HCA Healthcare (HCA) 8-K HCA Reports Fourth Quarter and Year End 2009 Results

Exhibit 99.1

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	FOR IMMEDIATE RELEASE
INVESTOR CONTACT:	MEDIA CONTACT:
Mark Kimbrough	Ed Fishbough
615-344-2688	615-344-2810

HCA Reports Fourth Quarter and Year End 2009 Results

Nashville, Tenn., February 18, 2010— HCA Inc. today announced financial and operating results for its fourth quarter and fiscal year ended December 31, 2009.

Fourth Quarter Summary:

• Revenues increased 4.7 percent to $7.605 billion from $7.265 billion in the fourth quarter of 2008.

• Net income attributable to HCA Inc. totaled $216 million, compared to $276 million in the prior year’s fourth quarter.

• Adjusted EBITDA totaled $1.343 billion, compared to $1.237 billion in the fourth quarter of 2008.

• Provision for doubtful accounts totaled $693 million, compared to $889 million in the prior year.

• Charity care and uninsured discounts totaled $1.499 billion, compared to $1.007 billion in the fourth quarter of 2008.

• Interest expense was flat at $500 million compared to the prior year’s fourth quarter.

• Same facility equivalent admissions and same facility admissions increased 2.6 percent and 1.2 percent, respectively, in the fourth quarter compared to the same period last year.

• Same facility revenue per equivalent admission increased 1.9 percent. Revenue per equivalent patient day, on a same facility basis, increased 3.3 percent.

• Total surgeries, on a same facility basis, declined 0.1 percent from the prior year’s fourth quarter.

• Same facility emergency department visits increased 9.1% compared to the fourth quarter of 2008.

Fourth quarter of 2009 performance was driven by solid inpatient, outpatient and emergency department volumes. HCA’s revenues for the fourth quarter totaled $7.605 billion, compared to $7.265 billion in the fourth quarter of 2008. Net income attributable to HCA Inc. for the fourth quarter of 2009 totaled $216 million, compared to $276 million in the prior year’s fourth quarter. Income before income taxes for the fourth quarter of 2009 was $451 million, compared to $379 million in the fourth of 2008. Adjusted EBITDA in the quarter totaled $1.343 billion, compared to $1.237 billion in the previous year’s fourth quarter. A table describing adjusted EBITDA and reconciling net income attributable to HCA Inc. to adjusted EBITDA is included in this release. Results for the fourth quarter of 2009 include impairments of

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long-lived assets of $27 million and losses on sales of facilities of $7 million. Fourth quarter 2008 results include impairments of long-lived assets of $11 million and gains on sales of facilities of $7 million. The provision for income taxes was $112 million higher for the fourth quarter of 2009 ($147 million) than for the fourth quarter of 2008 ($35 million) due to the benefit recorded in the fourth quarter of 2008 related to the favorable revision to the proposed disallowance of certain prior period expenses and related interest.

The provision for doubtful accounts decreased to $693 million, or 9.1 percent of revenues, in the fourth quarter of 2009 from $889 million, or 12.2 percent of revenues, in the fourth quarter of 2008. The reduction in our provision for doubtful accounts was primarily attributable to an increase in charity care and uninsured discounts which totaled $1.499 billion in the fourth quarter of 2009 compared to $1.007 billion in the fourth quarter of 2008. The sum of the provision for doubtful accounts, uninsured discounts and charity care, as a percentage of the sum of net revenues, uninsured discounts and charity care was 24.1 percent for the fourth quarter of 2009 compared to 22.9 percent for the fourth quarter of 2008. Same facility uninsured admissions increased 0.2 percent in the fourth quarter of 2009 compared to the prior year’s fourth quarter. Same facility uninsured admissions comprised 6.4 percent of total admissions in the fourth quarter of 2009 compared to 6.5 percent in the fourth quarter of 2008.

During the fourth quarter of 2009, salaries and benefits, supply expense and other operating expenses totaled $5.633 billion compared to $5.192 billion in the fourth quarter of 2008. These expenses, as a percent of revenues, increased 2.5 percent in the fourth quarter of 2009 compared to the fourth quarter of 2008. This increase was primarily due to the impact of the increased revenue reductions for uninsured discounts and charity care which reduced the Company’s rate of net revenue growth in the quarter.

Same facility admissions increased 1.2 percent and same facility equivalent admissions increased 2.6 percent in the fourth quarter of 2009 compared to the prior year’s fourth quarter. Same facility inpatient surgeries declined 0.3 percent and same facility outpatient surgeries declined 0.1 percent in the fourth quarter. Same facility revenue per equivalent admission increased 1.9 percent in the fourth quarter of 2009 compared to the fourth quarter of 2008.

Revenues for the twelve months ended December 31, 2009 totaled $30.052 billion compared to $28.374 billion in 2008. Net income attributable to HCA Inc. was $1.054 billion for the year ended December 31, 2009 compared to $673 million in 2008. Adjusted EBITDA totaled $5.472 billion for 2009 compared to $4.574 billion for 2008. Results for the year ended December 31, 2009 include losses on sales of facilities of $15 million and impairments of long-lived assets of $43 million compared to gains on sales of facilities of $97 million and impairments of long-lived assets of $64 million in 2008.

Cash flows from operating activities increased $757 million to $2.747 billion for the year ended December 31, 2009, from $1.990 billion for the year ended December 31, 2008. The increase was due primarily to the $473 million increase in net income and $143 million improvement from changes in operating assets and liabilities and the provision for doubtful accounts.

As of December 31, 2009, HCA’s balance sheet reflected cash and cash equivalents of $312 million, total debt of $25.670 billion, and total assets of $24.131 billion. During the fourth quarter of 2009, capital expenditures totaled $402 million, excluding acquisitions. For the year ended December 31, 2009, capital expenditures totaled $1.317 billion, excluding acquisitions.

During 2009, HCA issued $3.060 billion aggregate principal amount of first and second lien notes. The net proceeds from the debt issuances were used to repay outstanding indebtedness under the Company’s senior secured term loan facilities.

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On January 27, 2010, our Board of Directors declared a distribution to the Company’s stockholders and holders of vested stock options. The distribution was $17.50 per share and vested stock option, or approximately $1.750 billion in the aggregate. The distribution was paid on February 5, 2010 to holders of record on February 1, 2010. The distribution was funded using funds available under our existing senior secured credit facilities and approximately $100 million of cash on hand.

As of December 31, 2009, HCA operated 163 hospitals and 105 freestanding surgery centers (including eight hospitals and eight freestanding surgery centers operated through equity method joint ventures).

Earnings Conference Call

HCA will host a conference call for investors at 9:00 a.m. Central Time today. A live audio broadcast of the call via webcast will also be available to investors. The broadcast will be available on a replay basis beginning this afternoon. The webcast can be accessed at: http://www.videonewswire.com/event.asp?id=65983 or through the Company’s Investor Relations web page, www.hcahealthcare.com.

Cautionary Statement about Results and Other Forward-Looking Information

This press release contains forward-looking statements based on current management expectations. Those forward-looking statements include all statements other than those made solely with respect to historical fact. Numerous risks, uncertainties and other factors may cause actual results to differ materially from those expressed in any forward-looking statements. These factors include, but are not limited to, (1) the ability to recognize the benefits of the Recapitalization, (2) the impact of the substantial indebtedness incurred to finance the Recapitalization and the ability to refinance such indebtedness on acceptable terms, (3) the possible enactment of federal or state health care reform and changes in federal, state or local laws or regulations affecting the health care industry, (4) increases, particularly in the current economic downturn, in the amount and risk of collectibility of uninsured accounts and deductibles and copayment amounts for insured accounts, (5) the ability to achieve operating and financial targets, and attain expected levels of patient volumes and control the costs of providing services, (6) possible changes in the Medicare, Medicaid and other state programs, including Medicaid supplemental payments pursuant to upper payment limit (“UPL”) programs, that may impact reimbursements to health care providers and insurers, (7) the highly competitive nature of the health care business, (8) changes in revenue mix, including potential declines in the population covered under managed care agreements due to the current economic downturn and the ability to enter into and renew managed care provider agreements on acceptable terms, (9) the efforts of insurers, health care providers and others to contain health care costs, (10) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (11) increases in wages and the ability to attract and retain qualified management and personnel, including affiliated physicians, nurses and medical and technical support personnel, (12) the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities, (13) changes in accounting practices, (14) changes in general economic conditions nationally and regionally in our markets, (15) future divestitures which may result in charges, (16) changes in business strategy or development plans, (17) delays in receiving payments for services provided, (18) the outcome of pending and any future tax audits, appeals and litigation associated

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with our tax positions, (19) potential liabilities and other claims that may be asserted against us, and (20) other risk factors described in our annual report on Form 10-K and other filings with the Securities and Exchange Commission. Many of the factors that will determine our future results are beyond our ability to control or predict. In light of the significant uncertainties inherent in the forward-looking statements contained herein, readers should not place undue reliance on forward-looking statements, which reflect management’s views only as of the date hereof. We undertake no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise.

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HCA Inc.
Condensed Consolidated Income Statements
Fourth Quarter
(Dollars in millions)

	2009						2008
	Amount			Ratio			Amount			Ratio
Revenues	$	7,605			100.0	%	$	7,265			100.0	%
Salaries and benefits		3,078			40.5			2,877			39.6
Supplies		1,241			16.3			1,157			15.9
Other operating expenses		1,314			17.2			1,158			16.0
Provision for doubtful accounts		693			9.1			889			12.2
Equity in earnings of affiliates		(64	)		(0.8	)		(53	)		(0.7	)
Depreciation and amortization		358			4.7			354			4.9
Interest expense		500			6.6			500			6.9
Losses (gains) on sales of facilities		7			0.1			(7	)		(0.1	)
Impairment of long-lived assets		27			0.4			11			0.1
		7,154			94.1			6,886			94.8
Income before income taxes		451			5.9			379			5.2
Provision for income taxes		147			1.9			35			0.5
Net income		304			4.0			344			4.7
Net income attributable to noncontrolling interests		88			1.2			68			0.9
Net income attributable to HCA Inc.	$	216			2.8		$	276			3.8

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HCA Inc.
Condensed Consolidated Income Statements
For the Years Ended December 31, 2009 and 2008
(Dollars in millions)

	2009						2008
	Amount			Ratio			Amount			Ratio
Revenues	$	30,052			100.0	%	$	28,374			100.0	%
Salaries and benefits		11,958			39.8			11,440			40.3
Supplies		4,868			16.2			4,620			16.3
Other operating expenses		4,724			15.7			4,554			16.1
Provision for doubtful accounts		3,276			10.9			3,409			12.0
Equity in earnings of affiliates		(246	)		(0.8	)		(223	)		(0.8	)
Depreciation and amortization		1,425			4.8			1,416			5.0
Interest expense		1,987			6.6			2,021			7.1
Losses (gains) on sales of facilities		15			—			(97	)		(0.3	)
Impairment of long-lived assets		43			0.1			64			0.2
		28,050			93.3			27,204			95.9
Income before income taxes		2,002			6.7			1,170			4.1
Provision for income taxes		627			2.1			268			0.9
Net income		1,375			4.6			902			3.2
Net income attributable to noncontrolling interests		321			1.1			229			0.8
Net income attributable to HCA Inc.	$	1,054			3.5		$	673			2.4

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HCA Inc.
Supplemental Operating Results Summary
(Dollars in millions)

						For the Years
	Fourth Quarter					Ended December 31,
	2009		2008			2009		2008
Revenues	$	7,605	$	7,265		$	30,052	$	28,374
Net income attributable to HCA Inc.	$	216	$	276		$	1,054	$	673
Losses (gains) on sales of facilities (net of tax)		4		(5	)		9		(58	)
Impairment of long-lived assets (net of tax)		24		6			34		40
Net income attributable to HCA Inc., excluding losses (gains) on sales of facilities and impairment of long-lived assets (a)		244		277			1,097		655
Depreciation and amortization		358		354			1,425		1,416
Interest expense		500		500			1,987		2,021
Provision for income taxes		153		38			642		253
Net income attributable to noncontrolling interests		88		68			321		229
Adjusted EBITDA (a)	$	1,343	$	1,237		$	5,472	$	4,574

(a)	Net income attributable to HCA Inc., excluding losses (gains) on sales of facilities and impairment of long-lived assets and adjusted EBITDA are non-GAAP financial measures. We believe net income attributable to HCA Inc., excluding losses (gains) on sales of facilities and impairment of long-lived assets and adjusted EBITDA are important measures that supplement discussions and analysis of our results of operations. We believe it is useful to investors to provide disclosures of our results of operations on the same basis used by management. Management relies upon net income attributable to HCA Inc., excluding losses (gains) on sales of facilities and impairment of long-lived assets and adjusted EBITDA as the primary measures to review and assess operating performance of its hospital facilities and their management teams.
	Management and investors review both the overall performance (including; net income attributable to HCA Inc., excluding losses (gains) on sales of facilities and impairment of long-lived assets and GAAP net income attributable to HCA Inc.) and operating performance (adjusted EBITDA) of our health care facilities.
	Adjusted EBITDA and the adjusted EBITDA margin (adjusted EBITDA divided by revenues) are utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry. It is reasonable to expect that losses (gains) on sales of facilities and impairment of long-lived assets will occur in future periods, but the amounts recognized can vary significantly from period to period, do not directly relate to the ongoing operations of our health care facilities and complicate period comparisons of our results of operations and operations comparisons with other health care companies.
	Net income attributable to HCA Inc., excluding losses (gains) on sales of facilities and impairment of long-lived assets and adjusted EBITDA are not measures of financial performance under accounting principles generally accepted in the United States, and should not be considered as alternatives to net income attributable to HCA Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because net income attributable to HCA Inc., excluding losses (gains) on sales of facilities and impairment of long-lived assets and adjusted EBITDA are not measurements determined in accordance with generally accepted accounting principles and are susceptible to varying calculations, net income attributable to HCA Inc., excluding losses (gains) on sales of facilities and impairment of long-lived assets and adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.

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HCA Inc.
Condensed Consolidated Balance Sheets
(Dollars in millions)

	December 31,			September 30,			December 31
	2009			2009			2008
ASSETS
Current assets:
Cash and cash equivalents	$	312		$	443		$	465
Accounts receivable, net		3,692			3,499			3,780
Inventories		802			745			737
Deferred income taxes		1,192			1,099			914
Other		579			515			405
Total current assets		6,577			6,301			6,301
Property and equipment, at cost		24,669			24,389			23,714
Accumulated depreciation		(13,242	)		(13,038	)		(12,185	)
		11,427			11,351			11,529
Investments of insurance subsidiary		1,166			1,371			1,422
Investments in and advances to affiliates		853			855			842
Goodwill		2,577			2,596			2,580
Deferred loan costs		418			436			458
Other		1,113			1,210			1,148
	$	24,131		$	24,120		$	24,280
LIABILITIES AND STOCKHOLDERS’ DEFICIT
Current liabilities:
Accounts payable	$	1,460		$	1,199		$	1,370
Accrued salaries		849			954			854
Other accrued expenses		1,158			1,316			1,282
Long-term debt due within one year		846			635			404
Total current liabilities		4,313			4,104			3,910
Long-term debt		24,824			25,279			26,585
Professional liability risks		1,057			1,097			1,108
Income taxes and other liabilities		1,768			1,782			1,782
Total liabilities		31,962			32,262			33,385
Equity securities with contingent redemption rights		147			147			155
EQUITY (DEFICIT)
HCA Inc. stockholders’ deficit		(8,986	)		(9,279	)		(10,255	)
Noncontrolling interests		1,008			990			995
Total deficit		(7,978	)		(8,289	)		(9,260	)
	$	24,131		$	24,120		$	24,280

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HCA Inc.
Condensed Consolidated Statements of Cash Flow
For the Years Ended December 31, 2009 and 2008
(Dollars in millions)

	2009			2008
Cash flows from operating activities:
Net income	$	1,375		$	902
Adjustments to reconcile net income to net cash provided by operating activitie
Change in operating assets and liabilities		(3,091	)		(3,367	)
Provision for doubtful accounts		3,276			3,409
Depreciation and amortization		1,425			1,416
Income taxes		(520	)		(448	)
Losses (gains) sales of facilities		15			(97	)
Impairment of long-lived assets		43			64
Amortization of deferred loan costs		80			79
Pay-in-kind interest		58			—
Share-based compensation		40			32
Other		46			—
Net cash provided by operating activities		2,747			1,990
Cash flows from investing activities:
Purchase of property and equipment		(1,317	)		(1,600	)
Acquisition of hospitals and health care entities		(61	)		(85	)
Disposal of hospitals and health care entities		41			193
Change in investments		303			21
Other		(1	)		4
Net cash used in investing activities		(1,035	)		(1,467	)
Cash flows from financing activities:
Issuance of long-term debt		2,979			—
Net change in revolving bank credit facilities		(1,335	)		700
Repayment of long-term debt		(3,103	)		(960	)
Distributions to noncontrolling interests		(330	)		(178	)
Payment of debt issuance costs		(70	)		—
Other		(6	)		(13	)
Net cash used in financing activities		(1,865	)		(451	)
Change in cash and cash equivalents		(153	)		72
Cash and cash equivalents at beginning of period		465			393
Cash and cash equivalents at end of period	$	312		$	465
Interest payments	$	1,751		$	1,979
Income tax payments, net of refunds	$	1,147		$	716

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HCA Inc.
Operating Statistics

							For the Years
	Fourth Quarter						Ended December 31,
	2009			2008			2009			2008
Consolidating Hospitals:
Number of Hospitals		155			158			155			158
Weighted Average Licensed Beds		38,843			38,474			38,825			38,422
Licensed Beds at End of Period		38,839			38,504			38,839			38,504
Reported:
Admissions		385,300			380,100			1,556,500			1,541,800
% Change		1.4	%					1.0	%
Equivalent Admissions		603,800			587,300			2,439,000			2,363,600
% Change		2.8	%					3.2	%
Revenue per Equivalent Admission	$	12,595		$	12,370		$	12,321		$	12,005
% Change		1.8	%					2.6	%
Inpatient Revenue per Admission	$	12,368		$	11,742		$	11,809		$	11,336
% Change		5.3	%					4.2	%
Patient Days		1,863,500			1,865,100			7,537,100			7,611,000
Equivalent Patient Days		2,920,200			2,882,100			11,810,700			11,667,700
Inpatient Surgery Cases		122,200			121,300			494,500			493,100
% Change		0.7	%					0.3	%
Outpatient Surgery Cases		200,900			201,900			794,600			797,400
% Change		-0.5	%					-0.4	%
Emergency Room Visits		1,394,600			1,276,900			5,593,500			5,246,400
% Change		9.2	%					6.6	%
Outpatient Revenues as a Percentage of Patient Revenues		36.3	%		37.5	%		37.8	%		37.4	%
Average Length of Stay		4.8			4.9			4.8			4.9
Occupancy		52.1	%		52.7	%		53.2	%		54.1	%
Equivalent Occupancy		81.6	%		81.5	%		83.4	%		82.9	%
Same Facility:
Admissions		378,400			374,000			1,528,500			1,510,600
% Change		1.2	%					1.2	%
Equivalent Admissions		591,800			577,100			2,390,600			2,312,700
% Change		2.6	%					3.4	%
Revenue per Equivalent Admission	$	12,599		$	12,362		$	12,325		$	12,007
% Change		1.9	%					2.6	%
Inpatient Revenue per Admission	$	12,401		$	11,777		$	11,849		$	11,377
% Change		5.3	%					4.1	%
Inpatient Surgery Cases		120,200			120,500			487,400			485,000
% Change		-0.3	%					0.5	%
Outpatient Surgery Cases		197,900			198,100			783,600			784,400
% Change		-0.1	%					-0.1	%
Emergency Room Visits		1,361,400			1,247,800			5,455,100			5,096,200
% Change		9.1	%					7.0	%
Number of Consolidating and Nonconsolidating (Equity Joint Ventures) Hospitals:
Consolidating		155			158			155			158
Nonconsolidating (Equity Joint Ventures)		8			8			8			8
Total Number of Hospitals		163			166			163			166

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