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Summary of Significant Accounting Policies (Tables)
12 Months Ended
Dec. 31, 2020
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 RehabilitationHome Health and HospiceConsolidated
Year Ended December 31,Year Ended December 31,Year Ended December 31,
202020192018202020192018202020192018
Medicare$2,375.5 $2,537.3 $2,451.7 $896.0 $920.0 $794.5 $3,271.5 $3,457.3 $3,246.2 
Medicare Advantage
544.9 375.5 306.5 116.2 111.9 88.6 661.1 487.4 395.1 
Managed care
371.4 342.7 343.3 47.8 39.1 33.2 419.2 381.8 376.5 
Medicaid140.1 110.3 101.3 15.6 18.4 11.6 155.7 128.7 112.9 
Other third-party payors43.0 43.4 49.0 — — — 43.0 43.4 49.0 
Workers’ compensation21.5 29.2 27.4 1.0 1.0 1.5 22.5 30.2 28.9 
Patients19.2 23.3 18.7 0.9 0.6 0.8 20.1 23.9 19.5 
Other income50.6 51.3 48.3 0.7 1.0 0.9 51.3 52.3 49.2 
Total$3,566.2 $3,513.0 $3,346.2 $1,078.2 $1,092.0 $931.1 $4,644.4 $4,605.0 $4,277.3 
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,
 20202019
Medicare66.5 %72.1 %
Managed care and other discount plans, including Medicare Advantage25.0 %20.1 %
Medicaid3.7 %3.1 %
Other third-party payors2.7 %2.6 %
Workers' compensation1.2 %1.2 %
Patients0.9 %0.9 %
Total100.0 %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,
 20202019
Land$217.2 $169.6 
Buildings2,357.0 2,084.8 
Leasehold improvements232.5 192.6 
Vehicles33.9 31.2 
Furniture, fixtures, and equipment537.9 505.1 
 3,378.5 2,983.3 
Less: Accumulated depreciation and amortization(1,374.4)(1,211.8)
 2,004.1 1,771.5 
Construction in progress202.5 187.8 
Property and equipment, net$2,206.6 $1,959.3 
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 AmountAccumulated AmortizationNet
Certificates of need:   
2020$197.3 $(54.5)$142.8 
2019197.2 (40.4)156.8 
Licenses:   
2020$187.9 $(107.4)$80.5 
2019187.3 (94.1)93.2 
Noncompete agreements:   
2020$75.2 $(65.8)$9.4 
201974.2 (62.3)11.9 
Trade name - Encompass:
2020$135.2 $— $135.2 
2019135.2 — 135.2 
Trade names - all other:   
2020$44.3 $(25.5)$18.8 
201941.6 (22.4)19.2 
Internal-use software:   
2020$184.2 $(141.4)$42.8 
2019173.8 (116.0)57.8 
Market access assets:
2020$13.2 $(11.4)$1.8 
201913.2 (11.0)2.2 
Total intangible assets:   
2020$837.3 $(406.0)$431.3 
2019822.5 (346.2)476.3 
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