Select Medical (SEM) 10-Q 30 Jul 20 2020 Q2 Quarterly report Financial data

Cover

Cover	6 Months Ended
	Jun. 30, 2020shares
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2020
Document Transition Report	false
Entity File Number	001-34465
Entity Registrant Name	SELECT MEDICAL HOLDINGS CORP
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	20-1764048
Entity Address, Address Line One	4714 Gettysburg Road
Entity Address, Address Line Two	P.O. Box 2034
Entity Address, City or Town	Mechanicsburg
Entity Address, State or Province	PA
Entity Address, Postal Zip Code	17055
City Area Code	717
Local Phone Number	972-1100
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	SEM
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding	133,970,064
Current Fiscal Year End Date	--12-31
Amendment Flag	false
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q2
Entity Central Index Key	0001320414

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (unaudited) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Current Assets:
Cash and cash equivalents	$ 509,737	$ 335,882
Accounts receivable	749,245	762,677
Prepaid income taxes	9,204	18,585
Other current assets	95,143	95,848
Total Current Assets	1,363,329	1,212,992
Operating lease right-of-use assets	1,022,721	1,003,986
Property and equipment, net	959,086	998,406
Goodwill	3,391,196	3,391,955
Identifiable intangible assets, net	398,266	409,068
Other assets	333,860	323,881
Total Assets	7,468,458	7,340,288
Current Liabilities:
Current operating lease liabilities	216,689	207,950
Current portion of long-term debt and notes payable	13,435	25,167
Accounts payable	142,946	145,731
Accrued payroll	125,109	183,754
Accrued vacation	124,624	124,111
Accrued interest	29,610	33,853
Accrued other	204,074	191,076
Government advances (Note 12)	316,992	0
Unearned government assistance (Note 12)	45,505	0
Income taxes payable	36,985	2,638
Total Current Liabilities	1,255,969	914,280
Non-current operating lease liabilities	866,097	852,897
Long-term debt, net of current portion	3,390,417	3,419,943
Non-current deferred tax liability	144,697	148,258
Other non-current liabilities	142,861	101,334
Total Liabilities	5,800,041	5,436,712
Commitments and contingencies (Note 11)
Redeemable non-controlling interests	495,987	974,541
Stockholders’ Equity:
Common stock, $0.001 par value, 700,000,000 shares authorized, 134,328,112 and 133,970,064 shares issued and outstanding at 2019 and 2020, respectively	134	134
Capital in excess of par	496,785	491,038
Retained earnings	495,964	279,800
Total Stockholders’ Equity	992,883	770,972
Non-controlling interests	179,547	158,063
Total Equity	1,172,430	929,035
Total Liabilities and Equity	$ 7,468,458	$ 7,340,288

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (unaudited) (Parenthetical) - $ / shares	Jun. 30, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	700,000,000	700,000,000
Common stock, shares issued (in shares)	133,970,064	134,328,112
Common stock, shares outstanding (in shares)	133,970,064	134,328,112

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Income Statement [Abstract]
Net operating revenues	$ 1,232,718	$ 1,361,364	$ 2,647,350	$ 2,685,995
Costs and expenses:
Cost of services, exclusive of depreciation and amortization	1,082,456	1,150,150	2,282,827	2,282,242
General and administrative	33,461	31,339	67,292	60,016
Depreciation and amortization	52,271	54,993	104,023	107,131
Total costs and expenses	1,168,188	1,236,482	2,454,142	2,449,389
Other operating income (Note 12)	54,988	0	54,988	0
Income from operations	119,518	124,882	248,196	236,606
Other income and expense:
Equity in earnings of unconsolidated subsidiaries	8,324	7,394	10,912	11,760
Gain on sale of businesses	346	0	7,547	6,532
Interest expense	(37,366)	(51,464)	(83,473)	(102,275)
Income before income taxes	90,822	80,812	183,182	152,623
Income tax expense	23,336	20,826	45,248	39,293
Net income	67,486	59,986	137,934	113,330
Less: Net income attributable to non-controlling interests	15,836	15,170	33,159	27,680
Net income attributable to Select Medical Holdings Corporation	$ 51,650	$ 44,816	$ 104,775	$ 85,650
Earnings per common share (Note 10):
Basic (in dollars per share)	$ 0.39	$ 0.33	$ 0.78	$ 0.63
Diluted (in dollars per share)	$ 0.39	$ 0.33	$ 0.78	$ 0.63

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Changes in Equity and Income (unaudited) - USD ($) $ in Thousands	Total	Common Stock	Capital in Excess of Par	Retained Earnings (Accumulated Deficit)	Total Stockholders’ Equity	Non-controlling Interests
Balance (in shares) at Dec. 31, 2018		135,266,000
Balance at Dec. 31, 2018	$ 916,240	$ 135	$ 482,556	$ 320,351	$ 803,042	$ 113,198
Increase (Decrease) in Stockholders' Equity
Net income attributable to Select Medical Holdings Corporation	40,834			40,834	40,834
Net income attributable to non-controlling interests	4,810					4,810
Issuance of restricted stock (in shares)		21,000
Issuance of restricted stock	0	$ 0	0
Forfeitures of unvested restricted stock (in shares)		(24,000)
Forfeitures of unvested restricted stock	0	$ 0	0
Vesting of restricted stock	5,488		5,488		5,488
Issuance of non-controlling interests	6,837					6,837
Distributions to and purchases of non-controlling interests	(2,480)		259		259	(2,739)
Redemption adjustment on non-controlling interests	(47,470)			(47,470)	(47,470)
Other	291			(122)	(122)	413
Balance (in shares) at Mar. 31, 2019		135,263,000
Balance at Mar. 31, 2019	924,550	$ 135	488,303	313,593	802,031	122,519
Balance (in shares) at Dec. 31, 2018		135,266,000
Balance at Dec. 31, 2018	916,240	$ 135	482,556	320,351	803,042	113,198
Increase (Decrease) in Stockholders' Equity
Net income attributable to Select Medical Holdings Corporation	85,650
Balance (in shares) at Jun. 30, 2019		134,564,000
Balance at Jun. 30, 2019	995,950	$ 135	492,569	353,305	846,009	149,941
Balance (in shares) at Mar. 31, 2019		135,263,000
Balance at Mar. 31, 2019	924,550	$ 135	488,303	313,593	802,031	122,519
Increase (Decrease) in Stockholders' Equity
Net income attributable to Select Medical Holdings Corporation	44,816			44,816	44,816
Net income attributable to non-controlling interests	3,663					3,663
Issuance of restricted stock (in shares)		187,000
Issuance of restricted stock	0	$ 0	0
Vesting of restricted stock	5,591		5,591		5,591
Repurchase of common shares (in shares)		(936,000)
Repurchase of common shares	(13,620)	$ 0	(8,164)	(5,456)	(13,620)
Exercises of stock options (in shares)		50,000
Exercise of stock options	459	$ 0	459		459
Issuance of non-controlling interests	31,127		6,366		6,366	24,761
Distributions to and purchases of non-controlling interests	(1,416)		14		14	(1,430)
Redemption adjustment on non-controlling interests	270			270	270
Other	510			82	82	428
Balance (in shares) at Jun. 30, 2019		134,564,000
Balance at Jun. 30, 2019	$ 995,950	$ 135	492,569	353,305	846,009	149,941
Balance (in shares) at Dec. 31, 2019	134,328,112	134,328,000
Balance at Dec. 31, 2019	$ 929,035	$ 134	491,038	279,800	770,972	158,063
Increase (Decrease) in Stockholders' Equity
Net income attributable to Select Medical Holdings Corporation	53,125			53,125	53,125
Net income attributable to non-controlling interests	10,067					10,067
Issuance of restricted stock (in shares)		2,000
Issuance of restricted stock	0	$ 0	0
Forfeitures of unvested restricted stock (in shares)		(15,000)
Forfeitures of unvested restricted stock	0	$ 0	0
Vesting of restricted stock	6,136		6,136		6,136
Repurchase of common shares (in shares)		(492,000)
Repurchase of common shares	(8,691)	$ 0	(5,350)	(3,341)	(8,691)
Issuance of non-controlling interests	1,679					1,679
Distributions to and purchases of non-controlling interests	(6,774)			(2,726)	(2,726)	(4,048)
Redemption adjustment on non-controlling interests	(10,123)			(10,123)	(10,123)
Other	365			(55)	(55)	420
Balance (in shares) at Mar. 31, 2020		133,823,000
Balance at Mar. 31, 2020	$ 974,819	$ 134	491,824	316,680	808,638	166,181
Balance (in shares) at Dec. 31, 2019	134,328,112	134,328,000
Balance at Dec. 31, 2019	$ 929,035	$ 134	491,038	279,800	770,972	158,063
Increase (Decrease) in Stockholders' Equity
Net income attributable to Select Medical Holdings Corporation	$ 104,775
Balance (in shares) at Jun. 30, 2020	133,970,064	133,970,000
Balance at Jun. 30, 2020	$ 1,172,430	$ 134	496,785	495,964	992,883	179,547
Balance (in shares) at Mar. 31, 2020		133,823,000
Balance at Mar. 31, 2020	974,819	$ 134	491,824	316,680	808,638	166,181
Increase (Decrease) in Stockholders' Equity
Net income attributable to Select Medical Holdings Corporation	51,650			51,650	51,650
Net income attributable to non-controlling interests	12,572					12,572
Issuance of restricted stock (in shares)		200,000
Issuance of restricted stock	0	$ 0	0
Forfeitures of unvested restricted stock (in shares)		(7,000)
Forfeitures of unvested restricted stock	0	$ 0	0
Vesting of restricted stock	6,262		6,262		6,262
Repurchase of common shares (in shares)		(46,000)
Repurchase of common shares	(724)	$ 0	(441)	(283)	(724)
Issuance of non-controlling interests	7					7
Distributions to and purchases of non-controlling interests	(483)		(65)		(65)	(418)
Redemption adjustment on non-controlling interests	127,916			127,916	127,916
Other	$ 411		(795)	1	(794)	1,205
Balance (in shares) at Jun. 30, 2020	133,970,064	133,970,000
Balance at Jun. 30, 2020	$ 1,172,430	$ 134	$ 496,785	$ 495,964	$ 992,883	$ 179,547

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019	Dec. 31, 2018
Operating activities
Net income	$ 67,486	$ 59,986	$ 137,934	$ 113,330
Adjustments to reconcile net income to net cash provided by operating activities:
Distributions from unconsolidated subsidiaries			11,223	11,148
Depreciation and amortization	52,271	54,993	104,023	107,131
Provision for expected credit losses			253	1,958	$ 3,000	$ (100)
Equity in earnings of unconsolidated subsidiaries	(8,324)	(7,394)	(10,912)	(11,760)
Gain on sale of assets and businesses			(7,881)	(6,354)
Stock compensation expense			13,866	12,613
Amortization of debt discount, premium and issuance costs			1,093	6,326
Deferred income taxes			(3,416)	(6,290)
Changes in operating assets and liabilities, net of effects of business combinations:
Accounts receivable			13,179	(85,873)
Other current assets			713	(9,236)
Other assets			11,504	(939)
Accounts payable			4,251	2,670
Accrued expenses			4,028	(18,156)
Government advances			316,992	0
Unearned government assistance			45,505	0
Income taxes			43,743	16,346
Net cash provided by operating activities			686,098	132,914
Investing activities
Business combinations, net of cash acquired			(6,961)	(86,062)
Purchases of property and equipment	(32,045)	(40,212)	(71,253)	(89,285)
Investment in businesses			(14,749)	(52,257)
Proceeds from sale of assets and businesses			12,401	125
Net cash used in investing activities			(80,562)	(227,479)
Financing activities
Borrowings on revolving facilities			470,000	635,000
Payments on revolving facilities			(470,000)	(460,000)
Payments on term loans			(39,843)	(132,685)
Borrowings of other debt			31,487	14,230
Principal payments on other debt			(35,733)	(12,680)
Repurchase of common stock			(9,415)	(13,620)
Proceeds from exercise of stock options			0	459
Increase in overdrafts			0	2,176
Proceeds from issuance of non-controlling interests			1,686	18,288
Distributions to and purchases of non-controlling interests			(13,660)	(7,745)
Purchase of membership interests of Concentra Group Holdings Parent (Note 4)			(366,203)	0
Net cash provided by (used in) financing activities			(431,681)	43,423
Net increase (decrease) in cash and cash equivalents			173,855	(51,142)
Cash and cash equivalents at beginning of period			335,882	175,178	175,178
Cash and cash equivalents at end of period	$ 509,737	$ 124,036	509,737	124,036	$ 335,882	$ 175,178
Supplemental Information
Cash paid for interest			86,124	97,909
Cash paid for taxes			4,920	29,241
Operating lease right-of-use assets obtained in exchange for lease liabilities, excluding adoption impact of ASC Topic 842 at January 1, 2019			$ 132,125	$ 66,977

Basis of Presentation

Basis of Presentation	6 Months Ended
	Jun. 30, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	Basis of Presentation The unaudited condensed consolidated financial statements of Select Medical Holdings Corporation (“Holdings”) include the accounts of its wholly owned subsidiary, Select Medical Corporation (“Select”). Holdings conducts substantially all of its business through Select and its subsidiaries. Holdings and Select and its subsidiaries are collectively referred to as the “Company.” The unaudited condensed consolidated financial statements of the Company as of June 30, 2020, and for the three and six month periods ended June 30, 2019 and 2020, have been prepared pursuant to the rules and regulations of the Securities Exchange Commission (the “SEC”) for interim reporting and accounting principles generally accepted in the United States of America (“GAAP”). Accordingly, certain information and disclosures required by GAAP, which are normally included in the notes to consolidated financial statements, have been condensed or omitted pursuant to those rules and regulations, although the Company believes the disclosure is adequate to make the information presented not misleading. In the opinion of management, such information contains all adjustments, which are normal and recurring in nature, necessary for a fair statement of the financial position, results of operations and cash flow for such periods. All significant intercompany transactions and balances have been eliminated. The results of operations for the three and six months ended June 30, 2020, are not necessarily indicative of the results to be expected for the full fiscal year ending December 31, 2020. These unaudited condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto for the year ended December 31, 2019, contained in the Company’s Annual Report on Form 10-K filed with the SEC on February 20, 2020.

Accounting Policies

Accounting Policies	6 Months Ended
	Jun. 30, 2020
Accounting Policies [Abstract]
Accounting Policies	Accounting Policies Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, including disclosure of contingencies, at the date of the financial statements and reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Recently Adopted Accounting Pronouncements Financial Instruments On January 1, 2020, the Company adopted Accounting Standards Update (“ASU”) 2016-13, Financial Instruments - Credit Losses: Measurement of Credit Losses on Financial Instruments (Topic 326) , which replaced the incurred loss approach for recognizing credit losses on financial instruments with an expected loss approach. The expected loss approach is subject to management judgments using assessments of incurred credit losses, assessments of current conditions, and forecasts using reasonable and supportable assumptions. The standard was required to be applied using the modified retrospective approach with a cumulative-effect adjustment to retained earnings, if any, upon adoption. The Company’s primary financial instrument subject to the standard is its accounts receivable derived from contracts with patients. Historically, the Company has experienced infrequent, immaterial credit losses related to its accounts receivable and, based on its experience, believes the risk of material defaults is low. The Company experienced credit losses of $1.1 million for the year ended December 31, 2017, credit loss recoveries of $0.1 million for the year ended December 31, 2018, and credit losses of $3.0 million for the year ended December 31, 2019. The Company’s historical credit losses have been infrequent and immaterial largely because the Company’s accounts receivable are typically paid for by highly-solvent, creditworthy payors such as Medicare, other governmental programs, and highly-regulated commercial insurers, on behalf of the patient. The Company believes it has moderate credit risk related to defaults on self-pay amounts in accounts receivable; however, these amounts represented less than 1.0% of the Company’s accounts receivable at January 1, 2020. In estimating the Company’s expected credit losses under Topic 326, the Company considers its incurred loss experience and adjusts for known and expected events and other circumstances, identified using periodic assessments implemented by the Company, which management believes are relevant in assessing the collectability of its accounts receivable. Because of the infrequent and insignificant nature of the Company’s historical credit losses, forecasts of expected credit losses are generally unnecessary. Expected credit losses are recognized by the Company through an allowance for credit losses and related credit loss expense.

Credit Risk Concentrations

Credit Risk Concentrations	6 Months Ended
	Jun. 30, 2020
Credit Loss [Abstract]
Credit Risk Concentrations	Credit Risk Concentrations Financial instruments that potentially subject the Company to concentrations of credit risk consist primarily of cash balances and accounts receivables. The Company’s excess cash is held with large financial institutions. The Company grants unsecured credit to its patients, most of whom reside in the service area of the Company’s facilities and are insured under third-party payor agreements. The Company’s general policy is to verify insurance coverage prior to the date of admission for patients admitted to its critical illness recovery hospitals and rehabilitation hospitals. Within the Company’s outpatient rehabilitation clinics, insurance coverage is verified prior to the patient’s visit. Within the Company’s Concentra centers, insurance coverage is verified or an authorization is received from the patient’s employer prior to the patient’s visit. Because of the diversity in the Company’s non-governmental third-party payor base, as well as their geographic dispersion, patient accounts receivable which are due from the Medicare program represent the Company’s only significant concentration of credit risk. Approximately 15% and 13% of the Company’s accounts receivable is from Medicare at December 31, 2019, and June 30, 2020, respectively.

Redeemable Non-Controlling Inte

Redeemable Non-Controlling Interests	6 Months Ended
	Jun. 30, 2020
Noncontrolling Interest [Abstract]
Redeemable Non-Controlling Interests	Redeemable Non-Controlling Interests The ownership interests held by outside parties in subsidiaries, limited liability companies, and limited partnerships controlled by the Company are classified as non-controlling interests. Some of the Company’s non-controlling ownership interests consist of outside parties that have certain redemption rights that, if exercised, require the Company to purchase the parties’ ownership interests. These interests are classified and reported as redeemable non-controlling interests and have been adjusted to their approximate redemption values. On January 1, 2020, Select acquired approximately 17.2% of the outstanding membership interests of Concentra Group Holdings Parent on a fully diluted basis from Welsh, Carson, Anderson & Stowe XII, L.P. (“WCAS”), Dignity Health Holding Corporation (“DHHC”), and certain other sellers in exchange for an aggregate purchase price of approximately $338.4 million. On February 1, 2020, Select acquired an additional 1.4% of the outstanding membership interests of Concentra Group Holdings Parent on a fully diluted basis from WCAS, DHHC, and certain other sellers in exchange for an aggregate purchase price of approximately $27.8 million. These purchases were in lieu of, and are considered to be, the exercise of the first put right provided to certain equity holders under the terms of the Amended and Restated Limited Liability Company Agreement of Concentra Group Holdings Parent, dated as of February 1, 2018, as amended (the “Concentra LLC Agreement”). Following these purchases, Select owns approximately 66.6% of the outstanding membership interests of Concentra Group Holdings Parent on a fully diluted basis and approximately 68.8% of the outstanding Class A membership interests of Concentra Group Holdings Parent. The changes in redeemable non-controlling interests are as follows (in thousands): Six Months Ended June 30, 2019 2020 Balance as of January 1 $ 780,488 $ 974,541 Net income attributable to redeemable non-controlling interests 7,700 7,256 Distributions to and purchases of redeemable non-controlling interests (2,771) (5,687) Purchase of membership interests of Concentra Group Holdings Parent — (366,203) Redemption adjustment on redeemable non-controlling interests 47,470 10,123 Other 354 347 Balance as of March 31 $ 833,241 $ 620,377 Net income attributable to redeemable non-controlling interests 11,507 3,264 Distributions to and purchases of redeemable non-controlling interests (395) (30) Redemption adjustment on redeemable non-controlling interests (270) (127,916) Other 339 292 Balance as of June 30 $ 844,422 $ 495,987

Variable Interest Entities

Variable Interest Entities	6 Months Ended
	Jun. 30, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Variable Interest Entities	Variable Interest Entities Concentra does not own many of its medical practices, as certain states prohibit the “corporate practice of medicine,” which restricts business corporations from practicing medicine through the direct employment of physicians or from exercising control over medical decisions by physicians. In these states, Concentra typically enters into long-term management agreements with professional corporations or associations that are owned by licensed physicians, which, in turn, employ or contract with physicians who provide professional medical services in Concentra’s occupational health centers. The management agreements have terms that provide for Concentra to conduct, supervise, and manage the day-to-day non-medical operations of the occupational health centers and provide all management and administrative services. Concentra receives a management fee for these services, which is based, in part, on the performance of the professional corporation or association. Additionally, the outstanding voting equity interests of the professional corporations or associations are typically owned by licensed physicians appointed at Concentra’s discretion. Concentra has the ability to direct the transfer of ownership of the professional corporation or association to a new licensed physician at any time.

Intangible Assets

Intangible Assets	6 Months Ended
	Jun. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets	Intangible Assets Goodwill The following table shows changes in the carrying amounts of goodwill by reporting unit for the six months ended June 30, 2020: Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Total (in thousands) Balance as of December 31, 2019 $ 1,078,804 $ 430,900 $ 649,763 $ 1,232,488 $ 3,391,955 Acquired — — 728 4,567 5,295 Sold — — (6,034) — (6,034) Measurement period adjustment — — — (20) (20) Balance as of June 30, 2020 $ 1,078,804 $ 430,900 $ 644,457 $ 1,237,035 $ 3,391,196 Identifiable Intangible Assets The following table provides the gross carrying amounts, accumulated amortization, and net carrying amounts for the Company’s identifiable intangible assets: December 31, 2019 June 30, 2020 Gross Accumulated Net Gross Accumulated Net (in thousands) Indefinite-lived intangible assets: Trademarks $ 166,698 $ — $ 166,698 $ 166,698 $ — $ 166,698 Certificates of need 17,157 — 17,157 18,410 — 18,410 Accreditations 1,874 — 1,874 1,874 — 1,874 Finite-lived intangible assets: Trademarks 5,000 (5,000) — 5,000 (5,000) — Customer relationships 287,373 (87,346) 200,027 288,963 (100,300) 188,663 Non-compete agreements 32,114 (8,802) 23,312 32,883 (10,262) 22,621 Total identifiable intangible assets $ 510,216 $ (101,148) $ 409,068 $ 513,828 $ (115,562) $ 398,266 The Company’s accreditations and indefinite-lived trademarks have renewal terms and the costs to renew these intangible assets are expensed as incurred. At June 30, 2020, the accreditations and indefinite-lived trademarks have a weighted average time until next renewal of 1.5 years and 6.7 years, respectively. The Company’s finite-lived intangible assets amortize over their estimated useful lives. Amortization expense was $8.9 million and $6.9 million for the three months ended June 30, 2019 and 2020, respectively. Amortization expense was $16.0 million and $13.8 million for the six months ended June 30, 2019 and 2020, respectively.

Long-Term Debt and Notes Payabl

Long-Term Debt and Notes Payable	6 Months Ended
	Jun. 30, 2020
Debt Disclosure [Abstract]
Long-Term Debt and Notes Payable	Long-Term Debt and Notes Payable As of June 30, 2020, the Company’s long-term debt and notes payable were as follows (in thousands): Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value Select 6.250% senior notes $ 1,225,000 $ 36,890 $ (18,455) $ 1,243,435 $ 1,238,353 Select credit facilities: Select term loan 2,103,437 (9,404) (10,251) 2,083,782 1,987,748 Other debt, including finance leases 76,984 — (349) 76,635 76,635 Total debt $ 3,405,421 $ 27,486 $ (29,055) $ 3,403,852 $ 3,302,736 Principal maturities of the Company’s long-term debt and notes payable were approximately as follows (in thousands): 2020 2021 2022 2023 2024 Thereafter Total Select 6.250% senior notes $ — $ — $ — $ — $ — $ 1,225,000 $ 1,225,000 Select credit facilities: Select term loan — — — 4,757 11,150 2,087,530 2,103,437 Other debt, including finance leases 8,745 8,510 3,583 20,715 23,532 11,899 76,984 Total debt $ 8,745 $ 8,510 $ 3,583 $ 25,472 $ 34,682 $ 3,324,429 $ 3,405,421 As of December 31, 2019, the Company’s long-term debt and notes payable were as follows (in thousands): Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value Select 6.250% senior notes $ 1,225,000 $ 39,988 $ (19,944) $ 1,245,044 $ 1,322,020 Select credit facilities: Select term loan 2,143,280 (10,411) (11,348) 2,121,521 2,145,959 Other debt, including finance leases 78,941 — (396) 78,545 78,545 Total debt $ 3,447,221 $ 29,577 $ (31,688) $ 3,445,110 $ 3,546,524 Excess Cash Flow Payment In February 2020, Select made a principal prepayment of approximately $39.8 million associated with its term loans in accordance with the provision in its senior secured credit agreement, dated March 6, 2017 (together with any borrowings thereunder, the “Select credit facilities”) that requires mandatory prepayments of term loans as a result of annual excess cash flow, as defined in the Select credit facilities. Fair Value The Company considers the inputs in the valuation process to be Level 2 in the fair value hierarchy for its 6.250% senior notes due August 15, 2026 (the “senior notes”) and the Select credit facilities. Level 2 in the fair value hierarchy is defined as inputs that are observable for the asset or liability, either directly or indirectly, which includes quoted prices for identical assets or liabilities in markets that are not active. The fair value of the Select credit facilities was based on quoted market prices for this debt in the syndicated loan market. The fair value of the senior notes was based on quoted market prices. The carrying amount of other debt, principally short-term notes payable, approximates fair value.

Segment Information

Segment Information	6 Months Ended
	Jun. 30, 2020
Segment Reporting [Abstract]
Segment Information	Segment Information The Company’s reportable segments include the critical illness recovery hospital segment, rehabilitation hospital segment, outpatient rehabilitation segment, and Concentra segment. Other activities include the Company’s corporate shared services, certain investments, and employee leasing services with non-consolidating subsidiaries. For the three and six months ended June 30, 2020, the Company’s other activities include other operating income related to the recognition of payments received under the Provider Relief Fund for losses of revenue and health care related expenses attributable to the coronavirus disease 2019 (“COVID-19”). Refer to Note 12 – CARES Act for further information. The Company evaluates performance of the segments based on Adjusted EBITDA. Adjusted EBITDA is defined as earnings excluding interest, income taxes, depreciation and amortization, gain (loss) on early retirement of debt, stock compensation expense, gain (loss) on sale of businesses, and equity in earnings (losses) of unconsolidated subsidiaries. The Company has provided additional information regarding its reportable segments, such as total assets, which contributes to the understanding of the Company and provides useful information to the users of the consolidated financial statements. The following tables summarize selected financial data for the Company’s reportable segments. Three Months Ended June 30, Six Months Ended June 30, 2019 2020 2019 2020 (in thousands) Net operating revenues: Critical illness recovery hospital $ 461,143 $ 519,626 $ 918,677 $ 1,020,147 Rehabilitation hospital 160,374 168,667 314,932 350,686 Outpatient rehabilitation 261,891 167,138 508,796 422,387 Concentra 413,451 312,338 809,772 710,873 Other 64,505 64,949 133,818 143,257 Total Company $ 1,361,364 $ 1,232,718 $ 2,685,995 $ 2,647,350 Adjusted EBITDA: Critical illness recovery hospital $ 64,138 $ 89,743 $ 137,136 $ 178,313 Rehabilitation hospital 29,968 27,605 55,765 66,174 Outpatient rehabilitation 42,584 (6,282) 71,575 20,840 Concentra 76,087 41,497 142,345 102,963 Other (26,544) 26,189 (50,471) (2,205) Total Company $ 186,233 $ 178,752 $ 356,350 $ 366,085 Total assets: Critical illness recovery hospital $ 2,119,574 $ 2,115,294 $ 2,119,574 $ 2,115,294 Rehabilitation hospital 1,107,852 1,135,206 1,107,852 1,135,206 Outpatient rehabilitation 1,265,487 1,267,308 1,265,487 1,267,308 Concentra 2,447,387 2,351,974 2,447,387 2,351,974 Other 166,640 598,676 166,640 598,676 Total Company $ 7,106,940 $ 7,468,458 $ 7,106,940 $ 7,468,458 Purchases of property and equipment: Critical illness recovery hospital $ 14,488 $ 14,970 $ 24,648 $ 23,935 Rehabilitation hospital 5,356 1,923 18,539 5,248 Outpatient rehabilitation 6,705 6,593 15,745 14,977 Concentra 12,240 6,820 27,938 22,406 Other 1,423 1,739 2,415 4,687 Total Company $ 40,212 $ 32,045 $ 89,285 $ 71,253 A reconciliation of Adjusted EBITDA to income before income taxes is as follows: Three Months Ended June 30, 2019 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 64,138 $ 29,968 $ 42,584 $ 76,087 $ (26,544) Depreciation and amortization (14,495) (6,696) (6,991) (24,479) (2,332) Stock compensation expense — — — (767) (5,591) Income (loss) from operations $ 49,643 $ 23,272 $ 35,593 $ 50,841 $ (34,467) $ 124,882 Equity in earnings of unconsolidated subsidiaries 7,394 Interest expense (51,464) Income before income taxes $ 80,812 Three Months Ended June 30, 2020 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 89,743 $ 27,605 $ (6,282) $ 41,497 $ 26,189 Depreciation and amortization (13,892) (6,907) (7,194) (21,857) (2,421) Stock compensation expense — — — (701) (6,262) Income (loss) from operations $ 75,851 $ 20,698 $ (13,476) $ 18,939 $ 17,506 $ 119,518 Equity in earnings of unconsolidated subsidiaries 8,324 Gain on sale of business 346 Interest expense (37,366) Income before income taxes $ 90,822 Six Months Ended June 30, 2019 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 137,136 $ 55,765 $ 71,575 $ 142,345 $ (50,471) Depreciation and amortization (25,946) (13,098) (14,023) (49,383) (4,681) Stock compensation expense — — — (1,534) (11,079) Income (loss) from operations $ 111,190 $ 42,667 $ 57,552 $ 91,428 $ (66,231) $ 236,606 Equity in earnings of unconsolidated subsidiaries 11,760 Gain on sale of businesses 6,532 Interest expense (102,275) Income before income taxes $ 152,623 Six Months Ended June 30, 2020 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 178,313 $ 66,174 $ 20,840 $ 102,963 $ (2,205) Depreciation and amortization (26,228) (13,794) (14,412) (44,744) (4,845) Stock compensation expense — — — (1,468) (12,398) Income (loss) from operations $ 152,085 $ 52,380 $ 6,428 $ 56,751 $ (19,448) $ 248,196 Equity in earnings of unconsolidated subsidiaries 10,912 Gain on sale of businesses 7,547 Interest expense (83,473) Income before income taxes $ 183,182

Revenue from Contracts with Cus

Revenue from Contracts with Customers	6 Months Ended
	Jun. 30, 2020
Revenue from Contract with Customer [Abstract]
Revenue from Contracts with Customers	Revenue from Contracts with Customers Net operating revenues consist primarily of revenues generated from services provided to patients and other revenues for services provided to healthcare institutions under contractual arrangements. The following tables disaggregate the Company’s net operating revenues for the three and six months ended June 30, 2019 and 2020: Three Months Ended June 30, 2019 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenues: Medicare $ 223,688 $ 77,260 $ 43,869 $ 474 $ — $ 345,291 Non-Medicare 234,616 73,972 198,241 410,277 — 917,106 Total patient services revenues 458,304 151,232 242,110 410,751 — 1,262,397 Other revenues 2,839 9,142 19,781 2,700 64,505 98,967 Total net operating revenues $ 461,143 $ 160,374 $ 261,891 $ 413,451 $ 64,505 $ 1,361,364 Three Months Ended June 30, 2020 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenues: Medicare $ 215,508 $ 71,510 $ 20,049 $ 257 $ — $ 307,324 Non-Medicare 301,065 87,697 135,103 309,467 — 833,332 Total patient services revenues 516,573 159,207 155,152 309,724 — 1,140,656 Other revenues 3,053 9,460 11,986 2,614 64,949 92,062 Total net operating revenues $ 519,626 $ 168,667 $ 167,138 $ 312,338 $ 64,949 $ 1,232,718 Six Months Ended June 30, 2019 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenues: Medicare $ 461,857 $ 151,839 $ 84,147 $ 1,029 $ — $ 698,872 Non-Medicare 451,575 144,614 386,155 803,513 — 1,785,857 Total patient services revenues 913,432 296,453 470,302 804,542 — 2,484,729 Other revenues 5,245 18,479 38,494 5,230 133,818 201,266 Total net operating revenues $ 918,677 $ 314,932 $ 508,796 $ 809,772 $ 133,818 $ 2,685,995 Six Months Ended June 30, 2020 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenues: Medicare $ 457,017 $ 162,262 $ 60,881 $ 729 $ — $ 680,889 Non-Medicare 557,012 169,133 331,993 704,500 — 1,762,638 Total patient services revenues 1,014,029 331,395 392,874 705,229 — 2,443,527 Other revenues 6,118 19,291 29,513 5,644 143,257 203,823 Total net operating revenues $ 1,020,147 $ 350,686 $ 422,387 $ 710,873 $ 143,257 $ 2,647,350

Earnings per Share

Earnings per Share	6 Months Ended
	Jun. 30, 2020
Earnings Per Share [Abstract]
Earnings per Share	Earnings per Share The Company’s capital structure includes common stock and unvested restricted stock awards. To compute earnings per share (“EPS”), the Company applies the two-class method because the Company’s unvested restricted stock awards are participating securities which are entitled to participate equally with the Company’s common stock in undistributed earnings. Application of the Company’s two-class method is as follows: (i) Net income attributable to the Company is reduced by the amount of dividends declared and by the contractual amount of dividends that must be paid for the current period for each class of stock. There were no dividends declared or contractual dividends paid for the three and six months ended June 30, 2019 and 2020. (ii) The remaining undistributed net income of the Company is then equally allocated to its common stock and unvested restricted stock awards, as if all of the earnings for the period had been distributed. The total net income allocated to each security is determined by adding both distributed and undistributed net income for the period. (iii) The net income allocated to each security is then divided by the weighted average number of outstanding shares for the period to determine the EPS for each security considered in the two-class method. The following table sets forth the net income attributable to the Company, its common shares outstanding, and its participating securities outstanding. Basic EPS Diluted EPS Three Months Ended June 30, Three Months Ended June 30, 2019 2020 2019 2020 (in thousands) Net income $ 59,986 $ 67,486 $ 59,986 $ 67,486 Less: net income attributable to non-controlling interests 15,170 15,836 15,170 15,836 Net income attributable to the Company 44,816 51,650 44,816 51,650 Less: net income attributable to participating securities 1,484 1,778 1,484 1,778 Net income attributable to common shares $ 43,332 $ 49,872 $ 43,332 $ 49,872 Basic EPS Diluted EPS Six Months Ended June 30, Six Months Ended June 30, 2019 2020 2019 2020 (in thousands) Net income $ 113,330 $ 137,934 $ 113,330 $ 137,934 Less: net income attributable to non-controlling interests 27,680 33,159 27,680 33,159 Net income attributable to the Company 85,650 104,775 85,650 104,775 Less: net income attributable to participating securities 2,827 3,596 2,826 3,596 Net income attributable to common shares $ 82,823 $ 101,179 $ 82,824 $ 101,179 The following tables set forth the computation of EPS under the two-class method: Three Months Ended June 30, 2019 Net Income Allocation Shares (1) Basic EPS Net Income Allocation Shares (1) Diluted EPS (in thousands, except for per share amounts) Common shares $ 43,332 130,525 $ 0.33 $ 43,332 130,562 $ 0.33 Participating securities 1,484 4,471 $ 0.33 1,484 4,471 $ 0.33 Total Company $ 44,816 $ 44,816 Three Months Ended June 30, 2020 Net Income Allocation Shares (1) Basic EPS Net Income Allocation Shares (1) Diluted EPS (in thousands, except for per share amounts) Common shares $ 49,872 129,319 $ 0.39 $ 49,872 129,319 $ 0.39 Participating securities 1,778 4,610 $ 0.39 1,778 4,610 $ 0.39 Total Company $ 51,650 $ 51,650 Six Months Ended June 30, 2019 Net Income Allocation Shares (1) Basic EPS Net Income Allocation Shares (1) Diluted EPS (in thousands, except for per share amounts) Common shares $ 82,823 130,672 $ 0.63 $ 82,824 130,711 $ 0.63 Participating securities 2,827 4,460 $ 0.63 2,826 4,460 $ 0.63 Total Company $ 85,650 $ 85,650 Six Months Ended June 30, 2020 Net Income Allocation Shares (1) Basic EPS Net Income Allocation Shares (1) Diluted EPS (in thousands, except for per share amounts) Common shares $ 101,179 129,479 $ 0.78 $ 101,179 129,479 $ 0.78 Participating securities 3,596 4,602 $ 0.78 3,596 4,602 $ 0.78 Total Company $ 104,775 $ 104,775 _______________________________________________________________________________ (1) Represents the weighted average share count outstanding during the period.

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2020
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Litigation The Company is a party to various legal actions, proceedings, and claims (some of which are not insured), and regulatory and other governmental audits and investigations in the ordinary course of its business. The Company cannot predict the ultimate outcome of pending litigation, proceedings, and regulatory and other governmental audits and investigations. These matters could potentially subject the Company to sanctions, damages, recoupments, fines, and other penalties. The Department of Justice, Centers for Medicare & Medicaid Services (“CMS”), or other federal and state enforcement and regulatory agencies may conduct additional investigations related to the Company’s businesses in the future that may, either individually or in the aggregate, have a material adverse effect on the Company’s business, financial position, results of operations, and liquidity. To address claims arising out of the Company’s operations, the Company maintains professional malpractice liability insurance and general liability insurance coverages through a number of different programs that are dependent upon such factors as the state where the Company is operating and whether the operations are wholly owned or are operated through a joint venture. For the Company’s wholly owned operations, the Company currently maintains insurance coverages under a combination of policies with a total annual aggregate limit of up to $40.0 million. The Company’s insurance for the professional liability coverage is written on a “claims-made” basis, and its commercial general liability coverage is maintained on an “occurrence” basis. These coverages apply after a self-insured retention limit is exceeded. For the Company’s joint venture operations, the Company has designed a separate insurance program that responds to the risks of the specific joint venture. The Company’s joint ventures are insured under a master program with an annual aggregate limit of up to $80.0 million, subject to a sublimit aggregate ranging from $23.0 million to $33.0 million for each specific joint venture. The policies are generally written on a “claims-made” basis. Each of these programs has either a deductible or self-insured retention limit. The Company reviews its insurance program annually and may make adjustments to the amount of insurance coverage and self-insured retentions in future years. The Company also maintains umbrella liability insurance covering claims which, due to their nature or amount, are not covered by or not fully covered by the Company’s other insurance policies. These insurance policies also do not generally cover punitive damages and are subject to various deductibles and policy limits. Significant legal actions, as well as the cost and possible lack of available insurance, could subject the Company to substantial uninsured liabilities. In the Company’s opinion, the outcome of these actions, individually or in the aggregate, will not have a material adverse effect on its financial position, results of operations, or cash flows. Healthcare providers are subject to lawsuits under the qui tam provisions of the federal False Claims Act. Qui tam lawsuits typically remain under seal (hence, usually unknown to the defendant) for some time while the government decides whether or not to intervene on behalf of a private qui tam plaintiff (known as a relator) and take the lead in the litigation. These lawsuits can involve significant monetary damages and penalties and award bounties to private plaintiffs who successfully bring the suits. The Company is and has been a defendant in these cases in the past, and may be named as a defendant in similar cases from time to time in the future. Wilmington Litigation. On January 19, 2017, the United States District Court for the District of Delaware unsealed a qui tam Complaint in United States of America and State of Delaware ex rel. Theresa Kelly v. Select Specialty Hospital-Wilmington, Inc. (“SSH-Wilmington”), Select Specialty Hospitals, Inc., Select Employment Services, Inc., Select Medical Corporation, and Crystal Cheek, No. 16‑347‑LPS. The Complaint was initially filed under seal in May 2016 by a former chief nursing officer at SSH-Wilmington and was unsealed after the United States filed a Notice of Election to Decline Intervention in January 2017. The corporate defendants were served in March 2017. In the complaint, the plaintiff-relator alleges that the Select defendants and an individual defendant, who is a former health information manager at SSH-Wilmington, violated the False Claims Act and the Delaware False Claims and Reporting Act based on allegedly falsifying medical practitioner signatures on medical records and failing to properly examine the credentials of medical practitioners at SSH-Wilmington. In response to the Select defendants’ motion to dismiss the Complaint, in May 2017 the plaintiff-relator filed an Amended Complaint asserting the same causes of action. The Select defendants filed a Motion to Dismiss the Amended Complaint based on numerous grounds, including that the Amended Complaint did not plead any alleged fraud with sufficient particularity, failed to plead that the alleged fraud was material to the government’s payment decision, failed to plead sufficient facts to establish that the Select defendants knowingly submitted false claims or records, and failed to allege any reverse false claim. In March 2018, the District Court dismissed the plaintiff-relator’s claims related to the alleged failure to properly examine medical practitioners’ credentials, her reverse false claims allegations, and her claim that defendants violated the Delaware False Claims and Reporting Act. It denied the defendants’ motion to dismiss claims that the allegedly falsified medical practitioner signatures violated the False Claims Act. Separately, the District Court dismissed the individual defendant due to plaintiff-relator’s failure to timely serve the amended complaint upon her. In March 2017, the plaintiff-relator initiated a second action by filing a Complaint in the Superior Court of the State of Delaware in Theresa Kelly v. Select Medical Corporation, Select Employment Services, Inc., and SSH-Wilmington, C.A. No. N17C-03-293 CLS. The Delaware Complaint alleges that the defendants retaliated against her in violation of the Delaware Whistleblowers’ Protection Act for reporting the same alleged violations that are the subject of the federal Amended Complaint. The defendants filed a motion to dismiss, or alternatively to stay, the Delaware Complaint based on the pending federal Amended Complaint and the failure to allege facts to support a violation of the Delaware Whistleblowers’ Protection Act. In January 2018, the Court stayed the Delaware Complaint pending the outcome of the federal case. The Company intends to vigorously defend these actions, but at this time the Company is unable to predict the timing and outcome of this matter. Contract Therapy Subpoena. On May 18, 2017, the Company received a subpoena from the U.S. Attorney’s Office for the District of New Jersey seeking various documents principally relating to the Company’s contract therapy division, which contracted to furnish rehabilitation therapy services to residents of skilled nursing facilities (“SNFs”) and other providers. The Company operated its contract therapy division through a subsidiary until March 31, 2016, when the Company sold the stock of the subsidiary. The subpoena seeks documents that appear to be aimed at assessing whether therapy services were furnished and billed in compliance with Medicare SNF billing requirements, including whether therapy services were coded at inappropriate levels and whether excessive or unnecessary therapy was furnished to justify coding at higher paying levels. The Company does not know whether the subpoena has been issued in connection with a qui tam lawsuit or in connection with possible civil, criminal or administrative proceedings by the government. The Company has produced documents in response to the subpoena and intends to fully cooperate with this investigation. At this time, the Company is unable to predict the timing and outcome of this matter. Ann Arbor Complaint . On May 12, 2020, the United States District Court for the Eastern District of Michigan unsealed qui tam Complaints in United States of America and State of Michigan ex rel. Neal Elkin v. Select Medical Holdings Corp., Select Medical, and Select Specialty Hospital – Ann Arbor, Inc. (“SSH-Ann Arbor”), No. 12-cv-13984. An initial Complaint was filed under seal in September 2012 and a First Amended Complaint was filed under seal in September 2019. Both Complaints were unsealed after the United States and State of Michigan filed a Notice of Election to Decline Intervention in May 2020. In the First Amended Complaint, the plaintiff-relator, a physician formerly practicing at SSH-Ann Arbor, alleges that the defendants had a policy to keep respiratory patients on ventilators longer than medically necessary in order to increase reimbursement, and that, after he complained of this practice, SSH-Ann Arbor retaliated by refusing to assign new patients to him. The First Amended Complaint has not yet been served on the defendants. If the plaintiff-relator serves the First Amended Complaint and pursues this action, the Company intends to vigorously defend this action; however, at this time the Company is unable to predict the timing and outcome of this matter.

CARES Act

CARES Act	6 Months Ended
	Jun. 30, 2020
Unusual or Infrequent Items, or Both [Abstract]
CARES Act	CARES Act Provider Relief Funds On March 27, 2020, the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) was enacted. The CARES Act provided additional waivers, reimbursement, grants and other funds to assist health care providers during the COVID-19 pandemic, including $100.0 billion in appropriations for the Public Health and Social Services Emergency Fund, also referred to as the Provider Relief Fund, to be used for preventing, preparing, and responding to the coronavirus, and for reimbursing eligible health care providers for lost revenues and health care related expenses that are attributable to COVID-19. These health care related expenses could include costs associated with constructing temporary structures or emergency operation centers, retrofitting facilities, purchasing medical supplies and equipment including personal protective equipment and testing supplies, and increasing workforce and trainings. The Company’s consolidated subsidiaries received approximately $100.5 million of payments under the Provider Relief Fund as of June 30, 2020. Under the Company’s accounting policy, it will recognize these payments as other operating income when it is probable that it has complied with the terms and conditions of the funds. Other operating income will be recognized as the Company incurs a loss of revenues or health care related expenses attributable to COVID-19. For the three and six months ended June 30, 2020, the Company has recognized approximately $55.0 million as other operating income on the accompanying condensed consolidated statement of operations. The remaining Provider Relief Fund payments of approximately $45.5 million are recorded within “unearned government assistance” on the accompanying condensed consolidated balance sheet and will be recognized as other operating income in future periods when the Company incurs additional lost revenues or health care related expenses attributable to COVID-19. There is uncertainty regarding whether all payments received by the Company’s consolidated subsidiaries will be recognized as other operating income in future periods; such funds may need to be repaid to the government to the extent that payments received exceed lost revenues and health care related expenses attributable to COVID-19. Medicare Accelerated and Advance Payments Program In accordance with the CARES Act, CMS temporarily expanded its current Accelerated and Advance Payment Program for Medicare providers. Under this program, qualified healthcare providers could receive advanced or accelerated payments from CMS. The Company’s consolidated subsidiaries received approximately $317.0 million of advanced payments under this program. The majority of these payments were received in April 2020. Amounts received under the Accelerated and Advance Payment Program are reflected in “government advances” on the accompanying condensed consolidated balance sheet. For the Company’s critical illness recovery hospitals and rehabilitation hospitals, repayment of amounts received under the Accelerated and Advance Payment Program are due 210 days after the advanced payment was issued. Failure to repay the advanced payments when due results in interest charges on the outstanding balance owed. CMS has the ability to recoup the advanced payments through future Medicare claims billed by the Company’s hospitals, beginning 121 days after the advanced payment was issued. Employer Payroll Tax Deferral In April 2020, the Company began deferring payment on its share of payroll taxes owed, as allowed by the CARES Act through December 31, 2020. The Company is able to defer half of its share of payroll taxes owed until December 31, 2021, with the remaining half due on December 31, 2022. As of June 30, 2020, the Company deferred approximately $33.1 million of payroll taxes. These amounts are reflected in “other non-current liabilities” on the accompanying condensed consolidated balance sheet.

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2020
Income Tax Disclosure [Abstract]
Increase (decrease) current income taxes payable	Income Taxes The CARES Act, which was enacted on March 27, 2020, includes changes to certain tax law related to net operating losses and the deductibility of interest expense and depreciation. ASC 740, Income Taxes , requires the effects of changes in tax rates and laws on deferred tax balances to be recognized in the period in which the legislation is enacted. This legislation had the effect of increasing the Company’s deferred income taxes and decreasing its current income taxes payable by approximately $15.5 million and resulted from a correction to allow for bonus depreciation on certain types of qualified property for tax years beginning January 1, 2018, and the provision for an increase in the amounts allowed for interest expense deductions for tax years beginning January 1, 2019. The legislation related to net operating losses did not impact the Company’s deferred tax balances.

Accounting Policies (Policies)

Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2020
Accounting Policies [Abstract]
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, including disclosure of contingencies, at the date of the financial statements and reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements Financial Instruments On January 1, 2020, the Company adopted Accounting Standards Update (“ASU”) 2016-13, Financial Instruments - Credit Losses: Measurement of Credit Losses on Financial Instruments (Topic 326) , which replaced the incurred loss approach for recognizing credit losses on financial instruments with an expected loss approach. The expected loss approach is subject to management judgments using assessments of incurred credit losses, assessments of current conditions, and forecasts using reasonable and supportable assumptions. The standard was required to be applied using the modified retrospective approach with a cumulative-effect adjustment to retained earnings, if any, upon adoption. The Company’s primary financial instrument subject to the standard is its accounts receivable derived from contracts with patients. Historically, the Company has experienced infrequent, immaterial credit losses related to its accounts receivable and, based on its experience, believes the risk of material defaults is low. The Company experienced credit losses of $1.1 million for the year ended December 31, 2017, credit loss recoveries of $0.1 million for the year ended December 31, 2018, and credit losses of $3.0 million for the year ended December 31, 2019. The Company’s historical credit losses have been infrequent and immaterial largely because the Company’s accounts receivable are typically paid for by highly-solvent, creditworthy payors such as Medicare, other governmental programs, and highly-regulated commercial insurers, on behalf of the patient. The Company believes it has moderate credit risk related to defaults on self-pay amounts in accounts receivable; however, these amounts represented less than 1.0% of the Company’s accounts receivable at January 1, 2020. In estimating the Company’s expected credit losses under Topic 326, the Company considers its incurred loss experience and adjusts for known and expected events and other circumstances, identified using periodic assessments implemented by the Company, which management believes are relevant in assessing the collectability of its accounts receivable. Because of the infrequent and insignificant nature of the Company’s historical credit losses, forecasts of expected credit losses are generally unnecessary. Expected credit losses are recognized by the Company through an allowance for credit losses and related credit loss expense.
Credit Risk Concentrations	Credit Risk ConcentrationsFinancial instruments that potentially subject the Company to concentrations of credit risk consist primarily of cash balances and accounts receivables. The Company’s excess cash is held with large financial institutions. The Company grants unsecured credit to its patients, most of whom reside in the service area of the Company’s facilities and are insured under third-party payor agreements. The Company’s general policy is to verify insurance coverage prior to the date of admission for patients admitted to its critical illness recovery hospitals and rehabilitation hospitals. Within the Company’s outpatient rehabilitation clinics, insurance coverage is verified prior to the patient’s visit. Within the Company’s Concentra centers, insurance coverage is verified or an authorization is received from the patient’s employer prior to the patient’s visit.Because of the diversity in the Company’s non-governmental third-party payor base, as well as their geographic dispersion, patient accounts receivable which are due from the Medicare program represent the Company’s only significant concentration of credit risk.
Redeemable Non-Controlling Interests	Redeemable Non-Controlling InterestsThe ownership interests held by outside parties in subsidiaries, limited liability companies, and limited partnerships controlled by the Company are classified as non-controlling interests. Some of the Company’s non-controlling ownership interests consist of outside parties that have certain redemption rights that, if exercised, require the Company to purchase the parties’ ownership interests. These interests are classified and reported as redeemable non-controlling interests and have been adjusted to their approximate redemption values.
Variable Interest Entities	Variable Interest Entities Concentra does not own many of its medical practices, as certain states prohibit the “corporate practice of medicine,” which restricts business corporations from practicing medicine through the direct employment of physicians or from exercising control over medical decisions by physicians. In these states, Concentra typically enters into long-term management agreements with professional corporations or associations that are owned by licensed physicians, which, in turn, employ or contract with physicians who provide professional medical services in Concentra’s occupational health centers. The management agreements have terms that provide for Concentra to conduct, supervise, and manage the day-to-day non-medical operations of the occupational health centers and provide all management and administrative services. Concentra receives a management fee for these services, which is based, in part, on the performance of the professional corporation or association. Additionally, the outstanding voting equity interests of the professional corporations or associations are typically owned by licensed physicians appointed at Concentra’s discretion. Concentra has the ability to direct the transfer of ownership of the professional corporation or association to a new licensed physician at any time.

Redeemable Non-Controlling In_2

Redeemable Non-Controlling Interests (Tables)	6 Months Ended
	Jun. 30, 2020
Noncontrolling Interest [Abstract]
Schedule of redeemable non-controlling interests	The changes in redeemable non-controlling interests are as follows (in thousands): Six Months Ended June 30, 2019 2020 Balance as of January 1 $ 780,488 $ 974,541 Net income attributable to redeemable non-controlling interests 7,700 7,256 Distributions to and purchases of redeemable non-controlling interests (2,771) (5,687) Purchase of membership interests of Concentra Group Holdings Parent — (366,203) Redemption adjustment on redeemable non-controlling interests 47,470 10,123 Other 354 347 Balance as of March 31 $ 833,241 $ 620,377 Net income attributable to redeemable non-controlling interests 11,507 3,264 Distributions to and purchases of redeemable non-controlling interests (395) (30) Redemption adjustment on redeemable non-controlling interests (270) (127,916) Other 339 292 Balance as of June 30 $ 844,422 $ 495,987

Intangible Assets (Tables)

Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of carrying amount of goodwill	The following table shows changes in the carrying amounts of goodwill by reporting unit for the six months ended June 30, 2020: Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Total (in thousands) Balance as of December 31, 2019 $ 1,078,804 $ 430,900 $ 649,763 $ 1,232,488 $ 3,391,955 Acquired — — 728 4,567 5,295 Sold — — (6,034) — (6,034) Measurement period adjustment — — — (20) (20) Balance as of June 30, 2020 $ 1,078,804 $ 430,900 $ 644,457 $ 1,237,035 $ 3,391,196
Schedule of carrying value and amortization of identifiable intangible assets	The following table provides the gross carrying amounts, accumulated amortization, and net carrying amounts for the Company’s identifiable intangible assets: December 31, 2019 June 30, 2020 Gross Accumulated Net Gross Accumulated Net (in thousands) Indefinite-lived intangible assets: Trademarks $ 166,698 $ — $ 166,698 $ 166,698 $ — $ 166,698 Certificates of need 17,157 — 17,157 18,410 — 18,410 Accreditations 1,874 — 1,874 1,874 — 1,874 Finite-lived intangible assets: Trademarks 5,000 (5,000) — 5,000 (5,000) — Customer relationships 287,373 (87,346) 200,027 288,963 (100,300) 188,663 Non-compete agreements 32,114 (8,802) 23,312 32,883 (10,262) 22,621 Total identifiable intangible assets $ 510,216 $ (101,148) $ 409,068 $ 513,828 $ (115,562) $ 398,266

Long-Term Debt and Notes Paya_2

Long-Term Debt and Notes Payable (Tables)	6 Months Ended
	Jun. 30, 2020
Debt Disclosure [Abstract]
Schedule of Company's long-term debt and notes payable	As of June 30, 2020, the Company’s long-term debt and notes payable were as follows (in thousands): Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value Select 6.250% senior notes $ 1,225,000 $ 36,890 $ (18,455) $ 1,243,435 $ 1,238,353 Select credit facilities: Select term loan 2,103,437 (9,404) (10,251) 2,083,782 1,987,748 Other debt, including finance leases 76,984 — (349) 76,635 76,635 Total debt $ 3,405,421 $ 27,486 $ (29,055) $ 3,403,852 $ 3,302,736 As of December 31, 2019, the Company’s long-term debt and notes payable were as follows (in thousands): Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value Select 6.250% senior notes $ 1,225,000 $ 39,988 $ (19,944) $ 1,245,044 $ 1,322,020 Select credit facilities: Select term loan 2,143,280 (10,411) (11,348) 2,121,521 2,145,959 Other debt, including finance leases 78,941 — (396) 78,545 78,545 Total debt $ 3,447,221 $ 29,577 $ (31,688) $ 3,445,110 $ 3,546,524
Schedule of principal maturities of the Company's long-term debt and notes payable	Principal maturities of the Company’s long-term debt and notes payable were approximately as follows (in thousands): 2020 2021 2022 2023 2024 Thereafter Total Select 6.250% senior notes $ — $ — $ — $ — $ — $ 1,225,000 $ 1,225,000 Select credit facilities: Select term loan — — — 4,757 11,150 2,087,530 2,103,437 Other debt, including finance leases 8,745 8,510 3,583 20,715 23,532 11,899 76,984 Total debt $ 8,745 $ 8,510 $ 3,583 $ 25,472 $ 34,682 $ 3,324,429 $ 3,405,421

Segment Information (Tables)

Segment Information (Tables)	6 Months Ended
	Jun. 30, 2020
Segment Reporting [Abstract]
Schedule of selected financial data for the Company's reportable segments	The following tables summarize selected financial data for the Company’s reportable segments. Three Months Ended June 30, Six Months Ended June 30, 2019 2020 2019 2020 (in thousands) Net operating revenues: Critical illness recovery hospital $ 461,143 $ 519,626 $ 918,677 $ 1,020,147 Rehabilitation hospital 160,374 168,667 314,932 350,686 Outpatient rehabilitation 261,891 167,138 508,796 422,387 Concentra 413,451 312,338 809,772 710,873 Other 64,505 64,949 133,818 143,257 Total Company $ 1,361,364 $ 1,232,718 $ 2,685,995 $ 2,647,350 Adjusted EBITDA: Critical illness recovery hospital $ 64,138 $ 89,743 $ 137,136 $ 178,313 Rehabilitation hospital 29,968 27,605 55,765 66,174 Outpatient rehabilitation 42,584 (6,282) 71,575 20,840 Concentra 76,087 41,497 142,345 102,963 Other (26,544) 26,189 (50,471) (2,205) Total Company $ 186,233 $ 178,752 $ 356,350 $ 366,085 Total assets: Critical illness recovery hospital $ 2,119,574 $ 2,115,294 $ 2,119,574 $ 2,115,294 Rehabilitation hospital 1,107,852 1,135,206 1,107,852 1,135,206 Outpatient rehabilitation 1,265,487 1,267,308 1,265,487 1,267,308 Concentra 2,447,387 2,351,974 2,447,387 2,351,974 Other 166,640 598,676 166,640 598,676 Total Company $ 7,106,940 $ 7,468,458 $ 7,106,940 $ 7,468,458 Purchases of property and equipment: Critical illness recovery hospital $ 14,488 $ 14,970 $ 24,648 $ 23,935 Rehabilitation hospital 5,356 1,923 18,539 5,248 Outpatient rehabilitation 6,705 6,593 15,745 14,977 Concentra 12,240 6,820 27,938 22,406 Other 1,423 1,739 2,415 4,687 Total Company $ 40,212 $ 32,045 $ 89,285 $ 71,253
Schedule of reconciliation of Adjusted EBITDA to income before income taxes	A reconciliation of Adjusted EBITDA to income before income taxes is as follows: Three Months Ended June 30, 2019 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 64,138 $ 29,968 $ 42,584 $ 76,087 $ (26,544) Depreciation and amortization (14,495) (6,696) (6,991) (24,479) (2,332) Stock compensation expense — — — (767) (5,591) Income (loss) from operations $ 49,643 $ 23,272 $ 35,593 $ 50,841 $ (34,467) $ 124,882 Equity in earnings of unconsolidated subsidiaries 7,394 Interest expense (51,464) Income before income taxes $ 80,812 Three Months Ended June 30, 2020 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 89,743 $ 27,605 $ (6,282) $ 41,497 $ 26,189 Depreciation and amortization (13,892) (6,907) (7,194) (21,857) (2,421) Stock compensation expense — — — (701) (6,262) Income (loss) from operations $ 75,851 $ 20,698 $ (13,476) $ 18,939 $ 17,506 $ 119,518 Equity in earnings of unconsolidated subsidiaries 8,324 Gain on sale of business 346 Interest expense (37,366) Income before income taxes $ 90,822 Six Months Ended June 30, 2019 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 137,136 $ 55,765 $ 71,575 $ 142,345 $ (50,471) Depreciation and amortization (25,946) (13,098) (14,023) (49,383) (4,681) Stock compensation expense — — — (1,534) (11,079) Income (loss) from operations $ 111,190 $ 42,667 $ 57,552 $ 91,428 $ (66,231) $ 236,606 Equity in earnings of unconsolidated subsidiaries 11,760 Gain on sale of businesses 6,532 Interest expense (102,275) Income before income taxes $ 152,623 Six Months Ended June 30, 2020 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 178,313 $ 66,174 $ 20,840 $ 102,963 $ (2,205) Depreciation and amortization (26,228) (13,794) (14,412) (44,744) (4,845) Stock compensation expense — — — (1,468) (12,398) Income (loss) from operations $ 152,085 $ 52,380 $ 6,428 $ 56,751 $ (19,448) $ 248,196 Equity in earnings of unconsolidated subsidiaries 10,912 Gain on sale of businesses 7,547 Interest expense (83,473) Income before income taxes $ 183,182

Revenue from Contracts with C_2

Revenue from Contracts with Customers (Tables)	6 Months Ended
	Jun. 30, 2020
Revenue from Contract with Customer [Abstract]
Schedule of disaggregation of net operating revenues by operating segment	The following tables disaggregate the Company’s net operating revenues for the three and six months ended June 30, 2019 and 2020: Three Months Ended June 30, 2019 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenues: Medicare $ 223,688 $ 77,260 $ 43,869 $ 474 $ — $ 345,291 Non-Medicare 234,616 73,972 198,241 410,277 — 917,106 Total patient services revenues 458,304 151,232 242,110 410,751 — 1,262,397 Other revenues 2,839 9,142 19,781 2,700 64,505 98,967 Total net operating revenues $ 461,143 $ 160,374 $ 261,891 $ 413,451 $ 64,505 $ 1,361,364 Three Months Ended June 30, 2020 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenues: Medicare $ 215,508 $ 71,510 $ 20,049 $ 257 $ — $ 307,324 Non-Medicare 301,065 87,697 135,103 309,467 — 833,332 Total patient services revenues 516,573 159,207 155,152 309,724 — 1,140,656 Other revenues 3,053 9,460 11,986 2,614 64,949 92,062 Total net operating revenues $ 519,626 $ 168,667 $ 167,138 $ 312,338 $ 64,949 $ 1,232,718 Six Months Ended June 30, 2019 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenues: Medicare $ 461,857 $ 151,839 $ 84,147 $ 1,029 $ — $ 698,872 Non-Medicare 451,575 144,614 386,155 803,513 — 1,785,857 Total patient services revenues 913,432 296,453 470,302 804,542 — 2,484,729 Other revenues 5,245 18,479 38,494 5,230 133,818 201,266 Total net operating revenues $ 918,677 $ 314,932 $ 508,796 $ 809,772 $ 133,818 $ 2,685,995 Six Months Ended June 30, 2020 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenues: Medicare $ 457,017 $ 162,262 $ 60,881 $ 729 $ — $ 680,889 Non-Medicare 557,012 169,133 331,993 704,500 — 1,762,638 Total patient services revenues 1,014,029 331,395 392,874 705,229 — 2,443,527 Other revenues 6,118 19,291 29,513 5,644 143,257 203,823 Total net operating revenues $ 1,020,147 $ 350,686 $ 422,387 $ 710,873 $ 143,257 $ 2,647,350

Earnings per Share (Tables)

Earnings per Share (Tables)	6 Months Ended
	Jun. 30, 2020
Earnings Per Share [Abstract]
Schedule of computation of basic and diluted earnings per share	The following table sets forth the net income attributable to the Company, its common shares outstanding, and its participating securities outstanding. Basic EPS Diluted EPS Three Months Ended June 30, Three Months Ended June 30, 2019 2020 2019 2020 (in thousands) Net income $ 59,986 $ 67,486 $ 59,986 $ 67,486 Less: net income attributable to non-controlling interests 15,170 15,836 15,170 15,836 Net income attributable to the Company 44,816 51,650 44,816 51,650 Less: net income attributable to participating securities 1,484 1,778 1,484 1,778 Net income attributable to common shares $ 43,332 $ 49,872 $ 43,332 $ 49,872 Basic EPS Diluted EPS Six Months Ended June 30, Six Months Ended June 30, 2019 2020 2019 2020 (in thousands) Net income $ 113,330 $ 137,934 $ 113,330 $ 137,934 Less: net income attributable to non-controlling interests 27,680 33,159 27,680 33,159 Net income attributable to the Company 85,650 104,775 85,650 104,775 Less: net income attributable to participating securities 2,827 3,596 2,826 3,596 Net income attributable to common shares $ 82,823 $ 101,179 $ 82,824 $ 101,179 The following tables set forth the computation of EPS under the two-class method: Three Months Ended June 30, 2019 Net Income Allocation Shares (1) Basic EPS Net Income Allocation Shares (1) Diluted EPS (in thousands, except for per share amounts) Common shares $ 43,332 130,525 $ 0.33 $ 43,332 130,562 $ 0.33 Participating securities 1,484 4,471 $ 0.33 1,484 4,471 $ 0.33 Total Company $ 44,816 $ 44,816 Three Months Ended June 30, 2020 Net Income Allocation Shares (1) Basic EPS Net Income Allocation Shares (1) Diluted EPS (in thousands, except for per share amounts) Common shares $ 49,872 129,319 $ 0.39 $ 49,872 129,319 $ 0.39 Participating securities 1,778 4,610 $ 0.39 1,778 4,610 $ 0.39 Total Company $ 51,650 $ 51,650 Six Months Ended June 30, 2019 Net Income Allocation Shares (1) Basic EPS Net Income Allocation Shares (1) Diluted EPS (in thousands, except for per share amounts) Common shares $ 82,823 130,672 $ 0.63 $ 82,824 130,711 $ 0.63 Participating securities 2,827 4,460 $ 0.63 2,826 4,460 $ 0.63 Total Company $ 85,650 $ 85,650 Six Months Ended June 30, 2020 Net Income Allocation Shares (1) Basic EPS Net Income Allocation Shares (1) Diluted EPS (in thousands, except for per share amounts) Common shares $ 101,179 129,479 $ 0.78 $ 101,179 129,479 $ 0.78 Participating securities 3,596 4,602 $ 0.78 3,596 4,602 $ 0.78 Total Company $ 104,775 $ 104,775 _______________________________________________________________________________ (1) Represents the weighted average share count outstanding during the period.

Accounting Policies (Details)

Accounting Policies (Details) - USD ($)	Jan. 01, 2020	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Concentration Risk [Line Items]
Credit loss (recoveries)		$ 253,000	$ 1,958,000	$ 3,000,000	$ (100,000)	$ 1,100,000
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Allowance for credit losses	$ 0
Retained earnings		$ 495,964,000		$ 279,800,000
Cumulative Effect, Period Of Adoption, Adjustment
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Retained earnings	$ 0
Credit Concentration Risk | Accounts Receivable
Concentration Risk [Line Items]
Percentage of concentration risk	1.00%

Credit Risk Concentrations (Det

Credit Risk Concentrations (Details) - Credit Concentration Risk - Accounts Receivable	Jan. 01, 2020	Jun. 30, 2020	Dec. 31, 2019
Concentration Risk [Line Items]
Percentage of concentration risk	1.00%
Medicare Receivable
Concentration Risk [Line Items]
Percentage of concentration risk		13.00%	15.00%

Redeemable Non-Controlling In_3

Redeemable Non-Controlling Interests - Narrative (Details) - USD ($) $ in Thousands	Feb. 01, 2020	Jan. 01, 2020	Jun. 30, 2020	Jun. 30, 2019
Noncontrolling Interest [Line Items]
Aggregate purchase price			$ 366,203	$ 0
Concentra Group Holdings Parent, LLC
Noncontrolling Interest [Line Items]
Aggregate purchase price	$ 27,800	$ 338,400
Concentra Group Holdings Parent, LLC
Noncontrolling Interest [Line Items]
Percentage of membership interests purchased	1.40%	17.20%
Outstanding member interest	66.60%
Concentra Group Holdings Parent, LLC | Class A Units
Noncontrolling Interest [Line Items]
Outstanding member interest	68.80%

Redeemable Non-Controlling In_4

Redeemable Non-Controlling Interests - Schedule of Redeemable Non-Controlling Interests (Details) - USD ($) $ in Thousands	3 Months Ended
	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2019	Mar. 31, 2019
Increase (Decrease) in Temporary Equity [Roll Forward]
Balance, beginning	$ 620,377	$ 974,541	$ 833,241	$ 780,488
Net income attributable to redeemable non-controlling interests	3,264	7,256	11,507	7,700
Distributions to and purchases of redeemable non-controlling interests	(30)	(5,687)	(395)	(2,771)
Purchase of membership interests of Concentra Group Holdings Parent		(366,203)		0
Redemption adjustment on redeemable non-controlling interests	(127,916)	10,123	(270)	47,470
Other	292	347	339	354
Balance, ending	$ 495,987	$ 620,377	$ 844,422	$ 833,241

Variable Interest Entities (Det

Variable Interest Entities (Details) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019	Jun. 30, 2019
Variable Interest Entity [Line Items]
Assets	$ 7,468,458	$ 7,340,288	$ 7,106,940
Liabilities	5,800,041	5,436,712
Variable Interest Entity, Primary Beneficiary
Variable Interest Entity [Line Items]
Assets	153,200	178,400
Liabilities	$ 151,900	$ 176,700

Intangible Assets - Carrying Am

Intangible Assets - Carrying Amount of Goodwill (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2020USD ($)
Goodwill
Goodwill, Beginning Balance	$ 3,391,955
Acquired	5,295
Sold	(6,034)
Measurement period adjustment	(20)
Goodwill, Ending Balance	3,391,196
Critical Illness Recovery Hospital
Goodwill
Goodwill, Beginning Balance	1,078,804
Acquired	0
Sold	0
Measurement period adjustment	0
Goodwill, Ending Balance	1,078,804
Rehabilitation Hospital
Goodwill
Goodwill, Beginning Balance	430,900
Acquired	0
Sold	0
Measurement period adjustment	0
Goodwill, Ending Balance	430,900
Outpatient Rehabilitation
Goodwill
Goodwill, Beginning Balance	649,763
Acquired	728
Sold	(6,034)
Measurement period adjustment	0
Goodwill, Ending Balance	644,457
Concentra
Goodwill
Goodwill, Beginning Balance	1,232,488
Acquired	4,567
Sold	0
Measurement period adjustment	(20)
Goodwill, Ending Balance	$ 1,237,035

Intangible Assets - Carrying Va

Intangible Assets - Carrying Value and Amortization of Identifiable Intangible Assets and Liabilities (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Finite Lived And Indefinite Lived Intangible Assets By Major Class [Line Items]
Total identifiable intangible assets, gross carrying amount	$ 513,828		$ 513,828		$ 510,216
Finite-lived intangible assets, accumulated amortization	(115,562)		(115,562)		(101,148)
Total identifiable intangible assets, net carrying amount	398,266		398,266		409,068
Amortized intangible assets:
Amortization expense	6,900	$ 8,900	13,800	$ 16,000
Trademarks
Finite Lived And Indefinite Lived Intangible Assets By Major Class [Line Items]
Finite-lived intangible assets, gross carrying amount	5,000		5,000		5,000
Finite-lived intangible assets, accumulated amortization	(5,000)		(5,000)		(5,000)
Finite-lived intangible assets, net carrying amount	0		0		0
Customer relationships
Finite Lived And Indefinite Lived Intangible Assets By Major Class [Line Items]
Finite-lived intangible assets, gross carrying amount	288,963		288,963		287,373
Finite-lived intangible assets, accumulated amortization	(100,300)		(100,300)		(87,346)
Finite-lived intangible assets, net carrying amount	188,663		188,663		200,027
Non-compete agreements
Finite Lived And Indefinite Lived Intangible Assets By Major Class [Line Items]
Finite-lived intangible assets, gross carrying amount	32,883		32,883		32,114
Finite-lived intangible assets, accumulated amortization	(10,262)		(10,262)		(8,802)
Finite-lived intangible assets, net carrying amount	22,621		22,621		23,312
Trademarks
Finite Lived And Indefinite Lived Intangible Assets By Major Class [Line Items]
Indefinite-lived intangible assets, carrying amount	166,698		$ 166,698		166,698
Amortized intangible assets:
Weighted average time until next renewal			6 years 8 months 12 days
Certificates of need
Finite Lived And Indefinite Lived Intangible Assets By Major Class [Line Items]
Indefinite-lived intangible assets, carrying amount	18,410		$ 18,410		17,157
Accreditations
Finite Lived And Indefinite Lived Intangible Assets By Major Class [Line Items]
Indefinite-lived intangible assets, carrying amount	$ 1,874		$ 1,874		$ 1,874
Amortized intangible assets:
Weighted average time until next renewal			1 year 6 months

Long-Term Debt and Notes Paya_3

Long-Term Debt and Notes Payable - Components of Long-Term Debt And Notes Payable (Details) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Principal Outstanding	$ 3,405,421	$ 3,447,221
Unamortized Premium (Discount)	27,486	29,577
Unamortized Issuance Costs	(29,055)	(31,688)
Carrying Value	3,403,852	3,445,110
Fair Value	3,302,736	3,546,524
Other debt, including finance leases
Debt Instrument [Line Items]
Principal Outstanding	76,984	78,941
Unamortized Premium (Discount)	0	0
Unamortized Issuance Costs	(349)	(396)
Carrying Value	76,635	78,545
Fair Value	$ 76,635	78,545
Select Medical Corporation | Senior Notes
Debt Instrument [Line Items]
Interest rate of debt (as a percent)	6.25%
Principal Outstanding	$ 1,225,000	1,225,000
Unamortized Premium (Discount)	36,890	39,988
Unamortized Issuance Costs	(18,455)	(19,944)
Carrying Value	1,243,435	1,245,044
Fair Value	1,238,353	1,322,020
Select Medical Corporation | Term loans
Debt Instrument [Line Items]
Principal Outstanding	2,103,437	2,143,280
Unamortized Premium (Discount)	(9,404)	(10,411)
Unamortized Issuance Costs	(10,251)	(11,348)
Carrying Value	2,083,782	2,121,521
Fair Value	$ 1,987,748	$ 2,145,959

Long-Term Debt and Notes Paya_4

Long-Term Debt and Notes Payable - Principal Maturities Of Long-Term Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
2020	$ 8,745
2021	8,510
2022	3,583
2023	25,472
2024	34,682
Thereafter	3,324,429
Total	3,405,421	$ 3,447,221
Other debt, including finance leases
Debt Instrument [Line Items]
2020	8,745
2021	8,510
2022	3,583
2023	20,715
2024	23,532
Thereafter	11,899
Total	$ 76,984	78,941
Select Medical Corporation | Senior Notes
Debt Instrument [Line Items]
Interest rate of debt (as a percent)	6.25%
2020	$ 0
2021	0
2022	0
2023	0
2024	0
Thereafter	1,225,000
Total	1,225,000	1,225,000
Select Medical Corporation | Term loans
Debt Instrument [Line Items]
2020	0
2021	0
2022	0
2023	4,757
2024	11,150
Thereafter	2,087,530
Total	$ 2,103,437	$ 2,143,280

Long-Term Debt and Notes Paya_5

Long-Term Debt and Notes Payable - Narrative (Details) - USD ($) $ in Thousands	1 Months Ended	6 Months Ended
	Feb. 29, 2020	Jun. 30, 2020	Jun. 30, 2019
Line of Credit Facility [Line Items]
Payments on term loans		$ 39,843	$ 132,685
Select Medical Corporation | Term loans
Line of Credit Facility [Line Items]
Payments on term loans	$ 39,800
Select Medical Corporation | Senior notes
Line of Credit Facility [Line Items]
Interest rate of debt (as a percent)		6.25%

Segment Information - Selected

Segment Information - Selected Financial Data (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Segment information
Net operating revenues	$ 1,232,718	$ 1,361,364	$ 2,647,350	$ 2,685,995
Adjusted EBITDA	178,752	186,233	366,085	356,350
Total assets	7,468,458	7,106,940	7,468,458	7,106,940	$ 7,340,288
Purchases of property and equipment, net	32,045	40,212	71,253	89,285
Operating Segments | Critical Illness Recovery Hospital
Segment information
Net operating revenues	519,626	461,143	1,020,147	918,677
Adjusted EBITDA	89,743	64,138	178,313	137,136
Total assets	2,115,294	2,119,574	2,115,294	2,119,574
Purchases of property and equipment, net	14,970	14,488	23,935	24,648
Operating Segments | Rehabilitation Hospital
Segment information
Net operating revenues	168,667	160,374	350,686	314,932
Adjusted EBITDA	27,605	29,968	66,174	55,765
Total assets	1,135,206	1,107,852	1,135,206	1,107,852
Purchases of property and equipment, net	1,923	5,356	5,248	18,539
Operating Segments | Outpatient Rehabilitation
Segment information
Net operating revenues	167,138	261,891	422,387	508,796
Adjusted EBITDA	(6,282)	42,584	20,840	71,575
Total assets	1,267,308	1,265,487	1,267,308	1,265,487
Purchases of property and equipment, net	6,593	6,705	14,977	15,745
Operating Segments | Concentra
Segment information
Net operating revenues	312,338	413,451	710,873	809,772
Adjusted EBITDA	41,497	76,087	102,963	142,345
Total assets	2,351,974	2,447,387	2,351,974	2,447,387
Purchases of property and equipment, net	6,820	12,240	22,406	27,938
Other
Segment information
Net operating revenues	64,949	64,505	143,257	133,818
Adjusted EBITDA	26,189	(26,544)	(2,205)	(50,471)
Total assets	598,676	166,640	598,676	166,640
Purchases of property and equipment, net	$ 1,739	$ 1,423	$ 4,687	$ 2,415

Segment Information - Reconcili

Segment Information - Reconciliation of Adjusted EBITDA to Income Before Taxes (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Segment information
Adjusted EBITDA	$ 178,752	$ 186,233	$ 366,085	$ 356,350
Depreciation and amortization	(52,271)	(54,993)	(104,023)	(107,131)
Income from operations	119,518	124,882	248,196	236,606
Equity in earnings of unconsolidated subsidiaries	8,324	7,394	10,912	11,760
Gain on sale of business	346	0	7,547	6,532
Interest expense	(37,366)	(51,464)	(83,473)	(102,275)
Income before income taxes	90,822	80,812	183,182	152,623
Operating Segments | Critical Illness Recovery Hospital
Segment information
Adjusted EBITDA	89,743	64,138	178,313	137,136
Depreciation and amortization	(13,892)	(14,495)	(26,228)	(25,946)
Stock compensation expense	0	0	0	0
Income from operations	75,851	49,643	152,085	111,190
Operating Segments | Rehabilitation Hospital
Segment information
Adjusted EBITDA	27,605	29,968	66,174	55,765
Depreciation and amortization	(6,907)	(6,696)	(13,794)	(13,098)
Stock compensation expense	0	0	0	0
Income from operations	20,698	23,272	52,380	42,667
Operating Segments | Outpatient Rehabilitation
Segment information
Adjusted EBITDA	(6,282)	42,584	20,840	71,575
Depreciation and amortization	(7,194)	(6,991)	(14,412)	(14,023)
Stock compensation expense	0	0	0	0
Income from operations	(13,476)	35,593	6,428	57,552
Operating Segments | Concentra
Segment information
Adjusted EBITDA	41,497	76,087	102,963	142,345
Depreciation and amortization	(21,857)	(24,479)	(44,744)	(49,383)
Stock compensation expense	(701)	(767)	(1,468)	(1,534)
Income from operations	18,939	50,841	56,751	91,428
Other
Segment information
Adjusted EBITDA	26,189	(26,544)	(2,205)	(50,471)
Depreciation and amortization	(2,421)	(2,332)	(4,845)	(4,681)
Stock compensation expense	(6,262)	(5,591)	(12,398)	(11,079)
Income from operations	$ 17,506	$ (34,467)	$ (19,448)	$ (66,231)

Revenue from Contracts with C_3

Revenue from Contracts with Customers (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Disaggregation of Revenue [Line Items]
Total net operating revenues	$ 1,232,718	$ 1,361,364	$ 2,647,350	$ 2,685,995
Patient services revenue
Disaggregation of Revenue [Line Items]
Total net operating revenues	1,140,656	1,262,397	2,443,527	2,484,729
Medicare
Disaggregation of Revenue [Line Items]
Total net operating revenues	307,324	345,291	680,889	698,872
Non-Medicare
Disaggregation of Revenue [Line Items]
Total net operating revenues	833,332	917,106	1,762,638	1,785,857
Other revenues
Disaggregation of Revenue [Line Items]
Total net operating revenues	92,062	98,967	203,823	201,266
Operating Segments | Critical Illness Recovery Hospital
Disaggregation of Revenue [Line Items]
Total net operating revenues	519,626	461,143	1,020,147	918,677
Operating Segments | Critical Illness Recovery Hospital | Patient services revenue
Disaggregation of Revenue [Line Items]
Total net operating revenues	516,573	458,304	1,014,029	913,432
Operating Segments | Critical Illness Recovery Hospital | Medicare
Disaggregation of Revenue [Line Items]
Total net operating revenues	215,508	223,688	457,017	461,857
Operating Segments | Critical Illness Recovery Hospital | Non-Medicare
Disaggregation of Revenue [Line Items]
Total net operating revenues	301,065	234,616	557,012	451,575
Operating Segments | Critical Illness Recovery Hospital | Other revenues
Disaggregation of Revenue [Line Items]
Total net operating revenues	3,053	2,839	6,118	5,245
Operating Segments | Rehabilitation Hospital
Disaggregation of Revenue [Line Items]
Total net operating revenues	168,667	160,374	350,686	314,932
Operating Segments | Rehabilitation Hospital | Patient services revenue
Disaggregation of Revenue [Line Items]
Total net operating revenues	159,207	151,232	331,395	296,453
Operating Segments | Rehabilitation Hospital | Medicare
Disaggregation of Revenue [Line Items]
Total net operating revenues	71,510	77,260	162,262	151,839
Operating Segments | Rehabilitation Hospital | Non-Medicare
Disaggregation of Revenue [Line Items]
Total net operating revenues	87,697	73,972	169,133	144,614
Operating Segments | Rehabilitation Hospital | Other revenues
Disaggregation of Revenue [Line Items]
Total net operating revenues	9,460	9,142	19,291	18,479
Operating Segments | Outpatient Rehabilitation
Disaggregation of Revenue [Line Items]
Total net operating revenues	167,138	261,891	422,387	508,796
Operating Segments | Outpatient Rehabilitation | Patient services revenue
Disaggregation of Revenue [Line Items]
Total net operating revenues	155,152	242,110	392,874	470,302
Operating Segments | Outpatient Rehabilitation | Medicare
Disaggregation of Revenue [Line Items]
Total net operating revenues	20,049	43,869	60,881	84,147
Operating Segments | Outpatient Rehabilitation | Non-Medicare
Disaggregation of Revenue [Line Items]
Total net operating revenues	135,103	198,241	331,993	386,155
Operating Segments | Outpatient Rehabilitation | Other revenues
Disaggregation of Revenue [Line Items]
Total net operating revenues	11,986	19,781	29,513	38,494
Operating Segments | Concentra
Disaggregation of Revenue [Line Items]
Total net operating revenues	312,338	413,451	710,873	809,772
Operating Segments | Concentra | Patient services revenue
Disaggregation of Revenue [Line Items]
Total net operating revenues	309,724	410,751	705,229	804,542
Operating Segments | Concentra | Medicare
Disaggregation of Revenue [Line Items]
Total net operating revenues	257	474	729	1,029
Operating Segments | Concentra | Non-Medicare
Disaggregation of Revenue [Line Items]
Total net operating revenues	309,467	410,277	704,500	803,513
Operating Segments | Concentra | Other revenues
Disaggregation of Revenue [Line Items]
Total net operating revenues	2,614	2,700	5,644	5,230
Other
Disaggregation of Revenue [Line Items]
Total net operating revenues	64,949	64,505	143,257	133,818
Other | Patient services revenue
Disaggregation of Revenue [Line Items]
Total net operating revenues	0	0	0	0
Other | Medicare
Disaggregation of Revenue [Line Items]
Total net operating revenues	0	0	0	0
Other | Non-Medicare
Disaggregation of Revenue [Line Items]
Total net operating revenues	0	0	0	0
Other | Other revenues
Disaggregation of Revenue [Line Items]
Total net operating revenues	$ 64,949	$ 64,505	$ 143,257	$ 133,818

Earnings per Share - Narrative

Earnings per Share - Narrative (Details) - $ / shares	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Earnings Per Share [Abstract]
Dividends declared and contractual dividends paid, basic (in dollars per share)	$ 0	$ 0	$ 0	$ 0
Dividends declared and contractual dividends paid, diluted (in dollars per share)	$ 0	$ 0	$ 0	$ 0

Earnings per Share - Net Income

Earnings per Share - Net Income Attributable to the Company, Common Shares Outstanding, and Participating Securities Outstanding (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2019	Mar. 31, 2019	Jun. 30, 2020	Jun. 30, 2019
Earnings Per Share [Abstract]
Net income	$ 67,486		$ 59,986		$ 137,934	$ 113,330
Less: Net income attributable to non-controlling interests	15,836		15,170		33,159	27,680
Net income attributable to Select Medical Holdings Corporation	51,650	$ 53,125	44,816	$ 40,834	104,775	85,650
Basic EPS
Less: net income attributable to participating securities	1,778		1,484		3,596	2,827
Net income attributable to common shares	49,872		43,332		101,179	82,823
Diluted EPS
Less: net income attributable to participating securities	1,778		1,484		3,596	2,826
Net income attributable to common shares	$ 49,872		$ 43,332		$ 101,179	$ 82,824

Earnings per Share - Computatio

Earnings per Share - Computation of EPS Under the Two-Class Method (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2019	Mar. 31, 2019	Jun. 30, 2020	Jun. 30, 2019
Net Income Allocation, Basic [Abstract]
Net income allocated to common shares	$ 49,872		$ 43,332		$ 101,179	$ 82,823
Net income allocated to participating securities	1,778		1,484		3,596	2,827
Net Income Allocation, Diluted [Abstract]
Net income attributable to common shares	49,872		43,332		101,179	82,824
Net income allocated to participating securities	1,778		1,484		3,596	2,826
Net income attributable to Select Medical Holdings Corporation	$ 51,650	$ 53,125	$ 44,816	$ 40,834	$ 104,775	$ 85,650
Weighted average common shares outstanding, basic (in shares)	129,319		130,525		129,479	130,672
Weighted average common shares outstanding, diluted (in shares)	129,319		130,562		129,479	130,711
Weighted average participating securities outstanding (in shares)	4,610		4,471		4,602	4,460
Basic EPS
Basic EPS (in dollars per share)	$ 0.39		$ 0.33		$ 0.78	$ 0.63
Diluted EPS
Diluted EPS (in dollars per share)	$ 0.39		$ 0.33		$ 0.78	$ 0.63

Commitments and Contingencies -

Commitments and Contingencies - Litigation (Details) - Professional liability claims $ in Millions	6 Months Ended
	Jun. 30, 2020USD ($)
Joint Venture Operations
Commitments and Contingencies
Total annual aggregate limit of insurance coverage	$ 80
Maximum
Commitments and Contingencies
Total annual aggregate limit of insurance coverage	40
Maximum | Joint Venture Operations
Commitments and Contingencies
Total annual aggregate limit of insurance coverage	33
Minimum | Joint Venture Operations
Commitments and Contingencies
Total annual aggregate limit of insurance coverage	$ 23

CARES Act (Details)

CARES Act (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2020	Jun. 30, 2020	Apr. 30, 2020	Dec. 31, 2019
Unusual or Infrequent Items, or Both [Abstract]
Government assistance, provider relief payments received, CARES Act		$ 100,500
Government assistance recognized in earnings, CARES Act	$ 55,000		$ 55,000
Unearned government assistance, CARES Act	45,505	45,505	45,505		$ 0
Government advances, CARES Act	316,992	316,992	316,992	$ 317,000	$ 0
Deferred payroll taxes, CARES Act	$ 33,100	$ 33,100	$ 33,100

Income Taxes (Details)

Income Taxes (Details) $ in Millions	Mar. 27, 2020USD ($)
Income Tax Disclosure [Abstract]
Increase in deferred income taxes	$ 15.5
Decrease in current income taxes payable	$ 15.5