareImpact.com. Sponsorships and memberships
Practice Greenhealth: HCA Healthcare Healthier Hospitals Initiative:
and its facilities are members of this HCA Healthcare is a founder of this free
organization that provides sustainable Practice Greenhealth initiative, now known
healthcare solutions. Members work to as Healthier Hospitals. Its basic tenets are to
Awards and recognition for achieve virtual elimination of mercury in improve environmental health and patient
environmental stewardship facilities, reduce the quantity and
toxicity of healthcare waste, minimize the
safety, reduce waste and the use of natural
resources, and establish sustainability and
use of and exposure to hazardous chemicals, safety protocols.
HCA Healthcare has received 178 Practice Greenhealth reduce healthcare’s environmental footprint
awards since 2002. and integrate sustainable design and Read about our sustainability strategy, and
building techniques with environmentally additional sponsorships and memberships,
sound operational practices. at HCAhealthcareImpact.com.

70 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 71
 Bottom: David O’Brien, RN, EMT-P, C-NPT, Pediatric and Neonatal Flight Nurse/

Economic impact
ECMO Specialist, and Stacy Greiner, MSN, RN, C-NPT, Specialty Transport Team
Supervisor, Medical City Healthcare

in our communities
At HCA Healthcare, we believe in taking care of others and our communities.
As evidenced below, our strong operations make us a major contributor to
local economies and help us create healthier tomorrows for all who live in
the communities we serve.

283,000+
people employed

$26.7B+
in payroll and benefits

$3.5B+
in capital investment

$3.3B+
estimated cost for the
delivery of charity care,
uninsured discounts and
other uncompensated care

$5.5B
federal, state and local taxes
incurred in 2021, including
$2.8B of income, property,
sales and use taxes

72 | HCA Healthcare Annual Impact Report HCA Healthcare Annual Impact Report | 73
 Looking to
the future
Our accomplishments this past year would not be
possible without the commitment of our colleagues,
physicians and partners. Their incredible resilience
and dedication to show up and do what is needed
for our patients, each other and our communities
brings our mission to life every day.

As we navigate the journey ahead, we will continue

to focus on leveraging our collective strength
and expanding our network of care to meet the
needs of our patients, supporting and investing
in our colleagues, deepening our partnerships in
communities and positively impacting healthcare.

Learn more about the many ways we create

healthier tomorrows at HCAhealthcareImpact.com.

74 | HCA Healthcare Annual Impact Report