HCA spent $190 million to acquire two hospital facilities and $37 million to acquire nonhospital health care entities. This demonstrates a continued strategy of expanding its footprint through strategic acquisitions.

Planned capital expenditures are expected to approximate between $5.0 billion and $5.2 billion in 2025. Projects under construction have estimated additional costs to complete and equip over the next five years of approximately $5.6 billion.

HCA repurchased 7.762 million shares of common stock for the quarter ended March 31, 2025. The company has $8.259 billion of repurchase authorization available under the January 2025 authorization.

Same facility salaries and benefits per full time equivalent increased 2.0% for the first quarter of 2025 compared to the first quarter of 2024. This indicates management is focused on controlling labor costs.

The effective tax rate increased to 23.8% from 21.8%, related primarily to a reduction in the amount of deductible share-based compensation for vested employee equity awards. This indicates management is focused on managing tax obligations.

Management is focused on efficiency, as indicated by the results of efforts to use technology and resilience initiatives, including artificial intelligence and machine learning, to drive efficiencies, better outcomes and an enhanced patient experience.

HCA's total indebtedness was $44.576 billion as of March 31, 2025, which could impact the company's ability to fund operations, react to economic changes, and meet obligations. The company also has the ability to incur additional debt.

HCA may not be able to generate sufficient cash to service all of its indebtedness and may not be able to refinance its indebtedness on favorable terms. If HCA is unable to do so, it may be forced to take other actions to satisfy its obligations under its indebtedness, which may not be successful.

HCA's senior unsecured credit facility and the indentures governing outstanding notes contain various covenants that limit its ability to engage in specified types of transactions. These covenants limit HCA's and/or certain of its subsidiaries' ability to, among other things: incur additional indebtedness or issue certain preferred shares; create liens; engage in certain sale and lease-back transactions; and consolidate, merge, sell or otherwise dispose of all or substantially all of its assets.

The highly competitive nature of the health care business, changes in service mix, revenue mix and surgical volumes, including potential declines in the population covered under third-party payer agreements, the ability to enter into and renew third-party payer provider agreements on acceptable terms and the impact of consumer-driven health plans and physician utilization trends and practices.

The efforts of health insurers, health care providers, large employer groups and others to contain health care costs.

The impact of known and unknown government investigations, litigation and other claims that may be made against us.

Supply costs per equivalent admission increased 0.4% in the first quarter of 2025 compared to the first quarter of 2024. Supply costs per equivalent admission increased 4.6% for medical devices and declined 3.9% for pharmacy supplies and 1.8% for general medical and surgical items in the first quarter of 2025 compared to the first quarter of 2024.

We have seen inflation have a negative impact on certain of these expenses and expect inflationary pressures will continue to impact operating expenses in the future.

Personnel-related capacity constraints, increases in wages and the ability to attract, utilize and retain qualified management and other personnel, including affiliated physicians, nurses and medical and technical support personnel.

The results of our efforts to use technology and resilience initiatives, including artificial intelligence and machine learning, to drive efficiencies, better outcomes and an enhanced patient experience.

Our ongoing ability to demonstrate meaningful use of certified electronic health record technology and the impact of interoperability requirements.

The impact of actual and potential cybersecurity incidents or security breaches involving us or our vendors and other third parties.

HCA repaid $2.6 billion of senior notes and issued $5.250 billion of new senior notes with varying interest rates and maturities. This indicates active management of the capital structure to optimize costs and maturities.

HCA repurchased $2.506 billion of common stock during the quarter. This demonstrates a commitment to returning capital to shareholders and confidence in the company's financial performance.

Planned capital expenditures are expected to approximate between $5.0 billion and $5.2 billion in 2025. Projects under construction have estimated additional costs to complete and equip over the next five years of approximately $5.6 billion.

There is no explicit mention of ESG initiatives or targets within this 10-Q filing. This suggests a lack of focus on ESG factors in their reporting, or that these factors are not considered material enough to disclose in the quarterly report.

Changes in or related to general economic or business conditions nationally and regionally in our markets, including inflation and the impact of trade policies, including changes in, or the imposition of, tariffs and/or trade barriers.

The impact of current and future health care public policy developments and possible changes to other federal, state or local laws and regulations affecting the health care industry, including the expiration of enhanced premium tax credits for individuals eligible to purchase insurance coverage through federal and state-based health insurance marketplaces and changes in the structure and administration of, and funding for, federal and state agencies and programs.

The impact of known and unknown government investigations, litigation and other claims that may be made against us.