Health-care heavyweight HCA, which had $33 billion in revenue last year, operates 164 hospitals in the United States and England. Exactly one of those finished atop the organization’s employee-satisfaction scores in 2010: Lafayette Regional Health Center. That says a lot about the kind of workplace it is for 214 people—176 of them full-timers—in Lexington, Mo. And that No. 1 was no fluke: LRHC was in the top four among those 164 in each of the previous four years. Physicians affiliated with the hospital turned in similar satisfaction scores. Employee satisfaction starts with the paycheck, and the average hourly wage of $30.94 makes the hospital a key economic force in the county. No one on staff earns less than $8.80 an hour, or 20 percent more than the minimum wage, and the hospital provides free health insurance to employees who earn below 200 percent of federal poverty guidelines. It doesn’t stop with pay: “We believe in investing in our employees,” says HR director Lee Tagai, and they do so with a whopping $4,500 maximum reimbursement for tuition and leadership seminars. Driving the development message further, and building shared values: A $225 stipend to employees who read a self-development book and take an open-book test, something nearly 75 percent of the staff has done. It all pays off with a turnover rate of just 11 percent—nearly half the national norm.