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Consolidated Statements of Changes in Equity - USD ($) $ in Thousands | Total | Redeemable Noncontrolling Interest | Class A | Class B | Class C | Class D | Cumulative Dividends | Retained Earnings | Retained Earnings Cumulative Effect Period of Adoption Adjustment | Accumulated Other Comprehensive Income (Loss) | Accumulated Other Comprehensive Income (Loss) Cumulative Effect Period of Adoption Adjustment | UHS Common Stockholders' Equity | Noncontrolling Interest
--- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | ---
Balance at Dec. 31, 2017 | $ 5,051,436 |  | $ 66 | $ 869 | $ 7 | $ 0 | $ (371,814) | $ 5,353,209 | $ (3,353) | $ 7,177 | $ 3,353 | $ 4,989,514 | $ 61,922
Balance at Dec. 31, 2017 |  | $ 6,702 |  |  |  |  |  |  |  |  |  |  |
Common Stock |  |  |  |  |  |  |  |  |  |  |  |  |
Issued/(converted) including tax benefits from exercise of stock options | 11,888 |  |  | 6 |  |  |  | 11,882 |  |  |  | 11,888 |
Repurchased | (414,002) |  |  | (34) |  |  |  | (413,968) |  |  |  | (414,002) |
Restricted share-based compensation expense | 2,924 |  |  |  |  |  |  | 2,924 |  |  |  | 2,924 |
Dividends paid | (37,342) |  |  |  |  |  | (37,342) |  |  |  |  | (37,342) |
Stock option expense | 61,061 |  |  |  |  |  |  | 61,061 |  |  |  | 61,061 |
Distributions to noncontrolling interests | (12,095) | (2,500) |  |  |  |  |  |  |  |  |  |  | (12,095)
Other | 8,616 |  |  |  |  |  |  |  |  |  |  |  | 8,616
Comprehensive income: |  |  |  |  |  |  |  |  |  |  |  |  |
Net income to UHS / noncontrolling interests | 797,793 |  |  |  |  |  |  | 779,705 |  |  |  | 779,705 | 18,088
Net income attributable to redeemable noncontrolling interest |  | 90 |  |  |  |  |  |  |  |  |  |  |
Reclassification due to adoption of ASU 2018-02 |  |  |  |  |  |  |  | 1,802 |  | (1,802) |  |  |
Foreign currency translation adjustments (net of income tax effect) | 2,894 |  |  |  |  |  |  |  |  | 2,894 |  | 2,894 |
Unrealized derivative gains on cash flow hedges (net of income tax effect) | (2,138) |  |  |  |  |  |  |  |  | (2,138) |  | (2,138) |
Minimum pension liability (net of income tax effect) | (5,242) |  |  |  |  |  |  |  |  | (5,242) |  | (5,242) |
Subtotal - comprehensive income | 793,307 |  |  |  |  |  |  | 778,154 |  | (2,935) |  | 775,219 | 18,088
Subtotal attributable to redeemable noncontrolling interest |  | 90 |  |  |  |  |  |  |  |  |  |  |
Balance at Dec. 31, 2018 | 5,465,793 |  | 66 | 841 | 7 |  | (409,156) | 5,793,262 |  | 4,242 |  | 5,389,262 | 76,531
Balance at Dec. 31, 2018 |  | 4,292 |  |  |  |  |  |  |  |  |  |  |
Common Stock |  |  |  |  |  |  |  |  |  |  |  |  |
Issued/(converted) including tax benefits from exercise of stock options | 10,940 |  |  | 10 |  |  |  | 10,930 |  |  |  | 10,940 |
Repurchased | (753,927) |  |  | (57) |  |  |  | (753,870) |  |  |  | (753,927) |
Restricted share-based compensation expense | 8,222 |  |  |  |  |  |  | 8,222 |  |  |  | 8,222 |
Dividends paid | (53,003) |  |  |  |  |  | (53,003) |  |  |  |  | (53,003) |
Stock option expense | 60,106 |  |  |  |  |  |  | 60,106 |  |  |  | 60,106 |
Distributions to noncontrolling interests | (15,359) | (500) |  |  |  |  |  |  |  |  |  |  | (15,359)
Other | 1,446 |  |  |  |  |  |  |  |  |  |  |  | 1,446
Comprehensive income: |  |  |  |  |  |  |  |  |  |  |  |  |
Net income to UHS / noncontrolling interests | 827,002 |  |  |  |  |  |  | 814,854 |  |  |  | 814,854 | 12,148
Net income attributable to redeemable noncontrolling interest |  | 541 |  |  |  |  |  |  |  |  |  |  |
Foreign currency translation adjustments (net of income tax effect) | 24,193 |  |  |  |  |  |  |  |  | 24,193 |  | 24,193 |
Unrealized derivative gains on cash flow hedges (net of income tax effect) | (2,997) |  |  |  |  |  |  |  |  | (2,997) |  | (2,997) |
Minimum pension liability (net of income tax effect) | 6,455 |  |  |  |  |  |  |  |  | 6,455 |  | 6,455 |
Subtotal - comprehensive income | 854,653 |  |  |  |  |  |  | 814,854 |  | 27,651 |  | 842,505 | 12,148
Subtotal attributable to redeemable noncontrolling interest |  | 541 |  |  |  |  |  |  |  |  |  |  |
Balance at Dec. 31, 2019 | 5,578,871 |  | 66 | 794 | 7 |  | (462,159) | 5,933,504 |  | 31,893 |  | 5,504,105 | 74,766
Balance at Dec. 31, 2019 |  | 4,333 |  |  |  |  |  |  |  |  |  |  |
Common Stock |  |  |  |  |  |  |  |  |  |  |  |  |
Issued/(converted) including tax benefits from exercise of stock options | 12,758 |  |  | 4 |  |  |  | 12,754 |  |  |  | 12,758 |
Repurchased | (206,719) |  |  | (20) |  |  |  | (206,699) |  |  |  | (206,719) |
Restricted share-based compensation expense | 9,505 |  |  |  |  |  |  | 9,505 |  |  |  | 9,505 |
Dividends paid | (17,344) |  |  |  |  |  | (17,344) |  |  |  |  | (17,344) |
Stock option expense | 54,661 |  |  |  |  |  |  | 54,661 |  |  |  | 54,661 |
Distributions to noncontrolling interests | (19,305) | (500) |  |  |  |  |  |  |  |  |  |  | (19,305)
Purchase of Ownership Interests by Minority Members | 17,959 |  |  |  |  |  |  |  |  |  |  |  | 17,959
Other | 3,300 |  |  |  |  |  |  |  |  |  |  |  | 3,300
Comprehensive income: |  |  |  |  |  |  |  |  |  |  |  |  |
Net income to UHS / noncontrolling interests | 952,054 |  |  |  |  |  |  | 943,953 |  |  |  | 943,953 | 8,101
Net income attributable to redeemable noncontrolling interest |  | 736 |  |  |  |  |  |  |  |  |  |  |
Foreign currency translation adjustments (net of income tax effect) | 12,870 |  |  |  |  |  |  |  |  | 12,870 |  | 12,870 |
Minimum pension liability (net of income tax effect) | 3,357 |  |  |  |  |  |  |  |  | 3,357 |  | 3,357 |
Subtotal - comprehensive income | 968,281 |  |  |  |  |  |  | 943,953 |  | 16,227 |  | 960,180 | 8,101
Subtotal attributable to redeemable noncontrolling interest |  | 736 |  |  |  |  |  |  |  |  |  |  |
Balance at Dec. 31, 2020 | 6,401,967 |  | $ 66 | $ 778 | $ 7 |  | $ (479,503) | $ 6,747,678 |  | $ 48,120 |  | $ 6,317,146 | $ 84,821
Balance at Dec. 31, 2020 | $ 5,000 | $ 4,569 |  |  |  |  |  |  |  |  |  |  |

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