<SEC-DOCUMENT>0001193125-23-157949.txt : 20230713
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<ACCEPTANCE-DATETIME>20230531165757
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ACCESSION NUMBER:		0001193125-23-157949
CONFORMED SUBMISSION TYPE:	CORRESP
PUBLIC DOCUMENT COUNT:		1
FILED AS OF DATE:		20230531

FILER:

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			HCA Healthcare, Inc.
		CENTRAL INDEX KEY:			0000860730
		STANDARD INDUSTRIAL CLASSIFICATION:	SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062]
		IRS NUMBER:				273865930
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		CORRESP

	BUSINESS ADDRESS:	
		STREET 1:		ONE PARK PLZ
		CITY:			NASHVILLE
		STATE:			TN
		ZIP:			37203
		BUSINESS PHONE:		6153449551

	MAIL ADDRESS:	
		STREET 1:		ONE PARK PLAZA
		CITY:			NASHVILLE
		STATE:			TN
		ZIP:			37203

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	HCA Holdings, Inc.
		DATE OF NAME CHANGE:	20101126

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	HCA INC/TN
		DATE OF NAME CHANGE:	20010627

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	HCA THE HEALTHCARE CO
		DATE OF NAME CHANGE:	20010419

FILER:

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			HCA Inc./DE
		CENTRAL INDEX KEY:			0001526688
		STANDARD INDUSTRIAL CLASSIFICATION:	SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062]
		IRS NUMBER:				752497104

	FILING VALUES:
		FORM TYPE:		CORRESP

	BUSINESS ADDRESS:	
		STREET 1:		ONE PARK PLAZA
		CITY:			NASHVILLE
		STATE:			TN
		ZIP:			37203
		BUSINESS PHONE:		615-344-9551

	MAIL ADDRESS:	
		STREET 1:		ONE PARK PLAZA
		CITY:			NASHVILLE
		STATE:			TN
		ZIP:			37203
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<TYPE>CORRESP
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<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>HCA Healthcare, Inc. </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>HCA Inc. </B></P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>One Park Plaza
</B></P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Nashville, Tennessee 37203 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">May&nbsp;31, 2023 </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Securities and Exchange Commission </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Division of Corporation Finance </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">100 F Street, N.E. </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Washington, D.C. 20549 </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD WIDTH="9%">&nbsp;</TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left">Re:</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>HCA Healthcare, Inc. </B><B>and HCA Inc. Registration Statement on Form
<FONT STYLE="white-space:nowrap">S-4</FONT> (File No.</B><B></B><B>&nbsp;333-</B><B>272298</B><B>), filed on May</B><B></B><B>&nbsp;31, 2023</B> </P></TD></TR></TABLE>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Ladies and Gentlemen: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">On May&nbsp;31, 2023, HCA
Healthcare, Inc. (the &#147;<B>Parent</B>&#148;) and HCA Inc. (the &#147;<B>Issuer</B>&#148;) filed with the Securities and Exchange Commission (the &#147;<B>Commission</B>&#148;) a registration statement (the &#147;<B>Registration
Statement</B>&#148;) on Form <FONT STYLE="white-space:nowrap">S-4</FONT> under the Securities Act of 1933, as amended (the &#147;<B>Securities Act</B>&#148;). The Registration Statement registers the Issuer&#146;s new $1,000,000,000 in aggregate
principal amount of 3 1/8% Senior Notes due 2027, $500,000,000 in aggregate principal amount of 3 3/8% Senior Notes due 2029, $2,000,000,000 in aggregate principal amount of 3 5/8% Senior Notes due 2032, $500,000,000 in aggregate principal amount of
4 3/8% Senior Notes due 2042 and $2,000,000,000 in aggregate principal amount of 4 5/8% Senior Notes due 2052, each of which is guaranteed by the Parent (collectively, the &#147;<B>Exchange Notes</B>&#148;), to be exchanged in an exchange offer (the
&#147;<B>Exchange Offer</B>&#148;) for a like principal amount of the Issuer&#146;s outstanding 3 1/8% Senior Notes due 2027, 3 3/8% Senior Notes due 2029, 3 5/8% Senior Notes due 2032, 4 3/8% Senior Notes due 2042 and 4 5/8% Senior Notes due 2052,
each of which is guaranteed by the Parent (collectively, the &#147;<B>Original Notes</B>&#148;). We are submitting this letter in order to inform you that the Issuer and the Parent are registering the Exchange Offer in reliance on the position of
the staff of the Commission (the &#147;<B>Staff</B>&#148;) stated in the <U>Exxon Capital Holdings Corporation</U>, SEC <FONT STYLE="white-space:nowrap">No-Action</FONT> Letter (available May&nbsp;13, 1988) (the &#147;<B>Exxon Capital
Letter</B>&#148;), <U>Morgan Stanley</U><U></U><U>&nbsp;&amp; Co. Incorporated</U>, SEC <FONT STYLE="white-space:nowrap">No-Action</FONT> Letter (available June&nbsp;5, 1991) (the &#147;<B>Morgan Stanley Letter</B>&#148;) and
<U>Shearman</U><U></U><U>&nbsp;&amp; Sterling</U>, SEC <FONT STYLE="white-space:nowrap">No-Action</FONT> Letter (available July&nbsp;2, 1993) (the &#147;<B>Shearman</B><B></B><B>&nbsp;&amp; Sterling Letter</B>&#148;). In connection with the filing
of the Registration Statement and in anticipation of the acceleration of the effectiveness thereof, the Issuer and the Parent hereby represent as follows: </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Issuer and the Parent have not entered into any arrangement or understanding with any person to distribute the Exchange Notes to be
received in the Exchange Offer and to the best of the Issuer&#146;s and the Parent&#146;s information and belief, each person participating in the Exchange Offer is acquiring the Exchange Notes in its ordinary course of business and has no
arrangement or understanding with any person to participate in the distribution of the Exchange Notes to be received in the Exchange Offer. In this regard, the Issuer and the Parent will make each person participating in the Exchange Offer aware
(through the Exchange Offer prospectus or otherwise) that if the Exchange Offer is being registered for the purpose of secondary resales, any </P>
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securityholder using the Exchange Offer to participate in a distribution of the Exchange Notes to be acquired in the Exchange Offer (1)&nbsp;cannot rely on the Staff&#146;s position in the Exxon
Capital Letter, the Morgan Stanley Letter, the Shearman&nbsp;&amp; Sterling Letter or similar letters and (2)&nbsp;must comply with registration and prospectus delivery requirements of the Securities Act in connection with a secondary resale
transaction. The Issuer and the Parent acknowledge that such a secondary resale transaction should be covered by an effective registration statement containing the selling securityholder information required by Item 507 of Regulation <FONT
STYLE="white-space:nowrap">S-K</FONT> under the Securities Act. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Issuer and the Parent will also include in the letter of transmittal
to be agreed to by each person participating in the Exchange Offer (the &#147;<B>Letter of Transmittal</B>&#148;) disclosure that, by accepting the Exchange Offer, each holder (including any broker-dealer) of the Original Notes represents to the
Issuer and the Parent that (i)&nbsp;it is not an affiliate of the Issuer or the Parent, or, if it is an affiliate of the Issuer or the Parent, it will comply with the registration and prospectus delivery requirements of the Securities Act to the
extent applicable in connection with the resale of the Exchange Notes, (ii)&nbsp;the Exchange Notes will be acquired in the ordinary course of business, and (iii)&nbsp;it is not engaged in, and does not intend to engage in, a distribution of the
Exchange Notes to be received in the Exchange Offer. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">With respect to any broker-dealer participating in the Exchange Offer with respect
to Original Notes acquired for its own account as a result of market-making activities or other trading activities, each such broker-dealer must confirm that it has not entered into any arrangement or understanding with the Issuer or the Parent or
any affiliate thereof to distribute the Exchange Notes. In addition, the Issuer and the Parent (i)&nbsp;will make each person participating in the Exchange Offer aware (through the Exchange Offer prospectus or otherwise) that any broker-dealer who
holds Original Notes acquired for its own account as a result of market-making activities or other trading activities, and who receives Exchange Notes in exchange therefor pursuant to the Exchange Offer, may be a statutory underwriter and must
deliver a prospectus meeting the requirements of the Securities Act in connection with any resale of such Exchange Notes and (ii)&nbsp;will include in the Letter of Transmittal the additional requirement that if the exchange offeree is a
broker-dealer holding Original Notes acquired for its own account as a result of market-making activities or other trading activities, an acknowledgment that such broker-dealer will deliver a prospectus meeting the requirements of the Securities Act
in connection with any resale of Exchange Notes received in respect of such Original Notes pursuant to the Exchange Offer. The Letter of Transmittal will also include a statement to the effect that by so acknowledging and by delivering a prospectus,
a broker-dealer will not be deemed to admit that it is an &#147;underwriter&#148; within the meaning of the Securities Act. </P>
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<TD VALIGN="top">Very Truly yours,</TD></TR>
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<TD HEIGHT="16"></TD></TR>
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<TD VALIGN="top">HCA HEALTHCARE, INC.</TD></TR>
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<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ John M. Franck II</P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Name: John M. Franck II</P> <P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Title: &nbsp;&nbsp;Vice President &#150;
Legal and Corporate Secretary</P></TD></TR>
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<TD VALIGN="top">HCA INC.</TD></TR>
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<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ John M. Franck II</P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Name: John M. Franck II</P> <P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Title: &nbsp;&nbsp;Vice President &#150;
Legal and Corporate Secretary</P></TD></TR>
</TABLE></DIV> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><I>[Signature Page to Exxon Capital Reliance Letter] </I></P>
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