What are the red flags for Charles Gressle?

Charles Gressle

Trustee, term 2027-2029

President, East Florida Division | HCA Healthcare

Last verified November 4, 2026

7 Red Flags

Affiliations

•President of HCA Healthcare's Fort Lauderdale-based East Florida Division since December 1, 2019, succeeding Michael Joseph; the division had 14 hospitals when he took over.
•Previously chief administrative officer of the East Florida Division, CEO of Medical City Plano and Medical City Frisco, and COO of Medical City Dallas and Medical City Children's Hospital in Texas.
•Has spent about two decades in HCA leadership roles; began his career over 30 years ago as a nursing technician and EMT paramedic.
•Serves on AHA Regional Policy Board 4.
•Bachelor's in chemistry and economics from the University of North Carolina and an MBA from Wake Forest University.
•Elected an AHA trustee in July 2026 for a three-year term beginning January 1, 2027, giving the largest investor-owned hospital chain a seat on the board.

Financial / Compensation

•HCA Healthcare is publicly traded and files no Form 990; Gressle is not a named executive officer in its proxy, so his personal pay is not publicly disclosed.
•HCA reported 2025 revenue of $75.6 billion, up from $70.6 billion in 2024, and net income of $6.8 billion, up 17.8%.
•HCA guided 2026 net income of $6.5 billion to $7 billion on $76.5 billion to $80 billion in revenue, with $5 billion to $5.5 billion in capital spending excluding acquisitions.
•On July 14, 2026 HCA cut its 2026 guidance, lowering net income to $6.3 billion to $6.7 billion from $6.495 billion to $7.035 billion, after uninsured volume from patients losing exchange coverage cost about $400 million in second-quarter pretax income; it raised its full-year exchange headwind estimate to $1.0 billion to $1.2 billion.
•In the same quarter HCA booked about $400 million in incremental net benefit from Medicaid supplemental payment programs, mainly related to Florida, and raised its 2026 estimate for those programs to $300 million to $500 million from a $50 million to $250 million loss.
•CEO Sam Hazen received $26,456,606 in total compensation for 2025; COO Jon Foster received $10,992,786 and CFO Mike Marks $10,355,111.
•HCA operated 190 hospitals and about 2,500 ambulatory sites in 19 states and the United Kingdom at the end of 2025, with Florida among its largest markets.
•Division-level financial results for East Florida are not separately reported by HCA.

Lobbying and Political

•HCA and its outside firms reported about $5.4 million in federal lobbying for 2025 in Senate LDA filings, including $4.15 million in-house plus Alston & Bird, Smith-Free Group, Mehlman Consulting, Rubin Turnbull & Associates and Hance Scarborough.
•HCA reported about $5.17 million in federal lobbying in the first three quarters of 2026, including $4.15 million in-house, already near its full-year 2025 total.
•In October 2026 HCA Management Services registered Jeffrey J. Kimbell & Associates as a new outside lobbying firm.
•HCA runs a federal PAC, the HCA Healthcare Good Government Fund; full 2025-2026 cycle totals were not verified for this dossier.
•HCA joins an AHA board whose lobbying defends tax-exempt hospital privileges such as the 340B program, which HCA's for-profit hospitals largely do not share.

Revolving Door

•No government employment is publicly reported for Gressle; his career has been inside HCA.
•His seat on AHA Regional Policy Board 4 already gave him a role in shaping AHA's Southeast policy positions before his trustee election.

Home System Record

•HCA's East Florida Division covers hospitals in the Fort Lauderdale, Miami and Palm Beach markets, including HCA Florida JFK in Atlantis.
•A 2023 WPTV investigation, following an NBC News report, found two HCA hospitals in Palm Beach County held two-star CMS overall ratings, HCA Florida JFK had a Leapfrog C, and JFK had 11 complaints, six citations and seven sanctions from Florida's AHCA over two years.
•The AHA bio credits Gressle with expanding clinical services, physician clinics and freestanding emergency rooms, a high-margin outpatient strategy that critics say steers insured patients to costly ER billing.
•HCA reported a July 2023 data breach affecting about 11.27 million patients; a class settlement was approved in 2025.

Litigation and Scrutiny

•North Carolina's attorney general sued HCA in late 2023 alleging it broke quality and access commitments made when it bought Mission Health in 2019; Attorney General Jeff Jackson has said he will not drop the case.
•HCA and Mission settled antitrust-related claims brought by North Carolina counties and cities, agreeing to a $1 million charity fund and to keep Transylvania Regional Hospital open three more years; HCA denies the allegations.
•A federal court in the Western District of North Carolina granted preliminary approval in 2026 to a $1.563 million wage-and-hour settlement for hourly workers at HCA's North Carolina facilities.
•The class action over HCA's 2023 data breach was settled; the settlement fund amount was not disclosed, with plaintiffs' counsel eligible for up to $3.1 million in fees.
•In February 2026 nurse Leelamma Lal sued HCA Florida Palms West Hospital in Palm Beach County, HCA and security contractor Allied Universal, alleging negligent security after a Baker Act patient beat her on February 18, 2025; the complaint cites a history of violence at the hospital, and HCA says two regulators found no deficiencies.
•After HCA's July 14, 2026 guidance cut sent its stock down about 6% to 7%, several plaintiffs' firms opened securities investigations covering shareholders who bought between October 24, 2025 and July 13, 2026; no filed complaint was confirmed.

Red Flags

Gressle's employer earned $6.8 billion in 2025 and paid its CEO $26.5 million, putting a profit-maximizing chain on the board of the trade group that defends nonprofit tax exemptions.

HCA's federal lobbying reached about $5.17 million in the first nine months of 2026, close to its 2025 total of $5.4 million.

HCA's 2026 numbers were propped up by about $400 million in a single quarter from Medicaid supplemental payments, mainly in Florida, Gressle's home market, so a for-profit chain is leaning on the same government money the AHA lobbies to protect.

Quality reporting on HCA's South Florida hospitals has shown low CMS star ratings and state sanctions at HCA Florida JFK.

HCA remains in litigation with North Carolina's attorney general over broken commitments from its Mission Health acquisition.

Gressle's division strategy has leaned on freestanding emergency rooms, a facility type tied to high facility fees for insured patients.

A Palm Beach County nurse's 2026 negligence suit alleges HCA Florida Palms West ran thin security despite a record of violence before a patient beat her in 2025.

Pattern Summary

Charles Gressle is a career HCA operator who has run the chain's East Florida Division since 2019 and joins the AHA board in 2027. He represents a for-profit company that earned $6.8 billion in 2025, paid its CEO $26.5 million, spends more than $5 million a year on federal lobbying and, in mid-2026, offset exchange-coverage losses with about $400 million of mostly Florida Medicaid supplemental payments. HCA's record includes the unresolved North Carolina attorney general suit over Mission Health, a 2026 negligent-security suit at Palms West and quality concerns at South Florida hospitals. His seat shows how closely AHA's subsidy agenda now tracks the interests of the largest investor-owned chains.

Charles Gressle

Red Flags

Sources and Citations