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Segment Reporting
 6 Months Ended
Jun. 30, 2021
Segment Reporting [Abstract]  
Segment Reporting Segment Reporting
The Company currently operates in two major lines of business that are also the Company's reportable operating segments - the operation of surgical facilities and the operation of ancillary services. The Surgical Facility Services segment consists of the operation of ASCs and surgical hospitals and includes anesthesia services. The Ancillary Services segment consists of multi-specialty physician practices and a diagnostic laboratory, which was closed during the third quarter of 2020. The Optical Services segment for the three and six months ended June 30, 2020 reflected in the table below consisted of an optical products group purchasing organization, which was sold on December 31, 2020. "All other" primarily consists of the Company's corporate general and administrative functions.
The following tables present financial information for each reportable segment (in millions):
Three Months Ended June 30,Six Months Ended June 30,
2021202020212020
Revenues:
Surgical Facility Services$525.8 $361.0 $1,021.6 $784.2 
Ancillary Services17.5 13.2 34.1 30.2 
Optical Services— 0.5 — 1.3 
Total$543.3 $374.7 $1,055.7 $815.7 
Adjusted EBITDA:
Surgical Facility Services$95.6 $80.0 $190.6 $147.2 
Ancillary Services(0.1)(1.3)(1.0)(3.3)
Optical Services— 0.2 — 0.6 
All other(19.6)(20.7)(40.8)(39.8)
Total$75.9 $58.2 $148.8 $104.7 
Reconciliation of Adjusted EBITDA:
Income (loss) before income taxes$6.1 $(4.5)$17.1 $(28.1)
Net income attributable to non-controlling interests(35.7)(28.6)(67.5)(47.7)
Depreciation and amortization25.2 23.4 50.9 45.2 
Interest expense, net53.4 49.2 106.7 96.3 
Equity-based compensation expense4.1 3.4 9.3 6.9 
Transaction, integration and acquisition costs (1)
11.4 10.1 20.8 22.7 
Loss on disposals and deconsolidations, net1.0 2.9 0.1 6.4 
Litigation settlement and other litigation costs (2)
0.8 2.3 1.8 3.8 
Loss on debt extinguishment9.6 — 9.6 — 
Gain on escrow release (3)
— — — (0.8)
Adjusted EBITDA$75.9 $58.2 $148.8 $104.7 
(1)This amount includes transaction and integration costs of $9.2 million and $4.9 million for the three months ended June 30, 2021 and 2020, respectively. This amount further includes start-up costs related to a de novo surgical hospital of $2.2 million and $5.2 million for the three months ended June 30, 2021 and 2020, respectively.
This amount includes transaction and integration costs of $14.5 million and $10.4 million for the six months ended June 30, 2021 and 2020, respectively. This amount further includes start-up costs related to a de novo surgical hospital of $6.3 million and $12.3 million for the six months ended June 30, 2021 and 2020, respectively.
(2)This amount includes other litigation costs of $0.8 million and $2.3 million for the three months ended June 30, 2021 and 2020, respectively.
This amount includes other litigation costs of $1.8 million and $2.6 million for the six months ended June 30, 2021 and 2020, respectively. This amount includes litigation settlement costs of $1.2 million for the six months ended June 30, 2020, with no comparable costs in the 2021 period.
(3)Included in other income in the condensed consolidated statement of operations for the six months ended June 30, 2020.
June 30,
2021		December 31,
2020
Assets:
Surgical Facility Services$5,021.6 $4,962.4 
Ancillary Services32.7 35.0 
All other566.3 415.8 
Total assets$5,620.6 $5,413.2 
Six Months Ended June 30,
20212020
Cash purchases of property and equipment:
Surgical Facility Services$27.2 $16.8 
Ancillary Services0.2 0.1 
All other0.6 3.0 
Total cash purchases of property and equipment$28.0 $19.9