| Metric | Details |
|---|---|
| Parent / Legal Entity | HCA Healthcare, Inc. (NYSE: HCA) |
| S&P / Moody’s / Fitch | S&P: BBB |
| Investment Grade Status | Investment Grade |
| Sector | Healthcare, Hospital Systems / Medical Office / Ambulatory |
| Ownership | Public (NYSE: HCA) |
| Location count | 190 hospitals (179 general acute, 7 behavioral, 4 rehabilitation), 121 freestanding ambulatory surgery centers and 31 freestanding endoscopy centers in 19 states and England at December 31, 2025 (2025 Form 10-K); 190 hospitals, 118 freestanding surgery centers and 30 freestanding endoscopy centers at June 30, 2026 (Form 10-Q) |
| Geographic Concentration | Texas (55 hospitals), Florida (47), Tennessee (12; headquarters in Nashville), Virginia (11), Utah (8), Colorado (7) and North Carolina (7) at December 31, 2025. Florida and Texas account for 102 of 190 hospitals (54%) and 51% of 2025 consolidated revenues per the FY2025 10-K. |
| Median asking cap rate | HCA sample too small (fewer than three tracked listings with a published asking cap rate); see comparable tenants in the table below |
| Typical Lease Term Remaining | Varies by property; confirm in the lease |
| Guarantee Type | Varies; confirm whether any guarantee is from HCA Healthcare, Inc., HCA Inc., another subsidiary, or no guarantor |
| Typical Building Size | Varies by facility type; confirm with the property information |
HCA Healthcare Business Overview & NNN Investment Profile
HCA Healthcare, Inc. describes itself as one of the leading health care services companies in the United States. According to its 2025 Form 10-K, at December 31, 2025 HCA operated 190 hospitals (179 general acute care, seven behavioral and four rehabilitation), 121 freestanding ambulatory surgery centers and 31 freestanding endoscopy centers in 19 states and England. In its Form 10-Q for the quarter ended June 30, 2026, it reported 190 hospitals, 118 freestanding surgery centers and 30 freestanding endoscopy centers. Its broader network also includes freestanding emergency rooms, urgent care clinics and physician practices, some of which occupy leased real estate that trades in the net lease market.
For NNN investors, HCA Healthcare, Inc. is an S&P-rated healthcare credit (investment grade; the investment-grade scale starts at BBB-), but that rating belongs to HCA Healthcare, Inc., not automatically to the entity that signs a lease. The company is a public filer with quarterly 10-Q disclosure, is rated BBB by S&P (Fitch does not currently rate HCA), and paid dividends and repurchased shares in each of 2023, 2024 and 2025 (2025 Form 10-K). Cross-reference against the tenant credit ratings database to see how HCA compares to other rated healthcare tenants such as DaVita and Fresenius Medical Care.
HCA Healthcare Credit Rating Analysis
S&P Global Ratings rates HCA Healthcare, Inc. BBB; the date of the rating action is in the source note below. BBB- is the lowest investment-grade rating on S&P’s scale. Fitch does not currently rate HCA, and we could not confirm HCA’s current Moody’s rating from a primary source, so only the S&P rating is shown.
Source: S&P Global Ratings BBB, as of June 23, 2026. Ratings checked September 27, 2026.
The primary credit consideration for HCA is operating leverage: as a public for-profit hospital operator, the company is exposed to Medicare and Medicaid reimbursement rates, labor cost inflation (particularly nursing labor), and payer mix shifts. HCA reported revenues of $75.600 billion for 2025 (earnings release, January 27, 2026).
HCA Healthcare NNN Lease Structure
HCA NNN properties span multiple lease formats depending on the underlying asset type. Initial terms, which costs the tenant pays, rent escalations (fixed or CPI-linked) and renewal options vary by lease for medical office buildings (MOBs), ambulatory surgery centers (ASCs) and other HCA-occupied properties, so confirm each in the lease. HCA’s 2025 Form 10-K says the medical office buildings it operates in conjunction with some of its hospitals are primarily occupied by physicians who practice at its hospitals, so confirm whether HCA itself is the tenant.
For freestanding emergency rooms (FSERs), urgent care clinics and other HCA-occupied properties, identify whether any guarantee exists and its exact legal obligor: HCA Healthcare, Inc., HCA Inc., another subsidiary, or no guarantor. No executed HCA lease or guaranty was reviewed for this page. If the tenant or guarantor is a subsidiary, review that entity’s own credit, which may differ materially from the S&P rating on HCA Healthcare, Inc. The investment grade guide covers the framework for tiering guarantee quality within a single national tenant.
HCA Healthcare NNN Cap Rate & Pricing Trends
HCA sample too small: InvestmentGrade.com does not currently track at least three active HCA Healthcare listings with a published asking cap rate, so no HCA median is shown. Comparable healthcare tenants with enough tracked listings:
| Tenant | S&P / Moody’s | Median asking cap rate | Middle half of listings | Listings | Median vs. 10-year Treasury |
|---|---|---|---|---|---|
| Fresenius Medical Care | BBB- / Baa3 | 6.55% | 6.28% to 7.10% | 6 | +131 bps |
| DaVita | BB / n/a | 6.75% | 6.15% to 7.30% | 37 | +151 bps |
Active listings InvestmentGrade.com tracks with an asking cap rate (stated in the listing, or computed from its stated income and price when no rate is stated), listings last observed October 12, 2026. Asking cap rates are not closed-sale cap rates. The middle half is the range from the 25th to the 75th percentile of listings. The 10-year Treasury yield is 5.24% as of October 1, 2026 (FRED series DGS10). Ratings are the agency ratings in our ratings database for the entity shown, which may be a parent company; the rating type (for example issuer, senior unsecured debt, long-term debt or revenue bond ratings) varies by company and is shown on each tenant page. A rating applies to a lease only if the rated entity signs or guarantees it, so confirm the tenant and any guarantor in the lease. n/a means no verified rating is on file. Not shown because fewer than 3 active listings with a published cap rate were observed: HCA Healthcare.
Pricing varies with property type, size, lease term and location. A property where an HCA-affiliated joint venture or practice subleases from another operator is not direct HCA Healthcare, Inc. lease credit; confirm the master tenant and any guarantor. The NNN cap rates 2026 report provides the full cross-sector benchmark context for how HCA healthcare product prices against retail and industrial IG tenants.
HCA Healthcare Real Estate Footprint
HCA’s hospital footprint is concentrated in Texas and Florida, which held 102 of its 190 hospitals at December 31, 2025. At that date it operated 55 hospitals in Texas, 47 in Florida, 12 in Tennessee (where it is headquartered, in Nashville), 11 in Virginia, 8 in Utah, 8 in England, 7 each in Colorado and North Carolina, and five or fewer in each of 11 other states (2025 Form 10-K).
HCA’s 2025 Form 10-K lists 190 hospitals directly or indirectly owned and operated by HCA at December 31, 2025, and says it also operates medical office buildings in conjunction with some of its hospitals. The live table above includes HCA Healthcare only when at least three active listings with a published asking cap rate are tracked. Cross-reference against Ardent Health, Community Health Systems, and Tenet Healthcare for comparable hospital system NNN footprint and sale-leaseback activity.
HCA Healthcare Growth Strategy & Forward Outlook
HCA’s 2025 Form 10-K lists a growth agenda that includes growing its presence in existing markets and pursuing a disciplined development strategy, and describes developing outpatient facilities such as surgery centers, urgent care clinics and freestanding emergency care facilities.
Risks HCA discusses in its 2025 Form 10-K include changes in government health care programs such as Medicare and Medicaid, competition for staffing and the shortage of experienced nurses, the expiration at the end of 2025 of enhanced premium tax credits (EPTCs) for ACA marketplace enrollees, which HCA expects to adversely impact Exchange enrollment and increase the uninsured rate, and the effects of the 2025 federal budget law that HCA calls the 2025 Federal Budget Act. For NNN landlords, the practical implication is that HCA Healthcare, Inc.’s S&P rating is investment grade, but each lease still has to be underwritten on its tenant entity, guarantor, term and real estate.
HCA Healthcare NNN Investment: Pros & Cons
| Pros | Cons |
|---|---|
| Investment Grade at S&P: BBB; 190 hospitals at June 30, 2026, with facilities in 19 states and England (Form 10-Q). | Downgrade Risk: Ratings can change; check how far S&P’s current BBB rating sits above BBB-, the lowest investment-grade rating, and its outlook before relying on it; monitor Medicare/Medicaid and labor cost trends. |
| Sunbelt Market Concentration: Texas, Florida, Tennessee and Virginia held 125 of 190 hospitals at December 31, 2025 (2025 Form 10-K). | Format Specificity: MOB, ASC and FSER build-outs can limit alternative uses compared with general retail space; get reuse estimates for the specific property. |
| Large Outpatient Network: 118 freestanding surgery centers and 30 freestanding endoscopy centers at June 30, 2026 (Form 10-Q), in addition to its hospitals. | Guarantor Variation: Confirm whether any guarantee is from HCA Healthcare, Inc., HCA Inc., another subsidiary, or no guarantor. |
| Public Filer: quarterly 10-Q and annual 10-K disclosure supports ongoing credit monitoring. | Lease-Level Diligence: No executed HCA lease was reviewed for this page; confirm tenant, guarantor, term and rent in each lease. |
Comparable NNN Tenants
| Tenant | Rating | Sector |
|---|---|---|
| HCA Healthcare | BBB | Hospital / MOB / ASC |
| Tenet Healthcare | Not tracked | Hospital / ASC |
| Universal Health Services | Not tracked | Hospital / Behavioral |
| DaVita | BB | Dialysis Centers |
| Fresenius Medical Care | BBB-/Baa3 | Dialysis Centers |
Frequently Asked Questions About HCA Healthcare NNN Investments
Yes. S&P Global Ratings rates HCA Healthcare, Inc. BBB; the rating source note on this page gives the action date. BBB- is the lowest investment-grade rating on S&P’s scale. Fitch does not currently rate HCA, and we could not confirm HCA’s current Moody’s rating from a primary source.
What asking cap rates do HCA Healthcare NNN properties carry in 2026?
The HCA sample is too small to report a median: InvestmentGrade.com does not currently track at least three active HCA Healthcare listings with a published asking cap rate. The live table on this page shows comparable healthcare tenants with enough tracked listings. Pricing for a specific property depends on the remaining lease term, rent level, location and lease guarantor, and asking cap rates are not closed-sale cap rates.
HCA’s facilities include hospitals, freestanding surgery centers and freestanding endoscopy centers, and its 2025 Form 10-K describes developing outpatient facilities such as surgery centers, urgent care clinics and freestanding emergency care facilities. The medical office buildings it operates with some of its hospitals are primarily occupied by physicians, according to the 10-K, so confirm the tenant entity in each lease. Cap rates vary by format, lease term and guarantor; the live table shows current asking cap rates for comparable healthcare tenants.
Lease terms vary by property: confirm the initial term, which costs the tenant pays, rent escalations (fixed or CPI-linked) and renewal options in each lease. Identify whether any guarantee exists and its exact legal obligor (HCA Healthcare, Inc., HCA Inc., another subsidiary, or none); no executed HCA lease or guaranty was reviewed for this page.
At December 31, 2025, HCA operated 55 hospitals in Texas, 47 in Florida, 12 in Tennessee (its headquarters state), 11 in Virginia, 8 in Utah and 7 each in Colorado and North Carolina, with the rest in 11 other states and England (2025 Form 10-K).
HCA is rated BBB by S&P. Tenet Healthcare and Universal Health Services are not tracked in our ratings database. In dialysis, DaVita (BB) is rated below investment grade and Fresenius Medical Care sits at BBB-/Baa3. Compare current asking cap rates in the live table above.
When the buyer owns the building, a cost segregation analysis may reclassify part of the purchase price, such as site improvements and some building systems and equipment, into 5-, 7- or 15-year property.
Under IRC section 168(k), 100% bonus depreciation can apply to qualified property, such as tangible property with a MACRS recovery period of 20 years or less, that is both acquired and placed in service after January 19, 2025. Used property qualifies only in certain cases, some property is excepted, and a taxpayer can elect out (IRS Publication 946).
How much qualifies varies widely by property; support any allocation with appropriate records and analysis, such as an engineering-based study. Depreciation is generally available only on property the investor owns. Land cannot be depreciated, so on a ground lease where the tenant owns the building the investor may have little or nothing to depreciate, and improvements or equipment owned by the tenant are not the landlord’s to depreciate. Confirm in the lease and title documents who owns the building, improvements and equipment.
On a taxable sale, depreciation taken on section 1245 property is generally recaptured as ordinary income, limited to the gain on that property (IRC 1245(a)). A qualifying 1031 exchange may defer some gain, but section 1245(b)(4) can still require ordinary-income recapture, including when non-section-1245 property is received. This is general information, not tax advice; consult a tax professional. Medical buildouts can include specialized systems that may qualify for shorter lives; confirm who owns the medical equipment, because a landlord generally cannot depreciate equipment the tenant owns. See the Medical NNN Depreciation Guide.
HCA Healthcare Net Lease Property: Buying, Selling and Financing
Buying: We find on-market and off-market HCA Healthcare properties, review the lease and the tenant’s credit, and compare pricing with current listings. On the majority of transactions, there is no separate fee to you as the buyer; the listing broker pays a cooperating commission.
Selling: We can prepare an opinion of value from current listings and recent sales and, when it fits your goals, run a confidential sale to private investors, family offices and institutional buyers. See our guide to off-market sales.
Financing: Investment Grade Capital, a service of Investment Grade LLC, matches buyers and owners with lenders for acquisitions and refinancing.
1031 exchanges: Tell us your identification and closing deadlines so we can plan the search around them.
Request an NNN investment consultation or email team@investmentgrade.com.
1031 buyer benchmark: health-system credit before yield
For 1031 buyers comparing hospital, MOB, urgent-care, and outpatient NNN properties, HCA Healthcare should be screened first as a health-system credit decision, then as a real estate yield decision. The key questions are the credit support behind the lease, remaining lease term, facility mission criticality, and whether the quoted cap rate compensates for location and build-out reuse risk.
Use this page alongside the best investment grade NNN tenants for 1031 exchange guide and the 2026 NNN cap rate framework before identifying replacement property.
