HCA 11-K
Table of Contents

 
 
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 11-K
     
þ   ANNUAL REPORT PURSUANT TO SECTION 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the fiscal year ended December 31, 2005
OR
     
o   TRANSITION REPORT PURSUANT TO SECTION 15 (d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from                      to                     
Commission file number 5-41652
A. Full title of the plan and the address of the plan, if different from that of the issuer named below:
HCA 401(k) Plan
B. Name of issuer of the securities held pursuant to the plan and the address of its principal executive office:
HCA Inc.
One Park Plaza
Nashville, Tennessee
37203
 
 


 

HCA 401(k) Plan
Financial Statements and Supplemental Schedule
Years Ended December 31, 2005 and 2004
Contents
         
    1  
 
       
Audited Financial Statements:
       
 
       
    2  
    3  
    4  
 
       
Supplemental Schedule:
       
 
       
    27  
 
       
       
 
       
Exhibits:
       
 EX-23 CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM


Table of Contents

Report of Independent Registered Public Accounting Firm
Plan Administration Committee
HCA Inc.
We have audited the accompanying statements of net assets available for benefits of the HCA 401(k) Plan as of December 31, 2005 and 2004, and the related statements of changes in net assets available for benefits for the years then ended. These financial statements are the responsibility of the Plan’s management. Our responsibility is to express an opinion on these financial statements based on our audits.
We conducted our audits in accordance with the standards of the Public Company Accounting Oversight Board (United States). Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. We were not engaged to perform an audit of the Plan’s internal control over financial reporting. Our audits included consideration of internal control over financial reporting as a basis for designing audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the Plan’s internal control over financial reporting. Accordingly, we express no such opinion. An audit also includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements, assessing the accounting principles used and significant estimates made by management, and evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion.
In our opinion, the financial statements referred to above present fairly, in all material respects, the net assets available for benefits of the Plan at December 31, 2005 and 2004, and the changes in its net assets available for benefits for the years then ended, in conformity with U.S. generally accepted accounting principles.
As described in Note 2 to the financial statements, the Company changed to the accrual basis of accounting from the modified cash basis of accounting, which is a comprehensive basis of accounting other than U.S. generally accepted accounting principles.
Our audits were performed for the purpose of forming an opinion on the financial statements taken as a whole. The accompanying supplemental schedule of assets (held at end of year) as of December 31, 2005 is presented for purposes of additional analysis and is not a required part of the financial statements, but is supplementary information required by the Department of Labor’s Rules and Regulations for Reporting and Disclosure under the Employee Retirement Income Security Act of 1974. This supplemental schedule is the responsibility of the Plan’s management. The supplemental schedule has been subjected to the auditing procedures applied in our audits of the financial statements and, in our opinion, is fairly stated in all material respects in relation to the financial statements taken as a whole.
/s/ Ernst & Young LLP
Nashville, Tennessee
June 19, 2006


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HCA 401(k) Plan
Statements of Net Assets Available for Benefits
                 
    December 31
    2005   2004
Assets
               
Investments, at fair value:
               
Participation in Fixed Income Pool
  $ 593,544,304     $ 532,342,101  
Participation in Interest Income Pool
    567,465,882       503,369,864  
Participation in Large Company Growth Pool
    417,257,462       368,731,369  
Participation in Large Company Value Pool
    526,231,859       461,632,468  
Participation in Small Company Growth Pool
    243,154,295       220,030,552  
Participation in Small Company Value Pool
    470,866,045       397,528,459  
Participation in International Pool
    249,503,601       194,293,831  
Participation in Company Stock Pool
          780,541,938  
Participation in S&P 500 Index Fund Pool
    298,163,473        
HCA Common Stock
    886,771,870        
Common Collective Funds
    22,497,776       278,569,127  
     
Total Participation in HCA Inc. Master Retirement Trust
    4,275,456,567       3,737,039,709  
 
               
Participant loans
    118,819,568       120,832,381  
     
Total investments
    4,394,276,135       3,857,872,090  
 
               
Participant contributions receivable
    7,527,064        
Employer contributions receivable
    1,572,196        
Income receivable
    58,696        
     
Total assets
    4,403,434,091       3,857,872,090  
 
               
Liabilities
               
Accrued expenses
    1,261,747        
     
 
               
Net assets available for benefits
  $ 4,402,172,344     $ 3,857,872,090  
     
See accompanying notes.

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HCA 401(k) Plan
Statements of Changes in Net Assets Available for Benefits
                 
    Years Ended December 31
    2005   2004
Additions to net assets attributed to:
               
Participant contributions
  $ 336,428,744     $ 307,546,313  
Employer contributions
    61,054,841       54,248,130  
Participant loan interest
    4,924,925       4,525,223  
Net investment results from HCA Inc. Master Retirement Trust
    401,025,423       221,275,885  
Assets transferred into the Plan from EPIC Healthcare Group, Inc. Profit Sharing Plan and Healthtrust, Inc. 401(k)Retirement Program
          474,655,201  
Assets transferred into the Plan from MCA 401(k) Plan
    29,913,312        
     
 
               
Total additions to net assets
    833,347,245       1,062,250,752  
 
               
Deductions from net assets attributed to:
               
Benefits paid to participants
    292,092,430       242,756,393  
Administrative expenses
    5,739,104       8,172,953  
     
Total deductions from net assets
    297,831,534       250,929,346  
     
 
               
Net increase
    535,515,711       811,321,406  
 
               
Net assets available for benefits:
               
Beginning of year
    3,857,872,090       3,046,550,684  
Cumulative effect of a change in accounting method
    8,784,543        
     
End of year
  $ 4,402,172,344     $ 3,857,872,090  
     
See accompanying notes.

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HCA 401(k) Plan
Notes to Financial Statements
December 31, 2005
1. Description of the Plan
The following description of the HCA 401(k) Plan (the Plan) provides only general information. Participants should refer to the summary plan description for a more complete description of the Plan’s provisions.
General
The Plan is a defined contribution plan, established January 1, 1983, which provides retirement benefits for all eligible employees of HCA Inc. or its affiliates (the Company or HCA), and is subject to the provisions of the Employee Retirement Income Security Act of 1974, as amended (ERISA). Effective January 1, 2005, participants are eligible to participate on the first day of the month following two months of continuous employment and upon attaining age eighteen. Prior to January 1, 2005, the age for eligibility was twenty-one.
Contributions and Vesting
Participants may defer from 1% to 50% of eligible salary to the Plan subject to Internal Revenue Code limitations. Such amounts, along with earnings thereon, are fully vested at all times. The Company, in its sole discretion, may limit the contributions of highly compensated employees. Participants who have attained age 50 before the close of the Plan year are eligible to make catch-up contributions subject to Internal Revenue Code limitations.
The Company contributes to the Plan a matching employer contribution of $0.50 for every dollar of participant deferrals, up to the first 3.0% of eligible compensation deferred (Matching Contribution). The Company may, at its sole discretion, make a Stock Bonus Contribution or a Profit Sharing Contribution to the Plan for any Plan year, which will be shared among active participants, as defined in the Plan document, for the Plan year. Participants are 100% vested in all Company Matching Contributions after earning three years of vesting service. The Plan provides for a vesting schedule relative to the Stock Bonus Contribution and Profit Sharing Contribution that occurs ratably beginning with three years of vesting service, with 100% vesting occurring after seven years of vesting service. Participants will be fully vested upon retirement, death or disability, without regard to years of vesting service.

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HCA 401(k) Plan
Notes to Financial Statements (continued)
1. Description of the Plan (continued)
Participant Loans
Participants may borrow from their accounts a minimum of $1,000, but borrowings may not exceed the lesser of $50,000, reduced by all other outstanding loans, or 50% of the participant’s total vested account balance. Loan terms range from one to five years (ten years if loan is used to acquire a principal residence). The loans are secured by the balance in the respective participant’s account and bear interest at rates commensurate with local prevailing rates. Principal and interest are paid ratably through payroll deductions.
Participant Accounts
Each participant’s account is credited with the participant’s contributions and allocations of the Company’s contributions. Additionally, each participant’s account is credited/charged with Plan earnings/losses and charged with an allocation of administrative expenses. Allocations are based on participant earnings or account balances, as defined. The benefit to which a participant is entitled is the benefit that can be provided from the participant’s vested account.
Benefit Payments
A participant can only receive a distribution in the form of a lump sum payment. Upon the death of a participant, the vested account balance will be distributed in a single lump sum. Hardship withdrawals are permitted under the Plan.
Administrative Expenses
In accordance with the Plan document, expenses incurred to administer the Plan are paid by the Plan unless paid by the Company, at the Company’s discretion.
Plan Termination
Although it has not expressed any intent to do so, the Company has the right to terminate the Plan, subject to the provisions of ERISA. Upon termination of the Plan, each participant will be fully vested in the value of his/her account after payment of any accrued expenses and liabilities of the Plan.

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HCA 401(k) Plan
Notes to Financial Statements (continued)
1. Description of the Plan (continued)
Plan Merger
The Healthtrust, Inc. 401(k) Retirement Program and the EPIC Healthcare Group, Inc. Profit Sharing Plan, which were participants in the Master Trust, merged into the Plan effective midnight December 31, 2003. On January 1, 2004, the Plan reflected assets transferred in at fair value of $474,655,201. The MCA 401(k) Plan merged into the Plan effective October 1, 2005. The assets transferred to the Plan reflected fair value of $29,913,312.
2. Summary of Significant Accounting Policies
Basis of Accounting
For the year ended December 31, 2005, the accompanying financial statements and supplemental schedule are prepared on the accrual basis of accounting. Accordingly, participants’ and employer contribution receivables and other expenses payable are reflected in the statement of net assets available for benefits. The effect of the change on current year and prior year net assets and the changes thereto is not material. Purchases and sales of securities are recorded on a trade-date basis. Dividends are recorded on the ex-dividend date.
For the year ended December 31, 2004, the accompanying financial statements were prepared using the modified cash basis of accounting, which is a comprehensive basis of accounting other than U.S. generally accepted accounting principles. Under this basis, investment assets are reported at fair value, net realized and unrealized appreciation (depreciation) in fair value of investments is recognized, contributions are recognized when received rather than as earned, and benefits and expenses are recognized when paid.
Valuation of Investments
The Plan’s investments in the HCA Inc. Master Retirement Trust (Master Trust) are participant directed and stated at fair value, except for certain investment contracts held in the Interest Income Pool. Securities traded on a national securities exchange, including HCA Inc. common stock, are valued at the last reported sales price on the primary exchange on the last business day of the Plan year. Investments traded in the over-the-counter market and listed securities for which no sale was reported on that date are valued at the average of the last reported bid and ask prices. When such prices are unavailable, The Northern Trust Company (the Trustee) determines a valuation from the market maker dealing in that particular security. Joint ventures and other limited partnerships owned by the Master Trust are valued at the appraised values available as of the last business day of the Plan year. The fair value of participation units owned by the Master Trust in the collective trust funds are based on quoted redemption values on the last business day of the Plan year. Investments in the insurance general account are reported at contract value. Participant loans are valued at their outstanding balance, which approximates fair value.

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HCA 401(k) Plan
Notes to Financial Statements (continued)
2. Summary of Significant Accounting Policies (continued)
Valuation of Investments (Continued)
Investment contracts held in the Master Trust are wrapper contracts with insurance companies that generally change the investment characteristic of underlying securities (such as U.S. government securities) to those of guaranteed investment contracts. The investment contracts are fully benefit-responsive and are recorded at their contract values. The contract values represent participant contributions (less any participant withdrawals), reinvested income and accruals. Participants may ordinarily direct the withdrawal or transfer of all or a portion of their investment at contract value. However, withdrawals influenced by Company-initiated events, such as in connection with the sale of a business, may result in a distribution at other than contract value. There are no reserves against contract values for credit risk of contract issuers or otherwise. The contract value of the investment contracts at December 31, 2005 and 2004 was $251,383,316 and $235,963,009, respectively. The fair value of the investment contracts at December 31, 2005 and 2004 was $263,710,152 and $261,581,824, respectively. The crediting interest rate for these investment contracts is reset quarterly by the issuer and ranged from 6.255% to 6.705% during 2005 and 5.702% to 6.391% during 2004. The average yield was 6.535% and 5.934%, respectively, during 2005 and 2004. The crediting interest rates were 6.255% at December 31, 2005, and 6.391% at December 31, 2004.
Derivative Financial Instruments
The Master Trust, through activities of certain of its investment managers, uses derivative financial instruments in connection with its normal trading activities in an effort to improve investment returns, manage exposure to fluctuations in interest rates or otherwise manage risk. A derivative financial instrument is a security or contractual agreement that derives its value from some other security, commodity, currency or index. The Master Trust is invested in various types of derivative financial instruments including forward contracts, futures contracts, swaps, options, investment contracts and collateralized mortgage obligations.
The Master Trust’s equity and fixed income investment managers are permitted to hedge the currency risks of their foreign security investments. In addition, certain equity and fixed income investment managers are permitted to use derivative instruments as part of their investment strategies. These strategies use derivative instruments to replicate the risk/return profile of assets, asset classes, equity or fixed income market indices and to assist in the management of the risk exposure of the investment portfolio. The investment managers are prohibited from using derivatives for speculative purposes and any hedged positions are not permitted to exceed the level of exposure in the related Master Trust assets. Changes in fair value of the derivative financial instruments are recorded separate from the related investment (see Note 3 -

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Table of Contents

HCA 401(k) Plan
Notes to Financial Statements (continued)
2. Summary of Significant Accounting Policies (continued)
Derivative Financial Instruments (continued)
Investments). As such, a change in fair value of the derivative financial instruments, including associated investment income (loss), may offset or reflect an inverse relationship with a change in fair value, including associated investment income (loss), in the related investment. The Master Trust’s investment managers are required to combine such changes in the fair value, including associated investment income (loss), of the derivative financial instruments with those of the related investments to determine the effectiveness of their strategies.
The Master Trust is exposed to risks from unfavorable changes in interest rates or market values of the securities underlying the derivative financial instruments. The Master Trust is also exposed to credit risk in the event of nonperformance by the counterparties to the derivative instruments. However, the Master Trust seeks to minimize its exposure to credit loss by requiring settlement with the counterparties as frequently as daily and/or requiring settlement based upon pre-established dollar amount limits with those counterparties. The Master Trust does not anticipate nonperformance by the counterparties and generally does not require counterparty collateral.
Use of Estimates
The preparation of financial statements requires management to make estimates that affect the amounts reported in the financial statements and accompanying notes. Actual results could differ from those estimates.
Reclassifications
Certain prior year amounts have been reclassified to conform to the current year presentation.

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HCA 401(k) Plan
Notes to Financial Statements (continued)
3. Investments
All of the Plan’s investments (except participant loans) are in the Master Trust, which invests in a variety of investments and was established for the investment of assets of the Plan and several other Company-sponsored retirement plans. The Master Trust includes several Master Trust Investment Accounts (or Investment Pools). Each participating retirement plan has an undivided interest in the Investment Pools selected by the Plan. The Investment Pools that the Plan invests in are disclosed separately. At December 31, 2005 and 2004, the Plan’s interest in the net assets of the Master Trust was approximately 63.52% and 62.18%, respectively. Investment income and expenses are allocated to the Plan based upon each plan’s share of elected investments and the income and expenses earned/charged on those investments.

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HCA 401(k) Plan
Notes to Financial Statements (continued)
3. Investments (continued)
The following table presents the net assets of the Master Trust at December 31:
                 
    2005   2004
     
Investments, at fair value:
               
Money market securities
  $ 41,662,794     $ 179,592,156  
Money market securities: collateral held under securities lending agreements (excluding noncash collateral)
    710,261,287       492,522,476  
U.S. government securities
    524,903,325       631,059,350  
U.S. government securities — loaned
    (53,533,459 )     (24,796,453 )
Corporate bonds — preferred
    657,017,757       568,700,793  
Corporate bonds — other
    332,558,629       150,857,530  
Corporate bonds — other — loaned
    (62,342,305 )     (41,008,811 )
Corporate stock — preferred
    2,849,508       15,986,713  
Corporate stock — common
    2,641,406,217       2,290,703,541  
Corporate stock — common — loaned
    (583,747,580 )     (447,725,568 )
HCA common stock
    886,771,870       767,801,070  
Interest in partnerships/joint ventures
    10,118,130       14,249,162  
Interest in common/collective trusts
    1,409,944,483       1,383,621,313  
Interest in registered investment companies
    125,845,468       104,578,658  
Interest in insurance general account
    7,597,179       7,321,041  
Synthetic guaranteed investment contract wrapper
    (12,326,836 )     (25,618,815 )
Other investments
    152,481,024       25,392,500  
Other investments — loaned
    (12,117,934 )     (3,337,942 )
Securities on loan
    711,741,278       516,868,774  
     
Total investments
    7,491,090,835       6,606,767,488  
 
               
Investment income receivable
    14,310,660       13,898,367  
     
Total assets
    7,505,401,495       6,620,665,855  
Other liabilities
    (11,334,193 )     (20,849,642 )
Obligation under securities lending agreements
    (710,261,287 )     (492,522,476 )
Pending trades
    (54,996,053 )     (97,671,015 )
     
Total net assets of the Master Trust
  $ 6,728,809,962     $ 6,009,622,722  
     

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Table of Contents

HCA 401(k) Plan
Notes to Financial Statements (continued)
3. Investments (continued)
Investment income for the Master Trust for the years ended December 31, 2005 and 2004:
                 
    2005   2004
     
Net appreciation (depreciation) in the fair value of investments:
               
U.S. government securities
  $ (10,176,824 )   $ (1,765,078 )
Corporate bonds — preferred
    (7,678,459 )     (2,131,076 )
Corporate bonds — other
    (6,696,560 )     378,966  
Corporate stock — preferred
    935,424       (3,241,599 )
Corporate stock — common
    185,563,570       271,548,689  
HCA common stock
    201,205,997       (61,293,218 )
Interest in partnerships/joint ventures
    (1,315,628 )     2,630,411  
Interest in common/collective trusts
    79,040,105       110,970,343  
Interest in registered investment companies
    9,000,971       7,470,691  
Other investments
    (8,122,829 )     1,929,911  
     
Total net appreciation
    441,755,767       326,498,040  
 
               
Interest and dividends
    144,337,114       114,868,762  
Other income
    376,899       617,212  
     
Total investment income
  $ 586,469,780     $ 441,984,014  
     

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HCA 401(k) Plan
Notes to Financial Statements (continued)
3. Investments (continued)
The following schedules represent the net assets and investment income (loss) for each Investment Pool owned by the Master Trust for the years ended December 31, 2005 and 2004. At both December 31, 2005 and 2004, the Plan’s interest in the net assets of the Fixed Income Pool was approximately 33%.
Fixed Income Pool
                 
    December 31
    2005   2004
     
Investments, at fair value:
               
Money market securities
  $ 28,517,338     $ 168,231,818  
Money market securities: collateral held under securities lending agreements (excluding noncash collateral)
    102,980,913       69,207,752  
U.S. government securities
    348,006,287       631,059,350  
U.S. government securities — loaned
    (36,707,985 )     (24,796,453 )
Corporate bonds — preferred
    89,532,887       568,700,793  
Corporate bonds — other
    199,138,809       150,232,698  
Corporate bonds — other — loaned
    (62,342,305 )     (40,606,843 )
Corporate stock — preferred
    103,250       12,832,914  
Corporate stock — common
    43,371       623,475  
Corporate stock — common — loaned
    (615 )      
Interest in partnerships/joint ventures
    9,695,278       10,968,913  
Interest in common/collective trusts
    114,889,700       156,268,965  
Interest in LIBOR Pool
    838,940,178        
Other investments
    151,691,739       16,224,398  
Other investments — loaned
    (12,117,934 )     (3,337,942 )
Securities on loan
    111,168,839       68,741,238  
     
Total investments
    1,883,539,750       1,784,351,076  
 
               
Investment income receivable
    7,288,891       11,374,091  
     
Total assets
    1,890,828,641       1,795,725,167  
Other liabilities
    (857,894 )     (997,855 )
Obligation under securities lending agreements
    (102,980,913 )     (69,207,752 )
Pending trades
    (111,086 )     (95,893,915 )
     
Total net assets of the Fixed Income Pool
  $ 1,786,878,748     $ 1,629,625,645  
     

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HCA 401(k) Plan
Notes to Financial Statements (continued)
3. Investments (continued)
Fixed Income Pool
                 
    Years Ended December 31
    2005   2004
Net appreciation (depreciation) in the fair value of investments:
               
U.S. government securities
  $ (7,604,988 )   $ (1,765,067 )
Corporate bonds — preferred
    (2,418,519 )     (2,131,076 )
Corporate bonds — other
    (8,094,121 )     280,885  
Corporate stock — preferred
    (5,684 )     (3,647,487 )
Corporate stock — common
    69,510       253,471  
Interest in partnerships/joint ventures
    (1,273,635 )     2,007,634  
Interest in common/collective trusts
    2,631,790       4,873,763  
Interest in LIBOR Pool
    31,853,606        
Other investments
    (9,508,505 )     1,633,958  
     
Total net appreciation
    5,649,454       1,506,081  
 
               
Interest and dividends
    41,363,485       60,272,292  
     
Total investment income of the Fixed Income Pool
  $ 47,012,939     $ 61,778,373  
     

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HCA 401(k) Plan
Notes to Financial Statements (continued)
3. Investments (continued)
As of December 31, 2005, the Plan’s interest in the net assets of the LIBOR Pool was approximately 33%. This is a new Investment Pool created in 2005. The investments of this pool are included in the Fixed Income Pool.
LIBOR Pool
         
    December 31,  
    2005  
Investments, at fair value:
       
Money market securities: collateral held under securities lending agreements (excluding noncash collateral)
  $ 12,563,227  
U.S. government securities
    176,897,038  
U.S. government securities — loaned
    (16,825,474 )
Corporate bonds — preferred
    567,484,870  
Corporate bonds — other
    133,419,820  
Interest in common/collective trusts
    9,743,216  
Other investments
    342,054  
Securities on loan
    16,825,474  
 
     
Total investments
    900,450,225  
 
       
Investment income receivable
    2,472,876  
 
     
Total assets
    902,923,101  
 
       
Obligation under securities lending agreements
    (12,563,227 )
Pending trades
    (51,419,696 )
 
     
Total net assets of the LIBOR Pool
  $ 838,940,178  
 
     
LIBOR Pool
         
    Year Ended  
    December 31, 2005  
Net appreciation (depreciation) in the fair value of investments:
       
U.S. government securities
  $ (2,571,836 )
Corporate bonds — preferred
    (5,259,940 )
Corporate bonds — other
    1,707,852  
Other investments
    1,622,625  
Total net depreciation
    (4,501,299 )
 
Interest and dividends
    36,354,904  
Total investment income of the LIBOR Pool
  $ 31,853,605  

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HCA 401(k) Plan
Notes to Financial Statements (continued)
3. Investments (continued)
At December 31, 2005 and 2004, the Plan’s interest in the net assets of the Interest Income Pool was approximately 99% and 99%, respectively.
Interest Income Pool
                 
    December 31
    2005   2004
     
Investments, at fair value:
               
Interest in common/collective trusts
  $ 312,087,814     $ 268,029,839  
Interest in insurance general account
    7,597,179       7,321,041  
Interest in Fixed Income Pool
    263,710,154       261,581,824  
Synthetic guaranteed investment contract wrapper
    (12,326,836 )     (25,618,815 )
     
Total investments
    571,068,311       511,313,889  
 
               
Investment income receivable
    1,516,309       63,036  
Total assets
    572,584,620       511,376,925  
Other liabilities
    (126,555 )     (434,152 )
Pending trades
    (1,315,713 )      
     
Total net assets of the Interest Income Pool
  $ 571,142,352     $ 510,942,773  
     
Interest Income Pool
                 
    Years Ended December 31
    2005   2004
     
Net appreciation in the fair value of investments:
               
Interest in common/collective trusts
  $ 7,021,884     $ 3,538,983  
Interest in Fixed Income Pool
    2,128,328       16,145,447  
     
Total net appreciation
    9,150,212       19,684,430  
 
               
Interest and dividends
    17,500,424       13,835,000  
     
Total investment income of the Interest Income Pool
  $ 26,650,636     $ 33,519,430  
     

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HCA 401(k) Plan
Notes to Financial Statements (continued)
3. Investments (continued)
At December 31, 2005 and 2004, the Plan’s interest in the net assets of the Large Company Growth Pool was approximately 57% and 56%, respectively.
Large Company Growth Pool
                 
    December 31
    2005   2004
     
Investments, at fair value:
               
Money market securities: collateral held under securities lending agreements (excluding noncash collateral)
  $ 93,147,470     $ 60,354,411  
Corporate stock — common
    644,368,679       585,185,859  
Corporate stock — common — loaned
    (92,738,770 )     (67,645,442 )
Interest in common/collective trusts
    88,320,069       77,236,805  
Securities on loan
    92,738,770       67,645,442  
     
Total investments
    825,836,218       722,777,075  
 
               
Investment income receivable
    336,699       235,894  
     
Total assets
    826,172,917       723,012,969  
Other liabilities
    (636,024 )     (808,077 )
Obligation under securities lending agreements
    (93,147,470 )     (60,354,411 )
Pending trades
    (1,629,598 )     (796,363 )
     
Total net assets of the Large Company Growth Pool
  $ 730,759,825     $ 661,054,118  
     
Large Company Growth Pool
                 
    Years Ended December 31
    2005   2004
     
Net appreciation (depreciation) in the fair value of investments:
               
Corporate stock — preferred
  $     $ (58,473 )
Corporate stock — common
    42,820,522       49,408,230  
Interest in common/collective trusts
    3,895,400       3,118,739  
Total net appreciation
    46,715,922       52,468,496  
 
               
Interest and dividends
    3,538,240       3,714,833  
Other income
    178,819       241,014  
     
Total investment income of the Large Company Growth Pool
  $ 50,432,981     $ 56,424,343  
     

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HCA 401(k) Plan
Notes to Financial Statements (continued)
3. Investments (continued)
At December 31, 2005 and 2004, the Plan’s interest in the net assets of the Large Company Value Pool was approximately 64% and 61%, respectively.
Large Company Value Pool
                 
    December 31
    2005   2004
     
Investments, at fair value:
               
Money market securities: collateral held under securities lending agreements (excluding noncash collateral)
  $ 80,237,602     $ 56,109,307  
Corporate stock — common
    740,461,465       657,617,111  
Corporate stock — common — loaned
    (81,022,882 )     (66,363,068 )
Interest in common/collective trusts
    87,008,991       95,039,778  
Securities on loan
    81,022,882       66,363,068  
     
Total investments
    907,708,058       808,766,196  
 
               
Investment income receivable
    1,220,607       1,151,851  
     
Total assets
    908,928,665       809,918,047  
Other liabilities
    (745,606 )     (1,009,422 )
Obligation under securities lending agreements
    (80,237,602 )     (56,109,307 )
Pending trades
    (99,480 )     (25,133 )
     
Total net assets of the Large Company Value Pool
  $ 827,845,977     $ 752,774,185  
     
Large Company Value Pool
                 
    Years Ended December 31
    2005   2004
     
Net appreciation in the fair value of investments:
               
Corporate stock — preferred
  $     $ 7,478  
Corporate stock — common
    39,238,789       68,170,564  
Interest in common/collective trusts
    4,794,857       6,644,429  
Interest in registered investment companies
          408,875  
     
Total net appreciation
    44,033,646       75,231,346  
 
               
Interest and dividends
    14,895,062       11,406,238  
Other income
    69,847       145,255  
     
Total investment income of the Large Company Value Pool
  $ 58,998,555     $ 86,782,839  
     

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HCA 401(k) Plan
Notes to Financial Statements (continued)
3. Investments (continued)
At December 31, 2005 and 2004, the Plan’s interest in the net assets of the Small Company Growth Pool was approximately 55% and 52%, respectively.
Small Company Growth Pool
                 
    December 31
    2005   2004
     
Investments, at fair value:
               
Money market securities: collateral held under securities lending agreements (excluding noncash collateral)
  $ 114,470,031     $ 101,018,000  
Corporate stock — common
    260,518,603       245,828,973  
Corporate stock — common — loaned
    (112,446,222 )     (103,053,929 )
Interest in common/collective trusts
    179,843,574       174,059,996  
Other investments
          223,728  
Securities on loan
    112,446,222       103,053,929  
     
Total investments
    554,832,208       521,130,697  
 
               
Investment income receivable
    53,108       47,533  
     
Total assets
    554,885,316       521,178,230  
Other liabilities
    (533,919 )     (520,913 )
Obligation under securities lending agreements
    (114,470,031 )     (101,018,000 )
Pending trades
    (495,481 )     (286,811 )
     
Total net assets of the Small Company Growth Pool
  $ 439,385,885     $ 419,352,506  
     
Small Company Growth Pool
                 
    Years Ended December 31
    2005   2004
     
Net appreciation in the fair value of investments:
               
Corporate stock — common
  $ 12,871,032     $ 17,910,071  
Interest in common/collective trusts
    6,482,308       21,245,148  
     
Total net appreciation
    19,353,340       39,155,219  
 
               
Interest and dividends
    948,878       946,985  
Other income
    113,786       173,052  
     
Total investment income of the Small Company Growth Pool
  $ 20,416,004     $ 40,275,256  
     

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`

HCA 401(k) Plan
Notes to Financial Statements (continued)
3. Investments (continued)
At December 31, 2005 and 2004, the Plan’s interest in the net assets of the Small Company Value Pool was approximately 70% and 66%, respectively.
Small Company Value Pool
                 
    December 31
    2005   2004
     
Investments, at fair value:
               
Money market securities: collateral held under securities lending agreements (excluding noncash collateral)
  $ 206,214,556     $ 108,603,911  
Corporate bonds — other
          397,470  
Corporate bonds — other — loaned
          (397,470 )
Corporate stock — common
    469,191,853       391,103,739  
Corporate stock — common — loaned
    (200,943,533 )     (114,628,181 )
Interest in partnerships/joint ventures
          2,815,404  
Interest in common/collective trusts
    199,239,474       204,539,331  
Other investments
    104,415       135,774  
Securities on loan
    200,943,533       115,025,651  
     
Total investments
    874,750,298       707,595,629  
 
               
Investment income receivable
    542,107       322,239  
     
Total assets
    875,292,405       707,917,868  
Other liabilities
    (1,024,062 )     (1,063,399 )
Obligation under securities lending agreements
    (206,214,556 )     (108,603,911 )
Pending trades
    312,700       (176,569 )
     
Total net assets of the Small Company Value Pool
  $ 668,366,487     $ 598,073,989  
     
Small Company Value Pool
                 
    Years Ended December 31
    2005   2004
     
Net appreciation (depreciation) in the fair value of investments:
               
Corporate bonds — other
  $ (310,291 )   $ 61,726  
Corporate stock — common
    38,991,774       74,459,984  
Interest in partnerships/joint ventures
          404,404  
Interest in common/collective trusts
    26,981,953       30,390,722  
     
Total net appreciation
    65,663,436       105,316,836  
 
               
Interest and dividends
    6,993,764       4,358,515  
Other income
    14,447       57,890  
     
Total investment income of the Small Company Value Pool
  $ 72,671,647     $ 109,733,241  
     

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Table of Contents

HCA 401(k) Plan
Notes to Financial Statements (continued)
3. Investments
At December 31, 2005 and 2004, the Plan’s interest in the net assets of the International Pool was approximately 40% and 38%, respectively.
International Pool
                 
    December 31
    2005   2004
     
Investments, at fair value:
               
Money market securities
  $ 13,145,456     $ 11,360,338  
Money market securities: collateral held under securities lending agreements (excluding noncash collateral)
    100,309,049       97,107,070  
Corporate bonds — other
          227,363  
Corporate stock — preferred
    2,746,258       3,153,799  
Corporate stock — common
    521,943,560       405,015,171  
Corporate stock — common — loaned
    (96,266,053 )     (95,919,894 )
Interest in common/collective trusts
    78,698,311       80,687,517  
Interest in registered investment companies
    9,144,086       2,176,530  
Other investments
    342,854       8,808,976  
Securities on loan
    96,266,053       95,919,894  
     
Total investments
    726,329,574       608,536,764  
 
               
Investment income receivable
    786,139       655,911  
     
Total assets
    727,115,713       609,192,675  
Other liabilities
    (584,378 )     (538,064 )
Obligation under securities lending agreements
    (100,309,049 )     (97,107,070 )
Pending trades
    (237,699 )     (492,224 )
     
Total net assets of the International Pool
  $ 625,984,587     $ 511,055,317  
     

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HCA 401(k) Plan
Notes to Financial Statements (continued)
3. Investments (continued)
International Pool
                 
    Years Ended December 31
    2005   2004
     
Net appreciation (depreciation) in the fair value of investments:
               
Corporate bonds — other
  $     $ 36,354  
Corporate stock — preferred
    941,108       456,882  
Corporate stock — common
    51,538,436       60,017,457  
Interest in common/collective trusts
    11,360,178       11,824,837  
Interest in registered investment companies
    878,337       616,771  
Other investments
    (2,294,443 )     913,165  
     
Total net appreciation
    62,423,616       73,865,466  
 
               
Interest and dividends
    11,294,877       8,724,484  
     
Total investment income of the International Pool
  $ 73,718,493     $ 82,589,950  
     

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HCA 401(k) Plan
Notes to Financial Statements (continued)
3. Investments (continued)
At December 31, 2004, the Plan’s interest in the net assets of the Company Stock Pool was approximately 100%. During 2005, the investments of the Company Stock Pool were transferred to the Plan and the Company Stock Pool was eliminated.
Company Stock Pool
         
    December 31  
    2004  
Investments, at fair value:
       
HCA common stock
  $ 767,718,593  
Interest in common/collective trusts
    13,376,326  
 
     
Total investments
    781,094,919  
 
       
Investment income receivable
    25,068  
 
     
Total assets
    781,119,987  
Other liabilities
    (578,049 )
 
     
Total net assets of the Company Stock Pool
  $ 780,541,938  
 
     
Company Stock Pool
         
    December 31  
    2004  
Net depreciation in the fair value of investments:
       
HCA common stock
  $ (61,282,878 )
 
       
Interest and dividends
    8,466,180  
 
     
Total investment loss of the Company Stock Pool
  $ (52,816,698 )
 
     

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Table of Contents

HCA 401(k) Plan
Notes to Financial Statements (continued)
3. Investments (continued)
At December 31, 2005, the Plan’s interest in the net assets of the S&P 500 Index Pool was approximately 96%. This is a new Investment Pool created in 2005.
S&P 500 Index Fund Pool
         
    December 31  
    2005  
Investments, at fair value
   
Interest in common/collective trusts
  $ 311,549,919  
 
       
Other liabilities
    (15,142 )
 
     
Total net assets of the S&P 500 Index Fund Pool
  $ 311,534,777  
 
     
S&P 500 Index Fund Pool
         
    Year Ended  
    December 31, 2005  
Net appreciation in the fair value of investments:
       
Interest in common/collective trusts
  $ 21,846,895  
 
Interest and dividends
    63  
 
     
Total investment income of the S&P500 Index Fund Pool
  $ 21,846,958  
 
     

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HCA 401(k) Plan
Notes to Financial Statements (continued)
4. Securities Lending
The Trustee is authorized to engage in the lending of certain Master Trust assets. Securities lending is an investment management strategy that utilizes the existing securities (government bonds, corporate bonds or equities) of the Master Trust to earn additional income. It involves the loaning of securities to a select group of approved broker-dealers. In return for the loaned securities, the Trustee simultaneously receives collateral in the form of cash or U.S. Treasury bills as a safeguard against possible default of any borrower on the return of the loan. Each security lending transaction is collateralized by a margin requirement, as specified in the terms of the securities borrowing agreements, from a minimum of 102% to a maximum of 105% of the fair value of the securities loaned plus accrued interest. The collateral is marked-to-market on a daily basis to maintain the margin requirement. The Master Trust accounts for its securities lending activities in accordance with Statement of Financial Accounting Standards No. 140, Accounting for Transfers and Servicing of Financial Assets and Extinguishments of Liabilities, (FASB 140). At December 31, 2005 and 2004, the Master Trust had securities on loan of $711,741,278 and $516,868,774, respectively. At December 31, 2005 and 2004, debtors provided the Trustee with cash collateral totaling $710,261,287 and $492,522,476, respectively. Cash received by the Trustee is invested in money market securities by the Master Trust and accordingly, recorded at fair value in the financial statements with a corresponding obligation to repay the collateral in accordance with the securities borrowing agreements. Noncash collateral provided to the Master Trust (U.S. Treasury bills) at December 31, 2005 and 2004 was $23,279,230 and $38,230,142, respectively, and in accordance with FASB 140, is not recorded in the investments of the Master Trust. The income earned by the Master Trust under the securities lending program with the Trustee in 2005 and 2004 was $1,337,754 and $815,877, respectively.
5. Risks and Uncertainties
The Plan invests in various investment securities. Investment securities are exposed to various risks such as interest rate, market and credit risks. Due to the level of risk associated with certain investment securities, it is at least reasonably possible that changes in the values of investment securities will occur in the near term and that such changes could materially affect participants’ account balances and the amounts reported in the statements of net assets available for benefits.
6. Income Tax Status
The Plan has received its most recent determination letter from the Internal Revenue Service dated September 29, 2005, stating that the Plan is qualified under Section 401(a) of the Internal Revenue Code (the Code) and, therefore, the related trust is exempt from taxation. Subsequent to the issuance of this determination letter, the Plan was amended. Once qualified, the Plan is required to operate in conformity with the Code to maintain its qualification. The Company

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Table of Contents

HCA 401(k) Plan
Notes to Financial Statements (continued)
6. Income Tax Status (continued)
believes the Plan is being operated in compliance with the applicable requirements of the Code and, therefore, believes that the Plan, as amended, is qualified and the related trust is tax exempt.
7. Commitments and Contingencies
On November 22, 2005, Brenda Thurman, a former employee of an HCA affiliate, filed a complaint in the United States District Court for the Middle District of Tennessee on behalf of herself, the HCA Savings and Retirement Program, and a class of Participants in the HCA Savings and Retirement Program, who held an interest in HCA common stock, against HCA Inc., HCA’s Chairman and Chief Executive Officer, President and Chief Operating Officer, Executive Vice President and Chief Financial Officer, and other unnamed individuals. The lawsuit, filed under sections 502(a)(2) and 502(a)(3) of the ERISA, 29 U.S.C. §§ 1132(a)(2) and (3), alleges that defendants breached their fiduciary duties owed to the HCA Savings and Retirement Program and its participants.
On January 13, 2006, the court stayed all proceedings and discovery in this matter, pending resolution of a motion to dismiss the consolidated amended complaint in the related federal securities class action against HCA. On January 17, 2006, the magistrate judge (i) consolidated Thurman’s cause of action with all other future actions making the same claims and arising out of the same operative facts, (ii) appointed Thurman as lead plaintiff, and (iii) appointed Thurman’s attorneys as lead counsel and liaison counsel. On January 26, 2006, the court reassigned the case to United States District Court Judge William J. Haynes, Jr., who has been presiding over certain related federal securities class action and federal derivative lawsuits.
8. Transactions with Parties-In-Interest
Transactions with parties-in-interest include purchases and sales of assets through the Trustee, contributions from the Company, dividends received on HCA Inc. common stock and fees paid during the year for accounting and other services.
9. Subsequent Event
Effective January 1, 2006, the Plan was amended to automatically enroll an employee in the Plan upon becoming eligible to participate unless the employee notifies the Plan that he or she will not participate. An employee thus enrolled will be deemed to have elected a deferral rate of 3%, unless the employee notifies the Plan that he or she elects a different percentage. Each participant’s deferral election will increase by 1% each year up to a maximum of 15%, unless the participant directs otherwise.

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10. Difference Between Financial Statements and Form 5500
HCA 401(k) Plan
Notes to Financial Statements (continued)
The following is a reconciliation of net assets available for benefits, deemed distributions, and contributions per the financial statements to the Form 5500:
                 
    December 31
    2005   2004
     
Net assets available for benefits per the financial statements
  $ 4,402,172,344     $ 3,857,872,090  
Less: Deemed distributions of participant loans
    (3,496,261 )     (2,703,496 )
     
Net assets available for benefits per the Form 5500
  $ 4,398,676,083     $ 3,855,168,594  
     
         
    Year Ended  
    December 31, 2005  
Deemed distributions per the financial statements
  $  
Add: Deemed distributions at December 31, 2005
    3,496,261  
Less: Deemed distributions at December 31, 2004
    (2,703,496 )
 
     
Deemed Distributions per the Form 5500
  $ 792,765  
 
     
         
    Year Ended  
    December 31, 2005  
Employer contributions per the financial statements
  $ 61,054,841  
Add: Employer contributions receivable at December 31, 2004
    1,453,548  
 
     
Employer contributions per the Form 5500
  $ 62,508,389  
 
     
         
    Year Ended  
    December 31, 2005  
Participant contributions per the financial statements
  $ 336,428,744  
Add: Participant contributions receivable at December 31, 2004
    7,330,995  
 
     
 
       
Participant contributions per the Form 5500
  $ 343,759,739  
 
     

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HCA 401(k) Plan
EIN: 75-2497104 Plan Number: 004
Schedule H, Line 4i
Schedule of Assets (Held at End of Year)
December 31, 2005
                         
                (c) Description of Investment,    
          Including Maturity Date,    
        (b) Identity of Issue, Borrower,   Rate of Interest, Collateral,   (e) Current
(a)   Lessor or Similar Party   Par or Maturity Value   Value
 
  *     Participant loans  
Interest ranging from 4.75% to 7.00%
  $ 118,819,568  
               
     
 
*   Indicates party-in-interest to the Plan.
 
    Note: Column (d) is not included as the investments are participant directed.

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SIGNATURE
Pursuant to the requirements of the Securities Exchange Act of 1934, the Committee Members have duly caused this annual report to be signed on its behalf by the undersigned hereunto duly authorized.
Dated: June 29, 2006
     
 
  HCA 401(k) PLAN
 
  By: Plan Administration Committee, Plan Administrator
         
     
  /s/ A. Bruce Moore, Jr.    
  Name:   A. Bruce Moore, Jr.   
  Title:   Chairman, Plan Administration Committee  
 

28