Select Medical (SEM) 10-Q 4 Aug 22 2022 Q2 Quarterly report Financial data

Cover

Cover - shares	6 Months Ended
	Jun. 30, 2022	Jul. 31, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2022
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		125,916,075
Current Fiscal Year End Date	--12-31
Amendment Flag	false
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q2
Entity Central Index Key	0001320414

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (unaudited) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Current Assets:
Cash and cash equivalents	$ 94,669	$ 74,310
Accounts receivable	921,623	889,303
Prepaid income taxes	42,642	55,620
Other current assets	162,114	120,206
Total Current Assets	1,221,048	1,139,439
Operating lease right-of-use assets	1,136,678	1,078,754
Property and equipment, net	955,752	961,467
Goodwill	3,476,213	3,448,912
Identifiable intangible assets, net	366,222	374,879
Other assets	395,745	356,720
Total Assets	7,551,658	7,360,171
Current Liabilities:
Overdrafts	31,298	42,353
Current operating lease liabilities	233,917	229,334
Current portion of long-term debt and notes payable	44,009	17,572
Accounts payable	231,472	233,844
Accrued payroll	257,612	247,292
Accrued vacation	152,281	144,048
Accrued interest	29,339	29,002
Accrued other	242,980	244,312
Government advances	6,471	83,790
Unearned government assistance	586	93
Income taxes payable	11,774	1,437
Total Current Liabilities	1,241,739	1,273,077
Non-current operating lease liabilities	974,657	916,540
Long-term debt, net of current portion	3,723,734	3,556,385
Non-current deferred tax liability	157,892	142,792
Other non-current liabilities	107,738	106,442
Total Liabilities	6,205,760	5,995,236
Commitments and contingencies (Note 14)
Redeemable non-controlling interests	42,197	39,033
Stockholders’ Equity:
Common stock, $0.001 par value, 700,000,000 shares authorized, 133,884,817 and 126,491,347 shares issued and outstanding at 2021 and 2022, respectively	126	134
Capital in excess of par	441,769	504,314
Retained earnings	565,556	593,251
Accumulated other comprehensive income	63,962	12,282
Total Stockholders’ Equity	1,071,413	1,109,981
Non-controlling interests	232,288	215,921
Total Equity	1,303,701	1,325,902
Total Liabilities and Equity	$ 7,551,658	$ 7,360,171

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (unaudited) (Parenthetical) - $ / shares	Jun. 30, 2022	Dec. 31, 2021
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)	126,491,347	133,884,817
Common stock, shares outstanding (in shares)	126,491,347	133,884,817

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Income Statement [Abstract]
Revenue	$ 1,584,741	$ 1,564,020	$ 3,184,288	$ 3,110,483
Costs and expenses:
Cost of services, exclusive of depreciation and amortization	1,390,550	1,291,448	2,797,560	2,584,897
General and administrative	37,268	35,737	74,781	71,140
Depreciation and amortization	51,081	50,954	102,120	100,574
Total costs and expenses	1,478,899	1,378,139	2,974,461	2,756,611
Other operating income	15,125	98,087	15,125	132,108
Income (loss) from operations	120,967	283,968	224,952	485,980
Other income and expense:
Equity in earnings of unconsolidated subsidiaries	6,167	11,809	11,564	21,728
Interest income	0	0	0	4,749
Interest expense	(41,052)	(33,888)	(76,566)	(68,290)
Income before income taxes	86,082	261,889	159,950	444,167
Income tax expense	19,820	65,681	37,762	110,745
Net income	66,262	196,208	122,188	333,422
Less: Net income attributable to non-controlling interests	11,055	31,314	17,864	57,982
Net income attributable to Select Medical Holdings Corporation	$ 55,207	$ 164,894	$ 104,324	$ 275,440
Earnings per common share (Note 13):
Basic (in dollars per share)	$ 0.43	$ 1.22	$ 0.79	$ 2.04
Diluted (in dollars per share)	$ 0.43	$ 1.22	$ 0.79	$ 2.04

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Income (unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Statement of Comprehensive Income [Abstract]
Net income	$ 66,262	$ 196,208	$ 122,188	$ 333,422
Other comprehensive income (loss), net of tax:
Gain (loss) on interest rate cash flow hedge	11,833	(1,403)	51,647	6,748
Reclassification adjustment for losses (gains) included in net income	(6)	6	33	6
Net change, net of tax benefit (expense) of $486, $(3,942), $(2,348) and $(17,227)	11,827	(1,397)	51,680	6,754
Comprehensive income	78,089	194,811	173,868	340,176
Less: Comprehensive income attributable to non-controlling interests	11,055	31,314	17,864	57,982
Comprehensive income attributable to Select Medical Holdings Corporation	$ 67,034	$ 163,497	$ 156,004	$ 282,194

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Comprehensive Income (unaudited) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Statement of Comprehensive Income [Abstract]
Tax benefit (expense) on components of other comprehensive income	$ (3,942)	$ 486	$ (17,227)	$ (2,348)

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	Non-controlling Interests
Beginning balance (in shares) at Dec. 31, 2020			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	0					17,042
Issuance of restricted stock (in shares)			2,000
Issuance of restricted stock	0	0	$ 0	0
Forfeitures of unvested restricted stock (in shares)			(14,000)
Forfeitures of unvested restricted stock	0	0	$ 0	0
Vesting of restricted stock	6,173	6,173		6,173
Non-controlling interests acquired in business combination	8,193	0					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			134,850,000
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			135,005,000
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	0					13,241
Cash 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	0
Forfeitures of unvested restricted stock (in shares)			(2,000)
Forfeitures of unvested restricted stock	0	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			135,005,000
Ending balance at Jun. 30, 2021	$ 1,449,892	1,234,225	$ 135	516,172	713,191	4,727	215,667
Increase (Decrease) in Stockholders' Equity
Cash dividend declared (in dollars per share)	$ 0.125
Beginning balance (in shares) at Dec. 31, 2021	133,884,817		133,884,000
Beginning balance at Dec. 31, 2021	$ 1,325,902	1,109,981	$ 134	504,314	593,251	12,282	215,921
Increase (Decrease) in Stockholders' Equity
Net income attributable to Select Medical Holdings Corporation	49,117	49,117			49,117
Net income attributable to non-controlling interests	4,891	0					4,891
Cash dividends declared for common stockholders ($0.125 per share)	(16,691)	(16,691)			(16,691)
Issuance of restricted stock (in shares)			13,000
Issuance of restricted stock	0	0	$ 0	0
Vesting of restricted stock	8,288	8,288		8,288
Repurchase of common shares (in shares)			(2,128,000)
Repurchase of common shares	(51,676)	(51,676)	$ (2)	(23,459)	(28,215)
Issuance of non-controlling interests	5,229	651		651			4,578
Non-controlling interests acquired in business combination	12,463	0					12,463
Distributions to and purchases of non-controlling interests	(9,097)	0					(9,097)
Redemption value adjustment on non-controlling interests	(1,381)	(1,381)			(1,381)
Other comprehensive income (loss)	39,853	39,853				39,853
Other	(2)	(2)			(2)
Ending balance (in shares) at Mar. 31, 2022			131,769,000
Ending balance at Mar. 31, 2022	$ 1,366,896	1,138,140	$ 132	489,794	596,079	52,135	228,756
Increase (Decrease) in Stockholders' Equity
Cash dividend declared (in dollars per share)	$ 0.125
Beginning balance (in shares) at Dec. 31, 2021	133,884,817		133,884,000
Beginning balance at Dec. 31, 2021	$ 1,325,902	1,109,981	$ 134	504,314	593,251	12,282	215,921
Increase (Decrease) in Stockholders' Equity
Net income attributable to Select Medical Holdings Corporation	$ 104,324
Ending balance (in shares) at Jun. 30, 2022	126,491,347		126,491,000
Ending balance at Jun. 30, 2022	$ 1,303,701	1,071,413	$ 126	441,769	565,556	63,962	232,288
Beginning balance (in shares) at Mar. 31, 2022			131,769,000
Beginning balance at Mar. 31, 2022	1,366,896	1,138,140	$ 132	489,794	596,079	52,135	228,756
Increase (Decrease) in Stockholders' Equity
Net income attributable to Select Medical Holdings Corporation	55,207	55,207			55,207
Net income attributable to non-controlling interests	9,155	0					9,155
Cash dividends declared for common stockholders ($0.125 per share)	(16,108)	(16,108)			(16,108)
Issuance of restricted stock (in shares)			211,000
Issuance of restricted stock	0	0	$ 0	0
Forfeitures of unvested restricted stock (in shares)			(6,000)
Forfeitures of unvested restricted stock	3	3	$ 0	0	3
Vesting of restricted stock	8,406	8,406		8,406
Repurchase of common shares (in shares)			(5,483,000)
Repurchase of common shares	(126,947)	(126,947)	$ (6)	(56,965)	(69,976)
Issuance of non-controlling interests	1,725	0					1,725
Distributions to and purchases of non-controlling interests	(6,814)	534		534			(7,348)
Redemption value adjustment on non-controlling interests	355	355			355
Other comprehensive income (loss)	11,827	11,827				11,827
Other	$ (4)	(4)			(4)
Ending balance (in shares) at Jun. 30, 2022	126,491,347		126,491,000
Ending balance at Jun. 30, 2022	$ 1,303,701	$ 1,071,413	$ 126	$ 441,769	$ 565,556	$ 63,962	$ 232,288
Increase (Decrease) in Stockholders' Equity
Cash dividend declared (in dollars per share)	$ 0.125

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Changes in Equity and Income (unaudited) (Parenthetical) - $ / shares	3 Months Ended
	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2021
Statement of Stockholders' Equity [Abstract]
Cash dividend declared (in dollars per share)	$ 0.125	$ 0.125	$ 0.125

Condensed Consolidated Statem_6

Condensed Consolidated Statements of Cash Flows (unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021
Operating activities
Net income	$ 122,188	$ 333,422
Adjustments to reconcile net income to net cash provided by operating activities:
Distributions from unconsolidated subsidiaries	11,140	19,384
Depreciation and amortization	102,120	100,574
Provision for expected credit losses	111	212
Equity in earnings of unconsolidated subsidiaries	(11,564)	(21,728)
Loss (gain) on sale or disposal of assets	(1,476)	494
Stock compensation expense	17,769	13,808
Amortization of debt discount, premium and issuance costs	1,123	1,095
Deferred income taxes	(1,965)	(8,323)
Changes in operating assets and liabilities, net of effects of business combinations:
Accounts receivable	(32,431)	(31,751)
Other current assets	(2,128)	(12,856)
Other assets	1,275	(11,984)
Accounts payable	4,879	18,881
Accrued expenses	20,488	71,034
Government advances	(77,319)	(73,703)
Unearned government assistance	493	(78,509)
Income taxes	23,315	42,976
Net cash provided by operating activities	178,018	363,026
Investing activities
Business combinations, net of cash acquired	(19,241)	(10,081)
Purchases of property and equipment	(93,177)	(76,442)
Investment in businesses	(6,990)	(11,185)
Proceeds from sale of assets	5,314	9,463
Net cash used in investing activities	(114,094)	(88,245)
Financing activities
Borrowings on revolving facilities	565,000	0
Payments on revolving facilities	(375,000)	0
Borrowings of other debt	17,494	8,915
Principal payments on other debt	(16,874)	(15,314)
Dividends paid to common stockholders	(32,799)	(16,876)
Repurchase of common stock	(178,623)	(1,610)
Decrease in overdrafts	(11,055)	0
Proceeds from issuance of non-controlling interests	6,955	5,688
Distributions to and purchases of non-controlling interests	(18,663)	(29,152)
Net cash used in financing activities	(43,565)	(48,349)
Net increase in cash and cash equivalents	20,359	226,432
Cash and cash equivalents at beginning of period	74,310	577,061
Cash and cash equivalents at end of period	94,669	803,493
Supplemental Information
Cash paid for interest	74,217	66,955
Cash paid for taxes	$ 16,423	$ 76,094

Basis of Presentation

Basis of Presentation	6 Months Ended
	Jun. 30, 2022
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, Select, and Select’s subsidiaries are collectively referred to as the “Company.” The unaudited condensed consolidated financial statements of the Company as of June 30, 2022, and for the three and six month periods ended June 30, 2021 and 2022, 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, 2022, are not necessarily indicative of the results to be expected for the full fiscal year ending December 31, 2022. 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, 2021, contained in the Company’s Annual Report on Form 10-K filed with the SEC on February 24, 2022.

Accounting Policies

Accounting Policies	6 Months Ended
	Jun. 30, 2022
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.

Credit Risk Concentrations

Credit Risk Concentrations	6 Months Ended
	Jun. 30, 2022
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 15% and 17% of the Company’s accounts receivable is due from Medicare at December 31, 2021 and June 30, 2022, respectively.

Redeemable Non-Controlling Inte

Redeemable Non-Controlling Interests	6 Months Ended
	Jun. 30, 2022
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 changes in redeemable non-controlling interests are as follows: Six Months Ended June 30, 2021 2022 (in thousands) Balance as of January 1 $ 398,171 $ 39,033 Net income attributable to redeemable non-controlling interests 9,626 1,918 Distributions to and purchases of redeemable non-controlling interests (614) (1,198) Redemption value adjustment on redeemable non-controlling interests 38,405 1,381 Other 343 536 Balance as of March 31 $ 445,931 $ 41,670 Net income attributable to redeemable non-controlling interests 18,073 1,900 Distributions to and purchases of redeemable non-controlling interests (1,987) (1,553) Redemption value adjustment on redeemable non-controlling interests 59,370 (355) Other 165 535 Balance as of June 30 $ 521,552 $ 42,197

Variable Interest Entities

Variable Interest Entities	6 Months Ended
	Jun. 30, 2022
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, 2021, and June 30, 2022, the total assets of the Company’s variable interest entities were $225.1 million and $256.9 million, respectively, and are principally comprised of accounts receivable. As of December 31, 2021, and June 30, 2022, the total liabilities of the Company’s variable interest entities were $74.8 million and $85.2 million, respectively, and are principally comprised of accounts payable and accrued expenses. These variable interest entities have obligations payable for services received under their management agreements with the Company of $150.3 million and $172.7 million as of December 31, 2021, and June 30, 2022, respectively. These intercompany balances are eliminated in consolidation.

Leases

Leases	6 Months Ended
	Jun. 30, 2022
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 is as follows: Three Months Ended June 30, 2021 Three Months Ended June 30, 2022 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 70,739 $ 1,798 $ 72,537 $ 73,969 $ 1,809 $ 75,778 Finance lease cost: Amortization of right-of-use assets 105 — 105 377 — 377 Interest on lease liabilities 254 — 254 336 — 336 Short-term lease cost — — — 15 — 15 Variable lease cost 13,086 141 13,227 14,407 141 14,548 Sublease income (2,229) — (2,229) (1,940) — (1,940) Total lease cost $ 81,955 $ 1,939 $ 83,894 $ 87,164 $ 1,950 $ 89,114 Six Months Ended June 30, 2021 Six Months Ended June 30, 2022 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 140,853 $ 3,597 $ 144,450 $ 147,931 $ 3,618 $ 151,549 Finance lease cost: Amortization of right-of-use assets 140 — 140 724 — 724 Interest on lease liabilities 505 — 505 676 — 676 Short-term lease cost — — — 50 — 50 Variable lease cost 26,095 144 26,239 28,062 180 28,242 Sublease income (4,463) — (4,463) (3,906) — (3,906) Total lease cost $ 163,130 $ 3,741 $ 166,871 $ 173,537 $ 3,798 $ 177,335 Supplemental cash flow information related to leases is as follows: Six Months Ended June 30, 2021 2022 (in thousands) Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 145,652 $ 155,160 Operating cash flows for finance leases 505 676 Financing cash flows for finance leases 145 475 Right-of-use assets obtained in exchange for lease liabilities: Operating leases $ 138,606 $ 185,739 Finance leases 138 312 Supplemental balance sheet information related to leases is as follows: December 31, 2021 June 30, 2022 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating Leases Operating lease right-of-use assets $ 1,052,603 $ 26,151 $ 1,078,754 $ 1,113,431 $ 23,247 $ 1,136,678 Current operating lease liabilities $ 222,865 $ 6,469 $ 229,334 $ 228,920 $ 4,997 $ 233,917 Non-current operating lease liabilities 894,104 22,436 916,540 953,918 20,739 974,657 Total operating lease liabilities $ 1,116,969 $ 28,905 $ 1,145,874 $ 1,182,838 $ 25,736 $ 1,208,574 December 31, 2021 June 30, 2022 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Finance Leases Property and equipment, net $ 8,505 $ — $ 8,505 $ 8,125 $ — $ 8,125 Current portion of long-term debt and notes payable $ 1,404 $ — $ 1,404 $ 1,544 $ — $ 1,544 Long-term debt, net of current portion 16,679 — 16,679 16,142 — 16,142 Total finance lease liabilities $ 18,083 $ — $ 18,083 $ 17,686 $ — $ 17,686 The weighted average remaining lease terms and discount rates are as follows: December 31, 2021 June 30, 2022 Weighted average remaining lease term (in years): Operating leases 7.8 7.7 Finance leases 24.7 24.6 Weighted average discount rate: Operating leases 5.6 % 5.6 % Finance leases 7.4 % 7.4 % As of June 30, 2022, maturities of lease liabilities are approximately as follows: Operating Leases Finance Leases (in thousands) 2022 (remainder of year) $ 151,002 $ 1,360 2023 274,735 2,747 2024 235,883 2,384 2025 192,554 2,101 2026 161,205 2,126 Thereafter 558,633 28,181 Total undiscounted cash flows 1,574,012 38,899 Less: Imputed interest 365,438 21,213 Total discounted lease liabilities $ 1,208,574 $ 17,686
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 is as follows: Three Months Ended June 30, 2021 Three Months Ended June 30, 2022 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 70,739 $ 1,798 $ 72,537 $ 73,969 $ 1,809 $ 75,778 Finance lease cost: Amortization of right-of-use assets 105 — 105 377 — 377 Interest on lease liabilities 254 — 254 336 — 336 Short-term lease cost — — — 15 — 15 Variable lease cost 13,086 141 13,227 14,407 141 14,548 Sublease income (2,229) — (2,229) (1,940) — (1,940) Total lease cost $ 81,955 $ 1,939 $ 83,894 $ 87,164 $ 1,950 $ 89,114 Six Months Ended June 30, 2021 Six Months Ended June 30, 2022 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 140,853 $ 3,597 $ 144,450 $ 147,931 $ 3,618 $ 151,549 Finance lease cost: Amortization of right-of-use assets 140 — 140 724 — 724 Interest on lease liabilities 505 — 505 676 — 676 Short-term lease cost — — — 50 — 50 Variable lease cost 26,095 144 26,239 28,062 180 28,242 Sublease income (4,463) — (4,463) (3,906) — (3,906) Total lease cost $ 163,130 $ 3,741 $ 166,871 $ 173,537 $ 3,798 $ 177,335 Supplemental cash flow information related to leases is as follows: Six Months Ended June 30, 2021 2022 (in thousands) Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 145,652 $ 155,160 Operating cash flows for finance leases 505 676 Financing cash flows for finance leases 145 475 Right-of-use assets obtained in exchange for lease liabilities: Operating leases $ 138,606 $ 185,739 Finance leases 138 312 Supplemental balance sheet information related to leases is as follows: December 31, 2021 June 30, 2022 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating Leases Operating lease right-of-use assets $ 1,052,603 $ 26,151 $ 1,078,754 $ 1,113,431 $ 23,247 $ 1,136,678 Current operating lease liabilities $ 222,865 $ 6,469 $ 229,334 $ 228,920 $ 4,997 $ 233,917 Non-current operating lease liabilities 894,104 22,436 916,540 953,918 20,739 974,657 Total operating lease liabilities $ 1,116,969 $ 28,905 $ 1,145,874 $ 1,182,838 $ 25,736 $ 1,208,574 December 31, 2021 June 30, 2022 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Finance Leases Property and equipment, net $ 8,505 $ — $ 8,505 $ 8,125 $ — $ 8,125 Current portion of long-term debt and notes payable $ 1,404 $ — $ 1,404 $ 1,544 $ — $ 1,544 Long-term debt, net of current portion 16,679 — 16,679 16,142 — 16,142 Total finance lease liabilities $ 18,083 $ — $ 18,083 $ 17,686 $ — $ 17,686 The weighted average remaining lease terms and discount rates are as follows: December 31, 2021 June 30, 2022 Weighted average remaining lease term (in years): Operating leases 7.8 7.7 Finance leases 24.7 24.6 Weighted average discount rate: Operating leases 5.6 % 5.6 % Finance leases 7.4 % 7.4 % As of June 30, 2022, maturities of lease liabilities are approximately as follows: Operating Leases Finance Leases (in thousands) 2022 (remainder of year) $ 151,002 $ 1,360 2023 274,735 2,747 2024 235,883 2,384 2025 192,554 2,101 2026 161,205 2,126 Thereafter 558,633 28,181 Total undiscounted cash flows 1,574,012 38,899 Less: Imputed interest 365,438 21,213 Total discounted lease liabilities $ 1,208,574 $ 17,686

Intangible Assets

Intangible Assets	6 Months Ended
	Jun. 30, 2022
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, 2022: Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Total (in thousands) Balance as of December 31, 2021 $ 1,131,440 $ 442,155 $ 654,125 $ 1,221,192 $ 3,448,912 Acquisition of businesses 6,505 — 3,618 3,927 14,050 Measurement period adjustment 13,251 — — — 13,251 Balance as of June 30, 2022 $ 1,151,196 $ 442,155 $ 657,743 $ 1,225,119 $ 3,476,213 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, 2021 June 30, 2022 Gross Accumulated Net Gross Accumulated Net (in thousands) Indefinite-lived intangible assets: Trademarks $ 166,698 $ — $ 166,698 $ 166,698 $ — $ 166,698 Certificates of need 21,478 — 21,478 22,966 — 22,966 Accreditations 1,874 — 1,874 1,874 — 1,874 Finite-lived intangible assets: Trademarks 5,000 (5,000) — 5,000 (5,000) — Customer relationships 304,289 (141,111) 163,178 309,109 (155,537) 153,572 Non-compete agreements 36,746 (15,095) 21,651 38,004 (16,892) 21,112 Total identifiable intangible assets $ 536,085 $ (161,206) $ 374,879 $ 543,651 $ (177,429) $ 366,222 The Company’s accreditations and trademarks have renewal terms, and the costs to renew these intangible assets are expensed as incurred. At June 30, 2022, the accreditations and trademarks have a weighted average time until next renewal of 1.5 years and 7.2 years, respectively. The Company’s finite-lived intangible assets amortize over their estimated useful lives. Amortization expense was $7.3 million and $7.7 million for the three months ended June 30, 2021 and 2022, respectively. Amortization expense was $14.4 million and $15.2 million for the six months ended June 30, 2021 and 2022, respectively.

Long-Term Debt and Notes Payabl

Long-Term Debt and Notes Payable	6 Months Ended
	Jun. 30, 2022
Debt Disclosure [Abstract]
Long-Term Debt and Notes Payable	Long-Term Debt and Notes Payable As of June 30, 2022, the Company’s long-term debt and notes payable were as follows: Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value (in thousands) 6.250% senior notes $ 1,225,000 $ 24,613 $ (12,463) $ 1,237,150 $ 1,142,313 Credit facilities: Revolving facility 350,000 — — 350,000 348,688 Term loan 2,103,437 (5,390) (5,875) 2,092,172 2,008,782 Other debt, including finance leases 88,595 — (174) 88,421 88,421 Total debt $ 3,767,032 $ 19,223 $ (18,512) $ 3,767,743 $ 3,588,204 Principal maturities of the Company’s long-term debt and notes payable were approximately as follows: 2022 2023 2024 2025 2026 Thereafter Total (in thousands) 6.250% senior notes $ — $ — $ — $ — $ 1,225,000 $ — $ 1,225,000 Credit facilities: Revolving facility — — 350,000 — — — 350,000 Term loan — 4,757 11,150 2,087,530 — — 2,103,437 Other debt, including finance leases 14,264 33,399 26,164 1,920 1,286 11,562 88,595 Total debt $ 14,264 $ 38,156 $ 387,314 $ 2,089,450 $ 1,226,286 $ 11,562 $ 3,767,032 As of December 31, 2021, the Company’s long-term debt and notes payable were as follows: Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value (in thousands) 6.250% senior notes $ 1,225,000 $ 27,635 $ (13,951) $ 1,238,684 $ 1,297,104 Credit facilities: Revolving facility 160,000 — — 160,000 159,400 Term loan 2,103,437 (6,386) (6,961) 2,090,090 2,087,661 Other debt, including finance leases 85,398 — (215) 85,183 85,183 Total debt $ 3,573,835 $ 21,249 $ (21,127) $ 3,573,957 $ 3,629,348

Interest Rate Cap

Interest Rate Cap	6 Months Ended
	Jun. 30, 2022
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 its term loan, which bears interest at a rate that is indexed to one-month LIBOR. 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 one-month LIBOR rate to 1.0% on $2.0 billion of principal outstanding under the term loan, as the interest rate cap provides for payments from the counterparty when interest rates rise above 1.0%. The interest rate cap has a $2.0 billion notional amount and became effective March 31, 2021, for the monthly periods from and including April 30, 2021, through September 30, 2024. The Company will pay a monthly premium for the interest rate cap over the term of the agreement. The annual premium is equal to 0.0916% of the notional amount, or approximately $1.8 million. The interest rate cap has been designated as a cash flow hedge and is highly effective at offsetting the changes in cash outflows when one-month LIBOR 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 and into interest expense when the hedged interest obligations affect earnings. The following table outlines the changes in accumulated other comprehensive income, net of tax, during the periods presented: Six Months Ended June 30, 2021 2022 (in thousands) Balance as of January 1 $ (2,027) $ 12,282 Gain on interest rate cap cash flow hedge 8,151 39,814 Amounts reclassified from accumulated other comprehensive income — 39 Balance as of March 31 $ 6,124 $ 52,135 Gain (loss) on interest rate cap cash flow hedge (1,403) 11,833 Amounts reclassified from accumulated other comprehensive income 6 (6) Balance as of June 30 $ 4,727 $ 63,962 The Company expects that approximately $40.3 million of estimated pre-tax gains will be reclassified from accumulated other comprehensive income into interest expense within the next twelve months.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	6 Months Ended
	Jun. 30, 2022
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 in the condensed consolidated balance sheets 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, 2021 June 30, 2022 Asset: (in thousands) Interest rate cap contract, current portion Other current assets Level 2 $ — $ 39,488 Interest rate cap contract, non-current portion Other assets Level 2 18,055 47,918 Liability: Interest rate cap contract, current portion Accrued other Level 2 $ 330 $ — The Company does not measure its indebtedness at fair value in its condensed consolidated balance sheets. The fair value of the 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, 2021 June 30, 2022 Financial Instrument Level Carrying Value Fair Value Carrying Value Fair Value (in thousands) 6.250% senior notes Level 2 $ 1,238,684 $ 1,297,104 $ 1,237,150 $ 1,142,313 Credit facilities: Revolving facility Level 2 160,000 159,400 350,000 348,688 Term loan Level 2 2,090,090 2,087,661 2,092,172 2,008,782

Segment Information

Segment Information	6 Months Ended
	Jun. 30, 2022
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 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, 2021 2022 2021 2022 (in thousands) Revenue: Critical illness recovery hospital $ 544,059 $ 545,908 $ 1,138,931 $ 1,147,663 Rehabilitation hospital 212,666 228,887 420,470 449,521 Outpatient rehabilitation 280,409 287,258 532,370 559,198 Concentra 456,372 441,357 879,212 864,780 Other 70,514 81,331 139,500 163,126 Total Company $ 1,564,020 $ 1,584,741 $ 3,110,483 $ 3,184,288 Adjusted EBITDA: Critical illness recovery hospital $ 72,904 $ 20,019 $ 186,176 $ 55,986 Rehabilitation hospital 50,768 49,845 101,302 92,224 Outpatient rehabilitation 45,633 33,601 71,962 60,197 Concentra (1) 137,060 92,607 219,075 182,076 Other (2) 35,656 (15,078) 21,847 (45,642) Total Company $ 342,021 $ 180,994 $ 600,362 $ 344,841 Total assets: Critical illness recovery hospital $ 2,187,181 $ 2,387,516 $ 2,187,181 $ 2,387,516 Rehabilitation hospital 1,186,886 1,194,739 1,186,886 1,194,739 Outpatient rehabilitation 1,333,661 1,360,600 1,333,661 1,360,600 Concentra 2,518,369 2,301,296 2,518,369 2,301,296 Other 730,282 307,507 730,282 307,507 Total Company $ 7,956,379 $ 7,551,658 $ 7,956,379 $ 7,551,658 Purchases of property and equipment: Critical illness recovery hospital $ 16,499 $ 19,528 $ 30,884 $ 39,097 Rehabilitation hospital 3,257 4,821 3,922 11,095 Outpatient rehabilitation 7,448 9,314 14,783 18,728 Concentra 7,591 8,716 20,271 18,956 Other 1,928 3,953 6,582 5,301 Total Company $ 36,723 $ 46,332 $ 76,442 $ 93,177 _______________________________________________________________________________ (1) For the three and six months ended June 30, 2021, Adjusted EBITDA included other operating income of $32.3 million 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”). (2) For the three and six months ended June 30, 2022, Adjusted EBITDA included other operating income of $15.1 million. For the three and six months ended June 30, 2021, Adjusted EBITDA included other operating income of $65.8 million and $81.9 million, respectively. The other operating income is related to the recognition of payments received under the Provider Relief Fund for health care related expenses and loss of revenue attributable to COVID-19. A reconciliation of Adjusted EBITDA to income before income taxes is as follows: 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 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 Three Months Ended June 30, 2022 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 20,019 $ 49,845 $ 33,601 $ 92,607 $ (15,078) Depreciation and amortization (14,603) (7,175) (8,130) (18,730) (2,443) Stock compensation expense — — — (536) (8,410) Income (loss) from operations $ 5,416 $ 42,670 $ 25,471 $ 73,341 $ (25,931) $ 120,967 Equity in earnings of unconsolidated subsidiaries 6,167 Interest expense (41,052) Income before income taxes $ 86,082 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 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 Six Months Ended June 30, 2022 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 55,986 $ 92,224 $ 60,197 $ 182,076 $ (45,642) Depreciation and amortization (29,221) (13,977) (16,159) (37,542) (5,221) Stock compensation expense — — — (1,071) (16,698) Income (loss) from operations $ 26,765 $ 78,247 $ 44,038 $ 143,463 $ (67,561) $ 224,952 Equity in earnings of unconsolidated subsidiaries 11,564 Interest expense (76,566) Income before income taxes $ 159,950

Revenue from Contracts with Cus

Revenue from Contracts with Customers	6 Months Ended
	Jun. 30, 2022
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, 2021 and 2022: 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 Three Months Ended June 30, 2022 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 213,680 $ 105,030 $ 44,433 $ 195 $ — $ 363,338 Non-Medicare 329,118 113,001 224,957 439,779 — 1,106,855 Total patient services revenues 542,798 218,031 269,390 439,974 — 1,470,193 Other revenue 3,110 10,856 17,868 1,383 81,331 114,548 Total revenue $ 545,908 $ 228,887 $ 287,258 $ 441,357 $ 81,331 $ 1,584,741 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 Six Months Ended June 30, 2022 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 432,667 $ 208,051 $ 86,337 $ 372 $ — $ 727,427 Non-Medicare 710,104 220,143 439,070 861,825 — 2,231,142 Total patient services revenues 1,142,771 428,194 525,407 862,197 — 2,958,569 Other revenue 4,892 21,327 33,791 2,583 163,126 225,719 Total revenue $ 1,147,663 $ 449,521 $ 559,198 $ 864,780 $ 163,126 $ 3,184,288

Earnings per Share

Earnings per Share	6 Months Ended
	Jun. 30, 2022
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, 2021 and 2022. (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, 2021 2022 2021 2022 (in thousands) Net income $ 196,208 $ 66,262 $ 333,422 $ 122,188 Less: net income attributable to non-controlling interests 31,314 11,055 57,982 17,864 Net income attributable to the Company 164,894 55,207 275,440 104,324 Less: Distributed and undistributed income attributable to participating securities 5,560 1,920 9,250 3,558 Distributed and undistributed income attributable to common shares $ 159,334 $ 53,287 $ 266,190 $ 100,766 The following tables set forth the computation of EPS under the two-class method: Three Months Ended June 30, 2021 2022 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 $ 159,334 130,396 $ 1.22 $ 53,287 124,897 $ 0.43 Participating securities 5,560 4,550 $ 1.22 1,920 4,500 $ 0.43 Total Company $ 164,894 $ 55,207 Six Months Ended June 30, 2021 2022 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 $ 266,190 130,362 $ 2.04 $ 100,766 126,942 $ 0.79 Participating securities 9,250 4,530 $ 2.04 3,558 4,482 $ 0.79 Total Company $ 275,440 $ 104,324 _______________________________________________________________________________ (1) Represents the weighted average share count outstanding during the period.

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2022
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 also maintains additional types of liability insurance covering claims which, due to their nature or amount, are not covered by or not fully covered by the Company’s professional and general liability insurance policies. These insurance policies also do not generally cover punitive damages and are subject to various deductibles and policy limits. The Company reviews its insurance program annually and may make adjustments to the amount of insurance coverage and self-insured retentions in future years. 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. 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 government’s investigation appears to be focused on respiratory therapy services and billings. 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 is fully cooperating with this investigation. At this time, the Company is unable to predict the timing and outcome of this matter. Physical Therapy Billing . On October 7, 2021, the Company received a letter from a Trial Attorney at the U.S. Department of Justice, Civil Division, Commercial Litigation Branch, Fraud Section (“DOJ”) stating that the DOJ, in conjunction with the U.S. Department of health and Human Services, is investigating the Company in connection with potential violations of the False Claims Act, 31 U.S.C. § 3729, et seq . The letter specified that the investigation relates to the Company’s billing for physical therapy services, and indicated that the DOJ would be requesting certain records from the Company. In October and December 2021, the DOJ requested, and the Company furnished, records relating to six of the Company’s outpatient therapy clinics in Florida. In May and July 2022, the DOJ requested certain data relating to all of the Company’s outpatient therapy clinics nationwide, and sought information about the Company’s ability to produce additional data relating to the physical therapy services furnished by the Company and Concentra. The Company is fully cooperating with the DOJ on this investigation. At this time, the Company is unable to predict the timing and outcome of this matter.

Subsequent Event

Subsequent Event	6 Months Ended
	Jun. 30, 2022
Subsequent Events [Abstract]
Subsequent Event	Subsequent Event On August 2, 2022, the Company’s board of directors declared a cash dividend of $0.125 per share. The dividend will be payable on or about September 2, 2022, to stockholders of record as of the close of business on August 16, 2022.

Accounting Policies (Policies)

Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2022
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.
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 InterestsThe 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.
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, 2022
Noncontrolling Interest [Abstract]
Schedule of redeemable non-controlling interests	The changes in redeemable non-controlling interests are as follows: Six Months Ended June 30, 2021 2022 (in thousands) Balance as of January 1 $ 398,171 $ 39,033 Net income attributable to redeemable non-controlling interests 9,626 1,918 Distributions to and purchases of redeemable non-controlling interests (614) (1,198) Redemption value adjustment on redeemable non-controlling interests 38,405 1,381 Other 343 536 Balance as of March 31 $ 445,931 $ 41,670 Net income attributable to redeemable non-controlling interests 18,073 1,900 Distributions to and purchases of redeemable non-controlling interests (1,987) (1,553) Redemption value adjustment on redeemable non-controlling interests 59,370 (355) Other 165 535 Balance as of June 30 $ 521,552 $ 42,197

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 2022
Leases [Abstract]
Schedule of lease cost	The Company’s total lease cost is as follows: Three Months Ended June 30, 2021 Three Months Ended June 30, 2022 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 70,739 $ 1,798 $ 72,537 $ 73,969 $ 1,809 $ 75,778 Finance lease cost: Amortization of right-of-use assets 105 — 105 377 — 377 Interest on lease liabilities 254 — 254 336 — 336 Short-term lease cost — — — 15 — 15 Variable lease cost 13,086 141 13,227 14,407 141 14,548 Sublease income (2,229) — (2,229) (1,940) — (1,940) Total lease cost $ 81,955 $ 1,939 $ 83,894 $ 87,164 $ 1,950 $ 89,114 Six Months Ended June 30, 2021 Six Months Ended June 30, 2022 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 140,853 $ 3,597 $ 144,450 $ 147,931 $ 3,618 $ 151,549 Finance lease cost: Amortization of right-of-use assets 140 — 140 724 — 724 Interest on lease liabilities 505 — 505 676 — 676 Short-term lease cost — — — 50 — 50 Variable lease cost 26,095 144 26,239 28,062 180 28,242 Sublease income (4,463) — (4,463) (3,906) — (3,906) Total lease cost $ 163,130 $ 3,741 $ 166,871 $ 173,537 $ 3,798 $ 177,335 The weighted average remaining lease terms and discount rates are as follows: December 31, 2021 June 30, 2022 Weighted average remaining lease term (in years): Operating leases 7.8 7.7 Finance leases 24.7 24.6 Weighted average discount rate: Operating leases 5.6 % 5.6 % Finance leases 7.4 % 7.4 %
Supplemental cash flow information	Supplemental cash flow information related to leases is as follows: Six Months Ended June 30, 2021 2022 (in thousands) Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 145,652 $ 155,160 Operating cash flows for finance leases 505 676 Financing cash flows for finance leases 145 475 Right-of-use assets obtained in exchange for lease liabilities: Operating leases $ 138,606 $ 185,739 Finance leases 138 312
Supplemental balance sheet information	Supplemental balance sheet information related to leases is as follows: December 31, 2021 June 30, 2022 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating Leases Operating lease right-of-use assets $ 1,052,603 $ 26,151 $ 1,078,754 $ 1,113,431 $ 23,247 $ 1,136,678 Current operating lease liabilities $ 222,865 $ 6,469 $ 229,334 $ 228,920 $ 4,997 $ 233,917 Non-current operating lease liabilities 894,104 22,436 916,540 953,918 20,739 974,657 Total operating lease liabilities $ 1,116,969 $ 28,905 $ 1,145,874 $ 1,182,838 $ 25,736 $ 1,208,574 December 31, 2021 June 30, 2022 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Finance Leases Property and equipment, net $ 8,505 $ — $ 8,505 $ 8,125 $ — $ 8,125 Current portion of long-term debt and notes payable $ 1,404 $ — $ 1,404 $ 1,544 $ — $ 1,544 Long-term debt, net of current portion 16,679 — 16,679 16,142 — 16,142 Total finance lease liabilities $ 18,083 $ — $ 18,083 $ 17,686 $ — $ 17,686
Maturities of operating lease liabilities	As of June 30, 2022, maturities of lease liabilities are approximately as follows: Operating Leases Finance Leases (in thousands) 2022 (remainder of year) $ 151,002 $ 1,360 2023 274,735 2,747 2024 235,883 2,384 2025 192,554 2,101 2026 161,205 2,126 Thereafter 558,633 28,181 Total undiscounted cash flows 1,574,012 38,899 Less: Imputed interest 365,438 21,213 Total discounted lease liabilities $ 1,208,574 $ 17,686
Maturities of finance lease liabilities	As of June 30, 2022, maturities of lease liabilities are approximately as follows: Operating Leases Finance Leases (in thousands) 2022 (remainder of year) $ 151,002 $ 1,360 2023 274,735 2,747 2024 235,883 2,384 2025 192,554 2,101 2026 161,205 2,126 Thereafter 558,633 28,181 Total undiscounted cash flows 1,574,012 38,899 Less: Imputed interest 365,438 21,213 Total discounted lease liabilities $ 1,208,574 $ 17,686

Intangible Assets (Tables)

Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2022
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, 2022: Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Total (in thousands) Balance as of December 31, 2021 $ 1,131,440 $ 442,155 $ 654,125 $ 1,221,192 $ 3,448,912 Acquisition of businesses 6,505 — 3,618 3,927 14,050 Measurement period adjustment 13,251 — — — 13,251 Balance as of June 30, 2022 $ 1,151,196 $ 442,155 $ 657,743 $ 1,225,119 $ 3,476,213
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, 2021 June 30, 2022 Gross Accumulated Net Gross Accumulated Net (in thousands) Indefinite-lived intangible assets: Trademarks $ 166,698 $ — $ 166,698 $ 166,698 $ — $ 166,698 Certificates of need 21,478 — 21,478 22,966 — 22,966 Accreditations 1,874 — 1,874 1,874 — 1,874 Finite-lived intangible assets: Trademarks 5,000 (5,000) — 5,000 (5,000) — Customer relationships 304,289 (141,111) 163,178 309,109 (155,537) 153,572 Non-compete agreements 36,746 (15,095) 21,651 38,004 (16,892) 21,112 Total identifiable intangible assets $ 536,085 $ (161,206) $ 374,879 $ 543,651 $ (177,429) $ 366,222

Long-Term Debt and Notes Paya_2

Long-Term Debt and Notes Payable (Tables)	6 Months Ended
	Jun. 30, 2022
Debt Disclosure [Abstract]
Schedule of long-term debt and notes payable	As of June 30, 2022, the Company’s long-term debt and notes payable were as follows: Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value (in thousands) 6.250% senior notes $ 1,225,000 $ 24,613 $ (12,463) $ 1,237,150 $ 1,142,313 Credit facilities: Revolving facility 350,000 — — 350,000 348,688 Term loan 2,103,437 (5,390) (5,875) 2,092,172 2,008,782 Other debt, including finance leases 88,595 — (174) 88,421 88,421 Total debt $ 3,767,032 $ 19,223 $ (18,512) $ 3,767,743 $ 3,588,204 As of December 31, 2021, the Company’s long-term debt and notes payable were as follows: Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value (in thousands) 6.250% senior notes $ 1,225,000 $ 27,635 $ (13,951) $ 1,238,684 $ 1,297,104 Credit facilities: Revolving facility 160,000 — — 160,000 159,400 Term loan 2,103,437 (6,386) (6,961) 2,090,090 2,087,661 Other debt, including finance leases 85,398 — (215) 85,183 85,183 Total debt $ 3,573,835 $ 21,249 $ (21,127) $ 3,573,957 $ 3,629,348
Schedule of principal maturities of long-term debt and notes payable	Principal maturities of the Company’s long-term debt and notes payable were approximately as follows: 2022 2023 2024 2025 2026 Thereafter Total (in thousands) 6.250% senior notes $ — $ — $ — $ — $ 1,225,000 $ — $ 1,225,000 Credit facilities: Revolving facility — — 350,000 — — — 350,000 Term loan — 4,757 11,150 2,087,530 — — 2,103,437 Other debt, including finance leases 14,264 33,399 26,164 1,920 1,286 11,562 88,595 Total debt $ 14,264 $ 38,156 $ 387,314 $ 2,089,450 $ 1,226,286 $ 11,562 $ 3,767,032

Interest Rate Cap (Tables)

Interest Rate Cap (Tables)	6 Months Ended
	Jun. 30, 2022
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of accumulated other comprehensive income	The following table outlines the changes in accumulated other comprehensive income, net of tax, during the periods presented: Six Months Ended June 30, 2021 2022 (in thousands) Balance as of January 1 $ (2,027) $ 12,282 Gain on interest rate cap cash flow hedge 8,151 39,814 Amounts reclassified from accumulated other comprehensive income — 39 Balance as of March 31 $ 6,124 $ 52,135 Gain (loss) on interest rate cap cash flow hedge (1,403) 11,833 Amounts reclassified from accumulated other comprehensive income 6 (6) Balance as of June 30 $ 4,727 $ 63,962

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	6 Months Ended
	Jun. 30, 2022
Fair Value Disclosures [Abstract]
Schedule of interest rate cap	Financial Instrument Balance Sheet Classification Level December 31, 2021 June 30, 2022 Asset: (in thousands) Interest rate cap contract, current portion Other current assets Level 2 $ — $ 39,488 Interest rate cap contract, non-current portion Other assets Level 2 18,055 47,918 Liability: Interest rate cap contract, current portion Accrued other Level 2 $ 330 $ —
Schedule of long-term debt	December 31, 2021 June 30, 2022 Financial Instrument Level Carrying Value Fair Value Carrying Value Fair Value (in thousands) 6.250% senior notes Level 2 $ 1,238,684 $ 1,297,104 $ 1,237,150 $ 1,142,313 Credit facilities: Revolving facility Level 2 160,000 159,400 350,000 348,688 Term loan Level 2 2,090,090 2,087,661 2,092,172 2,008,782

Segment Information (Tables)

Segment Information (Tables)	6 Months Ended
	Jun. 30, 2022
Segment Reporting [Abstract]
Schedule of selected financial data for 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, 2021 2022 2021 2022 (in thousands) Revenue: Critical illness recovery hospital $ 544,059 $ 545,908 $ 1,138,931 $ 1,147,663 Rehabilitation hospital 212,666 228,887 420,470 449,521 Outpatient rehabilitation 280,409 287,258 532,370 559,198 Concentra 456,372 441,357 879,212 864,780 Other 70,514 81,331 139,500 163,126 Total Company $ 1,564,020 $ 1,584,741 $ 3,110,483 $ 3,184,288 Adjusted EBITDA: Critical illness recovery hospital $ 72,904 $ 20,019 $ 186,176 $ 55,986 Rehabilitation hospital 50,768 49,845 101,302 92,224 Outpatient rehabilitation 45,633 33,601 71,962 60,197 Concentra (1) 137,060 92,607 219,075 182,076 Other (2) 35,656 (15,078) 21,847 (45,642) Total Company $ 342,021 $ 180,994 $ 600,362 $ 344,841 Total assets: Critical illness recovery hospital $ 2,187,181 $ 2,387,516 $ 2,187,181 $ 2,387,516 Rehabilitation hospital 1,186,886 1,194,739 1,186,886 1,194,739 Outpatient rehabilitation 1,333,661 1,360,600 1,333,661 1,360,600 Concentra 2,518,369 2,301,296 2,518,369 2,301,296 Other 730,282 307,507 730,282 307,507 Total Company $ 7,956,379 $ 7,551,658 $ 7,956,379 $ 7,551,658 Purchases of property and equipment: Critical illness recovery hospital $ 16,499 $ 19,528 $ 30,884 $ 39,097 Rehabilitation hospital 3,257 4,821 3,922 11,095 Outpatient rehabilitation 7,448 9,314 14,783 18,728 Concentra 7,591 8,716 20,271 18,956 Other 1,928 3,953 6,582 5,301 Total Company $ 36,723 $ 46,332 $ 76,442 $ 93,177 _______________________________________________________________________________ (1) For the three and six months ended June 30, 2021, Adjusted EBITDA included other operating income of $32.3 million 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”). (2) For the three and six months ended June 30, 2022, Adjusted EBITDA included other operating income of $15.1 million. For the three and six months ended June 30, 2021, Adjusted EBITDA included other operating income of $65.8 million and $81.9 million, respectively. The other operating income is related to the recognition of payments received under the Provider Relief Fund for health care related expenses and loss of revenue attributable to COVID-19.
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, 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 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 Three Months Ended June 30, 2022 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 20,019 $ 49,845 $ 33,601 $ 92,607 $ (15,078) Depreciation and amortization (14,603) (7,175) (8,130) (18,730) (2,443) Stock compensation expense — — — (536) (8,410) Income (loss) from operations $ 5,416 $ 42,670 $ 25,471 $ 73,341 $ (25,931) $ 120,967 Equity in earnings of unconsolidated subsidiaries 6,167 Interest expense (41,052) Income before income taxes $ 86,082 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 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 Six Months Ended June 30, 2022 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 55,986 $ 92,224 $ 60,197 $ 182,076 $ (45,642) Depreciation and amortization (29,221) (13,977) (16,159) (37,542) (5,221) Stock compensation expense — — — (1,071) (16,698) Income (loss) from operations $ 26,765 $ 78,247 $ 44,038 $ 143,463 $ (67,561) $ 224,952 Equity in earnings of unconsolidated subsidiaries 11,564 Interest expense (76,566) Income before income taxes $ 159,950

Revenue from Contracts with C_2

Revenue from Contracts with Customers (Tables)	6 Months Ended
	Jun. 30, 2022
Revenue from Contract with Customer [Abstract]
Schedule of disaggregation of revenue	The following tables disaggregate the Company’s revenue for the three and six months ended June 30, 2021 and 2022: 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 Three Months Ended June 30, 2022 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 213,680 $ 105,030 $ 44,433 $ 195 $ — $ 363,338 Non-Medicare 329,118 113,001 224,957 439,779 — 1,106,855 Total patient services revenues 542,798 218,031 269,390 439,974 — 1,470,193 Other revenue 3,110 10,856 17,868 1,383 81,331 114,548 Total revenue $ 545,908 $ 228,887 $ 287,258 $ 441,357 $ 81,331 $ 1,584,741 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 Six Months Ended June 30, 2022 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 432,667 $ 208,051 $ 86,337 $ 372 $ — $ 727,427 Non-Medicare 710,104 220,143 439,070 861,825 — 2,231,142 Total patient services revenues 1,142,771 428,194 525,407 862,197 — 2,958,569 Other revenue 4,892 21,327 33,791 2,583 163,126 225,719 Total revenue $ 1,147,663 $ 449,521 $ 559,198 $ 864,780 $ 163,126 $ 3,184,288

Earnings per Share (Tables)

Earnings per Share (Tables)	6 Months Ended
	Jun. 30, 2022
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, 2021 2022 2021 2022 (in thousands) Net income $ 196,208 $ 66,262 $ 333,422 $ 122,188 Less: net income attributable to non-controlling interests 31,314 11,055 57,982 17,864 Net income attributable to the Company 164,894 55,207 275,440 104,324 Less: Distributed and undistributed income attributable to participating securities 5,560 1,920 9,250 3,558 Distributed and undistributed income attributable to common shares $ 159,334 $ 53,287 $ 266,190 $ 100,766 The following tables set forth the computation of EPS under the two-class method: Three Months Ended June 30, 2021 2022 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 $ 159,334 130,396 $ 1.22 $ 53,287 124,897 $ 0.43 Participating securities 5,560 4,550 $ 1.22 1,920 4,500 $ 0.43 Total Company $ 164,894 $ 55,207 Six Months Ended June 30, 2021 2022 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 $ 266,190 130,362 $ 2.04 $ 100,766 126,942 $ 0.79 Participating securities 9,250 4,530 $ 2.04 3,558 4,482 $ 0.79 Total Company $ 275,440 $ 104,324 _______________________________________________________________________________ (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, 2022	Dec. 31, 2021
Medicare Receivable | Credit Concentration Risk | Accounts Receivable
Concentration Risk [Line Items]
Percentage of concentration risk	17%	15%

Redeemable Non-Controlling In_3

Redeemable Non-Controlling Interests - Schedule of Redeemable Non-Controlling Interests (Details) - USD ($) $ in Thousands	3 Months Ended
	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2021	Mar. 31, 2021
Increase (Decrease) in Temporary Equity [Roll Forward]
Balance, beginning	$ 41,670	$ 39,033	$ 445,931	$ 398,171
Net income attributable to redeemable non-controlling interests	1,900	1,918	18,073	9,626
Distributions to and purchases of redeemable non-controlling interests	(1,553)	(1,198)	(1,987)	(614)
Redemption value adjustment on redeemable non-controlling interests	(355)	1,381	59,370	38,405
Other	535	536	165	343
Balance, ending	$ 42,197	$ 41,670	$ 521,552	$ 445,931

Variable Interest Entities (Det

Variable Interest Entities (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021	Jun. 30, 2021
Variable Interest Entity [Line Items]
Assets	$ 7,551,658	$ 7,360,171	$ 7,956,379
Liabilities	6,205,760	5,995,236
Variable Interest Entity, Primary Beneficiary
Variable Interest Entity [Line Items]
Assets	256,900	225,100
Liabilities	85,200	74,800
Obligations payable	$ 172,700	$ 150,300

Leases - Schedule of Lease Cost

Leases - Schedule of Lease Cost (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Operating lease cost
Unrelated Parties	$ 73,969	$ 70,739	$ 147,931	$ 140,853
Related Parties	1,809	1,798	3,618	3,597
Total	75,778	72,537	151,549	144,450
Amortization of right-of-use assets
Unrelated Parties	377	105	724	140
Related Parties	0	0	0	0
Total	377	105	724	140
Interest on lease liabilities
Unrelated Parties	336	254	676	505
Related Parties	0	0	0	0
Total	336	254	676	505
Short-term lease cost
Unrelated Parties	15	0	50	0
Related Parties	0	0	0	0
Total	15	0	50	0
Variable lease cost
Unrelated Parties	14,407	13,086	28,062	26,095
Related Parties	141	141	180	144
Total	14,548	13,227	28,242	26,239
Sublease income
Unrelated Parties	(1,940)	(2,229)	(3,906)	(4,463)
Related Parties	0	0	0	0
Total	(1,940)	(2,229)	(3,906)	(4,463)
Total lease cost
Unrelated Parties	87,164	81,955	173,537	163,130
Related Parties	1,950	1,939	3,798	3,741
Total	$ 89,114	$ 83,894	$ 177,335	$ 166,871

Leases - Supplemental Cash Flow

Leases - Supplemental Cash Flow Information (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$ 155,160	$ 145,652
Operating cash flows for finance leases	676	505
Financing cash flows for finance leases	475	145
Right-of-use assets obtained in exchange for lease liabilities:
Operating leases	185,739	138,606
Finance leases	$ 312	$ 138

Leases - Supplemental Balance S

Leases - Supplemental Balance Sheet Information (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Operating lease right-of-use assets
Unrelated Parties	$ 1,113,431	$ 1,052,603
Related Parties	23,247	26,151
Total	1,136,678	1,078,754
Current operating lease liabilities
Unrelated Parties	228,920	222,865
Related Parties	4,997	6,469
Total	233,917	229,334
Non-current operating lease liabilities
Unrelated Parties	953,918	894,104
Related Parties	20,739	22,436
Total	974,657	916,540
Total operating lease liabilities
Unrelated Parties	1,182,838	1,116,969
Related Parties	25,736	28,905
Total	1,208,574	1,145,874
Property and equipment, net
Unrelated Parties	8,125	8,505
Related Parties	0	0
Total	$ 8,125	$ 8,505
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Property and equipment, net	Property and equipment, net
Current portion of long-term debt and notes payable
Unrelated Parties	$ 1,544	$ 1,404
Related Parties	0	0
Total	$ 1,544	$ 1,404
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Current portion of long-term debt and notes payable	Current portion of long-term debt and notes payable
Long-term debt, net of current portion
Unrelated Parties	$ 16,142	$ 16,679
Related Parties	0	0
Total	$ 16,142	$ 16,679
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Long-term debt, net of current portion	Long-term debt, net of current portion
Total finance lease liabilities
Unrelated Parties	$ 17,686	$ 18,083
Related Parties	0	0
Total	$ 17,686	$ 18,083

Leases - Weighted Average Lease

Leases - Weighted Average Lease Terms and Discount Rates (Details)	Jun. 30, 2022	Dec. 31, 2021
Weighted average remaining lease term (in years):
Operating leases	7 years 8 months 12 days	7 years 9 months 18 days
Finance leases	24 years 7 months 6 days	24 years 8 months 12 days
Weighted average discount rate:
Operating leases	5.60%	5.60%
Finance leases	7.40%	7.40%

Leases - Maturities of Operatin

Leases - Maturities of Operating and Finance Lease Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Operating Leases
2022 (remainder of year)	$ 151,002
2023	274,735
2024	235,883
2025	192,554
2026	161,205
Thereafter	558,633
Total undiscounted cash flows	1,574,012
Less: Imputed interest	365,438
Total discounted lease liabilities	1,208,574	$ 1,145,874
Finance Leases
2022 (remainder of year)	1,360
2023	2,747
2024	2,384
2025	2,101
2026	2,126
Thereafter	28,181
Total undiscounted cash flows	38,899
Less: Imputed interest	21,213
Total finance lease liabilities	$ 17,686	$ 18,083

Intangible Assets - Carrying Am

Intangible Assets - Carrying Amount of Goodwill (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2022 USD ($)
Goodwill [Roll Forward]
Goodwill, Beginning Balance	$ 3,448,912
Acquisition of businesses	14,050
Measurement period adjustment	13,251
Goodwill, Ending Balance	3,476,213
Critical Illness Recovery Hospital
Goodwill [Roll Forward]
Goodwill, Beginning Balance	1,131,440
Acquisition of businesses	6,505
Measurement period adjustment	13,251
Goodwill, Ending Balance	1,151,196
Rehabilitation Hospital
Goodwill [Roll Forward]
Goodwill, Beginning Balance	442,155
Acquisition of businesses	0
Measurement period adjustment	0
Goodwill, Ending Balance	442,155
Outpatient Rehabilitation
Goodwill [Roll Forward]
Goodwill, Beginning Balance	654,125
Acquisition of businesses	3,618
Measurement period adjustment	0
Goodwill, Ending Balance	657,743
Concentra
Goodwill [Roll Forward]
Goodwill, Beginning Balance	1,221,192
Acquisition of businesses	3,927
Measurement period adjustment	0
Goodwill, Ending Balance	$ 1,225,119

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, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2021
Finite Lived And Indefinite Lived Intangible Assets By Major Class [Line Items]
Finite-lived intangible assets, accumulated amortization	$ (177,429)		$ (177,429)		$ (161,206)
Total identifiable intangible assets, gross carrying amount	543,651		543,651		536,085
Total identifiable intangible assets, net carrying amount	366,222		366,222		374,879
Amortized intangible assets:
Amortization expense	7,700	$ 7,300	15,200	$ 14,400
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	309,109		309,109		304,289
Finite-lived intangible assets, accumulated amortization	(155,537)		(155,537)		(141,111)
Finite-lived intangible assets, net carrying amount	153,572		153,572		163,178
Non-compete agreements
Finite Lived And Indefinite Lived Intangible Assets By Major Class [Line Items]
Finite-lived intangible assets, gross carrying amount	38,004		38,004		36,746
Finite-lived intangible assets, accumulated amortization	(16,892)		(16,892)		(15,095)
Finite-lived intangible assets, net carrying amount	21,112		21,112		21,651
Trademarks
Finite Lived And Indefinite Lived Intangible Assets By Major Class [Line Items]
Indefinite-lived intangible assets	166,698		$ 166,698		166,698
Amortized intangible assets:
Weighted average time until next renewal (in years)			7 years 2 months 12 days
Certificates of need
Finite Lived And Indefinite Lived Intangible Assets By Major Class [Line Items]
Indefinite-lived intangible assets	22,966		$ 22,966		21,478
Accreditations
Finite Lived And Indefinite Lived Intangible Assets By Major Class [Line Items]
Indefinite-lived intangible assets	$ 1,874		$ 1,874		$ 1,874
Amortized intangible assets:
Weighted average time until next renewal (in years)			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, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Principal Outstanding	$ 3,767,032	$ 3,573,835
Unamortized Premium (Discount)	19,223	21,249
Unamortized Issuance Costs	(18,512)	(21,127)
Carrying Value	3,767,743	3,573,957
Fair Value	$ 3,588,204	$ 3,629,348
Senior notes | 6.250% 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)	24,613	27,635
Unamortized Issuance Costs	(12,463)	(13,951)
Carrying Value	1,237,150	1,238,684
Fair Value	1,142,313	1,297,104
Term loan
Debt Instrument [Line Items]
Principal Outstanding	2,103,437	2,103,437
Unamortized Premium (Discount)	(5,390)	(6,386)
Unamortized Issuance Costs	(5,875)	(6,961)
Carrying Value	2,092,172	2,090,090
Fair Value	2,008,782	2,087,661
Other debt, including finance leases
Debt Instrument [Line Items]
Principal Outstanding	88,595	85,398
Unamortized Premium (Discount)	0	0
Unamortized Issuance Costs	(174)	(215)
Carrying Value	88,421	85,183
Fair Value	88,421	85,183
Revolving facility | Revolving facility
Debt Instrument [Line Items]
Principal Outstanding	350,000	160,000
Unamortized Premium (Discount)	0	0
Unamortized Issuance Costs	0	0
Carrying Value	350,000	160,000
Fair Value	$ 348,688	$ 159,400

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, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
2022	$ 14,264
2023	38,156
2024	387,314
2025	2,089,450
2026	1,226,286
Thereafter	11,562
Total	$ 3,767,032	$ 3,573,835
Senior notes | 6.250% senior notes
Debt Instrument [Line Items]
Interest rate of debt (as a percent)	6.25%	6.25%
2022	$ 0
2023	0
2024	0
2025	0
2026	1,225,000
Thereafter	0
Total	1,225,000	$ 1,225,000
Revolving facility | Revolving facility
Debt Instrument [Line Items]
2022	0
2023	0
2024	350,000
2025	0
2026	0
Thereafter	0
Total	350,000	160,000
Term loan
Debt Instrument [Line Items]
2022	0
2023	4,757
2024	11,150
2025	2,087,530
2026	0
Thereafter	0
Total	2,103,437	2,103,437
Other debt, including finance leases
Debt Instrument [Line Items]
2022	14,264
2023	33,399
2024	26,164
2025	1,920
2026	1,286
Thereafter	11,562
Total	$ 88,595	$ 85,398

Interest Rate Cap - Narrative (

Interest Rate Cap - Narrative (Details) - Interest Rate Cap $ in Millions	6 Months Ended
	Jun. 30, 2022 USD ($)
Derivative [Line Items]
Derivative cap interest rate (as a percent)	1%
Notional amount	$ 2,000
Annual premium (in percent)	0.000916
Annual premium amount	$ 1.8
Estimated pre-tax gain expected to be reclassified in the next twelve months	$ 40.3

Interest Rate Cap - Schedule of

Interest Rate Cap - Schedule of Accumulated Other Comprehensive Income (Details) - USD ($) $ in Thousands	3 Months Ended
	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2021	Mar. 31, 2021
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	$ 1,366,896	$ 1,325,902	$ 1,350,617	$ 1,252,973
Ending balance	1,303,701	1,366,896	1,449,892	1,350,617
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	52,135	12,282	6,124	(2,027)
Gain (loss) on interest rate cap cash flow hedge	11,833	39,814	(1,403)	8,151
Amounts reclassified from accumulated other comprehensive income	(6)	39	6	0
Ending balance	$ 63,962	$ 52,135	$ 4,727	$ 6,124

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, 2022	Dec. 31, 2021
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Interest rate cap contract, current portion	$ 39,488	$ 0
Interest rate cap contract, non-current portion	47,918	18,055
Interest rate cap contract, current portion	$ 0	$ 330

Fair Value of Financial Instr_4

Fair Value of Financial Instruments - Schedule of Long-Term Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	$ 3,588,204	$ 3,629,348
Senior notes | 6.250% senior notes
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	$ 1,237,150	$ 1,238,684
Fair Value	1,142,313	1,297,104
Senior notes | Fair Value, Inputs, Level 2 | 6.250% senior notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Carrying Value	1,237,150	1,238,684
Fair Value	1,142,313	1,297,104
Revolving facility | Fair Value, Inputs, Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Carrying Value	350,000	160,000
Fair Value	348,688	159,400
Term loan
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Carrying Value	2,092,172	2,090,090
Fair Value	2,008,782	2,087,661
Term loan | Fair Value, Inputs, Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Carrying Value	2,092,172	2,090,090
Fair Value	$ 2,008,782	$ 2,087,661

Segment Information - Selected

Segment Information - Selected Financial Data (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2021
Segment Reporting Information [Line Items]
Revenue	$ 1,584,741	$ 1,564,020	$ 3,184,288	$ 3,110,483
Adjusted EBITDA	180,994	342,021	344,841	600,362
Total assets	7,551,658	7,956,379	7,551,658	7,956,379	$ 7,360,171
Purchases of property and equipment	46,332	36,723	93,177	76,442
Operating Segments | Critical Illness Recovery Hospital
Segment Reporting Information [Line Items]
Revenue	545,908	544,059	1,147,663	1,138,931
Adjusted EBITDA	20,019	72,904	55,986	186,176
Total assets	2,387,516	2,187,181	2,387,516	2,187,181
Purchases of property and equipment	19,528	16,499	39,097	30,884
Operating Segments | Rehabilitation Hospital
Segment Reporting Information [Line Items]
Revenue	228,887	212,666	449,521	420,470
Adjusted EBITDA	49,845	50,768	92,224	101,302
Total assets	1,194,739	1,186,886	1,194,739	1,186,886
Purchases of property and equipment	4,821	3,257	11,095	3,922
Operating Segments | Outpatient Rehabilitation
Segment Reporting Information [Line Items]
Revenue	287,258	280,409	559,198	532,370
Adjusted EBITDA	33,601	45,633	60,197	71,962
Total assets	1,360,600	1,333,661	1,360,600	1,333,661
Purchases of property and equipment	9,314	7,448	18,728	14,783
Operating Segments | Concentra
Segment Reporting Information [Line Items]
Revenue	441,357	456,372	864,780	879,212
Adjusted EBITDA	92,607	137,060	182,076	219,075
Total assets	2,301,296	2,518,369	2,301,296	2,518,369
Purchases of property and equipment	8,716	7,591	18,956	20,271
Government assistance recognized in earnings, CARES Act		32,300		32,300
Other
Segment Reporting Information [Line Items]
Revenue	81,331	70,514	163,126	139,500
Adjusted EBITDA	(15,078)	35,656	(45,642)	21,847
Total assets	307,507	730,282	307,507	730,282
Purchases of property and equipment	3,953	1,928	5,301	6,582
Government assistance recognized in earnings, CARES Act	$ 15,100	$ 65,800	$ 15,100	$ 81,900

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, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Segment Reporting Information [Line Items]
Adjusted EBITDA	$ 180,994	$ 342,021	$ 344,841	$ 600,362
Depreciation and amortization	(51,081)	(50,954)	(102,120)	(100,574)
Income (loss) from operations	120,967	283,968	224,952	485,980
Equity in earnings of unconsolidated subsidiaries	6,167	11,809	11,564	21,728
Interest income	0	0	0	4,749
Interest expense	(41,052)	(33,888)	(76,566)	(68,290)
Income before income taxes	86,082	261,889	159,950	444,167
Operating Segments | Critical Illness Recovery Hospital
Segment Reporting Information [Line Items]
Adjusted EBITDA	20,019	72,904	55,986	186,176
Depreciation and amortization	(14,603)	(12,936)	(29,221)	(25,986)
Stock compensation expense	0	0	0	0
Income (loss) from operations	5,416	59,968	26,765	160,190
Operating Segments | Rehabilitation Hospital
Segment Reporting Information [Line Items]
Adjusted EBITDA	49,845	50,768	92,224	101,302
Depreciation and amortization	(7,175)	(6,939)	(13,977)	(13,999)
Stock compensation expense	0	0	0	0
Income (loss) from operations	42,670	43,829	78,247	87,303
Operating Segments | Outpatient Rehabilitation
Segment Reporting Information [Line Items]
Adjusted EBITDA	33,601	45,633	60,197	71,962
Depreciation and amortization	(8,130)	(7,345)	(16,159)	(14,536)
Stock compensation expense	0	0	0	0
Income (loss) from operations	25,471	38,288	44,038	57,426
Operating Segments | Concentra
Segment Reporting Information [Line Items]
Adjusted EBITDA	92,607	137,060	182,076	219,075
Depreciation and amortization	(18,730)	(21,230)	(37,542)	(41,128)
Stock compensation expense	(536)	(535)	(1,071)	(1,071)
Income (loss) from operations	73,341	115,295	143,463	176,876
Other
Segment Reporting Information [Line Items]
Adjusted EBITDA	(15,078)	35,656	(45,642)	21,847
Depreciation and amortization	(2,443)	(2,504)	(5,221)	(4,925)
Stock compensation expense	(8,410)	(6,564)	(16,698)	(12,737)
Income (loss) from operations	$ (25,931)	$ 26,588	$ (67,561)	$ 4,185

Revenue from Contracts with C_3

Revenue from Contracts with Customers (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Disaggregation of Revenue [Line Items]
Total revenue	$ 1,584,741	$ 1,564,020	$ 3,184,288	$ 3,110,483
Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	1,470,193	1,462,039	2,958,569	2,911,042
Medicare
Disaggregation of Revenue [Line Items]
Total revenue	363,338	350,649	727,427	721,685
Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	1,106,855	1,111,390	2,231,142	2,189,357
Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	114,548	101,981	225,719	199,441
Operating Segments | Critical Illness Recovery Hospital
Disaggregation of Revenue [Line Items]
Total revenue	545,908	544,059	1,147,663	1,138,931
Operating Segments | Critical Illness Recovery Hospital | Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	542,798	542,127	1,142,771	1,135,419
Operating Segments | Critical Illness Recovery Hospital | Medicare
Disaggregation of Revenue [Line Items]
Total revenue	213,680	201,198	432,667	433,338
Operating Segments | Critical Illness Recovery Hospital | Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	329,118	340,929	710,104	702,081
Operating Segments | Critical Illness Recovery Hospital | Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	3,110	1,932	4,892	3,512
Operating Segments | Rehabilitation Hospital
Disaggregation of Revenue [Line Items]
Total revenue	228,887	212,666	449,521	420,470
Operating Segments | Rehabilitation Hospital | Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	218,031	202,308	428,194	400,025
Operating Segments | Rehabilitation Hospital | Medicare
Disaggregation of Revenue [Line Items]
Total revenue	105,030	103,865	208,051	206,240
Operating Segments | Rehabilitation Hospital | Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	113,001	98,443	220,143	193,785
Operating Segments | Rehabilitation Hospital | Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	10,856	10,358	21,327	20,445
Operating Segments | Outpatient Rehabilitation
Disaggregation of Revenue [Line Items]
Total revenue	287,258	280,409	559,198	532,370
Operating Segments | Outpatient Rehabilitation | Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	269,390	263,184	525,407	500,294
Operating Segments | Outpatient Rehabilitation | Medicare
Disaggregation of Revenue [Line Items]
Total revenue	44,433	45,291	86,337	81,582
Operating Segments | Outpatient Rehabilitation | Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	224,957	217,893	439,070	418,712
Operating Segments | Outpatient Rehabilitation | Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	17,868	17,225	33,791	32,076
Operating Segments | Concentra
Disaggregation of Revenue [Line Items]
Total revenue	441,357	456,372	864,780	879,212
Operating Segments | Concentra | Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	439,974	454,420	862,197	875,304
Operating Segments | Concentra | Medicare
Disaggregation of Revenue [Line Items]
Total revenue	195	295	372	525
Operating Segments | Concentra | Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	439,779	454,125	861,825	874,779
Operating Segments | Concentra | Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	1,383	1,952	2,583	3,908
Other
Disaggregation of Revenue [Line Items]
Total revenue	81,331	70,514	163,126	139,500
Other | Total patient services revenues
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	$ 81,331	$ 70,514	$ 163,126	$ 139,500

Earnings per Share - Narrative

Earnings per Share - Narrative (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Earnings Per Share [Abstract]
Contractual dividends paid	$ 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, 2022	Mar. 31, 2022	Jun. 30, 2021	Mar. 31, 2021	Jun. 30, 2022	Jun. 30, 2021
Earnings Per Share [Abstract]
Net income	$ 66,262		$ 196,208		$ 122,188	$ 333,422
Less: Net income attributable to non-controlling interests	11,055		31,314		17,864	57,982
Net income attributable to Select Medical Holdings Corporation	55,207	$ 49,117	164,894	$ 110,546	104,324	275,440
Basic EPS
Less: Distributed and undistributed income attributable to participating securities - Basic EPS	1,920		5,560		3,558	9,250
Distributed and undistributed income attributable to common shares	53,287		159,334		100,766	266,190
Diluted EPS
Less: Distributed and undistributed income attributable to participating securities - Diluted EPS	1,920		5,560		3,558	9,250
Distributed and undistributed income attributable to common shares	$ 53,287		$ 159,334		$ 100,766	$ 266,190

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, 2022	Mar. 31, 2022	Jun. 30, 2021	Mar. 31, 2021	Jun. 30, 2022	Jun. 30, 2021
Net Income Allocation
Net income allocated to common shares - basic	$ 53,287		$ 159,334		$ 100,766	$ 266,190
Participating securities - basic	1,920		5,560		3,558	9,250
Net income allocated to common shares - diluted	53,287		159,334		100,766	266,190
Participating securities - diluted	1,920		5,560		3,558	9,250
Net income attributable to Select Medical Holdings Corporation	$ 55,207	$ 49,117	$ 164,894	$ 110,546	$ 104,324	$ 275,440
Weighted average common shares outstanding, basic (in shares)	124,897		130,396		126,942	130,362
Weighted average common shares outstanding, diluted (in shares)	124,897		130,396		126,942	130,362
Weighted average participating securities outstanding (in shares)	4,500		4,550		4,482	4,530
Basic EPS
Basic EPS (in dollars per share)	$ 0.43		$ 1.22		$ 0.79	$ 2.04
Diluted EPS
Diluted EPS (in dollars per share)	$ 0.43		$ 1.22		$ 0.79	$ 2.04

Commitments and Contingencies (

Commitments and Contingencies (Details) $ in Millions	6 Months Ended
	Jun. 30, 2022 USD ($)
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

Subsequent Event (Details)

Subsequent Event (Details)	Aug. 02, 2022 $ / shares
Subsequent Event
Subsequent Event [Line Items]
Cash dividend declared (in dollars per share)	$ 0.125