<PAGE>
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 11-K
(Mark One)
[X] ANNUAL REPORT PURSUANT TO SECTION 15 (D) OF THE
SECURITIES EXCHANGE ACT OF 1934 (FEE REQUIRED)
For the fiscal year ended December 31, 1997
OR
[ ] TRANSITION REPORT PURSUANT TO SECTION 15(d) OF THE
SECURITIES EXCHANGE ACT OF 1934 (NO FEE REQUIRED)
For the transaction period from ____ to ____
Commission File Number 1-11141
---------
HEALTH MANAGEMENT ASSOCIATES, INC.
RETIREMENT SAVINGS PLAN
(Full title of the plan)
HEALTH MANAGEMENT ASSOCIATES, INC.
5811 PELICAN BAY BLVD., SUITE 500
NAPLES, FLORIDA 34108-2710
(Name of issuer of the securities held pursuant to the
plan and address of its principal executive office)
<PAGE>
Audited Financial Statements
and Supplemental Schedules
Health Management Associates, Inc.
Retirement Savings Plan
Years ended December 31, 1997 and 1996
with Report of Independent Auditors
<PAGE>
Health Management Associates, Inc. Retirement Savings Plan
Audited Financial Statements and Supplemental Schedules
Years ended December 31, 1997 and 1996
CONTENTS
<TABLE>
<CAPTION>
<S> <C>
Report of Independent Auditors............................... 4
Audited Financial Statements
Statements of Net Assets Available for Benefits.............. 5
Statements of Changes in Net Assets Available for Benefits... 6
Notes to Financial Statements................................ 7
Supplemental Schedules
Line 27a - Schedule of Assets Held for Investment Purposes... 17
Line 27d - Schedule of Reportable Transactions............... 18
Line 27e - Schedule of Non-Exempt Transactions............... 19
</TABLE>
<PAGE>
Report of Independent Auditors
The Plan Sponsor
Health Management Associates, Inc.
Retirement Savings Plan
We have audited the accompanying statements of net assets available for benefits
of Health Management Associates, Inc. Retirement Savings Plan (the "Plan"), as
of December 31, 1997 and 1996, and the related statements of changes in net
assets available for benefits for the years then ended. These financial
statements are the responsibility of the Plan's management. Our responsibility
is to express an opinion on these financial statements based on our audits.
We conducted our audits in accordance with generally accepted auditing
standards. Those standards require that we plan and perform the audit to obtain
reasonable assurance about whether the financial statements are free of material
misstatement. An audit includes examining, on a test basis, evidence supporting
the amounts and disclosures in the financial statements. An audit also includes
assessing the accounting principles used and significant estimates made by
management, as well as evaluating the overall financial statement presentation.
We believe that our audits provide a reasonable basis for our opinion.
In our opinion, the financial statements referred to above present fairly, in
all material respects, the net assets available for benefits of the Plan at
December 31, 1997 and 1996, and the changes in net assets available for benefits
for the years then ended, in conformity with generally accepted accounting
principles.
Our audits were performed for the purpose of forming an opinion on the basic
financial statements taken as a whole. The accompanying supplemental schedule
of assets held for investment purposes as of December 31, 1997, schedule of
reportable transactions for the year ended December 31, 1997, and schedule of
non-exempt transactions for the year ended December 31, 1997 are presented for
purposes of complying with the Department of Labor's Rules and Regulations for
Reporting and Disclosure under the Employee Retirement Income Security Act of
1974, and are not a required part of the basic financial statements. These
supplemental schedules are the responsibility of the Plan's management. The
supplemental schedules have been subjected to the auditing procedures applied in
our audit of the basic financial statements and, in our opinion, are fairly
stated in all material respects in relation to the basic financial statements
taken as a whole.
ERNST & YOUNG LLP
June 5, 1998
4
<PAGE>
Health Management Associates, Inc. Retirement Savings Plan
Statements of Net Assets Available for Benefits
<TABLE>
<CAPTION>
DECEMBER 31
1997 1996
--------------------------
<S> <C> <C>
ASSETS
Investments, at fair value $75,041,104 $46,032,810
Receivables:
Participants' contributions 724,408 692,543
Employer's contributions 505,069 419,387
------------ ------------
Total receivables 1,229,477 1,111,930
------------ ------------
Net assets available for benefits $76,270,581 $47,144,740
============ ============
</TABLE>
See accompanying notes.
5
<PAGE>
Health Management Associates, Inc. Retirement Savings Plan
Statements of Changes in Net Assets Available for Benefits
<TABLE>
<CAPTION>
YEAR ENDED DECEMBER 31
1997 1996
----------- -----------
<S> <C> <C>
ADDITIONS
Investment income:
Net realized and unrealized gains on investments $21,434,508 $ 6,523,484
Interest and dividends 206,551 149,341
----------- -----------
21,641,059 6,672,825
Contributions:
Participants 9,811,079 8,247,677
Employer 2,383,490 2,261,253
----------- -----------
12,194,569 10,508,930
----------- -----------
Total additions 33,835,628 17,181,755
DEDUCTIONS
Benefit payments 4,699,482 3,113,444
Administrative expenses 10,305 8,023
----------- -----------
Total deductions 4,709,787 3,121,467
----------- -----------
Increase in net assets available for benefits 29,125,841 14,060,288
Net assets available for benefits at beginning of
year 47,144,740 33,084,452
----------- -----------
Net assets available for benefits at end of year $76,270,581 $47,144,740
=========== ===========
</TABLE>
See accompanying notes.
6
<PAGE>
Health Management Associates, Inc. Retirement Savings Plan
Notes to Financial Statements
December 31, 1997
1. DESCRIPTION OF THE PLAN
The following description of Health Management Associates, Inc. Retirement
Savings Plan (the "Plan") provides only general information. Participants
should refer to the Plan agreement for a more complete description of the Plan's
provisions.
GENERAL
The Plan's sponsor is Health Management Associates, Inc. (the "Company"). The
effective date of the Plan is October 1, 1990 (date of inception).
The Plan is intended to qualify as a salary reduction plan under Section 401(k)
and as a qualified defined contribution plan under Section 401(a) of the
Internal Revenue Code (the "Code"). The Plan is subject to the provisions of
the Employee Retirement Income Security Act of 1974, as amended (ERISA).
All eligible employees, as defined, who have attained the age of twenty one and
completed one year of service may elect to participate in the Plan, provided
that such employee is not a person covered under a collective bargaining
agreement under which retirement benefits have been the subject of good faith
bargaining or are participants in any other qualified plan maintained by the
Company.
CONTRIBUTIONS
Each year, participants may elect to defer from 1% to 16% of compensation
received during the plan year. The Company makes nondiscretionary matching
contributions equal to a percentage of each participants' deferred compensation.
In applying such matching percentage, only salary reductions up to 6% of total
compensation shall be considered, and such Company matching contributions are
limited to 2% of the participant's total compensation during the plan year.
7
<PAGE>
Health Management Associates, Inc. Retirement Savings Plan
Notes to Financial Statements (continued)
1. DESCRIPTION OF THE PLAN (CONTINUED)
CONTRIBUTIONS (CONTINUED)
In addition, the Company, at the sole discretion of its Board of Directors, may
make an additional contribution to the Plan. The Company match is in the form
of Company securities, with the exception of designated hospital subsidiaries
which receive the Company match in cash. The Company match in Company
securities is not subject to participant direction. During the years ended
December 31, 1997 and 1996, discretionary contributions of approximately
$320,000 and $239,000, respectively, were made to the Plan.
INVESTMENT OPTIONS
Upon enrollment in the Plan, a participant may direct participant contributions
in 1% increments to any of seven investment options.
FIXED INCOME FUND - Funds are invested in a pooled fund that invests in
investment contracts, commercial paper, and other fixed income securities.
(NationsBank Stable Capital Fund).
BALANCED FUND - Funds are invested in a pooled fund that invests in common
stock and U.S. Treasury and other fixed income securities. (Nations Balanced
Assets Fund).
BOND OPTION - Funds are invested in a pooled fund that invests in bonds.
(Strong Advantage Fund).
EQUITY FUND - Funds are invested in two pooled funds that invest primarily in
common stocks of domestic companies. (Nations Capital Growth Fund and
Seligman Frontier Fund).
8
<PAGE>
Health Management Associates, Inc. Retirement Savings Plan
Notes to Financial Statements (continued)
1. DESCRIPTION OF THE PLAN (CONTINUED)
INVESTMENT OPTIONS (CONTINUED)
INTERNATIONAL FUND - Funds are invested primarily in common stocks of foreign
companies. (SoGen International Fund).
COMPANY STOCK FUND - Funds are invested in a Qualifying Employer Securities
Fund that invests solely in Company securities. The Stock Fund was
established on December 31, 1990. However, no participant election was
available with respect to this fund until July 1, 1993. (Health Management
Associates, Inc. Common Stock Fund).
Participants may change their investment options daily.
A NationsBank Treasury Fund was established July 1, 1993 to invest forfeitures
primarily in U.S. Treasury Obligations and repurchase agreements secured by such
obligations. No participant election is available with respect to this fund.
PARTICIPANTS' ACCOUNTS
An individual account is maintained for each participant based on the value of
the investment option(s) elected by the participant. The participants' account
balances can be adjusted daily utilizing the Daily Choice Investment Program.
WITHDRAWALS AND PAYMENTS OF BENEFITS
Upon retirement or death, the total vested value of a participant's account is
distributed to the participant or the beneficiary in cash unless the participant
or the beneficiary elects certain other forms of distribution available under
the Plan.
A participant is only entitled to make a withdrawal from his or her account
prior to separation from service if the participant qualifies for a hardship
withdrawal. If a participant separates from service before vesting, the portion
of the account attributable to Company contributions is not forfeited until the
participant incurs a five-year break in service.
9
<PAGE>
Health Management Associates, Inc. Retirement Savings Plan
Notes to Financial Statements (continued)
1. DESCRIPTION OF THE PLAN (CONTINUED)
WITHDRAWALS AND PAYMENTS OF BENEFITS (CONTINUED)
Forfeited balances of terminated participants' nonvested accounts are used to
reduce future Company contributions. Forfeitures aggregated $313,000 and
$557,000 at December 31, 1997 and 1996, respectively.
VESTING
Participants are immediately vested in their voluntary contributions plus actual
earnings thereon. Participants become one hundred percent vested in the
remainder of their accounts upon the occurrence of any of the following events:
(a) The participant dies while still in service as an employee;
(b) The participant becomes totally and permanently disabled while
still in service as an employee; or
(c) The Plan is terminated by the Sponsor.
In other cases, a gradual vesting scale applies, with one hundred percent
vesting occurring upon reaching seven years of vesting service. A plan year
during which an employee works for at least one thousand hours is counted as one
year of vesting service.
TERMINATION OF THE PLAN
While the Company has not expressed any intent to discontinue the Plan, the Plan
may be terminated for any reason at any time.
10
<PAGE>
Health Management Associates, Inc. Retirement Savings Plan
Notes to Financial Statements (continued)
2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
INVESTMENT VALUATION
Investments in the NationsBank Stable Capital Fund are included in the
statements of net assets available for benefits at fair value (redemption price)
as established by the Trustee. The fair values of the remaining investments in
the Health Management Associates, Inc. Common Stock Fund, the Nations Capital
Growth Fund, the Nations Balanced Assets Fund, the Strong Advantage Fund, the
SoGen International Fund, the Seligman Frontier Fund, and the Nations Treasury
Fund are based upon quoted closing prices on national stock exchanges.
CONTRIBUTIONS
Contributions from participants are recorded when payroll deductions are made.
Company contributions accrue to the Plan at the payroll deduction dates. Such
amounts are remitted monthly to the Trustee for investment based on the
investment options designated by the Plan's participants.
Discretionary Company contributions accrue to the Plan when declared and are
remitted prior to the date the Company files its federal income tax return for
the corresponding fiscal year.
INVESTMENT INCOME
All interest and dividend income is recorded on an accrual basis. Upon
conversion to the Daily Choice Investment Program, investment income is added
daily to the fund and income, excluding dividend distributions, for all funds
except the Treasury Fund is presented as investment appreciation.
11
<PAGE>
Health Management Associates, Inc. Retirement Savings Plan
Notes to Financial Statements (continued)
2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED)
USE OF ESTIMATES
The preparation of the financial statements in conformity with generally
accepted accounting principles requires management to make estimates and
assumptions that affect the amounts reported in the financial statements and
accompanying notes. Actual results inevitably will differ from those estimates,
and such differences may be material to the financial statements.
CONCENTRATIONS OF CREDIT RISK
Financial instruments that potentially subject the Plan to significant
concentrations of credit risk consist principally of commingled investment
funds.
The Trustee maintains financial instruments within commingled investment funds
with various institutions. The Trustee's policy is designed to limit exposure
at any one institution. The Trustee performs periodic evaluations of the
relative credit standing of those institutions which are considered in the
fund's investment strategy.
RECLASSIFICATIONS
Reclassifications have been made to certain 1996 amounts to conform to the 1997
presentation.
3. INVESTMENTS
All investment information included in the financial statements, notes thereto,
and supplemental schedules, in total and by fund, was obtained or derived from
information which was provided and certified by NationsBank of Georgia, N.A (the
"Trustee") as complete and accurate.
12
<PAGE>
Health Management Associates, Inc. Retirement Savings Plan
Notes to Financial Statements (continued)
3. INVESTMENTS (CONTINUED)
The fair market value of individual investments that represent 5% or more of the
Plan's net assets at December 31 are as follows:
<TABLE>
<CAPTION>
1997 1996
--------------------------
<S> <C> <C>
Health Management Associates, Inc. Common Stock Fund
$45,379,028 $24,845,239
NationsBank Stable Capital Fund 10,004,579 8,370,443
Nations Capital Growth Fund 12,746,195 8,617,795
Nations Balanced Assets Fund 5,202,763 3,357,197
</TABLE>
13
<PAGE>
Health Management Associates, Inc. Retirement Savings Plan
Notes to Financial Statements (continued)
4. INVESTMENT FUND ACTIVITY
During the years ended December 31, 1997 and 1996, the changes in net assets
available for benefits by investment option and unallocated cash were as
follows:
<TABLE>
<CAPTION> Paricipant Directed Funds
---------------------------------------------------------------------------------------------
Nations NationsBank HMA Nations SoGen
Capital Stable Common Balanced Strong inter- Seligman
Growth Capital Stock Assets Advantage national Frontier
---------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
Net assets available for benefits at
December 31, 1995 $6,666,428 $7,556,047 $16,270,156 $2,253,944 $ - $ - $ -
Net realized and unrealized gains
(losses) on investments 1,230,499 440,282 4,569,845 287,724 43 (3,136) (1,776)
Interest and dividend income 33,235 - - 92,948 49 - -
Contributions:
Participants 2,091,469 1,706,642 3,325,386 1,109,458 2,390 5,522 6,810
Sponsor 8,345 19,047 2,231,575 2,220 32 27 7
Benefit payments (613,110) (790,207) (1,496,877) (213,250) - - -
Plan expenses (946) (3,708) (2,909) (460) - - -
Fund Transfers (653,887) (439,862) 723,656 (99,219) 22,720 93,046 106,592
--------------------------------------------------------------------------------------------
Net assets available for benefits at
December 31, 1996 8,762,033 8,488,241 25,620,832 3,433,365 25,234 95,459 111,633
Non-Participant
Directed Funds
------------------------------------------------
Nations
Treasury Cash Total
------------------------------------------------
Net assets available for benefits at
December 31, 1995 $ 323,249 $ 14,528 $ 33,084,452
Net realized and unrealized gains
(losses) on investments 3 - 6,523,484
Interest and dividend income 23,109 - 149,341
Contributions:
Participants - - 8,247,677
Sponsor - - 2,261,253
Benefit payments - - (3,113,444)
Plan expenses - - (8,023)
Fund Raisers 261,482 (14,528) -
------------------------------------------------
Net assets available for benefits at
December 31, 1996 607,943 - $ 47,144,740
</TABLE>
14
<PAGE>
4. INVESTMENT FUND ACTIVITY (CONTINUED)
<TABLE>
<CAPTION>
<CAPTION> Paricipant Directed Funds
---------------------------------------------------------------------------------------------
Nations NationsBank HMA Nations SoGen
Capital Stable Common Balanced Strong inter- Seligman
Growth Capital Stock Assets Advantage national Frontier
---------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
Net realized and unrealized gains
on investments 2,817,781 552,594 17,313,678 693,709 156 1,636 54,954
Interest and dividend income 14,603 - 2,400 134,337 7,088 17,665 -
Contributions:
Participants 2,217,526 1,796,533 3,975,061 1,312,461 66,392 197,541 245,565
Sponsor 49,758 127,344 2,568,172 34,345 1,154 1,689 1,450
Benefit payments (931,364) (908,770) (2,542,642) (300,367) (2,515) (5,086) (8,738)
Plan expenses (5,215) (2,460) (1,935) (605) - (15) (75)
Fund Transfers (145,769) 129,959 (706,878) 18,932 42,721 76,127 276,201
---------------------------------------------------------------------------------------------
Net assets available for benefits at
December 31, 1996 $12,779,353 $10,183,441 $46,228,688 $5,326,177 $140,230 $385,016 $680,990
=============================================================================================
Non-Participant
Directed Fund
----------------------------
Nations
Treasury Total
----------------------------
Net realized and unrealized gains
on investments - 21,434,508
Interest and dividend income 30,458 206,551
Contributions:
Participants - 9,811,079
Sponsor (400,422) 2,383,490
Benefit payments - (4,699,482)
Plan expenses - (10,305)
Fund Transfers 308,707 -
----------------------------
Net assets available for benefits at
December 31, 1996 $546,686 $76,270,581
============================
</TABLE>
15
<PAGE>
Health Management Associates, Inc. Retirement Savings Plan
Notes to Financial Statements (continued)
5. INCOME TAX STATUS
The Internal Revenue Service ruled on April 12, 1996 that the Plan qualified
under Section 401(a) of the Internal Revenue Code (IRC) and, therefore, the
related trust is exempt from tax pursuant to Section 501(a) of the IRC. The
plan has been amended since receiving the determination letter. The Plan is
required to operate in conformity with the IRC to maintain its qualification.
The plan administrator is not aware of any course of action or series of events
that have occurred that might adversely affect the Plan's qualified status.
6. PARTY-IN-INTEREST TRANSACTIONS
Certain Plan investments are shares of mutual and trust funds managed by
NationsBank of Georgia, N.A. NationsBank of Georgia, N.A is the trustee as
defined by the Plan and, therefore, these transactions qualify as party-in-
interest. The Health Management Associates, Inc. Common Stock Fund held
investments in Company securities with a market value of $45,379,028 and
$24,845,239 as of December 31, 1997 and 1996, respectively. The Company paid
administrative expenses on behalf of the Plan for the year ended December 31,
1997.
7. RECONCILIATION OF FINANCIAL STATEMENTS TO FORM 5500
Differences between the Form 5500 and the financial statements for the years
ended December 31, 1997 and 1996 relate to contributions receivable which are
recorded on the Plan's financial statements and not included in the Form 5500.
SUBSEQUENT EVENT
During January 1998 all investments held by NationsBank of Georgia, N.A. were
sold and transferred to Merrill Lynch Trust Company.
16
<PAGE>
Health Management Associates, Inc. Retirement Savings Plan
EIN: 65-0261425
Plan # 001
Line 27a - Schedule of Assets Held for Investment Purposes
December 31, 1997
<TABLE>
<CAPTION>
(A) (B) (C) (D) (E)
CURRENT
IDENTITY OF ISSUE DESCRIPTION OF INVESTMENT COST VALUE
- ------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C>
* Health Management
Associates, Inc. Common Stock $19,543,275 $45,379,028
* NationsBank of Georgia, N.A. Stable Capital Fund 8,662,350 10,004,579
* NationsBank of Georgia, N.A. Nations Capital Growth Fund 13,317,840 12,746,195
* NationsBank of Georgia, N.A. Nations Balanced Assets Fund 5,491,469 5,202,763
* NationsBank of Georgia, N.A. Nations Treasury Fund 546,684 546,684
Seligman Frontier Fund, Inc. Mutual Fund 665,691 659,666
SoGen International Fund, Inc. Mutual Fund 400,150 367,805
Strong Advantage Fund, Inc. Mutual Fund 134,486 134,383
----------------------------
$48,761,945 $75,041,103
============================
</TABLE>
* Indicates a party-in-interest to the Plan.
17
<PAGE>
Health Management Associates, Inc. Retirement Savings Plan
EIN: 65-0261425
Plan # 001
Line 27d - Schedule of Reportable Transactions
Year ended December 31, 1997
<TABLE>
<CAPTION>
CURRENT VALUE
PURCHASE AT DATE OF
IDENTITY OF PARTY INVOLVED DESCRIPTION OF ASSET PRICE SELLING PRICE COST OF ASSET TRANSACTION NET GAIN
- --------------------------------------------------------------------------------------------------------------------------------
CATEGORY (III) - SERIES OF TRANSACTIONS IN EXCESS OF 5% OF PLAN ASSETS.
<S> <C> <C> <C> <C> <C> <C>
Health Management Associates, Inc. Common Stock Fund
$ - $1,700,413 $1,038,170 $1,700,413 $662,243
Health Management Associates, Inc. Common Stock Fund
2,748,127 - 2,748,127 2,748,127 -
NationsBank of Georgia, N.A. Stable Capital Fund - 904,453 846,458 904,453 57,995
NationsBank of Georgia, N.A. Stable Capital Fund 1,879,490 - 1,879,490 1,879,490 -
</TABLE>
THERE WERE NO CATEGORY (I) - INDIVIDUAL TRANSACTIONS IN EXCESS OF 5% OF PLAN
ASSETS, CATEGORY (II) - SERIES OF TRANSACTIONS OTHER THAN SECURITIES
TRANSACTIONS OR CATEGORY (IV) - OTHER TRANSACTIONS DURING THE YEAR ENDED
DECEMBER 31, 1997.
18
<PAGE>
Health Management Associates, Inc. Retirement Savings Plan
EIN: 65-0261425
Plan # 001
Line 27e - Schedule of Non-Exempt Transactions
Year ended December 31, 1997
<TABLE>
<CAPTION>
(A) (B) (C)
DESCRIPTION OF TRANSACTIONS, INCLUDING
RELATIONSHIP TO PLAN, MATURITY DATE, RATE OF INTEREST,
EMPLOYER, OR OTHER PARTY- COLLATERAL, PAR, OR MATURITY VALUE
IDENTITY OF PARTY INVOLVED IN-INTEREST
- --------------------------------------------------------------------------------------------------------------
<S> <C> <C>
Health Management Associates, Inc. Employer/Plan Sponsor Contributions of $58,466 for the payroll
period ended March 31, 1997 remitted April
24, 1997.
Health Management Associates, Inc. Employer/Plan Sponsor Contributions of $58,314 for the payroll
period ended May 31, 1997 remitted June
24, 1997.
Health Management Associates, Inc. Employer/Plan Sponsor Contributions of $55,215 for the payroll
period ended July 31, 1997 remitted August
26, 1997.
Health Management Associates, Inc. Employer/Plan Sponsor Contributions of $54,156 for the payroll
period ended August 31, 1997 remitted
October 9, 1997.
Health Management Associates, Inc. Employer/Plan Sponsor Contributions of $38,951 and $685,459 for
the payroll period ended December 31,
1997 remitted March 5, 1998 and January
30, 1998, respectively.
</TABLE>
19
<PAGE>
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, Health
Management Associates, Inc., as Administrator, has duly caused this Annual
Report to be signed on its behalf by the undersigned hereunto duly authorized.
Health Management Associates, Inc.,
AS ADMINISTRATOR OF
Health Management Associates, Inc.
Retirement Savings Plan
Date: June 23, 1998 By: /s/ Robert E. Farnham
----------------------
Robert E. Farnham
Vice President
Corporate Controller
20
<PAGE>
INDEX TO EXHIBITS
(23) Consents of experts and counsel
Consent of Ernst & Young is included as Exhibit 23.1 at page 22 of this
Report.
21
<PAGE>
EXHIBIT 23.1
CONSENT OF INDEPENDENT AUDITORS
We consent to the incorporation by reference in the Registration Statement (Form
S-8 No. 33-80433) pertaining to the Health Management Associates, Inc.
Regirement Savings Plan of our report dated June 5, 1998, with respect to the
financial statements and supplemental schedules of the Health Management
Associates, Inc. Retirement Savings Plan included in this Annual Report (Form
11-K) for the year ended December 31, 1997.
ERNST & YOUNG LLP
Atlanta, Georgia
June 22, 1998
22
