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Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2023

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