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Segment Reporting (Tables)

12 Months Ended

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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Tabular disclosure of all significant reconciling items in the reconciliation of total assets from reportable segments to the entity's consolidated assets.

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