During 2018, we completed the divestiture of 11 hospitals. Expanding Patient Access Points, Health Services and Infrastructure. 2 We work hard to develop positive, collaborative relationships with physicians. Procurement and Materials Management. 3) Admissions represent the number of patients admitted for inpatient treatment. ( In addition, most of our hospitals are accredited by The Joint Commission. Government regulations may change. These regulations are known as "safe harbor" regulations. The Social Security Act also includes a provision commonly known as the "Stark Law." The civil penalties are adjusted annually based on updates to the consumer price index. We also receive Medicare reimbursement for hospital outpatient services through a PPS. For calendar year 2021 and beyond, CMS is continuing the payment policy. Finalization of these audits often takes several years. Thus, we may experience significant delays in appealing any RAC payment denials. Certain waivers are available from fraud and abuse laws for ACOs. As of December 31, 2020, we had a 13.9% ownership interest in HealthTrust. These hospitals are exempt from sales, property and income taxes. The extent of 21 unionization may affect labor costs in the future. Certain areas of focus in this regard are summarized below. 8226; The impact of acquisitions could have a negative effect on our operations. 8226; The demand for our services can be impacted by factors beyond our control. 8226; Our performance depends on our ability to recruit and retain quality physicians. This could further exacerbate the risks described in this section. Pending the appeals process, the law remains in place. Those proceedings include, among other things, government investigations.