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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2019
Sep. 30, 2018
Cash flows from operating activities:    
Net income $ 355.6 $ 327.7
Loss from discontinued operations, net of tax 0.6 0.4
Adjustments to reconcile net income to net cash provided by operating activities—    
Depreciation and amortization 160.3 146.8
Loss on early extinguishment of debt 2.3 0.0
Stock-based compensation 87.0 65.6
Deferred tax expense (benefit) 20.8 (8.0)
Gain on consolidation of Yuma Rehabilitation Hospital (19.2) 0.0
Other, net 2.3 5.1
Change in assets and liabilities, net of acquisitions—    
Accounts receivable (37.8) 12.3
Other assets (11.1) 15.3
Accounts payable (4.2) 0.0
Accrued payroll (21.0) (6.7)
Accrued interest payable 7.4 8.2
Other liabilities (118.7) 18.0
Net cash used in operating activities of discontinued operations (4.6) (0.7)
Total adjustments 63.5 255.9
Net cash provided by operating activities 419.7 584.0
Cash flows from investing activities:    
Purchases of property and equipment (259.9) (171.5)
Additions to capitalized software costs (9.2) (13.2)
Acquisitions of businesses, net of cash acquired (231.2) (135.8)
Other, net (11.4) (5.8)
Net cash used in investing activities (511.7) (326.3)
Cash flows from financing activities:    
Proceeds from bond issuance 1,000.0 0.0
Principal payments on debt, including pre-payments (115.8) (16.1)
Borrowings on revolving credit facility 525.0 285.0
Payments on revolving credit facility (555.0) (315.0)
Principal payments under finance lease obligations (14.2) (13.0)
Debt issuance costs (15.2) 0.0
Repurchases of common stock, including fees and expenses (45.9) 0.0
Dividends paid on common stock (81.3) (74.4)
Purchase of equity interests in consolidated affiliates (162.9) (65.1)
Distributions paid to noncontrolling interests of consolidated affiliates (57.6) (56.5)
Taxes paid on behalf of employees for shares withheld (16.2) (8.3)
Other, net 11.4 9.9
Net cash provided by (used in) financing activities 472.3 (253.5)
Increase in cash, cash equivalents, and restricted cash 380.3 4.2
Cash, cash equivalents, and restricted cash at beginning of period 133.5 116.8
Cash, cash equivalents, and restricted cash at end of period 513.8 121.0
Reconciliation of Cash, Cash Equivalents, and Restricted Cash    
Cash and cash equivalents at beginning of period 69.2 54.4
Restricted cash at beginning of period 59.0 62.4
Restricted cash included in other long-term assets at beginning of period 5.3 0.0
Cash, cash equivalents, and restricted cash at beginning of period 133.5 116.8
Cash and cash equivalents at end of period 422.0 56.9
Restricted cash at end of period 66.8 62.1
Restricted cash included in other long-term assets at end of period 25.0 2.0
Cash, cash equivalents, and restricted cash at end of period $ 513.8 $ 121.0