Select Medical (SEM) 10-Q 4 May 23 2023 Q1 Quarterly report Financial data

Cover

Cover - shares	3 Months Ended
	Mar. 31, 2023	Apr. 30, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2023
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		127,126,909
Current Fiscal Year End Date	--12-31
Amendment Flag	false
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q1
Entity Central Index Key	0001320414

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (unaudited) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Current Assets:
Cash and cash equivalents	$ 83,703	$ 97,906
Accounts receivable	997,274	941,312
Prepaid income taxes	16,893	31,868
Current portion of interest rate cap contract	72,127	74,857
Other current assets	143,736	125,370
Total Current Assets	1,313,733	1,271,313
Operating lease right-of-use assets	1,186,534	1,169,740
Property and equipment, net	987,283	1,001,440
Goodwill	3,484,594	3,484,200
Identifiable intangible assets, net	346,606	351,662
Interest rate cap contract, net of current portion	26,994	45,200
Other assets	353,992	341,738
Total Assets	7,699,736	7,665,293
Current Liabilities:
Overdrafts	31,237	31,961
Current operating lease liabilities	239,713	236,784
Current portion of long-term debt and notes payable	113,894	44,351
Accounts payable	174,101	186,729
Accrued payroll	171,815	209,789
Accrued vacation	156,433	150,695
Accrued interest	10,241	29,837
Accrued other	274,654	264,525
Income taxes payable	13,618	480
Total Current Liabilities	1,185,706	1,155,151
Non-current operating lease liabilities	1,024,676	1,008,394
Long-term debt, net of current portion	3,766,838	3,835,211
Non-current deferred tax liability	163,024	169,793
Other non-current liabilities	106,652	106,137
Total Liabilities	6,246,896	6,274,686
Commitments and contingencies (Note 13)
Redeemable non-controlling interests	34,399	34,043
Stockholders’ Equity:
Common stock, $0.001 par value, 700,000,000 shares authorized, 127,173,871 and 127,176,279 shares issued and outstanding at 2022 and 2023, respectively	127	127
Capital in excess of par	462,185	452,183
Retained earnings	635,483	581,010
Accumulated other comprehensive income	72,654	88,602
Total Stockholders’ Equity	1,170,449	1,121,922
Non-controlling interests	247,992	234,642
Total Equity	1,418,441	1,356,564
Total Liabilities and Equity	$ 7,699,736	$ 7,665,293

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (unaudited) (Parenthetical) - $ / shares	Mar. 31, 2023	Dec. 31, 2022
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)	127,176,279	127,173,871
Common stock, shares outstanding (in shares)	127,176,279	127,173,871

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Income Statement [Abstract]
Revenue	$ 1,664,980	$ 1,599,547
Costs and expenses:
Cost of services, exclusive of depreciation and amortization	1,418,819	1,407,010
General and administrative	42,279	37,513
Depreciation and amortization	52,425	51,039
Total costs and expenses	1,513,523	1,495,562
Income from operations	151,457	103,985
Other income and expense:
Equity in earnings of unconsolidated subsidiaries	8,556	5,397
Interest expense	(48,571)	(35,514)
Income before income taxes	111,442	73,868
Income tax expense	26,185	17,942
Net income	85,257	55,926
Less: Net income attributable to non-controlling interests	14,452	6,809
Net income attributable to Select Medical Holdings Corporation	$ 70,805	$ 49,117
Earnings per common share (Note 12):
Basic (in dollars per share)	$ 0.56	$ 0.37
Diluted (in dollars per share)	$ 0.56	$ 0.37

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Income (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Statement of Comprehensive Income [Abstract]
Net income	$ 85,257	$ 55,926
Other comprehensive income (loss), net of tax:
Gain (loss) on interest rate cap contract	(2,696)	39,814
Reclassification adjustment for losses (gains) included in net income	(13,252)	39
Net change, net of tax benefit (expense) of $(13,284) and $5,175	(15,948)	39,853
Comprehensive income	69,309	95,779
Less: Comprehensive income attributable to non-controlling interests	14,452	6,809
Comprehensive income attributable to Select Medical Holdings Corporation	$ 54,857	$ 88,970

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Comprehensive Income (unaudited) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Statement of Comprehensive Income [Abstract]
Tax benefit (expense) on components of other comprehensive income	$ 5,175	$ (13,284)

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, 2021			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, measurement period adjustment	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	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
Beginning balance (in shares) at Dec. 31, 2022	127,173,871		127,173,000
Beginning balance at Dec. 31, 2022	$ 1,356,564	1,121,922	$ 127	452,183	581,010	88,602	234,642
Increase (Decrease) in Stockholders' Equity
Net income attributable to Select Medical Holdings Corporation	70,805	70,805			70,805
Net income attributable to non-controlling interests	12,811	0					12,811
Cash dividends declared for common stockholders ($0.125 per share)	(15,897)	(15,897)			(15,897)
Issuance of restricted stock (in shares)			3,000
Issuance of restricted stock	0	0	$ 0	0
Vesting of restricted stock	10,003	10,003		10,003
Issuance of non-controlling interests	2,731	0					2,731
Non-controlling interests acquired in business combination, measurement period adjustment	3,877	0					3,877
Distributions to and purchases of non-controlling interests	(6,069)	0					(6,069)
Redemption value adjustment on non-controlling interests	(436)	(436)			(436)
Other comprehensive income	(15,948)	(15,948)				(15,948)
Other	$ 0	0		(1)	1
Ending balance (in shares) at Mar. 31, 2023	127,176,279		127,176,000
Ending balance at Mar. 31, 2023	$ 1,418,441	$ 1,170,449	$ 127	$ 462,185	$ 635,483	$ 72,654	$ 247,992

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Changes in Equity and Income (unaudited) (Parenthetical) - $ / shares	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Statement of Stockholders' Equity [Abstract]
Cash dividend declared (in dollars per share)	$ 0.125	$ 0.125

Condensed Consolidated Statem_6

Condensed Consolidated Statements of Cash Flows (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Operating activities
Net income	$ 85,257	$ 55,926
Adjustments to reconcile net income to net cash provided by operating activities:
Distributions from unconsolidated subsidiaries	2,566	7,486
Depreciation and amortization	52,425	51,039
Provision for expected credit losses	429	94
Equity in earnings of unconsolidated subsidiaries	(8,556)	(5,397)
Gain on sale or disposal of assets	(7)	(23)
Stock compensation expense	10,181	8,823
Amortization of debt discount, premium and issuance costs	565	558
Deferred income taxes	(2,601)	420
Changes in operating assets and liabilities, net of effects of business combinations:
Accounts receivable	(55,397)	(52,225)
Other current assets	(11,742)	(1,819)
Other assets	3,659	2,686
Accounts payable	(4,564)	16,074
Accrued expenses	(20,775)	(14,377)
Government advances	0	(62,928)
Net cash provided by operating activities	51,440	6,337
Investing activities
Business combinations, net of cash acquired	(397)	(5,186)
Purchases of property, equipment, and other assets	(58,885)	(46,845)
Investment in businesses	(9,800)	(3,337)
Proceeds from sale of assets	20	37
Net cash used in investing activities	(69,062)	(55,331)
Financing activities
Borrowings on revolving facilities	225,000	280,000
Payments on revolving facilities	(210,000)	(100,000)
Borrowings of other debt	21,448	15,794
Principal payments on other debt	(11,170)	(9,188)
Dividends paid to common stockholders	(15,897)	(16,691)
Repurchase of common stock	0	(51,676)
Decrease in overdrafts	(724)	(7,608)
Proceeds from issuance of non-controlling interests	2,731	5,229
Distributions to and purchases of non-controlling interests	(7,969)	(10,295)
Net cash provided by financing activities	3,419	105,565
Net increase (decrease) in cash and cash equivalents	(14,203)	56,571
Cash and cash equivalents at beginning of period	97,906	74,310
Cash and cash equivalents at end of period	83,703	130,881
Supplemental information
Cash paid for interest, excluding amounts received of $17,828 under the interest rate cap contract for the three months ended March 31, 2023	84,531	53,517
Cash paid for taxes	$ 336	$ 923

Condensed Consolidated Statem_7

Condensed Consolidated Statements of Cash Flows (unaudited) (Parenthetical) $ in Thousands	3 Months Ended
	Mar. 31, 2023 USD ($)
Statement of Cash Flows [Abstract]
Interest received under interest rate cash flow hedge	$ 17,828

Basis of Presentation

Basis of Presentation	3 Months Ended
	Mar. 31, 2023
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 March 31, 2023, and for the three month periods ended March 31, 2022 and 2023, 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 months ended March 31, 2023, are not necessarily indicative of the results to be expected for the full fiscal year ending December 31, 2023. 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, 2022, contained in the Company’s Annual Report on Form 10-K filed with the SEC on February 23, 2023.

Accounting Policies

Accounting Policies	3 Months Ended
	Mar. 31, 2023
Accounting Policies [Abstract]
Accounting Policies	Accounting Policies Recent Accounting Guidance Not Yet Adopted In March 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023-01, Leases (Topic 842): Common Control Arrangements , which requires companies to amortize leasehold improvements associated with related party leases under common control over the useful life of the leasehold improvement to the common control group. The ASU is effective for annual reporting periods beginning on or after December 15, 2023, however, early adoption is permitted. The ASU can either be applied prospectively or retrospectively. The Company is currently evaluating this ASU, but does not expect it to have a material impact on its consolidated financial statements upon adoption. The Company plans to adopt the ASU using the prospective method as of January 1, 2024. Recently Adopted Accounting Guidance Reference Rate Reform In December 2022, FASB issued ASU 2022-06, Reference Rate Reform (Topic 848), Deferral of the Sunset Date of Topic 848 , which extended the relief provided under Topic 848 to contract modifications made and hedging relationships entered into on or before December 31, 2024. The FASB had previously issued ASU 2020-04, Reference Rate Reform (Topic 848), Facilitation of the Effects of Reference Rate Reform on Financial Reporting in March 2020, which provided temporary relief from some of the existing accounting rules governing contract modifications when the modification is related to the replacement of the London Interbank Offered Rate (“LIBOR”) or other reference rates discontinued as a result of reference rate reform. For eligible contract modifications, the update generally allows an entity to account for and present modifications as an event that does not require contract remeasurement at the modification date or reassessment of a previous accounting determination. That is, the modified contract is accounted for as a continuation of the existing contract. For cash flow hedging relationships affected by reference rate reform, Topic 848 provides expedients that allow an entity to (i) change the reference rate of either the forecasted transaction or hedging instrument without requiring dedesignation of the hedging relationship; (ii) assert that changes to the hedged forecasted transaction will not impact whether it remains probable of occurring; and (iii) for the purposes of assessment of hedge effectiveness assume that the reference rate will not be replaced for the remainder of the hedging relationship if both the hedged forecasted transaction and hedging instrument are expected to be impacted by reference rate reform. In March 2021, the Financial Conduct Authority announced that the intended cessation date of the one-, three-, six-, and 12-month tenors of USD LIBOR is June 30, 2023. Borrowings under the Company’s credit agreement bear interest, at the election of Select, based on LIBOR or an alternate base rate. The Company currently elects for its term loan borrowings to bear interest at a rate that is indexed to one-month LIBOR. Provisions within the credit agreement provide the Company with the ability to agree with JPMorgan Chase Bank, N.A., as administrative agent to the lenders, to replace LIBOR with a different reference rate in the event that LIBOR ceases to exist. The Company has not yet agreed upon a different reference rate with JPMorgan Chase Bank, N.A. For the Company’s cash flow hedge, which mitigates the Company’s exposure to increases in the one-month LIBOR rate above 1.0% on $2.0 billion of principal outstanding under the term loan, the Company has elected to assert that the hedged forecasted transaction remains probable of occurring, regardless of a modification or expected modification that may replace one-month LIBOR with a different reference rate. The Company intends to modify the cash flow hedge’s contractual terms related to the replacement of the reference rate, as necessary, to align with the reference rate specified for the Company’s term loan. For the purpose of the assessment of hedge effectiveness, the Company assumes that the reference rate will not be replaced for the remainder of the hedging relationship, as outlined by Topic 848. The Company’s cash flow hedge is described further in Note 8 – Interest Rate Cap. These updates have not had, and the Company does not expect them to have in future periods, a material impact on the Company's consolidated financial statements. 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	3 Months Ended
	Mar. 31, 2023
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 19% and 20% of the Company’s accounts receivable is due from Medicare at December 31, 2022 and March 31, 2023, respectively.

Redeemable Non-Controlling Inte

Redeemable Non-Controlling Interests	3 Months Ended
	Mar. 31, 2023
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: Three Months Ended March 31, 2022 2023 (in thousands) Balance as of January 1 $ 39,033 $ 34,043 Net income attributable to redeemable non-controlling interests 1,918 1,641 Distributions to redeemable non-controlling interests (1,198) (1,900) Redemption value adjustment on redeemable non-controlling interests 1,381 436 Other 536 179 Balance as of March 31 $ 41,670 $ 34,399

Variable Interest Entities

Variable Interest Entities	3 Months Ended
	Mar. 31, 2023
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 or therapists and from exercising control over medical decisions by physicians and therapists. In these states, the Company enters into long-term management agreements with medical practices that are owned by licensed physicians or therapists, which, in turn, employ or contract with physicians or therapists who provide professional medical services. The management agreements provide for the Company to direct the transfer of ownership of the medical practices. 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, 2022, and March 31, 2023, the total assets of the Company’s variable interest entities were $232.1 million and $254.1 million, respectively, and are principally comprised of accounts receivable. As of December 31, 2022, and March 31, 2023, the total liabilities of the Company’s variable interest entities were $78.8 million and $82.2 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 $158.3 million and $178.4 million as of December 31, 2022, and March 31, 2023, respectively. These intercompany balances are eliminated in consolidation.

Leases

Leases	3 Months Ended
	Mar. 31, 2023
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 March 31, 2022 Three Months Ended March 31, 2023 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 73,962 $ 1,809 $ 75,771 $ 76,632 $ 1,834 $ 78,466 Finance lease cost: Amortization of right-of-use assets 347 — 347 394 — 394 Interest on lease liabilities 340 — 340 320 — 320 Short-term lease cost 35 — 35 — — — Variable lease cost 13,655 39 13,694 15,761 84 15,845 Sublease income (1,966) — (1,966) (1,678) — (1,678) Total lease cost $ 86,373 $ 1,848 $ 88,221 $ 91,429 $ 1,918 $ 93,347
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 March 31, 2022 Three Months Ended March 31, 2023 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 73,962 $ 1,809 $ 75,771 $ 76,632 $ 1,834 $ 78,466 Finance lease cost: Amortization of right-of-use assets 347 — 347 394 — 394 Interest on lease liabilities 340 — 340 320 — 320 Short-term lease cost 35 — 35 — — — Variable lease cost 13,655 39 13,694 15,761 84 15,845 Sublease income (1,966) — (1,966) (1,678) — (1,678) Total lease cost $ 86,373 $ 1,848 $ 88,221 $ 91,429 $ 1,918 $ 93,347

Long-Term Debt and Notes Payabl

Long-Term Debt and Notes Payable	3 Months Ended
	Mar. 31, 2023
Debt Disclosure [Abstract]
Long-Term Debt and Notes Payable	Long-Term Debt and Notes Payable As of March 31, 2023, the Company’s long-term debt and notes payable are as follows: Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value (in thousands) 6.250% senior notes $ 1,225,000 $ 20,065 $ (10,206) $ 1,234,859 $ 1,188,250 Credit facilities: Revolving facility 460,000 — — 460,000 458,275 Term loan 2,103,437 (3,881) (4,230) 2,095,326 2,095,549 Other debt, including finance leases 90,664 — (117) 90,547 90,547 Total debt $ 3,879,101 $ 16,184 $ (14,553) $ 3,880,732 $ 3,832,621 Principal maturities of the Company’s long-term debt and notes payable are approximately as follows: 2023 2024 2025 2026 2027 Thereafter Total (in thousands) 6.250% senior notes $ — $ — $ — $ 1,225,000 $ — $ — $ 1,225,000 Credit facilities: Revolving facility — 84,923 375,077 — — — 460,000 Term loan 4,757 11,150 2,087,530 — — — 2,103,437 Other debt, including finance leases 19,928 56,356 1,408 1,308 823 10,841 90,664 Total debt $ 24,685 $ 152,429 $ 2,464,015 $ 1,226,308 $ 823 $ 10,841 $ 3,879,101 As of December 31, 2022, the Company’s long-term debt and notes payable are as follows: Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value (in thousands) 6.250% senior notes $ 1,225,000 $ 21,555 $ (10,948) $ 1,235,607 $ 1,163,689 Credit facilities: Revolving facility 445,000 — — 445,000 443,331 Term loan 2,103,437 (4,376) (4,771) 2,094,290 2,056,110 Other debt, including finance leases 104,800 — (135) 104,665 104,665 Total debt $ 3,878,237 $ 17,179 $ (15,854) $ 3,879,562 $ 3,767,795 Select Credit Facilities On February 21, 2023, Select entered into Amendment No. 6 to its senior secured credit agreement (the “Select credit agreement”). Amendment No. 6 extended the maturity date on $530.0 million of the total borrowing capacity of $650.0 million under its revolving credit facility (the “Select revolving facility”) to March 6, 2025; however, in the event the Company’s term loan is not refinanced by January 3, 2025, the maturity date for those revolving borrowings will be January 3, 2025.

Interest Rate Cap

Interest Rate Cap	3 Months Ended
	Mar. 31, 2023
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 is effective 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 (loss), net of tax, during the periods presented: Three Months Ended March 31, 2022 2023 (in thousands) Balance as of January 1 $ 12,282 $ 88,602 Gain (loss) on interest rate cap cash flow hedge 39,814 (2,696) Amounts reclassified from accumulated other comprehensive income 39 (13,252) Balance as of March 31 $ 52,135 $ 72,654 The effects on net income of amounts reclassified from accumulated other comprehensive income are as follows: Three Months Ended March 31, Statement of Operations 2022 2023 (in thousands) Gains (losses) included in interest expense $ (51) $ 17,552 Income tax benefit (expense) 12 (4,300) Amounts reclassified from accumulated other comprehensive income $ (39) $ 13,252 The Company expects that approximately $71.1 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	3 Months Ended
	Mar. 31, 2023
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, 2022 March 31, 2023 Asset: (in thousands) Interest rate cap contract, current portion Current portion of interest rate cap contract Level 2 $ 74,857 $ 72,127 Interest rate cap contract, non-current portion Interest rate cap contract, net of current portion Level 2 45,200 26,994 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 7 – Long-Term Debt and Notes Payable, approximates fair value. December 31, 2022 March 31, 2023 Financial Instrument Level Carrying Value Fair Value Carrying Value Fair Value (in thousands) 6.250% senior notes Level 2 $ 1,235,607 $ 1,163,689 $ 1,234,859 $ 1,188,250 Credit facilities: Revolving facility Level 2 445,000 443,331 460,000 458,275 Term loan Level 2 2,094,290 2,056,110 2,095,326 2,095,549

Segment Information

Segment Information	3 Months Ended
	Mar. 31, 2023
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 March 31, 2022 2023 (in thousands) Revenue: Critical illness recovery hospital $ 601,755 $ 593,926 Rehabilitation hospital 220,634 231,462 Outpatient rehabilitation 271,940 295,903 Concentra 423,423 456,298 Other 81,795 87,391 Total Company $ 1,599,547 $ 1,664,980 Adjusted EBITDA: Critical illness recovery hospital $ 35,967 $ 76,773 Rehabilitation hospital 42,379 47,216 Outpatient rehabilitation 26,596 30,199 Concentra 89,469 93,748 Other (30,564) (33,873) Total Company $ 163,847 $ 214,063 Total assets: Critical illness recovery hospital $ 2,367,490 $ 2,507,265 Rehabilitation hospital 1,187,118 1,203,069 Outpatient rehabilitation 1,350,374 1,397,823 Concentra 2,339,940 2,300,632 Other 291,022 290,947 Total Company $ 7,535,944 $ 7,699,736 Purchases of property, equipment, and other assets: Critical illness recovery hospital $ 19,569 $ 23,658 Rehabilitation hospital 6,274 8,582 Outpatient rehabilitation 9,414 9,932 Concentra 10,240 14,400 Other 1,348 2,313 Total Company $ 46,845 $ 58,885 A reconciliation of Adjusted EBITDA to income before income taxes is as follows: Three Months Ended March 31, 2022 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 35,967 $ 42,379 $ 26,596 $ 89,469 $ (30,564) Depreciation and amortization (14,618) (6,802) (8,029) (18,812) (2,778) Stock compensation expense — — — (535) (8,288) Income (loss) from operations $ 21,349 $ 35,577 $ 18,567 $ 70,122 $ (41,630) $ 103,985 Equity in earnings of unconsolidated subsidiaries 5,397 Interest expense (35,514) Income before income taxes $ 73,868 Three Months Ended March 31, 2023 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 76,773 $ 47,216 $ 30,199 $ 93,748 $ (33,873) Depreciation and amortization (16,637) (6,888) (8,457) (18,310) (2,133) Stock compensation expense — — — (178) (10,003) Income (loss) from operations $ 60,136 $ 40,328 $ 21,742 $ 75,260 $ (46,009) $ 151,457 Equity in earnings of unconsolidated subsidiaries 8,556 Interest expense (48,571) Income before income taxes $ 111,442

Revenue from Contracts with Cus

Revenue from Contracts with Customers	3 Months Ended
	Mar. 31, 2023
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 months ended March 31, 2022 and 2023: Three Months Ended March 31, 2022 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 218,987 $ 103,021 $ 41,904 $ 177 $ — $ 364,089 Non-Medicare 380,986 107,142 214,113 422,046 — 1,124,287 Total patient services revenues 599,973 210,163 256,017 422,223 — 1,488,376 Other revenue 1,782 10,471 15,923 1,200 81,795 111,171 Total revenue $ 601,755 $ 220,634 $ 271,940 $ 423,423 $ 81,795 $ 1,599,547 Three Months Ended March 31, 2023 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 229,383 $ 110,055 $ 45,801 $ 243 $ — $ 385,482 Non-Medicare 363,305 109,925 231,985 454,598 — 1,159,813 Total patient services revenues 592,688 219,980 277,786 454,841 — 1,545,295 Other revenue 1,238 11,482 18,117 1,457 87,391 119,685 Total revenue $ 593,926 $ 231,462 $ 295,903 $ 456,298 $ 87,391 $ 1,664,980

Earnings per Share

Earnings per Share	3 Months Ended
	Mar. 31, 2023
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 months ended March 31, 2022 and 2023. (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 Three Months Ended March 31, 2022 2023 (in thousands) Net income $ 55,926 $ 85,257 Less: net income attributable to non-controlling interests 6,809 14,452 Net income attributable to the Company 49,117 70,805 Less: Distributed and undistributed income attributable to participating securities 1,643 2,573 Distributed and undistributed income attributable to common shares $ 47,474 $ 68,232 The following tables set forth the computation of EPS under the two-class method: Three Months Ended March 31, 2022 2023 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 $ 47,474 129,010 $ 0.37 $ 68,232 122,553 $ 0.56 Participating securities 1,643 4,464 $ 0.37 2,573 4,622 $ 0.56 Total Company $ 49,117 $ 70,805 _______________________________________________________________________________ (1) Represents the weighted average share count outstanding during the period.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2023
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 hospital and outpatient clinic 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. For the Company’s Concentra center operations, the Company currently maintains insurance coverages under a combination of policies with a total annual aggregate limit of up to $19.0 million for professional malpractice liability insurance and $19.0 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 (“CIDs”) from the U.S. Attorney’s Office for the Western District of Oklahoma seeking responses to interrogatories and the production of various documents principally relating to the documentation, billing and reviews of medical services furnished to patients at SSH-Oklahoma City. The Company understands that the investigation arose from a qui tam lawsuit alleging billing fraud related to charges for respiratory therapy services at SSH-Oklahoma City and Select Specialty Hospital - Wichita, Inc. The Company has produced documents in response to the CIDs 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 (“HHS”), 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 2021, the DOJ requested, and the Company furnished, records relating to six of the Company’s outpatient therapy clinics in Florida. In 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’s outpatient therapy clinics and Concentra. The Company continues to produce data and other documents requested by the DOJ and is fully cooperating on this investigation. At this time, the Company is unable to predict the timing and outcome of this matter.

Subsequent Event

Subsequent Event	3 Months Ended
	Mar. 31, 2023
Subsequent Events [Abstract]
Subsequent Event	Subsequent Event On May 3, 2023, the Company’s Board of Directors declared a cash dividend of $0.125 per share. The dividend will be payable on or about May 31, 2023, to stockholders of record as of the close of business on May 18, 2023.

Accounting Policies (Policies)

Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2023
Accounting Policies [Abstract]
Recent Accounting Guidance Not Yet Adopted and Recently Adopted Accounting Guidance	Recent Accounting Guidance Not Yet Adopted In March 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023-01, Leases (Topic 842): Common Control Arrangements , which requires companies to amortize leasehold improvements associated with related party leases under common control over the useful life of the leasehold improvement to the common control group. The ASU is effective for annual reporting periods beginning on or after December 15, 2023, however, early adoption is permitted. The ASU can either be applied prospectively or retrospectively. The Company is currently evaluating this ASU, but does not expect it to have a material impact on its consolidated financial statements upon adoption. The Company plans to adopt the ASU using the prospective method as of January 1, 2024. Recently Adopted Accounting Guidance Reference Rate Reform In December 2022, FASB issued ASU 2022-06, Reference Rate Reform (Topic 848), Deferral of the Sunset Date of Topic 848 , which extended the relief provided under Topic 848 to contract modifications made and hedging relationships entered into on or before December 31, 2024. The FASB had previously issued ASU 2020-04, Reference Rate Reform (Topic 848), Facilitation of the Effects of Reference Rate Reform on Financial Reporting in March 2020, which provided temporary relief from some of the existing accounting rules governing contract modifications when the modification is related to the replacement of the London Interbank Offered Rate (“LIBOR”) or other reference rates discontinued as a result of reference rate reform. For eligible contract modifications, the update generally allows an entity to account for and present modifications as an event that does not require contract remeasurement at the modification date or reassessment of a previous accounting determination. That is, the modified contract is accounted for as a continuation of the existing contract. For cash flow hedging relationships affected by reference rate reform, Topic 848 provides expedients that allow an entity to (i) change the reference rate of either the forecasted transaction or hedging instrument without requiring dedesignation of the hedging relationship; (ii) assert that changes to the hedged forecasted transaction will not impact whether it remains probable of occurring; and (iii) for the purposes of assessment of hedge effectiveness assume that the reference rate will not be replaced for the remainder of the hedging relationship if both the hedged forecasted transaction and hedging instrument are expected to be impacted by reference rate reform. In March 2021, the Financial Conduct Authority announced that the intended cessation date of the one-, three-, six-, and 12-month tenors of USD LIBOR is June 30, 2023. Borrowings under the Company’s credit agreement bear interest, at the election of Select, based on LIBOR or an alternate base rate. The Company currently elects for its term loan borrowings to bear interest at a rate that is indexed to one-month LIBOR. Provisions within the credit agreement provide the Company with the ability to agree with JPMorgan Chase Bank, N.A., as administrative agent to the lenders, to replace LIBOR with a different reference rate in the event that LIBOR ceases to exist. The Company has not yet agreed upon a different reference rate with JPMorgan Chase Bank, N.A. For the Company’s cash flow hedge, which mitigates the Company’s exposure to increases in the one-month LIBOR rate above 1.0% on $2.0 billion of principal outstanding under the term loan, the Company has elected to assert that the hedged forecasted transaction remains probable of occurring, regardless of a modification or expected modification that may replace one-month LIBOR with a different reference rate. The Company intends to modify the cash flow hedge’s contractual terms related to the replacement of the reference rate, as necessary, to align with the reference rate specified for the Company’s term loan. For the purpose of the assessment of hedge effectiveness, the Company assumes that the reference rate will not be replaced for the remainder of the hedging relationship, as outlined by Topic 848. The Company’s cash flow hedge is described further in Note 8 – Interest Rate Cap. These updates have not had, and the Company does not expect them to have in future periods, a material impact on the Company's consolidated financial statements.
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 or therapists and from exercising control over medical decisions by physicians and therapists. In these states, the Company enters into long-term management agreements with medical practices that are owned by licensed physicians or therapists, which, in turn, employ or contract with physicians or therapists who provide professional medical services. The management agreements provide for the Company to direct the transfer of ownership of the medical practices. 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)	3 Months Ended
	Mar. 31, 2023
Noncontrolling Interest [Abstract]
Schedule of redeemable non-controlling interests	The changes in redeemable non-controlling interests are as follows: Three Months Ended March 31, 2022 2023 (in thousands) Balance as of January 1 $ 39,033 $ 34,043 Net income attributable to redeemable non-controlling interests 1,918 1,641 Distributions to redeemable non-controlling interests (1,198) (1,900) Redemption value adjustment on redeemable non-controlling interests 1,381 436 Other 536 179 Balance as of March 31 $ 41,670 $ 34,399

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2023
Leases [Abstract]
Schedule of lease cost	The Company’s total lease cost is as follows: Three Months Ended March 31, 2022 Three Months Ended March 31, 2023 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 73,962 $ 1,809 $ 75,771 $ 76,632 $ 1,834 $ 78,466 Finance lease cost: Amortization of right-of-use assets 347 — 347 394 — 394 Interest on lease liabilities 340 — 340 320 — 320 Short-term lease cost 35 — 35 — — — Variable lease cost 13,655 39 13,694 15,761 84 15,845 Sublease income (1,966) — (1,966) (1,678) — (1,678) Total lease cost $ 86,373 $ 1,848 $ 88,221 $ 91,429 $ 1,918 $ 93,347

Long-Term Debt and Notes Paya_2

Long-Term Debt and Notes Payable (Tables)	3 Months Ended
	Mar. 31, 2023
Debt Disclosure [Abstract]
Schedule of long-term debt and notes payable	As of March 31, 2023, the Company’s long-term debt and notes payable are as follows: Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value (in thousands) 6.250% senior notes $ 1,225,000 $ 20,065 $ (10,206) $ 1,234,859 $ 1,188,250 Credit facilities: Revolving facility 460,000 — — 460,000 458,275 Term loan 2,103,437 (3,881) (4,230) 2,095,326 2,095,549 Other debt, including finance leases 90,664 — (117) 90,547 90,547 Total debt $ 3,879,101 $ 16,184 $ (14,553) $ 3,880,732 $ 3,832,621 As of December 31, 2022, the Company’s long-term debt and notes payable are as follows: Principal Unamortized Premium (Discount) Unamortized Carrying Value Fair Value (in thousands) 6.250% senior notes $ 1,225,000 $ 21,555 $ (10,948) $ 1,235,607 $ 1,163,689 Credit facilities: Revolving facility 445,000 — — 445,000 443,331 Term loan 2,103,437 (4,376) (4,771) 2,094,290 2,056,110 Other debt, including finance leases 104,800 — (135) 104,665 104,665 Total debt $ 3,878,237 $ 17,179 $ (15,854) $ 3,879,562 $ 3,767,795
Schedule of principal maturities of long-term debt and notes payable	Principal maturities of the Company’s long-term debt and notes payable are approximately as follows: 2023 2024 2025 2026 2027 Thereafter Total (in thousands) 6.250% senior notes $ — $ — $ — $ 1,225,000 $ — $ — $ 1,225,000 Credit facilities: Revolving facility — 84,923 375,077 — — — 460,000 Term loan 4,757 11,150 2,087,530 — — — 2,103,437 Other debt, including finance leases 19,928 56,356 1,408 1,308 823 10,841 90,664 Total debt $ 24,685 $ 152,429 $ 2,464,015 $ 1,226,308 $ 823 $ 10,841 $ 3,879,101

Interest Rate Cap (Tables)

Interest Rate Cap (Tables)	3 Months Ended
	Mar. 31, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of accumulated other comprehensive income (loss)	The following table outlines the changes in accumulated other comprehensive income (loss), net of tax, during the periods presented: Three Months Ended March 31, 2022 2023 (in thousands) Balance as of January 1 $ 12,282 $ 88,602 Gain (loss) on interest rate cap cash flow hedge 39,814 (2,696) Amounts reclassified from accumulated other comprehensive income 39 (13,252) Balance as of March 31 $ 52,135 $ 72,654
Schedule of reclassification out of accumulated other comprehensive income	The effects on net income of amounts reclassified from accumulated other comprehensive income are as follows: Three Months Ended March 31, Statement of Operations 2022 2023 (in thousands) Gains (losses) included in interest expense $ (51) $ 17,552 Income tax benefit (expense) 12 (4,300) Amounts reclassified from accumulated other comprehensive income $ (39) $ 13,252

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2023
Fair Value Disclosures [Abstract]
Schedule of interest rate cap	Financial Instrument Balance Sheet Classification Level December 31, 2022 March 31, 2023 Asset: (in thousands) Interest rate cap contract, current portion Current portion of interest rate cap contract Level 2 $ 74,857 $ 72,127 Interest rate cap contract, non-current portion Interest rate cap contract, net of current portion Level 2 45,200 26,994
Schedule of long-term debt	December 31, 2022 March 31, 2023 Financial Instrument Level Carrying Value Fair Value Carrying Value Fair Value (in thousands) 6.250% senior notes Level 2 $ 1,235,607 $ 1,163,689 $ 1,234,859 $ 1,188,250 Credit facilities: Revolving facility Level 2 445,000 443,331 460,000 458,275 Term loan Level 2 2,094,290 2,056,110 2,095,326 2,095,549

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2023
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 March 31, 2022 2023 (in thousands) Revenue: Critical illness recovery hospital $ 601,755 $ 593,926 Rehabilitation hospital 220,634 231,462 Outpatient rehabilitation 271,940 295,903 Concentra 423,423 456,298 Other 81,795 87,391 Total Company $ 1,599,547 $ 1,664,980 Adjusted EBITDA: Critical illness recovery hospital $ 35,967 $ 76,773 Rehabilitation hospital 42,379 47,216 Outpatient rehabilitation 26,596 30,199 Concentra 89,469 93,748 Other (30,564) (33,873) Total Company $ 163,847 $ 214,063 Total assets: Critical illness recovery hospital $ 2,367,490 $ 2,507,265 Rehabilitation hospital 1,187,118 1,203,069 Outpatient rehabilitation 1,350,374 1,397,823 Concentra 2,339,940 2,300,632 Other 291,022 290,947 Total Company $ 7,535,944 $ 7,699,736 Purchases of property, equipment, and other assets: Critical illness recovery hospital $ 19,569 $ 23,658 Rehabilitation hospital 6,274 8,582 Outpatient rehabilitation 9,414 9,932 Concentra 10,240 14,400 Other 1,348 2,313 Total Company $ 46,845 $ 58,885
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 March 31, 2022 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 35,967 $ 42,379 $ 26,596 $ 89,469 $ (30,564) Depreciation and amortization (14,618) (6,802) (8,029) (18,812) (2,778) Stock compensation expense — — — (535) (8,288) Income (loss) from operations $ 21,349 $ 35,577 $ 18,567 $ 70,122 $ (41,630) $ 103,985 Equity in earnings of unconsolidated subsidiaries 5,397 Interest expense (35,514) Income before income taxes $ 73,868 Three Months Ended March 31, 2023 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 76,773 $ 47,216 $ 30,199 $ 93,748 $ (33,873) Depreciation and amortization (16,637) (6,888) (8,457) (18,310) (2,133) Stock compensation expense — — — (178) (10,003) Income (loss) from operations $ 60,136 $ 40,328 $ 21,742 $ 75,260 $ (46,009) $ 151,457 Equity in earnings of unconsolidated subsidiaries 8,556 Interest expense (48,571) Income before income taxes $ 111,442

Revenue from Contracts with C_2

Revenue from Contracts with Customers (Tables)	3 Months Ended
	Mar. 31, 2023
Revenue from Contract with Customer [Abstract]
Schedule of disaggregation of revenue	The following tables disaggregate the Company’s revenue for the three months ended March 31, 2022 and 2023: Three Months Ended March 31, 2022 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 218,987 $ 103,021 $ 41,904 $ 177 $ — $ 364,089 Non-Medicare 380,986 107,142 214,113 422,046 — 1,124,287 Total patient services revenues 599,973 210,163 256,017 422,223 — 1,488,376 Other revenue 1,782 10,471 15,923 1,200 81,795 111,171 Total revenue $ 601,755 $ 220,634 $ 271,940 $ 423,423 $ 81,795 $ 1,599,547 Three Months Ended March 31, 2023 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 229,383 $ 110,055 $ 45,801 $ 243 $ — $ 385,482 Non-Medicare 363,305 109,925 231,985 454,598 — 1,159,813 Total patient services revenues 592,688 219,980 277,786 454,841 — 1,545,295 Other revenue 1,238 11,482 18,117 1,457 87,391 119,685 Total revenue $ 593,926 $ 231,462 $ 295,903 $ 456,298 $ 87,391 $ 1,664,980

Earnings per Share (Tables)

Earnings per Share (Tables)	3 Months Ended
	Mar. 31, 2023
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 Three Months Ended March 31, 2022 2023 (in thousands) Net income $ 55,926 $ 85,257 Less: net income attributable to non-controlling interests 6,809 14,452 Net income attributable to the Company 49,117 70,805 Less: Distributed and undistributed income attributable to participating securities 1,643 2,573 Distributed and undistributed income attributable to common shares $ 47,474 $ 68,232 The following tables set forth the computation of EPS under the two-class method: Three Months Ended March 31, 2022 2023 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 $ 47,474 129,010 $ 0.37 $ 68,232 122,553 $ 0.56 Participating securities 1,643 4,464 $ 0.37 2,573 4,622 $ 0.56 Total Company $ 49,117 $ 70,805 _______________________________________________________________________________ (1) Represents the weighted average share count outstanding during the period.

Accounting Policies (Details)

Accounting Policies (Details) - Interest Rate Cap $ in Billions	Mar. 31, 2023 USD ($)
Derivative [Line Items]
Derivative cap interest rate (as a percent)	1%
Notional amount	$ 2

Credit Risk Concentrations (Det

Credit Risk Concentrations (Details)	3 Months Ended	12 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Medicare Receivable | Credit Concentration Risk | Accounts Receivable
Concentration Risk [Line Items]
Percentage of concentration risk	20%	19%

Redeemable Non-Controlling In_3

Redeemable Non-Controlling Interests - Schedule of Redeemable Non-Controlling Interests (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Increase (Decrease) in Temporary Equity [Roll Forward]
Balance, beginning	$ 34,043	$ 39,033
Net income attributable to redeemable non-controlling interests	1,641	1,918
Distributions to redeemable non-controlling interests	(1,900)	(1,198)
Redemption value adjustment on redeemable non-controlling interests	436	1,381
Other	179	536
Balance, ending	$ 34,399	$ 41,670

Variable Interest Entities (Det

Variable Interest Entities (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2022
Variable Interest Entity [Line Items]
Assets	$ 7,699,736	$ 7,665,293	$ 7,535,944
Liabilities	6,246,896	6,274,686
Variable Interest Entity, Primary Beneficiary
Variable Interest Entity [Line Items]
Assets	254,100	232,100
Liabilities	82,200	78,800
Obligations payable	$ 178,400	$ 158,300

Leases - Schedule of Lease Cost

Leases - Schedule of Lease Cost (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Operating lease cost
Unrelated Parties	$ 76,632	$ 73,962
Related Parties	1,834	1,809
Total	78,466	75,771
Amortization of right-of-use assets
Unrelated Parties	394	347
Related Parties	0	0
Total	394	347
Interest on lease liabilities
Unrelated Parties	320	340
Related Parties	0	0
Total	320	340
Short-term lease cost
Unrelated Parties	0	35
Related Parties	0	0
Total	0	35
Variable lease cost
Unrelated Parties	15,761	13,655
Related Parties	84	39
Total	15,845	13,694
Sublease income
Unrelated Parties	(1,678)	(1,966)
Related Parties	0	0
Total	(1,678)	(1,966)
Total lease cost
Unrelated Parties	91,429	86,373
Related Parties	1,918	1,848
Total	$ 93,347	$ 88,221

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	Mar. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Principal Outstanding	$ 3,879,101	$ 3,878,237
Unamortized Premium (Discount)	16,184	17,179
Unamortized Issuance Costs	(14,553)	(15,854)
Carrying Value	3,880,732	3,879,562
Fair Value	$ 3,832,621	$ 3,767,795
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)	20,065	21,555
Unamortized Issuance Costs	(10,206)	(10,948)
Carrying Value	1,234,859	1,235,607
Fair Value	1,188,250	1,163,689
Term loan
Debt Instrument [Line Items]
Principal Outstanding	2,103,437	2,103,437
Unamortized Premium (Discount)	(3,881)	(4,376)
Unamortized Issuance Costs	(4,230)	(4,771)
Carrying Value	2,095,326	2,094,290
Fair Value	2,095,549	2,056,110
Other debt, including finance leases
Debt Instrument [Line Items]
Principal Outstanding	90,664	104,800
Unamortized Premium (Discount)	0	0
Unamortized Issuance Costs	(117)	(135)
Carrying Value	90,547	104,665
Fair Value	90,547	104,665
Revolving facility | Revolving facility
Debt Instrument [Line Items]
Principal Outstanding	460,000	445,000
Unamortized Premium (Discount)	0	0
Unamortized Issuance Costs	0	0
Carrying Value	460,000	445,000
Fair Value	$ 458,275	$ 443,331

Long-Term Debt and Notes Paya_4

Long-Term Debt and Notes Payable - Principal Maturities Of Long-Term Debt (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
2023	$ 24,685
2024	152,429
2025	2,464,015
2026	1,226,308
2027	823
Thereafter	10,841
Total	$ 3,879,101	$ 3,878,237
Senior notes | 6.250% senior notes
Debt Instrument [Line Items]
Interest rate of debt (as a percent)	6.25%	6.25%
2023	$ 0
2024	0
2025	0
2026	1,225,000
2027	0
Thereafter	0
Total	1,225,000	$ 1,225,000
Revolving facility | Revolving facility
Debt Instrument [Line Items]
2023	0
2024	84,923
2025	375,077
2026	0
2027	0
Thereafter	0
Total	460,000	445,000
Term loan
Debt Instrument [Line Items]
2023	4,757
2024	11,150
2025	2,087,530
2026	0
2027	0
Thereafter	0
Total	2,103,437	2,103,437
Other debt, including finance leases
Debt Instrument [Line Items]
2023	19,928
2024	56,356
2025	1,408
2026	1,308
2027	823
Thereafter	10,841
Total	$ 90,664	$ 104,800

Long-Term Debt and Notes Paya_5

Long-Term Debt and Notes Payable - Narrative (Details) - Revolving facility - Select Medical Corporation - Revolving facility $ in Millions	Feb. 21, 2023 USD ($)
Amendment No. 6 To 2017 Select Credit Facilities
Line of Credit Facility [Line Items]
Borrowing capacity, extended maturity date	$ 530
2017 Select Credit Facilities
Line of Credit Facility [Line Items]
Maximum borrowing capacity	$ 650

Interest Rate Cap - Narrative (

Interest Rate Cap - Narrative (Details) - Interest Rate Cap $ in Millions	3 Months Ended
	Mar. 31, 2023 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	$ 71.1

Interest Rate Cap - Schedule of

Interest Rate Cap - Schedule of Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	$ 1,356,564	$ 1,325,902
Ending balance	1,418,441	1,366,896
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	88,602	12,282
Gain (loss) on interest rate cap cash flow hedge	(2,696)	39,814
Amounts reclassified from accumulated other comprehensive income	(13,252)	39
Ending balance	$ 72,654	$ 52,135

Interest Rate Cap - Schedule _2

Interest Rate Cap - Schedule of Reclassification out of Accumulated Other Comprehensive Income (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Reclassification Adjustment out of Accumulated Other Comprehensive Income on Derivatives [Line Items]
Gains (losses) included in interest expense	$ (48,571)	$ (35,514)
Income tax benefit (expense)	(26,185)	(17,942)
Amounts reclassified from accumulated other comprehensive income	70,805	49,117
Reclassification out of Accumulated Other Comprehensive Income | Accumulated Gain (Loss), Net, Cash Flow Hedge, Parent | Interest Rate Cap
Reclassification Adjustment out of Accumulated Other Comprehensive Income on Derivatives [Line Items]
Gains (losses) included in interest expense	17,552	(51)
Income tax benefit (expense)	(4,300)	12
Amounts reclassified from accumulated other comprehensive income	$ 13,252	$ (39)

Fair Value of Financial Instr_3

Fair Value of Financial Instruments - Schedule of Interest Rate Cap (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Interest rate cap contract, current portion	$ 72,127	$ 74,857
Interest rate cap contract, non-current portion	26,994	45,200
Interest Rate Cap | Fair Value, Inputs, Level 2 | Fair Value, Recurring
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Interest rate cap contract, current portion	72,127	74,857
Interest rate cap contract, non-current portion	$ 26,994	$ 45,200

Fair Value of Financial Instr_4

Fair Value of Financial Instruments - Schedule of Long-Term Debt (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	$ 3,832,621	$ 3,767,795
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	$ 1,234,859	$ 1,235,607
Fair Value	1,188,250	1,163,689
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	1,234,859	1,235,607
Fair Value	1,188,250	1,163,689
Revolving facility | Fair Value, Inputs, Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Carrying Value	460,000	445,000
Fair Value	458,275	443,331
Term loan
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Carrying Value	2,095,326	2,094,290
Fair Value	2,095,549	2,056,110
Term loan | Fair Value, Inputs, Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Carrying Value	2,095,326	2,094,290
Fair Value	$ 2,095,549	$ 2,056,110

Segment Information - Selected

Segment Information - Selected Financial Data (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Segment Reporting Information [Line Items]
Revenue	$ 1,664,980	$ 1,599,547
Adjusted EBITDA	214,063	163,847
Total assets	7,699,736	7,535,944	$ 7,665,293
Purchases of property, equipment, and other assets	58,885	46,845
Operating Segments | Critical Illness Recovery Hospital
Segment Reporting Information [Line Items]
Revenue	593,926	601,755
Adjusted EBITDA	76,773	35,967
Total assets	2,507,265	2,367,490
Purchases of property, equipment, and other assets	23,658	19,569
Operating Segments | Rehabilitation Hospital
Segment Reporting Information [Line Items]
Revenue	231,462	220,634
Adjusted EBITDA	47,216	42,379
Total assets	1,203,069	1,187,118
Purchases of property, equipment, and other assets	8,582	6,274
Operating Segments | Outpatient Rehabilitation
Segment Reporting Information [Line Items]
Revenue	295,903	271,940
Adjusted EBITDA	30,199	26,596
Total assets	1,397,823	1,350,374
Purchases of property, equipment, and other assets	9,932	9,414
Operating Segments | Concentra
Segment Reporting Information [Line Items]
Revenue	456,298	423,423
Adjusted EBITDA	93,748	89,469
Total assets	2,300,632	2,339,940
Purchases of property, equipment, and other assets	14,400	10,240
Other
Segment Reporting Information [Line Items]
Revenue	87,391	81,795
Adjusted EBITDA	(33,873)	(30,564)
Total assets	290,947	291,022
Purchases of property, equipment, and other assets	$ 2,313	$ 1,348

Segment Information - Reconcili

Segment Information - Reconciliation of Adjusted EBITDA to Income Before Taxes (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Segment Reporting Information [Line Items]
Adjusted EBITDA	$ 214,063	$ 163,847
Depreciation and amortization	(52,425)	(51,039)
Income from operations	151,457	103,985
Equity in earnings of unconsolidated subsidiaries	8,556	5,397
Interest expense	(48,571)	(35,514)
Income before income taxes	111,442	73,868
Operating Segments | Critical Illness Recovery Hospital
Segment Reporting Information [Line Items]
Adjusted EBITDA	76,773	35,967
Depreciation and amortization	(16,637)	(14,618)
Stock compensation expense	0	0
Income from operations	60,136	21,349
Operating Segments | Rehabilitation Hospital
Segment Reporting Information [Line Items]
Adjusted EBITDA	47,216	42,379
Depreciation and amortization	(6,888)	(6,802)
Stock compensation expense	0	0
Income from operations	40,328	35,577
Operating Segments | Outpatient Rehabilitation
Segment Reporting Information [Line Items]
Adjusted EBITDA	30,199	26,596
Depreciation and amortization	(8,457)	(8,029)
Stock compensation expense	0	0
Income from operations	21,742	18,567
Operating Segments | Concentra
Segment Reporting Information [Line Items]
Adjusted EBITDA	93,748	89,469
Depreciation and amortization	(18,310)	(18,812)
Stock compensation expense	(178)	(535)
Income from operations	75,260	70,122
Other
Segment Reporting Information [Line Items]
Adjusted EBITDA	(33,873)	(30,564)
Depreciation and amortization	(2,133)	(2,778)
Stock compensation expense	(10,003)	(8,288)
Income from operations	$ (46,009)	$ (41,630)

Revenue from Contracts with C_3

Revenue from Contracts with Customers (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Disaggregation of Revenue [Line Items]
Total revenue	$ 1,664,980	$ 1,599,547
Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	1,545,295	1,488,376
Medicare
Disaggregation of Revenue [Line Items]
Total revenue	385,482	364,089
Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	1,159,813	1,124,287
Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	119,685	111,171
Operating Segments | Critical Illness Recovery Hospital
Disaggregation of Revenue [Line Items]
Total revenue	593,926	601,755
Operating Segments | Critical Illness Recovery Hospital | Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	592,688	599,973
Operating Segments | Critical Illness Recovery Hospital | Medicare
Disaggregation of Revenue [Line Items]
Total revenue	229,383	218,987
Operating Segments | Critical Illness Recovery Hospital | Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	363,305	380,986
Operating Segments | Critical Illness Recovery Hospital | Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	1,238	1,782
Operating Segments | Rehabilitation Hospital
Disaggregation of Revenue [Line Items]
Total revenue	231,462	220,634
Operating Segments | Rehabilitation Hospital | Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	219,980	210,163
Operating Segments | Rehabilitation Hospital | Medicare
Disaggregation of Revenue [Line Items]
Total revenue	110,055	103,021
Operating Segments | Rehabilitation Hospital | Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	109,925	107,142
Operating Segments | Rehabilitation Hospital | Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	11,482	10,471
Operating Segments | Outpatient Rehabilitation
Disaggregation of Revenue [Line Items]
Total revenue	295,903	271,940
Operating Segments | Outpatient Rehabilitation | Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	277,786	256,017
Operating Segments | Outpatient Rehabilitation | Medicare
Disaggregation of Revenue [Line Items]
Total revenue	45,801	41,904
Operating Segments | Outpatient Rehabilitation | Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	231,985	214,113
Operating Segments | Outpatient Rehabilitation | Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	18,117	15,923
Operating Segments | Concentra
Disaggregation of Revenue [Line Items]
Total revenue	456,298	423,423
Operating Segments | Concentra | Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	454,841	422,223
Operating Segments | Concentra | Medicare
Disaggregation of Revenue [Line Items]
Total revenue	243	177
Operating Segments | Concentra | Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	454,598	422,046
Operating Segments | Concentra | Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	1,457	1,200
Other
Disaggregation of Revenue [Line Items]
Total revenue	87,391	81,795
Other | Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	0	0
Other | Medicare
Disaggregation of Revenue [Line Items]
Total revenue	0	0
Other | Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	0	0
Other | Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	$ 87,391	$ 81,795

Earnings per Share - Narrative

Earnings per Share - Narrative (Details) - USD ($)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Earnings Per Share [Abstract]
Contractual dividends paid	$ 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
	Mar. 31, 2023	Mar. 31, 2022
Earnings Per Share [Abstract]
Net income	$ 85,257	$ 55,926
Less: Net income attributable to non-controlling interests	14,452	6,809
Net income attributable to Select Medical Holdings Corporation	70,805	49,117
Basic EPS
Less: Distributed and undistributed income attributable to participating securities - Basic EPS	2,573	1,643
Distributed and undistributed income attributable to common shares	68,232	47,474
Diluted EPS
Less: Distributed and undistributed income attributable to participating securities - Diluted EPS	2,573	1,643
Distributed and undistributed income attributable to common shares	$ 68,232	$ 47,474

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
	Mar. 31, 2023	Mar. 31, 2022
Net Income Allocation
Net income allocated to common shares - basic	$ 68,232	$ 47,474
Participating securities - basic	2,573	1,643
Net income allocated to common shares - diluted	68,232	47,474
Participating securities - diluted	2,573	1,643
Net income attributable to Select Medical Holdings Corporation	$ 70,805	$ 49,117
Weighted average common shares outstanding, basic (in shares)	122,553	129,010
Weighted average common shares outstanding, diluted (in shares)	122,553	129,010
Weighted average participating securities outstanding (in shares)	4,622	4,464
Basic EPS
Basic EPS (in dollars per share)	$ 0.56	$ 0.37
Diluted EPS
Diluted EPS (in dollars per share)	$ 0.56	$ 0.37

Commitments and Contingencies (

Commitments and Contingencies (Details) $ in Millions	3 Months Ended
	Mar. 31, 2023 USD ($)
Professional liability claims | Critical Illness Recovery Hospitals, Rehabilitation Hospitals And Outpatient Rehabilitiation
Commitments and Contingencies
Total annual aggregate limit of insurance coverage	$ 37
Professional liability claims | Concentra
Commitments and Contingencies
Total annual aggregate limit of insurance coverage	19
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 | Critical Illness Recovery Hospitals, Rehabilitation Hospitals And Outpatient Rehabilitiation
Commitments and Contingencies
Total annual aggregate limit of insurance coverage	40
General Liability | Concentra
Commitments and Contingencies
Total annual aggregate limit of insurance coverage	$ 19

Subsequent Event (Details)

Subsequent Event (Details)	May 03, 2023 $ / shares
Subsequent Event
Subsequent Event [Line Items]
Cash dividend declared (in dollars per share)	$ 0.125