Acquisitions (Tables)

12 Months Ended

Dec. 31, 2021

Summary of Preliminary Fair Values of Assets Acquired and Liabilities Assumed

The preliminary fair values of assets acquired and liabilities assumed in the CenterPointe acquisition were as follows (in thousands):

Cash	$	5,640
Accounts receivable, net		10,230
Other current assets		2,087
Property and equipment		35,670
Goodwill		97,122
Intangible assets		825
Deferred tax assets		1,573
Operating lease right-of-use assets		28,858
Total assets acquired		182,005
Accounts payable		3,820
Accrued salaries and benefits		3,585
Current portion of operating lease liabilities		2,582
Other accrued liabilities		1,088
Operating lease liabilities		26,275
Total liabilities assumed		37,350
Net assets acquired	$	144,655

Summary of Changes in Goodwill

The following table summarizes changes in goodwill for the years 2020 and 2021 (in thousands):

Balance at January 1, 2020	$	2,085,104
Increase from contribution of redeemable noncontrolling interests		20,200
Adjustments related to 2019 acquisitions		(40	)
Balance at December 31, 2020		2,105,264
Increase from acquisitions		97,122
2021 dispositions		(2,449	)
Balance at December 31, 2021	$	2,199,937

Transaction-related expenses represent costs primarily related to termination, restructuring, strategic review, management transition and other acquisition-related costs. Transaction-related expenses comprised the following costs for the years ended December 31, 2021, 2020 and 2019 (in thousands):

	Year Ended December 31,
	2021		2020		2019
Legal, accounting and other acquisition-related costs	$	8,315	$	8,252	$	3,030
Termination, restructuring and strategic review costs		4,463		3,468		12,598
Management transition costs		—		—		5,529
	$	12,778	$	11,720	$	21,157