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Segment Reporting (Tables) | 9 Months Ended
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Sep. 30, 2023
Segment Reporting [Abstract] |
Schedule of Segment Revenue and Operating Income | The following tables present financial information for each reportable segment (in millions):
|  | Three Months Ended September 30, |  | Nine Months Ended September 30,
|  | 2023 |  | 2022 |  | 2023 |  | 2022
Revenues: |  |  |  |  |  |  |  |
Surgical Facility Services |  | $ | 657.3 |  |  | $ | 603.9 |  |  | $ | 1,956.5 |  |  | $ | 1,780.6 |
Ancillary Services |  | 16.8 |  |  | 16.7 |  |  | 51.4 |  |  | 51.6 |
Total |  | $ | 674.1 |  |  | $ | 620.6 |  |  | $ | 2,007.9 |  |  | $ | 1,832.2 |
Adjusted EBITDA: |  |  |  |  |  |  |  |
Surgical Facility Services |  | $ | 138.6 |  |  | $ | 110.2 |  |  | $ | 384.1 |  |  | $ | 319.9 |
Ancillary Services |  | (1.2) |  |  | (1.5) |  |  | (2.7) |  |  | (2.2) |
All other |  | (31.9) |  |  | (12.5) |  |  | (85.6) |  |  | (58.3) |
Total |  | $ | 105.5 |  |  | $ | 96.2 |  |  | $ | 295.8 |  |  | $ | 259.4 |
Reconciliation of Adjusted EBITDA: |  |  |  |  |  |  |  |
Income before income taxes |  | $ | 32.8 |  |  | $ | 13.4 |  |  | $ | 82.3 |  |  | $ | 77.1 |
Net income attributable to non-controlling interests |  | (34.6) |  |  | (30.6) |  |  | (99.5) |  |  | (94.9) |
Interest expense, net |  | 49.8 |  |  | 60.7 |  |  | 144.3 |  |  | 173.9 |
Depreciation and amortization |  | 28.9 |  |  | 29.8 |  |  | 87.0 |  |  | 85.2 |
Equity-based compensation expense |  | 4.4 |  |  | 5.0 |  |  | 13.2 |  |  | 13.0 |
Transaction, integration and acquisition costs (1) |  | 13.0 |  |  | 13.1 |  |  | 38.8 |  |  | 28.4 |
Net loss on disposals, consolidations and deconsolidations |  | 5.8 |  |  | 2.2 |  |  | 7.5 |  |  | 3.2 |
Litigation settlements and regulatory change impact (2) |  | 4.2 |  |  | 1.5 |  |  | 13.9 |  |  | (27.6) |
Undesignated derivative activity |  | — |  |  | — |  |  | 0.6 |  |  | — |
Other (3) |  | 1.2 |  |  | 1.1 |  |  | 7.7 |  |  | 1.1 |
Adjusted EBITDA |  | $ | 105.5 |  |  | $ | 96.2 |  |  | $ | 295.8 |  |  | $ | 259.4 |
(1)This amount includes transaction and integration costs of $12.8 million and $12.5 million for the three months ended September 30, 2023 and 2022, respectively. This amount further includes start-up costs related to de novo surgical facilities of $0.2 million and $0.6 million for the three months ended September 30, 2023 and 2022, respectively. This amount includes transaction and integration costs of $37.3 million and $27.8 million for the nine months ended September 30, 2023 and 2022, respectively. This amount further includes start-up costs related to de novo surgical facilities of $1.5 million and $0.6 million for the nine months ended September 30, 2023 and 2022, respectively. (2)This amount includes a litigation settlement loss of $3.6 million for the three months ended September 30, 2023. This amount also includes other litigation costs of $0.6 million and $1.5 million for the three months ended September 30, 2023 and 2022, respectively. This amount includes a litigation settlement loss of $8.1 million and a gain of $32.8 million for the nine months ended September 30, 2023 and 2022, respectively. This amount also includes other litigation costs of $1.4 million and $5.2 million for the nine months ended September 30, 2023 and 2022, respectively. Additionally, the nine months ended September 30, 2023, includes $4.4 million related to the impact of recent changes in Florida law regarding the use of letters of protection. (3)This amount includes estimates for the net impact of the May 2023 cyber event for the three months ended September 30, 2023.This amount includes estimates for the net impact of a cyber event and losses from a divested business for the nine months ended September 30, 2023. Amounts presented for the three and nine months ended September 30, 2022 reflect losses incurred, net of insurance proceeds received, related to certain surgical facilities that were closed following Hurricane Ian.
Schedule of Reconciliation of Assets from Segment to Consolidated |
|  | September 30, 2023 |  | December 31, 2022
Assets: |  |  |  |
Surgical Facility Services |  | $ | 6,183.9 |  |  | $ | 6,001.1 |
Ancillary Services |  | 38.1 |  |  | 41.7 |
All other |  | 558.1 |  |  | 639.3 |
Total assets |  | $ | 6,780.1 |  |  | $ | 6,682.1 |
Schedule of Financial Information by Reportable Segment |
|  | Nine Months Ended September 30,
|  | 2023 |  | 2022
Cash purchases of property and equipment: |  |  |  |
Surgical Facility Services |  | $ | 68.4 |  |  | $ | 52.8 |
Ancillary Services |  | 0.6 |  |  | 0.4 |
All other |  | — |  |  | 4.7 |
Total cash purchases of property and equipment |  | $ | 69.0 |  |  | $ | 57.9 |

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