Pummeled by the politics of the Affordable Care Act, the health care industry is in flux, a waiting room of uncertainty and complexity. A former nurse, Lewis has it squarely on her plate as president of HCA’s Capital Division, which has operations in four states. Locally that includes Chippenham, Johnston-Willis, John Randolph, Retreat Doctors’ Hospital, Henrico Doctors’ Hospital and Parham Doctors’ Hospital — some 9,500 employees in greater Richmond. So its stance matters in the local debate to build a freestanding children’s hospital. HCA has come down on the side of VCU Medical Center, insisting on its direct inclusion, and declining to support the proposal of PACKids in its current form. Lewis, chair of the board of the Virginia Hospital and Health Care Association, is involved in a variety of community causes. She stands out as a female leader among Richmond’s sea of male executives.