EX-4.1





 Exhibit 4.1 

DESCRIPTION OF THE REGISTRANT’S SECURITIES 

REGISTERED PURSUANT TO SECTION 12 OF THE 

SECURITIES EXCHANGE ACT OF 1934 

As of December 31, 2019, HCA Healthcare, Inc. had one class of securities registered under Section 12 of the Securities Exchange Act
of 1934, as amended: our common stock. 
 In this Exhibit 4.1, when we refer to the “Company,” “we,” “us” or
“our” or when we otherwise refer to ourselves, we mean HCA Healthcare, Inc., excluding, unless otherwise expressly stated, our subsidiaries and affiliates. 

The following description is a summary of the material terms of our Certificate of Incorporation, as amended (the “Certificate of
Incorporation”), and our Bylaws, as amended (the “Bylaws”), as currently in effect. This description is subject to, and qualified in its entirety by reference to, our Certificate of Incorporation and our Bylaws, each of which are
incorporated by reference as an exhibit to the Annual Report on Form 10-K of which this Exhibit 4.1 is a part. We encourage you to read our Certificate of Incorporation, our Bylaws and the applicable
provisions of the Delaware General Corporation Law (“DGCL”), for additional information. 
 Authorized Capital 

As of December 31, 2019, our authorized capital stock consisted of 1,800,000,000 shares of common stock, par value $.01 per share and
200,000,000 shares of preferred stock. 
 Common Stock 

Voting Rights. Under the terms of the Certificate of Incorporation, each holder of common stock is entitled to one vote for each share
on all matters submitted to a vote of the stockholders, including the election of directors. Our stockholders do not have cumulative voting rights. Because of this, the holders of a majority of the shares of common stock entitled to vote and present
in person or by proxy at any annual meeting of stockholders are able to elect all of the directors standing for election, if they should so choose. 

Dividends. Subject to preferences that may be applicable to any then outstanding preferred stock, holders of common stock are entitled
to receive ratably those dividends, if any, as may be declared from time to time by the Board of Directors out of legally available assets or funds. 

Liquidation. In the event of our liquidation, dissolution, or winding up, holders of common stock are entitled to share ratably in the
net assets legally available for distribution to stockholders after the payment of all of our debts and other liabilities and the satisfaction of any liquidation preference granted to the holders of any outstanding shares of preferred stock. 

Rights and Preferences. Holders of common stock have no preemptive or conversion rights, and there are no redemption or sinking fund
provisions applicable to the common stock. The rights, preferences, and privileges of the holders of common stock are subject to, and may be adversely affected by, the rights of the holders of shares of any series of preferred stock, which we may
designate in the future. 
 Board of Directors 

The Certificate of Incorporation provides for a Board of Directors of not less than three members, the exact number to be determined from time
to time by resolution adopted by the affirmative vote of a majority of the total number of directors then in office. The Certificate of Incorporation provides that directors will be elected to hold office for a term expiring at the next annual
meeting of stockholders and until a successor is duly elected and qualified or until his or her earlier death, resignation, disqualification or removal. In uncontested director elections each director is elected by the vote of the majority of the
votes cast. An incumbent nominee not receiving a majority of the votes cast in an uncontested election shall continue to serve until (i) the director’s successor is elected and qualifies or (ii) the Board of Directors accepts the
director’s resignation. Newly created directorships and vacancies may be filled, so long as there is at least one remaining director, only by the Board of Directors. 












 Amendment to Bylaws 

The Certificate of Incorporation and Bylaws provide that the Board of Directors is expressly authorized to make, alter, amend, change, add to
or repeal the Bylaws of the Company by the affirmative vote of a majority of the total number of directors then in office. Any amendment, alteration, change, addition or repeal of the Bylaws of the Company by the stockholders of the Company shall
require the affirmative vote of the holders of at least a majority of the outstanding shares of the Company, voting together as a class, entitled to vote on such amendment, alteration, change, addition or repeal. 

Amendment to Certificate of Incorporation 

The Certificate of Incorporation provides that the affirmative vote of the holders of at least a majority of the voting power of all
outstanding shares of the Company entitled to vote generally in the election of directors, voting together in a single class, is required to adopt any provision inconsistent with, to amend or repeal any provision of, or to adopt a bylaw inconsistent
with certain specified provisions of the Certificate of Incorporation. 
 Special Meetings of Stockholders 

The Certificate of Incorporation provides that special meetings of stockholders of the Company may be called only by either the Board of
Directors, pursuant to a resolution adopted by the affirmative vote of the majority of the total number of directors then in office, or by the Chairman of the Board or the Chief Executive Officer of the Company. 

Action on Written Consent 
 Pursuant to
the Certificate of Incorporation and Bylaws, any action required or permitted to be taken at an annual or special meeting of stockholders of the Company may be taken only upon the vote of the stockholders at an annual or special meeting duly called
and may not be taken by written consent of the stockholders. 
 Corporate Opportunities 

The Certificate of Incorporation provides that we renounce any interest or expectancy of the Company in the business opportunities of certain
of our current and prior investors and of their officers, directors, agents, shareholders, members, partners, affiliates and subsidiaries and each such party shall not have any obligation to offer us those opportunities unless presented to a
director or officer of the Company in his or her capacity as a director or officer of the Company. 
 Advance Notice Requirements for Stockholder
Proposals and Director Nominations 
 Our Bylaws provide that stockholders seeking to nominate candidates for election as directors or to
bring business before an annual or special meeting of stockholders must provide timely notice of their proposal in writing to the secretary of the Company. Generally, to be timely, a stockholder’s notice must be delivered to, mailed or received
at our principal executive offices, addressed to the secretary of the Company, and within the following time periods: 
  

	 	•	 	 in the case of an annual meeting, no earlier than 120 days and no later than 90 days prior to the first
anniversary of the date of the preceding year’s annual meeting; provided, however, that if (A) the annual meeting is advanced by more than 30 days, or delayed by more than 60 days, from the first anniversary of the preceding year’s
annual meeting, or (B) no annual meeting was held during the preceding year, to be timely the stockholder notice must be received no earlier than 120 days before such annual meeting and no later than the later of 90 days before such annual
meeting or the tenth day after the day on which public disclosure of the date of such meeting is first made; and 















	 	•	 	 in the case of a nomination of a person or persons for election to the Board of Directors at a special meeting of
the stockholders called for the purpose of electing directors, no earlier than 120 days before such special meeting and no later than the later of 90 days before such annual or special meeting or the tenth day after the day on which public
disclosure of the date of such meeting is first made. 


 In no event shall an adjournment, postponement or deferral, or
public disclosure of an adjournment, postponement or deferral, of a meeting of the stockholders commence a new time period (or extend any time period) for the giving of the stockholder’s notice. 

We have also adopted a proxy access right that permits a stockholder, or a group of up to 20 stockholders, owning continuously for at least
three years shares of our stock representing an aggregate of at least 3% of the voting power entitled to vote in the election of directors, to nominate and include in our proxy materials director nominees, provided that the stockholder(s) and the
nominee(s) satisfy the requirements in our Bylaws. Under our Bylaws, to be considered timely, compliant notice of proxy access director nominations for next year’s proxy statement and form of proxy must be submitted to the Corporate Secretary
at the address specified in our proxy statement no earlier than 150 days and no later than 120 days prior to the first anniversary of the date the Company mailed its proxy statement for the preceding year’s annual meeting; provided, however,
that if (A) the annual meeting is not within 30 days before or after the anniversary date of the preceding year’s annual meeting, or (B) no annual meeting was held during the preceding year, to be timely the stockholder notice must be
received no later than 90 days prior to such annual meeting or, if later, the tenth day after the day on which notice of the date of the meeting was mailed or public disclosure of the date of such meeting is first made, whichever occurs first. 

Authorized but Unissued Capital Stock 

Our Certificate of Incorporation authorizes our Board of Directors, without further action by the stockholders, to issue up to 200,000,000
shares of preferred stock, par value $.01 per share, in one or more classes or series, to establish from time to time the number of shares to be included in each such class or series, to fix the rights, powers and preferences of the shares of each
such class or series and any qualifications, limitations, or restrictions thereon. 
 Delaware law does not require stockholder approval for
any issuance of authorized shares. However, the listing requirements of the New York Stock Exchange, which would apply as long as our common stock is listed on the New York Stock Exchange, require stockholder approval of certain issuances equal to
or exceeding 20% of the then outstanding voting power or then outstanding number of shares of common stock. These additional shares may be used for a variety of corporate purposes, including future public offerings, to raise additional capital or to
facilitate acquisitions. 
 One of the effects of the existence of unissued and unreserved common stock or preferred stock may be to enable
our Board of Directors to issue shares to persons friendly to current management, which issuance could render more difficult or discourage an attempt to obtain control of our company by means of a merger, tender offer, proxy contest or otherwise,
and thereby protect the continuity of our management and possibly deprive the stockholder of opportunities to sell their shares of common stock at prices higher than prevailing market prices. 

Limitation on Directors’ Liability and Indemnification 

Section 145(a) of the DGCL grants each corporation organized thereunder the power to indemnify any person who was or is a party or is
threatened to be made a party to any threatened, pending or completed action, suit or proceeding, whether civil, criminal, administrative or investigative (other than an action by or in the right of the corporation) by reason of the fact that the
person is or was a director, officer, employee or agent of the corporation, or is or was serving at the request of the corporation as a director, officer, employee or agent of another corporation, partnership, joint venture, trust or other
enterprise, against expenses (including attorneys’ fees), judgments, fines and amounts paid in settlement that were actually and reasonably incurred by the person in connection with such action, suit or proceeding if the person acted in good
faith and in a manner the person reasonably believed to be in or not opposed to the best interests of the corporation, and, with respect to any criminal action or proceeding, had no reasonable cause to believe the person’s conduct was unlawful.
The termination of any action, suit or proceeding by judgment, order, settlement, conviction, or upon a plea of nolo contendere or its equivalent, shall not, of itself, create a presumption that the person did not act in good faith and in a manner
which the person reasonably believed to be in or not opposed to the best interests of the corporation, and, with respect to any criminal action or proceeding, had reasonable cause to believe that the person’s conduct was unlawful. 












 Section 145(b) of the DGCL grants each corporation organized thereunder the power to
indemnify any person who was or is a party or is threatened to be made a party to any threatened, pending or completed action or suit by or in the right of the corporation to procure a judgment in its favor by reason of the fact that the person is
or was a director, officer, employee or agent of the corporation, or is or was serving at the request of the corporation as a director, officer, employee or agent of another corporation, partnership, joint venture, trust or other enterprise against
expenses (including attorneys’ fees) actually and reasonably incurred by the person in connection with the defense or settlement of such action or suit if the person acted in good faith and in a manner the person reasonably believed to be in or
not opposed to the best interests of the corporation and except that no indemnification shall be made pursuant to Section 145(b) of the DGCL in respect of any claim, issue or matter as to which such person shall have been adjudged to be liable
to the corporation unless and only to the extent that the Delaware Court of Chancery or the court in which such action or suit was brought shall determine upon application that, despite the adjudication of liability but in view of all the
circumstances of the case, such person is fairly and reasonably entitled to indemnity for such expenses which the Court of Chancery or such other court shall deem proper. 

Section 145(c) of the DGCL provides that to the extent that a present or former director or officer of a corporation has been successful
on the merits or otherwise in defense of any action, suit or proceeding referred to in Sections 145(a) and (b) of the DGCL, as described in the preceding paragraphs, or in defense of any claim, issue or matter therein, such person shall be
indemnified against expenses (including attorneys’ fees) actually and reasonably incurred by such person in connection therewith. 

Section 145(g) of the DGCL provides, in general, that a corporation shall have the power to purchase and maintain insurance on behalf of
any person who is or was a director, officer, employee or agent of the corporation against any liability asserted against the person in any such capacity, or arising out of the person’s status as such, regardless of whether the corporation
would have the power to indemnify the person against such liability under the provisions of the DGCL. We maintain a directors’ and officers’ insurance policy that insures our directors and officers against liabilities incurred in their
capacity as such for which they are not otherwise indemnified, subject to certain exclusions. 
 Section 102(b)(7) of the DGCL enables
a corporation in its certificate of incorporation, or an amendment thereto, to eliminate or limit the personal liability of a director to the corporation or its stockholders of monetary damages for violations of the directors’ fiduciary duty of
care as a director, except (i) for any breach of the director’s duty of loyalty to the corporation or its stockholders, (ii) for acts or omissions not in good faith or that involve intentional misconduct or a knowing violation of law,
(iii) pursuant to Section 174 of the DGCL (providing for director liability in the event of unlawful payment of dividends or unlawful stock purchases or redemptions) or (iv) for any transaction from which a director derived an
improper personal benefit. Our Certificate of Incorporation indemnifies the directors and officers to the full extent of the DGCL and also allows the Board of Directors to indemnify all other employees. Such right of indemnification is not exclusive
of any right to which such officer or director may be entitled as a matter of law and shall extend and apply to the estates, heirs, executors and administrators of such persons. 

We maintain a directors’ and officers’ insurance policy. The policy insures directors and officers against unindemnified losses
arising from certain wrongful acts in their capacities as directors and officers and reimburses us for those losses for which we have lawfully indemnified the directors and officers. The policy contains various exclusions that are normal and
customary for policies of this type. 
 Our employment agreements with certain of our officers provide indemnification for adverse tax
consequences they may suffer pursuant to their employment agreements. 
 We have entered into an indemnification priority and information
sharing agreement with certain of our current and prior investors and certain of their affiliated funds to clarify the priority of advancement and indemnification obligations among us and any of our directors appointed by such investors and other
related matters. 












 We believe that our Certificate of Incorporation, Bylaws and insurance policies are
necessary to attract and retain qualified persons to serve as directors and officers of the Company. 
 The limitation of liability and
indemnification provisions in our Certificate of Incorporation and Bylaws may discourage stockholders from bringing a lawsuit against directors for breach of their fiduciary duty. They may also reduce the likelihood of derivative litigation against
directors and officers, even though an action, if successful, might benefit us and other stockholders. Furthermore, a stockholder’s investment may be adversely affected to the extent we pay the costs of settlement and damage awards against
directors and officers as required or allowed by these indemnification provisions. 
 Insofar as indemnification for liabilities arising
under the Securities Act may be permitted to directors, officers or persons controlling us pursuant to the foregoing provisions or any other provisions described in this prospectus, we have been informed that in the opinion of the Securities and
Exchange Commission such indemnification is against public policy as expressed in the Securities Act and is therefore unenforceable. 
 Delaware
Anti-Takeover Statutes 
 Certain Delaware law provisions may make it more difficult for someone to acquire us through a tender offer,
proxy contest or otherwise. 
 Section 203 of the DGCL provides that, subject to certain stated exceptions, an “interested
stockholder” is any person (other than the corporation and any direct or indirect majority-owned subsidiary) who owns 15% or more of the outstanding voting stock of the corporation or is an affiliate or associate of the corporation and was the
owner of 15% or more of the outstanding voting stock of the corporation at any time within the three-year period immediately prior to the date of determination, and the affiliates and associates of such person. A corporation may not engage in a
business combination with any interested stockholder for a period of three years following the time that such stockholder became an interested stockholder unless: 
  

	 	•	 	 prior to such time the board of directors of the corporation approved either the business combination or
transaction which resulted in the stockholder becoming an interested stockholder; 


  

	 	•	 	 upon consummation of the transaction which resulted in the stockholder becoming an interested stockholder, the
interested stockholder owned at least 85% of the voting stock of the corporation outstanding at the time the transaction commenced, excluding shares owned by (i) persons who are directors and also officers and (ii) employee stock plans in
which participants do not have the right to determine confidentially whether shares held subject to the plan will be tendered in a tender or exchange offer; or 



 

	 	•	 	 at or subsequent to such time, the business combination is approved by the board of directors and authorized at
an annual or special meeting of stockholders, and not by written consent, by the affirmative vote of at least 66 2/3% of the outstanding voting stock which is not owned by the interested stockholder. 



The effect of these provisions may make a change in control of our business more difficult by delaying, deferring or preventing a tender offer
or other takeover attempt that a stockholder might consider in its best interest. This includes attempts that might result in the payment of a premium to stockholders over the market price for their shares. These provisions also may promote the
continuity of our management by making it more difficult for a person to remove or change the incumbent members of the board of directors. 
 Transfer
Agent and Registrar 
 EQ Shareowner Services is the transfer agent and registrar for our common stock. 

Listing 
 Our common stock is listed on
the New York Stock Exchange under the symbol “HCA.”