Better Health for All
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HCA Healthcare's core business, operating 186 hospitals and approximately 2,400 ambulatory sites, provides transformative health benefits, with over 43 million annual patient encounters used to advance science and improve care.
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Clinical protocols identified by HCA have reduced bloodstream infections in ICU patients by 44%, and 32 of its hospitals were recognized on the Fortune/PINC AI 100 Top Hospitals list.
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The company has no revenue from products with negative health impacts, with its entire business model oriented toward health improvement. HCA Healthcare provided an estimated $3.7 billion in charity care and uncompensated care in 2024.
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It offers extensive price accessibility, including a 100% write-off for emergency services for patients below 200% of the Federal Poverty Guidelines (FPG), a 92% discount for uninsured patients, and a cap of 4% of annual income for those between 200% and 400% FPG.
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These programs, along with targeted grants for food insecurity and scholarships for HBCU/HSI students, demonstrate groundbreaking approaches to reach vulnerable populations. The company shows strong healthcare workforce support, recruiting over 116,500 colleagues in 2023, investing over $300 million in nurse education and training, and providing $37.5 million in tuition assistance in 2023.
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Its 24/7 Enterprise Emergency Operations Center (EEOC) provides comprehensive crisis response, including over 1,200 staff hours and significant resources during Hurricane Idalia.
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HCA also supports mental health initiatives, such as a Mental Wellness Patch Program for Girl Scouts, which has reached over 7,000 girls.
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Fair Money & Economic Opportunity
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HCA Healthcare is a healthcare provider, not a financial institution. The company does not offer lending, deposit, or other consumer financial products or services. Therefore, the KPIs under the 'Fair Money & Economic Opportunity' value, which are designed for financial institutions, are not applicable to HCA Healthcare, and no relevant evidence could be found in the provided articles to score these financial services-specific metrics.
Fair Pay & Worker Respect
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HCA Healthcare has faced multiple labor-related issues and allegations in 2023. The National Labor Relations Board (NLRB) ruled in August 2023 that HCA violated labor laws by unilaterally implementing a pandemic pay program in March 2020 without union consultation at three Southern California hospitals.
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An NLRB judge also found in May 2023 that an HCA facility in Missouri violated federal labor law by withdrawing union recognition, failing to provide information, and not honoring contract terms.
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The U.S. Equal Employment Opportunity Commission (EEOC) filed a lawsuit in July 2023, alleging race, national origin, and age discrimination, and retaliation against an employee.
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Workers at HCA Florida hospitals voted in May 2023 to refuse voluntary overtime due to staffing shortages and working conditions.
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An unfair labor practice complaint was filed in May 2023 against HCA-affiliated hospitals in Florida for failing to provide information on safe staffing.
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A planned strike at five California hospitals was averted in May 2023 after a settlement included 15% raises over three years and staffing investments.
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However, workers at other California facilities had voted 97% in favor of a strike in May 2023, citing management threats, intimidation, and failure to bargain over short-staffing, low wages, and safety.
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Protests in Florida in May 2023 highlighted chronic understaffing, patient safety concerns, and low wages, with some workers earning as little as $12 per hour.
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Union reports in April and January 2023 indicated staffing levels at HCA's Florida and Nevada hospitals were significantly below state and national averages, respectively, leading to compromised patient care and decreased retention rates.
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Fair Trade & Ethical Sourcing
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HCA Healthcare has a Human Trafficking Workgroup focused on awareness, prevention, and mitigating human trafficking in the supply chain.
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This workgroup partners with the U.S. Department of Health and Human Services Office of Trafficked Persons and facilitates human trafficking education for healthcare professionals.
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HCA Healthcare's UK division publishes annual Modern Slavery Statements, with the 2024 statement reaffirming a zero-tolerance approach to human trafficking, forced labor, and unlawful child labor.
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HCA UK commits to taking immediate action to address modern slavery risks with suppliers and will review contractual due diligence processes for supplier understanding of their supply chains.
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HCA Healthcare emphasizes ethical procurement policies, collaborates with suppliers adhering to recognized labor standards, and conducts regular audits and risk assessments to verify supplier commitment.
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HealthTrust, a partner, prohibits human rights violations in supplier operations, outlines expectations in contracts and its Supplier Code of Conduct, and is implementing technology to alert to potential forced-labor violations.
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HCA Healthcare's Code of Conduct applies to relationships with vendors.
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The company has been recognized 15 times as one of the World’s Most Ethical Companies by Ethisphere.
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Honest & Fair Business
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HCA Healthcare faces significant ethical challenges, including multiple public scandals and recurring compliance lapses. In July 2023, a cyberattack affected 11.27 million patients.
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Additionally, 0% of 188 HCA hospitals reviewed were found to be complying with price transparency rules.
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In November 2023, the North Carolina Attorney General criticized HCA for allegedly failing to maintain services as agreed during its Mission Hospital acquisition, an allegation HCA disputes.
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Concerns about conflicts of interest were also raised during the 2018 Mission Health acquisition process.
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Despite these issues, HCA Healthcare has a formal whistleblower policy with non-retribution assurance, a 24/7 multi-language Ethics Line, and colleagues complete Code of Conduct training annually, though program effectiveness is not publicly measured.
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The company also maintains a comprehensive Global Anti-Corruption Policy, complies with the U.S. Foreign Corrupt Practices Act and UK Bribery Act, and provides annual training, including specific gift limits.
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HCA Healthcare has been recognized by Ethisphere as one of the World’s Most Ethical Companies 15 times, including in 2025, based on an assessment of over 240 criteria covering ethics and compliance programs, governance, and social impact.
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Kind to Animals
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HCA Healthcare has a formal policy, effective February 1, 2017, that guides the appropriate care and use of all animals involved in research, research training, and biological testing activities.
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This policy is enforced by an Institutional Animal Care and Use Committee (IACUC), which reviews the institution's program and inspects facilities at least every six months.
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The IACUC is authorized to suspend activities involving animals
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and is required to report any serious noncompliance to the Office of Laboratory Animal Welfare (OLAW) annually.
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The policy also endorses the "Three Rs" (Replacement, Reduction, and Refinement)
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and the U.S. Government Principles for the Utilization and Care of Vertebrate Animals.
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No War, No Weapons
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HCA Healthcare is committed to delivering patient-focused care without involvement in arms manufacturing, military contracts, or activities facilitating conflict.
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This commitment serves as a clear corporate ban on military sales and codifies ethical red lines against engagement in the arms industry. As a healthcare provider, the company's core business has no defense or arms-related activities, no dual-use products, no sales to embargoed regimes, no defense business to oversee, and no defense assets to divest. The company also has no exports requiring military certification, no defense-related lobbying, no operations in conflict regions, no assets in conflict-exposed sectors, no dual-use portfolio, no surveillance or intelligence activities, no exposure to any weapons, no war-risk audits required, no conflict-linked partners, no mineral inputs in products or services, no applicable technology development, and no conflict zone procurement activity.
Planet-Friendly Business
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HCA Healthcare's total Scope 1 and 2 greenhouse gas emissions were 2,054,000 tCO2e in 2022.
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It aims for net-zero Scope 1 and 2 emissions by 2050
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and Scope 3 emissions by 2045.
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HCA Healthcare has recorded 20 environmental violation records since 2000.
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The company publishes a TCFD-aligned climate risk report, integrating climate risk into its Enterprise Risk Management.
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It conducts climate scenario analysis for 1.5°C and >2°C warming pathways, aligned with NGFS scenarios, and is beginning to incorporate these into strategic planning.
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HCA Healthcare has 10 LEED-certified facilities.
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Respect for Cultures & Communities
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HCA Healthcare supports the national Equity of Care initiative, emphasizing inclusion, compassion, and respect
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. The company enhances language services to improve communication with patients facing language barriers
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. HCA Healthcare offers diversity programs, including a Cultural Inclusion Series and Colleague Networks
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, and provides cultural competency training for healthcare professionals
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. The company collaborates with organizations on mental wellness, with programs like the GSUSA Mental Wellness Patch engaging over 20,000 participants in July 2023
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Safe & Smart Tech
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HCA Healthcare has a robust Responsible AI Program with a governance framework, an AI Governance Council, and an AI Ethics Committee established in March 2024.
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This committee is responsible for developing and maintaining an AI ethics framework, applying the framework to AI use at HCA or on HCA data, providing recommendations to the HCA Data Utilization Committee and HCA Research Advisory Council.
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The framework includes guiding principles such as fairness, inclusion, non-discrimination, privacy, data protection, accountability, transparency, and explainability, and adopts NIST's assessment of bias.
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In July 2023, HCA Healthcare reported a data security incident where an unauthorized party accessed and posted patient information, including names, contact details, birth dates, gender, service dates, and appointment information, from an external storage location.
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Following this breach, the U.S. Department of Health and Human Services (HHS) launched an investigation into potential HIPAA violations, and HCA Healthcare faced multiple class-action lawsuits alleging negligence in data security.
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HCA Healthcare's information security program and policies reference compliance with major regulations such as HIPAA, CCPA, GDPR, HITECH, Sarbanes-Oxley, and PCI.
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The company also has policies addressing patients' rights to access, amend, request privacy restrictions, and request confidential communication.
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Zero Waste & Sustainable Products
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HCA Healthcare has implemented numerous waste reduction initiatives, including an integrated waste management project, reprocessing programs for single-use devices, and purchasing reusable items such as gowns and instrument cases. The company also recycles various materials like cardboard, paper, aluminum, wood, rechargeable batteries, and construction waste. In 2022, over 100 million pounds of materials were diverted from landfills.
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Specific efforts include reviewing theatre packs, introducing bulk toiletries, expanding food-waste collection, and switching to pre-dosed mops, which saved over 1,500kg of plastic.
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For hazardous waste management, HCA Healthcare has a proactive pharmaceutical waste program that reduces drugs entering the water supply by at least 90 percent.
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The company also works to eliminate mercury use in facilities, minimize exposure to persistent, bioaccumulative, and toxic (PBT) substances, and provides continuing education on proper disposal for clinicians and staff.
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