The short answer
HCA is HALAL on ZakatInvest's qualitative core-business assessment, but its current total-assets debt screens fail. HCA owns and operates hospitals, surgery centers, endoscopy centers and outpatient services. Medical care is generally permissible and socially beneficial; the main current concern is $48.023 billion of interest-bearing debt, not the hospital business itself.
This is a reproducible research screen, not a fatwa or investment recommendation. Scholars and screening providers can differ on debt denominators, insurance-subsidiary investments, elective procedures, facility-level activities and purification.
Current quantitative Sharia screen
Based on 10-Q figures for the period ended 2026-03-31; calculated 2026-07-13.
48,023 / 61,450
1,327 / 61,450
12,264 / 61,450
- Financial
- Fails
- Overall
- Fails
Debt is 78.15%, above the examined FTSE 33.333% asset limit. Liquidity is 2.16% and receivables plus cash are 19.96%; gross interest income is unavailable, but the debt failure is decisive.
- Financial
- Fails
- Overall
- Fails
Debt is 78.15%, above the examined MSCI total-assets limit. Liquidity is 2.16% and receivables plus cash are 19.96%. This is a calculation against the named method, not an index-membership claim; business and income allocation remain incomplete.
- Financial
- Fails
- Overall
- Fails
Debt is 78.15%, above the examined 33% Malaysia SAC financial limit; identifiable liquidity is 2.16%. This is a calculation against SAC ratios, not an official classification of a U.S.-listed security; screened business revenue remains unavailable.
- Financial
- Not calculated
- Overall
- Not calculated
A properly licensed and reproducible historical market-cap series is not stored, so these methods are not estimated from a current spot price.
Business-activity disclosure
HCA owns and operates hospitals, surgery centers, endoscopy centers and outpatient and ancillary healthcare services. Medical care is generally permissible and socially beneficial; the filing does not disclose a conventional lending or financial-services segment.
Limitation: The filing reports consolidated healthcare revenue and facility operations but does not quantify a universal prohibited-revenue numerator by elective procedure, behavioral-health service, pharmacy, payer, patient end use or affiliate activity.
Purification
HCA does not separately disclose gross interest income and does not provide a universal activity-level allocation for every healthcare service or facility. No fixed purification percentage is prescribed here; readers should follow the scholar or methodology they use.
Inputs, assumptions and primary sources
- Debt uses HCA's disclosed $48.023 billion total debt: $3.650 billion of commercial paper and $44.373 billion of long-term debt net of issuance costs and discounts. Operating lease obligations are not entered as conventional debt.
- Cash uses $940 million of cash and cash equivalents. The balance sheet separately reports $387 million of insurance-subsidiary investments; these include debt securities and money-market funds and are entered as interest-bearing securities without double-counting cash.
- Receivables use $11.324 billion of accounts receivable. HCA's patient-revenue cycle, insurance reimbursement and government-program receivables are not treated as a financing arm.
- Revenue uses $19.109 billion for the quarter ended March 31, 2026. HCA operates hospitals, surgery centers, endoscopy centers and extensive outpatient and ancillary services.
- The filing reports $584 million of interest expense but does not separately disclose gross interest income. The income input is therefore unavailable rather than estimated.
- HCA's healthcare services are generally permissible, but the filing does not quantify every elective, behavioral-health, pharmacy, payer, patient or facility activity into a universal prohibited-revenue numerator.
This is a reproducible financial screen, not a fatwa. A failed total-assets screen can coexist with a pass under a market-cap methodology. ZakatInvest keeps the qualitative assessment separate so numerical thresholds do not erase material context.
Current quantitative screen
The calculations above use HCA's official filing (Form 10-Q for the quarter ended March 31, 2026). Amounts are in USD millions and use total assets as the denominator so the inputs can be reproduced.
- Interest-bearing debt / assets: 78.15%, using $48.023 billion of commercial paper and long-term debt.
- Cash plus insurance-subsidiary investments / assets: 2.16%, using $940 million of cash and $387 million of investments carried on the balance sheet.
- Receivables plus cash / assets: 19.96%, using $11.324 billion of accounts receivable plus cash.
- Interest income / sales: unavailable. The filing reports $584 million of interest expense but does not separately disclose gross interest income, so no numerator is invented.
FTSE Yasaar, MSCI total-assets and Malaysia SAC financial screens fail on debt. The other known asset ratios are below the examined limits, but market-cap denominator methods are not calculated because ZakatInvest does not store a licensed, reproducible historical market-cap series.
What HCA Healthcare does
HCA's affiliates owned and operated 189 hospitals, 119 freestanding surgery centers and 30 freestanding endoscopy centers at March 31, 2026, with extensive outpatient and ancillary services in 19 states and England. First-quarter revenue was $19.109 billion, driven by patient admissions and revenue per equivalent admission.
Healthcare delivery is generally permissible: emergency care, surgery, inpatient treatment, outpatient services, imaging, laboratories and rehabilitation serve the preservation of life. The filing does not disclose a conventional lending or financial-services segment. It also does not quantify every elective, cosmetic, behavioral-health, pharmacy, payer or facility activity into a universal prohibited-revenue numerator, so “zero haram revenue” is not asserted as a filing fact.
Debt and investments
HCA's debt totaled $48.023 billion at quarter-end, including $3.650 billion of commercial paper and $43.700 billion of senior unsecured notes before debt issuance costs and discounts. Quarterly interest expense was $584 million. The debt finances hospitals, equipment, acquisitions and other capital needs, but its social purpose does not remove it from a quantitative Sharia debt screen.
Insurance subsidiaries held investments carried at $387 million, including debt securities and money-market funds. These balances support statutory equity and claims liquidity; methodologies can differ on how to treat those instruments, so the input is disclosed rather than silently omitted.
Qualitative considerations
- Patient receivables: $11.324 billion depends on Medicare, Medicaid, private-insurance and self-pay reimbursement cycles.
- Services: elective procedures, behavioral-health care, pharmacy activity and affiliate operations are not fully disaggregated for a universal activity screen.
- Social obligations: the filing reports $5.513 billion of charity-care charges for the quarter; staffing, patient safety, privacy and malpractice remain material diligence matters.
- Purification: gross interest income is not separately disclosed, so no fixed purification percentage is prescribed here.
Verdict: HALAL on the business, with a debt failure
HCA is presented as HALAL on ZakatInvest's qualitative healthcare assessment, while the examined FTSE Yasaar, MSCI total-assets and Malaysia SAC debt screens fail. The result is not official index membership or a fatwa. The hospital core is generally permissible, but HCA's high interest-bearing debt, insurance-subsidiary investments and incomplete service-level allocation require a scholar or methodology-specific decision.
Use the quantitative screen alongside the debt, investments, reimbursement and facility-activity analysis and consult a qualified scholar for your chosen methodology.
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