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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