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Segment Reporting (Tables) | 9 Months Ended
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Sep. 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 September 30, |  |  |  | Nine Months Ended September 30,
|  | 2024 |  | 2023 |  |  |  | 2024 |  | 2023
Revenues: |  |  |  |  |  |  |  |  |  |
Surgical Facility Services |  | $ | 735.4 |  |  | $ | 657.3 |  |  |  |  | $ | 2,158.5 |  |  | $ | 1,956.5 |
Ancillary Services |  | 35.0 |  |  | 16.8 |  |  |  |  | 91.4 |  |  | 51.4 |
Total |  | $ | 770.4 |  |  | $ | 674.1 |  |  |  |  | $ | 2,249.9 |  |  | $ | 2,007.9 |
Adjusted EBITDA: |  |  |  |  |  |  |  |  |  |
Surgical Facility Services |  | $ | 149.6 |  |  | $ | 138.6 |  |  |  |  | $ | 419.3 |  |  | $ | 384.1 |
Ancillary Services |  | 0.7 |  |  | (1.2) |  |  |  |  | (0.6) |  |  | (2.7) |
All other |  | (21.7) |  |  | (31.9) |  |  |  |  | (74.3) |  |  | (85.6) |
Total |  | $ | 128.6 |  |  | $ | 105.5 |  |  |  |  | $ | 344.4 |  |  | $ | 295.8 |
Reconciliation of Adjusted EBITDA: |  |  |  |  |  |  |  |  |  |
Income before income taxes |  | $ | 10.9 |  |  | $ | 32.8 |  |  |  |  | $ | 72.9 |  |  | $ | 82.3 |
Net income attributable to non-controlling interests |  | (38.1) |  |  | (34.6) |  |  |  |  | (118.7) |  |  | (99.5) |
Interest expense, net |  | 50.0 |  |  | 49.8 |  |  |  |  | 148.8 |  |  | 144.3 |
Depreciation and amortization |  | 50.2 |  |  | 28.9 |  |  |  |  | 118.7 |  |  | 87.0 |
Equity-based compensation expense |  | 7.1 |  |  | 4.4 |  |  |  |  | 27.1 |  |  | 13.2 |
Transaction, integration and acquisition costs (1) |  | 31.5 |  |  | 13.0 |  |  |  |  | 71.2 |  |  | 38.8 |
Net loss on disposals, consolidations and deconsolidations |  | 14.7 |  |  | 5.8 |  |  |  |  | 21.5 |  |  | 7.5 |
Litigation settlements and regulatory change impact (2) |  | 1.6 |  |  | 4.2 |  |  |  |  | 1.5 |  |  | 13.9 |
Loss on debt extinguishment |  | — |  |  | — |  |  |  |  | 5.1 |  |  | — |
Undesignated derivative activity |  | — |  |  | — |  |  |  |  | — |  |  | 0.6 |
Other (3) |  | 0.7 |  |  | 1.2 |  |  |  |  | (3.7) |  |  | 7.7 |
Adjusted EBITDA |  | $ | 128.6 |  |  | $ | 105.5 |  |  |  |  | $ | 344.4 |  |  | $ | 295.8 |
(1)This amount includes transaction and integration costs of $29.4 million and $12.8 million for the three months ended September 30, 2024 and 2023, respectively. This amount further includes start-up costs related to de novo surgical facilities of $2.1 million and $0.2 million for the three months ended September 30, 2024 and 2023, respectively. This amount includes transaction and integration costs of $66.1 million and $37.3 million for the nine months ended September 30, 2024 and 2023, respectively. This amount further includes start-up costs related to de novo surgical facilities of $5.1 million and $1.5 million for the nine months ended September 30, 2024 and 2023, respectively. (2)This amount includes a litigation settlement loss of $0.5 million and $3.6 million for the three months ended September 30, 2024 and 2023, respectively. This amount also includes other litigation costs of $1.1 million and $0.6 million for the three months ended September 30, 2024 and 2023, respectively. This amount includes a litigation settlements gain of $0.8 million and a loss of $8.1 million for the nine months ended September 30, 2024 and 2023, respectively. This amount also includes other litigation costs of $2.3 million and $1.4 million for the nine months ended September 30, 2024 and 2023, 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)For the three months ended September 30, 2024, this amount includes hurricane-related impacts. For the three months ended September 30, 2023, this amount includes estimates for the net impact of a cyber event. For the nine months ended September 30, 2024, this amount includes hurricane-related impacts in the third quarter of 2024, net of insurance proceeds related to cyber event losses predominantly incurred in 2023. For the nine months ended September 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 |
|  | September 30, 2024 |  | December 31, 2023
Assets: |  |  |  |
Surgical Facility Services |  | $ | 6,935.7 |  |  | $ | 6,347.4 |
Ancillary Services |  | 85.1 |  |  | 36.3 |
All other |  | 513.6 |  |  | 493.0 |
Total assets |  | $ | 7,534.4 |  |  | $ | 6,876.7 |
Schedule of Financial Information by Reportable Segment |
|  | Nine Months Ended September 30,
|  | 2024 |  | 2023 |  |
Cash purchases of property and equipment: |  |  |  |  |  |
Surgical Facility Services |  | $ | 62.5 |  |  | $ | 68.4 |  |  |
Ancillary Services |  | 1.9 |  |  | 0.6 |  |  |
All other |  | 3.7 |  |  | — |  |  |
Total cash purchases of property and equipment |  | $ | 68.1 |  |  | $ | 69.0 |  |  |

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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 -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 25 -Publisher FASB -URI https://asc.fasb.org/1943274/2147482810/280-10-50-25 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 22 -Publisher FASB -URI https://asc.fasb.org/1943274/2147482810/280-10-50-22 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 30 -Publisher FASB -URI https://asc.fasb.org/1943274/2147482810/280-10-50-30 + Details
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