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Segment Reporting (Tables) | 6 Months Ended
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Jun. 30, 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 June 30, |  |  |  | Six Months Ended June 30,
|  | 2024 |  | 2023 |  |  |  | 2024 |  | 2023
Revenues: |  |  |  |  |  |  |  |  |  |
Surgical Facility Services |  | $ | 730.4 |  |  | $ | 650.2 |  |  |  |  | $ | 1,423.1 |  |  | $ | 1,299.2 |
Ancillary Services |  | 31.7 |  |  | 17.4 |  |  |  |  | 56.4 |  |  | 34.6 |
Total |  | $ | 762.1 |  |  | $ | 667.6 |  |  |  |  | $ | 1,479.5 |  |  | $ | 1,333.8 |
Adjusted EBITDA: |  |  |  |  |  |  |  |  |  |
Surgical Facility Services |  | $ | 143.0 |  |  | $ | 126.7 |  |  |  |  | $ | 269.7 |  |  | $ | 245.5 |
Ancillary Services |  | 0.1 |  |  | (0.1) |  |  |  |  | (1.3) |  |  | (1.5) |
All other |  | (24.8) |  |  | (26.4) |  |  |  |  | (52.6) |  |  | (53.7) |
Total |  | $ | 118.3 |  |  | $ | 100.2 |  |  |  |  | $ | 215.8 |  |  | $ | 190.3 |
Reconciliation of Adjusted EBITDA: |  |  |  |  |  |  |  |  |  |
Income before income taxes |  | $ | 33.3 |  |  | $ | 49.9 |  |  |  |  | $ | 62.0 |  |  | $ | 49.5 |
Net income attributable to non-controlling interests |  | (43.9) |  |  | (38.8) |  |  |  |  | (80.6) |  |  | (64.9) |
Interest expense, net |  | 51.5 |  |  | 47.7 |  |  |  |  | 98.8 |  |  | 94.5 |
Depreciation and amortization |  | 34.8 |  |  | 24.4 |  |  |  |  | 68.5 |  |  | 58.1 |
Equity-based compensation expense |  | 15.1 |  |  | 4.6 |  |  |  |  | 20.0 |  |  | 8.8 |
Transaction, integration and acquisition costs (1) |  | 20.8 |  |  | 13.0 |  |  |  |  | 39.7 |  |  | 25.8 |
Net loss (gain) on disposals, consolidations and deconsolidations |  | 5.3 |  |  | (8.8) |  |  |  |  | 6.8 |  |  | 1.7 |
Litigation settlements and regulatory change impact (2) |  | 1.1 |  |  | 1.7 |  |  |  |  | (0.1) |  |  | 9.7 |
Loss on debt extinguishment |  | 5.1 |  |  | — |  |  |  |  | 5.1 |  |  | — |
Undesignated derivative activity |  | — |  |  | — |  |  |  |  | — |  |  | 0.6 |
Other (3) |  | (4.8) |  |  | 6.5 |  |  |  |  | (4.4) |  |  | 6.5 |
Adjusted EBITDA |  | $ | 118.3 |  |  | $ | 100.2 |  |  |  |  | $ | 215.8 |  |  | $ | 190.3 |
(1)This amount includes transaction and integration costs of $19.3 million and $12.0 million for the three months ended June 30, 2024 and 2023, respectively. This amount further includes start-up costs related to de novo surgical facilities of $1.5 million and $1.0 million for the three months ended June 30, 2024 and 2023, respectively. This amount includes transaction and integration costs of $36.7 million and $24.5 million for the six months ended June 30, 2024 and 2023, respectively. This amount further includes start-up costs related to de novo surgical facilities of $3.0 million and $1.3 million for the six months ended June 30, 2024 and 2023, respectively. (2)This amount includes a litigation settlement loss of $0.5 million and $1.5 million for the three months ended June 30, 2024 and 2023, respectively. This amount also includes other litigation costs of $0.6 million and $0.2 million for the three months ended June 30, 2024 and 2023, respectively. This amount includes a litigation settlements gain of $1.3 million and a loss of $4.5 million for the six months ended June 30, 2024 and 2023, respectively. This amount also includes other litigation costs of $1.2 million and $0.8 million for the six months ended June 30, 2024 and 2023, respectively. Additionally, the six months ended June 30, 2023 includes $4.4 million related to the impact of recent changes in Florida law regarding the use of letters of protection. (3)For the three and six months ended June 30, 2024, this amount includes insurance proceeds related to cyber event losses predominantly incurred in 2023. For the three and six months ended June 30, 2023, this amount includes estimates for the net impact of the same cyber event and losses from a divested business.
Schedule of Reconciliation of Assets from Segment to Consolidated |
|  | June 30, 2024 |  | December 31, 2023
Assets: |  |  |  |
Surgical Facility Services |  | $ | 6,874.7 |  |  | $ | 6,347.4 |
Ancillary Services |  | 68.1 |  |  | 36.3 |
All other |  | 545.8 |  |  | 493.0 |
Total assets |  | $ | 7,488.6 |  |  | $ | 6,876.7 |
Schedule of Financial Information by Reportable Segment |
|  | Six Months Ended June 30,
|  | 2024 |  | 2023 |  |
Cash purchases of property and equipment: |  |  |  |  |  |
Surgical Facility Services |  | $ | 39.1 |  |  | $ | 49.5 |  |  |
Ancillary Services |  | 1.3 |  |  | 0.6 |  |  |
All other |  | 7.5 |  |  | — |  |  |
Total cash purchases of property and equipment |  | $ | 47.9 |  |  | $ | 50.1 |  |  |

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