Select Medical (SEM) 10-Q 3 Aug 23 2023 Q2 Quarterly report Financial data

Cover

Cover - shares	6 Months Ended
	Jun. 30, 2023	Jul. 31, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 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		127,143,417
Current Fiscal Year End Date	--12-31
Amendment Flag	false
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q2
Entity Central Index Key	0001320414

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (unaudited) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Current Assets:
Cash and cash equivalents	$ 101,167	$ 97,906
Accounts receivable	964,680	941,312
Prepaid income taxes	16,513	31,868
Current portion of interest rate cap contract	83,938	74,857
Other current assets	138,186	125,370
Total Current Assets	1,304,484	1,271,313
Operating lease right-of-use assets	1,182,839	1,169,740
Property and equipment, net	1,004,430	1,001,440
Goodwill	3,486,050	3,484,200
Identifiable intangible assets, net	346,733	351,662
Interest rate cap contract, net of current portion	18,396	45,200
Other assets	358,937	341,738
Total Assets	7,701,869	7,665,293
Current Liabilities:
Overdrafts	31,494	31,961
Current operating lease liabilities	241,517	236,784
Current portion of long-term debt and notes payable	57,205	44,351
Accounts payable	186,787	186,729
Accrued payroll	191,061	209,789
Accrued vacation	159,168	150,695
Accrued interest	29,514	29,837
Accrued other	283,257	264,525
Income taxes payable	8,209	480
Total Current Liabilities	1,188,212	1,155,151
Non-current operating lease liabilities	1,021,314	1,008,394
Long-term debt, net of current portion	3,695,341	3,835,211
Non-current deferred tax liability	155,925	169,793
Other non-current liabilities	105,123	106,137
Total Liabilities	6,165,915	6,274,686
Commitments and contingencies (Note 13)
Redeemable non-controlling interests	34,375	34,043
Stockholders’ Equity:
Common stock, $0.001 par value, 700,000,000 shares authorized, 127,173,871 and 127,387,869 shares issued and outstanding at 2022 and 2023, respectively	127	127
Capital in excess of par	473,942	452,183
Retained earnings	696,922	581,010
Accumulated other comprehensive income	75,047	88,602
Total Stockholders’ Equity	1,246,038	1,121,922
Non-controlling interests	255,541	234,642
Total Equity	1,501,579	1,356,564
Total Liabilities and Equity	$ 7,701,869	$ 7,665,293

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (unaudited) (Parenthetical) - $ / shares	Jun. 30, 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)	127,387,869	127,173,871
Common stock, shares outstanding (in shares)	127,387,869	127,173,871

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Income Statement [Abstract]
Revenue	$ 1,674,528	$ 1,584,741	$ 3,339,508	$ 3,184,288
Costs and expenses:
Cost of services, exclusive of depreciation and amortization	1,423,603	1,390,550	2,842,422	2,797,560
General and administrative	42,508	37,268	84,787	74,781
Depreciation and amortization	49,939	51,081	102,364	102,120
Total costs and expenses	1,516,050	1,478,899	3,029,573	2,974,461
Other operating income	726	15,125	726	15,125
Income from operations	159,204	120,967	310,661	224,952
Other income and expense:
Equity in earnings of unconsolidated subsidiaries	10,501	6,167	19,057	11,564
Interest expense	(48,997)	(41,052)	(97,568)	(76,566)
Income before income taxes	120,708	86,082	232,150	159,950
Income tax expense	28,848	19,820	55,033	37,762
Net income	91,860	66,262	177,117	122,188
Less: Net income attributable to non-controlling interests	13,623	11,055	28,075	17,864
Net income attributable to Select Medical Holdings Corporation	$ 78,237	$ 55,207	$ 149,042	$ 104,324
Earnings per common share (Note 12):
Basic (in dollars per share)	$ 0.61	$ 0.43	$ 1.17	$ 0.79
Diluted (in dollars per share)	$ 0.61	$ 0.43	$ 1.17	$ 0.79

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Income (unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Statement of Comprehensive Income [Abstract]
Net income	$ 91,860	$ 66,262	$ 177,117	$ 122,188
Other comprehensive income (loss), net of tax:
Gain on interest rate cap contract	17,527	11,833	14,831	51,647
Reclassification adjustment for losses (gains) included in net income	(15,134)	(6)	(28,386)	33
Net change, net of tax benefit (expense) of $(3,942), $(777), $(17,227), and $4,398	2,393	11,827	(13,555)	51,680
Comprehensive income	94,253	78,089	163,562	173,868
Less: Comprehensive income attributable to non-controlling interests	13,623	11,055	28,075	17,864
Comprehensive income attributable to Select Medical Holdings Corporation	$ 80,630	$ 67,034	$ 135,487	$ 156,004

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Comprehensive Income (unaudited) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Statement of Comprehensive Income [Abstract]
Tax benefit (expense) on components of other comprehensive income	$ (777)	$ (3,942)	$ 4,398	$ (17,227)

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 (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
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	104,324
Ending balance (in shares) at Jun. 30, 2022			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		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)		0
Ending balance (in shares) at Jun. 30, 2022			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 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 (loss)	(15,948)	(15,948)				(15,948)
Other	0	0		(1)	1
Ending balance (in shares) at Mar. 31, 2023			127,176,000
Ending balance at Mar. 31, 2023	$ 1,418,441	1,170,449	$ 127	462,185	635,483	72,654	247,992
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	$ 149,042
Ending balance (in shares) at Jun. 30, 2023	127,387,869		127,388,000
Ending balance at Jun. 30, 2023	$ 1,501,579	1,246,038	$ 127	473,942	696,922	75,047	255,541
Beginning balance (in shares) at Mar. 31, 2023			127,176,000
Beginning balance at Mar. 31, 2023	1,418,441	1,170,449	$ 127	462,185	635,483	72,654	247,992
Increase (Decrease) in Stockholders' Equity
Net income attributable to Select Medical Holdings Corporation	78,237	78,237			78,237
Net income attributable to non-controlling interests	11,539	0					11,539
Cash dividends declared for common stockholders ($0.125 per share)	(15,924)	(15,924)			(15,924)
Issuance of restricted stock (in shares)			261,000
Issuance of restricted stock	0	0	$ 0	0
Vesting of restricted stock	10,326	10,326		10,326
Repurchase of common shares (in shares)			(49,000)
Repurchase of common shares	(1,506)	(1,506)	$ 0	(634)	(872)
Issuance of non-controlling interests	12,081	1,870		1,870			10,211
Distributions to and purchases of non-controlling interests	(14,006)	195		195			(14,201)
Redemption value adjustment on non-controlling interests	(2)	(2)			(2)
Other comprehensive income (loss)	$ 2,393	2,393				2,393
Ending balance (in shares) at Jun. 30, 2023	127,387,869		127,388,000
Ending balance at Jun. 30, 2023	$ 1,501,579	$ 1,246,038	$ 127	$ 473,942	$ 696,922	$ 75,047	$ 255,541

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Changes in Equity and Income (unaudited) (Parenthetical) - $ / shares	3 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022
Statement of Stockholders' Equity [Abstract]
Cash dividend declared (in dollars per share)	$ 0.125	$ 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, 2023	Jun. 30, 2022
Operating activities
Net income	$ 177,117	$ 122,188
Adjustments to reconcile net income to net cash provided by operating activities:
Distributions from unconsolidated subsidiaries	8,841	11,140
Depreciation and amortization	102,364	102,120
Provision for expected credit losses	761	111
Equity in earnings of unconsolidated subsidiaries	(19,057)	(11,564)
Gain on sale or disposal of assets	(23)	(1,476)
Stock compensation expense	20,508	17,769
Amortization of debt discount, premium and issuance costs	1,174	1,123
Deferred income taxes	(10,876)	(1,965)
Changes in operating assets and liabilities, net of effects of business combinations:
Accounts receivable	(23,135)	(32,431)
Other current assets	(5,997)	(2,128)
Other assets	5,472	1,275
Accounts payable	7,096	4,879
Accrued expenses	22,033	44,296
Government advances	0	(77,319)
Net cash provided by operating activities	286,278	178,018
Investing activities
Business combinations, net of cash acquired	(7,732)	(19,241)
Purchases of property, equipment, and other assets	(118,399)	(93,177)
Investment in businesses	(9,800)	(6,990)
Proceeds from sale of assets	56	5,314
Net cash used in investing activities	(135,875)	(114,094)
Financing activities
Borrowings on revolving facilities	435,000	565,000
Payments on revolving facilities	(535,000)	(375,000)
Borrowings of other debt	22,298	17,494
Principal payments on other debt	(26,373)	(16,874)
Dividends paid to common stockholders	(31,821)	(32,799)
Repurchase of common stock	(1,506)	(178,623)
Decrease in overdrafts	(467)	(11,055)
Proceeds from issuance of non-controlling interests	14,812	6,955
Distributions to and purchases of non-controlling interests	(24,085)	(18,663)
Net cash used in financing activities	(147,142)	(43,565)
Net increase in cash and cash equivalents	3,261	20,359
Cash and cash equivalents at beginning of period	97,906	74,310
Cash and cash equivalents at end of period	101,167	94,669
Supplemental information
Cash paid for interest, excluding amounts received of $103 and $38,284 under the interest rate cap contract	133,581	74,217
Cash paid for taxes	$ 42,755	$ 16,423

Condensed Consolidated Statem_7

Condensed Consolidated Statements of Cash Flows (unaudited) (Parenthetical) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Statement of Cash Flows [Abstract]
Interest received under interest rate cash flow hedge	$ 38,284	$ 103

Basis of Presentation

Basis of Presentation	6 Months Ended
	Jun. 30, 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 June 30, 2023, and for the three and six month periods ended June 30, 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 and six months ended June 30, 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	6 Months Ended
	Jun. 30, 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 assessing 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 June 30, 2023 as the intended cessation date of the one-, three-, six-, and 12-month tenors of USD 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. On May 31, 2023, the Company replaced LIBOR with the forward looking Secured Overnight Financing Rate (“Adjusted Term SOFR”) within the credit agreement. On May 31, 2023, the Company also modified the cash flow hedge’s contractual terms to replace LIBOR with SOFR. The amendment to the credit agreement is described further in Note 7 -Long-term Debt and Notes Payable. The Company’s cash flow hedge is described further in Note 8 – Interest Rate Cap. These updates have not had 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	6 Months Ended
	Jun. 30, 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% of the Company’s accounts receivable is due from Medicare at both December 31, 2022 and June 30, 2023.

Redeemable Non-Controlling Inte

Redeemable Non-Controlling Interests	6 Months Ended
	Jun. 30, 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: Six Months Ended June 30, 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 Net income attributable to redeemable non-controlling interests 1,900 2,084 Distributions to and purchases of redeemable non-controlling interests (1,553) (2,110) Redemption value adjustment on redeemable non-controlling interests (355) 2 Other 535 — Balance as of June 30 $ 42,197 $ 34,375

Variable Interest Entities

Variable Interest Entities	6 Months Ended
	Jun. 30, 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 June 30, 2023, the total assets of the Company’s variable interest entities were $232.1 million and $263.6 million, respectively, and are principally comprised of accounts receivable. As of December 31, 2022, and June 30, 2023, the total liabilities of the Company’s variable interest entities were $78.8 million and $84.1 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 $186.7 million as of December 31, 2022, and June 30, 2023, respectively. These intercompany balances are eliminated in consolidation.

Leases

Leases	6 Months Ended
	Jun. 30, 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 June 30, 2022 Three Months Ended June 30, 2023 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 73,969 $ 1,809 $ 75,778 $ 76,892 $ 1,833 $ 78,725 Finance lease cost: Amortization of right-of-use assets 377 — 377 404 — 404 Interest on lease liabilities 336 — 336 387 — 387 Short-term lease cost 15 — 15 — — — Variable lease cost 14,407 141 14,548 16,532 — 16,532 Sublease income (1,940) — (1,940) (1,716) — (1,716) Total lease cost $ 87,164 $ 1,950 $ 89,114 $ 92,499 $ 1,833 $ 94,332 Six Months Ended June 30, 2022 Six Months Ended June 30, 2023 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 147,931 $ 3,618 $ 151,549 $ 153,524 $ 3,667 $ 157,191 Finance lease cost: Amortization of right-of-use assets 724 — 724 798 — 798 Interest on lease liabilities 676 — 676 707 — 707 Short-term lease cost 50 — 50 — — — Variable lease cost 28,062 180 28,242 32,293 84 32,377 Sublease income (3,906) — (3,906) (3,394) — (3,394) Total lease cost $ 173,537 $ 3,798 $ 177,335 $ 183,928 $ 3,751 $ 187,679
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, 2022 Three Months Ended June 30, 2023 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 73,969 $ 1,809 $ 75,778 $ 76,892 $ 1,833 $ 78,725 Finance lease cost: Amortization of right-of-use assets 377 — 377 404 — 404 Interest on lease liabilities 336 — 336 387 — 387 Short-term lease cost 15 — 15 — — — Variable lease cost 14,407 141 14,548 16,532 — 16,532 Sublease income (1,940) — (1,940) (1,716) — (1,716) Total lease cost $ 87,164 $ 1,950 $ 89,114 $ 92,499 $ 1,833 $ 94,332 Six Months Ended June 30, 2022 Six Months Ended June 30, 2023 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 147,931 $ 3,618 $ 151,549 $ 153,524 $ 3,667 $ 157,191 Finance lease cost: Amortization of right-of-use assets 724 — 724 798 — 798 Interest on lease liabilities 676 — 676 707 — 707 Short-term lease cost 50 — 50 — — — Variable lease cost 28,062 180 28,242 32,293 84 32,377 Sublease income (3,906) — (3,906) (3,394) — (3,394) Total lease cost $ 173,537 $ 3,798 $ 177,335 $ 183,928 $ 3,751 $ 187,679

Long-Term Debt and Notes Payabl

Long-Term Debt and Notes Payable	6 Months Ended
	Jun. 30, 2023
Debt Disclosure [Abstract]
Long-Term Debt and Notes Payable	Long-Term Debt and Notes Payable As of June 30, 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 $ 18,562 $ (9,456) $ 1,234,106 $ 1,204,175 Credit facilities: Revolving facility 345,000 — — 345,000 343,706 Term loan 2,103,437 (3,379) (3,684) 2,096,374 2,098,178 Other debt, including finance leases 77,164 — (98) 77,066 77,066 Total debt $ 3,750,601 $ 15,183 $ (13,238) $ 3,752,546 $ 3,723,125 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 — 31,846 313,154 — — — 345,000 Term loan 4,757 11,150 2,087,530 — — — 2,103,437 Other debt, including finance leases 11,738 51,046 1,408 1,309 823 10,840 77,164 Total debt $ 16,495 $ 94,042 $ 2,402,092 $ 1,226,309 $ 823 $ 10,840 $ 3,750,601 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 May 31, 2023, Select entered into Amendment No. 7 to the Select credit agreement. Amendment No. 7 replaced the interest rate based on LIBOR and LIBOR-based mechanics applicable to borrowings under the Select credit agreement with an interest rate based on Adjusted Term SOFR (as defined in the credit agreement). The Adjusted Term SOFR Rate includes a credit spread adjustment of 0.10%. On July 31, 2023, the Company entered into Amendment No. 8 to the Select credit agreement. Amendment No. 8 provides for a new tranche of refinancing term loan in an aggregate principal amount of $2,103.0 million to replace the existing term loans and a $710.0 million new revolving credit facility to replace the existing revolving credit facility. The refinancing term loan and the extended revolving credit facility will mature on March 6, 2027, with an early springing maturity 90 days prior to the senior notes maturity, triggered if more than $300.0 million of senior notes remain outstanding on May 15, 2026. The refinancing term loan has an interest rate of Term SOFR (without the 0.10% credit spread adjustment) plus 3.00% and the refinancing revolving credit facility has an interest rate of Adjusted Term SOFR plus 2.50%, in each case, subject to a leverage-based pricing grid.

Interest Rate Cap

Interest Rate Cap	6 Months Ended
	Jun. 30, 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. The term loan bears interest at a variable rate that is indexed to a benchmark which changed from LIBOR to SOFR on May 31, 2023. 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 variable interest 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 the variable interest rate exceeds 1.0%. Changes in the fair value of the interest rate cap, net of tax, are recognized in other comprehensive income and are reclassified out of accumulated other comprehensive income 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: Six Months Ended June 30, 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 Gain on interest rate cap cash flow hedge 11,833 17,527 Amounts reclassified from accumulated other comprehensive income (6) (15,134) Balance as of June 30 $ 63,962 $ 75,047 The effects on net income of amounts reclassified from accumulated other comprehensive income are as follows: Three Months Ended June 30, Six Months Ended June 30, Statement of Operations 2022 2023 2022 2023 (in thousands) Gains (losses) included in interest expense $ 8 $ 20,045 $ (43) $ 37,597 Income tax benefit (expense) (2) (4,911) 10 (9,211) Amounts reclassified from accumulated other comprehensive income $ 6 $ 15,134 $ (33) $ 28,386 The Company expects that approximately $82.1 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	6 Months Ended
	Jun. 30, 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 June 30, 2023 Asset: (in thousands) Interest rate cap contract, current portion Current portion of interest rate cap contract Level 2 $ 74,857 $ 83,938 Interest rate cap contract, non-current portion Interest rate cap contract, net of current portion Level 2 45,200 18,396 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 June 30, 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 $ 1,234,106 $ 1,204,175 Credit facilities: Revolving facility Level 2 445,000 443,331 345,000 343,706 Term loan Level 2 2,094,290 2,056,110 2,096,374 2,098,178

Segment Information

Segment Information	6 Months Ended
	Jun. 30, 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 June 30, Six Months Ended June 30, 2022 2023 2022 2023 (in thousands) Revenue: Critical illness recovery hospital $ 545,908 $ 575,091 $ 1,147,663 $ 1,169,017 Rehabilitation hospital 228,887 240,856 449,521 472,318 Outpatient rehabilitation 287,258 302,972 559,198 598,875 Concentra 441,357 467,079 864,780 923,377 Other 81,331 88,530 163,126 175,921 Total Company $ 1,584,741 $ 1,674,528 $ 3,184,288 $ 3,339,508 Adjusted EBITDA: Critical illness recovery hospital $ 20,019 $ 65,496 $ 55,986 $ 142,269 Rehabilitation hospital 49,845 54,689 92,224 101,905 Outpatient rehabilitation 33,601 32,850 60,197 63,049 Concentra 92,607 100,391 182,076 194,139 Other (1) (15,078) (33,957) (45,642) (67,830) Total Company $ 180,994 $ 219,469 $ 344,841 $ 433,532 Total assets: Critical illness recovery hospital $ 2,387,516 $ 2,492,370 $ 2,387,516 $ 2,492,370 Rehabilitation hospital 1,194,739 1,209,737 1,194,739 1,209,737 Outpatient rehabilitation 1,360,600 1,399,782 1,360,600 1,399,782 Concentra 2,301,296 2,314,328 2,301,296 2,314,328 Other 307,507 285,652 307,507 285,652 Total Company $ 7,551,658 $ 7,701,869 $ 7,551,658 $ 7,701,869 Purchases of property, equipment, and other assets: Critical illness recovery hospital $ 19,528 $ 31,363 $ 39,097 $ 55,021 Rehabilitation hospital 4,821 1,903 11,095 10,485 Outpatient rehabilitation 9,314 10,476 18,728 20,408 Concentra 8,716 15,846 18,956 30,246 Other 3,953 (74) 5,301 2,239 Total Company $ 46,332 $ 59,514 $ 93,177 $ 118,399 _______________________________________________________________________________ (1) For the three and six months ended June 30, 2022, Adjusted EBITDA included other operating income of $15.1 million. 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, 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 Three Months Ended June 30, 2023 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 65,496 $ 54,689 $ 32,850 $ 100,391 $ (33,957) Depreciation and amortization (13,886) (6,887) (8,779) (18,283) (2,104) Stock compensation expense — — — — (10,326) Income (loss) from operations $ 51,610 $ 47,802 $ 24,071 $ 82,108 $ (46,387) $ 159,204 Equity in earnings of unconsolidated subsidiaries 10,501 Interest expense (48,997) Income before income taxes $ 120,708 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 Six Months Ended June 30, 2023 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 142,269 $ 101,905 $ 63,049 $ 194,139 $ (67,830) Depreciation and amortization (30,523) (13,775) (17,236) (36,593) (4,237) Stock compensation expense — — — (178) (20,329) Income (loss) from operations $ 111,746 $ 88,130 $ 45,813 $ 157,368 $ (92,396) $ 310,661 Equity in earnings of unconsolidated subsidiaries 19,057 Interest expense (97,568) Income before income taxes $ 232,150

Revenue from Contracts with Cus

Revenue from Contracts with Customers	6 Months Ended
	Jun. 30, 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 and six months ended June 30, 2022 and 2023: 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 Three Months Ended June 30, 2023 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 207,743 $ 113,450 $ 46,647 $ 250 $ — $ 368,090 Non-Medicare 366,498 115,436 236,246 465,367 — 1,183,547 Total patient services revenues 574,241 228,886 282,893 465,617 — 1,551,637 Other revenue 850 11,970 20,079 1,462 88,530 122,891 Total revenue $ 575,091 $ 240,856 $ 302,972 $ 467,079 $ 88,530 $ 1,674,528 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 Six Months Ended June 30, 2023 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 437,126 $ 223,505 $ 92,448 $ 493 $ — $ 753,572 Non-Medicare 729,803 225,361 468,231 919,965 — 2,343,360 Total patient services revenues 1,166,929 448,866 560,679 920,458 — 3,096,932 Other revenue 2,088 23,452 38,196 2,919 175,921 242,576 Total revenue $ 1,169,017 $ 472,318 $ 598,875 $ 923,377 $ 175,921 $ 3,339,508

Earnings per Share

Earnings per Share	6 Months Ended
	Jun. 30, 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 and six months ended June 30, 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 June 30, Six Months Ended June 30, 2022 2023 2022 2023 (in thousands) Net income $ 66,262 $ 91,860 $ 122,188 $ 177,117 Less: net income attributable to non-controlling interests 11,055 13,623 17,864 28,075 Net income attributable to the Company 55,207 78,237 104,324 149,042 Less: Distributed and undistributed income attributable to participating securities 1,920 2,877 3,558 5,449 Distributed and undistributed income attributable to common shares $ 53,287 $ 75,360 $ 100,766 $ 143,593 The following tables set forth the computation of EPS under the two-class method: Three Months Ended June 30, 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 $ 53,287 124,897 $ 0.43 $ 75,360 122,634 $ 0.61 Participating securities 1,920 4,500 $ 0.43 2,877 4,681 $ 0.61 Total Company $ 55,207 $ 78,237 Six Months Ended June 30, 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 $ 100,766 126,942 $ 0.79 $ 143,593 122,594 $ 1.17 Participating securities 3,558 4,482 $ 0.79 5,449 4,652 $ 1.17 Total Company $ 104,324 $ 149,042 _______________________________________________________________________________ (1) Represents the weighted average share count outstanding during the period.

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 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. 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, that 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 has produced 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 Events

Subsequent Events	6 Months Ended
	Jun. 30, 2023
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events On August 2, 2023, the Company’s Board of Directors declared a cash dividend of $0.125 per share. The dividend will be payable on or about September 1, 2023, to stockholders of record as of the close of business on August 15, 2023. On July 31, 2023, the Company entered into Amendment No. 8 to the Select credit agreement. Amendment No. 8 provides for a new tranche of refinancing term loan in an aggregate principal amount of $2,103.0 million to replace the existing term loans and a $710.0 million new revolving credit facility to replace the existing revolving credit facility. The refinancing term loan and the extended revolving credit facility will mature on March 6, 2027, with an early springing maturity 90 days prior to the senior notes maturity, triggered if more than $300.0 million of senior notes remain outstanding on May 15, 2026. The refinancing term loan has an interest rate of Term SOFR (without the 0.10% credit spread adjustment) plus 3.00% and the refinancing revolving credit facility has an interest rate of Adjusted Term SOFR plus 2.50%, in each case, subject to a leverage-based pricing grid.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2023	Jun. 30, 2022
Pay vs Performance Disclosure
Net income attributable to Select Medical Holdings Corporation	$ 78,237	$ 70,805	$ 55,207	$ 49,117	$ 149,042	$ 104,324

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Jun. 30, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Accounting Policies (Policies)

Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 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 assessing 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 June 30, 2023 as the intended cessation date of the one-, three-, six-, and 12-month tenors of USD 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. On May 31, 2023, the Company replaced LIBOR with the forward looking Secured Overnight Financing Rate (“Adjusted Term SOFR”) within the credit agreement. On May 31, 2023, the Company also modified the cash flow hedge’s contractual terms to replace LIBOR with SOFR. The amendment to the credit agreement is described further in Note 7 -Long-term Debt and Notes Payable. The Company’s cash flow hedge is described further in Note 8 – Interest Rate Cap. These updates have not had 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)	6 Months Ended
	Jun. 30, 2023
Noncontrolling Interest [Abstract]
Schedule of redeemable non-controlling interests	The changes in redeemable non-controlling interests are as follows: Six Months Ended June 30, 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 Net income attributable to redeemable non-controlling interests 1,900 2,084 Distributions to and purchases of redeemable non-controlling interests (1,553) (2,110) Redemption value adjustment on redeemable non-controlling interests (355) 2 Other 535 — Balance as of June 30 $ 42,197 $ 34,375

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 2023
Leases [Abstract]
Schedule of lease cost	The Company’s total lease cost is as follows: Three Months Ended June 30, 2022 Three Months Ended June 30, 2023 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 73,969 $ 1,809 $ 75,778 $ 76,892 $ 1,833 $ 78,725 Finance lease cost: Amortization of right-of-use assets 377 — 377 404 — 404 Interest on lease liabilities 336 — 336 387 — 387 Short-term lease cost 15 — 15 — — — Variable lease cost 14,407 141 14,548 16,532 — 16,532 Sublease income (1,940) — (1,940) (1,716) — (1,716) Total lease cost $ 87,164 $ 1,950 $ 89,114 $ 92,499 $ 1,833 $ 94,332 Six Months Ended June 30, 2022 Six Months Ended June 30, 2023 Unrelated Parties Related Parties Total Unrelated Parties Related Parties Total (in thousands) Operating lease cost $ 147,931 $ 3,618 $ 151,549 $ 153,524 $ 3,667 $ 157,191 Finance lease cost: Amortization of right-of-use assets 724 — 724 798 — 798 Interest on lease liabilities 676 — 676 707 — 707 Short-term lease cost 50 — 50 — — — Variable lease cost 28,062 180 28,242 32,293 84 32,377 Sublease income (3,906) — (3,906) (3,394) — (3,394) Total lease cost $ 173,537 $ 3,798 $ 177,335 $ 183,928 $ 3,751 $ 187,679

Long-Term Debt and Notes Paya_2

Long-Term Debt and Notes Payable (Tables)	6 Months Ended
	Jun. 30, 2023
Debt Disclosure [Abstract]
Schedule of long-term debt and notes payable	As of June 30, 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 $ 18,562 $ (9,456) $ 1,234,106 $ 1,204,175 Credit facilities: Revolving facility 345,000 — — 345,000 343,706 Term loan 2,103,437 (3,379) (3,684) 2,096,374 2,098,178 Other debt, including finance leases 77,164 — (98) 77,066 77,066 Total debt $ 3,750,601 $ 15,183 $ (13,238) $ 3,752,546 $ 3,723,125 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 — 31,846 313,154 — — — 345,000 Term loan 4,757 11,150 2,087,530 — — — 2,103,437 Other debt, including finance leases 11,738 51,046 1,408 1,309 823 10,840 77,164 Total debt $ 16,495 $ 94,042 $ 2,402,092 $ 1,226,309 $ 823 $ 10,840 $ 3,750,601

Interest Rate Cap (Tables)

Interest Rate Cap (Tables)	6 Months Ended
	Jun. 30, 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: Six Months Ended June 30, 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 Gain on interest rate cap cash flow hedge 11,833 17,527 Amounts reclassified from accumulated other comprehensive income (6) (15,134) Balance as of June 30 $ 63,962 $ 75,047
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 June 30, Six Months Ended June 30, Statement of Operations 2022 2023 2022 2023 (in thousands) Gains (losses) included in interest expense $ 8 $ 20,045 $ (43) $ 37,597 Income tax benefit (expense) (2) (4,911) 10 (9,211) Amounts reclassified from accumulated other comprehensive income $ 6 $ 15,134 $ (33) $ 28,386

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	6 Months Ended
	Jun. 30, 2023
Fair Value Disclosures [Abstract]
Schedule of interest rate cap	Financial Instrument Balance Sheet Classification Level December 31, 2022 June 30, 2023 Asset: (in thousands) Interest rate cap contract, current portion Current portion of interest rate cap contract Level 2 $ 74,857 $ 83,938 Interest rate cap contract, non-current portion Interest rate cap contract, net of current portion Level 2 45,200 18,396
Schedule of long-term debt	December 31, 2022 June 30, 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 $ 1,234,106 $ 1,204,175 Credit facilities: Revolving facility Level 2 445,000 443,331 345,000 343,706 Term loan Level 2 2,094,290 2,056,110 2,096,374 2,098,178

Segment Information (Tables)

Segment Information (Tables)	6 Months Ended
	Jun. 30, 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 June 30, Six Months Ended June 30, 2022 2023 2022 2023 (in thousands) Revenue: Critical illness recovery hospital $ 545,908 $ 575,091 $ 1,147,663 $ 1,169,017 Rehabilitation hospital 228,887 240,856 449,521 472,318 Outpatient rehabilitation 287,258 302,972 559,198 598,875 Concentra 441,357 467,079 864,780 923,377 Other 81,331 88,530 163,126 175,921 Total Company $ 1,584,741 $ 1,674,528 $ 3,184,288 $ 3,339,508 Adjusted EBITDA: Critical illness recovery hospital $ 20,019 $ 65,496 $ 55,986 $ 142,269 Rehabilitation hospital 49,845 54,689 92,224 101,905 Outpatient rehabilitation 33,601 32,850 60,197 63,049 Concentra 92,607 100,391 182,076 194,139 Other (1) (15,078) (33,957) (45,642) (67,830) Total Company $ 180,994 $ 219,469 $ 344,841 $ 433,532 Total assets: Critical illness recovery hospital $ 2,387,516 $ 2,492,370 $ 2,387,516 $ 2,492,370 Rehabilitation hospital 1,194,739 1,209,737 1,194,739 1,209,737 Outpatient rehabilitation 1,360,600 1,399,782 1,360,600 1,399,782 Concentra 2,301,296 2,314,328 2,301,296 2,314,328 Other 307,507 285,652 307,507 285,652 Total Company $ 7,551,658 $ 7,701,869 $ 7,551,658 $ 7,701,869 Purchases of property, equipment, and other assets: Critical illness recovery hospital $ 19,528 $ 31,363 $ 39,097 $ 55,021 Rehabilitation hospital 4,821 1,903 11,095 10,485 Outpatient rehabilitation 9,314 10,476 18,728 20,408 Concentra 8,716 15,846 18,956 30,246 Other 3,953 (74) 5,301 2,239 Total Company $ 46,332 $ 59,514 $ 93,177 $ 118,399 _______________________________________________________________________________ (1) For the three and six months ended June 30, 2022, Adjusted EBITDA included other operating income of $15.1 million. 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, 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 Three Months Ended June 30, 2023 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 65,496 $ 54,689 $ 32,850 $ 100,391 $ (33,957) Depreciation and amortization (13,886) (6,887) (8,779) (18,283) (2,104) Stock compensation expense — — — — (10,326) Income (loss) from operations $ 51,610 $ 47,802 $ 24,071 $ 82,108 $ (46,387) $ 159,204 Equity in earnings of unconsolidated subsidiaries 10,501 Interest expense (48,997) Income before income taxes $ 120,708 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 Six Months Ended June 30, 2023 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Adjusted EBITDA $ 142,269 $ 101,905 $ 63,049 $ 194,139 $ (67,830) Depreciation and amortization (30,523) (13,775) (17,236) (36,593) (4,237) Stock compensation expense — — — (178) (20,329) Income (loss) from operations $ 111,746 $ 88,130 $ 45,813 $ 157,368 $ (92,396) $ 310,661 Equity in earnings of unconsolidated subsidiaries 19,057 Interest expense (97,568) Income before income taxes $ 232,150

Revenue from Contracts with C_2

Revenue from Contracts with Customers (Tables)	6 Months Ended
	Jun. 30, 2023
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, 2022 and 2023: 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 Three Months Ended June 30, 2023 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 207,743 $ 113,450 $ 46,647 $ 250 $ — $ 368,090 Non-Medicare 366,498 115,436 236,246 465,367 — 1,183,547 Total patient services revenues 574,241 228,886 282,893 465,617 — 1,551,637 Other revenue 850 11,970 20,079 1,462 88,530 122,891 Total revenue $ 575,091 $ 240,856 $ 302,972 $ 467,079 $ 88,530 $ 1,674,528 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 Six Months Ended June 30, 2023 Critical Illness Recovery Hospital Rehabilitation Hospital Outpatient Concentra Other Total (in thousands) Patient service revenue: Medicare $ 437,126 $ 223,505 $ 92,448 $ 493 $ — $ 753,572 Non-Medicare 729,803 225,361 468,231 919,965 — 2,343,360 Total patient services revenues 1,166,929 448,866 560,679 920,458 — 3,096,932 Other revenue 2,088 23,452 38,196 2,919 175,921 242,576 Total revenue $ 1,169,017 $ 472,318 $ 598,875 $ 923,377 $ 175,921 $ 3,339,508

Earnings per Share (Tables)

Earnings per Share (Tables)	6 Months Ended
	Jun. 30, 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 June 30, Six Months Ended June 30, 2022 2023 2022 2023 (in thousands) Net income $ 66,262 $ 91,860 $ 122,188 $ 177,117 Less: net income attributable to non-controlling interests 11,055 13,623 17,864 28,075 Net income attributable to the Company 55,207 78,237 104,324 149,042 Less: Distributed and undistributed income attributable to participating securities 1,920 2,877 3,558 5,449 Distributed and undistributed income attributable to common shares $ 53,287 $ 75,360 $ 100,766 $ 143,593 The following tables set forth the computation of EPS under the two-class method: Three Months Ended June 30, 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 $ 53,287 124,897 $ 0.43 $ 75,360 122,634 $ 0.61 Participating securities 1,920 4,500 $ 0.43 2,877 4,681 $ 0.61 Total Company $ 55,207 $ 78,237 Six Months Ended June 30, 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 $ 100,766 126,942 $ 0.79 $ 143,593 122,594 $ 1.17 Participating securities 3,558 4,482 $ 0.79 5,449 4,652 $ 1.17 Total Company $ 104,324 $ 149,042 _______________________________________________________________________________ (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, 2023	Dec. 31, 2022
Medicare Receivable | Credit Concentration Risk | Accounts Receivable
Concentration Risk [Line Items]
Percentage of concentration risk	19%	19%

Redeemable Non-Controlling In_3

Redeemable Non-Controlling Interests - Schedule of Redeemable Non-Controlling Interests (Details) - USD ($) $ in Thousands	3 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022
Increase (Decrease) in Temporary Equity [Roll Forward]
Balance, beginning	$ 34,399	$ 34,043	$ 41,670	$ 39,033
Net income attributable to redeemable non-controlling interests	2,084	1,641	1,900	1,918
Distributions to and purchases of redeemable non-controlling interests	(2,110)	(1,900)	(1,553)	(1,198)
Redemption value adjustment on redeemable non-controlling interests	2	436	(355)	1,381
Other	0	179	535	536
Balance, ending	$ 34,375	$ 34,399	$ 42,197	$ 41,670

Variable Interest Entities (Det

Variable Interest Entities (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022	Jun. 30, 2022
Variable Interest Entity [Line Items]
Assets	$ 7,701,869	$ 7,665,293	$ 7,551,658
Liabilities	6,165,915	6,274,686
Variable Interest Entity, Primary Beneficiary
Variable Interest Entity [Line Items]
Assets	263,600	232,100
Liabilities	84,100	78,800
Variable Interest Entity, Primary Beneficiary | Related Party
Variable Interest Entity [Line Items]
Obligations payable	$ 186,700	$ 158,300

Leases - Schedule of Lease Cost

Leases - Schedule of Lease Cost (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Operating lease cost
Unrelated Parties	$ 76,892	$ 73,969	$ 153,524	$ 147,931
Related Parties	1,833	1,809	3,667	3,618
Total	78,725	75,778	157,191	151,549
Amortization of right-of-use assets
Unrelated Parties	404	377	798	724
Related Parties	0	0	0	0
Total	404	377	798	724
Interest on lease liabilities
Unrelated Parties	387	336	707	676
Related Parties	0	0	0	0
Total	387	336	707	676
Short-term lease cost
Unrelated Parties	0	15	0	50
Related Parties	0	0	0	0
Total	0	15	0	50
Variable lease cost
Unrelated Parties	16,532	14,407	32,293	28,062
Related Parties	0	141	84	180
Total	16,532	14,548	32,377	28,242
Sublease income
Unrelated Parties	(1,716)	(1,940)	(3,394)	(3,906)
Related Parties	0	0	0	0
Total	(1,716)	(1,940)	(3,394)	(3,906)
Total lease cost
Unrelated Parties	92,499	87,164	183,928	173,537
Related Parties	1,833	1,950	3,751	3,798
Total	$ 94,332	$ 89,114	$ 187,679	$ 177,335

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, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Principal Outstanding	$ 3,750,601	$ 3,878,237
Unamortized Premium (Discount)	15,183	17,179
Unamortized Issuance Costs	(13,238)	(15,854)
Carrying Value	3,752,546	3,879,562
Fair Value	$ 3,723,125	$ 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)	18,562	21,555
Unamortized Issuance Costs	(9,456)	(10,948)
Carrying Value	1,234,106	1,235,607
Fair Value	1,204,175	1,163,689
Term loan
Debt Instrument [Line Items]
Principal Outstanding	2,103,437	2,103,437
Unamortized Premium (Discount)	(3,379)	(4,376)
Unamortized Issuance Costs	(3,684)	(4,771)
Carrying Value	2,096,374	2,094,290
Fair Value	2,098,178	2,056,110
Other debt, including finance leases
Debt Instrument [Line Items]
Principal Outstanding	77,164	104,800
Unamortized Premium (Discount)	0	0
Unamortized Issuance Costs	(98)	(135)
Carrying Value	77,066	104,665
Fair Value	77,066	104,665
Revolving facility | Revolving facility
Debt Instrument [Line Items]
Principal Outstanding	345,000	445,000
Unamortized Premium (Discount)	0	0
Unamortized Issuance Costs	0	0
Carrying Value	345,000	445,000
Fair Value	$ 343,706	$ 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	Jun. 30, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
2023	$ 16,495
2024	94,042
2025	2,402,092
2026	1,226,309
2027	823
Thereafter	10,840
Total	$ 3,750,601	$ 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	31,846
2025	313,154
2026	0
2027	0
Thereafter	0
Total	345,000	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	11,738
2024	51,046
2025	1,408
2026	1,309
2027	823
Thereafter	10,840
Total	$ 77,164	$ 104,800

Long-Term Debt and Notes Paya_5

Long-Term Debt and Notes Payable - Narrative (Details) - USD ($) $ in Millions	Jul. 31, 2023	May 31, 2023
Amendment No. 8 To Select Credit Agreement | Subsequent Event
Line of Credit Facility [Line Items]
Spring maturity period (in days)	90 days
Principal outstanding	$ 300
Revolving facility | Revolving facility | Amendment No. 8 To Select Credit Agreement | Subsequent Event
Line of Credit Facility [Line Items]
Aggregate principal amount	$ 710
Revolving facility | Revolving facility | Amendment No. 8 To Select Credit Agreement | Adjusted Term SOFR | Subsequent Event
Line of Credit Facility [Line Items]
Credit spread adjustment	2.50%
Revolving facility | Select Medical Corporation | Amendment No. 7 To Select Credit Agreement | Adjusted Term SOFR
Line of Credit Facility [Line Items]
Credit spread adjustment		0.10%
Term loan | Amendment No. 8 To Select Credit Agreement | Subsequent Event
Line of Credit Facility [Line Items]
Aggregate principal amount	$ 2,103
Term loan | Amendment No. 8 To Select Credit Agreement | Adjusted Term SOFR | Subsequent Event
Line of Credit Facility [Line Items]
Credit spread adjustment	0.10%
Term loan | Amendment No. 8 To Select Credit Agreement | Term Secured Overnight Financing Rate | Subsequent Event
Line of Credit Facility [Line Items]
Credit spread adjustment	3%

Interest Rate Cap - Narrative (

Interest Rate Cap - Narrative (Details) - Interest Rate Cap $ in Millions	6 Months Ended
	Jun. 30, 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	$ 82.1

Interest Rate Cap - Schedule of

Interest Rate Cap - Schedule of Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	3 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	$ 1,418,441	$ 1,356,564	$ 1,366,896	$ 1,325,902
Ending balance	1,501,579	1,418,441	1,303,701	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	72,654	88,602	52,135	12,282
Gain (loss) on interest rate cap cash flow hedge	17,527	(2,696)	11,833	39,814
Amounts reclassified from accumulated other comprehensive income	(15,134)	(13,252)	(6)	39
Ending balance	$ 75,047	$ 72,654	$ 63,962	$ 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				6 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2023	Jun. 30, 2022
Reclassification Adjustment out of Accumulated Other Comprehensive Income on Derivatives [Line Items]
Gains (losses) included in interest expense	$ (48,997)		$ (41,052)		$ (97,568)	$ (76,566)
Income tax benefit (expense)	(28,848)		(19,820)		(55,033)	(37,762)
Amounts reclassified from accumulated other comprehensive income	78,237	$ 70,805	55,207	$ 49,117	149,042	104,324
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	20,045		8		37,597	(43)
Income tax benefit (expense)	(4,911)		(2)		(9,211)	10
Amounts reclassified from accumulated other comprehensive income	$ 15,134		$ 6		$ 28,386	$ (33)

Fair Value of Financial Instr_3

Fair Value of Financial Instruments - Schedule of Interest Rate Cap (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Interest rate cap contract, current portion	$ 83,938	$ 74,857
Interest rate cap contract, non-current portion	18,396	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	83,938	74,857
Interest rate cap contract, non-current portion	$ 18,396	$ 45,200

Fair Value of Financial Instr_4

Fair Value of Financial Instruments - Schedule of Long-Term Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value	$ 3,723,125	$ 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	$ 1,234,106	$ 1,235,607
Fair Value	1,204,175	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	1,234,106	1,235,607
Fair Value	1,204,175	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	345,000	445,000
Fair Value	343,706	443,331
Term loan
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Carrying Value	2,096,374	2,094,290
Fair Value	2,098,178	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	2,096,374	2,094,290
Fair Value	$ 2,098,178	$ 2,056,110

Segment Information - Selected

Segment Information - Selected Financial Data (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Segment Reporting Information [Line Items]
Revenue	$ 1,674,528	$ 1,584,741	$ 3,339,508	$ 3,184,288
Adjusted EBITDA	219,469	180,994	433,532	344,841
Total assets	7,701,869	7,551,658	7,701,869	7,551,658	$ 7,665,293
Purchases of property, equipment, and other assets	59,514	46,332	118,399	93,177
Operating Segments | Critical Illness Recovery Hospital
Segment Reporting Information [Line Items]
Revenue	575,091	545,908	1,169,017	1,147,663
Adjusted EBITDA	65,496	20,019	142,269	55,986
Total assets	2,492,370	2,387,516	2,492,370	2,387,516
Purchases of property, equipment, and other assets	31,363	19,528	55,021	39,097
Operating Segments | Rehabilitation Hospital
Segment Reporting Information [Line Items]
Revenue	240,856	228,887	472,318	449,521
Adjusted EBITDA	54,689	49,845	101,905	92,224
Total assets	1,209,737	1,194,739	1,209,737	1,194,739
Purchases of property, equipment, and other assets	1,903	4,821	10,485	11,095
Operating Segments | Outpatient Rehabilitation
Segment Reporting Information [Line Items]
Revenue	302,972	287,258	598,875	559,198
Adjusted EBITDA	32,850	33,601	63,049	60,197
Total assets	1,399,782	1,360,600	1,399,782	1,360,600
Purchases of property, equipment, and other assets	10,476	9,314	20,408	18,728
Operating Segments | Concentra
Segment Reporting Information [Line Items]
Revenue	467,079	441,357	923,377	864,780
Adjusted EBITDA	100,391	92,607	194,139	182,076
Total assets	2,314,328	2,301,296	2,314,328	2,301,296
Purchases of property, equipment, and other assets	15,846	8,716	30,246	18,956
Other
Segment Reporting Information [Line Items]
Revenue	88,530	81,331	175,921	163,126
Adjusted EBITDA	(33,957)	(15,078)	(67,830)	(45,642)
Total assets	285,652	307,507	285,652	307,507
Purchases of property, equipment, and other assets	$ (74)	3,953	$ 2,239	5,301
Government assistance recognized in earnings, CARES Act		$ 15,100		$ 15,100

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, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Segment Reporting Information [Line Items]
Adjusted EBITDA	$ 219,469	$ 180,994	$ 433,532	$ 344,841
Depreciation and amortization	(49,939)	(51,081)	(102,364)	(102,120)
Income from operations	159,204	120,967	310,661	224,952
Equity in earnings of unconsolidated subsidiaries	10,501	6,167	19,057	11,564
Interest expense	(48,997)	(41,052)	(97,568)	(76,566)
Income before income taxes	120,708	86,082	232,150	159,950
Operating Segments | Critical Illness Recovery Hospital
Segment Reporting Information [Line Items]
Adjusted EBITDA	65,496	20,019	142,269	55,986
Depreciation and amortization	(13,886)	(14,603)	(30,523)	(29,221)
Stock compensation expense	0	0	0	0
Income from operations	51,610	5,416	111,746	26,765
Operating Segments | Rehabilitation Hospital
Segment Reporting Information [Line Items]
Adjusted EBITDA	54,689	49,845	101,905	92,224
Depreciation and amortization	(6,887)	(7,175)	(13,775)	(13,977)
Stock compensation expense	0	0	0	0
Income from operations	47,802	42,670	88,130	78,247
Operating Segments | Outpatient Rehabilitation
Segment Reporting Information [Line Items]
Adjusted EBITDA	32,850	33,601	63,049	60,197
Depreciation and amortization	(8,779)	(8,130)	(17,236)	(16,159)
Stock compensation expense	0	0	0	0
Income from operations	24,071	25,471	45,813	44,038
Operating Segments | Concentra
Segment Reporting Information [Line Items]
Adjusted EBITDA	100,391	92,607	194,139	182,076
Depreciation and amortization	(18,283)	(18,730)	(36,593)	(37,542)
Stock compensation expense	0	(536)	(178)	(1,071)
Income from operations	82,108	73,341	157,368	143,463
Other
Segment Reporting Information [Line Items]
Adjusted EBITDA	(33,957)	(15,078)	(67,830)	(45,642)
Depreciation and amortization	(2,104)	(2,443)	(4,237)	(5,221)
Stock compensation expense	(10,326)	(8,410)	(20,329)	(16,698)
Income from operations	$ (46,387)	$ (25,931)	$ (92,396)	$ (67,561)

Revenue from Contracts with C_3

Revenue from Contracts with Customers (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Disaggregation of Revenue [Line Items]
Total revenue	$ 1,674,528	$ 1,584,741	$ 3,339,508	$ 3,184,288
Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	1,551,637	1,470,193	3,096,932	2,958,569
Medicare
Disaggregation of Revenue [Line Items]
Total revenue	368,090	363,338	753,572	727,427
Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	1,183,547	1,106,855	2,343,360	2,231,142
Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	122,891	114,548	242,576	225,719
Operating Segments | Critical Illness Recovery Hospital
Disaggregation of Revenue [Line Items]
Total revenue	575,091	545,908	1,169,017	1,147,663
Operating Segments | Critical Illness Recovery Hospital | Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	574,241	542,798	1,166,929	1,142,771
Operating Segments | Critical Illness Recovery Hospital | Medicare
Disaggregation of Revenue [Line Items]
Total revenue	207,743	213,680	437,126	432,667
Operating Segments | Critical Illness Recovery Hospital | Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	366,498	329,118	729,803	710,104
Operating Segments | Critical Illness Recovery Hospital | Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	850	3,110	2,088	4,892
Operating Segments | Rehabilitation Hospital
Disaggregation of Revenue [Line Items]
Total revenue	240,856	228,887	472,318	449,521
Operating Segments | Rehabilitation Hospital | Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	228,886	218,031	448,866	428,194
Operating Segments | Rehabilitation Hospital | Medicare
Disaggregation of Revenue [Line Items]
Total revenue	113,450	105,030	223,505	208,051
Operating Segments | Rehabilitation Hospital | Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	115,436	113,001	225,361	220,143
Operating Segments | Rehabilitation Hospital | Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	11,970	10,856	23,452	21,327
Operating Segments | Outpatient Rehabilitation
Disaggregation of Revenue [Line Items]
Total revenue	302,972	287,258	598,875	559,198
Operating Segments | Outpatient Rehabilitation | Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	282,893	269,390	560,679	525,407
Operating Segments | Outpatient Rehabilitation | Medicare
Disaggregation of Revenue [Line Items]
Total revenue	46,647	44,433	92,448	86,337
Operating Segments | Outpatient Rehabilitation | Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	236,246	224,957	468,231	439,070
Operating Segments | Outpatient Rehabilitation | Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	20,079	17,868	38,196	33,791
Operating Segments | Concentra
Disaggregation of Revenue [Line Items]
Total revenue	467,079	441,357	923,377	864,780
Operating Segments | Concentra | Total patient services revenues
Disaggregation of Revenue [Line Items]
Total revenue	465,617	439,974	920,458	862,197
Operating Segments | Concentra | Medicare
Disaggregation of Revenue [Line Items]
Total revenue	250	195	493	372
Operating Segments | Concentra | Non-Medicare
Disaggregation of Revenue [Line Items]
Total revenue	465,367	439,779	919,965	861,825
Operating Segments | Concentra | Other revenue
Disaggregation of Revenue [Line Items]
Total revenue	1,462	1,383	2,919	2,583
Other
Disaggregation of Revenue [Line Items]
Total revenue	88,530	81,331	175,921	163,126
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	$ 88,530	$ 81,331	$ 175,921	$ 163,126

Earnings per Share - Narrative

Earnings per Share - Narrative (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
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, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2023	Jun. 30, 2022
Earnings Per Share [Abstract]
Net income	$ 91,860		$ 66,262		$ 177,117	$ 122,188
Less: Net income attributable to non-controlling interests	13,623		11,055		28,075	17,864
Net income attributable to Select Medical Holdings Corporation	78,237	$ 70,805	55,207	$ 49,117	149,042	104,324
Basic EPS
Less: Distributed and undistributed income attributable to participating securities - Basic EPS	2,877		1,920		5,449	3,558
Distributed and undistributed income attributable to common shares	75,360		53,287		143,593	100,766
Diluted EPS
Less: Distributed and undistributed income attributable to participating securities - Diluted EPS	2,877		1,920		5,449	3,558
Distributed and undistributed income attributable to common shares	$ 75,360		$ 53,287		$ 143,593	$ 100,766

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, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2023	Jun. 30, 2022
Net Income Allocation
Net income allocated to common shares - basic	$ 75,360		$ 53,287		$ 143,593	$ 100,766
Participating securities - basic	2,877		1,920		5,449	3,558
Net income allocated to common shares - diluted	75,360		53,287		143,593	100,766
Participating securities - diluted	2,877		1,920		5,449	3,558
Net income attributable to Select Medical Holdings Corporation	$ 78,237	$ 70,805	$ 55,207	$ 49,117	$ 149,042	$ 104,324
Weighted average common shares outstanding, basic (in shares)	122,634		124,897		122,594	126,942
Weighted average common shares outstanding, diluted (in shares)	122,634		124,897		122,594	126,942
Weighted average participating securities outstanding (in shares)	4,681		4,500		4,652	4,482
Basic EPS
Basic EPS (in dollars per share)	$ 0.61		$ 0.43		$ 1.17	$ 0.79
Diluted EPS
Diluted EPS (in dollars per share)	$ 0.61		$ 0.43		$ 1.17	$ 0.79

Commitments and Contingencies (

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

Subsequent Events (Details) - Subsequent Event - USD ($) $ / shares in Units, $ in Millions	Jul. 31, 2023	Aug. 02, 2023
Subsequent Event [Line Items]
Cash dividend declared (in dollars per share)		$ 0.125
Amendment No. 8 To Select Credit Agreement
Subsequent Event [Line Items]
Spring maturity period (in days)	90 days
Principal outstanding	$ 300
Amendment No. 8 To Select Credit Agreement | Term loan
Subsequent Event [Line Items]
Aggregate principal amount	$ 2,103
Amendment No. 8 To Select Credit Agreement | Term loan | Adjusted Term SOFR
Subsequent Event [Line Items]
Credit spread adjustment	0.10%
Amendment No. 8 To Select Credit Agreement | Term loan | Term Secured Overnight Financing Rate
Subsequent Event [Line Items]
Credit spread adjustment	3%
Revolving facility | Amendment No. 8 To Select Credit Agreement | Revolving facility
Subsequent Event [Line Items]
Aggregate principal amount	$ 710
Revolving facility | Amendment No. 8 To Select Credit Agreement | Revolving facility | Adjusted Term SOFR
Subsequent Event [Line Items]
Credit spread adjustment	2.50%