Bond HCA International 5.875% ( US404121AG00 ) in USD

HCA International

100 % ▼

United States

US404121AG00 ( in USD )

5.875% per year ( payment 2 times a year)

01/05/2023 - Bond has expired

Prospectus brochure of the bond HCA US404121AG00 in USD 5.875%, expired

2 000 USD

1 250 000 000 USD

404121AG0

N/A

HCA, or Healthcare Associated Infections, are infections acquired in healthcare settings, affecting patients, healthcare workers, and visitors.

The Bond issued by HCA International ( United States ) , in USD, with the ISIN code US404121AG00, pays a coupon of 5.875% per year.
The coupons are paid 2 times per year and the Bond maturity is 01/05/2023

Final Prospectus Supplement
http://www.sec.gov/Archives/edgar/data/841985/000119312512425779/...
424B5 1 d422328d424b5.htm FINAL PROSPECTUS SUPPLEMENT
Table of Contents
Filed Pursuant to Rule 424(b)5
Registration No. 333-175791
CALCULATION OF REGISTRATION FEE

Proposed
Proposed
maximum
maximum
Amount of
Title of each class of
Amount to be
offering price
aggregate
registration
securities to be registered

registered

per security

offering price

fee(1)
4.75% Senior Secured Notes due 2023
$1,250,000,000
100.00%
$1,250,000,000
$170,500
5.875% Senior Notes due 2023
$1,250,000,000
100.00%
$1,250,000,000
$170,500

(1) Calculated in accordance with Rule 457(r) under the Securities Act of 1933, as amended. The total registration fee due for this
offering is $341,000.
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Prospectus Supplement to Prospectus dated July 26, 2011
$2,500,000,000

HCA Inc.
$1,250,000,000 4.75% Senior Secured Notes due 2023
$1,250,000,000 5.875% Senior Notes due 2023

HCA Inc. is offering $1,250,000,000 aggregate principal amount of 4.75% senior secured notes due 2023, which we refer to
as the "secured notes," and $1,250,000,000 aggregate principal amount of 5.875% senior notes due 2023, which we refer to as the
"unsecured notes." The secured notes and the unsecured notes are collectively referred to herein as the "notes," unless the context
otherwise requires. The secured notes will bear interest at a rate of 4.75% per annum and the unsecured notes will bear interest at a
rate of 5.875% per annum. HCA Inc. will pay interest on the notes semi-annually, in cash in arrears, on May 1 and November 1 of
each year, beginning on May 1, 2013. The secured notes will mature on May 1, 2023 and the unsecured notes will mature on May 1,
2023.
We may redeem the notes, at any time in whole or from time to time in part, at the redemption prices described in this
prospectus supplement. In addition, if we experience certain kinds of changes in control, we may be required to repurchase the notes
on the terms described in this prospectus supplement. If we sell certain assets and do not reinvest the proceeds or repay indebtedness,
we must offer to repurchase the secured notes.
The notes will be HCA Inc.'s senior obligations and will rank equally and ratably with all of its future senior indebtedness
and senior to any of its future subordinated indebtedness. The obligations under the unsecured notes will be fully and unconditionally
guaranteed by HCA Holdings, Inc. on a senior unsecured basis and will rank equally and ratably with HCA Inc.'s existing and future
senior indebtedness and senior to any of its future subordinated indebtedness and will be structurally subordinated in right of payment
to all obligations of HCA Inc.'s subsidiaries and will be subordinated to any of HCA Inc.'s secured indebtedness (including the
secured notes) to the extent of the value of the collateral securing such indebtedness. The secured notes will be fully and
unconditionally guaranteed on a senior unsecured basis by HCA Holdings, Inc. and on a senior secured basis by each domestic
subsidiary that guarantees HCA Inc.'s senior secured credit facilities (as defined herein), other than certain subsidiaries that
guarantee only HCA Inc.'s asset-based revolving credit facility. To the extent lenders under the senior secured credit facilities release
any guarantor from its obligations, such guarantor will also be released from its obligations under the secured notes.
The secured notes and related guarantees will be secured by first-priority liens, subject to permitted liens, on HCA Inc.'s
and HCA Inc.'s subsidiary guarantors' assets, subject to certain exceptions, that will from time to time secure HCA Inc.'s cash flow
credit facility on a first-priority basis. The secured notes and related guarantees will be secured by second-priority liens, subject to
permitted liens, on HCA Inc.'s and HCA Inc.'s subsidiary guarantors' assets that will secure HCA Inc.'s asset-based revolving credit
facility on a first-priority basis. The secured notes will share equally in the collateral (other than any European collateral securing the
senior secured European term loan facility) securing HCA Inc.'s cash flow credit facility and other first lien notes. To the extent the
collateral agent for the lenders under the cash flow credit facility releases any liens during any period when the collateral agent has
authority to do so under the first lien intercreditor agreement, the lien securing the obligations under the secured notes will also be
released.
HCA Inc. intends to use the net proceeds of this offering for general corporate purposes, which may include the repayment of
a portion of its existing term loan facilities and the financing of a dividend to stockholders of HCA Holdings, Inc.
Investing in the notes involves risks. See "Risk Factors" beginning on page S-22.
Neither the Securities and Exchange Commission nor any other regulatory body has approved or disapproved of
these securities or determined if this prospectus supplement or the attached prospectus is truthful or complete. Any
representation to the contrary is a criminal offense.

Proceeds to
HCA Inc.(1)

Public offering price(1)

Underwriting discount

(before expenses)

Per note

Total
Per note

Total
Per note

Total

4.75% Senior Secured Notes due 2023
100%
$1,250,000,000 1.125% $14,062,500 98.875% $1,235,937,500
5.875% Senior Notes due 2023
100%
$1,250,000,000 1.125% $14,062,500 98.875% $1,235,937,500
(1) Plus accrued interest, if any, from October 23, 2012.
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The underwriters expect to deliver the notes to investors on or about October 23, 2012 in book-entry form only through the
facilities of The Depository Trust Company.

Joint Book-Running Managers

BofA Merrill Lynch

Barclays

Citigroup
Deutsche Bank Securities
Goldman, Sachs & Co.

J.P. Morgan

Wells Fargo Securities

Senior Co-Managers

Credit Agricole CIB

Credit Suisse

Mizuho Securities
Morgan Stanley
RBC Capital Markets

SunTrust Robinson Humphrey

UBS Investment Bank

Co-Managers

Fifth Third Securities, Inc.

SMBC Nikko

Prospectus Supplement dated October 16, 2012
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You should rely only on the information contained and incorporated by reference in this prospectus supplement and the
accompanying prospectus. Neither HCA Inc. nor the underwriters has authorized anyone to provide you with any information
or represent anything about HCA Inc., its financial results or this offering that is not contained or incorporated by reference in
this prospectus supplement or the accompanying prospectus. If given or made, any such other information or representation
should not be relied upon as having been authorized by HCA Inc. or the underwriters. Neither HCA Inc. nor the underwriters
is making an offer to sell these notes in any jurisdiction where the offer or sale is not permitted. The information contained
and incorporated by reference in this prospectus supplement and the accompanying prospectus may only be accurate on the
date of this document.

TABLE OF CONTENTS

Prospectus Supplement

Page
Summary
S-1

Risk Factors
S-22

Use of Proceeds
S-35

Capitalization
S-36

Description of Other Indebtedness
S-38

Description of the Secured Notes
S-50

Description of the Unsecured Notes
S-107
Certain United States Federal Tax Consequences
S-125
Certain ERISA Considerations
S-130
Underwriting
S-132
Legal Matters
S-137
Experts
S-137
Available Information
S-137
Incorporation by Reference
S-138
Prospectus

Page
About This Prospectus
1

Where You Can Find More Information
1

Incorporation By Reference
2

Forward-looking Statements
3

Our Company
4

Risk Factors
5

Use of Proceeds
5

Ratio of Earnings to Fixed Charges
5

Description of Debt Securities and Guarantees
6

Plan of Distribution
23

Legal Matters
24

Experts
24

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ABOUT THIS PROSPECTUS SUPPLEMENT
This document is in two parts. The first part is this prospectus supplement, which describes the terms of the offering of the
notes and adds to and supplements information contained in the accompanying prospectus and the documents incorporated by
reference therein. The second part is the accompanying prospectus, which we refer to as the "accompanying prospectus." The
accompanying prospectus contains a description of our debt securities and gives more general information, some of which may not
apply to the notes. The accompanying prospectus also incorporates by reference documents that are described under "Incorporation
by Reference" in that prospectus.
You should rely only on the information contained or incorporated by reference in this prospectus supplement, in the
accompanying prospectus or in any free writing prospectus filed by us with the Securities and Exchange Commission. If information
in this prospectus supplement is inconsistent with the accompanying prospectus, you should rely on this prospectus supplement. We
have not, and the underwriters have not, authorized any other person to provide you with different information. If anyone provides you
with different or inconsistent information, you should not rely on it. You should not assume that the information contained or
incorporated by reference in this prospectus supplement and the accompanying prospectus or in any such free writing prospectus is
accurate as of any date other than the respective dates thereof. Our business, financial condition, results of operations and prospects
may have changed since those dates.
We are not, and the underwriters are not, making an offer of the notes in any jurisdiction where the offer or sale is not
permitted.
MARKET, RANKING AND OTHER INDUSTRY DATA
The data included or incorporated by reference in this prospectus supplement regarding markets and ranking, including the
size of certain markets and our position and the position of our competitors within these markets, are based on reports of government
agencies or published industry sources and estimates based on management's knowledge and experience in the markets in which we
operate. These estimates have been based on information obtained from our trade and business organizations and other contacts in the
markets in which we operate. We believe these estimates to be accurate as of the date of this prospectus supplement. However, this
information may prove to be inaccurate because of the method by which we obtained some of the data for the estimates or because
this information cannot always be verified with complete certainty due to the limits on the availability and reliability of raw data, the
voluntary nature of the data gathering process and other limitations and uncertainties. As a result, you should be aware that market,
ranking and other similar industry data included or incorporated by reference in this prospectus supplement, and estimates and beliefs
based on that data, may not be reliable. Neither we nor the underwriters can guarantee the accuracy or completeness of any such
information contained or incorporated by reference in this prospectus supplement.
FORWARD-LOOKING AND CAUTIONARY STATEMENTS
This prospectus supplement and the accompanying prospectus contain and incorporate by reference "forward-looking
statements" within the meaning of the federal securities laws, which involve risks and uncertainties. Forward-looking statements
include statements regarding estimated electronic health record ("EHR") incentive income and related EHR operating expenses,
expected capital expenditures and expected net claim payments and all other statements that do not relate solely to historical or
current facts, including statements with respect to our estimated results of operations for the third quarter ended September 30, 2012,
which are subject to finalization and contingencies associated with our third quarter financial and accounting procedures, and the
proposed special dividend and related debt financing, and can be identified by the use of words like "may," "believe," "will,"
"expect," "project," "estimate," "anticipate," "plan," "initiative" or "continue." These forward-looking statements are based on our
current plans and expectations and are subject to a number of known and unknown uncertainties and risks, many of which are beyond
our control, which could

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significantly affect current plans and expectations and our future financial position and results of operations. These factors include,
but are not limited to, (1) the ability to fund and the determination to declare and pay the special dividend, (2) the impact of our
substantial indebtedness and the ability to refinance such indebtedness on acceptable terms, (3) the effects related to the enactment
and implementation of the Budget Control Act of 2011 ("BCA") and the Patient Protection and Affordable Care Act, as amended by
the Health Care and Education Reconciliation Act (collectively, the "Health Reform Law"), the possible enactment of additional
federal or state health care reforms and possible changes to the Health Reform Law and other federal, state or local laws or
regulations affecting the health care industry, (4) increases 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 upper payment limit ("UPL") programs or waiver programs, that may impact reimbursements to health
care providers and insurers, (7) the highly competitive nature of the health care business, (8) changes in service mix, revenue mix and
surgical volumes, including potential declines in the population covered under managed care agreements and the ability to enter into
and renew managed care provider agreements on acceptable terms and the impact of consumer driven health plans and physician
utilization trends and practices, (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 and possible impairments of long-lived
assets, (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 with our tax positions, (19) potential adverse impact
of known and unknown government investigations, litigation and other claims that may be made against us, (20) our ongoing ability to
demonstrate meaningful use of certified electronic health record technology and recognize income for the related Medicare or
Medicaid incentive payments, and (21) other risk factors disclosed under "Risk Factors" and elsewhere in or incorporated by
reference in this prospectus supplement and the accompanying prospectus. As a consequence, current plans, anticipated actions and
future financial position and results of operations may differ from those expressed in any forward-looking statements made by or on
behalf of HCA Inc. You are cautioned not to unduly rely on such forward-looking statements when evaluating the information
presented in this prospectus supplement and the accompanying prospectus, which forward-looking statements reflect management's
views only as of the date of this prospectus supplement and the accompanying prospectus. We do not undertake any obligation to
publicly update or revise any forward-looking statement as a result of new information, future events or otherwise, except as
otherwise required by law.

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SUMMARY
This summary highlights information appearing elsewhere in and incorporated by reference in this prospectus
supplement and the accompanying prospectus. This summary is not complete and does not contain all of the information that
you should consider before investing in the notes. You should carefully read the entire prospectus supplement, the
accompanying prospectus and the information incorporated herein by reference, including the financial data and related
notes and the section entitled "Risk Factors."
As used herein, unless otherwise stated or indicated by context, references to (i) the "Issuer" refer to HCA Inc. and
its affiliates, (ii) "HCA Holdings, Inc." refer to HCA Holdings, Inc., parent of HCA Inc., and its affiliates and (iii) the
"Company," "HCA," "we," "our" or "us" refer to HCA Inc. and its affiliates prior to the Corporate Reorganization (as
defined herein) and to HCA Holdings, Inc. and its affiliates upon the consummation of the Corporate Reorganization. The
term "affiliates" means direct and indirect subsidiaries and partnerships and joint ventures in which such subsidiaries are
partners. The terms "facilities" or "hospitals" refer to entities owned and operated by affiliates of HCA and the term
"employees" refers to employees of affiliates of HCA.
Our Company
We are the largest non-governmental hospital operator in the U.S. and a leading comprehensive, integrated provider of
health care and related services. We provide these services through a network of acute care hospitals, outpatient facilities, clinics
and other patient care delivery settings. As of June 30, 2012, we operated a diversified portfolio of 163 hospitals (with
approximately 41,800 beds) and 110 freestanding surgery centers across 20 states throughout the U.S. and in England. As a result
of our efforts to establish significant market share in large and growing urban markets with attractive demographic and economic
profiles, we currently have a substantial market presence in 14 of the top 25 fastest growing markets with populations greater than
500,000 in the U.S. and currently maintain the first or second position, based on inpatient admissions, in many of our key markets.
We believe our ability to successfully position and grow our assets in attractive markets and execute our operating plan has
contributed to the strength of our financial performance over the last several years. For the six months ended June 30, 2012, we
generated revenues of $16.517 billion, net income attributable to HCA Holdings, Inc. of $931 million and Adjusted EBITDA of
$3.392 billion.
Our patient-first strategy is to provide high quality health care services in a cost-efficient manner. We intend to build
upon our history of profitable growth by maintaining our dedication to quality care, increasing our presence in key markets
through organic expansion and strategic acquisitions and joint ventures, leveraging our scale and infrastructure, and further
developing our physician and employee relationships. We believe pursuing these core elements of our strategy helps us develop a
faster-growing, more stable and more profitable business and increases our relevance to patients, physicians, payers and
employers.
Using our scale, significant resources and over 40 years of operating experience, we have developed a significant
management and support infrastructure. Some of the key components of our support infrastructure include a revenue cycle
management organization, a health care group purchasing organization ("GPO"), an information technology and services provider,
a nurse staffing agency and a medical malpractice insurance underwriter. These shared services have helped us to maximize our
cash collection efficiency, achieve savings in purchasing through our scale, more rapidly deploy information technology upgrades,
more effectively manage our labor pool and achieve greater stability in malpractice insurance premiums. Collectively, these
components have helped us to further enhance our operating effectiveness, cost efficiency and overall financial results. We have
also created a subsidiary, Parallon Business Solutions, that offers certain of these component services to other health care
companies.

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Since the founding of our business in 1968 as a single-facility hospital company, we have demonstrated an ability to
consistently innovate and sustain growth during varying economic and regulatory climates. Under the leadership of an
experienced senior management team, whose tenure at HCA averages approximately 20 years, we have established an extensive
record of providing high quality care, profitably growing our business, making and integrating strategic acquisitions and
efficiently and strategically allocating capital spending.
On November 17, 2006, HCA Inc. was acquired by a private investor group, including affiliates of or funds sponsored
by Bain Capital Partners, LLC, Kohlberg Kravis Roberts & Co. and HCA founder Dr. Thomas F. Frist, Jr., and by members of
management and certain other investors. We refer to the merger, the financing transactions related to the merger and other related
transactions collectively as the "Recapitalization."
Since the Recapitalization, we have achieved substantial operational and financial progress. During this time, we have
made significant investments in expanding our service lines and expanding our alignment with highly specialized and primary
care physicians. In addition, we have enhanced our operating efficiencies through a number of corporate cost-saving initiatives
and an expansion of our support infrastructure. We have made investments in information technology to optimize our facilities and
systems. We have also undertaken a number of initiatives to improve clinical quality and patient satisfaction. As a result of these
initiatives, our financial performance improved significantly from the year ended December 31, 2007, the first full year following
the Recapitalization, to the year ended December 31, 2011, with revenues growing by $5.954 billion, net income attributable to
HCA Holdings, Inc. increasing by $1.591 billion and Adjusted EBITDA increasing by $1.469 billion. This represents
compounded annual growth rates on these key metrics of 5.8%, 29.6% and 7.2%, respectively.
Our Industry
We believe well-capitalized, comprehensive and integrated health care delivery providers are well-positioned to
benefit from the current industry trends, some of which include:
Aging Population and Continued Growth in the Need for Health Care Services. According to the U.S. Census
Bureau, the demographic age group of persons aged 65 and over is expected to experience compounded annual growth
of 3.0% over the next 20 years, and constitute 19.3% of the total U.S. population by 2030. The Centers for Medicare &
Medicaid Services ("CMS") projects continued increases in hospital services based on the aging of the U.S. population,
advances in medical procedures, expansion of health coverage, increasing consumer demand for expanded medical
services and increased prevalence of chronic conditions such as diabetes, heart disease and obesity. We believe these
factors will continue to drive increased utilization of health care services and the need for comprehensive, integrated
hospital networks that can provide a wide array of essential and sophisticated health care.
Continued Evolution of Quality-Based Reimbursement Favors Large-Scale, Comprehensive and Integrated
Providers. We believe the U.S. health care system is continuing to evolve in ways that favor large-scale, comprehensive
and integrated providers that provide high levels of quality care. Specifically, we believe there are a number of
initiatives that will continue to gain importance in the foreseeable future, including introduction of value-based payment
methodologies tied to performance, quality and coordination of care, implementation of integrated electronic health
records and information, and an increasing ability for patients and consumers to make choices about all aspects of health
care. We believe our company is well positioned to respond to these emerging trends and has the resources, expertise
and flexibility necessary to adapt in a timely manner to the changing health care regulatory and reimbursement
environment.

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Impact of Health Reform Law. The Health Reform Law will change how health care services are covered,
delivered and reimbursed. It will do so through expanded coverage of uninsured individuals, significant reductions in
the growth of Medicare program payments, material decreases in Medicare and Medicaid disproportionate share
hospital ("DSH") payments, and the establishment of programs where reimbursement is tied in part to quality and
integration. After taking into account the June 28, 2012 United States Supreme Court decision upholding the Health
Reform Law, but allowing states to opt out of the Medicaid expansion provisions, the Health Reform Law is expected to
expand health insurance coverage to approximately 30 million additional individuals through a combination of public
program expansion and private sector health insurance reforms. We believe the expansion of private sector and
Medicaid coverage will, over time, increase our reimbursement related to providing services to individuals who were
previously uninsured. On the other hand, the reductions in the growth in Medicare payments and the decreases in DSH
payments will adversely affect our government reimbursement. Because of the many variables involved, including
pending court challenges, the potential for changes to the law as a result and efforts to amend or repeal the law, we are
unable to predict the net impact of the Health Reform Law on us; however, we believe our experienced management
team, emphasis on quality care and diverse service offerings will enable us to capitalize on the opportunities presented
by the Health Reform Law, as well as adapt in a timely manner to its challenges.
Our Competitive Strengths
We believe our key competitive strengths include:
Largest Comprehensive, Integrated Health Care Delivery System. We are the largest non-governmental
hospital operator in the U.S., providing approximately 4% to 5% of all U.S. hospital services through our national
footprint. The scope and scale of our operations, evidenced by the types of facilities we operate, the diverse medical
specialties we offer and the numerous patient care access points we provide, enable us to provide a comprehensive
range of health care services in a cost-effective manner. As a result, we believe the breadth of our platform is a
competitive advantage in the marketplace enabling us to attract patients, physicians and clinical staff while also
providing significant economies of scale and increasing our relevance with commercial payers.
Reputation for High Quality Patient-Centered Care. Since our founding, we have maintained an unwavering
focus on patients and clinical outcomes. We believe clinical quality influences physician and patient choices about
health care delivery. We align our quality initiatives throughout the organization by engaging corporate, local, physician
and nurse leaders to share best practices and develop standards for delivering high quality care. We have invested
extensively in quality of care initiatives, with an emphasis on implementing information technology and adopting
industry-wide best practices and clinical protocols. As a result of these efforts, we have achieved significant progress in
clinical quality. As measured by the CMS clinical core measures reported on the CMS Hospital Compare website and
based on publicly available data for the twelve months ended September 30, 2011, our hospitals achieved a composite
score of 99.2% of the CMS core measures versus the national average of 97.1%, making us among the top performing
major health systems in the U.S. Payors, including the Medicare program, are increasing efforts to tie payments to quality
and clinical performance. For example, CMS is implementing a value-based purchasing system and has begun adjusting
hospital payment rates based on "excess" readmissions. We also believe our quality initiatives favorably position us in a
payment environment that is increasingly performance-based.
Leading Local Market Positions in Large, Growing, Urban Markets. Over our history, we have sought to
selectively expand and upgrade our asset base to create a premium portfolio of assets in attractive growing markets. As
a result, we have a strong market presence in 14 of the top 25 fastest

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growing markets with populations greater than 500,000 in the U.S. In addition, we currently operate in 19 markets with
populations of one million or more, with all but two of these markets projecting growth above the national average from
2011 to 2016. Our inpatient market share places us first or second in many of our key markets. We believe the strength
and stability of these market positions will create organic growth opportunities and allow us to develop long-term
relationships with patients, physicians, large employers and third-party payers.
Diversified Revenue Base and Payer Mix. We believe our broad geographic footprint, varied service lines and
diverse revenue base mitigate our risks in numerous ways. Our diversification limits our exposure to competitive
dynamics and economic conditions in any single local market, reimbursement changes in specific service lines and
disruptions with respect to payers such as state Medicaid programs or large commercial insurers. We have a diverse
portfolio of assets with no single facility contributing more than 2.3% of our revenues and no single metropolitan
statistical area contributing more than 7.7% of revenues for the year ended December 31, 2011. We have also developed
a highly diversified payer base, with no single commercial payer representing more than 7% of revenues for the year
ended December 31, 2011. In addition, we are one of the country's largest providers of outpatient services, which
accounted for approximately 37% of our revenues for the year ended December 31, 2011. We believe the geographic
diversity of our markets and the scope of our inpatient and outpatient operations help reduce volatility in our operating
results.
Scale and Infrastructure Drive Cost Savings and Efficiencies. Our scale allows us to leverage our support
infrastructure to achieve significant cost savings and operating efficiencies, thereby driving margin expansion. We
strategically manage our supply chain through centralized purchasing and supply warehouses, as well as our revenue
cycle through centralized billing, collections and health information management functions. We also manage the
provision of information technology through a combination of centralized systems with regional service support as well
as centralize many other clinical and corporate functions, creating economies of scale in managing expenses and
business processes. In addition to the cost savings and operating efficiencies, this support infrastructure simultaneously
generates revenue from third parties that utilize our services.
Well-Capitalized Portfolio of High Quality Assets. In order to expand the range and improve the quality of
services provided at our facilities, we invested over $7.4 billion in our facilities and information technology systems
over the five-year period ended June 30, 2012. We believe our significant capital investments in these areas will
continue to attract new and returning patients, attract and retain high quality physicians, maximize cost efficiencies and
address the health care needs of our local communities. Furthermore, we believe our platform, as well as electronic
health record infrastructure, national research and physician management capabilities, provide a strategic advantage by
enhancing our ability to capitalize on anticipated incentives through the Health Information Technology for Economic and
Clinical Health Act ("HITECH") provisions of the American Recovery and Reinvestment Act of 2009 ("ARRA") and
position us well in an environment that increasingly emphasizes quality, transparency and coordination of care.
Strong Operating Results and Cash Flows. Our leading scale, diversification, favorable market positions,
dedication to clinical quality and focus on operational efficiency have enabled us to achieve attractive historical
financial performance. In the six months ended June 30, 2012, we generated net income attributable to HCA Holdings,
Inc. of $931 million, Adjusted EBITDA of $3.392 billion and cash flows from operating activities of $2.257 billion.
Our ability to generate strong and consistent cash flow from operations has enabled us to invest in our operations, reduce
our debt, enhance earnings per share and continue to pursue attractive growth opportunities.

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