Cover
Cover - shares | 6 Months Ended | |
Jun. 30, 2021 | Jul. 31, 2021 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Jun. 30, 2021 | |
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 $0.001 per share | |
Trading Symbol | SEM | |
Security Exchange Name | NYSE | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding | 134,576,139 | |
Current Fiscal Year End Date | --12-31 | |
Amendment Flag | false | |
Document Fiscal Year Focus | 2021 | |
Document Fiscal Period Focus | Q2 | |
Entity Central Index Key | 0001320414 |
Condensed Consolidated Balance
Condensed Consolidated Balance Sheets (unaudited) - USD ($) $ in Thousands | Jun. 30, 2021 | Dec. 31, 2020 |
Current Assets: | ||
Cash and cash equivalents | $ 803,493 | $ 577,061 |
Accounts receivable | 931,179 | 896,763 |
Prepaid income taxes | 5,417 | 5,686 |
Other current assets | 128,081 | 114,490 |
Total Current Assets | 1,868,170 | 1,594,000 |
Operating lease right-of-use assets | 1,053,331 | 1,032,217 |
Property and equipment, net | 928,226 | 943,420 |
Goodwill | 3,391,040 | 3,379,014 |
Identifiable intangible assets, net | 380,302 | 387,541 |
Other assets | 335,310 | 319,207 |
Total Assets | 7,956,379 | 7,655,399 |
Current Liabilities: | ||
Current operating lease liabilities | 224,868 | 220,413 |
Current portion of long-term debt and notes payable | 11,608 | 12,621 |
Accounts payable | 187,736 | 177,087 |
Accrued payroll | 246,960 | 224,876 |
Accrued vacation | 146,790 | 132,811 |
Accrued interest | 28,938 | 29,240 |
Accrued other | 256,095 | 228,948 |
Government advances (Note 15) | 251,272 | 321,807 |
Unearned government assistance (Note 15) | 4,099 | 82,607 |
Income taxes payable | 50,662 | 7,956 |
Total Current Liabilities | 1,409,028 | 1,438,366 |
Non-current operating lease liabilities | 893,478 | 875,367 |
Long-term debt, net of current portion | 3,386,214 | 3,389,398 |
Non-current deferred tax liability | 123,559 | 132,421 |
Other non-current liabilities | 172,656 | 168,703 |
Total Liabilities | 5,984,935 | 6,004,255 |
Commitments and contingencies (Note 14) | ||
Redeemable non-controlling interests | 521,552 | 398,171 |
Stockholders’ Equity: | ||
Common stock, $0.001 par value, 700,000,000 shares authorized, 134,850,735 and 135,005,369 shares issued and outstanding at 2020 and 2021, respectively | 135 | 135 |
Capital in excess of par | 516,172 | 509,128 |
Retained earnings | 713,191 | 553,244 |
Accumulated other comprehensive income (loss) | 4,727 | (2,027) |
Total Stockholders’ Equity | 1,234,225 | 1,060,480 |
Non-controlling interests | 215,667 | 192,493 |
Total Equity | 1,449,892 | 1,252,973 |
Total Liabilities and Equity | $ 7,956,379 | $ 7,655,399 |
Condensed Consolidated Balanc_2
Condensed Consolidated Balance Sheets (unaudited) (Parenthetical) - $ / shares | Jun. 30, 2021 | Dec. 31, 2020 |
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) | 135,005,369 | 134,850,735 |
Common stock, shares outstanding (in shares) | 135,005,369 | 134,850,735 |
Condensed Consolidated Statemen
Condensed Consolidated Statements of Operations (unaudited) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2021 | Jun. 30, 2020 | Jun. 30, 2021 | Jun. 30, 2020 | |
Income Statement [Abstract] | ||||
Revenue | $ 1,564,020 | $ 1,232,718 | $ 3,110,483 | $ 2,647,350 |
Costs and expenses: | ||||
Cost of services, exclusive of depreciation and amortization | 1,291,448 | 1,082,456 | 2,584,897 | 2,282,827 |
General and administrative | 35,737 | 33,461 | 71,140 | 67,292 |
Depreciation and amortization | 50,954 | 52,271 | 100,574 | 104,023 |
Total costs and expenses | 1,378,139 | 1,168,188 | 2,756,611 | 2,454,142 |
Other operating income | 98,087 | 54,988 | 132,108 | 54,988 |
Income from operations | 283,968 | 119,518 | 485,980 | 248,196 |
Other income and expense: | ||||
Equity in earnings of unconsolidated subsidiaries | 11,809 | 8,324 | 21,728 | 10,912 |
Gain on sale of businesses | 0 | 346 | 0 | 7,547 |
Interest income | 0 | 0 | 4,749 | 0 |
Interest expense | (33,888) | (37,366) | (68,290) | (83,473) |
Income before income taxes | 261,889 | 90,822 | 444,167 | 183,182 |
Income tax expense | 65,681 | 23,336 | 110,745 | 45,248 |
Net income | 196,208 | 67,486 | 333,422 | 137,934 |
Less: Net income attributable to non-controlling interests | 31,314 | 15,836 | 57,982 | 33,159 |
Net income attributable to Select Medical Holdings Corporation | $ 164,894 | $ 51,650 | $ 275,440 | $ 104,775 |
Earnings per common share (Note 13): | ||||
Basic (in dollars per share) | $ 1.22 | $ 0.39 | $ 2.04 | $ 0.78 |
Diluted (in dollars per share) | $ 1.22 | $ 0.39 | $ 2.04 | $ 0.78 |
Condensed Consolidated Statem_2
Condensed Consolidated Statements of Comprehensive Income (unaudited) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2021 | Jun. 30, 2020 | Jun. 30, 2021 | Jun. 30, 2020 | |
Statement of Comprehensive Income [Abstract] | ||||
Net income | $ 196,208 | $ 67,486 | $ 333,422 | $ 137,934 |
Other comprehensive income (loss), net of tax: | ||||
Gain (loss) on interest rate cap cash flow hedge | (1,403) | 0 | 6,748 | 0 |
Reclassification adjustment for (gains) losses included in net income | 6 | 0 | 6 | 0 |
Net change, net of tax benefit (expense) | (1,397) | 0 | 6,754 | 0 |
Comprehensive income | 194,811 | 67,486 | 340,176 | 137,934 |
Less: Comprehensive income attributable to non-controlling interests | 31,314 | 15,836 | 57,982 | 33,159 |
Comprehensive income attributable to Select Medical Holdings Corporation | $ 163,497 | $ 51,650 | $ 282,194 | $ 104,775 |
Condensed Consolidated Statem_3
Condensed Consolidated Statements of Comprehensive Income (unaudited) (Parenthetical) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2021 | Jun. 30, 2020 | Jun. 30, 2021 | Jun. 30, 2020 | |
Statement of Comprehensive Income [Abstract] | ||||
Tax benefit (expense) on components of other comprehensive income | $ 486 | $ 0 | $ (2,348) | $ 0 |
Condensed Consolidated Statem_4
Condensed Consolidated Statements of Changes in Equity and Income (unaudited) - USD ($) $ in Thousands | Total | Total Stockholders’ Equity | Common Stock | Capital in Excess of Par | Retained Earnings | Accumulated Other Comprehensive Income (Loss) | Non-controlling Interests |
Beginning balance (in shares) at Dec. 31, 2019 | 134,328,000 | ||||||
Beginning balance at Dec. 31, 2019 | $ 929,035 | $ 770,972 | $ 134 | $ 491,038 | $ 279,800 | $ 0 | $ 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) | (8,691) | $ 0 | (5,350) | (3,341) | ||
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 value adjustment on non-controlling interests | (10,123) | (10,123) | (10,123) | ||||
Other | 365 | (55) | (55) | 420 | |||
Ending balance (in shares) at Mar. 31, 2020 | 133,823,000 | ||||||
Ending balance at Mar. 31, 2020 | 974,819 | 808,638 | $ 134 | 491,824 | 316,680 | 0 | 166,181 |
Beginning balance (in shares) at Dec. 31, 2019 | 134,328,000 | ||||||
Beginning balance at Dec. 31, 2019 | 929,035 | 770,972 | $ 134 | 491,038 | 279,800 | 0 | 158,063 |
Increase (Decrease) in Stockholders' Equity | |||||||
Net income attributable to Select Medical Holdings Corporation | 104,775 | ||||||
Ending balance (in shares) at Jun. 30, 2020 | 133,970,000 | ||||||
Ending balance at Jun. 30, 2020 | 1,172,430 | 992,883 | $ 134 | 496,785 | 495,964 | 0 | 179,547 |
Beginning balance (in shares) at Mar. 31, 2020 | 133,823,000 | ||||||
Beginning balance at Mar. 31, 2020 | 974,819 | 808,638 | $ 134 | 491,824 | 316,680 | 0 | 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) | (724) | $ 0 | (441) | (283) | ||
Issuance of non-controlling interests | 7 | 0 | 7 | ||||
Distributions to and purchases of non-controlling interests | (483) | (65) | (65) | (418) | |||
Redemption value adjustment on non-controlling interests | 127,916 | 127,916 | 127,916 | ||||
Other | 411 | (794) | (795) | 1 | 1,205 | ||
Ending balance (in shares) at Jun. 30, 2020 | 133,970,000 | ||||||
Ending balance at Jun. 30, 2020 | $ 1,172,430 | 992,883 | $ 134 | 496,785 | 495,964 | 0 | 179,547 |
Beginning balance (in shares) at Dec. 31, 2020 | 134,850,735 | 134,850,000 | |||||
Beginning balance at Dec. 31, 2020 | $ 1,252,973 | 1,060,480 | $ 135 | 509,128 | 553,244 | (2,027) | 192,493 |
Increase (Decrease) in Stockholders' Equity | |||||||
Net income attributable to Select Medical Holdings Corporation | 110,546 | 110,546 | 110,546 | ||||
Net income attributable to non-controlling interests | 17,042 | 17,042 | |||||
Issuance of restricted stock (in shares) | 2,000 | ||||||
Issuance of restricted stock | 0 | $ 0 | 0 | ||||
Forfeitures of unvested restricted stock (in shares) | (14,000) | ||||||
Forfeitures of unvested restricted stock | 0 | $ 0 | 0 | ||||
Vesting of restricted stock | 6,173 | 6,173 | 6,173 | ||||
Non-controlling interests acquired in business combination | 8,193 | 8,193 | |||||
Distributions to and purchases of non-controlling interests | (14,245) | (787) | (787) | (13,458) | |||
Redemption value adjustment on non-controlling interests | (38,405) | (38,405) | (38,405) | ||||
Other comprehensive income (loss) | 8,151 | 8,151 | 8,151 | ||||
Other | 189 | (182) | (178) | (4) | 371 | ||
Ending balance (in shares) at Mar. 31, 2021 | 134,838,000 | ||||||
Ending balance at Mar. 31, 2021 | $ 1,350,617 | 1,145,976 | $ 135 | 514,336 | 625,381 | 6,124 | 204,641 |
Beginning balance (in shares) at Dec. 31, 2020 | 134,850,735 | 134,850,000 | |||||
Beginning balance at Dec. 31, 2020 | $ 1,252,973 | 1,060,480 | $ 135 | 509,128 | 553,244 | (2,027) | 192,493 |
Increase (Decrease) in Stockholders' Equity | |||||||
Net income attributable to Select Medical Holdings Corporation | $ 275,440 | ||||||
Ending balance (in shares) at Jun. 30, 2021 | 135,005,369 | 135,005,000 | |||||
Ending balance at Jun. 30, 2021 | $ 1,449,892 | 1,234,225 | $ 135 | 516,172 | 713,191 | 4,727 | 215,667 |
Beginning balance (in shares) at Mar. 31, 2021 | 134,838,000 | ||||||
Beginning balance at Mar. 31, 2021 | 1,350,617 | 1,145,976 | $ 135 | 514,336 | 625,381 | 6,124 | 204,641 |
Increase (Decrease) in Stockholders' Equity | |||||||
Net income attributable to Select Medical Holdings Corporation | 164,894 | 164,894 | 164,894 | ||||
Net income attributable to non-controlling interests | 13,241 | 13,241 | |||||
Dividends declared for common stockholders ($0.125 per share) | (16,876) | (16,876) | (16,876) | ||||
Issuance of restricted stock (in shares) | 211,000 | ||||||
Issuance of restricted stock | 0 | $ 0 | 0 | ||||
Forfeitures of unvested restricted stock (in shares) | (2,000) | ||||||
Forfeitures of unvested restricted stock | 0 | $ 0 | 0 | ||||
Vesting of restricted stock | 6,564 | 6,564 | 6,564 | ||||
Repurchase of common shares (in shares) | (42,000) | ||||||
Repurchase of common shares | (1,610) | (1,610) | $ 0 | (707) | (903) | ||
Issuance of non-controlling interests | 5,688 | (1,051) | (1,051) | 6,739 | |||
Distributions to and purchases of non-controlling interests | (12,294) | (2,970) | (2,970) | (9,324) | |||
Redemption value adjustment on non-controlling interests | (59,370) | (59,370) | (59,370) | ||||
Other comprehensive income (loss) | (1,397) | (1,397) | (1,397) | ||||
Other | $ 435 | 65 | 65 | 370 | |||
Ending balance (in shares) at Jun. 30, 2021 | 135,005,369 | 135,005,000 | |||||
Ending balance at Jun. 30, 2021 | $ 1,449,892 | $ 1,234,225 | $ 135 | $ 516,172 | $ 713,191 | $ 4,727 | $ 215,667 |
Condensed Consolidated Statem_5
Condensed Consolidated Statements of Changes in Equity and Income (unaudited) (Parenthetical) | 3 Months Ended |
Jun. 30, 2021$ / shares | |
Statement of Stockholders' Equity [Abstract] | |
Cash dividend declared (in dollars per share) | $ 0.125 |
Condensed Consolidated Statem_6
Condensed Consolidated Statements of Cash Flows (unaudited) - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2021 | Jun. 30, 2020 | |
Operating activities | ||
Net income | $ 333,422 | $ 137,934 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Distributions from unconsolidated subsidiaries | 19,384 | 11,223 |
Depreciation and amortization | 100,574 | 104,023 |
Provision for expected credit losses | 212 | 253 |
Equity in earnings of unconsolidated subsidiaries | (21,728) | (10,912) |
Loss (gain) on sale or disposal of assets and businesses | 494 | (7,881) |
Stock compensation expense | 13,808 | 13,866 |
Amortization of debt discount, premium and issuance costs | 1,095 | 1,093 |
Deferred income taxes | (8,323) | (3,416) |
Changes in operating assets and liabilities, net of effects of business combinations: | ||
Accounts receivable | (31,751) | 13,179 |
Other current assets | (12,856) | 713 |
Other assets | (11,984) | 11,504 |
Accounts payable | 18,881 | 4,251 |
Accrued expenses | 71,034 | 4,028 |
Government advances | (73,703) | 316,992 |
Unearned government assistance | (78,509) | 45,505 |
Income taxes | 42,976 | 43,743 |
Net cash provided by operating activities | 363,026 | 686,098 |
Investing activities | ||
Business combinations, net of cash acquired | (10,081) | (6,961) |
Purchases of property and equipment | (76,442) | (71,253) |
Investment in businesses | (11,185) | (14,749) |
Proceeds from sale of assets and businesses | 9,463 | 12,401 |
Net cash used in investing activities | (88,245) | (80,562) |
Financing activities | ||
Borrowings on revolving facilities | 0 | 470,000 |
Payments on revolving facilities | 0 | (470,000) |
Payments on term loans | 0 | (39,843) |
Borrowings of other debt | 8,915 | 31,487 |
Principal payments on other debt | (15,314) | (35,733) |
Dividends paid to common stockholders | (16,876) | 0 |
Repurchase of common stock | (1,610) | (9,415) |
Proceeds from issuance of non-controlling interests | 5,688 | 1,686 |
Distributions to and purchases of non-controlling interests | (29,152) | (13,660) |
Purchase of membership interests of Concentra Group Holdings Parent | 0 | (366,203) |
Net cash provided by (used in) financing activities | (48,349) | (431,681) |
Net increase in cash and cash equivalents | 226,432 | 173,855 |
Cash and cash equivalents at beginning of period | 577,061 | 335,882 |
Cash and cash equivalents at end of period | 803,493 | 509,737 |
Supplemental Information | ||
Cash paid for interest | 66,955 | 86,124 |
Cash paid for taxes | $ 76,094 | $ 4,920 |
Basis of Presentation
Basis of Presentation | 6 Months Ended |
Jun. 30, 2021 | |
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, 2021, and for the three and six month periods ended June 30, 2020 and 2021, have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (the “SEC”) for interim reporting and the 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 the 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, 2021, are not necessarily indicative of the results to be expected for the full fiscal year ending December 31, 2021. 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, 2020, contained in the Company’s Annual Report on Form 10-K filed with the SEC on February 25, 2021. |
Accounting Policies
Accounting Policies | 6 Months Ended |
Jun. 30, 2021 | |
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, liabilities, revenues, and expenses. Actual results could differ from those estimates. Recent Accounting Pronouncements Convertible Instruments and Contracts on an Entity’s Own Equity In August 2020, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity. The ASU simplifies the accounting for certain financial instruments with characteristics of liabilities and equity, including convertible instruments and contracts on an entity’s own equity. As part of this update, convertible instruments are to be included in diluted earnings per share using the if-converted method, rather than the treasury stock method. Further, contracts which can be settled in cash or shares, excluding liability-classified share-based payment awards, are to be included in diluted earnings per share on an if-converted basis if the effect is dilutive, regardless of whether the entity or the counterparty can choose between cash and share settlement. The share-settlement presumption may not be rebutted based on past experience or a stated policy. This pronouncement is effective for fiscal years, and for interim periods within those fiscal years, beginning after December 15, 2021. The Company plans to adopt this pronouncement as of January 1, 2022. The use of either the modified retrospective or fully retrospective method of transition is permitted. |
Credit Risk Concentrations
Credit Risk Concentrations | 6 Months Ended |
Jun. 30, 2021 | |
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 receivable. 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. Because of the diversity in the Company’s non-governmental third-party payor base, as well as their geographic dispersion, accounts receivable due from the Medicare program represent the Company’s only significant concentration of credit risk. Approximately 18% and 15% of the Company’s accounts receivable is due from Medicare at December 31, 2020, and June 30, 2021, respectively. |
Redeemable Non-Controlling Inte
Redeemable Non-Controlling Interests | 6 Months Ended |
Jun. 30, 2021 | |
Noncontrolling Interest [Abstract] | |
Redeemable Non-Controlling Interests | Redeemable Non-Controlling Interests The ownership interests held by outside parties in subsidiaries, which include 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, after the attribution of net income or loss. The Company’s redeemable non-controlling interests are comprised primarily of the voting membership interests owned by outside members of Concentra Group Holdings Parent, each of which have put rights with respect to their interests in Concentra Group Holdings Parent. The changes in redeemable non-controlling interests were as follows: Six Months Ended June 30, 2020 2021 (in thousands) Balance as of January 1 $ 974,541 $ 398,171 Net income attributable to redeemable non-controlling interests 7,256 9,626 Distributions to and purchases of redeemable non-controlling interests (5,687) (614) Purchase of membership interests of Concentra Group Holdings Parent (366,203) — Redemption value adjustment on redeemable non-controlling interests 10,123 38,405 Other 347 343 Balance as of March 31 $ 620,377 $ 445,931 Net income attributable to redeemable non-controlling interests 3,264 18,073 Distributions to and purchases of redeemable non-controlling interests (30) (1,987) Redemption value adjustment on redeemable non-controlling interests (127,916) 59,370 Other 292 165 Balance as of June 30 $ 495,987 $ 521,552 |
Variable Interest Entities
Variable Interest Entities | 6 Months Ended |
Jun. 30, 2021 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Variable Interest Entities | Variable Interest Entities Certain states prohibit the “corporate practice of medicine,” which restricts the Company from owning medical practices which directly employ physicians and from exercising control over medical decisions by physicians. In these states, the Company enters into long-term management agreements with medical practices that are owned by licensed physicians, which, in turn, employ or contract with physicians who provide professional medical services. The management agreements provide for the Company to direct the transfer of ownership of the medical practices to new licensed physicians at any time. Based on the provisions of the management agreements, the medical practices are variable interest entities for which the Company is the primary beneficiary. As of December 31, 2020 and June 30, 2021, the total assets of the Company’s variable interest entities were $208.4 million and $242.3 million, respectively, and are principally comprised of accounts receivable. As of December 31, 2020 and June 30, 2021, the total liabilities of these variable interest entities were $55.1 million and $58.8 million, respectively, and are principally comprised of accounts payable and accrued expenses. The Company’s variable interest entities have obligations payable for services received under the aforementioned management agreements of $151.8 million and $182.1 million as of December 31, 2020 and June 30, 2021, respectively; these intercompany balances are eliminated in consolidation. |
Leases
Leases | 6 Months Ended |
Jun. 30, 2021 | |
Leases [Abstract] | |
Leases | Leases The Company has operating and finance leases for its facilities. The Company leases its corporate office space from related parties. The Company’s total lease cost was as follows: Three Months Ended June 30, 2020 Three Months Ended June 30, 2021 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 69,367 $ 1,787 $ 71,154 $ 70,739 $ 1,798 $ 72,537 Finance lease cost: Amortization of right-of-use assets 69 — 69 105 — 105 Interest on lease liabilities 231 — 231 254 — 254 Variable lease cost 11,780 112 11,892 13,086 141 13,227 Sublease income (2,621) — (2,621) (2,229) — (2,229) Total lease cost $ 78,826 $ 1,899 $ 80,725 $ 81,955 $ 1,939 $ 83,894 Six Months Ended June 30, 2020 Six Months Ended June 30, 2021 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 139,159 $ 3,520 $ 142,679 $ 140,853 $ 3,597 $ 144,450 Finance lease cost: Amortization of right-of-use assets 131 — 131 140 — 140 Interest on lease liabilities 487 — 487 505 — 505 Variable lease cost 24,012 268 24,280 26,095 144 26,239 Sublease income (5,176) — (5,176) (4,463) — (4,463) Total lease cost $ 158,613 $ 3,788 $ 162,401 $ 163,130 $ 3,741 $ 166,871 Supplemental cash flow information related to leases was as follows: Six Months Ended June 30, 2020 2021 (in thousands) Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 140,300 $ 145,652 Operating cash flows for finance leases 487 505 Financing cash flows for finance leases 89 145 Right-of-use assets obtained in exchange for lease liabilities: Operating leases $ 132,125 $ 138,606 Finance leases 989 138 Supplemental balance sheet information related to leases was as follows: December 31, 2020 June 30, 2021 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating Leases Operating lease right-of-use assets $ 1,002,151 $ 30,066 $ 1,032,217 $ 1,026,058 $ 27,273 $ 1,053,331 Current operating lease liabilities $ 214,377 $ 6,036 $ 220,413 $ 218,723 $ 6,145 $ 224,868 Non-current operating lease liabilities 848,215 27,152 875,367 869,421 24,057 893,478 Total operating lease liabilities $ 1,062,592 $ 33,188 $ 1,095,780 $ 1,088,144 $ 30,202 $ 1,118,346 December 31, 2020 June 30, 2021 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Finance Leases Property and equipment, net $ 5,644 $ — $ 5,644 $ 5,711 $ — $ 5,711 Current portion of long-term debt and notes payable $ 663 $ — $ 663 $ 638 $ — $ 638 Long-term debt, net of current portion 13,491 — 13,491 13,509 — 13,509 Total finance lease liabilities $ 14,154 $ — $ 14,154 $ 14,147 $ — $ 14,147 The weighted average remaining lease terms and discount rates were as follows: December 31, 2020 June 30, 2021 Weighted average remaining lease term (in years): Operating leases 7.8 7.8 Finance leases 31.2 30.6 Weighted average discount rate: Operating leases 5.6 % 5.5 % Finance leases 7.2 % 7.2 % As of June 30, 2021, maturities of lease liabilities were approximately as follows: Operating Leases Finance Leases (in thousands) 2021 (remainder of year) $ 143,539 $ 790 2022 258,011 1,699 2023 211,514 1,710 2024 172,183 1,381 2025 138,429 1,205 Thereafter 533,811 29,019 Total undiscounted cash flows 1,457,487 35,804 Less: Imputed interest 339,141 21,657 Total discounted lease liabilities $ 1,118,346 $ 14,147 |
Leases | Leases The Company has operating and finance leases for its facilities. The Company leases its corporate office space from related parties. The Company’s total lease cost was as follows: Three Months Ended June 30, 2020 Three Months Ended June 30, 2021 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 69,367 $ 1,787 $ 71,154 $ 70,739 $ 1,798 $ 72,537 Finance lease cost: Amortization of right-of-use assets 69 — 69 105 — 105 Interest on lease liabilities 231 — 231 254 — 254 Variable lease cost 11,780 112 11,892 13,086 141 13,227 Sublease income (2,621) — (2,621) (2,229) — (2,229) Total lease cost $ 78,826 $ 1,899 $ 80,725 $ 81,955 $ 1,939 $ 83,894 Six Months Ended June 30, 2020 Six Months Ended June 30, 2021 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 139,159 $ 3,520 $ 142,679 $ 140,853 $ 3,597 $ 144,450 Finance lease cost: Amortization of right-of-use assets 131 — 131 140 — 140 Interest on lease liabilities 487 — 487 505 — 505 Variable lease cost 24,012 268 24,280 26,095 144 26,239 Sublease income (5,176) — (5,176) (4,463) — (4,463) Total lease cost $ 158,613 $ 3,788 $ 162,401 $ 163,130 $ 3,741 $ 166,871 Supplemental cash flow information related to leases was as follows: Six Months Ended June 30, 2020 2021 (in thousands) Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 140,300 $ 145,652 Operating cash flows for finance leases 487 505 Financing cash flows for finance leases 89 145 Right-of-use assets obtained in exchange for lease liabilities: Operating leases $ 132,125 $ 138,606 Finance leases 989 138 Supplemental balance sheet information related to leases was as follows: December 31, 2020 June 30, 2021 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating Leases Operating lease right-of-use assets $ 1,002,151 $ 30,066 $ 1,032,217 $ 1,026,058 $ 27,273 $ 1,053,331 Current operating lease liabilities $ 214,377 $ 6,036 $ 220,413 $ 218,723 $ 6,145 $ 224,868 Non-current operating lease liabilities 848,215 27,152 875,367 869,421 24,057 893,478 Total operating lease liabilities $ 1,062,592 $ 33,188 $ 1,095,780 $ 1,088,144 $ 30,202 $ 1,118,346 December 31, 2020 June 30, 2021 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Finance Leases Property and equipment, net $ 5,644 $ — $ 5,644 $ 5,711 $ — $ 5,711 Current portion of long-term debt and notes payable $ 663 $ — $ 663 $ 638 $ — $ 638 Long-term debt, net of current portion 13,491 — 13,491 13,509 — 13,509 Total finance lease liabilities $ 14,154 $ — $ 14,154 $ 14,147 $ — $ 14,147 The weighted average remaining lease terms and discount rates were as follows: December 31, 2020 June 30, 2021 Weighted average remaining lease term (in years): Operating leases 7.8 7.8 Finance leases 31.2 30.6 Weighted average discount rate: Operating leases 5.6 % 5.5 % Finance leases 7.2 % 7.2 % As of June 30, 2021, maturities of lease liabilities were approximately as follows: Operating Leases Finance Leases (in thousands) 2021 (remainder of year) $ 143,539 $ 790 2022 258,011 1,699 2023 211,514 1,710 2024 172,183 1,381 2025 138,429 1,205 Thereafter 533,811 29,019 Total undiscounted cash flows 1,457,487 35,804 Less: Imputed interest 339,141 21,657 Total discounted lease liabilities $ 1,118,346 $ 14,147 |
Intangible Assets
Intangible Assets | 6 Months Ended |
Jun. 30, 2021 | |
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, 2021: Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Total (in thousands) Balance as of December 31, 2020 $ 1,084,761 $ 432,753 $ 646,433 $ 1,215,067 $ 3,379,014 Acquisition of businesses — 9,402 1,436 1,188 12,026 Balance as of June 30, 2021 $ 1,084,761 $ 442,155 $ 647,869 $ 1,216,255 $ 3,391,040 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, 2020 June 30, 2021 Gross Accumulated Net Gross Accumulated Net (in thousands) Indefinite-lived intangible assets: Trademarks $ 166,698 $ — $ 166,698 $ 166,698 $ — $ 166,698 Certificates of need 18,392 — 18,392 18,413 — 18,413 Accreditations 1,874 — 1,874 1,874 — 1,874 Finite-lived intangible assets: Trademarks 5,000 (5,000) — 5,000 (5,000) — Customer relationships 291,923 (113,346) 178,577 298,514 (126,843) 171,671 Non-compete agreements 33,771 (11,771) 22,000 35,011 (13,365) 21,646 Total identifiable intangible assets $ 517,658 $ (130,117) $ 387,541 $ 525,510 $ (145,208) $ 380,302 The Company’s accreditations and trademarks have renewal terms and the costs to renew these intangible assets are expensed as incurred. At June 30, 2021, the accreditations and trademarks have a weighted average time until next renewal of 1.5 years and 8.2 years, respectively. The Company’s finite-lived intangible assets amortize over their estimated useful lives. Amortization expense was $6.9 million and $7.3 million for the three months ended June 30, 2020 and 2021, respectively. Amortization expense was $13.8 million and $14.4 million for the six months ended June 30, 2020 and 2021, respectively. |
Long-Term Debt and Notes Payabl
Long-Term Debt and Notes Payable | 6 Months Ended |
Jun. 30, 2021 | |
Debt Disclosure [Abstract] | |
Long-Term Debt and Notes Payable | Long-Term Debt and Notes Payable As of June 30, 2021, the Company’s long-term debt and notes payable were as follows: Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value (in thousands) Select 6.250% senior notes $ 1,225,000 $ 30,722 $ (15,463) $ 1,240,259 $ 1,304,625 Select credit facilities: Select term loan 2,103,437 (7,398) (8,064) 2,087,975 2,077,144 Other debt, including finance leases 69,846 — (258) 69,588 69,588 Total debt $ 3,398,283 $ 23,324 $ (23,785) $ 3,397,822 $ 3,451,357 Principal maturities of the Company’s long-term debt and notes payable were approximately as follows: 2021 2022 2023 2024 2025 Thereafter Total (in thousands) 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 9,441 4,035 20,754 23,717 334 11,565 69,846 Total debt $ 9,441 $ 4,035 $ 25,511 $ 34,867 $ 2,087,864 $ 1,236,565 $ 3,398,283 As of December 31, 2020, the Company’s long-term debt and notes payable were as follows: Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value (in thousands) Select 6.250% senior notes $ 1,225,000 $ 33,773 $ (16,953) $ 1,241,820 $ 1,316,875 Select credit facilities: Select term loan 2,103,437 (8,393) (9,149) 2,085,895 2,082,403 Other debt, including finance leases 74,606 — (302) 74,304 74,304 Total debt $ 3,403,043 $ 25,380 $ (26,404) $ 3,402,019 $ 3,473,582 Select Credit Facilities On June 2, 2021, Select entered into Amendment No. 5 to its senior secured credit agreement (the “Select credit agreement”) which, among other things, increased the aggregate commitments available under its revolving credit facility (the “Select revolving facility”) from $450.0 million to $650.0 million, including a $125.0 million sublimit for the issuance of standby letters of credit. Concentra-JPM Revolving Facility |
Interest Rate Cap
Interest Rate Cap | 6 Months Ended |
Jun. 30, 2021 | |
Derivative Instruments and Hedging Activities Disclosure [Abstract] | |
Interest Rate Cap | Interest Rate Cap The Company is subject to market risk exposure arising from changes in interest rates on the Select term loan, which bears interest at a variable interest rate. The Company’s objective in using an interest rate derivative is to mitigate its exposure to increases in interest rates. The interest rate cap limits the Company’s exposure to increases in the reference rate to 1.0% on $2.0 billion of principal outstanding under the Select term loan. The interest rate cap became effective March 31, 2021 for the monthly periods from and including April 30, 2021 through September 30, 2024. The Company will pay a premium for the interest rate cap over the term of the agreement. The annual premium is equal to 0.0916% of the notional amount. The interest rate cap has been designated as a cash flow hedge and is highly effective at offsetting the changes in cash outflows when the reference rate exceeds 1.0%. Changes in the fair value of the interest rate cap, net of tax, are recognized in other comprehensive income and are reclassified out of accumulated other comprehensive income (“AOCI”) and into interest expense when the hedged interest obligations affect earnings. The following table outlines the changes in AOCI: Six Months Ended June 30, 2020 2021 (in thousands) Balance as of January 1 $ — $ (2,027) Gain on interest rate cap cash flow hedge — 8,151 Balance as of March 31 $ — $ 6,124 Loss on interest rate cap cash flow hedge — (1,403) Amounts reclassified from AOCI — 6 Balance as of June 30 $ — $ 4,727 The estimated pre-tax losses expected to be reclassified from AOCI into interest expense within the next twelve months are approximately $0.2 million. |
Fair Value of Financial Instrum
Fair Value of Financial Instruments | 6 Months Ended |
Jun. 30, 2021 | |
Fair Value Disclosures [Abstract] | |
Fair Value of Financial Instruments | Fair Value of Financial Instruments Financial instruments which are measured at fair value, or for which a fair value is disclosed, are classified in the fair value hierarchy, as outlined below, on the basis of the observability of the inputs used in the fair value measurement: • Level 1 – inputs are based upon quoted prices for identical instruments in active markets. • Level 2 – inputs are based upon quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active, and model-based valuation techniques for which all significant inputs are observable in the market or can be corroborated by observable market data. • Level 3 – inputs are generally unobservable and typically reflect management’s estimates of assumptions that market participants would use in pricing the instrument. The Company’s interest rate cap contract is recorded at its fair value on a recurring basis. The fair value of the interest rate cap contract is based upon a model-derived valuation using observable market inputs, such as interest rates and interest rate volatility, and the strike price. Financial Instrument Balance Sheet Classification Level December 31, 2020 June 30, 2021 Asset: (in thousands) Interest rate cap contract, non-current portion Other assets Level 2 $ — $ 8,776 Liability: Interest rate cap contract, current portion Accrued other Level 2 $ 1,339 $ 1,948 Interest rate cap contract, non-current portion Other non-current liabilities Level 2 1,392 — The Company does not measure its indebtedness at fair value in its condensed consolidated balance sheets. The fair value of the Select credit facilities is based on quoted market prices for this debt in the syndicated loan market. The fair value of the senior notes is based on quoted market prices. The carrying value of the Company’s other debt, as disclosed in Note 8 – Long-Term Debt and Notes Payable, approximates fair value. December 31, 2020 June 30, 2021 Financial Instrument Level Carrying Value Fair Value Carrying Value Fair Value (in thousands) Select 6.250% senior notes Level 2 $ 1,241,820 $ 1,316,875 $ 1,240,259 $ 1,304,625 Select credit facilities: Select term loan Level 2 2,085,895 2,082,403 2,087,975 2,077,144 |
Segment Information
Segment Information | 6 Months Ended |
Jun. 30, 2021 | |
Segment Reporting [Abstract] | |
Segment Information | Segment Information The Company’s reportable segments consist of 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. The Company’s other activities also include other operating income related to the recognition of payments received under the Provider Relief Fund for health care related expenses and loss of revenue attributable to the coronavirus disease 2019 (“COVID-19”). Refer to Note 15 – CARES Act for further information. The Company evaluates the performance of its 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, 2020 2021 2020 2021 (in thousands) Revenue: Critical illness recovery hospital $ 519,626 $ 544,059 $ 1,020,147 $ 1,138,931 Rehabilitation hospital 168,667 212,666 350,686 420,470 Outpatient rehabilitation 167,138 280,409 422,387 532,370 Concentra 312,338 456,372 710,873 879,212 Other 64,949 70,514 143,257 139,500 Total Company $ 1,232,718 $ 1,564,020 $ 2,647,350 $ 3,110,483 Adjusted EBITDA: Critical illness recovery hospital $ 89,743 $ 72,904 $ 178,313 $ 186,176 Rehabilitation hospital 27,605 50,768 66,174 101,302 Outpatient rehabilitation (6,282) 45,633 20,840 71,962 Concentra 41,497 137,060 102,963 219,075 Other 26,189 35,656 (2,205) 21,847 Total Company $ 178,752 $ 342,021 $ 366,085 $ 600,362 Total assets: Critical illness recovery hospital $ 2,115,294 $ 2,187,181 $ 2,115,294 $ 2,187,181 Rehabilitation hospital 1,135,206 1,186,886 1,135,206 1,186,886 Outpatient rehabilitation 1,267,308 1,333,661 1,267,308 1,333,661 Concentra 2,351,974 2,518,369 2,351,974 2,518,369 Other 598,676 730,282 598,676 730,282 Total Company $ 7,468,458 $ 7,956,379 $ 7,468,458 $ 7,956,379 Purchases of property and equipment: Critical illness recovery hospital $ 14,970 $ 16,499 $ 23,935 $ 30,884 Rehabilitation hospital 1,923 3,257 5,248 3,922 Outpatient rehabilitation 6,593 7,448 14,977 14,783 Concentra 6,820 7,591 22,406 20,271 Other 1,739 1,928 4,687 6,582 Total Company $ 32,045 $ 36,723 $ 71,253 $ 76,442 A reconciliation of Adjusted EBITDA to income before income taxes is as follows: 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 businesses 346 Interest expense (37,366) Income before income taxes $ 90,822 Three Months Ended June 30, 2021 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 72,904 $ 50,768 $ 45,633 $ 137,060 $ 35,656 Depreciation and amortization (12,936) (6,939) (7,345) (21,230) (2,504) Stock compensation expense — — — (535) (6,564) Income (loss) from operations $ 59,968 $ 43,829 $ 38,288 $ 115,295 $ 26,588 $ 283,968 Equity in earnings of unconsolidated subsidiaries 11,809 Interest expense (33,888) Income before income taxes $ 261,889 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 Six Months Ended June 30, 2021 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 186,176 $ 101,302 $ 71,962 $ 219,075 $ 21,847 Depreciation and amortization (25,986) (13,999) (14,536) (41,128) (4,925) Stock compensation expense — — — (1,071) (12,737) Income (loss) from operations $ 160,190 $ 87,303 $ 57,426 $ 176,876 $ 4,185 $ 485,980 Equity in earnings of unconsolidated subsidiaries 21,728 Interest income 4,749 Interest expense (68,290) Income before income taxes $ 444,167 |
Revenue from Contracts with Cus
Revenue from Contracts with Customers | 6 Months Ended |
Jun. 30, 2021 | |
Revenue from Contract with Customer [Abstract] | |
Revenue from Contracts with Customers | Revenue from Contracts with Customers The following tables disaggregate the Company’s revenue for the three and six months ended June 30, 2020 and 2021: Three Months Ended June 30, 2020 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: 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 revenue 3,053 9,460 11,986 2,614 64,949 92,062 Total revenue $ 519,626 $ 168,667 $ 167,138 $ 312,338 $ 64,949 $ 1,232,718 Three Months Ended June 30, 2021 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 201,198 $ 103,865 $ 45,291 $ 295 $ — $ 350,649 Non-Medicare 340,929 98,443 217,893 454,125 — 1,111,390 Total patient services revenues 542,127 202,308 263,184 454,420 — 1,462,039 Other revenue 1,932 10,358 17,225 1,952 70,514 101,981 Total revenue $ 544,059 $ 212,666 $ 280,409 $ 456,372 $ 70,514 $ 1,564,020 Six Months Ended June 30, 2020 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: 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 revenue 6,118 19,291 29,513 5,644 143,257 203,823 Total revenue $ 1,020,147 $ 350,686 $ 422,387 $ 710,873 $ 143,257 $ 2,647,350 Six Months Ended June 30, 2021 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 433,338 $ 206,240 $ 81,582 $ 525 $ — $ 721,685 Non-Medicare 702,081 193,785 418,712 874,779 — 2,189,357 Total patient services revenues 1,135,419 400,025 500,294 875,304 — 2,911,042 Other revenue 3,512 20,445 32,076 3,908 139,500 199,441 Total revenue $ 1,138,931 $ 420,470 $ 532,370 $ 879,212 $ 139,500 $ 3,110,483 |
Earnings per Share
Earnings per Share | 6 Months Ended |
Jun. 30, 2021 | |
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 contractual dividends paid for the three and six months ended June 30, 2020 and 2021. (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 and Diluted EPS Basic and Diluted EPS Three Months Ended June 30, Six Months Ended June 30, 2020 2021 2020 2021 (in thousands) Net income $ 67,486 $ 196,208 $ 137,934 $ 333,422 Less: net income attributable to non-controlling interests 15,836 31,314 33,159 57,982 Net income attributable to the Company 51,650 164,894 104,775 275,440 Less: Distributed and undistributed income attributable to participating securities 1,778 5,560 3,596 9,250 Distributed and undistributed income attributable to common shares $ 49,872 $ 159,334 $ 101,179 $ 266,190 The following tables set forth the computation of EPS under the two-class method: Three Months Ended June 30, 2020 2021 Net Income Allocation Shares (1) Basic and Diluted EPS Net Income Allocation Shares (1) Basic and Diluted EPS (in thousands, except for per share amounts) Common shares $ 49,872 129,319 $ 0.39 $ 159,334 130,396 $ 1.22 Participating securities 1,778 4,610 0.39 5,560 4,550 1.22 Total Company $ 51,650 $ 164,894 Six Months Ended June 30, 2020 2021 Net Income Allocation Shares (1) Basic and Diluted EPS Net Income Allocation Shares (1) Basic and Diluted EPS (in thousands, except for per share amounts) Common shares $ 101,179 129,479 $ 0.78 $ 266,190 130,362 $ 2.04 Participating securities 3,596 4,602 0.78 9,250 4,530 2.04 Total Company $ 104,775 $ 275,440 _______________________________________________________________________________ (1) Represents the weighted average share count outstanding during the period. |
Commitments and Contingencies
Commitments and Contingencies | 6 Months Ended |
Jun. 30, 2021 | |
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 $37.0 million for professional malpractice liability insurance and $40.0 million for general liability insurance. 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 specific joint ventures. Most of 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 most joint ventures. 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. Contract Therapy Subpoena. In May 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 U.S. Attorney’s Office indicated that the subpoena was issued in connection with a qui tam lawsuit. The Company produced documents in response to the subpoena and fully cooperated with this investigation. In July 2021, the Company entered into a settlement agreement with the United States government, the plaintiff-relator who filed the qui tam lawsuit, and the purchaser of the Company’s contract therapy division in March 2016. In satisfaction of its indemnity obligations under the purchase agreement signed in March 2016, the Company agreed to make payments related to the settlement that will not exceed the amount of a liability accrued, and a non-operating loss incurred, during the nine months ended September 30, 2020. Such payments, in the aggregate, are immaterial to the Company’s financial statements. In the settlement agreement, the government and the plaintiff-relator released the Company from liability for all conduct alleged in the complaint, and the Company admitted no liability or wrongdoing. Oklahoma City Subpoena. On August 24, 2020, the Company and Select Specialty Hospital – Oklahoma City, Inc. (“SSH–Oklahoma City”) received Civil Investigative Demands from the U.S. Attorney’s Office for the Western District of Oklahoma seeking responses to interrogatories and the production of various documents principally relating to the documentation, billing and reviews of medical services furnished to patients at SSH-Oklahoma City. 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 is producing 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. New Jersey Litigation. In December 2020, the United States District Court for the District of New Jersey unsealed a qui tam complaint in United States of America and State of New Jersey ex rel. Keith A. DiLello, Sr. v. Hackensack Meridian Health, Jersey Shore University Medical Center, Ocean Medical Center, Seaview Orthopaedics, Shrewsbury Surgery Center, Kessler Rehabilitation, Dr. Halambros Demetriades, Dr. Theodore Kutzan, Dr. Adam Myers, Dr. Hoan-Vu Nguyen, Dr. Frederick De Paola, ABC Corporations 1-10, and John/Jane Does 1-10, Case 3:20-cv-02949-FLW-ZNQ. The complaint was filed under seal in March 2020 and was unsealed after the United States and State of New Jersey declined to intervene in the case. In the complaint, the plaintiff-relator, an automobile accident victim and former patient of the defendant providers, alleges that they routinely billed both personal injury protection (“PIP”) carriers and CMS. He alleges that they violated federal and state law by billing CMS when other insurance is available and failing to return payment to CMS after payment was made by the PIP carriers. In March 2021, defendant Kessler Rehabilitation waived service of process of the complaint. The Company intends to vigorously defend this action, but at this time the Company is unable to predict the timing and outcome of this matter. Medicare Dual-Eligible Litigation |
CARES Act
CARES Act | 6 Months Ended |
Jun. 30, 2021 | |
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. Since the enactment of the CARES Act, the Company’s consolidated subsidiaries have received approximately $208.4 million of payments from the Public Health and Social Services Emergency Fund, also referred to as the Provider Relief Fund. The Company is able to use payments received under the Provider Relief Fund for “health care related expenses or lost revenues that are attributable to coronavirus.” The Provider Relief Fund payments must first be applied against health care related expenses attributable to COVID-19. Provider Relief Fund payments not fully expended on healthcare related expenses attributable to COVID-19 are then applied to lost revenues. The provisions of the Provider Relief Fund payments permit a parent organization to allocate all or a portion of its general and targeted distributions among its subsidiaries which are eligible health care providers. Since the CARES Act was enacted, the Department of Health and Human Services (“HHS”) has issued a series of post-payment notices of reporting requirements and other guidance which, in some instances, have significantly altered the terms and conditions surrounding the Provider Relief Fund payments. Additionally, certain provisions and reporting requirements associated with the Provider Relief Fund payments were signed into law as part of the Coronavirus Response and Relief Supplemental Appropriations Act of 2021 (“CRRSA Act”) on December 27, 2020. On June 11, 2021, HHS released an updated post-payment notice of reporting requirements and new and modified responses to its Frequently Asked Questions regarding the Provider Relief Fund payments. Among other things, HHS updated the period of time in which recipients must use the Provider Relief Fund payments. Under the revised guidance, the deadlines for utilizing the payments are based on the date in which the payments were received, rather than requiring all payments be used by June 30, 2021. The deadlines to use the Provider Relief Fund payments are now as follows: (i) payments received between April 10, 2020 and June 30, 2020 must have been used by June 30, 2021, (ii) payments received between July 1, 2020 and December 31, 2020 must be used by December 31, 2021, (iii) payments received between January 1, 2021 and June 30, 2021 must be used by June 30, 2022, and (iv) payments received between July 1, 2021 and December 31, 2021 must be used by December 31, 2022. Under the Company’s accounting policy, payments are recognized as other operating income when it is probable that it has complied with the terms and conditions of the payments. The Company evaluated its eligibility to utilize certain Provider Relief Fund payments and whether those payments were used in accordance with the terms and conditions set forth within the CRRSA Act and by HHS as of June 30, 2021. The Company’s assessment of uncertainties surrounding its ability to utilize certain of its Provider Relief Fund payments, including its ability to allocate general distributions among the Company’s subsidiaries, was updated for additional information obtained during the period. Based on this updated assessment, the Company believes it is probable that it has complied with the terms and conditions associated with the Provider Relief Fund payments as of June 30, 2021. During the three and six months ended June 30, 2021, the Company determined that it was eligible to recognize approximately $98.0 million and $114.1 million, respectively, of Provider Relief Fund payments as other operating income on the accompanying condensed consolidated statement of operations. The Company recognized $55.0 million of other operating income during both the three and six months ended June 30, 2020. As of June 30, 2021, $4.1 million of Provider Relief Fund payments have not yet been utilized by the Company in accordance with the regulations promulgated by HHS and the CRRSA Act and are reported as unearned government assistance on the accompanying condensed consolidated balance sheet. Of this amount, $1.7 million will be repaid to the government because the payments could not be utilized by the deadlines specified by HHS. The remaining Provider Relief Fund payments may need to be repaid to the extent they cannot be utilized in accordance with the terms and conditions set forth within the CRRSA Act and by HHS. Further changes to the regulations surrounding the Provider Relief Fund payments or amended interpretations of existing guidance may change the Company’s assessment of whether it is probable that is has complied with the terms of conditions of the Provider Relief Fund payments. These changes may result in the Company being unable to recognize additional Provider Relief Fund payments as other operating income or the reversal of amounts previously recognized. Medicare Accelerated and Advance Payments Program The Company’s consolidated subsidiaries received approximately $325.0 million of advance payments under CMS’s Accelerated and Advance Payment Program, which was temporarily expanded by the CARES Act. Repayment of the advance payments begins one year from the issuance date of the payment. After that first year, the Medicare program automatically recoups 25.0% of the Medicare payments otherwise owed to the provider or supplier for eleven months. At the end of the eleven-month period, recoupment increases to 50.0% for another six months. Any amounts that remain unpaid after 29 months are subject to a 4.0% interest rate. |
Subsequent Event
Subsequent Event | 6 Months Ended |
Jun. 30, 2021 | |
Subsequent Events [Abstract] | |
Subsequent Event | Subsequent Event On August 4, 2021, the Company’s board of directors declared a cash dividend of $0.125 per share. The dividend will be payable on or about August 30, 2021 to stockholders of record as of the close of business on August 18, 2021. |
Accounting Policies (Policies)
Accounting Policies (Policies) | 6 Months Ended |
Jun. 30, 2021 | |
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, liabilities, revenues, and expenses. Actual results could differ from those estimates. |
Recent Accounting Pronouncements | Recent Accounting Pronouncements Convertible Instruments and Contracts on an Entity’s Own Equity In August 2020, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity. The ASU simplifies the accounting for certain financial instruments with characteristics of liabilities and equity, including convertible instruments and contracts on an entity’s own equity. As part of this update, convertible instruments are to be included in diluted earnings per share using the if-converted method, rather than the treasury stock method. Further, contracts which can be settled in cash or shares, excluding liability-classified share-based payment awards, are to be included in diluted earnings per share on an if-converted basis if the effect is dilutive, regardless of whether the entity or the counterparty can choose between cash and share settlement. The share-settlement presumption may not be rebutted based on past experience or a stated policy. This pronouncement is effective for fiscal years, and for interim periods within those fiscal years, beginning after December 15, 2021. The Company plans to adopt this pronouncement as of January 1, 2022. The use of either the modified retrospective or fully retrospective method of transition is permitted. |
Credit Risk Concentrations | Credit Risk ConcentrationsFinancial instruments that potentially subject the Company to concentrations of credit risk consist primarily of cash balances and accounts receivable. 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.Because of the diversity in the Company’s non-governmental third-party payor base, as well as their geographic dispersion, accounts receivable due from the Medicare program represent the Company’s only significant concentration of credit risk. |
Redeemable Non-Controlling Interests | Redeemable Non-Controlling Interests The ownership interests held by outside parties in subsidiaries, which include 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, after the attribution of net income or loss. The Company’s redeemable non-controlling interests are comprised primarily of the voting membership interests owned by outside members of Concentra Group Holdings Parent, each of which have put rights with respect to their interests in Concentra Group Holdings Parent. |
Variable Interest Entities | Variable Interest EntitiesCertain states prohibit the “corporate practice of medicine,” which restricts the Company from owning medical practices which directly employ physicians and from exercising control over medical decisions by physicians. In these states, the Company enters into long-term management agreements with medical practices that are owned by licensed physicians, which, in turn, employ or contract with physicians who provide professional medical services. The management agreements provide for the Company to direct the transfer of ownership of the medical practices to new licensed physicians at any time. Based on the provisions of the management agreements, the medical practices are variable interest entities for which the Company is the primary beneficiary. |
Redeemable Non-Controlling In_2
Redeemable Non-Controlling Interests (Tables) | 6 Months Ended |
Jun. 30, 2021 | |
Noncontrolling Interest [Abstract] | |
Schedule of redeemable non-controlling interests | The changes in redeemable non-controlling interests were as follows: Six Months Ended June 30, 2020 2021 (in thousands) Balance as of January 1 $ 974,541 $ 398,171 Net income attributable to redeemable non-controlling interests 7,256 9,626 Distributions to and purchases of redeemable non-controlling interests (5,687) (614) Purchase of membership interests of Concentra Group Holdings Parent (366,203) — Redemption value adjustment on redeemable non-controlling interests 10,123 38,405 Other 347 343 Balance as of March 31 $ 620,377 $ 445,931 Net income attributable to redeemable non-controlling interests 3,264 18,073 Distributions to and purchases of redeemable non-controlling interests (30) (1,987) Redemption value adjustment on redeemable non-controlling interests (127,916) 59,370 Other 292 165 Balance as of June 30 $ 495,987 $ 521,552 |
Leases (Tables)
Leases (Tables) | 6 Months Ended |
Jun. 30, 2021 | |
Leases [Abstract] | |
Schedule of lease cost | The Company’s total lease cost was as follows: Three Months Ended June 30, 2020 Three Months Ended June 30, 2021 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 69,367 $ 1,787 $ 71,154 $ 70,739 $ 1,798 $ 72,537 Finance lease cost: Amortization of right-of-use assets 69 — 69 105 — 105 Interest on lease liabilities 231 — 231 254 — 254 Variable lease cost 11,780 112 11,892 13,086 141 13,227 Sublease income (2,621) — (2,621) (2,229) — (2,229) Total lease cost $ 78,826 $ 1,899 $ 80,725 $ 81,955 $ 1,939 $ 83,894 Six Months Ended June 30, 2020 Six Months Ended June 30, 2021 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 139,159 $ 3,520 $ 142,679 $ 140,853 $ 3,597 $ 144,450 Finance lease cost: Amortization of right-of-use assets 131 — 131 140 — 140 Interest on lease liabilities 487 — 487 505 — 505 Variable lease cost 24,012 268 24,280 26,095 144 26,239 Sublease income (5,176) — (5,176) (4,463) — (4,463) Total lease cost $ 158,613 $ 3,788 $ 162,401 $ 163,130 $ 3,741 $ 166,871 The weighted average remaining lease terms and discount rates were as follows: December 31, 2020 June 30, 2021 Weighted average remaining lease term (in years): Operating leases 7.8 7.8 Finance leases 31.2 30.6 Weighted average discount rate: Operating leases 5.6 % 5.5 % Finance leases 7.2 % 7.2 % |
Supplemental cash flow information | Supplemental cash flow information related to leases was as follows: Six Months Ended June 30, 2020 2021 (in thousands) Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 140,300 $ 145,652 Operating cash flows for finance leases 487 505 Financing cash flows for finance leases 89 145 Right-of-use assets obtained in exchange for lease liabilities: Operating leases $ 132,125 $ 138,606 Finance leases 989 138 |
Supplemental balance sheet information | Supplemental balance sheet information related to leases was as follows: December 31, 2020 June 30, 2021 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating Leases Operating lease right-of-use assets $ 1,002,151 $ 30,066 $ 1,032,217 $ 1,026,058 $ 27,273 $ 1,053,331 Current operating lease liabilities $ 214,377 $ 6,036 $ 220,413 $ 218,723 $ 6,145 $ 224,868 Non-current operating lease liabilities 848,215 27,152 875,367 869,421 24,057 893,478 Total operating lease liabilities $ 1,062,592 $ 33,188 $ 1,095,780 $ 1,088,144 $ 30,202 $ 1,118,346 December 31, 2020 June 30, 2021 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Finance Leases Property and equipment, net $ 5,644 $ — $ 5,644 $ 5,711 $ — $ 5,711 Current portion of long-term debt and notes payable $ 663 $ — $ 663 $ 638 $ — $ 638 Long-term debt, net of current portion 13,491 — 13,491 13,509 — 13,509 Total finance lease liabilities $ 14,154 $ — $ 14,154 $ 14,147 $ — $ 14,147 |
Maturities of finance lease liabilities | As of June 30, 2021, maturities of lease liabilities were approximately as follows: Operating Leases Finance Leases (in thousands) 2021 (remainder of year) $ 143,539 $ 790 2022 258,011 1,699 2023 211,514 1,710 2024 172,183 1,381 2025 138,429 1,205 Thereafter 533,811 29,019 Total undiscounted cash flows 1,457,487 35,804 Less: Imputed interest 339,141 21,657 Total discounted lease liabilities $ 1,118,346 $ 14,147 |
Maturities of operating lease liabilities | As of June 30, 2021, maturities of lease liabilities were approximately as follows: Operating Leases Finance Leases (in thousands) 2021 (remainder of year) $ 143,539 $ 790 2022 258,011 1,699 2023 211,514 1,710 2024 172,183 1,381 2025 138,429 1,205 Thereafter 533,811 29,019 Total undiscounted cash flows 1,457,487 35,804 Less: Imputed interest 339,141 21,657 Total discounted lease liabilities $ 1,118,346 $ 14,147 |
Intangible Assets (Tables)
Intangible Assets (Tables) | 6 Months Ended |
Jun. 30, 2021 | |
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, 2021: Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Total (in thousands) Balance as of December 31, 2020 $ 1,084,761 $ 432,753 $ 646,433 $ 1,215,067 $ 3,379,014 Acquisition of businesses — 9,402 1,436 1,188 12,026 Balance as of June 30, 2021 $ 1,084,761 $ 442,155 $ 647,869 $ 1,216,255 $ 3,391,040 |
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, 2020 June 30, 2021 Gross Accumulated Net Gross Accumulated Net (in thousands) Indefinite-lived intangible assets: Trademarks $ 166,698 $ — $ 166,698 $ 166,698 $ — $ 166,698 Certificates of need 18,392 — 18,392 18,413 — 18,413 Accreditations 1,874 — 1,874 1,874 — 1,874 Finite-lived intangible assets: Trademarks 5,000 (5,000) — 5,000 (5,000) — Customer relationships 291,923 (113,346) 178,577 298,514 (126,843) 171,671 Non-compete agreements 33,771 (11,771) 22,000 35,011 (13,365) 21,646 Total identifiable intangible assets $ 517,658 $ (130,117) $ 387,541 $ 525,510 $ (145,208) $ 380,302 |
Long-Term Debt and Notes Paya_2
Long-Term Debt and Notes Payable (Tables) | 6 Months Ended |
Jun. 30, 2021 | |
Debt Disclosure [Abstract] | |
Schedule of Company's long-term debt and notes payable | As of June 30, 2021, the Company’s long-term debt and notes payable were as follows: Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value (in thousands) Select 6.250% senior notes $ 1,225,000 $ 30,722 $ (15,463) $ 1,240,259 $ 1,304,625 Select credit facilities: Select term loan 2,103,437 (7,398) (8,064) 2,087,975 2,077,144 Other debt, including finance leases 69,846 — (258) 69,588 69,588 Total debt $ 3,398,283 $ 23,324 $ (23,785) $ 3,397,822 $ 3,451,357 As of December 31, 2020, the Company’s long-term debt and notes payable were as follows: Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value (in thousands) Select 6.250% senior notes $ 1,225,000 $ 33,773 $ (16,953) $ 1,241,820 $ 1,316,875 Select credit facilities: Select term loan 2,103,437 (8,393) (9,149) 2,085,895 2,082,403 Other debt, including finance leases 74,606 — (302) 74,304 74,304 Total debt $ 3,403,043 $ 25,380 $ (26,404) $ 3,402,019 $ 3,473,582 |
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: 2021 2022 2023 2024 2025 Thereafter Total (in thousands) 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 9,441 4,035 20,754 23,717 334 11,565 69,846 Total debt $ 9,441 $ 4,035 $ 25,511 $ 34,867 $ 2,087,864 $ 1,236,565 $ 3,398,283 |
Interest Rate Cap (Tables)
Interest Rate Cap (Tables) | 6 Months Ended |
Jun. 30, 2021 | |
Derivative Instruments and Hedging Activities Disclosure [Abstract] | |
Schedule of accumulated other comprehensive income | The following table outlines the changes in AOCI: Six Months Ended June 30, 2020 2021 (in thousands) Balance as of January 1 $ — $ (2,027) Gain on interest rate cap cash flow hedge — 8,151 Balance as of March 31 $ — $ 6,124 Loss on interest rate cap cash flow hedge — (1,403) Amounts reclassified from AOCI — 6 Balance as of June 30 $ — $ 4,727 |
Fair Value of Financial Instr_2
Fair Value of Financial Instruments (Tables) | 6 Months Ended |
Jun. 30, 2021 | |
Fair Value Disclosures [Abstract] | |
Schedule of Interest Rate Cap | Financial Instrument Balance Sheet Classification Level December 31, 2020 June 30, 2021 Asset: (in thousands) Interest rate cap contract, non-current portion Other assets Level 2 $ — $ 8,776 Liability: Interest rate cap contract, current portion Accrued other Level 2 $ 1,339 $ 1,948 Interest rate cap contract, non-current portion Other non-current liabilities Level 2 1,392 — |
Schedule of Long-Term Debt | December 31, 2020 June 30, 2021 Financial Instrument Level Carrying Value Fair Value Carrying Value Fair Value (in thousands) Select 6.250% senior notes Level 2 $ 1,241,820 $ 1,316,875 $ 1,240,259 $ 1,304,625 Select credit facilities: Select term loan Level 2 2,085,895 2,082,403 2,087,975 2,077,144 |
Segment Information (Tables)
Segment Information (Tables) | 6 Months Ended |
Jun. 30, 2021 | |
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, 2020 2021 2020 2021 (in thousands) Revenue: Critical illness recovery hospital $ 519,626 $ 544,059 $ 1,020,147 $ 1,138,931 Rehabilitation hospital 168,667 212,666 350,686 420,470 Outpatient rehabilitation 167,138 280,409 422,387 532,370 Concentra 312,338 456,372 710,873 879,212 Other 64,949 70,514 143,257 139,500 Total Company $ 1,232,718 $ 1,564,020 $ 2,647,350 $ 3,110,483 Adjusted EBITDA: Critical illness recovery hospital $ 89,743 $ 72,904 $ 178,313 $ 186,176 Rehabilitation hospital 27,605 50,768 66,174 101,302 Outpatient rehabilitation (6,282) 45,633 20,840 71,962 Concentra 41,497 137,060 102,963 219,075 Other 26,189 35,656 (2,205) 21,847 Total Company $ 178,752 $ 342,021 $ 366,085 $ 600,362 Total assets: Critical illness recovery hospital $ 2,115,294 $ 2,187,181 $ 2,115,294 $ 2,187,181 Rehabilitation hospital 1,135,206 1,186,886 1,135,206 1,186,886 Outpatient rehabilitation 1,267,308 1,333,661 1,267,308 1,333,661 Concentra 2,351,974 2,518,369 2,351,974 2,518,369 Other 598,676 730,282 598,676 730,282 Total Company $ 7,468,458 $ 7,956,379 $ 7,468,458 $ 7,956,379 Purchases of property and equipment: Critical illness recovery hospital $ 14,970 $ 16,499 $ 23,935 $ 30,884 Rehabilitation hospital 1,923 3,257 5,248 3,922 Outpatient rehabilitation 6,593 7,448 14,977 14,783 Concentra 6,820 7,591 22,406 20,271 Other 1,739 1,928 4,687 6,582 Total Company $ 32,045 $ 36,723 $ 71,253 $ 76,442 |
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, 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 businesses 346 Interest expense (37,366) Income before income taxes $ 90,822 Three Months Ended June 30, 2021 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 72,904 $ 50,768 $ 45,633 $ 137,060 $ 35,656 Depreciation and amortization (12,936) (6,939) (7,345) (21,230) (2,504) Stock compensation expense — — — (535) (6,564) Income (loss) from operations $ 59,968 $ 43,829 $ 38,288 $ 115,295 $ 26,588 $ 283,968 Equity in earnings of unconsolidated subsidiaries 11,809 Interest expense (33,888) Income before income taxes $ 261,889 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 Six Months Ended June 30, 2021 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 186,176 $ 101,302 $ 71,962 $ 219,075 $ 21,847 Depreciation and amortization (25,986) (13,999) (14,536) (41,128) (4,925) Stock compensation expense — — — (1,071) (12,737) Income (loss) from operations $ 160,190 $ 87,303 $ 57,426 $ 176,876 $ 4,185 $ 485,980 Equity in earnings of unconsolidated subsidiaries 21,728 Interest income 4,749 Interest expense (68,290) Income before income taxes $ 444,167 |
Revenue from Contracts with C_2
Revenue from Contracts with Customers (Tables) | 6 Months Ended |
Jun. 30, 2021 | |
Revenue from Contract with Customer [Abstract] | |
Schedule of disaggregation of net operating revenues by operating segment | The following tables disaggregate the Company’s revenue for the three and six months ended June 30, 2020 and 2021: Three Months Ended June 30, 2020 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: 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 revenue 3,053 9,460 11,986 2,614 64,949 92,062 Total revenue $ 519,626 $ 168,667 $ 167,138 $ 312,338 $ 64,949 $ 1,232,718 Three Months Ended June 30, 2021 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 201,198 $ 103,865 $ 45,291 $ 295 $ — $ 350,649 Non-Medicare 340,929 98,443 217,893 454,125 — 1,111,390 Total patient services revenues 542,127 202,308 263,184 454,420 — 1,462,039 Other revenue 1,932 10,358 17,225 1,952 70,514 101,981 Total revenue $ 544,059 $ 212,666 $ 280,409 $ 456,372 $ 70,514 $ 1,564,020 Six Months Ended June 30, 2020 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: 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 revenue 6,118 19,291 29,513 5,644 143,257 203,823 Total revenue $ 1,020,147 $ 350,686 $ 422,387 $ 710,873 $ 143,257 $ 2,647,350 Six Months Ended June 30, 2021 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 433,338 $ 206,240 $ 81,582 $ 525 $ — $ 721,685 Non-Medicare 702,081 193,785 418,712 874,779 — 2,189,357 Total patient services revenues 1,135,419 400,025 500,294 875,304 — 2,911,042 Other revenue 3,512 20,445 32,076 3,908 139,500 199,441 Total revenue $ 1,138,931 $ 420,470 $ 532,370 $ 879,212 $ 139,500 $ 3,110,483 |
Earnings per Share (Tables)
Earnings per Share (Tables) | 6 Months Ended |
Jun. 30, 2021 | |
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 and Diluted EPS Basic and Diluted EPS Three Months Ended June 30, Six Months Ended June 30, 2020 2021 2020 2021 (in thousands) Net income $ 67,486 $ 196,208 $ 137,934 $ 333,422 Less: net income attributable to non-controlling interests 15,836 31,314 33,159 57,982 Net income attributable to the Company 51,650 164,894 104,775 275,440 Less: Distributed and undistributed income attributable to participating securities 1,778 5,560 3,596 9,250 Distributed and undistributed income attributable to common shares $ 49,872 $ 159,334 $ 101,179 $ 266,190 The following tables set forth the computation of EPS under the two-class method: Three Months Ended June 30, 2020 2021 Net Income Allocation Shares (1) Basic and Diluted EPS Net Income Allocation Shares (1) Basic and Diluted EPS (in thousands, except for per share amounts) Common shares $ 49,872 129,319 $ 0.39 $ 159,334 130,396 $ 1.22 Participating securities 1,778 4,610 0.39 5,560 4,550 1.22 Total Company $ 51,650 $ 164,894 Six Months Ended June 30, 2020 2021 Net Income Allocation Shares (1) Basic and Diluted EPS Net Income Allocation Shares (1) Basic and Diluted EPS (in thousands, except for per share amounts) Common shares $ 101,179 129,479 $ 0.78 $ 266,190 130,362 $ 2.04 Participating securities 3,596 4,602 0.78 9,250 4,530 2.04 Total Company $ 104,775 $ 275,440 _______________________________________________________________________________ (1) Represents the weighted average share count outstanding during the period. |
Credit Risk Concentrations (Det
Credit Risk Concentrations (Details) | 6 Months Ended | 12 Months Ended |
Jun. 30, 2021 | Dec. 31, 2020 | |
Medicare Receivable | Credit Concentration Risk | Accounts Receivable | ||
Concentration Risk [Line Items] | ||
Percentage of concentration risk | 15.00% | 18.00% |
Redeemable Non-Controlling In_3
Redeemable Non-Controlling Interests - Schedule of Redeemable Non-Controlling Interests (Details) - USD ($) $ in Thousands | 3 Months Ended | |||
Jun. 30, 2021 | Mar. 31, 2021 | Jun. 30, 2020 | Mar. 31, 2020 | |
Increase (Decrease) in Temporary Equity [Roll Forward] | ||||
Balance, beginning | $ 445,931 | $ 398,171 | $ 620,377 | $ 974,541 |
Net income attributable to redeemable non-controlling interests | 18,073 | 9,626 | 3,264 | 7,256 |
Distributions to and purchases of redeemable non-controlling interests | (1,987) | (614) | (30) | (5,687) |
Purchase of membership interests of Concentra Group Holdings Parent | 0 | (366,203) | ||
Redemption value adjustment on redeemable non-controlling interests | 59,370 | 38,405 | (127,916) | 10,123 |
Other | 165 | 343 | 292 | 347 |
Balance, ending | $ 521,552 | $ 445,931 | $ 495,987 | $ 620,377 |
Variable Interest Entities (Det
Variable Interest Entities (Details) - USD ($) $ in Thousands | Jun. 30, 2021 | Dec. 31, 2020 | Jun. 30, 2020 |
Variable Interest Entity [Line Items] | |||
Assets | $ 7,956,379 | $ 7,655,399 | $ 7,468,458 |
Liabilities | 5,984,935 | 6,004,255 | |
Variable Interest Entity, Primary Beneficiary | |||
Variable Interest Entity [Line Items] | |||
Assets | 242,300 | 208,400 | |
Liabilities | 58,800 | 55,100 | |
Obligations payable | $ 182,100 | $ 151,800 |
Leases - Schedule of Lease Cost
Leases - Schedule of Lease Cost (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2021 | Jun. 30, 2020 | Jun. 30, 2021 | Jun. 30, 2020 | |
Operating lease cost | ||||
Unrelated Parties | $ 70,739 | $ 69,367 | $ 140,853 | $ 139,159 |
Related Parties | 1,798 | 1,787 | 3,597 | 3,520 |
Total | 72,537 | 71,154 | 144,450 | 142,679 |
Amortization of right-of-use assets | ||||
Unrelated Parties | 105 | 69 | 140 | 131 |
Related Parties | 0 | 0 | 0 | 0 |
Total | 105 | 69 | 140 | 131 |
Interest on lease liabilities | ||||
Unrelated Parties | 254 | 231 | 505 | 487 |
Related Parties | 0 | 0 | 0 | 0 |
Total | 254 | 231 | 505 | 487 |
Variable lease cost | ||||
Unrelated Parties | 13,086 | 11,780 | 26,095 | 24,012 |
Related Parties | 141 | 112 | 144 | 268 |
Total | 13,227 | 11,892 | 26,239 | 24,280 |
Sublease income | ||||
Unrelated Parties | (2,229) | (2,621) | (4,463) | (5,176) |
Related Parties | 0 | 0 | 0 | 0 |
Total | (2,229) | (2,621) | (4,463) | (5,176) |
Total lease cost | ||||
Unrelated Parties | 81,955 | 78,826 | 163,130 | 158,613 |
Related Parties | 1,939 | 1,899 | 3,741 | 3,788 |
Total | $ 83,894 | $ 80,725 | $ 166,871 | $ 162,401 |
Leases - Supplemental Cash Flow
Leases - Supplemental Cash Flow Information (Details) - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2021 | Jun. 30, 2020 | |
Cash paid for amounts included in the measurement of lease liabilities: | ||
Operating cash flows for operating leases | $ 145,652 | $ 140,300 |
Operating cash flows for finance leases | 505 | 487 |
Financing cash flows for finance leases | 145 | 89 |
Right-of-use assets obtained in exchange for lease liabilities: | ||
Operating leases | 138,606 | 132,125 |
Finance leases | $ 138 | $ 989 |
Leases - Supplemental Balance S
Leases - Supplemental Balance Sheet Information (Details) - USD ($) $ in Thousands | Jun. 30, 2021 | Dec. 31, 2020 |
Operating lease right-of-use assets | ||
Unrelated Parties | $ 1,026,058 | $ 1,002,151 |
Related Parties | 27,273 | 30,066 |
Total | 1,053,331 | 1,032,217 |
Current operating lease liabilities | ||
Unrelated Parties | 218,723 | 214,377 |
Related Parties | 6,145 | 6,036 |
Total | 224,868 | 220,413 |
Non-current operating lease liabilities | ||
Unrelated Parties | 869,421 | 848,215 |
Related Parties | 24,057 | 27,152 |
Total | 893,478 | 875,367 |
Total operating lease liabilities | ||
Unrelated Parties | 1,088,144 | 1,062,592 |
Related Parties | 30,202 | 33,188 |
Total | 1,118,346 | 1,095,780 |
Property and equipment, net | ||
Unrelated Parties | 5,711 | 5,644 |
Related Parties | 0 | 0 |
Total | 5,711 | 5,644 |
Current portion of long-term debt and notes payable | ||
Unrelated Parties | 638 | 663 |
Related Parties | 0 | 0 |
Total | 638 | 663 |
Long-term debt, net of current portion | ||
Unrelated Parties | 13,509 | 13,491 |
Related Parties | 0 | 0 |
Total | 13,509 | 13,491 |
Total finance lease liabilities | ||
Unrelated Parties | 14,147 | 14,154 |
Related Parties | 0 | 0 |
Total | $ 14,147 | $ 14,154 |
Leases - Weighted Average Lease
Leases - Weighted Average Lease Terms and Discount Rates (Details) | Jun. 30, 2021 | Dec. 31, 2020 |
Weighted average remaining lease term (in years): | ||
Operating leases | 7 years 9 months 18 days | 7 years 9 months 18 days |
Finance leases | 30 years 7 months 6 days | 31 years 2 months 12 days |
Weighted average discount rate: | ||
Operating leases | 5.50% | 5.60% |
Finance leases | 7.20% | 7.20% |
Leases - Maturities of Operatin
Leases - Maturities of Operating and Finance Lease Liabilities (Details) - USD ($) $ in Thousands | Jun. 30, 2021 | Dec. 31, 2020 |
Operating Leases | ||
2021 (remainder of year) | $ 143,539 | |
2022 | 258,011 | |
2023 | 211,514 | |
2024 | 172,183 | |
2025 | 138,429 | |
Thereafter | 533,811 | |
Total undiscounted cash flows | 1,457,487 | |
Less: Imputed interest | 339,141 | |
Total discounted lease liabilities | 1,118,346 | $ 1,095,780 |
Finance Leases | ||
2021 (remainder of year) | 790 | |
2022 | 1,699 | |
2023 | 1,710 | |
2024 | 1,381 | |
2025 | 1,205 | |
Thereafter | 29,019 | |
Total undiscounted cash flows | 35,804 | |
Less: Imputed interest | 21,657 | |
Total finance lease liabilities | $ 14,147 | $ 14,154 |
Intangible Assets - Carrying Am
Intangible Assets - Carrying Amount of Goodwill (Details) $ in Thousands | 6 Months Ended |
Jun. 30, 2021USD ($) | |
Goodwill | |
Goodwill, Beginning Balance | $ 3,379,014 |
Acquisition of businesses | 12,026 |
Goodwill, Ending Balance | 3,391,040 |
Critical Illness Recovery Hospital | |
Goodwill | |
Goodwill, Beginning Balance | 1,084,761 |
Acquisition of businesses | 0 |
Goodwill, Ending Balance | 1,084,761 |
Rehabilitation Hospital | |
Goodwill | |
Goodwill, Beginning Balance | 432,753 |
Acquisition of businesses | 9,402 |
Goodwill, Ending Balance | 442,155 |
Outpatient Rehabilitation | |
Goodwill | |
Goodwill, Beginning Balance | 646,433 |
Acquisition of businesses | 1,436 |
Goodwill, Ending Balance | 647,869 |
Concentra | |
Goodwill | |
Goodwill, Beginning Balance | 1,215,067 |
Acquisition of businesses | 1,188 |
Goodwill, Ending Balance | $ 1,216,255 |
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, 2021 | Jun. 30, 2020 | Jun. 30, 2021 | Jun. 30, 2020 | Dec. 31, 2020 | |
Finite Lived And Indefinite Lived Intangible Assets By Major Class [Line Items] | |||||
Total identifiable intangible assets, gross carrying amount | $ 525,510 | $ 525,510 | $ 517,658 | ||
Finite-lived intangible assets, accumulated amortization | (145,208) | (145,208) | (130,117) | ||
Total identifiable intangible assets, net carrying amount | 380,302 | 380,302 | 387,541 | ||
Amortized intangible assets: | |||||
Amortization expense | 7,300 | $ 6,900 | 14,400 | $ 13,800 | |
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 | 298,514 | 298,514 | 291,923 | ||
Finite-lived intangible assets, accumulated amortization | (126,843) | (126,843) | (113,346) | ||
Finite-lived intangible assets, net carrying amount | 171,671 | 171,671 | 178,577 | ||
Non-compete agreements | |||||
Finite Lived And Indefinite Lived Intangible Assets By Major Class [Line Items] | |||||
Finite-lived intangible assets, gross carrying amount | 35,011 | 35,011 | 33,771 | ||
Finite-lived intangible assets, accumulated amortization | (13,365) | (13,365) | (11,771) | ||
Finite-lived intangible assets, net carrying amount | 21,646 | 21,646 | 22,000 | ||
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 | 8 years 2 months 12 days | ||||
Certificates of need | |||||
Finite Lived And Indefinite Lived Intangible Assets By Major Class [Line Items] | |||||
Indefinite-lived intangible assets, carrying amount | 18,413 | $ 18,413 | 18,392 | ||
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, 2021 | Dec. 31, 2020 |
Debt Instrument [Line Items] | ||
Principal Outstanding | $ 3,398,283 | $ 3,403,043 |
Unamortized Premium (Discount) | 23,324 | 25,380 |
Unamortized Issuance Costs | (23,785) | (26,404) |
Carrying Value | 3,397,822 | 3,402,019 |
Fair Value | 3,451,357 | 3,473,582 |
Other debt, including finance leases | ||
Debt Instrument [Line Items] | ||
Principal Outstanding | 69,846 | 74,606 |
Unamortized Premium (Discount) | 0 | 0 |
Unamortized Issuance Costs | (258) | (302) |
Carrying Value | 69,588 | 74,304 |
Fair Value | $ 69,588 | $ 74,304 |
Select Medical Corporation | Senior notes | ||
Debt Instrument [Line Items] | ||
Interest rate of debt (as a percent) | 6.25% | 6.25% |
Principal Outstanding | $ 1,225,000 | $ 1,225,000 |
Unamortized Premium (Discount) | 30,722 | 33,773 |
Unamortized Issuance Costs | (15,463) | (16,953) |
Carrying Value | 1,240,259 | 1,241,820 |
Fair Value | 1,304,625 | 1,316,875 |
Select Medical Corporation | Term loans | ||
Debt Instrument [Line Items] | ||
Principal Outstanding | 2,103,437 | 2,103,437 |
Unamortized Premium (Discount) | (7,398) | (8,393) |
Unamortized Issuance Costs | (8,064) | (9,149) |
Carrying Value | 2,087,975 | 2,085,895 |
Fair Value | $ 2,077,144 | $ 2,082,403 |
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, 2021 | Dec. 31, 2020 |
Debt Instrument [Line Items] | ||
2021 | $ 9,441 | |
2022 | 4,035 | |
2023 | 25,511 | |
2024 | 34,867 | |
2025 | 2,087,864 | |
Thereafter | 1,236,565 | |
Total | 3,398,283 | $ 3,403,043 |
Other debt, including finance leases | ||
Debt Instrument [Line Items] | ||
2021 | 9,441 | |
2022 | 4,035 | |
2023 | 20,754 | |
2024 | 23,717 | |
2025 | 334 | |
Thereafter | 11,565 | |
Total | $ 69,846 | $ 74,606 |
Select Medical Corporation | Senior notes | ||
Debt Instrument [Line Items] | ||
Interest rate of debt (as a percent) | 6.25% | 6.25% |
2021 | $ 0 | |
2022 | 0 | |
2023 | 0 | |
2024 | 0 | |
2025 | 0 | |
Thereafter | 1,225,000 | |
Total | 1,225,000 | $ 1,225,000 |
Select Medical Corporation | Term loans | ||
Debt Instrument [Line Items] | ||
2021 | 0 | |
2022 | 0 | |
2023 | 4,757 | |
2024 | 11,150 | |
2025 | 2,087,530 | |
Thereafter | 0 | |
Total | $ 2,103,437 | $ 2,103,437 |
Long-Term Debt and Notes Paya_5
Long-Term Debt and Notes Payable - Narrative (Details) - Revolving facilities - USD ($) $ in Millions | Jun. 02, 2021 | Jun. 01, 2021 |
Select Medical Corporation | Revolving facility | ||
Line of Credit Facility [Line Items] | ||
Maximum borrowing capacity | $ 650 | $ 450 |
Select Medical Corporation | Standby Letters of Credit | ||
Line of Credit Facility [Line Items] | ||
Maximum borrowing capacity | 125 | |
Concentra | Concentra-JPM First Lien Credit Agreement | ||
Line of Credit Facility [Line Items] | ||
Terminated obligations | $ 100 |
Interest Rate Cap - Narrative (
Interest Rate Cap - Narrative (Details) - Interest Rate Cap $ in Millions | 6 Months Ended |
Jun. 30, 2021USD ($) | |
Derivative [Line Items] | |
Derivative cap interest rate (as a percent) | 1.00% |
Notional amount | $ 2,000 |
Annual premium (in percent) | 0.000916 |
Estimated pre-tax losses expected to be reclassified in the next twelve months | $ 0.2 |
Interest Rate Cap - Schedule of
Interest Rate Cap - Schedule of Accumulated Other Comprehensive Income (Details) - USD ($) $ in Thousands | 3 Months Ended | |||
Jun. 30, 2021 | Mar. 31, 2021 | Jun. 30, 2020 | Mar. 31, 2020 | |
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||||
Beginning balance | $ 1,350,617 | $ 1,252,973 | $ 974,819 | $ 929,035 |
Ending balance | 1,449,892 | 1,350,617 | 1,172,430 | 974,819 |
Accumulated Gain (Loss), Net, Cash Flow Hedge, Parent | Interest Rate Cap | ||||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||||
Beginning balance | 6,124 | (2,027) | 0 | 0 |
Gain on interest rate cap cash flow hedge | 8,151 | 0 | ||
Loss on interest rate cap cash flow hedge | (1,403) | 0 | ||
Amounts reclassified from AOCI | 6 | 0 | ||
Ending balance | $ 4,727 | $ 6,124 | $ 0 | $ 0 |
Fair Value of Financial Instr_3
Fair Value of Financial Instruments - Schedule of Interest Rate Cap (Details) - Interest Rate Cap - Fair Value, Inputs, Level 2 - Fair Value, Recurring - USD ($) $ in Thousands | Jun. 30, 2021 | Dec. 31, 2020 |
Other assets | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Interest rate cap contract, non-current portion | $ 8,776 | $ 0 |
Accrued other | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Interest rate cap contract, current portion | 1,948 | 1,339 |
Other non-current liabilities | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Interest rate cap contract, non-current portion | $ 0 | $ 1,392 |
Fair Value of Financial Instr_4
Fair Value of Financial Instruments - Schedule of Long-Term Debt (Details) - USD ($) $ in Thousands | Jun. 30, 2021 | Dec. 31, 2020 |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Fair Value | $ 3,451,357 | $ 3,473,582 |
Senior notes | Select Medical Corporation | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Interest rate of debt (as a percent) | 6.25% | 6.25% |
Carrying Value | $ 1,240,259 | $ 1,241,820 |
Fair Value | 1,304,625 | 1,316,875 |
Senior notes | Select Medical Corporation | Fair Value, Inputs, Level 2 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Carrying Value | 1,240,259 | 1,241,820 |
Fair Value | 1,304,625 | 1,316,875 |
Term loans | Select Medical Corporation | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Carrying Value | 2,087,975 | 2,085,895 |
Fair Value | 2,077,144 | 2,082,403 |
Term loans | Select Medical Corporation | Fair Value, Inputs, Level 2 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Carrying Value | 2,087,975 | 2,085,895 |
Fair Value | $ 2,077,144 | $ 2,082,403 |
Segment Information - Selected
Segment Information - Selected Financial Data (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | |||
Jun. 30, 2021 | Jun. 30, 2020 | Jun. 30, 2021 | Jun. 30, 2020 | Dec. 31, 2020 | |
Segment Reporting Information [Line Items] | |||||
Revenue | $ 1,564,020 | $ 1,232,718 | $ 3,110,483 | $ 2,647,350 | |
Adjusted EBITDA | 342,021 | 178,752 | 600,362 | 366,085 | |
Total assets | 7,956,379 | 7,468,458 | 7,956,379 | 7,468,458 | $ 7,655,399 |
Purchases of property and equipment | 36,723 | 32,045 | 76,442 | 71,253 | |
Operating Segments | Critical Illness Recovery Hospital | |||||
Segment Reporting Information [Line Items] | |||||
Revenue | 544,059 | 519,626 | 1,138,931 | 1,020,147 | |
Adjusted EBITDA | 72,904 | 89,743 | 186,176 | 178,313 | |
Total assets | 2,187,181 | 2,115,294 | 2,187,181 | 2,115,294 | |
Purchases of property and equipment | 16,499 | 14,970 | 30,884 | 23,935 | |
Operating Segments | Rehabilitation Hospital | |||||
Segment Reporting Information [Line Items] | |||||
Revenue | 212,666 | 168,667 | 420,470 | 350,686 | |
Adjusted EBITDA | 50,768 | 27,605 | 101,302 | 66,174 | |
Total assets | 1,186,886 | 1,135,206 | 1,186,886 | 1,135,206 | |
Purchases of property and equipment | 3,257 | 1,923 | 3,922 | 5,248 | |
Operating Segments | Outpatient Rehabilitation | |||||
Segment Reporting Information [Line Items] | |||||
Revenue | 280,409 | 167,138 | 532,370 | 422,387 | |
Adjusted EBITDA | 45,633 | (6,282) | 71,962 | 20,840 | |
Total assets | 1,333,661 | 1,267,308 | 1,333,661 | 1,267,308 | |
Purchases of property and equipment | 7,448 | 6,593 | 14,783 | 14,977 | |
Operating Segments | Concentra | |||||
Segment Reporting Information [Line Items] | |||||
Revenue | 456,372 | 312,338 | 879,212 | 710,873 | |
Adjusted EBITDA | 137,060 | 41,497 | 219,075 | 102,963 | |
Total assets | 2,518,369 | 2,351,974 | 2,518,369 | 2,351,974 | |
Purchases of property and equipment | 7,591 | 6,820 | 20,271 | 22,406 | |
Other | |||||
Segment Reporting Information [Line Items] | |||||
Revenue | 70,514 | 64,949 | 139,500 | 143,257 | |
Adjusted EBITDA | 35,656 | 26,189 | 21,847 | (2,205) | |
Total assets | 730,282 | 598,676 | 730,282 | 598,676 | |
Purchases of property and equipment | $ 1,928 | $ 1,739 | $ 6,582 | $ 4,687 |
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, 2021 | Jun. 30, 2020 | Jun. 30, 2021 | Jun. 30, 2020 | |
Segment Reporting Information [Line Items] | ||||
Adjusted EBITDA | $ 342,021 | $ 178,752 | $ 600,362 | $ 366,085 |
Depreciation and amortization | (50,954) | (52,271) | (100,574) | (104,023) |
Income from operations | 283,968 | 119,518 | 485,980 | 248,196 |
Equity in earnings of unconsolidated subsidiaries | 11,809 | 8,324 | 21,728 | 10,912 |
Gain on sale of businesses | 0 | 346 | 0 | 7,547 |
Interest income | 0 | 0 | 4,749 | 0 |
Interest expense | (33,888) | (37,366) | (68,290) | (83,473) |
Income before income taxes | 261,889 | 90,822 | 444,167 | 183,182 |
Operating Segments | Critical Illness Recovery Hospital | ||||
Segment Reporting Information [Line Items] | ||||
Adjusted EBITDA | 72,904 | 89,743 | 186,176 | 178,313 |
Depreciation and amortization | (12,936) | (13,892) | (25,986) | (26,228) |
Stock compensation expense | 0 | 0 | 0 | 0 |
Income from operations | 59,968 | 75,851 | 160,190 | 152,085 |
Operating Segments | Rehabilitation Hospital | ||||
Segment Reporting Information [Line Items] | ||||
Adjusted EBITDA | 50,768 | 27,605 | 101,302 | 66,174 |
Depreciation and amortization | (6,939) | (6,907) | (13,999) | (13,794) |
Stock compensation expense | 0 | 0 | 0 | 0 |
Income from operations | 43,829 | 20,698 | 87,303 | 52,380 |
Operating Segments | Outpatient Rehabilitation | ||||
Segment Reporting Information [Line Items] | ||||
Adjusted EBITDA | 45,633 | (6,282) | 71,962 | 20,840 |
Depreciation and amortization | (7,345) | (7,194) | (14,536) | (14,412) |
Stock compensation expense | 0 | 0 | 0 | 0 |
Income from operations | 38,288 | (13,476) | 57,426 | 6,428 |
Operating Segments | Concentra | ||||
Segment Reporting Information [Line Items] | ||||
Adjusted EBITDA | 137,060 | 41,497 | 219,075 | 102,963 |
Depreciation and amortization | (21,230) | (21,857) | (41,128) | (44,744) |
Stock compensation expense | (535) | (701) | (1,071) | (1,468) |
Income from operations | 115,295 | 18,939 | 176,876 | 56,751 |
Other | ||||
Segment Reporting Information [Line Items] | ||||
Adjusted EBITDA | 35,656 | 26,189 | 21,847 | (2,205) |
Depreciation and amortization | (2,504) | (2,421) | (4,925) | (4,845) |
Stock compensation expense | (6,564) | (6,262) | (12,737) | (12,398) |
Income from operations | $ 26,588 | $ 17,506 | $ 4,185 | $ (19,448) |
Revenue from Contracts with C_3
Revenue from Contracts with Customers (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2021 | Jun. 30, 2020 | Jun. 30, 2021 | Jun. 30, 2020 | |
Disaggregation of Revenue [Line Items] | ||||
Total revenue | $ 1,564,020 | $ 1,232,718 | $ 3,110,483 | $ 2,647,350 |
Patient services revenue | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 1,462,039 | 1,140,656 | 2,911,042 | 2,443,527 |
Medicare | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 350,649 | 307,324 | 721,685 | 680,889 |
Non-Medicare | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 1,111,390 | 833,332 | 2,189,357 | 1,762,638 |
Other revenue | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 101,981 | 92,062 | 199,441 | 203,823 |
Operating Segments | Critical Illness Recovery Hospital | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 544,059 | 519,626 | 1,138,931 | 1,020,147 |
Operating Segments | Critical Illness Recovery Hospital | Patient services revenue | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 542,127 | 516,573 | 1,135,419 | 1,014,029 |
Operating Segments | Critical Illness Recovery Hospital | Medicare | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 201,198 | 215,508 | 433,338 | 457,017 |
Operating Segments | Critical Illness Recovery Hospital | Non-Medicare | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 340,929 | 301,065 | 702,081 | 557,012 |
Operating Segments | Critical Illness Recovery Hospital | Other revenue | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 1,932 | 3,053 | 3,512 | 6,118 |
Operating Segments | Rehabilitation Hospital | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 212,666 | 168,667 | 420,470 | 350,686 |
Operating Segments | Rehabilitation Hospital | Patient services revenue | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 202,308 | 159,207 | 400,025 | 331,395 |
Operating Segments | Rehabilitation Hospital | Medicare | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 103,865 | 71,510 | 206,240 | 162,262 |
Operating Segments | Rehabilitation Hospital | Non-Medicare | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 98,443 | 87,697 | 193,785 | 169,133 |
Operating Segments | Rehabilitation Hospital | Other revenue | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 10,358 | 9,460 | 20,445 | 19,291 |
Operating Segments | Outpatient Rehabilitation | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 280,409 | 167,138 | 532,370 | 422,387 |
Operating Segments | Outpatient Rehabilitation | Patient services revenue | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 263,184 | 155,152 | 500,294 | 392,874 |
Operating Segments | Outpatient Rehabilitation | Medicare | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 45,291 | 20,049 | 81,582 | 60,881 |
Operating Segments | Outpatient Rehabilitation | Non-Medicare | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 217,893 | 135,103 | 418,712 | 331,993 |
Operating Segments | Outpatient Rehabilitation | Other revenue | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 17,225 | 11,986 | 32,076 | 29,513 |
Operating Segments | Concentra | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 456,372 | 312,338 | 879,212 | 710,873 |
Operating Segments | Concentra | Patient services revenue | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 454,420 | 309,724 | 875,304 | 705,229 |
Operating Segments | Concentra | Medicare | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 295 | 257 | 525 | 729 |
Operating Segments | Concentra | Non-Medicare | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 454,125 | 309,467 | 874,779 | 704,500 |
Operating Segments | Concentra | Other revenue | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 1,952 | 2,614 | 3,908 | 5,644 |
Other | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 70,514 | 64,949 | 139,500 | 143,257 |
Other | Patient services revenue | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 0 | 0 | 0 | 0 |
Other | Medicare | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 0 | 0 | 0 | 0 |
Other | Non-Medicare | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | 0 | 0 | 0 | 0 |
Other | Other revenue | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenue | $ 70,514 | $ 64,949 | $ 139,500 | $ 143,257 |
Earnings per Share - Narrative
Earnings per Share - Narrative (Details) - $ / shares | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2021 | Jun. 30, 2020 | Jun. 30, 2021 | Jun. 30, 2020 | |
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, 2021 | Mar. 31, 2021 | Jun. 30, 2020 | Mar. 31, 2020 | Jun. 30, 2021 | Jun. 30, 2020 | |
Earnings Per Share [Abstract] | ||||||
Net income | $ 196,208 | $ 67,486 | $ 333,422 | $ 137,934 | ||
Less: Net income attributable to non-controlling interests | 31,314 | 15,836 | 57,982 | 33,159 | ||
Net income attributable to Select Medical Holdings Corporation | 164,894 | $ 110,546 | 51,650 | $ 53,125 | 275,440 | 104,775 |
Basic EPS | ||||||
Less: Distributed and undistributed income attributable to participating securities - Basic EPS | 5,560 | 1,778 | 9,250 | 3,596 | ||
Distributed and undistributed income attributable to common shares | 159,334 | 49,872 | 266,190 | 101,179 | ||
Diluted EPS | ||||||
Less: Distributed and undistributed income attributable to participating securities - Diluted EPS | 5,560 | 1,778 | 9,250 | 3,596 | ||
Distributed and undistributed income attributable to common shares | $ 159,334 | $ 49,872 | $ 266,190 | $ 101,179 |
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, 2021 | Mar. 31, 2021 | Jun. 30, 2020 | Mar. 31, 2020 | Jun. 30, 2021 | Jun. 30, 2020 | |
Net Income Allocation | ||||||
Net income allocated to common shares - basic | $ 159,334 | $ 49,872 | $ 266,190 | $ 101,179 | ||
Net income allocated to common shares - diluted | 159,334 | 49,872 | 266,190 | 101,179 | ||
Net income allocated to participating securities | 5,560 | 1,778 | 9,250 | 3,596 | ||
Net income attributable to Select Medical Holdings Corporation | $ 164,894 | $ 110,546 | $ 51,650 | $ 53,125 | $ 275,440 | $ 104,775 |
Weighted average common shares outstanding, basic (in shares) | 130,396 | 129,319 | 130,362 | 129,479 | ||
Weighted average common shares outstanding, diluted (in shares) | 130,396 | 129,319 | 130,362 | 129,479 | ||
Weighted average participating securities outstanding (in shares) | 4,550 | 4,610 | 4,530 | 4,602 | ||
Basic EPS | ||||||
Basic earnings per share (in dollars per share) | $ 1.22 | $ 0.39 | $ 2.04 | $ 0.78 | ||
Diluted EPS | ||||||
Diluted earnings per share (in dollars per share) | $ 1.22 | $ 0.39 | $ 2.04 | $ 0.78 |
Commitments and Contingencies -
Commitments and Contingencies - Litigation (Details) $ in Millions | 6 Months Ended |
Jun. 30, 2021USD ($) | |
Professional liability claims | |
Commitments and Contingencies | |
Total annual aggregate limit of insurance coverage | $ 37 |
Professional liability claims | Joint Venture Operations | |
Commitments and Contingencies | |
Total annual aggregate limit of insurance coverage | 80 |
Professional liability claims | Joint Venture Operations | Minimum | |
Commitments and Contingencies | |
Total annual aggregate limit of insurance coverage | 23 |
Professional liability claims | Joint Venture Operations | Maximum | |
Commitments and Contingencies | |
Total annual aggregate limit of insurance coverage | 33 |
General Liability | |
Commitments and Contingencies | |
Total annual aggregate limit of insurance coverage | $ 40 |
Commitments and Contingencies_2
Commitments and Contingencies - Medicare Dual-Eligible Litigation (Details) - Judicial Ruling $ in Millions | 1 Months Ended |
Feb. 28, 2021USD ($) | |
Gain Contingencies [Line Items] | |
Medicare bad debt reimbursement claim | $ 17.9 |
Accrued interest | $ 4.7 |
CARES Act (Details)
CARES Act (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | 15 Months Ended | ||||
Jun. 30, 2021 | Jun. 30, 2020 | Jun. 30, 2021 | Jun. 30, 2020 | Jun. 30, 2021 | Dec. 31, 2020 | Apr. 30, 2020 | |
Unusual or Infrequent Items, or Both [Abstract] | |||||||
Government assistance, provider relief payments received, CARES Act | $ 208,400 | ||||||
Government assistance recognized in earnings, CARES Act | $ 98,000 | $ 55,000 | $ 114,100 | $ 55,000 | |||
Other operating income | 98,087 | $ 54,988 | 132,108 | $ 54,988 | |||
Unearned government assistance, CARES Act | 4,099 | 4,099 | 4,099 | $ 82,607 | |||
Unearned government assistance, amount expected to be repaid, CARES Act | 1,700 | 1,700 | 1,700 | ||||
Government advances, CARES Act | 251,272 | 251,272 | $ 251,272 | $ 321,807 | $ 325,000 | ||
Government advances recouped, CARES Act | $ 73,700 | $ 73,700 |
Subsequent Event (Details)
Subsequent Event (Details) | Aug. 04, 2021$ / shares |
Subsequent Event | |
Subsequent Event [Line Items] | |
Cash dividend declared (in dollars per share) | $ 0.125 |