[7] The company engaged in illegal accounting and other crimes in the 1990s that resulted in the payment of more than $2 billion in federal fines and other penalties, and the dismissal of the CEO Rick Scott by the board of directors.

[10] The company began with Nashville's Park View Hospital, which the elder Frist had founded in 1960 with other doctors and where he was serving as chief executive.

Believing its stock was undervalued, the company completed a $5.1 billion leveraged management buyout led by chairman Thomas F. Frist Jr.[12] in 1988.

[17] In 1992, Columbia made a stock purchase of Basic American Medical, which owned eight hospitals, primarily in southwestern Florida.

In September 1993, Columbia did another stock purchase, worth $3.4 billion, of Galen Healthcare, which had been spun off by Humana Inc. several months earlier.

[17] On November 17, 2006, HCA became a private company for the third time when it completed a merger in which the company was acquired by a private investor group including affiliates of Kohlberg Kravis Roberts and Bain Capital, together with Merrill Lynch and HCA Healthcare founder Thomas F. Frist Jr.

In March 2011, HCA sold 126.2 million shares for $30 each, raising about $3.79 billion, at that time, the largest private-equity backed IPO in U.S.

[25] In August 2021, HCA announced a deal with venture capital firm General Catalyst to develop digital solutions to streamline workflows and improve patient care; as part of the deal, HCA sold its healthcare app development firm PatientKeeper to General Catalyst's portfolio company Commure.

[28] In March 2024, it was announced HCA had completed the sale of West Hills Hospital and Medical Center and related assets in Los Angeles, California to UCLA Health, for an undisclosed amount.

[43] Later that year, it signed an agreement to sell Garden Park Medical Center to Singing River Health System.

[44] In 2021, HCA sold Redmond Regional Medical Center to AdventHealth for $635M,[45] and four other Georgia hospitals to Piedmont Healthcare for $950 million.

[47] HCA International, the UK arm of Hospital Corporation of America, "caters for around half of all private patients in London.

[54] In 1993, lawsuits were filed against HCA by former employees who alleged that the company had engaged in questionable Medicare billing practices.

[8] In 1997, with a federal investigation by the FBI, the IRS and the Department of Health and Human Services in its early stages, the Columbia/HCA board of directors forced Rick Scott to resign as chairman and CEO amid growing evidence that the company "had kept two sets of books, one to show the government and one with actual expenses listed.

Senator Bill Frist sold all of his HCA shares, which were held in a blind trust, two weeks before disappointing earnings sent the stock on a 9-point plunge.

[58] HCA settled the lawsuit in August 2007, agreeing to pay $20 million to the shareholders but admitting no wrongdoing, and no charges were brought.

[59] During the COVID-19 pandemic in the United States, HCA hospital nurses and other workers spoke out about the lack of PPE.