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Segment Reporting
 9 Months Ended
Sep. 30, 2022
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, surgical hospitals and anesthesia services. The Ancillary Services segment consists of multi-specialty physician practices. The "All other" line item 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,
2022202120222021
Revenues:
Surgical Facility Services$603.9 $542.1 $1,780.6 $1,563.7 
Ancillary Services16.7 17.1 51.6 51.2 
Total$620.6 $559.2 $1,832.2 $1,614.9 
Adjusted EBITDA:
Surgical Facility Services$110.2 $96.9 $319.9 $287.5 
Ancillary Services(1.5)— (2.2)(1.0)
All other(12.5)(20.5)(58.3)(61.3)
Total$96.2 $76.4 $259.4 $225.2 
Reconciliation of Adjusted EBITDA:
Income before income taxes$13.4 $9.4 $77.1 $26.5 
Net income attributable to non-controlling interests(30.6)(31.1)(94.9)(98.6)
Depreciation and amortization29.8 25.2 85.2 76.1 
Interest expense, net60.7 54.2 173.9 160.9 
Equity-based compensation expense5.0 4.1 13.0 13.4 
Transaction, integration and acquisition costs (1)
13.1 10.2 28.4 31.0 
Loss on disposals and deconsolidations, net2.2 1.9 3.2 2.0 
Loss (gain) on litigation settlement and other litigation costs (2)
1.5 2.5 (27.6)4.3 
(Gain) loss on debt extinguishment— (0.5)— 9.1 
Hurricane-related impacts (3)
1.1 0.5 1.1 0.5 
Adjusted EBITDA$96.2 $76.4 $259.4 $225.2 
(1)This amount includes transaction and integration costs of $12.5 million and $10.2 million for the three months ended September 30, 2022 and 2021, respectively. This amount further includes start-up costs related to de novo surgical facilities of $0.6 million for the three months ended September 30, 2022.
This amount includes transaction and integration costs of $27.8 million and $24.7 million for the nine months ended September 30, 2022 and 2021, respectively. This amount further includes start-up costs related to de novo surgical facilities of $0.6 million and $6.3 million for the nine months ended September 30, 2022 and 2021, respectively.
(2)This amount includes other litigation costs of $1.5 million and $2.5 million for the three months ended September 30, 2022 and 2021, respectively.
This amount includes other litigation costs of $5.2 million and $4.3 million for the nine months ended September 30, 2022 and 2021, respectively. This amount also includes gain on litigation settlement of $32.8 million for the nine months ended September 30, 2022.
(3) Reflects losses incurred, net of insurance proceeds received at certain surgical facilities that were closed following Hurricane Ida in September 2021 and Hurricane Ian in September 2022.
September 30,
2022		December 31,
2021
Assets:
Surgical Facility Services$5,915.0 $5,552.8 
Ancillary Services42.4 47.5 
All other579.1 517.3 
Total assets$6,536.5 $6,117.6 
Nine Months Ended September 30,
20222021
Cash purchases of property and equipment:
Surgical Facility Services$52.8 $42.0 
Ancillary Services0.4 0.4 
All other4.7 1.1 
Total cash purchases of property and equipment$57.9 $43.5