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Segment Reporting | 9 Months Ended
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Sep. 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 nine months ended September 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 September 30, |  | Nine Months Ended September 30,
|  | 2021 |  | 2020 |  | 2021 |  | 2020
Revenues: |  |  |  |  |  |  |  |
Surgical Facility Services |  | $ | 542.1 |  |  | $ | 478.6 |  |  | $ | 1,563.7 |  |  | $ | 1,262.8 |
Ancillary Services |  | 17.1 |  |  | 16.7 |  |  | 51.2 |  |  | 46.9 |
Optical Services |  | — |  |  | 0.8 |  |  | — |  |  | 2.1 |
Total |  | $ | 559.2 |  |  | $ | 496.1 |  |  | $ | 1,614.9 |  |  | $ | 1,311.8 |
Adjusted EBITDA: |  |  |  |  |  |  |  |
Surgical Facility Services |  | $ | 96.9 |  |  | $ | 82.5 |  |  | $ | 287.5 |  |  | $ | 229.7 |
Ancillary Services |  | — |  |  | (0.6) |  |  | (1.0) |  |  | (3.9) |
Optical Services |  | — |  |  | 0.4 |  |  | — |  |  | 1.0 |
All other |  | (20.5) |  |  | (21.2) |  |  | (61.3) |  |  | (61.0) |
Total |  | $ | 76.4 |  |  | $ | 61.1 |  |  | $ | 225.2 |  |  | $ | 165.8 |
Reconciliation of Adjusted EBITDA: |  |  |  |  |  |  |  |
Income (loss) before income taxes |  | $ | 9.4 |  |  | $ | (33.0) |  |  | $ | 26.5 |  |  | $ | (61.1) |
Net income attributable to non-controlling interests |  | (31.1) |  |  | (27.3) |  |  | (98.6) |  |  | (75.0) |
Depreciation and amortization |  | 25.2 |  |  | 24.1 |  |  | 76.1 |  |  | 69.3 |
Interest expense, net |  | 54.2 |  |  | 51.5 |  |  | 160.9 |  |  | 147.8 |
Equity-based compensation expense |  | 4.1 |  |  | 3.0 |  |  | 13.4 |  |  | 9.9 |
Transaction, integration and acquisition costs (1) |  | 10.2 |  |  | 7.5 |  |  | 31.0 |  |  | 30.2 |
Impairment charges |  | — |  |  | 33.5 |  |  | — |  |  | 33.5 |
Loss on disposals and deconsolidations, net |  | 1.9 |  |  | 0.7 |  |  | 2.0 |  |  | 7.1 |
Litigation settlement and other litigation costs (2) |  | 2.5 |  |  | 1.1 |  |  | 4.3 |  |  | 4.9 |
(Gain) loss on debt extinguishment |  | (0.5) |  |  | — |  |  | 9.1 |  |  | — |
Gain on escrow release (3) |  | — |  |  | — |  |  | — |  |  | (0.8) |
Hurricane-related operating losses (4) |  | 0.5 |  |  | — |  |  | 0.5 |  |  | — |
Adjusted EBITDA |  | $ | 76.4 |  |  | $ | 61.1 |  |  | $ | 225.2 |  |  | $ | 165.8 |
(1)This amount includes transaction and integration costs of $10.2 million and $5.4 million for the three months ended September 30, 2021 and 2020, respectively. This amount further includes start-up costs related to a de novo surgical hospital of $2.1 million for the three months ended September 30, 2020. This amount includes transaction and integration costs of $24.7 million and $15.8 million for the nine months ended September 30, 2021 and 2020, respectively. This amount further includes start-up costs related to a de novo surgical hospital of $6.3 million and $14.4 million for the nine months ended September 30, 2021 and 2020, respectively. (2)This amount includes other litigation costs of $2.5 million and $1.1 million for the three months ended September 30, 2021 and 2020, respectively. This amount includes other litigation costs of $4.3 million and $3.7 million for the nine months ended September 30, 2021 and 2020, respectively. This amount further includes litigation settlement costs of $1.2 million for the nine months ended September 30, 2020, with no comparable costs for the nine months ended September 30, 2021. (3)Included in other income in the condensed consolidated statement of operations for the nine months ended September 30, 2020. (4)Reflects losses incurred in the month of September 2021 at a surgical facility that was closed following Hurricane Ida.
|  | September 30, 2021 |  | December 31, 2020
Assets: |  |  |  |
Surgical Facility Services |  | $ | 5,124.4 |  |  | $ | 4,962.4 |
Ancillary Services |  | 32.5 |  |  | 35.0 |
All other |  | 474.7 |  |  | 415.8 |
Total assets |  | $ | 5,631.6 |  |  | $ | 5,413.2 |
|  | Nine Months Ended September 30,
|  | 2021 |  | 2020
Cash purchases of property and equipment: |  |  |  |
Surgical Facility Services |  | $ | 42.0 |  |  | $ | 24.1 |
Ancillary Services |  | 0.4 |  |  | 0.3 |
All other |  | 1.1 |  |  | 3.4 |
Total cash purchases of property and equipment |  | $ | 43.5 |  |  | $ | 27.8 |

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- Definition The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 31 -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8924-108599 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 34 -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8981-108599 Reference 3: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 21 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8721-108599 Reference 4: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 40 -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e9031-108599 Reference 5: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 32 -Subparagraph (f) -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599 Reference 6: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 32 -Subparagraph (e) -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599 Reference 7: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 26 -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8844-108599 Reference 8: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 41 -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e9038-108599 Reference 9: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 32 -Subparagraph (d) -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599 Reference 10: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 22 -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8736-108599 Reference 11: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 42 -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e9054-108599 Reference 12: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 15 -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8657-108599 Reference 13: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 21 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8721-108599 Reference 14: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -URI http://asc.fasb.org/topic&trid=2134510 + Details
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