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Segment Reporting (Tables) | 3 Months Ended
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Mar. 31, 2024
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 March 31,
|  | 2024 |  | 2023 |  |
Revenues: |  |  |  |  |  |
Surgical Facility Services |  | $ | 692.7 |  |  | $ | 649.0 |  |  |
Ancillary Services |  | 24.7 |  |  | 17.2 |  |  |
Total |  | $ | 717.4 |  |  | $ | 666.2 |  |  |
Adjusted EBITDA: |  |  |  |  |  |
Surgical Facility Services |  | $ | 126.7 |  |  | $ | 118.8 |  |  |
Ancillary Services |  | (1.4) |  |  | (1.4) |  |  |
All other |  | (27.8) |  |  | (27.3) |  |  |
Total |  | $ | 97.5 |  |  | $ | 90.1 |  |  |
Reconciliation of Adjusted EBITDA: |  |  |  |  |  |
Income (loss) before income taxes |  | $ | 28.7 |  |  | $ | (0.4) |  |  |
Net income attributable to non-controlling interests |  | (36.7) |  |  | (26.1) |  |  |
Interest expense, net |  | 47.3 |  |  | 46.8 |  |  |
Depreciation and amortization |  | 33.7 |  |  | 33.7 |  |  |
Equity-based compensation expense |  | 4.9 |  |  | 4.2 |  |  |
Transaction, integration and acquisition costs (1) |  | 18.9 |  |  | 12.8 |  |  |
Net loss on disposals, consolidations and deconsolidations |  | 1.5 |  |  | 10.5 |  |  |
Litigation settlements and regulatory change impact (2) |  | (1.2) |  |  | 8.0 |  |  |
Undesignated derivative activity |  | — |  |  | 0.6 |  |  |
Other |  | 0.4 |  |  | — |  |  |
Adjusted EBITDA |  | $ | 97.5 |  |  | $ | 90.1 |  |  |
(1)This amount includes transaction and integration costs of $17.4 million and $12.5 million for the three months ended March 31, 2024 and 2023, respectively. This amount further includes start-up costs related to de novo surgical facilities of $1.5 million and $0.3 million for the three months ended March 31, 2024 and 2023, respectively. (2)This amount includes a litigation settlements gain of $1.8 million and a loss of $3.0 million for the three months ended March 31, 2024 and 2023, respectively. This amount also includes other litigation costs of $0.6 million and $0.6 million for the three months ended March 31, 2024 and 2023, respectively. Additionally, the three months ended March 31, 2023, includes $4.4 million related to the impact of recent changes in Florida law regarding the use of letters of protection.
Schedule of Reconciliation of Assets from Segment to Consolidated |
|  | March 31, 2024 |  | December 31, 2023
Assets: |  |  |  |
Surgical Facility Services |  | $ | 6,420.9 |  |  | $ | 6,347.4 |
Ancillary Services |  | 60.6 |  |  | 36.3 |
All other |  | 494.1 |  |  | 493.0 |
Total assets |  | $ | 6,975.6 |  |  | $ | 6,876.7 |
Schedule of Financial Information by Reportable Segment |
|  | Three Months Ended March 31,
|  | 2024 |  | 2023 |  |
Cash purchases of property and equipment: |  |  |  |  |  |
Surgical Facility Services |  | $ | 16.3 |  |  | $ | 23.8 |  |  |
Ancillary Services |  | — |  |  | 0.5 |  |  |
All other |  | 4.7 |  |  | — |  |  |
Total cash purchases of property and equipment |  | $ | 21.0 |  |  | $ | 24.3 |  |  |

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