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Segment Reporting
 6 Months Ended
Jun. 30, 2025
Segment Reporting [Abstract]  
Segment Reporting Segment Reporting
Segment information is prepared on the same basis that our Chief Executive Officer, who is our Chief Operating Decision Maker ("CODM"), manages our segments, evaluates financial results, and makes key operating decisions. We have one reportable segment: Surgical Facilities.
The Surgical Facilities reportable segment is comprised of two operating segments, which we have aggregated to a single reportable segment in consideration of the aggregation criteria set forth in ASC 280.
The Surgical Facilities reportable segment includes the operation of ASCs, surgical hospitals, anesthesia services, and multi-specialty physician practices, which earns revenues primarily from contracts with patients in which the performance obligations are to provide health care services. The "All other" line item primarily consists of amounts attributable to the Company's corporate general and administrative functions. The Company defines its segments on the basis of the way in which its internally reported financial information is regularly reviewed by the CODM to assess performance and allocate resources.
During the three and six months ended June 30, 2025, the operating segment previously defined as "Ancillary services" was included with Surgical Facilities based on changes in the operational management of our multi-specialty physician practices. Accordingly, the Company has recast segment disclosures previously reported to conform to current year presentation.
The Company’s CODM uses Adjusted EBITDA to assess performance and allocate resources. The CODM considers budget-to-actual and actual versus prior period variances on a periodic basis as a means of assessing performance. The following segment information, including significant segment expenses, is presented in millions:
Three Months Ended June 30,Six Months Ended June 30,
2025202420252024
Surgical Facilities Revenues$826.2 $762.1 $1,602.2 $1,479.5 
Less:
Salaries and benefits
235.2 223.2 473.8 438.4 
Supplies
215.0 199.7 430.8 388.5 
Professional and medical fees
102.1 92.4 197.4 175.0 
Lease expense22.9 22.2 43.7 43.6 
Other segment items (1)
93.1 81.4 166.6 165.5 
668.3 618.9 1,312.3 1,211.0 
Adjusted Surgical Facilities EBITDA$157.9 $143.2 $289.9 $268.5 
Reconciliation:
Add back: Net income attributable to non-controlling interests(47.4)(43.9)(84.8)(80.6)
Unallocated amounts:
General and administrative expenses36.1 40.3 72.1 73.5 
Transaction and integration costs18.1 19.3 42.8 36.7 
Other corporate expenses(0.9)7.9 9.6 9.6 
Depreciation and amortization40.3 34.8 76.6 68.5 
Interest expense, net67.9 51.5 130.1 98.8 
Income before income taxes$43.8 $33.3 $43.5 $62.0 
(1)Other segment items includes equity in earnings of unconsolidated affiliates, net income attributable to non-controlling interests and other expenses, net.
Three Months Ended June 30,Six Months Ended June 30,
2025202420252024
Depreciation and amortization:
Surgical Facilities$37.3 $32.5 $71.1 $64.0 
All other3.0 2.3 5.5 4.5 
Total depreciation and amortization expense$40.3 $34.8 $76.6 $68.5 
June 30, 2025December 31, 2024
Assets:
Surgical Facilities
$7,510.4 $7,466.3 
All other444.4 423.7 
Total assets$7,954.8 $7,890.0 
Six Months Ended June 30,
20252024
Cash purchases of property and equipment:
Surgical Facilities
$45.2 $40.4 
All other0.9 7.5 
Total cash purchases of property and equipment$46.1 $47.9