XML 30 R20.htm IDEA: XBRL DOCUMENT
v3.21.2

Organization and Summary of Accounting Policies (Tables) | 9 Months Ended
--- | ---
Sep. 30, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract] |
Schedule of Carrying Amounts and Fair Values of Long-Term Debt | A summary of the carrying amounts and estimated fair values of the Company's long-term debt follows (in millions):
|  | Carrying Amount |  | Fair Value
|  | September 30, 2021 |  | December 31, 2020 |  | September 30, 2021 |  | December 31, 2020
Senior secured term loan |  | $ | 1,534.5 |  |  | $ | 1,539.4 |  |  | $ | 1,523.0 |  |  | $ | 1,533.4 |
6.750% senior unsecured notes due 2025 |  | $ | 370.0 |  |  | $ | 370.0 |  |  | $ | 376.0 |  |  | $ | 376.0 |
10.000% senior unsecured notes due 2027 |  | $ | 545.0 |  |  | $ | 545.0 |  |  | $ | 589.3 |  |  | $ | 596.8 |
Schedule of Revenues | A summary of revenues by service type as a percentage of total revenues follows:
|  | Three Months Ended September 30, |  | Nine Months Ended September 30,
|  | 2021 |  | 2020 |  | 2021 |  | 2020
Patient service revenues: |  |  |  |  |  |  |  |
Surgical facilities revenues |  | 95.6 | % |  | 95.4 | % |  | 95.5 | % |  | 95.0 | %
Ancillary services revenues |  | 3.0 | % |  | 3.4 | % |  | 3.1 | % |  | 3.6 | %
Total patient service revenues |  | 98.6 | % |  | 98.8 | % |  | 98.6 | % |  | 98.6 | %
Other service revenues |  | 1.4 | % |  | 1.2 | % |  | 1.4 | % |  | 1.4 | %
Total revenues |  | 100.0 | % |  | 100.0 | % |  | 100.0 | % |  | 100.0 | %
The following table sets forth patient service revenues by type of payor and as a percentage of total patient service revenues for the Company's consolidated surgical facilities (dollars in millions):
|  | Three Months Ended September 30,
|  | 2021 |  | 2020
|  | Amount |  | % |  | Amount |  | %
Patient service revenues: |  |  |  |  |  |  |  |
Private insurance |  | $ | 271.4 |  |  | 49.2 | % |  | $ | 257.4 |  |  | 52.6 | %
Government |  | 248.0 |  |  | 45.0 | % |  | 188.8 |  |  | 38.5 | %
Self-pay |  | 15.9 |  |  | 2.9 | % |  | 19.4 |  |  | 4.0 | %
Other (1) |  | 16.1 |  |  | 2.9 | % |  | 24.2 |  |  | 4.9 | %
Total patient service revenues |  | 551.4 |  |  | 100.0 | % |  | 489.8 |  |  | 100.0 | %
Other service revenues |  | 7.8 |  |  |  |  | 6.3 |  |  |
Total revenues |  | $ | 559.2 |  |  |  |  | $ | 496.1 |  |  |
|  | Nine Months Ended September 30,
|  | 2021 |  | 2020
|  | Amount |  | % |  | Amount |  | %
Patient service revenues: |  |  |  |  |  |  |  |
Private insurance |  | $ | 790.5 |  |  | 49.6 | % |  | $ | 682.6 |  |  | 52.8 | %
Government |  | 700.6 |  |  | 44.0 | % |  | 505.4 |  |  | 39.1 | %
Self-pay |  | 46.9 |  |  | 2.9 | % |  | 43.4 |  |  | 3.4 | %
Other (1) |  | 55.0 |  |  | 3.5 | % |  | 62.1 |  |  | 4.7 | %
Total patient service revenues |  | 1,593.0 |  |  | 100.0 | % |  | 1,293.5 |  |  | 100.0 | %
Other service revenues |  | 21.9 |  |  |  |  | 18.3 |  |  |
Total revenues |  | $ | 1,614.9 |  |  |  |  | $ | 1,311.8 |  |  |
(1)Other is comprised of anesthesia service agreements, automobile liability, letters of protection and other payor types.
Schedule of Rollforward of Goodwill | A summary of activity related to goodwill for the nine months ended September 30, 2021 is as follows (in millions):
Balance at December 31, 2020 |  | $ | 3,468.0 |
Acquisitions, including post acquisition adjustments |  | 145.7 |
Divestitures and deconsolidations |  | (0.1) |
Balance at September 30, 2021 |  | $ | 3,613.6 |
Schedule of Rollforward of Noncontrolling Interest - Redeemable | A summary of activity related to non-controlling interests—redeemable for the nine months ended September 30, 2021 and 2020 is as follows (in millions):
|  | 2021 |  | 2020
Balance at beginning of period |  | $ | 306.8 |  |  | $ | 321.0 |
Net income attributable to non-controlling interests—redeemable |  | 33.8 |  |  | 19.3 |
Acquisition (disposal) of shares of non-controlling interests, net—redeemable |  | 2.4 |  |  | (7.9) |
Distributions to non-controlling interest—redeemable holders |  | (32.6) |  |  | (27.7) |
Balance at end of period |  | $ | 310.4 |  |  | $ | 304.7 |

X
- References No definition available. + Details
Name: | us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract
Namespace Prefix: | us-gaap_
Data Type: | xbrli:stringItemType
Balance Type: | na
Period Type: | duration

X
- Definition Tabular disclosure of redeemable noncontrolling interest (as defined) included in the statement of financial position as either a liability or temporary equity. As of the date of the statement of financial position, such redeemable noncontrolling interest is currently redeemable, as defined, for cash or other assets of the entity at (1) at a fixed or determinable price on a fixed or determinable date, (2) at the option of the holder of the noncontrolling interest, or (3) upon occurrence of an event that is not solely within the control of the entity. + References No definition available. + Details
Name: | us-gaap_RedeemableNoncontrollingInterestTableTextBlock
Namespace Prefix: | us-gaap_
Data Type: | dtr-types:textBlockItemType
Balance Type: | na
Period Type: | duration

X
- Definition Tabular disclosure of information pertaining to carrying amount and estimated fair value of short-term and long-term debt instruments or arrangements, including but not limited to, identification of terms, features, and collateral requirements. + References No definition available. + Details
Name: | us-gaap_ScheduleOfCarryingValuesAndEstimatedFairValuesOfDebtInstrumentsTableTextBlock
Namespace Prefix: | us-gaap_
Data Type: | dtr-types:textBlockItemType
Balance Type: | na
Period Type: | duration

X
- Definition Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 20 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=121556970&loc=d3e13816-109267 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 20 -Section 50 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=121556970&loc=d3e13854-109267 + Details
Name: | us-gaap_ScheduleOfGoodwillTextBlock
Namespace Prefix: | us-gaap_
Data Type: | dtr-types:textBlockItemType
Balance Type: | na
Period Type: | duration

X
- Definition Tabular disclosure of the nature of a concentration, a benchmark to which it is compared, and the percentage that the risk is to the benchmark. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 825 -SubTopic 10 -Section 50 -Paragraph 21 -URI http://asc.fasb.org/extlink&oid=123594938&loc=d3e13537-108611 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 825 -SubTopic 10 -Section 50 -Paragraph 20 -URI http://asc.fasb.org/extlink&oid=123594938&loc=d3e13531-108611 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 275 -SubTopic 10 -Section 50 -Paragraph 20 -URI http://asc.fasb.org/extlink&oid=99393423&loc=d3e6404-108592 Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 275 -SubTopic 10 -Section 50 -Paragraph 16 -URI http://asc.fasb.org/extlink&oid=99393423&loc=d3e6327-108592 Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 275 -SubTopic 10 -Section 50 -Paragraph 18 -URI http://asc.fasb.org/extlink&oid=99393423&loc=d3e6351-108592 Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 275 -SubTopic 10 -Section 50 -Paragraph 21 -URI http://asc.fasb.org/extlink&oid=99393423&loc=d3e6442-108592 + Details
Name: | us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock
Namespace Prefix: | us-gaap_
Data Type: | dtr-types:textBlockItemType
Balance Type: | na
Period Type: | duration