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Segment Reporting (Tables) | 12 Months Ended
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Dec. 31, 2021
Segment Reporting [Abstract] |
Schedule of Segment Revenue and Operating Income | The following tables present financial information for each reportable segment (in millions):
|  | Year Ended December 31,
|  | 2021 |  | 2020 |  | 2019
Revenues: |  |  |  |  |  |
Surgical Facility Services |  | $ | 2,157.8 |  |  | $ | 1,793.4 |  |  | $ | 1,748.2 |
Ancillary Services |  | 67.3 |  |  | 63.6 |  |  | 79.4 |
Optical Services |  | — |  |  | 3.1 |  |  | 3.8 |
Total |  | $ | 2,225.1 |  |  | $ | 1,860.1 |  |  | $ | 1,831.4 |
Adjusted EBITDA: |  |  |  |  |  |
Surgical Facility Services |  | $ | 422.0 |  |  | $ | 339.3 |  |  | $ | 328.9 |
Ancillary Services |  | 1.7 |  |  | (3.4) |  |  | 2.6 |
Optical Services |  | — |  |  | 1.4 |  |  | 1.4 |
All other |  | (84.1) |  |  | (80.7) |  |  | (74.3) |
Total |  | $ | 339.6 |  |  | $ | 256.6 |  |  | $ | 258.6 |
Reconciliation of Adjusted EBITDA: |  |  |  |  |  |
Income (loss) before income taxes |  | $ | 81.2 |  |  | $ | (18.8) |  |  | $ | 54.6 |
Net income attributable to non-controlling interests |  | (141.6) |  |  | (117.4) |  |  | (119.9) |
Depreciation and amortization |  | 98.8 |  |  | 94.8 |  |  | 76.5 |
Interest expense, net |  | 221.0 |  |  | 201.8 |  |  | 178.9 |
Equity-based compensation expense |  | 17.4 |  |  | 13.2 |  |  | 10.2 |
Transaction and integration related costs (1) |  | 46.1 |  |  | 38.2 |  |  | 36.1 |
Loss (gain) on disposals, net |  | 2.2 |  |  | 5.7 |  |  | (4.4) |
Litigation settlement and other litigation costs (2) |  | 5.6 |  |  | 6.4 |  |  | 4.6 |
Impairment charges |  | — |  |  | 33.5 |  |  | 7.9 |
Gain on escrow release (3) |  | — |  |  | (0.8) |  |  | — |
Loss on debt extinguishment |  | 9.1 |  |  | — |  |  | 11.7 |
Hurricane-related impacts (4) |  | (0.2) |  |  | — |  |  | — |
Tax receivable agreement expense |  | — |  |  | — |  |  | 2.4 |
Adjusted EBITDA |  | $ | 339.6 |  |  | $ | 256.6 |  |  | $ | 258.6 |
(1)For the year ended December 31, 2021, this amount includes transaction and integration costs of $39.8 million and start-up costs related to a de novo surgical hospital of $6.3 million. For the year ended December 31, 2020, this amount includes transaction and integration costs of $23.2 million and start-up costs related to a de novo surgical hospital of $15.0 million. For the year ended December 31, 2019, this amount includes transaction and integration costs of $19.0 million and other acquisition costs and start-up costs related to a de novo surgical hospital of $17.1 million. (2)This amount includes litigation settlement costs of $1.2 million and $0.2 million for the years ended December 31, 2020 and 2019, respectively, with no comparable costs in 2021. This amount also includes other litigation costs of $5.6 million, $5.2 million and $4.4 million for the years ended December 31, 2021, 2020 and 2019, respectively. (3)Included in other income in the consolidated statement of operations for the year ended December 31, 2020, with no comparable gain in 2021 and 2019. (4)Reflects the impact of insurance proceeds received net of operating losses incurred in the six months ended December 31, 2021, at a surgical facility that was closed following Hurricane Ida.
Schedule of Reconciliation of Assets from Segment to Consolidated |
|  | December 31,
|  | 2021 |  | 2020
Assets: |  |  |  |
Surgical Facility Services |  | $ | 5,552.8 |  |  | $ | 4,962.4 |
Ancillary Services |  | 47.5 |  |  | 35.0 |
All other |  | 517.3 |  |  | 415.8 |
Total assets |  | $ | 6,117.6 |  |  | $ | 5,413.2 |
Schedule of Financial Information by Reportable Segment |
|  | Year Ended December 31,
|  | 2021 |  | 2020 |  | 2019
Cash purchases of property and equipment: |  |  |  |  |  |
Surgical Facility Services |  | $ | 55.0 |  |  | $ | 38.7 |  |  | $ | 65.9 |
Ancillary Services |  | 0.5 |  |  | 0.4 |  |  | 1.1 |
All other |  | 2.1 |  |  | 3.8 |  |  | 6.6 |
Total cash purchases of property and equipment |  | $ | 57.6 |  |  | $ | 42.9 |  |  | $ | 73.6 |

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- Definition Tabular disclosure of all significant reconciling items in the reconciliation of total assets from reportable segments to the entity's consolidated assets. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 30 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8906-108599 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -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 + Details
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- Definition Tabular disclosure of the reconciliation of profit (loss) from reportable segments to the consolidated income (loss) before income tax expense (benefit) and discontinued operations. Includes, but is not limited to, reconciliation after income tax if income tax is allocated to the reportable segment. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -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://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 30 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8906-108599 + Details
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- Definition Tabular disclosure of the profit or loss and total assets for each reportable segment. An entity discloses certain information on each reportable segment if the amounts (a) are included in the measure of segment profit or loss reviewed by the chief operating decision maker or (b) are otherwise regularly provided to the chief operating decision maker, even if not included in that measure of segment profit or loss. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -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 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 25 -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8813-108599 Reference 3: 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 4: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 30 -URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8906-108599 + Details
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