Segment Information - Segment Reporting (Details) $ in Thousands | 3 Months Ended | 6 Months Ended |
Jun. 30, 2015USD ($) | Jun. 30, 2014USD ($) | Jun. 30, 2015USD ($)segment | Jun. 30, 2014USD ($) |
Segment Reporting Information | | | | |
Number of Reportable Segments | segment | | | 3 | |
Net revenues | $ 1,419,475 | $ 1,200,651 | $ 2,762,476 | $ 2,387,195 |
Increase (Decrease) in Net Revenue From Prior Period | $ 218,824 | | $ 375,281 | |
Increase (Decrease) in Net Revenue as Percent of Prior Period Revenue | 18.20% | | 15.70% | |
Salaries, wages and benefits | $ 820,926 | 717,215 | $ 1,611,659 | 1,438,477 |
General and administrative | 44,983 | 35,980 | 86,516 | 71,844 |
Provision for losses on accounts receivable | 22,113 | 17,080 | 45,509 | 35,596 |
Other operating expenses | 348,236 | 269,603 | 660,797 | 533,149 |
Lease expense | 38,959 | 32,909 | 75,378 | 65,708 |
Depreciation and amortization expense | 53,605 | 48,930 | 113,538 | 96,430 |
Interest expense | 126,385 | 109,900 | 247,698 | 218,650 |
Loss on early extinguishment of debt | | 181 | 3,234 | 680 |
Investment income | (431) | (436) | (847) | (1,379) |
Other loss (income) | 50 | (667) | (7,560) | (667) |
Transaction costs | 2,642 | 1,298 | 88,710 | 3,547 |
Equity in net (income) loss of unconsolidated affiliates | (360) | (390) | (513) | (346) |
(Loss) income before income tax benefit | (37,633) | (30,952) | (161,643) | (74,494) |
Income tax benefit | (4,419) | (96) | (10,067) | (2,850) |
(Loss) income from continuing operations | $ (33,214) | $ (30,856) | $ (151,576) | $ (71,644) |
Product Concentration Risk [Member] | Sales Revenue, Net [Member] | | | | |
Segment Reporting Information | | | | |
Concentration Risk, Percentage | 100.00% | 100.00% | 100.00% | 100.00% |
Inpatient Services | | | | |
Segment Reporting Information | | | | |
Net revenues | $ 1,203,185 | $ 1,013,233 | $ 2,344,002 | $ 2,012,986 |
Increase (Decrease) in Net Revenue From Prior Period | $ 189,952 | | $ 331,016 | |
Increase (Decrease) in Net Revenue as Percent of Prior Period Revenue | 18.80% | | 16.40% | |
Inpatient Services | Product Concentration Risk [Member] | Sales Revenue, Net [Member] | | | | |
Segment Reporting Information | | | | |
Concentration Risk, Percentage | 84.80% | 84.40% | 84.90% | 84.30% |
Inpatient Services | Skilled Nursing Services [Member] | | | | |
Segment Reporting Information | | | | |
Net revenues | $ 1,164,674 | $ 983,071 | $ 2,269,665 | $ 1,952,698 |
Increase (Decrease) in Net Revenue From Prior Period | $ 181,603 | | $ 316,967 | |
Increase (Decrease) in Net Revenue as Percent of Prior Period Revenue | 18.50% | | 16.20% | |
Inpatient Services | Skilled Nursing Services [Member] | Product Concentration Risk [Member] | Sales Revenue, Net [Member] | | | | |
Segment Reporting Information | | | | |
Concentration Risk, Percentage | 82.00% | 81.90% | 82.20% | 81.80% |
Inpatient Services | Assisted Living Services [Member] | | | | |
Segment Reporting Information | | | | |
Net revenues | $ 36,206 | $ 28,006 | $ 69,862 | $ 55,963 |
Increase (Decrease) in Net Revenue From Prior Period | $ 8,200 | | $ 13,899 | |
Increase (Decrease) in Net Revenue as Percent of Prior Period Revenue | 29.30% | | 24.80% | |
Inpatient Services | Assisted Living Services [Member] | Product Concentration Risk [Member] | Sales Revenue, Net [Member] | | | | |
Segment Reporting Information | | | | |
Concentration Risk, Percentage | 2.60% | 2.30% | 2.50% | 2.30% |
Inpatient Services | Administrative Services [Member] | | | | |
Segment Reporting Information | | | | |
Net revenues | $ 2,828 | $ 2,618 | $ 5,499 | $ 5,251 |
Increase (Decrease) in Net Revenue From Prior Period | $ 210 | | $ 248 | |
Increase (Decrease) in Net Revenue as Percent of Prior Period Revenue | 8.00% | | 4.70% | |
Inpatient Services | Administrative Services [Member] | Product Concentration Risk [Member] | Sales Revenue, Net [Member] | | | | |
Segment Reporting Information | | | | |
Concentration Risk, Percentage | 0.20% | 0.20% | 0.20% | 0.20% |
Rehabilitation Therapy Services | | | | |
Segment Reporting Information | | | | |
Net revenues | $ 164,131 | $ 156,129 | $ 321,276 | $ 313,106 |
Increase (Decrease) in Net Revenue From Prior Period | $ 8,002 | | $ 8,170 | |
Increase (Decrease) in Net Revenue as Percent of Prior Period Revenue | 5.10% | | 2.60% | |
Rehabilitation Therapy Services | Product Concentration Risk [Member] | Sales Revenue, Net [Member] | | | | |
Segment Reporting Information | | | | |
Concentration Risk, Percentage | 11.60% | 13.00% | 11.60% | 13.10% |
Rehabilitation Therapy Services | Services Therapy Services [Member] | | | | |
Segment Reporting Information | | | | |
Net revenues | $ 274,133 | $ 254,941 | $ 537,184 | $ 510,265 |
Increase (Decrease) in Net Revenue From Prior Period | $ 19,192 | | $ 26,919 | |
Increase (Decrease) in Net Revenue as Percent of Prior Period Revenue | 7.50% | | 5.30% | |
Rehabilitation Therapy Services | Services Therapy Services [Member] | Product Concentration Risk [Member] | Sales Revenue, Net [Member] | | | | |
Segment Reporting Information | | | | |
Concentration Risk, Percentage | 19.30% | 21.20% | 19.40% | 21.40% |
Other Services | | | | |
Segment Reporting Information | | | | |
Net revenues | $ 52,159 | $ 31,289 | $ 97,198 | $ 61,103 |
Increase (Decrease) in Net Revenue From Prior Period | $ 20,870 | | $ 36,095 | |
Increase (Decrease) in Net Revenue as Percent of Prior Period Revenue | 66.70% | | 59.10% | |
Other Services | Product Concentration Risk [Member] | Sales Revenue, Net [Member] | | | | |
Segment Reporting Information | | | | |
Concentration Risk, Percentage | 3.60% | 2.60% | 3.50% | 2.60% |
Other Services | Services Other Services [Member] | | | | |
Segment Reporting Information | | | | |
Net revenues | $ 61,409 | $ 38,240 | $ 113,955 | $ 74,191 |
Increase (Decrease) in Net Revenue From Prior Period | $ 23,169 | | $ 39,764 | |
Increase (Decrease) in Net Revenue as Percent of Prior Period Revenue | 60.60% | | 53.60% | |
Other Services | Services Other Services [Member] | Product Concentration Risk [Member] | Sales Revenue, Net [Member] | | | | |
Segment Reporting Information | | | | |
Concentration Risk, Percentage | 4.30% | 3.20% | 4.10% | 3.10% |
Operating Segments | Inpatient Services | | | | |
Segment Reporting Information | | | | |
Net revenues | $ 1,203,708 | $ 1,013,695 | $ 2,345,026 | $ 2,013,912 |
Salaries, wages and benefits | 562,682 | 486,698 | 1,105,374 | 977,772 |
Provision for losses on accounts receivable | 17,271 | 12,272 | 36,344 | 26,855 |
Other operating expenses | 430,954 | 348,460 | 827,496 | 691,499 |
Lease expense | 37,738 | 32,436 | 73,266 | 64,756 |
Depreciation and amortization expense | 51,032 | 41,731 | 99,257 | 81,951 |
Interest expense | 105,815 | 94,841 | 209,469 | 191,300 |
Investment income | (420) | (415) | (778) | (839) |
Other loss (income) | | | 421 | |
Transaction costs | 50 | | | |
Equity in net (income) loss of unconsolidated affiliates | (514) | (390) | (823) | (680) |
(Loss) income before income tax benefit | (900) | (1,938) | (5,000) | (18,702) |
(Loss) income from continuing operations | (900) | (1,938) | (5,000) | (18,702) |
Operating Segments | Rehabilitation Therapy Services | | | | |
Segment Reporting Information | | | | |
Net revenues | 274,133 | 254,941 | 537,184 | 510,265 |
Salaries, wages and benefits | 220,782 | 205,821 | 435,579 | 411,970 |
Provision for losses on accounts receivable | 4,106 | 4,542 | 7,933 | 8,388 |
Other operating expenses | 19,595 | 15,888 | 34,994 | 30,972 |
Lease expense | 14 | 44 | 55 | 88 |
Depreciation and amortization expense | 3,032 | 2,785 | 5,899 | 5,572 |
Interest expense | 1 | 1 | 2 | 2 |
Transaction costs | | (9) | | (9) |
(Loss) income before income tax benefit | 26,603 | 25,869 | 52,722 | 53,282 |
(Loss) income from continuing operations | 26,603 | 25,869 | 52,722 | 53,282 |
Operating Segments | Other Services | | | | |
Segment Reporting Information | | | | |
Net revenues | 60,338 | 38,119 | 112,674 | 73,933 |
Salaries, wages and benefits | 37,462 | 24,696 | 70,706 | 48,735 |
General and administrative | 1 | | 3 | |
Provision for losses on accounts receivable | 779 | 266 | 1,318 | 356 |
Other operating expenses | 17,463 | 11,480 | 31,996 | 21,851 |
Lease expense | 747 | 207 | 1,206 | 420 |
Depreciation and amortization expense | 198 | 225 | 560 | 475 |
Interest expense | 10 | 241 | 20 | 450 |
Other loss (income) | | (667) | | (667) |
(Loss) income before income tax benefit | 3,678 | 1,671 | 6,865 | 2,313 |
(Loss) income from continuing operations | 3,678 | 1,671 | 6,865 | 2,313 |
Corporate, Non-Segment | | | | |
Segment Reporting Information | | | | |
Net revenues | 1,071 | 121 | 1,281 | 258 |
General and administrative | 44,982 | 35,980 | 86,513 | 71,844 |
Provision for losses on accounts receivable | (43) | | (86) | (3) |
Lease expense | 460 | 222 | 851 | 444 |
Depreciation and amortization expense | (657) | 4,189 | 7,822 | 8,432 |
Interest expense | 20,683 | 14,941 | 38,454 | 27,145 |
Loss on early extinguishment of debt | | 181 | 3,234 | 680 |
Investment income | (135) | (145) | (316) | (787) |
Other loss (income) | 50 | | (7,981) | |
Transaction costs | 2,592 | 1,307 | 88,710 | 3,556 |
Equity in net (income) loss of unconsolidated affiliates | (414) | | (634) | |
(Loss) income before income tax benefit | (66,447) | (56,554) | (215,286) | (111,053) |
Income tax benefit | (4,419) | (96) | (10,067) | (2,850) |
(Loss) income from continuing operations | (62,028) | (56,458) | (205,219) | (108,203) |
Elimination | | | | |
Segment Reporting Information | | | | |
Net revenues | (119,775) | (106,225) | (233,689) | (211,173) |
Other operating expenses | (119,776) | (106,225) | (233,689) | (211,173) |
Interest expense | (124) | (124) | (247) | (247) |
Investment income | 124 | 124 | 247 | 247 |
Equity in net (income) loss of unconsolidated affiliates | 568 | | 944 | 334 |
(Loss) income before income tax benefit | (567) | | (944) | (334) |
(Loss) income from continuing operations | (567) | | (944) | (334) |
Elimination | Inpatient Services | | | | |
Segment Reporting Information | | | | |
Net revenues | (523) | $ (462) | (1,024) | $ (926) |
Increase (Decrease) in Net Revenue From Prior Period | $ (61) | | $ (98) | |
Increase (Decrease) in Net Revenue as Percent of Prior Period Revenue | 13.20% | | 10.60% | |
Elimination | Inpatient Services | Product Concentration Risk [Member] | Sales Revenue, Net [Member] | | | | |
Segment Reporting Information | | | | |
Concentration Risk, Percentage | 0.00% | 0.00% | 0.00% | 0.00% |
Elimination | Rehabilitation Therapy Services | | | | |
Segment Reporting Information | | | | |
Net revenues | $ (110,002) | $ (98,812) | $ (215,908) | $ (197,159) |
Increase (Decrease) in Net Revenue From Prior Period | $ (11,190) | | $ (18,749) | |
Increase (Decrease) in Net Revenue as Percent of Prior Period Revenue | 11.30% | | 9.50% | |
Elimination | Rehabilitation Therapy Services | Product Concentration Risk [Member] | Sales Revenue, Net [Member] | | | | |
Segment Reporting Information | | | | |
Concentration Risk, Percentage | (7.70%) | (8.20%) | (7.80%) | (8.30%) |
Elimination | Other Services | | | | |
Segment Reporting Information | | | | |
Net revenues | $ (9,250) | $ (6,951) | $ (16,757) | $ (13,088) |
Increase (Decrease) in Net Revenue From Prior Period | $ (2,299) | | $ (3,669) | |
Increase (Decrease) in Net Revenue as Percent of Prior Period Revenue | 33.10% | | 28.00% | |
Elimination | Other Services | Product Concentration Risk [Member] | Sales Revenue, Net [Member] | | | | |
Segment Reporting Information | | | | |
Concentration Risk, Percentage | (0.70%) | (0.60%) | (0.60%) | (0.50%) |