XML 30 R31.htm IDEA: XBRL DOCUMENT
v3.19.3.a.u2

Summary of Significant Accounting Policies (Tables) | 12 Months Ended
--- | ---
Dec. 31, 2019
Accounting Policies [Abstract] |
Concentration of Net Operating Revenues by Payor | Our Net operating revenues disaggregated by payor source and segment are as follows (in millions):
| Inpatient Rehabilitation |  | Home Health and Hospice |  | Consolidated
| Year Ended December 31, |  | Year Ended December 31, |  | Year Ended December 31,
| 2019 |  | 2018 |  | 2017 |  | 2019 |  | 2018 |  | 2017 |  | 2019 |  | 2018 |  | 2017
Medicare | $ | 2,537.3 |  |  | $ | 2,451.7 |  |  | $ | 2,313.6 |  |  | $ | 920.0 |  |  | $ | 794.5 |  |  | $ | 662.9 |  |  | $ | 3,457.3 |  |  | $ | 3,246.2 |  |  | $ | 2,976.5 |
Medicare Advantage | 375.5 |  |  | 306.5 |  |  | 261.0 |  |  | 111.9 |  |  | 88.6 |  |  | 74.8 |  |  | 487.4 |  |  | 395.1 |  |  | 335.8 |
Managed care | 342.7 |  |  | 343.3 |  |  | 335.6 |  |  | 39.1 |  |  | 33.2 |  |  | 29.1 |  |  | 381.8 |  |  | 376.5 |  |  | 364.7 |
Medicaid | 110.3 |  |  | 101.3 |  |  | 93.2 |  |  | 18.4 |  |  | 11.6 |  |  | 4.3 |  |  | 128.7 |  |  | 112.9 |  |  | 97.5 |
Other third-party payors | 43.4 |  |  | 49.0 |  |  | 49.9 |  |  | — |  |  | — |  |  | — |  |  | 43.4 |  |  | 49.0 |  |  | 49.9 |
Workers’ compensation | 29.2 |  |  | 27.4 |  |  | 27.5 |  |  | 1.0 |  |  | 1.5 |  |  | 0.1 |  |  | 30.2 |  |  | 28.9 |  |  | 27.6 |
Patients | 23.3 |  |  | 18.7 |  |  | 18.4 |  |  | 0.6 |  |  | 0.8 |  |  | 0.7 |  |  | 23.9 |  |  | 19.5 |  |  | 19.1 |
Other income | 51.3 |  |  | 48.3 |  |  | 42.1 |  |  | 1.0 |  |  | 0.9 |  |  | 0.7 |  |  | 52.3 |  |  | 49.2 |  |  | 42.8 |
Total | $ | 3,513.0 |  |  | $ | 3,346.2 |  |  | $ | 3,141.3 |  |  | $ | 1,092.0 |  |  | $ | 931.1 |  |  | $ | 772.6 |  |  | $ | 4,605.0 |  |  | $ | 4,277.3 |  |  | $ | 3,913.9 |
Concentration of Net Operating Revenues and Net Patient Service Accounts Receivable by Payor and Payor Class | The concentration of patient service accounts receivable by payor class, as a percentage of total patient service accounts receivable, is as follows:
| As of December 31,
| 2019 |  | 2018
Medicare | 72.1 | % |  | 73.2 | %
Managed care and other discount plans, including Medicare Advantage | 20.1 | % |  | 19.3 | %
Medicaid | 3.1 | % |  | 2.8 | %
Other third-party payors | 2.6 | % |  | 2.7 | %
Workers' compensation | 1.2 | % |  | 1.1 | %
Patients | 0.9 | % |  | 0.9 | %
Total | 100.0 | % |  | 100.0 | %
Useful Lives of Property and Equipment | Useful lives are generally as follows:
| Years
Buildings | 10 to 30
Leasehold improvements | 2 to 15
Vehicles | 5
Furniture, fixtures, and equipment | 2 to 10
Property and equipment consists of the following (in millions):
| As of December 31,
| 2019 |  | 2018
Land | $ | 169.6 |  |  | $ | 142.4 |
Buildings | 2,084.8 |  |  | 1,875.2 |
Leasehold improvements | 192.6 |  |  | 147.5 |
Vehicles | 31.2 |  |  | 24.6 |
Furniture, fixtures, and equipment | 505.1 |  |  | 441.6 |
| 2,983.3 |  |  | 2,631.3 |
Less: Accumulated depreciation and amortization | (1,211.8 | ) |  | (1,147.0 | )
| 1,771.5 |  |  | 1,484.3 |
Construction in progress | 187.8 |  |  | 150.5 |
Property and equipment, net | $ | 1,959.3 |  |  | $ | 1,634.8 |
Estimated Useful Lives and Amortization Basis of Other Finite-lived Intangible Assets | The range of estimated useful lives and the amortization basis for our intangible assets, excluding goodwill, are generally as follows:
| Estimated Useful Life and Amortization Basis
Certificates of need | 10 to 30 years using straight-line basis
Licenses | 10 to 20 years using straight-line basis
Noncompete agreements | 1 to 18 years using straight-line basis
Trade names: |
Encompass | indefinite-lived asset
All other | 1 to 20 years using straight-line basis
Internal-use software | 3 to 7 years using straight-line basis
Market access assets | 20 years using accelerated basis
The following table provides information regarding our other intangible assets (in millions):
| Gross Carrying Amount |  | Accumulated Amortization |  | Net
Certificates of need: |  |  |  |  |
2019 | $ | 197.2 |  |  | $ | (40.4 | ) |  | $ | 156.8 |
2018 | 148.3 |  |  | (28.2 | ) |  | 120.1 |
Licenses: |  |  |  |  |  |  |  |
2019 | $ | 187.3 |  |  | $ | (94.1 | ) |  | $ | 93.2 |
2018 | 169.1 |  |  | (82.2 | ) |  | 86.9 |
Noncompete agreements: |  |  |  |  |  |  |  |
2019 | $ | 74.2 |  |  | $ | (62.3 | ) |  | $ | 11.9 |
2018 | 65.6 |  |  | (58.6 | ) |  | 7.0 |
Trade name - Encompass: |  |  |  |  |
2019 | $ | 135.2 |  |  | $ | — |  |  | $ | 135.2 |
2018 | 135.2 |  |  | — |  |  | 135.2 |
Trade names - all other: |  |  |  |  |  |  |  |
2019 | $ | 41.6 |  |  | $ | (22.4 | ) |  | $ | 19.2 |
2018 | 38.9 |  |  | (19.4 | ) |  | 19.5 |
Internal-use software: |  |  |  |  |  |  |  |
2019 | $ | 173.8 |  |  | $ | (116.0 | ) |  | $ | 57.8 |
2018 | 161.3 |  |  | (89.3 | ) |  | 72.0 |
Market access assets: |  |  |  |  |
2019 | $ | 13.2 |  |  | $ | (11.0 | ) |  | $ | 2.2 |
2018 | 13.2 |  |  | (10.5 | ) |  | 2.7 |
Total intangible assets: |  |  |  |  |  |  |  |
2019 | $ | 822.5 |  |  | $ | (346.2 | ) |  | $ | 476.3 |
2018 | 731.6 |  |  | (288.2 | ) |  | 443.4 |
Estimated Basis of Other Indefinite-lived Intangible Assets | The range of estimated useful lives and the amortization basis for our intangible assets, excluding goodwill, are generally as follows:
| Estimated Useful Life and Amortization Basis
Certificates of need | 10 to 30 years using straight-line basis
Licenses | 10 to 20 years using straight-line basis
Noncompete agreements | 1 to 18 years using straight-line basis
Trade names: |
Encompass | indefinite-lived asset
All other | 1 to 20 years using straight-line basis
Internal-use software | 3 to 7 years using straight-line basis
Market access assets | 20 years using accelerated basis

X
- References No definition available. + Details
Name: | us-gaap_AccountingPoliciesAbstract
Namespace Prefix: | us-gaap_
Data Type: | xbrli:stringItemType
Balance Type: | na
Period Type: | duration

X
- Definition Tabular disclosure of disaggregation of revenue into categories depicting how nature, amount, timing, and uncertainty of revenue and cash flows are affected by economic factor. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 5 -URI http://asc.fasb.org/extlink&oid=118956577&loc=SL49130545-203045 + Details
Name: | us-gaap_DisaggregationOfRevenueTableTextBlock
Namespace Prefix: | us-gaap_
Data Type: | nonnum:textBlockItemType
Balance Type: | na
Period Type: | duration

X
- Definition Tabular disclosure of physical assets used in the normal conduct of business and not intended for resale. Includes, but is not limited to, balances by class of assets, depreciation and depletion expense and method used, including composite depreciation, and accumulated deprecation. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 210 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.5-02(13)) -URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 360 -SubTopic 10 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=6391035&loc=d3e2868-110229 + Details
Name: | us-gaap_PropertyPlantAndEquipmentTextBlock
Namespace Prefix: | us-gaap_
Data Type: | nonnum:textBlockItemType
Balance Type: | na
Period Type: | duration

X
- Definition Tabular disclosure of assets, excluding financial assets and goodwill, lacking physical substance with a finite life, by either major class or business segment. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -Section 50 -Paragraph 2 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=66006027&loc=d3e16323-109275 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -Section 50 -Paragraph 1 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=66006027&loc=d3e16265-109275 + Details
Name: | us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock
Namespace Prefix: | us-gaap_
Data Type: | nonnum:textBlockItemType
Balance Type: | na
Period Type: | duration

X
- Definition Tabular disclosure of assets, excluding financial assets and goodwill, lacking physical substance and exist in perpetuity, by either major class or business segment. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -Section 50 -Paragraph 3 -Subparagraph (b),(d) -URI http://asc.fasb.org/extlink&oid=66006027&loc=d3e16373-109275 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -Section 50 -Paragraph 2 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=66006027&loc=d3e16323-109275 + Details
Name: | us-gaap_ScheduleOfIndefiniteLivedIntangibleAssetsTableTextBlock
Namespace Prefix: | us-gaap_
Data Type: | nonnum:textBlockItemType
Balance Type: | na
Period Type: | duration

X
- Definition Tabular disclosure of the nature of a concentration, a benchmark to which it is compared, and the percentage that the risk is to the benchmark. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 825 -SubTopic 10 -Section 50 -Paragraph 21 -URI http://asc.fasb.org/extlink&oid=118260190&loc=d3e13537-108611 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 825 -SubTopic 10 -Section 50 -Paragraph 20 -URI http://asc.fasb.org/extlink&oid=118260190&loc=d3e13531-108611 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 275 -SubTopic 10 -Section 50 -Paragraph 20 -URI http://asc.fasb.org/extlink&oid=99393423&loc=d3e6404-108592 Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 275 -SubTopic 10 -Section 50 -Paragraph 16 -URI http://asc.fasb.org/extlink&oid=99393423&loc=d3e6327-108592 Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 275 -SubTopic 10 -Section 50 -Paragraph 18 -URI http://asc.fasb.org/extlink&oid=99393423&loc=d3e6351-108592 Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 275 -SubTopic 10 -Section 50 -Paragraph 21 -URI http://asc.fasb.org/extlink&oid=99393423&loc=d3e6442-108592 + Details
Name: | us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock
Namespace Prefix: | us-gaap_
Data Type: | nonnum:textBlockItemType
Balance Type: | na
Period Type: | duration