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Segment Reporting (Tables) | 12 Months Ended
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Dec. 31, 2022
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,
|  | 2022 |  | 2021 |  | 2020
Revenues: |  |  |  |  |  |
Surgical Facility Services |  | $ | 2,470.4 |  |  | $ | 2,157.8 |  |  | $ | 1,793.4 |
Ancillary Services |  | 68.9 |  |  | 67.3 |  |  | 63.6 |
Optical Services |  | — |  |  | — |  |  | 3.1 |
Total |  | $ | 2,539.3 |  |  | $ | 2,225.1 |  |  | $ | 1,860.1 |
Adjusted EBITDA: |  |  |  |  |  |
Surgical Facility Services |  | $ | 473.6 |  |  | $ | 422.0 |  |  | $ | 339.3 |
Ancillary Services |  | (2.3) |  |  | 1.7 |  |  | (3.4) |
Optical Services |  | — |  |  | — |  |  | 1.4 |
All other |  | (91.1) |  |  | (84.1) |  |  | (80.7) |
Total |  | $ | 380.2 |  |  | $ | 339.6 |  |  | $ | 256.6 |
Reconciliation of Adjusted EBITDA: |  |  |  |  |  |
Income (loss) before income taxes |  | $ | 110.3 |  |  | $ | 81.2 |  |  | $ | (18.8) |
Net income attributable to non-controlling interests |  | (141.6) |  |  | (141.6) |  |  | (117.4) |
Interest expense, net |  | 234.9 |  |  | 221.0 |  |  | 201.8 |
Depreciation and amortization |  | 114.8 |  |  | 98.8 |  |  | 94.8 |
Equity-based compensation expense |  | 18.4 |  |  | 17.4 |  |  | 13.2 |
Transaction, integration and acquisition costs (1) |  | 48.6 |  |  | 46.1 |  |  | 38.2 |
Loss on disposals and deconsolidations, net |  | 11.1 |  |  | 2.2 |  |  | 5.7 |
Litigation settlements and other litigation costs (2) |  | (24.7) |  |  | 5.6 |  |  | 6.4 |
Loss on debt extinguishment |  | 14.9 |  |  | 9.1 |  |  | — |
Undesignated derivative activity (3) |  | (8.0) |  |  | — |  |  | — |
Hurricane-related impacts (4) |  | 1.5 |  |  | (0.2) |  |  | — |
Impairment charges |  | — |  |  | — |  |  | 33.5 |
Gain on escrow release (5) |  | — |  |  | — |  |  | (0.8) |
Adjusted EBITDA |  | $ | 380.2 |  |  | $ | 339.6 |  |  | $ | 256.6 |
(1)This amount includes transaction and integration costs of $47.5 million, $39.8 million and $23.2 million for the years ended December 31, 2022, 2021 and 2020, respectively. This amount further includes start-up costs related to de novo surgical facilities of $1.1 million, $6.3 million and $15.0 million for the years ended December 31, 2022, 2021 and 2020, respectively. (2)This amount includes a net litigation settlements gain of $29.3 million and a loss of $1.2 million for the years ended December 31, 2022 and 2020, respectively, with no comparable costs in 2021. This amount also includes other litigation costs of $4.6 million, $5.6 million and $5.2 million for the years ended December 31, 2022, 2021 and 2020, respectively. (3)This amount includes the reclassification of $7.5 million of unrealized gains out of accumulated OCI into income related to the de-designation of a portion of one of the Company's interest rate caps.This amount further includes fair value changes of undesignated derivatives. (4)Reflects losses incurred, net of insurance proceeds received at certain surgical facilities that were closed following Hurricane Ian in September 2022 and Hurricane Ida in September 2021. (5)Included in other income in the consolidated statement of operations for the year ended December 31, 2020, with no comparable gain in 2022 and 2021.
Schedule of Reconciliation of Assets from Segment to Consolidated |
|  | December 31,
|  | 2022 |  | 2021
Assets: |  |  |  |
Surgical Facility Services |  | $ | 6,001.1 |  |  | $ | 5,552.8 |
Ancillary Services |  | 41.7 |  |  | 47.5 |
All other |  | 639.3 |  |  | 517.3 |
Total assets |  | $ | 6,682.1 |  |  | $ | 6,117.6 |
Schedule of Financial Information by Reportable Segment |
|  | Year Ended December 31,
|  | 2022 |  | 2021 |  | 2020
Cash purchases of property and equipment: |  |  |  |  |  |
Surgical Facility Services |  | $ | 74.3 |  |  | $ | 55.0 |  |  | $ | 38.7 |
Ancillary Services |  | 1.1 |  |  | 0.5 |  |  | 0.4 |
All other |  | 5.2 |  |  | 2.1 |  |  | 3.8 |
Total cash purchases of property and equipment |  | $ | 80.6 |  |  | $ | 57.6 |  |  | $ | 42.9 |

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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 https://asc.fasb.org/extlink&oid=126901519&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 https://asc.fasb.org/extlink&oid=126901519&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 https://asc.fasb.org/extlink&oid=126901519&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 https://asc.fasb.org/extlink&oid=126901519&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 https://asc.fasb.org/extlink&oid=126901519&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 https://asc.fasb.org/extlink&oid=126901519&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 https://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 https://asc.fasb.org/extlink&oid=126901519&loc=d3e8906-108599 + Details
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