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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2021
Sep. 30, 2020
Cash flows from operating activities:    
Net income (loss) $ 27.8 $ (46.6)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:    
Depreciation and amortization 76.1 69.3
Non-cash interest expense, net 12.0 3.1
Equity-based compensation expense 13.4 9.9
Loss on disposals and deconsolidations, net 2.0 7.1
Impairment charges 0.0 33.5
(Gain) loss on debt extinguishment 9.1 0.0
Deferred income taxes (2.3) (15.3)
Income from equity investments, net of distributions received 0.2 (1.0)
Non-cash lease expense 30.3 29.4
Changes in operating assets and liabilities, net of acquisitions and divestitures:    
Accounts receivable (18.4) (11.9)
Medicare accelerated payments and deferred governmental grants (48.5) 141.0
DOJ settlement payments (32.2) 0.0
Other operating assets and liabilities (2.1) 19.5
Net cash provided by operating activities 67.4 238.0
Cash flows from investing activities:    
Purchases of property and equipment (43.5) (27.8)
Payments for acquisitions, net of cash acquired (101.0) (14.2)
Proceeds from disposals of facilities and other assets 2.5 48.3
Other investing activities 0.3 0.5
Net cash (used in) provided by investing activities (141.7) 6.8
Cash flows from financing activities:    
Principal payments on long-term debt (328.4) (197.3)
Borrowings of long-term debt 293.0 428.0
Payments of debt issuance costs (11.7) (8.3)
Proceeds from equity offering 260.9 0.0
Payments of equity offering costs (12.7) 0.0
Payment of preferred dividends (5.1) 0.0
Distributions to non-controlling interest holders (97.5) (82.3)
Receipts (payments) related to ownership transactions with non-controlling interest holders 2.4  
Receipts (payments) related to ownership transactions with non-controlling interest holders   (27.3)
Other financing activities (14.4) (0.3)
Net cash provided by financing activities 86.5 112.5
Net increase in cash, cash equivalents and restricted cash 12.2 357.3
Cash, cash equivalents and restricted cash at beginning of period 318.2 93.0
Cash, cash equivalents and restricted cash at end of period $ 330.4 $ 450.3