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Summary of Significant Accounting Policies (Tables) | 12 Months Ended
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Dec. 31, 2023
Accounting Policies [Abstract] |
Schedule of Concentration of Net Operating Revenues by Payor | Our Net operating revenues disaggregated by payor source are as follows (in millions):
| Year Ended December 31,
| 2023 |  | 2022 |  | 2021
Medicare | $ | 3,126.1 |  |  | $ | 2,843.1 |  |  | $ | 2,589.6 |
Medicare Advantage | 776.1 |  |  | 654.6 |  |  | 609.6 |
Managed care | 531.4 |  |  | 505.2 |  |  | 484.5 |
Medicaid | 190.7 |  |  | 183.3 |  |  | 163.1 |
Other third-party payors | 41.8 |  |  | 39.5 |  |  | 46.0 |
Workers’ compensation | 25.8 |  |  | 24.7 |  |  | 23.1 |
Patients | 14.9 |  |  | 16.6 |  |  | 19.3 |
Other income | 94.4 |  |  | 81.6 |  |  | 79.7 |
Total | $ | 4,801.2 |  |  | $ | 4,348.6 |  |  | $ | 4,014.9 |
Schedule of 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,
| 2023 |  | 2022
Medicare | 57.6 | % |  | 57.9 | %
Managed care and other discount plans, including Medicare Advantage | 32.3 | % |  | 31.1 | %
Medicaid | 4.0 | % |  | 4.4 | %
Other third-party payors | 2.7 | % |  | 3.4 | %
Workers' compensation | 2.5 | % |  | 2.2 | %
Patients | 0.9 | % |  | 1.0 | %
Total | 100.0 | % |  | 100.0 | %
Schedule of 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 | 3 to 10
Property and equipment consists of the following (in millions):
| As of December 31,
| 2023 |  | 2022
Land | $ | 294.0 |  |  | $ | 286.1 |
Buildings | 3,402.8 |  |  | 3,019.8 |
Leasehold improvements | 316.8 |  |  | 281.5 |
Vehicles | 5.3 |  |  | 4.5 |
Furniture, fixtures, and equipment | 723.3 |  |  | 647.2 |
| 4,742.2 |  |  | 4,239.1 |
Less: Accumulated depreciation and amortization | (1,872.2) |  |  | (1,659.4) |
| 2,870.0 |  |  | 2,579.7 |
Construction in progress | 431.0 |  |  | 359.5 |
Property and equipment, net | $ | 3,301.0 |  |  | $ | 2,939.2 |
Schedule of 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 | 10 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: |  |  |  |  |
2023 | $ | 120.9 |  |  | $ | (43.1) |  |  | $ | 77.8 |
2022 | 120.4 |  |  | (41.5) |  |  | 78.9 |
Licenses: |  |  |  |  |
2023 | $ | 65.7 |  |  | $ | (55.4) |  |  | $ | 10.3 |
2022 | 65.7 |  |  | (54.3) |  |  | 11.4 |
Noncompete agreements: |  |  |  |  |
2023 | $ | 66.7 |  |  | $ | (62.0) |  |  | $ | 4.7 |
2022 | 66.2 |  |  | (60.2) |  |  | 6.0 |
Trade name - Encompass: |  |  |  |  |
2023 | $ | 135.2 |  |  | $ | — |  |  | $ | 135.2 |
2022 | 135.2 |  |  | — |  |  | 135.2 |
Trade names - all other: |  |  |  |  |
2023 | $ | 39.3 |  |  | $ | (22.2) |  |  | $ | 17.1 |
2022 | 37.5 |  |  | (20.8) |  |  | 16.7 |
Internal-use software: |  |  |  |  |
2023 | $ | 198.6 |  |  | $ | (166.4) |  |  | $ | 32.2 |
2022 | 183.2 |  |  | (150.3) |  |  | 32.9 |
Market access assets: |  |  |  |  |
2023 | $ | 13.2 |  |  | $ | (12.3) |  |  | $ | 0.9 |
2022 | 13.2 |  |  | (12.0) |  |  | 1.2 |
Total intangible assets: |  |  |  |  |
2023 | $ | 639.6 |  |  | $ | (361.4) |  |  | $ | 278.2 |
2022 | 621.4 |  |  | (339.1) |  |  | 282.3 |
Schedule of 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 | 10 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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