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Summary of Significant Accounting Policies (Tables) | 12 Months Ended
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Dec. 31, 2021
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,
| 2021 |  | 2020 |  | 2019 |  | 2021 |  | 2020 |  | 2019 |  | 2021 |  | 2020 |  | 2019
Medicare | $ | 2,589.7 |  |  | $ | 2,375.5 |  |  | $ | 2,537.3 |  |  | $ | 906.5 |  |  | $ | 896.0 |  |  | $ | 920.0 |  |  | $ | 3,496.2 |  |  | $ | 3,271.5 |  |  | $ | 3,457.3 |
Medicare Advantage | 609.6 |  |  | 544.9 |  |  | 375.5 |  |  | 117.4 |  |  | 116.2 |  |  | 111.9 |  |  | 727.0 |  |  | 661.1 |  |  | 487.4 |
Managed care | 484.5 |  |  | 371.4 |  |  | 342.7 |  |  | 65.4 |  |  | 47.8 |  |  | 39.1 |  |  | 549.9 |  |  | 419.2 |  |  | 381.8 |
Medicaid | 163.1 |  |  | 140.1 |  |  | 110.3 |  |  | 15.5 |  |  | 15.6 |  |  | 18.4 |  |  | 178.6 |  |  | 155.7 |  |  | 128.7 |
Other third-party payors | 46.0 |  |  | 43.0 |  |  | 43.4 |  |  | — |  |  | — |  |  | — |  |  | 46.0 |  |  | 43.0 |  |  | 43.4 |
Workers’ compensation | 23.1 |  |  | 21.5 |  |  | 29.2 |  |  | 0.3 |  |  | 1.0 |  |  | 1.0 |  |  | 23.4 |  |  | 22.5 |  |  | 30.2 |
Patients | 19.3 |  |  | 19.2 |  |  | 23.3 |  |  | 0.8 |  |  | 0.9 |  |  | 0.6 |  |  | 20.1 |  |  | 20.1 |  |  | 23.9 |
Other income | 79.7 |  |  | 50.6 |  |  | 51.3 |  |  | 0.7 |  |  | 0.7 |  |  | 1.0 |  |  | 80.4 |  |  | 51.3 |  |  | 52.3 |
Total | $ | 4,015.0 |  |  | $ | 3,566.2 |  |  | $ | 3,513.0 |  |  | $ | 1,106.6 |  |  | $ | 1,078.2 |  |  | $ | 1,092.0 |  |  | $ | 5,121.6 |  |  | $ | 4,644.4 |  |  | $ | 4,605.0 |
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,
| 2021 |  | 2020
Medicare | 63.6 | % |  | 66.5 | %
Managed care and other discount plans, including Medicare Advantage | 27.4 | % |  | 25.0 | %
Medicaid | 3.7 | % |  | 3.7 | %
Other third-party payors | 2.6 | % |  | 2.7 | %
Workers' compensation | 1.5 | % |  | 1.2 | %
Patients | 1.2 | % |  | 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,
| 2021 |  | 2020
Land | $ | 259.8 |  |  | $ | 217.2 |
Buildings | 2,632.8 |  |  | 2,357.0 |
Leasehold improvements | 254.1 |  |  | 232.5 |
Vehicles | 35.0 |  |  | 33.9 |
Furniture, fixtures, and equipment | 606.1 |  |  | 537.9 |
| 3,787.8 |  |  | 3,378.5 |
Less: Accumulated depreciation and amortization | (1,539.4) |  |  | (1,374.4) |
| 2,248.4 |  |  | 2,004.1 |
Construction in progress | 353.2 |  |  | 202.5 |
Property and equipment, net | $ | 2,601.6 |  |  | $ | 2,206.6 |
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: |  |  |  |  |
2021 | $ | 204.5 |  |  | $ | (68.8) |  |  | $ | 135.7 |
2020 | 197.3 |  |  | (54.5) |  |  | 142.8 |
Licenses: |  |  |  |  |
2021 | $ | 194.5 |  |  | $ | (121.0) |  |  | $ | 73.5 |
2020 | 187.9 |  |  | (107.4) |  |  | 80.5 |
Noncompete agreements: |  |  |  |  |
2021 | $ | 78.5 |  |  | $ | (69.0) |  |  | $ | 9.5 |
2020 | 75.2 |  |  | (65.8) |  |  | 9.4 |
Trade name - Encompass: |  |  |  |  |
2021 | $ | 135.2 |  |  | $ | — |  |  | $ | 135.2 |
2020 | 135.2 |  |  | — |  |  | 135.2 |
Trade names - all other: |  |  |  |  |
2021 | $ | 45.0 |  |  | $ | (27.0) |  |  | $ | 18.0 |
2020 | 44.3 |  |  | (25.5) |  |  | 18.8 |
Internal-use software: |  |  |  |  |
2021 | $ | 209.0 |  |  | $ | (164.9) |  |  | $ | 44.1 |
2020 | 184.2 |  |  | (141.4) |  |  | 42.8 |
Market access assets: |  |  |  |  |
2021 | $ | 13.2 |  |  | $ | (11.7) |  |  | $ | 1.5 |
2020 | 13.2 |  |  | (11.4) |  |  | 1.8 |
Total intangible assets: |  |  |  |  |
2021 | $ | 879.9 |  |  | $ | (462.4) |  |  | $ | 417.5 |
2020 | 837.3 |  |  | (406.0) |  |  | 431.3 |
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

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