XML 17 R79.htm IDEA: XBRL DOCUMENT v3.19.3.a.u2
Selected Quarterly Financial Information - Summary of Company's Selected Quarterly Financial Information (Detail) - USD ($)
$ / shares in Units, shares in Thousands, $ in Thousands
 3 Months Ended 12 Months Ended
Dec. 31, 2019
Sep. 30, 2019
Jun. 30, 2019
Mar. 31, 2019
Dec. 31, 2018
Sep. 30, 2018
Jun. 30, 2018
Mar. 31, 2018
Dec. 31, 2019
Dec. 31, 2018
Dec. 31, 2017
Quarterly Financial Information Disclosure [Abstract]                      
Net revenue $ 905,375 $ 888,675 $ 868,309 $ 851,183 $ 888,436 $ 848,759 $ 864,987 $ 852,628 $ 3,513,542 $ 3,454,810 $ 3,253,391
Practice salaries and benefits 647,968 630,309 608,962 621,539 630,048 599,326 593,047 603,955 2,508,778 2,426,376 2,227,335
Practice supplies and other operating expenses 32,009 26,950 28,016 25,791 25,870 27,249 28,329 27,403 112,766 108,851 106,444
General and administrative expenses 96,926 102,356 103,540 101,821 105,532 95,771 100,938 101,693 404,643 403,934 385,864
Depreciation and amortization 19,410 19,608 19,809 20,033 21,433 22,205 20,280 19,914 78,860 83,832 78,856
Transformational and restructuring related expenses 44,311 19,992 27,482 3,544         95,329 0 0
Goodwill impairment   1,449,215             1,449,215 0 0
Total operating expenses 840,624 2,248,430 787,809 772,728 782,883 744,551 742,594 752,965 4,649,591 3,022,993 2,798,499
Income (loss) from operations 64,751 (1,359,755) 80,500 78,455 105,553 104,208 122,393 99,663 (1,136,049) 431,817 454,892
Investment and other income 1,429 1,373 1,222 1,647 981 1,531 1,225 1,474 5,671 5,211 4,385
Interest expense (27,677) (29,901) (31,080) (30,723) (25,448) (21,788) (21,618) (19,935) (119,381) (88,789) (74,556)
Equity in earnings of unconsolidated affiliates 2,304 2,249 1,990 1,236 2,277 1,766 1,257 1,525 7,779 6,825 952
Total non-operating expenses (23,944) (26,279) (27,868) (27,840) (22,190) (18,491) (19,136) (16,936) (105,931) (76,753) (69,219)
Income (loss) from continuing operations before income taxes 40,807 (1,386,034) 52,632 50,615 83,363 85,717 103,257 82,727 (1,241,980) 355,064 385,673
Income tax (provision) benefit (7,824) 125,788 (17,116) (8,962) (21,701) (23,550) (28,482) (22,720) 91,886 (96,453) (80,231)
Income (loss) from continuing operations 32,983 (1,260,246) 35,516 41,653 61,662 62,167 74,775 60,007 (1,150,094) 258,611 305,442
(Loss) income from discontinued operations, net of tax (23,652) 4,330 (43,761) (284,525) (1,448) 3,408 4,637 3,421 (347,608) 10,018 14,930
Net (loss) income $ 9,331 $ (1,255,916) $ (8,245) $ (242,872) $ 60,214 $ 65,575 $ 79,412 $ 63,428 $ (1,497,702) $ 268,629 $ 320,372
Income (loss) from continuing operations, Basic $ 0.40 $ (15.29) $ 0.43 $ 0.48 $ 700 $ 680 $ 800 $ 650 $ (13.78) $ 2.84 $ 3.31
Income (loss) from continuing operations, Diluted 0.40 (15.29) 0.42 0.48 700 680 800 640 (13.78) 2.82 3.29
(Loss) income from discontinued operations, Basic (0.29) 0.05 (0.53) (3.31) (20.00) 40.00 50.00 40.00 (4.16) 0.11 0.16
(Loss) income from discontinued operations, Diluted (0.29) 0.05 (0.52) (3.29) (20.00) 40.00 50.00 40.00 (4.16) 0.11 0.16
Earnings (loss) per share, Basic 0.11 (15.24) (0.10) (2.82) 0.68 0.72 0.85 0.68 (17.94) 2.95 3.47
Earnings (loss) per share, Diluted $ 0.11 $ (15.24) $ (0.10) $ (2.81) $ 0.68 $ 0.72 $ 0.85 $ 0.68 $ (17.94) $ 2.93 $ 3.45
Weighted average shares, Basic 82,592 82,441 83,234 86,073 87,810 90,984 92,987 92,859 83,495 91,104 92,431
Weighted average shares, Diluted 83,288 82,441 83,689 86,545 88,258 91,359 93,529 93,505 83,495 91,606 92,958