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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
 6 Months Ended
Jun. 30, 2022
Jun. 30, 2021
Cash flows from operating activities:    
Net income $ 58.1 $ 19.6
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 55.4 50.9
Non-cash interest expense, net 12.4 5.7
Equity-based compensation expense 8.0 9.3
Loss on disposals and deconsolidations, net 1.0 0.1
Loss on debt extinguishment 0.0 9.6
Deferred income taxes 4.9 (3.2)
Equity in earnings of unconsolidated affiliates, net of distributions received (0.4) (0.4)
Non-cash lease expense 17.1 20.0
Changes in operating assets and liabilities, net of acquisitions and divestitures:    
Accounts receivable 5.4 (3.1)
Medicare accelerated payments and deferred governmental grants (40.2) (28.8)
DOJ settlement payments 0.0 (32.2)
Other operating assets and liabilities 0.2 5.0
Net cash provided by operating activities 121.9 52.5
Cash flows from investing activities:    
Purchases of property and equipment (40.6) (28.0)
Payments for acquisitions, net of cash acquired (74.9) (15.2)
Proceeds from disposals of facilities and other assets 0.0 2.5
Purchases of equity investments (65.8) 0.0
Proceeds from sales of equity investments 11.5 0.0
Other investing activities (11.6) 0.0
Net cash used in investing activities (181.4) (40.7)
Cash flows from financing activities:    
Principal payments on long-term debt (33.3) (309.4)
Borrowings of long-term debt 12.4 283.1
Payments of debt issuance costs 0.0 (8.7)
Payment of premium on debt extinguishment 0.0 (2.4)
Proceeds from equity offering 0.0 260.9
Payments of equity offering costs 0.0 (12.7)
Payment of preferred dividends 0.0 (5.1)
Distributions to non-controlling interest holders (75.2) (63.4)
(Payments) receipts related to ownership transactions with non-controlling interest holders (4.0)  
(Payments) receipts related to ownership transactions with non-controlling interest holders   3.4
Other financing activities (2.9) (10.9)
Net cash (used in) provided by financing activities (103.0) 134.8
Net (decrease) increase in cash and cash equivalents (162.5) 146.6
Cash and cash equivalents at beginning of period 389.9 318.2
Cash and cash equivalents at end of period $ 227.4 $ 464.8