USMD Inactive 10-Q14 Nov 142014 Q3 Quarterly reportFinancial data

Company Profile

Document_and_Entity_Informatio

Document and Entity Information	9 Months Ended
Document and Entity Information	Sep. 30, 2014	Nov. 11, 2014
Document Information [Line Items]	'	'
Document Type	'10-Q	'
Amendment Flag	'false	'
Document Period End Date	30-Sep-14	'
Document Fiscal Year Focus	'2014	'
Document Fiscal Period Focus	'Q3	'
Trading Symbol	'USMD	'
Entity Registrant Name	'USMD Holdings, Inc.	'
Entity Central Index Key	'0001507881	'
Current Fiscal Year End Date	'--12-31	'
Entity Filer Category	'Smaller Reporting Company	'
Entity Common Stock, Shares Outstanding	'	10,181,258

Condensed_Consolidated_Balance

Condensed Consolidated Balance Sheets (USD $)	Sep. 30, 2014		Dec. 31, 2013
In Thousands, unless otherwise specified	Sep. 30, 2014		Dec. 31, 2013
Current assets:	'		'
Cash and cash equivalents	$26,669	[1]	$13,137	[1]
Restricted cash	'		5,000	[1]
Accounts receivable, net of allowance for doubtful accounts of $1,420 and $1,758 at September 30, 2014 and December 31, 2013, respectively	21,741	[1]	23,970	[1]
Inventories	2,136	[1]	1,580	[1]
Deferred tax assets, net	4,591	[1]	742	[1]
Prepaid expenses and other current assets	3,951	[1]	3,177	[1]
Total current assets	59,088	[1]	47,606	[1]
Property and equipment, net	20,019	[1]	23,491	[1]
Investments in nonconsolidated affiliates	59,005	[1]	61,822	[1]
Goodwill	118,176	[1]	118,176	[1]
Intangible assets, net	17,190	[1]	27,033	[1]
Other assets	350	[1]	324	[1]
Total assets	273,828	[1]	278,452	[1]
Current liabilities:	'		'
Accounts payable	9,845	[2]	2,500	[2]
Accrued payroll	16,044	[2]	12,599	[2]
Other accrued liabilities	18,682	[2]	10,757	[2]
Other current liabilities	656	[2]	1,059	[2]
Current portion of long-term debt	3,946	[2]	7,473	[2]
Current portion of related party long-term debt	665	[2]	650	[2]
Current portion of capital lease obligations	391	[2]	369	[2]
Total current liabilities	50,229	[2]	35,407	[2]
Other long-term liabilities	1,628	[2]	1,485	[2]
Deferred compensation payable	4,457	[2]	4,641	[2]
Long-term debt, less current portion	27,694	[2]	33,939	[2]
Related party long-term debt, less current portion	2,912	[2]	3,084	[2]
Capital lease obligations, less current portion	387	[2]	683	[2]
Deferred tax liabilities, net	20,177	[2]	23,688	[2]
Total liabilities	107,484	[2]	102,927	[2]
Commitments and contingencies	'		'
USMD Holdings, Inc. stockholders' equity:	'		'
Preferred stock, $0.01 par value, 1,000,000 shares authorized; none issued	'		'
Common stock, $0.01 par value, 49,000,000 shares authorized; 10,181,258 and 10,121,462 shares issued and outstanding at September 30, 2014 and December 31, 2013, respectively	102		101
Additional paid-in capital	160,174		158,360
Retained earnings	2,568		13,650
Accumulated other comprehensive loss	-2		-2
Total USMD Holdings, Inc. stockholders' equity	162,842		172,109
Noncontrolling interests in subsidiaries	3,502		3,416
Total equity	166,344		175,525
Total liabilities and equity	$273,828		$278,452

[1]	Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 15,655 $ 1,257 Accounts receivable 651 175 Prepaid expenses 27 - Deferred tax asset 3,750 - Total current assets 20,083 1,432 Deferred tax asset - 671 Total assets $ 20,083 $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.
[2]	Liabilities of consolidated VIE included in total liabilities above (after elimination of intercompany transactions and balances): Accounts payable $ 6,541 $ - Accrued payroll 378 - Other accrued liabilities 12,945 2,108 Total current liabilities $ 19,864 $ 2,108 The liabilities of the consolidated VIE are obligations of the VIE and the creditors have no recourse to USMD Holdings, Inc.

Condensed_Consolidated_Balance1

Condensed Consolidated Balance Sheets (Parenthetical) (USD $)	Sep. 30, 2014		Dec. 31, 2013
In Thousands, except Share data, unless otherwise specified	Sep. 30, 2014		Dec. 31, 2013
Allowance for doubtful accounts receivable	$1,420		$1,758
Preferred stock, par value	$0.01		$0.01
Preferred stock, shares authorized	1,000,000		1,000,000
Preferred stock, issued	'		'
Common stock, par value	$0.01		$0.01
Common stock, shares authorized	49,000,000		49,000,000
Common stock, shares issued	10,181,258		10,121,462
Common stock, shares outstanding	10,181,258		10,121,462
Cash and cash equivalents	26,669	[1]	13,137	[1]
Accounts receivable	21,741	[1]	23,970	[1]
Total current assets	59,088	[1]	47,606	[1]
Total assets	273,828	[1]	278,452	[1]
Accounts payable	9,845	[2]	2,500	[2]
Accrued payroll	16,044	[2]	12,599	[2]
Other accrued liabilities	18,682	[2]	10,757	[2]
Total current liabilities	50,229	[2]	35,407	[2]
Variable Interest Entity, Primary Beneficiary	'		'
Cash and cash equivalents	15,655		1,257
Accounts receivable	651		175
Prepaid expenses	27		'
Deferred tax asset	3,750		'
Total current assets	20,083		1,432
Deferred tax asset	'		671
Total assets	20,083		2,103
Accounts payable	4,245		'
Accrued payroll	378		'
Other accrued liabilities	12,945		2,108
Total current liabilities	$17,568		$2,108

[1]	Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 15,655 $ 1,257 Accounts receivable 651 175 Prepaid expenses 27 - Deferred tax asset 3,750 - Total current assets 20,083 1,432 Deferred tax asset - 671 Total assets $ 20,083 $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.
[2]	Liabilities of consolidated VIE included in total liabilities above (after elimination of intercompany transactions and balances): Accounts payable $ 6,541 $ - Accrued payroll 378 - Other accrued liabilities 12,945 2,108 Total current liabilities $ 19,864 $ 2,108 The liabilities of the consolidated VIE are obligations of the VIE and the creditors have no recourse to USMD Holdings, Inc.

Condensed_Consolidated_Stateme

Condensed Consolidated Statements of Operations (USD $)	3 Months Ended		9 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Revenue:	'	'	'	'
Patient service revenue	$48,907	$45,874	$139,175	$136,131
Provision for doubtful accounts related to patient service revenue	-1,013	-1,581	-2,276	-2,329
Net patient service revenue	47,894	44,293	136,899	133,802
Capitated revenue	18,500	3,759	47,360	5,621
Management and other services revenue	5,296	6,067	17,409	19,140
Lithotripsy revenue	5,742	5,492	15,930	16,157
Net operating revenue	77,432	59,611	217,598	174,720
Operating expenses:	'	'	'	'
Salaries, wages and employee benefits	42,637	38,557	123,465	115,033
Medical supplies and services expense	22,517	8,459	58,539	19,933
Rent expense	4,105	3,770	11,780	10,945
Provision for doubtful accounts	138	99	186	112
Other operating expenses	7,725	6,674	24,399	19,985
Depreciation and amortization	1,997	1,900	14,173	5,782
Total operating expenses	79,119	59,459	232,542	171,790
Income (loss) from operations	-1,687	152	-14,944	2,930
Other income (expense):	'	'	'	'
Interest expense, net	-706	-464	-2,099	-1,121
Equity in income of nonconsolidated affiliates, net	2,666	2,321	8,185	5,988
Other gain (loss), net	-15	'	-230	-58
Total other income, net	1,945	1,857	5,856	4,809
Income (loss) before income taxes	258	2,009	-9,088	7,739
Provision (benefit) for income taxes	-663	-110	-4,986	414
Net income (loss)	921	2,119	-4,102	7,325
Less: net income attributable to noncontrolling interests	-2,667	-2,555	-6,980	-7,447
Net loss attributable to USMD Holdings, Inc.	($1,746)	($436)	($11,082)	($122)
Loss per share attributable to USMD Holdings, Inc.	'	'	'	'
Basic	($0.17)	($0.04)	($1.09)	($0.01)
Diluted	($0.17)	($0.04)	($1.09)	($0.01)
Weighted average common shares outstanding	'	'	'	'
Basic	10,177	10,088	10,151	10,071
Diluted	10,177	10,088	10,151	10,071

Condensed_Consolidated_Stateme1

Condensed Consolidated Statements of Comprehensive Income (Loss) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Net income (loss)	$921	$2,119	($4,102)	$7,325
Other comprehensive income, net of tax:	'	'	'	'
Foreign currency translation adjustments, net of tax	'	1	'	13
Total other comprehensive income	'	1	'	13
Comprehensive income (loss)	921	2,120	-4,102	7,338
Less: comprehensive income attributable to noncontrolling interests	-2,667	-2,555	-6,980	-7,447
Comprehensive loss attributable to USMD Holdings, Inc. common stockholders	($1,746)	($435)	($11,082)	($109)

Condensed_Consolidated_Stateme2

Condensed Consolidated Statement of Stockholders' Equity (USD $)	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Loss	Retained Earnings	Total USMD Holdings Inc.	Noncontrolling Interests in Subsidiaries
In Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Loss	Retained Earnings	Total USMD Holdings Inc.	Noncontrolling Interests in Subsidiaries
Beginning balance at Dec. 31, 2013	$175,525	$101	$158,360	($2)	$13,650	$172,109	$3,416
Beginning balance (in shares) at Dec. 31, 2013	'	10,121	'	'	'	'	'
Net income (loss)	-4,102	'	'	'	-11,082	-11,082	6,980
Share-based payment expense - stock options	998	'	998	'	'	998	'
Share-based payment expense - common stock issued (in shares)	'	33	'	'	'	'	'
Share-based payment expense - common stock issued	407	1	406	'	'	407	'
Common stock issued in business combinations (in shares)	'	12	'	'	'	'	'
Common stock issued in business combinations	167	'	167	'	'	167	'
Common stock issued for payment of accrued liabilities (in shares)	'	15	'	'	'	'	'
Common stock issued for payment of accrued liabilities	243	'	243	'	'	243	'
Capital contributions from noncontrolling shareholders	119	'	'	'	'	'	119
Distributions to noncontrolling shareholders	-7,013	'	'	'	'	'	-7,013
Ending balance at Sep. 30, 2014	$166,344	$102	$160,174	($2)	$2,568	$162,842	$3,502
Ending balance (in shares) at Sep. 30, 2014	'	10,181	'	'	'	'	'

Condensed_Consolidated_Stateme3

Condensed Consolidated Statements of Cash Flows (USD $)	9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014		Sep. 30, 2013
Cash flows from operating activities:	'		'
Net income (loss)	($4,102)		$7,325
Adjustments to reconcile net income (loss) to net cash provided by operating activities:	'		'
Provision for doubtful accounts	2,462		2,441
Depreciation and amortization of property and equipment	4,310		4,438
Amortization of intangible assets and debt issuance costs	9,996		1,489
Accretion of debt discount	378		56
Loss on sale or disposal of assets, net	230		62
Equity in income of nonconsolidated affiliates, net	-8,185		-5,988
Distributions from nonconsolidated affiliates	11,002		5,308
Share-based payment expense	1,664		457
Deferred income tax benefit	-7,360		-943
Change in operating assets and liabilities, net of effects of business combinations:	'		'
Accounts receivable	-233		-5,524
Inventories	-518		-609
Prepaid expenses and other assets	-774		-926
Current liabilities	18,296		8,141
Other noncurrent liabilities	-41		154
Net cash provided by operating activities	27,125		15,881
Cash flows from investing activities:	'		'
Cash paid for business combinations, net of cash acquired	-104		'
Capital expenditures	-935		-2,357
Investments in nonconsolidated affiliates	'		-200
Proceeds from sale of property and equipment	80		64
Net cash used in investing activities	-959		-2,493
Cash flows from financing activities:	'		'
Payments on long-term debt and capital lease obligations	-8,924		-3,457
Principal payments on related party long-term debt	-157		-441
Payment of debt issuance costs	-159		-134
Restricted cash	5,000		'
Proceeds from (repayments of) borrowings under revolving credit facility	-1,500		3,000
Proceeds from exercise of stock options	'		100
Capital contributions from noncontrolling interests	119		562
Distributions to noncontrolling interests	-7,013		-7,768
Net cash used in financing activities	-12,634		-8,138
Net increase in cash and cash equivalents	13,532		5,250
Cash and cash equivalents at beginning of year	13,137	[1]	6,878
Cash and cash equivalents at end of period	26,669	[1]	12,128
Supplemental non-cash investing and financing information:	'		'
Fair value of assets acquired in business combinations, excluding cash	271		109
Other liabilities financed	'		461
Record convertible debt beneficial conversion discount, net of tax	'		2,424
Investment in nonconsolidated affiliate financed with debt	'		24,342
Cash paid for-	'		'
Interest, net of related parties	1,370		702
Interest to related parties	83		279
Income tax	1,915		1,448
Cash received for- Income tax refund	11		810
Payment for Liabilities	'		'
Supplemental non-cash investing and financing information:	'		'
Fair value of common stock issued	243		646
Payment for Business Combination	'		'
Supplemental non-cash investing and financing information:	'		'
Fair value of common stock issued	$167		'

[1]	Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 15,655 $ 1,257 Accounts receivable 651 175 Prepaid expenses 27 - Deferred tax asset 3,750 - Total current assets 20,083 1,432 Deferred tax asset - 671 Total assets $ 20,083 $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.

Description_of_Business_Basis_

Description of Business, Basis of Presentation and Recently Issued Accounting Pronouncements	9 Months Ended
	Sep. 30, 2014
Description of Business, Basis of Presentation and Recently Issued Accounting Pronouncements	'
	Note 1 – Description of Business, Basis of Presentation and Recently Issued Accounting Pronouncements
	Description of Business:
	USMD Holdings, Inc. (“USMD” or the “Company”) is a Delaware corporation formed on May 7, 2010 to facilitate the business combination of USMD Inc., a Texas corporation, Urology Associates of North Texas, L.L.P., a Texas limited liability partnership, and UANT Ventures, L.L.P., a Texas limited liability partnership (“Ventures”) (such transaction, the “Contribution”). USMD described this transaction in its registration statement on Form S-4 filed with the Securities and Exchange Commission (the “SEC”). Prior to the consummation of the Contribution, Ventures and USMD entered into a merger agreement with The Medical Clinic of North Texas, P.A., a Texas professional association (“MCNT”), and a merger agreement with Impel Management Services, L.L.C., a Texas limited liability company (“Impel”), pursuant to which the businesses of MCNT and Impel were merged into subsidiaries of Ventures immediately prior to the Contribution, and these businesses were contributed by Ventures to USMD as part of the Contribution. USMD described these transactions in a post-effective amendment to its registration statement filed with the SEC on February 10, 2012, which was declared effective on April 30, 2012. Effective August 31, 2012, USMD and the other parties consummated the Contribution.
	The Company is an innovative early-stage physician-led integrated health system. Through its subsidiaries and affiliates, the Company provides healthcare services to patients in physician clinics, hospitals and other healthcare facilities, and the Company also provides management and operational services to hospitals and other healthcare service providers. An integrated health system is considered early-stage when it has not yet established all the components necessary to be considered a fully integrated health system.
	A wholly owned subsidiary of the Company is the sole member of a Texas certified non-profit health organization that owns and operates a multi-specialty physician group practice (“USMD Physician Services”) in the Dallas-Fort Worth, Texas metropolitan area. Through other wholly owned subsidiaries, the Company provides management and operational services to two short-stay hospitals in the Dallas-Fort Worth, Texas metropolitan area and provides management and/or operational services to four cancer treatment centers in three states and 22 lithotripsy service providers primarily located in the South-Central United States. Of these managed entities, the Company has limited ownership interests in the two hospitals, two cancer treatment centers and 18 lithotripsy service providers. The Company consolidates the 18 lithotripsy service providers into its financial statements. In addition, the Company wholly owns and operates two clinical laboratories, one anatomical pathology laboratory, one cancer treatment center and one lithotripsy service provider in the Dallas-Fort Worth, Texas metropolitan area.
	Basis of Presentation:
	The unaudited condensed consolidated financial statements of the Company have been prepared in conformity with accounting principles generally accepted in the United States (“GAAP”) for interim financial statements and pursuant to the rules and regulations of the SEC for interim reporting. Certain information and note disclosures normally included in annual financial statements prepared in accordance with GAAP have been condensed or omitted pursuant to those rules and regulations, although the Company believes that the disclosures made are adequate to make the information in this report not misleading. These condensed consolidated financial statements reflect all adjustments that, in the opinion of the Company’s management, are necessary for fair presentation of the condensed consolidated financial statements. The December 31, 2013 condensed consolidated balance sheet data was derived from audited financial statements but does not include all disclosures required by GAAP. The operating results for the interim periods are not necessarily indicative of results for the full fiscal year. These condensed consolidated financial statements should be read in conjunction with the Company’s Annual Report on Form 10-K for the year ended December 31, 2013 filed with the SEC on April 15, 2014.

	The condensed consolidated financial statements include the accounts of the Company, entities controlled by the Company through its direct or indirect ownership of a majority interest and any other entities in which the Company has a controlling financial interest. The Company consolidates VIEs where the Company is the primary beneficiary. The primary beneficiary of a VIE is the party that has both the power to direct the activities that most significantly impact the VIE’s economic performance and the obligation to absorb losses or the right to receive benefits that could potentially be significant to the VIE. The Company consolidates entities in which it or its wholly owned subsidiary is the general partner or managing member and the limited partners or members, respectively, do not have sufficient rights to overcome the presumption of the Company’s control. The Company eliminates all significant intercompany accounts and transactions in consolidation.
	The Company uses the equity method to account for investments in entities it or its wholly owned subsidiaries do not control, but over which it or its wholly owned subsidiaries have the ability to exercise significant influence. The Company does not consolidate equity method investments, but rather measures them at their initial cost and subsequently adjusts their carrying values through income for the Company’s respective share of earnings or losses during the period.
	Recently Issued Accounting Pronouncements
	In August 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2014-15, “Presentation of Financial Statements - Going Concern (Subtopic 205-40) - Disclosure of Uncertainties about an Entity’s Ability to Continue as a Going Concern” (“ASU 2014-15”). ASU 2014-15 sets forth management’s responsibility to evaluate whether there is substantial doubt about an entity’s ability to continue as a going concern and to provide related footnote disclosures. ASU 2014-15 indicates that, when preparing interim and annual financial statements, management should evaluate whether conditions or events, considered in the aggregate, raise substantial doubt about the entity’s ability to continue as a going concern for one year from the date the financial statements are issued. This evaluation should include consideration of conditions and events that are either known or are reasonably knowable at the date the financial statements are issued, as well as whether it is probable that management’s plans to address the substantial doubt will be implemented and, if so, whether it is probable that the plans will alleviate the substantial doubt. It also requires certain disclosures when substantial doubt is alleviated as a result of consideration of management’s plans and requires an express statement and other disclosures when substantial doubt is not alleviated. ASU 2014-15 is effective for annual periods ending after December 15, 2016, and interim periods and annual periods thereafter. Early adoption is permitted. Adoption of this guidance is not expected to have a material impact on the Company’s consolidated financial position, results of operations or cash flows.
	In May 2014, the FASB issued ASU No. 2014-09, “Revenue from Contracts with Customers” (“ASU-2014-09”). ASU 2014-09 requires revenue recognition to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. ASU 2014-09 provides a single principles-based, five-step model to be applied to all contracts with customers. The five steps are to identify the contract(s) with the customer, identify the performance obligations in the contact, determine the transaction price, allocate the transaction price to the performance obligations in the contract and recognize revenue when each performance obligation is satisfied. The provisions of ASU 2014-09 may be applied either retrospectively to each prior reporting period presented or retrospectively with the cumulative effect of the update recognized at the date of the initial application along with additional disclosures. ASU 2014-09 is effective for the Company beginning January 1, 2017. Early adoption is not permitted. Management is evaluating the impact that adoption of ASU 2014-09 will have on the Company’s consolidated financial statements.
	In April 2014, the FASB issued ASU No. 2014-08, “Presentation of Financial Statements and Property, Plant, and Equipment - Reporting Discontinued Operations and Disclosures of Disposals of Components of an Entity” (“ASU 2014-08”). Among other provisions and in addition to expanded disclosures, ASU 2014-08 changes the definition of what components of an entity qualify for discontinued operations treatment and reporting from a reportable segment, operating segment, reporting unit, subsidiary or asset group to only those components of an entity that represent a strategic shift that has, or will have, a major effect on an entity’s operations and financial results. Additionally, ASU 2014-08 requires disclosure about a disposal of an individually significant component of an entity that does not qualify for discontinued operations presentation in the financial statements, including the pretax profit or loss, attributable to the component of an entity for the period in which it is disposed or is classified as held for sale. This disclosure is required for all of the same periods that are presented in the entity’s results of operations for the period. The provisions of ASU 2014-08 are effective prospectively for all disposals or classifications as held for sale of components of an entity that occur within annual periods beginning on or after December 15, 2014, and interim periods within those years. Early adoption is permitted.

	The Company may, from time-to-time, identify business units that do not meet the Company’s ongoing or future business strategy. In accordance with ASU 2014-08, in the event that an individually significant business unit is identified for disposal but does not represent a strategic shift that has, or will have, a major effect on the Company’s operations and financial results, the results of the identified business unit would continue to be reported as a component of the Company’s consolidated results. However, in this event and in accordance with ASU 2014-08, additional disclosures would be required.

Variable_Interest_Entity

Variable Interest Entity	9 Months Ended
Variable Interest Entity	Sep. 30, 2014
Variable Interest Entity	'

	Note 2 – Variable Interest Entity

	In April 2013, the Company became an equal co-member of a Texas non-profit corporation that has been approved by the Texas Medical Board as a certified non-profit health organization (“WNI-DFW”). WNI-DFW has a contractual arrangement to manage patient care by providing or arranging for the provision of all the necessary healthcare services for a health plan’s given Medicare Advantage patient population in the North Texas area served by WNI-DFW. Pursuant to the arrangement, WNI-DFW receives a fixed fee per patient under what is typically known as a “risk contract.” Risk contracting, or full risk capitation, refers to a model in which an entity receives from the third party payer a fixed payment per member per month for a defined patient population, and the entity is then responsible for arranging and/or providing all of the healthcare services required by that patient population. The entity accomplishes this by managing patient care and by contracting with healthcare providers to provide needed healthcare services for the patient population. In such a model, the contracting entity is then responsible for incurring or paying for the cost of healthcare services required by that patient population. The entity generates a net surplus if the cost of all healthcare services provided to the patient population is less than the payments received from the third party payer, and it generates a net deficit if the cost of such services is higher than the payments received. In early May 2013, the Company and its equal co-member both made a $100,000 capital contribution to WNI-DFW. On June 1, 2013, WNI-DFW commenced operations.

	The Company evaluated whether it has a variable interest in WNI-DFW, whether WNI-DFW is a VIE and whether the Company has a controlling financial interest in WNI-DFW. The Company concluded that it has variable interests in WNI-DFW on the basis of its capital contribution to WNI-DFW and because WNI-DFW has entered into a Primary Care Physician Agreement (“PCP Agreement”) with USMD Physician Services. WNI-DFW’s equity at risk, as defined by GAAP, is considered to be insufficient to finance its activities without additional support, and, therefore, WNI-DFW is considered a VIE.

	In order to determine whether the Company has a controlling financial interest in the VIE and, thus, is the VIE’s primary beneficiary, the Company considered whether it has i) the power to direct the activities of WNI-DFW that most significantly impact its economic performance and ii) the obligation to absorb losses of WNI-DFW that could potentially be significant to it or the right to receive benefits from WNI-DFW that could potentially be significant to it. The Company concluded that the members, the board of directors and the executive management team of WNI-DFW are structured in a way that neither member nor its designee has the individual power to direct the activities of WNI-DFW that most significantly impact its economic performance. Management considered whether the various service and support agreements between WNI-DFW and its members (or their affiliates) provide either variable interest party with this power and concluded that the PCP Agreement between USMD Physician Services and WNI-DFW does provide the power to USMD Physician Services to direct such activities. Under the PCP Agreement, USMD Physician Services is responsible for providing many services related to the growth of the patient population WNI-DFW will manage, the management of that population’s healthcare needs, and the provision of required healthcare services to those patients. The Company has concluded that the success or failure of USMD Physician Services in conducting these activities will most significantly impact the economic performance of WNI-DFW. In addition, the Company’s variable interests in WNI-DFW obligate the Company to absorb deficits and provide it with the right to receive benefits that could potentially be significant to WNI-DFW. As a result of this analysis, the Company concluded that it is the primary beneficiary of WNI-DFW and therefore consolidates the balance sheets, results of operations and cash flows of WNI-DFW. The Company performs a qualitative assessment of WNI-DFW on an ongoing basis to determine if it continues to be the primary beneficiary.



	The following table summarizes the carrying amount of the assets and liabilities of WNI-DFW included in the Company’s consolidated balance sheets (after elimination of intercompany transactions and balances) (in thousands):



		September 30,		December 31,
		2014		2013
	Current assets:
	Cash and cash equivalents	$	15,655	$	1,257
	Accounts receivable		651		175
	Prepaid expenses		27		—
	Deferred tax asset		3,750		—

	Total current assets		20,083		1,432
	Deferred tax asset		—		671

	Total assets	$	20,083	$	2,103


	Current liabilities:
	Accounts payable	$	4,245	$	—
	Accrued payroll		378		—
	Other accrued liabilities		12,945		2,108

	Total current liabilities	$	17,568	$	2,108


	The assets of WNI-DFW can only be used to settle obligations of WNI-DFW. The creditors of WNI-DFW have no recourse to the general credit of the Company. Upon notification from WNI-DFW, the Company is contractually obligated to fund certain cash requirements of WNI-DFW. In January 2014, as a result of a deficit at WNI-DFW, the Company advanced WNI-DFW $0.7 million.

	Beginning June 1, 2013, the results of operations and cash flows of WNI-DFW are included in the Company’s consolidated financial statements. For the three and nine months ended September 30, 2014, WNI-DFW contributed capitated revenue of $18.5 million and $47.4 million, respectively, and income before provision for income taxes of $1.7 million and $5.2 million (after elimination of intercompany transactions), respectively. For the three and nine months ended September 30, 2013, WNI-DFW contributed capitated revenue of $3.1 million and $4.0 million, respectively, and income before provision for income taxes of $0.3 million for both periods (after elimination of intercompany transactions).

	Estimated Medical Claims Liability

	In connection with the operations of WNI-DFW, the Company makes estimates related to incurred but not reported medical claims (“IBNR”) of WNI-DFW. The patient population to which WNI-DFW provides health services has limited medical claims activity from which claims-based actuarial judgments can be made. In addition, the full population is relatively small for precise actuarial determinations. Therefore, in addition to calculating IBNR using an actuarial estimate based on historical medical claims activity, management includes an adjustment factor based on broader patient populations deemed to be similar in risk profile to the WNI-DFW managed patient population. If actual results are not consistent with the Company’s estimate, the Company may be exposed to variances in medical supplies and services expense that may be material. At September 30, 2014 and December 31, 2013, the Company has recorded IBNR payable of $10.7 million and $1.9 million, respectively, which is included in other accrued liabilities.

Business_Combinations

Business Combinations	9 Months Ended
Business Combinations	Sep. 30, 2014
Business Combinations	'
	Note 3 – Business Combinations
	In February, March and August, 2014, the Company acquired four small physician practices and the physicians became employees or contractors of the Company. As consideration for the acquired practices, the Company paid $104,000 in cash and issued to the former owners of the acquired practices 12,385 shares of the Company’s common stock with an estimated fair value of $167,000. The following table summarizes the estimated fair values of assets acquired at the business combination date. No liabilities were assumed in the transactions.


	Inventories	$	38,022
	Property and equipment		212,565
	Identifiable intangible assets - noncompete agreements		20,536

	Assets acquired	$	271,123


	The physicians entered into employment agreements with the Company and these agreements include covenants not to compete. The Company recorded noncompete agreement intangible assets totaling $20,536 with a weighted-average amortization period of 3.1 years.

Investments_in_Nonconsolidated

Investments in Nonconsolidated Affiliates	9 Months Ended
Investments in Nonconsolidated Affiliates	Sep. 30, 2014
Investments in Nonconsolidated Affiliates	'
	Note 4 – Investments in Nonconsolidated Affiliates
	The net carrying values and ownership percentages of nonconsolidated affiliates accounted for under the equity method are as follows (dollars in thousands):


		September 30, 2014				December 31, 2013
		Carrying		Ownership		Carrying				Ownership
		Value		Percentage		Value				Percentage

	USMD Hospital at Arlington, L.P.	$	48,727	46.40%		$	50,055			46.40%
	USMD Hospital at Fort Worth, L.P.		10,098	30.88%			11,246			30.88%
	Other		180	4%-34%			521			4%-34%

		$	59,005			$	61,822

	At September 30, 2014, USMD Hospital at Arlington, L.P. (“USMD Arlington”) and USMD Hospital at Fort Worth, L.P. (“USMD Fort Worth”) were significant equity investees, as that term is defined by SEC Regulation S-X Rule 8-03(b)(3). Financial information for USMD Arlington and USMD Forth Worth is as follows (in thousands):


		Three Months Ended						Nine Months Ended
		September 30,						September 30,
		2014		2013				2014			2013
	USMD Arlington:
	Revenue	$	24,159	$	22,895			$	67,711		$	67,044
	Income from operations	$	5,212	$	5,527			$	15,009		$	15,769
	Income from continuing operations	$	4,916	$	4,901			$	13,232		$	15,013
	Net income	$	4,916	$	4,901			$	13,232		$	15,013

	USMD Fort Worth:
	Revenue	$	10,873	$	9,405			$	29,417		$	26,988
	Income from operations	$	3,064	$	2,113			$	7,449		$	5,577
	Income from continuing operations	$	2,861	$	1,924			$	6,871		$	4,946
	Net income	$	2,861	$	1,924			$	6,871		$	4,946

Patient_Service_Revenue

Patient Service Revenue	9 Months Ended
Patient Service Revenue	Sep. 30, 2014
Patient Service Revenue	'
	Note 5 – Patient Service Revenue
	The Company’s patient service revenue by payer is summarized in the table that follows (dollars in thousands):


			Three Months Ended September 30,																Nine Months Ended September 30,
			2014								2013								2014						2013
			Amount				Ratio of				Amount				Ratio of				Amount			Ratio of			Amount			Ratio of
							Net Patient								Net Patient							Net Patient						Net Patient
							Service								Service							Service						Service
							Revenue								Revenue							Revenue						Revenue
	Medicare		$	14,498				30.3	%		$	13,743				31	%		$	41,166			30.1	%	$	40,393			30.2	%
	Medicaid			350				0.7				309				0.7				1,084			0.8			1,079			0.8
	Managed care and commercial payers			33,185				69.3				30,775				69.5				94,274			68.9			91,472			68.4
	Self-pay			874				1.8				1,047				2.4				2,651			1.9			3,187			2.4

	Patient service revenue before provision for doubtful accounts			48,907				102.1				45,874				103.6				139,175			101.7			136,131			101.7
	Patient service revenue provision for doubtful accounts			(1,013	)			(2.1	)			(1,581	)			(3.6	)			(2,276	)		(1.7	)		(2,329	)		(1.7	)

	Net patient service revenue		$	47,894				100	%		$	44,293				100	%		$	136,899			100	%	$	133,802			100	%

	Allowance for Doubtful Accounts
	The allowance for doubtful accounts is based on management’s assessment of the collectibility of patient and customer accounts. The Company regularly reviews this allowance by considering factors such as historical experience, credit quality, the age of the accounts receivable balances and current economic conditions that may affect a patient’s or customer’s ability to pay. Uncollectible accounts are written off once collection efforts are exhausted. A summary of the Company’s accounts receivable allowance for doubtful accounts activity is as follows (in thousands):


	Balance at				Provision				Provision				Write-offs				Balance at
	December 31,				for Doubtful				for								September 30,
	2013				Accounts				Doubtful								2014
					Related to				Accounts
					Patient
					Service
					Revenue

	$	1,758				2,276				186				(2,800	)		$	1,420

Intangible_Assets

Intangible Assets	9 Months Ended
Intangible Assets	Sep. 30, 2014
Intangible Assets	'
	Note 6 – Intangible Assets
	In May 2014, the Company introduced a unified brand – USMD Health System – that will reinforce its physician-led integrated health system message. Over time, the Company will replace the historical brands of acquired companies with the USMD Health System brand. Prior to introduction of the new brand, the Company had on its balance sheet indefinite- and finite-lived intangible assets representing the trade names of acquired companies with carrying values of $10.7 million and $0.3 million, respectively.
	As result of the branding initiative, management concluded that the indefinite-lived trade names were now finite-lived assets. In connection with this change, the Company performed, with the assistance of independent valuation experts, an impairment test of the carrying value of the trade names to determine whether any impairment existed. The Company concluded that the estimated fair value of the trade names was less than the associated carrying value and that an impairment write-down was required. As a result of this determination, the Company recorded an impairment loss of $8.4 million, which is included in “depreciation and amortization” on the Company’s consolidated statement of operations for the nine months ended September 30, 2014. The estimated fair values of the trade names were calculated using an income approach – relief from royalty method, which assumes that in lieu of ownership, a third party would be willing to pay a royalty in order to exploit the related benefits of the trade name asset (see Note 9). The new $2.6 million carrying value of the trade names will be amortized on a straight line basis over the five year estimated useful life of the trade names. The actual useful life of the trade names will vary dependent upon certain factors including the availability of funding to execute the branding initiative.

	The components of amortizable intangible assets consist of the following:


		September 30, 2014							December 31, 2013
		Gross		Accumulated			Net		Gross		Accumulated			Net
		Carrying		Amortization			Carrying		Carrying		Amortization			Carrying
		Amount					Amount		Amount					Amount
	Management agreements	$	5,246	$	(689	)	$	4,557	$	5,246	$	(544	)	$	4,702
	Trade names		11,168		(8,706	)		2,462		462		(123	)		339
	Customer relationships		767		(533	)		234		767		(341	)		426
	Noncompete agreements		12,547		(2,610	)		9,937		12,527		(1,667	)		10,860

		$	29,728	$	(12,538	)	$	17,190	$	19,002	$	(2,675	)	$	16,327

	For the nine months ended September 30, 2014, amortization of intangible assets totaled $9.9 million including the $8.4 million impairment loss noted above. Total estimated amortization expense for the Company’s intangible assets through the end of 2014 and during the next five years is as follows (in thousands):


	October through December 2014	$	566
	2015	$	2,144
	2016	$	1,974
	2017	$	1,972
	2018	$	1,972
	2019	$	1,665

Other_Accrued_Liabilities

Other Accrued Liabilities	9 Months Ended
Other Accrued Liabilities	Sep. 30, 2014
Other Accrued Liabilities	'
	Note 7 – Other Accrued Liabilities
	Other accrued liabilities consist of the following (in thousands):


		September 30,		December 31,
		2014		2013
	Accrued payables	$	3,785	$	5,285
	Accrued bonus		980		1,860
	Other accrued liabilities		1,216		1,299
	IBNR payable		10,714		1,918
	Income taxes payable		1,987		395

		$	18,682	$	10,757

LongTerm_Debt_and_Capital_Leas

Long-Term Debt and Capital Lease Obligations	9 Months Ended
Long-Term Debt and Capital Lease Obligations	Sep. 30, 2014
Long-Term Debt and Capital Lease Obligations	'
	Note 8 – Long-Term Debt and Capital Lease Obligations
	Long-term debt and capital lease obligations consist of the following (in thousands):


		September 30,			December 31,
		2014			2013
	Holdings:
	Credit Agreement:
	Term debt	$	7,500		$	15,687
	Revolving credit facility		1,500			3,000
	Convertible subordinated notes, net of unamortized discount of $3,125 and $3,503 at September 30, 2014 and December 31, 2013, respectively		21,217			20,839
	Subordinated related party notes payable		3,577			3,734
	Other note payable		68			120

			33,862			43,380
	Consolidated lithotripsy entities:
	Notes payable		1,355			1,766
	Capital lease obligations		778			1,052

			2,133			2,818

	Total long-term debt and capital lease obligations		35,995			46,198
	Less: current portion		(5,002	)		(8,492	)

	Long-term debt and capital lease obligations, less current portion	$	30,993		$	37,706

	Credit Agreement
	On August 31, 2012, in connection with the Contribution, USMD and its wholly owned subsidiaries entered into a credit agreement with JPMorgan Chase Bank, N.A., as administrative agent, and additional lenders (as amended, the “Credit Agreement”). On February 25, 2014, the Company entered into Amendment No. 3 to Credit Agreement, which, among other things, extended the maturity date of the revolving credit facility (the “Revolver”) from February 28, 2014 to June 30, 2015. In addition, the amendment reduced the minimum fixed charge coverage ratio requirement and established a senior leverage ratio covenant.
	In March 2014, the Company determined that it had not been in compliance with its fixed charge coverage ratio or senior leverage ratio covenants. Effective April 14, 2014, the Company entered into Waiver and Amendment No. 4 to Credit Agreement (“Amendment No. 4”). Amendment No. 4 permanently waived the existing covenant violations, modified the fixed charge coverage ratio and senior leverage ratio covenants and established a minimum adjusted EBITDA financial covenant. In addition, the amendment reduced the Revolver commitment amount from $10.0 million to $3.0 million and accelerated the maturity date of one of the term loans (the “Tranche C Term Loan”) to April 21, 2014. Amendment No. 4 also prohibited scheduled payments of principal and interest on the Company’s subordinated related party notes payable through September 30, 2014.
	Effective September 23, 2014, the Company entered into Amendment No. 5 to Credit Agreement (“Amendment No. 5”). Among other things, Amendment No. 5 delays commencement of principal and interest payments on certain subordinated debt from September 30, 2014 to December 31, 2014. Amendment No. 5 also requires the Company to repay $1.5 million in principal under the Revolver. This payment was made on September 22, 2014. The Company may reborrow such amount under the Revolver in accordance with the terms of the Credit Agreement.
	The Credit Agreement requires the Company to maintain a fixed charge coverage ratio greater than or equal to 0.35:1.00 for the period of four consecutive fiscal quarters ended March 31, 2014 and 1.25:1.00 for any period of four consecutive fiscal quarters beginning June 30, 2014 through August 31, 2017. In addition, the Company is required to maintain a senior leverage ratio less than or equal to 3.10:1.00 for the period of four consecutive fiscal quarters ended March 31, 2014, 1.25:1.00 for the period of four consecutive fiscal quarters ended June 30, 2014 and 1.00:1.00 for any period of four consecutive fiscal quarters beginning September 30, 2014 through August 31, 2017. Finally, the Company must maintain a minimum adjusted EBITDA (as defined in the Credit Agreement) of $0.8 million for any calendar month beginning with the month ended April 30, 2014. As of September 30, 2014, the Company was in compliance with its Credit Agreement covenant requirements.

	Pursuant to the Credit Agreement, the Company was required to maintain a compensating balance of $5.0 million as collateral for its borrowings under the Credit Agreement. This amount was historically recorded as restricted cash on the Company’s consolidated balance sheets. The Credit Agreement provided that the balance be held in an account at JPMorgan Chase Bank, N.A. Amendment No. 4 modified the payment terms of the $5.0 million Tranche C Term Loan to allow the lender to utilize the $5.0 million compensating balance to pay off the Tranche C Term Loan on or before its amended April 21, 2014 maturity date. On April 18, 2014, the Tranche C Term Loan was paid in full with the compensating balance funds. At September 30, 2014, $1.5 million was available to borrow under the Company’s revolving credit facility.
	Long-Term Debt Maturities
	Maturities of the Company’s long-term debt (as amended) are as follows as of September 30, 2014 (in thousands):


	October through December, 2014	$	1,369
	2015		5,214
	2016		3,711
	2017		2,921
	2018		785
	2019		24,342

	Total	$	38,342

Fair_Value_of_Financial_Instru

Fair Value of Financial Instruments	9 Months Ended
Fair Value of Financial Instruments	Sep. 30, 2014
Fair Value of Financial Instruments	'
	Note 9 – Fair Value of Financial Instruments
	Financial Instruments Measured at Fair Value on a Nonrecurring Basis
	The Company measures certain financial and nonfinancial assets, including property and equipment, goodwill, intangible assets other than goodwill and investments in nonconsolidated affiliates, at fair value on a nonrecurring basis. These assets are not measured at fair value on an ongoing basis, but are subject to fair value adjustments in certain circumstances. Generally, assets are recorded at fair value on a nonrecurring basis as a result of impairment charges or similar adjustments made to the carrying value of the applicable assets.
	In connection with the Company’s branding initiative announced in May 2014, certain acquired trade names with a carrying value of $11.0 million were written down to their estimated fair value of $2.6 million, resulting in an impairment loss of $8.4 million (Level 3 fair value measurement). Fair value was estimated using an income approach – relief from royalty method, which assumes that in lieu of ownership, a third party would be willing to pay a royalty in order to exploit the related benefits of the trade name asset. The cash flow model the Company used to estimate the fair value of the trade names involves several assumptions, most significantly, projected revenue growth rates, a pre-tax royalty rate of 1.0% declining to 0.1% over the estimated five year life of the asset and a discount rate of 17%.
	Fair Value of Financial Instruments
	Financial instruments consist mainly of cash and cash equivalents, accounts receivable, accounts payable, short-term borrowings and long-term debt. The carrying value of financial instruments with a short-term or variable-rate nature approximate fair value and are not presented in the table below. The carrying value and estimated fair value of the Company’s financial instruments that do not approximate fair value are set forth in the table below (in thousands):


		September 30, 2014				December 31, 2013
		Carrying		Fair Value		Carrying		Fair Value
		Value		Fair Value		Value		Fair Value
	Convertible subordinated notes	$	21,217	$	19,488	$	20,839	$	25,985
	Subordinated related party notes payable	$	3,577	$	3,399	$	3,734	$	3,481
	Consolidated lithotripsy entity notes payable	$	1,355	$	1,357	$	1,766	$	1,767
	Other note payable	$	68	$	69	$	120	$	124

	The Company estimates the fair value of the convertible subordinated notes as the sum of the independently estimated fair values of the debt host instrument and embedded conversion option (Level 3 fair value measurement). The Company calculates the present value of future principal and interest payments of the debt host using borrowing rates currently available to it for similar subordinated debt or debt for which the Company could use to retire the existing debt. The fair value of the embedded conversion option is valued using a Black-Scholes option pricing model. Quoted market prices are not available for the convertible subordinated notes.
	The Company estimates the fair value of its subordinated related party notes payable using discounted cash flows based primarily on borrowing rates currently available to it for similar debt or debt for which the Company could use the proceeds to retire existing debt (Level 3 fair value measurement). The Company’s consolidated lithotripsy entities enter into term notes for equipment; borrowing rates are based on individual entity creditworthiness. The Company estimates current borrowing rates for the lithotripsy entity notes payable by adjusting the discount factor of the obligations at the balance sheet date by the variance in borrowing rates between the inception dates and balance sheet date (Level 2 fair value measurement). If the creditworthiness of an individual lithotripsy entity has significantly changed from the debt inception date, management estimates the applicable borrowing rate based on the current facts and circumstances. Quoted market prices are not available for the Company’s notes payable.

ShareBased_Payment

Share-Based Payment	9 Months Ended
Share-Based Payment	Sep. 30, 2014
Share-Based Payment	'
	Note 10 – Share-Based Payment
	Pursuant to the USMD Holdings, Inc. 2010 Equity Compensation Plan (the “Equity Compensation Plan”), the Company may grant equity awards to employees, nonemployee directors and nonemployee service providers in the form of stock options, restricted stock and stock appreciation rights. Effective, June 6, 2014, at the annual meeting of stockholders, the stockholders approved an amendment to the Equity Compensation Plan that increased the aggregate number of shares that may be issued under the Equity Compensation Plan from 1.0 million to 2.5 million. Stock options may be granted with a contractual life of up to ten years. At September 30, 2014, the Company had approximately 1.6 million shares available for grant under the Equity Compensation Plan.
	The fair value of stock option awards on the date of grant is estimated using the Black-Scholes option pricing model, which requires the Company to make certain predictive assumptions. The risk-free interest rate is based on the implied yield of U.S. Treasury zero-coupon securities that correspond to the expected life of the award. As a recently formed public entity with a small public float and limited trading of its common shares on the NASDAQ stock market, it was not practicable for the Company to estimate the volatility of its common shares; therefore, management estimated volatility based on the historical volatilities of a small group of companies considered as close to comparable to the Company as available and an industry index, all equally weighted, over the expected life of the option. Management concluded that this group is more characteristic of the Company’s business than a broad industry index. The expected life of awards granted represents the period of time that the awards are expected to be outstanding based on the “simplified” method, which is allowed for companies that cannot reasonably estimate the expected life of options based on its historical award exercise experience. The Company does not expect to pay dividends on its common stock. Due to the nature of the grants, the company estimated zero option forfeitures. Share-based payment expense is recorded only for those awards that are expected to vest. Weighted-average assumptions used in the Black-Scholes option pricing model for stock options granted were as follows:


		Nine Months Ended
		September 30, 2014
	Risk-free interest rate		1.94	%
	Expected volatility of common stock		45	%
	Expected life of options		5.9 years
	Dividend yield		0	%

	The Black-Scholes option pricing model was developed for estimating the fair value of traded options that have no vesting restrictions and are fully transferable. Because option valuation models require the use of subjective assumptions, changes in these assumptions can materially affect the fair value of the options. The Company’s options do not have the characteristics of exchange traded options and, therefore, the option valuation models do not necessarily provide a reliable measure of the fair value of stock options. A summary of stock option activity for the nine months ended September 30, 2014 is as follows:


	Options	Number of			Weighted-		Weighted-		Aggregate
		Shares			Average		Average		Intrinsic
					Exercise		Remaining		Value
					Price		Contractual
							Term
							(in years)
	Outstanding as of December 31, 2013		583,697		$	25.39
	Granted		150,000			17.25
	Exercised		—			—			$	—
	Forfeited		(543	)		20.23

	Outstanding as of September 30, 2014		733,154		$	23.73		6.28	$	—

	Vested and expected to vest at September 30, 2014		382,084		$	24		5.71	$	—
	Exercisable at September 30, 2014		277,279		$	23.97		5.41	$	—
	The weighted-average grant-date fair value of stock options granted during the nine months ended September 30, 2014 was $6.80 per option. The fair value of stock options vested and associated share-based payment expense recognized for the three and nine months ended September 30, 2014 was $229,000 and $998,000, respectively, and is included in salaries, wages and employee benefits. At September 30, 2014, the total unrecognized compensation cost related to nonvested share-based payment awards was $2.9 million, which is expected to be recognized over a remaining weighted-average period of 3.1 years.
	Payments in Common Stock
	For services rendered as members of the Company’s Board of Directors, the Company has elected to compensate directors in common stock of the Company. Grant dates occur on the last day of each month and shares granted are fully vested and non-forfeitable. Shares are generally issued in arrears in three month blocks. Pursuant to the Equity Compensation Plan, during the nine months ended September 30, 2014, the Company granted to members of its Board of Directors an aggregate 41,675 shares of its common stock with a grant date fair value of $478,000, which is included in other operating expenses on the Company’s statement of operations. During the nine months ended September 30, 2014, in payment of board compensation earned through July 31, 2014, the Company issued 29,600 of previously granted shares with an aggregate grant date fair value of $373,000. The shares were issued pursuant to the Equity Compensation Plan.
	Pursuant to the Equity Compensation Plan, on March 5 and 6, 2014, the Company issued an aggregate 14,958 shares of its common stock with a grant date fair value of $243,000 to a member of senior management and members of the Company’s Board of Directors in payment of certain compensation accrued at December 31, 2013.
	A consultant to the Company has agreed to be partially compensated in common stock for services rendered. Grant dates occur on the last day of each month and shares granted are fully vested and non-forfeitable. Pursuant to the Equity Compensation Plan, during the nine months ended September 30, 2014, the Company granted to the consultant 3,343 shares of common stock with a grant date fair value of $38,000. During the nine months ended September 30, 2014, the Company issued to the consultant 2,853 of those shares with a grant date fair value of $34,000.
	Of the shares of common stock described above, 19,501 shares have not been registered under the Securities Act of 1933, as amended, and may not be transferred without an effective registration statement or pursuant to an appropriate exemption from such act.
	Registration of Common Shares
	On July 14, 2014, USMD filed a registration statement on Form S-8 to register with the SEC approximately 1.7 million shares of USMD common stock available for issuance under the Equity Compensation Plan and the Deferral Plan. The registration statement became effective upon filing.

	Salary Deferral Plan
	On May 5, 2014, USMD’s Board of Directors approved and established the Salary Deferral Plan (the “Deferral Plan”). On July 18, 2014, the holder of a majority of USMD’s outstanding voting stock approved the Deferral Plan by written consent in lieu of a special meeting. The Company mailed an information statement on Schedule 14C to shareholders on or about July 22, 2014 informing the shareholders of the creation of the Deferral Plan. The Deferral Plan went into effect on August 11, 2014, 20 days after the information statement was mailed as required by law. The Deferral Plan permits the Company to defer the payment of a predetermined portion of a participant’s base salary each calendar quarter. The plan administrator will decide after the end of each quarter whether deferred amounts will be paid in the form of cash, shares of common stock or a combination of both. Any shares of common stock issued under the Deferral Plan will be issued from the shares of common stock authorized for issuance under the Equity Compensation Plan, as amended.
	In August 2014, pursuant to the Deferral Plan, the Company granted 15,700 shares of its common stock with a grant date fair value of $150,000 to certain of its executives in payment of salary amounts deferred during the second quarter of 2014. The Company anticipates issuing the common shares granted under the Deferral Plan in the first quarter of 2015.

Earnings_per_Share

Earnings per Share	9 Months Ended
Earnings per Share	Sep. 30, 2014
Earnings per Share	'
	Note 11 – Earnings per Share
	Basic earnings (loss) per share is computed by dividing net income (loss) attributable to the Company’s stockholders by the weighted-average number of common shares outstanding during the period, including fully vested and unissued common shares. Diluted earnings (loss) per share is based on the weighted-average number of common shares outstanding plus the number of additional shares that would have been outstanding had the potentially dilutive common shares been issued. Securities that are potentially dilutive to common shares include outstanding stock options and the convertible subordinated notes. Potential common shares are excluded from the computation of diluted earnings per common share when the effect would be antidilutive.
	Dilutive potential common shares related to stock options are calculated in accordance with the treasury stock method, which assumes that proceeds from the exercise of stock options are used to purchase common shares at the average market price during the period. Proceeds from the exercise of stock options include the amount the employee must pay for exercising stock options, the amount of compensation cost for future services that the Company has not yet recognized and the amount of tax benefits that would be recorded in additional paid-in capital when the award becomes deductible. The number of shares remaining represents the potentially dilutive effect of the securities. Stock options are only dilutive to the extent that the average market price of common stock during the period exceeds the exercise price of the options.
	Dilutive common shares related to the convertible subordinated notes are calculated in accordance with the if-converted method. Under the if-converted method, if dilutive, net income (loss) attributable to the Company’s stockholders is adjusted to add back the amount of after-tax interest charges recognized in the period, including any deemed interest from a beneficial conversion feature, and the convertible subordinated notes are assumed to have been converted with the resulting common shares added to weighted average shares outstanding. These securities are only dilutive to the extent that the after-tax interest charges per common share exceed basic earnings per share.

	The following table presents a reconciliation of the numerators and denominators of basic and diluted earnings (loss) per share and the computation of basic and diluted earnings (loss) per share (in thousands, except per share data):


		Three Months Ended						Nine Months Ended
		September 30,						September 30,
		2014			2013			2014			2013
	Numerator:
	Net loss attributable to USMD Holdings, Inc. - basic	$	(1,746	)	$	(436	)	$	(11,082	)	$	(122	)
	Effect of potentially dilutive securities:
	Interest on convertible subordinated notes, net of tax		—			—			—			—

	Net loss attributable to USMD Holdings, Inc. - diluted	$	(1,746	)	$	(436	)	$	(11,082	)	$	(122	)

	Denominator:
	Weighted-average common shares outstanding		10,177			10,088			10,151			10,071
	Effect of potentially dilutive securities:
	Stock options		—			—			—			—
	Convertible subordinated notes		—			—			—			—

	Weighted-average common shares outstanding assuming dilution		10,177			10,088			10,151			10,071

	Loss per share attributable to USMD Holdings, Inc.:
	Basic	$	(0.17	)	$	(0.04	)	$	(1.09	)	$	(0.01	)
	Diluted	$	(0.17	)	$	(0.04	)	$	(1.09	)	$	(0.01	)
	The following table presents the potential shares excluded from the diluted loss per share calculation because the effect of including theses potential shares would be antidilutive (in thousands):


		Three Months Ended						Nine Months Ended
		September 30,						September 30,
		2014			2013			2014			2013
	Stock options		802			576			802			576
	Convertible subordinated notes		1,042			1,042			1,042			1,042

			1,844			1,618			1,844			1,618

Commitments_and_Contingencies

Commitments and Contingencies	9 Months Ended
Commitments and Contingencies	Sep. 30, 2014
Commitments and Contingencies	'
	Note 12 – Commitments and Contingencies
	Financial Guarantees
	As of September 30, 2014, the Company had issued guarantees to third parties of the indebtedness and other obligations of certain of its nonconsolidated investees. Should the investees fail to pay the obligations due, the Company could be required to make payments totaling an aggregate of $19.6 million. The guarantees provide for recourse against the investee; however, if the Company were required to perform under the guarantees, recovery of any amount from investees would be unlikely. The remaining terms of these guarantees range from four to 65 months. The Company records a liability for performance under financial guarantees when, upon review of available financial information of the nonconsolidated affiliate and in consideration of pertinent factors, management determines that it is probable it will have to perform under the guarantee and the liability is reasonably estimable. The Company has not recorded a liability for these guarantees, as it believes it is not probable that it will have to perform under these agreements.

	Litigation
	The Company is from time to time subject to litigation and related claims and arbitration matters arising in the ordinary course of business, including claims relating to contracts and financial obligations, partnership or joint venture entity disputes and, with respect to USMD Physician Services, claims arising from the provision of professional medical services to patients. In some cases, plaintiffs may seek damages, including punitive damages that may not be covered by insurance. In other cases, claims may not be covered by insurance at all. The Company maintains professional and general liability insurance through commercial insurance carriers for claims and in amounts that the Company believes to be sufficient for its operations, although, potentially, some claims may exceed the scope and amount of coverage in effect. The Company expenses as incurred legal costs associated with litigation or other loss contingencies.
	The Company accrues for a contingent loss when it is both probable that a liability has been incurred and the amount of the loss can be reasonably estimated. Judgment is required in both the determination of the probability of a loss and the determination as to whether a loss is reasonably estimable. These determinations are updated at least quarterly and are adjusted to reflect the effects of negotiations, settlements, rulings, advice of legal counsel and technical experts and other information and events pertaining to a particular matter. To the extent there is a reasonable possibility that probable losses could exceed amounts already accrued, if any, and the additional loss or range of loss is estimable, management discloses the additional loss or range of loss. For matters where the Company has evaluated that a loss is not probable, but is reasonably possible, the Company will disclose an estimate of the possible loss or range of loss or make a statement that such an estimate cannot be made.
	Certain subsidiaries of the Company in the ordinary course of business are party to various medical negligence lawsuits and wrongful termination lawsuits. In addition, subsidiaries of the Company have received notices of potential claims. For lawsuits and claims where the Company can reasonably estimate a range of loss, the Company estimates a reasonably possible range of loss of $0.5 million to $1.2 million. In the remaining lawsuits and the potential claims, the parties are in the early stages of discovery and/or the plaintiffs have not made specific demands for damages. Due to these circumstances, the Company is unable to estimate a reasonably possible range of loss related to these lawsuits and claims. The Company is insured against the claims described above and believes based on the facts known to date that any damage award related to such claims would be recoverable from its insurer.
	The Company is subject to various additional claims and legal proceedings that have arisen in the ordinary course of its business activities. Management believes that any liability that may ultimately result from the resolution of these matters will not have a material adverse effect on the financial condition or results of operations of the Company.
	Resolution Agreement
	On October 26, 2012, a subsidiary of the Company entered into a Mediation Settlement Agreement with an entity to which the subsidiary had provided management services under a long term contract. The entity agreed to pay the Company the sum of $650,000 to settle certain claims between the Company and the entity arising from the entity’s early termination of the contract. The Mediation Settlement Agreement required the entity to pay the Company $100,000 in November 2012 and to make 55 monthly payments of $10,000 on the first day of each month beginning December 2012. The Company concluded that collection of the settlement amount was not reasonably assured and recorded the gain as amounts were collected. Effective April 11, 2014, the Company and the entity entered into a Lump Sum Settlement Agreement, whereby for one lump sum payment of $342,500 received and recorded by the Company on April 18, 2014, all outstanding liabilities due under the Mediation Settlement Agreement are deemed to be fully paid and satisfied.
	Financial Advisory Commitment
	The Company has in place with an investment banking firm a financial advisory services agreement, as amended, (“FAS Agreement”). Under the FAS Agreement, the Company is obligated to compensate the firm in cash for certain financial transactions in amounts generally equal to the greater of a minimum $1.0 million to $2.5 million dependent upon the transaction type or a percentage of the potential transaction value, as further defined in the FAS Agreement. If the Company enters into a qualifying financial transaction during a one year period subsequent to termination of the FAS Agreement, the investment banking firm is entitled to compensation under the terms of the FAS Agreement. The FAS Agreement remains in effect until terminated by either party. As of September 30, 2014, the Company has not closed any transaction for which compensation is due to the investment banking firm.

	Operating Lease Commitments
	Future minimum rental commitments under non-cancelable operating leases are as follows (in thousands):


	October through December, 2014	$	3,238
	2015		12,649
	2016		10,896
	2017		8,963
	2018		8,023
	2019		7,315
	Thereafter		33,907

	Total	$	84,991

Related_Party_Transactions

Related Party Transactions	9 Months Ended
Related Party Transactions	Sep. 30, 2014
Related Party Transactions	'
	Note 13 – Related Party Transactions
	The Company provides management, clinical and support services to various nonconsolidated affiliates in which it has limited partnership or ownership interests. Management and other services revenue and accounts receivable from these entities are as follows:


		Management and Other Services Revenue
		Three Months Ended September 30,				Nine Months Ended September 30,
		2014		2013		2014		2013
		(in thousands)
	USMD Arlington	$	2,689	$	2,624	$	7,855	$	7,797
	USMD Fort Worth		847		1,082		2,987		3,213
	Other equity method investees		406		413		1,398		944

		$	3,942	$	4,119	$	12,240	$	11,954



		Accounts Receivable
		September 30,		December 31,
		2014		2013
		(in thousands)
	USMD Arlington	$	370	$	388
	USMD Fort Worth		—		446
	Other equity method investees		154		203

		$	524	$	1,037

	One consolidated lithotripsy entity provides lithotripsy services to USMD Arlington and USMD Fort Worth. For the three months ended September 30, 2014 and 2013, the Company recognized lithotripsy revenues from USMD Arlington and USMD Fort Worth totaling $0.5 million and $0.6 million, respectively. For the nine months ended September 30, 2014 and 2013, the Company recognized lithotripsy revenues from USMD Arlington and USMD Fort Worth totaling $1.6 million for both periods.
	The Company leases space from USMD Arlington for certain of its physicians and its Arlington-based cancer treatment center. For the three months ended September 30, 2014 and 2013, the Company recognized rent expense related to USMD Arlington totaling $0.5 million and $0.4 million, respectively. For the nine months ended September 30, 2014 and 2013, the Company recognized rent expense related to USMD Arlington totaling $1.4 million and $1.3 million, respectively.

Subsequent_Events

Subsequent Events	9 Months Ended
Subsequent Events	Sep. 30, 2014
Subsequent Events	'
	Note 14 – Subsequent Events
	One-Time Termination Benefits
	In September 2014, in order to improve flexibility in the revenue cycle process, the Company entered into an arrangement to outsource the majority of its revenue cycle function to an external provider. Management expects that this arrangement will result in the termination of most of the Company’s revenue cycle employees as of or before early December 2014. Employees were first advised of the outsourcing in September; however, an approved termination benefit plan was not yet in place.

	In October 2014, the Company notified the first group of impacted employees of the approved termination plan and its benefits and recognized a liability of $0.4 million, which approximates fair value of the estimated one-time termination benefit. The 67 employees in this group were terminated effective October 31, 2014. Management expects to communicate termination benefits to the second and final group of 26 employees in mid-to-late November. At that date, management expects to recognize a termination benefit liability of approximately $0.3 million and those employees will be terminated in late November and early December. The Company anticipates paying all termination benefits prior to December 31, 2014.

Description_of_Business_Basis_1

Description of Business, Basis of Presentation and Recently Issued Accounting Pronouncements (Policies)	9 Months Ended
	Sep. 30, 2014
Description of Business	'
	Description of Business:
	USMD Holdings, Inc. (“USMD” or the “Company”) is a Delaware corporation formed on May 7, 2010 to facilitate the business combination of USMD Inc., a Texas corporation, Urology Associates of North Texas, L.L.P., a Texas limited liability partnership, and UANT Ventures, L.L.P., a Texas limited liability partnership (“Ventures”) (such transaction, the “Contribution”). USMD described this transaction in its registration statement on Form S-4 filed with the Securities and Exchange Commission (the “SEC”). Prior to the consummation of the Contribution, Ventures and USMD entered into a merger agreement with The Medical Clinic of North Texas, P.A., a Texas professional association (“MCNT”), and a merger agreement with Impel Management Services, L.L.C., a Texas limited liability company (“Impel”), pursuant to which the businesses of MCNT and Impel were merged into subsidiaries of Ventures immediately prior to the Contribution, and these businesses were contributed by Ventures to USMD as part of the Contribution. USMD described these transactions in a post-effective amendment to its registration statement filed with the SEC on February 10, 2012, which was declared effective on April 30, 2012. Effective August 31, 2012, USMD and the other parties consummated the Contribution.
	The Company is an innovative early-stage physician-led integrated health system. Through its subsidiaries and affiliates, the Company provides healthcare services to patients in physician clinics, hospitals and other healthcare facilities, and the Company also provides management and operational services to hospitals and other healthcare service providers. An integrated health system is considered early-stage when it has not yet established all the components necessary to be considered a fully integrated health system.
	A wholly owned subsidiary of the Company is the sole member of a Texas certified non-profit health organization that owns and operates a multi-specialty physician group practice (“USMD Physician Services”) in the Dallas-Fort Worth, Texas metropolitan area. Through other wholly owned subsidiaries, the Company provides management and operational services to two short-stay hospitals in the Dallas-Fort Worth, Texas metropolitan area and provides management and/or operational services to four cancer treatment centers in three states and 22 lithotripsy service providers primarily located in the South-Central United States. Of these managed entities, the Company has limited ownership interests in the two hospitals, two cancer treatment centers and 18 lithotripsy service providers. The Company consolidates the 18 lithotripsy service providers into its financial statements. In addition, the Company wholly owns and operates two clinical laboratories, one anatomical pathology laboratory, one cancer treatment center and one lithotripsy service provider in the Dallas-Fort Worth, Texas metropolitan area.
Basis of Presentation	'
	Basis of Presentation:
	The unaudited condensed consolidated financial statements of the Company have been prepared in conformity with accounting principles generally accepted in the United States (“GAAP”) for interim financial statements and pursuant to the rules and regulations of the SEC for interim reporting. Certain information and note disclosures normally included in annual financial statements prepared in accordance with GAAP have been condensed or omitted pursuant to those rules and regulations, although the Company believes that the disclosures made are adequate to make the information in this report not misleading. These condensed consolidated financial statements reflect all adjustments that, in the opinion of the Company’s management, are necessary for fair presentation of the condensed consolidated financial statements. The December 31, 2013 condensed consolidated balance sheet data was derived from audited financial statements but does not include all disclosures required by GAAP. The operating results for the interim periods are not necessarily indicative of results for the full fiscal year. These condensed consolidated financial statements should be read in conjunction with the Company’s Annual Report on Form 10-K for the year ended December 31, 2013 filed with the SEC on April 15, 2014.

	The condensed consolidated financial statements include the accounts of the Company, entities controlled by the Company through its direct or indirect ownership of a majority interest and any other entities in which the Company has a controlling financial interest. The Company consolidates VIEs where the Company is the primary beneficiary. The primary beneficiary of a VIE is the party that has both the power to direct the activities that most significantly impact the VIE’s economic performance and the obligation to absorb losses or the right to receive benefits that could potentially be significant to the VIE. The Company consolidates entities in which it or its wholly owned subsidiary is the general partner or managing member and the limited partners or members, respectively, do not have sufficient rights to overcome the presumption of the Company’s control. The Company eliminates all significant intercompany accounts and transactions in consolidation.
	The Company uses the equity method to account for investments in entities it or its wholly owned subsidiaries do not control, but over which it or its wholly owned subsidiaries have the ability to exercise significant influence. The Company does not consolidate equity method investments, but rather measures them at their initial cost and subsequently adjusts their carrying values through income for the Company’s respective share of earnings or losses during the period.
Recently Issued Accounting Pronouncements	'
	Recently Issued Accounting Pronouncements
	In August 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2014-15, “Presentation of Financial Statements - Going Concern (Subtopic 205-40) - Disclosure of Uncertainties about an Entity’s Ability to Continue as a Going Concern” (“ASU 2014-15”). ASU 2014-15 sets forth management’s responsibility to evaluate whether there is substantial doubt about an entity’s ability to continue as a going concern and to provide related footnote disclosures. ASU 2014-15 indicates that, when preparing interim and annual financial statements, management should evaluate whether conditions or events, considered in the aggregate, raise substantial doubt about the entity’s ability to continue as a going concern for one year from the date the financial statements are issued. This evaluation should include consideration of conditions and events that are either known or are reasonably knowable at the date the financial statements are issued, as well as whether it is probable that management’s plans to address the substantial doubt will be implemented and, if so, whether it is probable that the plans will alleviate the substantial doubt. It also requires certain disclosures when substantial doubt is alleviated as a result of consideration of management’s plans and requires an express statement and other disclosures when substantial doubt is not alleviated. ASU 2014-15 is effective for annual periods ending after December 15, 2016, and interim periods and annual periods thereafter. Early adoption is permitted. Adoption of this guidance is not expected to have a material impact on the Company’s consolidated financial position, results of operations or cash flows.
	In May 2014, the FASB issued ASU No. 2014-09, “Revenue from Contracts with Customers” (“ASU-2014-09”). ASU 2014-09 requires revenue recognition to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. ASU 2014-09 provides a single principles-based, five-step model to be applied to all contracts with customers. The five steps are to identify the contract(s) with the customer, identify the performance obligations in the contact, determine the transaction price, allocate the transaction price to the performance obligations in the contract and recognize revenue when each performance obligation is satisfied. The provisions of ASU 2014-09 may be applied either retrospectively to each prior reporting period presented or retrospectively with the cumulative effect of the update recognized at the date of the initial application along with additional disclosures. ASU 2014-09 is effective for the Company beginning January 1, 2017. Early adoption is not permitted. Management is evaluating the impact that adoption of ASU 2014-09 will have on the Company’s consolidated financial statements.
	In April 2014, the FASB issued ASU No. 2014-08, “Presentation of Financial Statements and Property, Plant, and Equipment - Reporting Discontinued Operations and Disclosures of Disposals of Components of an Entity” (“ASU 2014-08”). Among other provisions and in addition to expanded disclosures, ASU 2014-08 changes the definition of what components of an entity qualify for discontinued operations treatment and reporting from a reportable segment, operating segment, reporting unit, subsidiary or asset group to only those components of an entity that represent a strategic shift that has, or will have, a major effect on an entity’s operations and financial results. Additionally, ASU 2014-08 requires disclosure about a disposal of an individually significant component of an entity that does not qualify for discontinued operations presentation in the financial statements, including the pretax profit or loss, attributable to the component of an entity for the period in which it is disposed or is classified as held for sale. This disclosure is required for all of the same periods that are presented in the entity’s results of operations for the period. The provisions of ASU 2014-08 are effective prospectively for all disposals or classifications as held for sale of components of an entity that occur within annual periods beginning on or after December 15, 2014, and interim periods within those years. Early adoption is permitted.

	The Company may, from time-to-time, identify business units that do not meet the Company’s ongoing or future business strategy. In accordance with ASU 2014-08, in the event that an individually significant business unit is identified for disposal but does not represent a strategic shift that has, or will have, a major effect on the Company’s operations and financial results, the results of the identified business unit would continue to be reported as a component of the Company’s consolidated results. However, in this event and in accordance with ASU 2014-08, additional disclosures would be required.

Variable_Interest_Entity_Table

Variable Interest Entity (Tables)	9 Months Ended
Variable Interest Entity (Tables)	Sep. 30, 2014
Carrying Amount of Assets and Liabilities of WNI-DFW	'
	The following table summarizes the carrying amount of the assets and liabilities of WNI-DFW included in the Company’s consolidated balance sheets (after elimination of intercompany transactions and balances) (in thousands):



		September 30,		December 31,
		2014		2013
	Current assets:
	Cash and cash equivalents	$	15,655	$	1,257
	Accounts receivable		651		175
	Prepaid expenses		27		—
	Deferred tax asset		3,750		—

	Total current assets		20,083		1,432
	Deferred tax asset		—		671

	Total assets	$	20,083	$	2,103


	Current liabilities:
	Accounts payable	$	4,245	$	—
	Accrued payroll		378		—
	Other accrued liabilities		12,945		2,108

	Total current liabilities	$	17,568	$	2,108

Business_Combinations_Tables

Business Combinations (Tables)	9 Months Ended
Business Combinations (Tables)	Sep. 30, 2014
Estimated Fair Values of Assets Acquired at Business Combination Date	'
	The following table summarizes the estimated fair values of assets acquired at the business combination date. No liabilities were assumed in the transactions.


	Inventories	$	38,022
	Property and equipment		212,565
	Identifiable intangible assets - noncompete agreements		20,536

	Assets acquired	$	271,123

Investments_in_Nonconsolidated1

Investments in Nonconsolidated Affiliates (Tables)	9 Months Ended
Investments in Nonconsolidated Affiliates (Tables)	Sep. 30, 2014
Financial Information of Nonconsolidated Affiliates Accounted for Under Equity Method	'
	The net carrying values and ownership percentages of nonconsolidated affiliates accounted for under the equity method are as follows (dollars in thousands):


		September 30, 2014				December 31, 2013
		Carrying		Ownership		Carrying				Ownership
		Value		Percentage		Value				Percentage

	USMD Hospital at Arlington, L.P.	$	48,727	46.40%		$	50,055			46.40%
	USMD Hospital at Fort Worth, L.P.		10,098	30.88%			11,246			30.88%
	Other		180	4%-34%			521			4%-34%

		$	59,005			$	61,822

USMD Arlington and USMD Fort Worth	'
Financial Information of Nonconsolidated Affiliates Accounted for Under Equity Method	'
	Financial information for USMD Arlington and USMD Forth Worth is as follows (in thousands):


		Three Months Ended						Nine Months Ended
		September 30,						September 30,
		2014		2013				2014			2013
	USMD Arlington:
	Revenue	$	24,159	$	22,895			$	67,711		$	67,044
	Income from operations	$	5,212	$	5,527			$	15,009		$	15,769
	Income from continuing operations	$	4,916	$	4,901			$	13,232		$	15,013
	Net income	$	4,916	$	4,901			$	13,232		$	15,013

	USMD Fort Worth:
	Revenue	$	10,873	$	9,405			$	29,417		$	26,988
	Income from operations	$	3,064	$	2,113			$	7,449		$	5,577
	Income from continuing operations	$	2,861	$	1,924			$	6,871		$	4,946
	Net income	$	2,861	$	1,924			$	6,871		$	4,946

Patient_Service_Revenue_Tables

Patient Service Revenue (Tables)	9 Months Ended
Patient Service Revenue (Tables)	Sep. 30, 2014
Patient Service Revenue	'
	The Company’s patient service revenue by payer is summarized in the table that follows (dollars in thousands):


			Three Months Ended September 30,																Nine Months Ended September 30,
			2014								2013								2014						2013
			Amount				Ratio of				Amount				Ratio of				Amount			Ratio of			Amount			Ratio of
							Net Patient								Net Patient							Net Patient						Net Patient
							Service								Service							Service						Service
							Revenue								Revenue							Revenue						Revenue
	Medicare		$	14,498				30.3	%		$	13,743				31	%		$	41,166			30.1	%	$	40,393			30.2	%
	Medicaid			350				0.7				309				0.7				1,084			0.8			1,079			0.8
	Managed care and commercial payers			33,185				69.3				30,775				69.5				94,274			68.9			91,472			68.4
	Self-pay			874				1.8				1,047				2.4				2,651			1.9			3,187			2.4

	Patient service revenue before provision for doubtful accounts			48,907				102.1				45,874				103.6				139,175			101.7			136,131			101.7
	Patient service revenue provision for doubtful accounts			(1,013	)			(2.1	)			(1,581	)			(3.6	)			(2,276	)		(1.7	)		(2,329	)		(1.7	)

	Net patient service revenue		$	47,894				100	%		$	44,293				100	%		$	136,899			100	%	$	133,802			100	%

Summary of Accounts Receivable Allowance	'
	A summary of the Company’s accounts receivable allowance for doubtful accounts activity is as follows (in thousands):


	Balance at				Provision				Provision				Write-offs				Balance at
	December 31,				for Doubtful				for								September 30,
	2013				Accounts				Doubtful								2014
					Related to				Accounts
					Patient
					Service
					Revenue

	$	1,758				2,276				186				(2,800	)		$	1,420

Intangible_Assets_Tables

Intangible Assets (Tables)	9 Months Ended
Intangible Assets (Tables)	Sep. 30, 2014
Components of Amortizable Intangible Assets	'
	The components of amortizable intangible assets consist of the following:


		September 30, 2014							December 31, 2013
		Gross		Accumulated			Net		Gross		Accumulated			Net
		Carrying		Amortization			Carrying		Carrying		Amortization			Carrying
		Amount					Amount		Amount					Amount
	Management agreements	$	5,246	$	(689	)	$	4,557	$	5,246	$	(544	)	$	4,702
	Trade names		11,168		(8,706	)		2,462		462		(123	)		339
	Customer relationships		767		(533	)		234		767		(341	)		426
	Noncompete agreements		12,547		(2,610	)		9,937		12,527		(1,667	)		10,860

		$	29,728	$	(12,538	)	$	17,190	$	19,002	$	(2,675	)	$	16,327

Estimated Amortization Expense for Intangible Assets through End of 2014 and during Next Five Years	'
	Total estimated amortization expense for the Company’s intangible assets through the end of 2014 and during the next five years is as follows (in thousands):


	October through December 2014	$	566
	2015	$	2,144
	2016	$	1,974
	2017	$	1,972
	2018	$	1,972
	2019	$	1,665

Other_Accrued_Liabilities_Tabl

Other Accrued Liabilities (Tables)	9 Months Ended
Other Accrued Liabilities (Tables)	Sep. 30, 2014
Summary of Other Accrued Liabilities	'
	Other accrued liabilities consist of the following (in thousands):


		September 30,		December 31,
		2014		2013
	Accrued payables	$	3,785	$	5,285
	Accrued bonus		980		1,860
	Other accrued liabilities		1,216		1,299
	IBNR payable		10,714		1,918
	Income taxes payable		1,987		395

		$	18,682	$	10,757

LongTerm_Debt_and_Capital_Leas1

Long-Term Debt and Capital Lease Obligations (Tables)	9 Months Ended
Long-Term Debt and Capital Lease Obligations (Tables)	Sep. 30, 2014
Schedule of Long-term Debt Instruments	'
	Long-term debt and capital lease obligations consist of the following (in thousands):


		September 30,			December 31,
		2014			2013
	Holdings:
	Credit Agreement:
	Term debt	$	7,500		$	15,687
	Revolving credit facility		1,500			3,000
	Convertible subordinated notes, net of unamortized discount of $3,125 and $3,503 at September 30, 2014 and December 31, 2013, respectively		21,217			20,839
	Subordinated related party notes payable		3,577			3,734
	Other note payable		68			120

			33,862			43,380
	Consolidated lithotripsy entities:
	Notes payable		1,355			1,766
	Capital lease obligations		778			1,052

			2,133			2,818

	Total long-term debt and capital lease obligations		35,995			46,198
	Less: current portion		(5,002	)		(8,492	)

	Long-term debt and capital lease obligations, less current portion	$	30,993		$	37,706

Maturities of Long-Term Debt	'
	Maturities of the Company’s long-term debt (as amended) are as follows as of September 30, 2014 (in thousands):


	October through December, 2014	$	1,369
	2015		5,214
	2016		3,711
	2017		2,921
	2018		785
	2019		24,342

	Total	$	38,342

Fair_Value_of_Financial_Instru1

Fair Value of Financial Instruments (Tables)	9 Months Ended
Fair Value of Financial Instruments (Tables)	Sep. 30, 2014
Carrying Value and Estimated Fair Value of Financial Instruments	'
	The carrying value and estimated fair value of the Company’s financial instruments that do not approximate fair value are set forth in the table below (in thousands):


		September 30, 2014				December 31, 2013
		Carrying		Fair Value		Carrying		Fair Value
		Value		Fair Value		Value		Fair Value
	Convertible subordinated notes	$	21,217	$	19,488	$	20,839	$	25,985
	Subordinated related party notes payable	$	3,577	$	3,399	$	3,734	$	3,481
	Consolidated lithotripsy entity notes payable	$	1,355	$	1,357	$	1,766	$	1,767
	Other note payable	$	68	$	69	$	120	$	124

ShareBased_Payment_Tables

Share-Based Payment (Tables)	9 Months Ended
Share-Based Payment (Tables)	Sep. 30, 2014
Weighted Average Assumptions Used in Black-Scholes Model for Stock Options	'
	Weighted-average assumptions used in the Black-Scholes option pricing model for stock options granted were as follows:


		Nine Months Ended
		September 30, 2014
	Risk-free interest rate		1.94	%
	Expected volatility of common stock		45	%
	Expected life of options		5.9 years
	Dividend yield		0	%
Summary of Stock Option Activity	'
	A summary of stock option activity for the nine months ended September 30, 2014 is as follows:


	Options	Number of			Weighted-		Weighted-		Aggregate
		Shares			Average		Average		Intrinsic
					Exercise		Remaining		Value
					Price		Contractual
							Term
							(in years)
	Outstanding as of December 31, 2013		583,697		$	25.39
	Granted		150,000			17.25
	Exercised		—			—			$	—
	Forfeited		(543	)		20.23

	Outstanding as of September 30, 2014		733,154		$	23.73		6.28	$	—

	Vested and expected to vest at September 30, 2014		382,084		$	24		5.71	$	—
	Exercisable at September 30, 2014		277,279		$	23.97		5.41	$	—

Earnings_per_Share_Tables

Earnings per Share (Tables)	9 Months Ended
Earnings per Share (Tables)	Sep. 30, 2014
Reconciliation of Numerators and Denominators of Basic and Diluted Earnings (Loss) Per Share and Computation of Basic and Diluted Earnings (Loss) Per Share	'
	The following table presents a reconciliation of the numerators and denominators of basic and diluted earnings (loss) per share and the computation of basic and diluted earnings (loss) per share (in thousands, except per share data):


		Three Months Ended						Nine Months Ended
		September 30,						September 30,
		2014			2013			2014			2013
	Numerator:
	Net loss attributable to USMD Holdings, Inc. - basic	$	(1,746	)	$	(436	)	$	(11,082	)	$	(122	)
	Effect of potentially dilutive securities:
	Interest on convertible subordinated notes, net of tax		—			—			—			—

	Net loss attributable to USMD Holdings, Inc. - diluted	$	(1,746	)	$	(436	)	$	(11,082	)	$	(122	)

	Denominator:
	Weighted-average common shares outstanding		10,177			10,088			10,151			10,071
	Effect of potentially dilutive securities:
	Stock options		—			—			—			—
	Convertible subordinated notes		—			—			—			—

	Weighted-average common shares outstanding assuming dilution		10,177			10,088			10,151			10,071

	Loss per share attributable to USMD Holdings, Inc.:
	Basic	$	(0.17	)	$	(0.04	)	$	(1.09	)	$	(0.01	)
	Diluted	$	(0.17	)	$	(0.04	)	$	(1.09	)	$	(0.01	)
Potential Shares Excluded from Diluted Loss per share Calculation	'
	The following table presents the potential shares excluded from the diluted loss per share calculation because the effect of including theses potential shares would be antidilutive (in thousands):


		Three Months Ended						Nine Months Ended
		September 30,						September 30,
		2014			2013			2014			2013
	Stock options		802			576			802			576
	Convertible subordinated notes		1,042			1,042			1,042			1,042

			1,844			1,618			1,844			1,618

Commitments_and_Contingencies_

Commitments and Contingencies (Tables)	9 Months Ended
Commitments and Contingencies (Tables)	Sep. 30, 2014
Schedule of Future Minimum Lease Commitments under Operating Leases	'
	Future minimum rental commitments under non-cancelable operating leases are as follows (in thousands):


	October through December, 2014	$	3,238
	2015		12,649
	2016		10,896
	2017		8,963
	2018		8,023
	2019		7,315
	Thereafter		33,907

	Total	$	84,991

Related_Party_Transactions_Tab

Related Party Transactions (Tables)	9 Months Ended
Related Party Transactions (Tables)	Sep. 30, 2014
Management and Other Services Revenue and Accounts Receivable	'
	Management and other services revenue and accounts receivable from these entities are as follows:


		Management and Other Services Revenue
		Three Months Ended September 30,				Nine Months Ended September 30,
		2014		2013		2014		2013
		(in thousands)
	USMD Arlington	$	2,689	$	2,624	$	7,855	$	7,797
	USMD Fort Worth		847		1,082		2,987		3,213
	Other equity method investees		406		413		1,398		944

		$	3,942	$	4,119	$	12,240	$	11,954



		Accounts Receivable
		September 30,		December 31,
		2014		2013
		(in thousands)
	USMD Arlington	$	370	$	388
	USMD Fort Worth		—		446
	Other equity method investees		154		203

		$	524	$	1,037

Description_of_Business_Basis_2

Description of Business, Basis of Presentation and Recently Issued Accounting Pronouncements - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2014
	State
	TreatmentCenter
	Hospital
	Lab
Description Of Company And Significant Accounting Policies [Line Items]	'
Providing Management and operational services to care hospitals	2
Number of cancer treatment center	4
Number of states for cancer treatment	3
Number of lithotripsy service providers	22
Numbers of managed hospitals in which the Company has ownership interests	2
Number of cancer treatment centers in which Company has ownership interests	2
Number of managed lithotripsy service centers in which Company has ownership interests	18
Number of wholly owned and operated Clinical Labs	2
Numbers of wholly owned and operated anatomical pathology laboratories	1
Number of wholly owned and operated cancer treatment centers	1
Number of wholly owned and operated lithotripsy service centers	1

Variable_Interest_Entity_Addit

Variable Interest Entity - Additional Information (Detail) (USD $)	3 Months Ended		9 Months Ended			3 Months Ended		9 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013	Dec. 31, 2013	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013	Jan. 31, 2014	31-May-13
	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013	Dec. 31, 2013	Variable Interest Entity, Primary Beneficiary	Variable Interest Entity, Primary Beneficiary	Variable Interest Entity, Primary Beneficiary	Variable Interest Entity, Primary Beneficiary	Variable Interest Entity, Primary Beneficiary	Variable Interest Entity, Primary Beneficiary
Variable Interest Entity [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Advance to WNI-DFW	'	'	'	'	'	'	'	'	'	$700,000	$100,000
Net capitated revenue	18,500,000	3,759,000	47,360,000	5,621,000	'	18,500,000	3,100,000	47,400,000	4,000,000	'	'
Income before provision for income taxes	258,000	2,009,000	-9,088,000	7,739,000	'	1,700,000	300,000	5,200,000	300,000	'	'
Accrued medical claims IBNR	$10,700,000	'	$10,700,000	'	$1,900,000	'	'	'	'	'	'

Carrying_Amount_of_Assets_and_

Carrying Amount of Assets and Liabilities of WNI-DFW (Detail) (USD $)	Sep. 30, 2014		Dec. 31, 2013		Sep. 30, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified	Sep. 30, 2014		Dec. 31, 2013		Sep. 30, 2013	Dec. 31, 2012
Current assets:	'		'		'	'
Cash and cash equivalents	$26,669	[1]	$13,137	[1]	$12,128	$6,878
Accounts receivable	21,741	[1]	23,970	[1]	'	'
Total current assets	59,088	[1]	47,606	[1]	'	'
Total assets	273,828	[1]	278,452	[1]	'	'
Current liabilities:	'		'		'	'
Accounts payable	9,845	[2]	2,500	[2]	'	'
Accrued payroll	16,044	[2]	12,599	[2]	'	'
Other accrued liabilities	1,216		1,299		'	'
Total current liabilities	50,229	[2]	35,407	[2]	'	'
Variable Interest Entity, Primary Beneficiary	'		'		'	'
Current assets:	'		'		'	'
Cash and cash equivalents	15,655		1,257		'	'
Accounts receivable	651		175		'	'
Prepaid expenses	27		'		'	'
Deferred tax asset	3,750		'		'	'
Total current assets	20,083		1,432		'	'
Deferred tax asset	'		671		'	'
Total assets	20,083		2,103		'	'
Current liabilities:	'		'		'	'
Accounts payable	4,245		'		'	'
Accrued payroll	378		'		'	'
Other accrued liabilities	12,945		2,108		'	'
Total current liabilities	$17,568		$2,108		'	'

[1]	Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 15,655 $ 1,257 Accounts receivable 651 175 Prepaid expenses 27 - Deferred tax asset 3,750 - Total current assets 20,083 1,432 Deferred tax asset - 671 Total assets $ 20,083 $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.
[2]	Liabilities of consolidated VIE included in total liabilities above (after elimination of intercompany transactions and balances): Accounts payable $ 6,541 $ - Accrued payroll 378 - Other accrued liabilities 12,945 2,108 Total current liabilities $ 19,864 $ 2,108 The liabilities of the consolidated VIE are obligations of the VIE and the creditors have no recourse to USMD Holdings, Inc.

Business_Combinations_Addition

Business Combinations - Additional Information (Detail) (Physician Practice, USD $)	9 Months Ended
	Sep. 30, 2014
	Entity
Physician Practice	'
Business Acquisition [Line Items]	'
Number of businesses acquired	4
Cash paid or payable as consideration in the business combination	$104,000
Number of equity instruments paid as consideration in the business combination	12,385
Business combination consideration, payable in common stock	167,000
Total noncompete agreement intangible assets	$20,536
Weighted-average amortization period of acquired intangible assets	'3 years 1 month 6 days

Estimated_Fair_Values_of_Asset

Estimated Fair Values of Assets Acquired at Business Combination Date (Detail) (USD $)	Sep. 30, 2014
In Thousands, unless otherwise specified	Sep. 30, 2014
Business Acquisition [Line Items]	'
Inventories	$38,022
Property and equipment	212,565
Identifiable intangible assets - noncompete agreements	20,536
Assets acquired	$271,123

Net_Carrying_Values_and_Owners

Net Carrying Values and Ownership Percentages of Nonconsolidated Affiliates Accounted for Under Equity Method (Detail) (USD $)	Sep. 30, 2014		Dec. 31, 2013
In Thousands, unless otherwise specified	Sep. 30, 2014		Dec. 31, 2013
Schedule of Equity Method Investments [Line Items]	'		'
Equity method investments	$59,005	[1]	$61,822	[1]
USMD Hospital at Arlington, L.P.	'		'
Schedule of Equity Method Investments [Line Items]	'		'
Equity method investments	48,727		50,055
Percentage of wholly-owned subsidiary	46.40%		46.40%
USMD Hospital at Fort Worth, L.P.	'		'
Schedule of Equity Method Investments [Line Items]	'		'
Equity method investments	10,098		11,246
Percentage of wholly-owned subsidiary	30.88%		30.88%
Other	'		'
Schedule of Equity Method Investments [Line Items]	'		'
Equity method investments	$180		$521
Other \| Minimum	'		'
Schedule of Equity Method Investments [Line Items]	'		'
Percentage of wholly-owned subsidiary	4.00%		4.00%
Other \| Maximum	'		'
Schedule of Equity Method Investments [Line Items]	'		'
Percentage of wholly-owned subsidiary	34.00%		34.00%

[1]	Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 15,655 $ 1,257 Accounts receivable 651 175 Prepaid expenses 27 - Deferred tax asset 3,750 - Total current assets 20,083 1,432 Deferred tax asset - 671 Total assets $ 20,083 $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.

Summarized_Financial_Informati

Summarized Financial Information for Individually Significant Equity Method Investees (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
USMD Hospital at Arlington, L.P.	'	'	'	'
Schedule of Equity Method Investments [Line Items]	'	'	'	'
Revenue	$24,159	$22,895	$67,711	$67,044
Income from operations	5,212	5,527	15,009	15,769
Income from continuing operations	4,916	4,901	13,232	15,013
Net income	4,916	4,901	13,232	15,013
USMD Hospital at Fort Worth, L.P.	'	'	'	'
Schedule of Equity Method Investments [Line Items]	'	'	'	'
Revenue	10,873	9,405	29,417	26,988
Income from operations	3,064	2,113	7,449	5,577
Income from continuing operations	2,861	1,924	6,871	4,946
Net income	$2,861	$1,924	$6,871	$4,946

Patient_Service_Revenue_Detail

Patient Service Revenue (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Health Care Organization, Receivable and Revenue Disclosures [Line Items]	'	'	'	'
Health care organization patient service revenue one	$48,907	$45,874	$139,175	$136,131
Patient service revenue provision for doubtful accounts, Amount	-1,013	-1,581	-2,276	-2,329
Net patient service revenue, Amount	47,894	44,293	136,899	133,802
Health care organization patient service revenue percentage	102.10%	103.60%	101.70%	101.70%
Patient service revenue provision for doubtful accounts, percentage	-2.10%	-3.60%	-1.70%	-1.70%
Net patient service revenue, Percentage	100.00%	100.00%	100.00%	100.00%
Medicare	'	'	'	'
Health Care Organization, Receivable and Revenue Disclosures [Line Items]	'	'	'	'
Health care organization patient service revenue one	14,498	13,743	41,166	40,393
Health care organization patient service revenue percentage	30.30%	31.00%	30.10%	30.20%
Medicaid	'	'	'	'
Health Care Organization, Receivable and Revenue Disclosures [Line Items]	'	'	'	'
Health care organization patient service revenue one	350	309	1,084	1,079
Health care organization patient service revenue percentage	0.70%	0.70%	0.80%	0.80%
Managed care and commercial payers	'	'	'	'
Health Care Organization, Receivable and Revenue Disclosures [Line Items]	'	'	'	'
Health care organization patient service revenue one	33,185	30,775	94,274	91,472
Health care organization patient service revenue percentage	69.30%	69.50%	68.90%	68.40%
Self-pay	'	'	'	'
Health Care Organization, Receivable and Revenue Disclosures [Line Items]	'	'	'	'
Health care organization patient service revenue one	$874	$1,047	$2,651	$3,187
Health care organization patient service revenue percentage	1.80%	2.40%	1.90%	2.40%

Summary_of_Accounts_Receivable

Summary of Accounts Receivable Allowance (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Allowance for Doubtful Accounts [Line Items]	'	'	'	'
Beginning balance	'	'	$1,758	'
Provision for Doubtful Accounts Related to Patient Service Revenue	1,013	1,581	2,276	2,329
Provision for Doubtful Accounts	138	99	186	112
Write-offs, net of Recoveries	'	'	-2,800	'
Ending balance	$1,420	'	$1,420	'

Intangible_Assets_Additional_I

Intangible Assets - Additional Information (Detail) (USD $)	9 Months Ended			9 Months Ended
	Sep. 30, 2014	15-May-14	Dec. 31, 2013	Sep. 30, 2014	31-May-14	Dec. 31, 2013
	Sep. 30, 2014	15-May-14	Dec. 31, 2013	Trade names	Trade names	Trade names
Intangible Assets Disclosure [Line Items]	'	'	'	'	'	'
Indefinite lived intangible asset, trade name	'	$10,700,000	'	'	'	'
Finite lived intangible asset, trade name	'	300,000	'	'	'	'
Impairment loss	'	'	'	8,400,000	'	'
Carrying value of trade names	29,728,000	'	19,002,000	11,168,000	2,600,000	462,000
Estimated useful life of trade names	'	'	'	'5 years	'	'
Amortization of intangible assets	$9,900,000	'	'	'	'	'

Components_of_Amortizable_Inta

Components of Amortizable Intangible Assets (Detail) (USD $)	Sep. 30, 2014	31-May-14	Dec. 31, 2013
In Thousands, unless otherwise specified	Sep. 30, 2014	31-May-14	Dec. 31, 2013
Finite-Lived Intangible Assets [Line Items]	'	'	'
Gross Carrying Amount	$29,728	'	$19,002
Accumulated Amortization	-12,538	'	-2,675
Net Carrying Amount	17,190	'	16,327
Management agreement	'	'	'
Finite-Lived Intangible Assets [Line Items]	'	'	'
Gross Carrying Amount	5,246	'	5,246
Accumulated Amortization	-689	'	-544
Net Carrying Amount	4,557	'	4,702
Trade names	'	'	'
Finite-Lived Intangible Assets [Line Items]	'	'	'
Gross Carrying Amount	11,168	2,600	462
Accumulated Amortization	-8,706	'	-123
Net Carrying Amount	2,462	'	339
Customer relationships	'	'	'
Finite-Lived Intangible Assets [Line Items]	'	'	'
Gross Carrying Amount	767	'	767
Accumulated Amortization	-533	'	-341
Net Carrying Amount	234	'	426
Noncompete agreements	'	'	'
Finite-Lived Intangible Assets [Line Items]	'	'	'
Gross Carrying Amount	12,547	'	12,527
Accumulated Amortization	-2,610	'	-1,667
Net Carrying Amount	$9,937	'	$10,860

Estimated_Amortization_Expense

Estimated Amortization Expense for Intangible Assets through End of 2014 and during Next Five Years (Detail) (USD $)	Sep. 30, 2014
In Thousands, unless otherwise specified	Sep. 30, 2014
Finite-Lived Intangible Assets [Line Items]	'
October through December 2014	$566
2015	2,144
2016	1,974
2017	1,972
2018	1,972
2019	$1,665

Summary_of_Other_Accrued_Liabi

Summary of Other Accrued Liabilities (Detail) (USD $)	Sep. 30, 2014		Dec. 31, 2013
In Thousands, unless otherwise specified	Sep. 30, 2014		Dec. 31, 2013
Other Accrued Liabilities	'		'
Accrued payables	$3,785		$5,285
Accrued bonus	980		1,860
Other accrued liabilities	1,216		1,299
IBNR payable	10,714		1,918
Income taxes payable	1,987		395
Other accrued liabilities	$18,682	[1]	$10,757	[1]

[1]	Liabilities of consolidated VIE included in total liabilities above (after elimination of intercompany transactions and balances): Accounts payable $ 6,541 $ - Accrued payroll 378 - Other accrued liabilities 12,945 2,108 Total current liabilities $ 19,864 $ 2,108 The liabilities of the consolidated VIE are obligations of the VIE and the creditors have no recourse to USMD Holdings, Inc.

Long_Term_Debt_and_Capital_Lea

Long Term Debt and Capital Lease Obligations (Detail) (USD $)	Sep. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified	Sep. 30, 2014	Dec. 31, 2013
Schedule of Long-term Debt Instruments	'	'
Total long-term debt and capital lease obligations	$35,995	$46,198
Less: current portion	-5,002	-8,492
Long-term debt and capital lease obligations, less current portion	30,993	37,706
Total long-term debt and capital lease obligations	35,995	46,198
USMD Holdings	'	'
Schedule of Long-term Debt Instruments	'	'
Term debt	7,500	15,687
Revolving credit facility	1,500	3,000
Convertible subordinated notes	21,217	20,839
Subordinated related party notes payable	3,577	3,734
Other note payable	68	120
Total long-term debt and capital lease obligations	33,862	43,380
Total long-term debt and capital lease obligations	33,862	43,380
Lithotripsy Entity	'	'
Schedule of Long-term Debt Instruments	'	'
Notes payable	1,355	1,766
Capital lease obligations	778	1,052
Total long-term debt and capital lease obligations	2,133	2,818
Total long-term debt and capital lease obligations	$2,133	$2,818

Long_Term_Debt_and_Capital_Lea1

Long Term Debt and Capital Lease Obligations (Parenthetical) (Detail) (USMD Holdings, USD $)	Sep. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified	Sep. 30, 2014	Dec. 31, 2013
USMD Holdings	'	'
Debt Instrument [Line Items]	'	'
Convertible subordinated notes, unamortized discount	$3,125	$3,503

LongTerm_Debt_and_Capital_Leas2

Long-Term Debt and Capital Lease Obligations - Additional Information (Detail) (USD $)	0 Months Ended	9 Months Ended			3 Months Ended				3 Months Ended	9 Months Ended
In Millions, unless otherwise specified	Sep. 22, 2014	Sep. 30, 2014	Mar. 31, 2014	Mar. 31, 2014	Jun. 30, 2014	Mar. 31, 2014	Mar. 31, 2014	Jun. 30, 2014	Sep. 30, 2014	Sep. 30, 2014
	Revolving Credit Facility	Revolving Credit Facility	Revolving Credit Facility	Revolving Credit Facility	Revolving Credit Facility	Revolving Credit Facility	Revolving Credit Facility	Revolving Credit Facility	Revolving Credit Facility	Term Loans
			Before Amendment	After Amendment	Amendment No. 4	Amendment No. 4	Amendment No. 4	Amendment No. 4	Amendment No. 4	Amendment No. 4
					Quarter	Quarter	Minimum	Minimum	Scenario, Forecast	Tranche C
									Quarter
Debt Instrument [Line Items]	'	'	'	'	'	'	'	'	'	'
Revolver termination date	'	30-Jun-15	'	'	'	'	'	'	'	'
Aggregate principal amount	'	'	$10	$3	'	'	'	'	'	$5
Debt instrument restrictive covenants	'	'Amendment No. 4 also prohibited scheduled payments of principal and interest on the Company's subordinated related party notes payable through September 30, 2014.	'	'	'	'	'	'	'	'
Repayment of principal credit amount	1.5	'	'	'	'	'	'	'	'	'
Debt instrument fixed charge coverage ratio	'	'	'	'	'	'	35.00%	125.00%	'	'
Number of quarters for debt instrument fixed charge coverage ratios	'	'	'	'	4	4	'	'	'	'
Fixed charge coverage ratio, Covenant end date	'	'	'	'	31-Aug-17	'	'	'	'	'
Debt instrument senior leverage ratio	'	'	'	'	125.00%	310.00%	'	'	100.00%	'
Number of quarters for debt instrument senior leverage ratio	'	'	'	'	4	4	'	'	4	'
Adjusted earnings before interest tax, depreciation and amortization	'	'	'	'	'	'	0.8	'	'	'
Credit agreement compensation balance	'	'	'	'	'	'	'	'	'	5
Term loan, maturity date	'	'	'	'	'	'	'	'	'	21-Apr-14
Available borrowing capacity under revolving credit facility	'	$1.50	'	'	'	'	'	'	'	'

Maturities_of_LongTerm_Debt_De

Maturities of Long-Term Debt (Detail) (USD $)	Sep. 30, 2014
In Thousands, unless otherwise specified	Sep. 30, 2014
Debt Instrument [Line Items]	'
October through December, 2014	$1,369
2015	5,214
2016	3,711
2017	2,921
2018	785
2019	24,342
Total	$38,342

Fair_Value_of_Financial_Instru2

Fair Value of Financial Instruments - Additional Information (Detail) (USD $)	9 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2014	15-May-14
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Discount rate on trade name royalty	17.00%	'
Trade names	'	'
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Intangible asset, trade name	'	$11
Estimated fair value of acquired trade names	2.6	'
Impairment loss	$8.40	'
Estimated useful life of trade names	'5 years	'
Maximum	'	'
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Pre-tax royalty rate	1.00%	'
Minimum	'	'
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Pre-tax royalty rate	0.10%	'

Carrying_Value_and_Estimated_F

Carrying Value and Estimated Fair Value of Financial Instruments (Detail) (USD $)	Sep. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified	Sep. 30, 2014	Dec. 31, 2013
Carrying Value \| Convertible subordinated notes Payable	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	$21,217	$20,839
Carrying Value \| Subordinated Related Party Notes Payable	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	3,577	3,734
Carrying Value \| Lithotripsy Entity	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	1,355	1,766
Carrying Value \| Notes Payable, Other Payables	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	68	120
Fair Value \| Convertible subordinated notes Payable	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	19,488	25,985
Fair Value \| Subordinated Related Party Notes Payable	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	3,399	3,481
Fair Value \| Lithotripsy Entity	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	1,357	1,767
Fair Value \| Notes Payable, Other Payables	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	$69	$124

ShareBased_Payment_Additional_

Share-Based Payment - Additional Information (Detail) (USD $)

9 Months Ended

1 Months Ended

3 Months Ended

9 Months Ended

0 Months Ended

9 Months Ended

0 Months Ended

7 Months Ended

9 Months Ended

Sep. 30, 2014

Aug. 31, 2014

Sep. 30, 2014

Jul. 14, 2014

Jun. 06, 2014

Sep. 30, 2014

Jun. 06, 2014

Sep. 30, 2014

Mar. 06, 2014

Jul. 31, 2014

Sep. 30, 2014

Salary Deferral Plan

USMD Holdings

Equity Compensation Plan

Minimum

Maximum

Consultant

Senior Management

Board of Directors

Equity Compensation Plan

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Common stock for issuance

1,000,000

2,500,000

Stock options, contractual life

'10 years

Holdings reserved shares for grant

1,700,000

1,600,000

Stock option granted weighted average fair value

$6.80

Salaries, wages and employee benefits

$229,000

$998,000

Unrecognized compensation cost related to unvested share-based compensation awards

2,900,000

Share-based payment remaining weighted-average period

'3 years 1 month 6 days

Number of shares, granted

150,000

15,700

41,675

Common stock fair value

150,000

243,000

373,000

478,000

Number of shares, issued

14,958

29,600

Number of shares granted to consultant in payment of service rendered

3,343

Grant date fair value of shares granted to consultant in payment of service rendered

38,000

Number of shares issued to consultant in payment of service rendered

2,853

Grant date fair value of shares issued to consultant in payment of service rendered

$34,000

Number of common stock not registered under Securities Act

19,501

Weighted_Average_Assumptions_U

Weighted Average Assumptions Used in Black-Scholes Model for Stock Options (Detail)	9 Months Ended
	Sep. 30, 2014
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'
Risk-free interest rate	1.94%
Expected volatility of common stock	45.00%
Expected life of options	'5 years 10 months 24 days
Dividend yield	0.00%

Summary_of_Stock_Option_Activi

Summary of Stock Option Activity (Detail) (USD $)	9 Months Ended
Summary of Stock Option Activity (Detail) (USD $)	Sep. 30, 2014
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'
Opening balance of Number of Shares Outstanding	583,697
Number of shares, granted	150,000
Number of Shares, Exercised	'
Number of Shares, Forfeited	-543
Ending balance of Number of Shares Outstanding	733,154
Ending balance of Number of Shares, Vested and expected to vest	382,084
Ending balance of Number of Shares, Exercisable	277,279
Opening balance of Weighted-Average Exercise Price Outstanding	$25.39
Weighted-Average Exercise Price, Granted	$17.25
Weighted-Average Exercise Price, Exercised	'
Weighted-Average Exercise Price, Forfeited	$20.23
Ending balance of Weighted-Average Exercise Price, Outstanding	$23.73
Ending balance of Weighted-Average Exercise Price, Vested and expected to vest	$24
Ending balance of Weighted-Average Exercise Price, Exercisable	$23.97
Ending balance of Weighted-Average Remaining Contractual Term, Outstanding	'6 years 3 months 11 days
Ending balance of Weighted-Average Remaining Contractual Term, Vested and expected to vest	'5 years 8 months 16 days
Ending balance of Weighted-Average Remaining Contractual Term, Exercisable	'5 years 4 months 28 days
Exercised, Aggregate Intrinsic Value	'
Ending balance of Aggregate Intrinsic Value, Outstanding	'
Ending balance of Aggregate Intrinsic Value, Vested and expected to vest	'
Ending balance of Aggregate Intrinsic Value, Exercisable	'

Reconciliation_of_Numerators_a

Reconciliation of Numerators and Denominators of Basic and Diluted Earnings (Loss) Per Share and Computation of Basic and Diluted Earnings (Loss) Per Share (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Numerator:	'	'	'	'
Net loss attributable to USMD Holdings, Inc. - basic	($1,746)	($436)	($11,082)	($122)
Interest on convertible subordinated notes, net of tax	'	'	'	'
Net loss attributable to USMD Holdings, Inc. - diluted	($1,746)	($436)	($11,082)	($122)
Denominator:	'	'	'	'
Weighted-average common shares outstanding	10,177	10,088	10,151	10,071
Stock options	'	'	'	'
Convertible subordinated notes	'	'	'	'
Weighted-average common shares outstanding assuming dilution	10,177	10,088	10,151	10,071
Loss per share attributable to USMD Holdings, Inc.:	'	'	'	'
Basic	($0.17)	($0.04)	($1.09)	($0.01)
Diluted	($0.17)	($0.04)	($1.09)	($0.01)

Potential_Shares_Excluded_from

Potential Shares Excluded from Diluted Loss per share Calculation (Detail)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]	'	'	'	'
Antidilutive Securities Excluded From Computation of Earnings Per Share	1,844	1,618	1,844	1,618
Stock Option	'	'	'	'
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]	'	'	'	'
Antidilutive Securities Excluded From Computation of Earnings Per Share	802	576	802	576
Convertible Subordinated Notes	'	'	'	'
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]	'	'	'	'
Antidilutive Securities Excluded From Computation of Earnings Per Share	1,042	1,042	1,042	1,042

Commitments_and_Contingencies_1

Commitments and Contingencies - Additional Information (Detail) (USD $)	0 Months Ended		1 Months Ended	9 Months Ended
	Apr. 18, 2014	Oct. 26, 2012	Nov. 30, 2012	Sep. 30, 2014	Oct. 26, 2012
	Apr. 18, 2014	Oct. 26, 2012	Nov. 30, 2012	Sep. 30, 2014	Installment
Commitments and Contingencies Disclosure [Line Items]	'	'	'	'	'
Maximum aggregate payments to pay the obligations due	'	'	'	$19,600,000	'
Remaining terms of guarantees	'	'	'	'The remaining terms of these guarantees range from four to 65 months.	'
Claim settlement amount	'	'	'	'	650,000
Number of installments to pay settlement amount	'	'	'	'	55
Installments on the first day of each of month	'	10,000	'	'	'
Cash received associated with the settlement	342,500	'	100,000	'	'
Medical Negligence Lawsuits	'	'	'	'	'
Commitments and Contingencies Disclosure [Line Items]	'	'	'	'	'
Estimate range of loss, minimum	'	'	'	500,000	'
Estimate range of loss, maximum	'	'	'	1,200,000	'
Minimum	'	'	'	'	'
Commitments and Contingencies Disclosure [Line Items]	'	'	'	'	'
Remaining terms of guarantees	'	'	'	'4 months	'
Financial transactions amounts	'	'	'	1,000,000	'
Maximum	'	'	'	'	'
Commitments and Contingencies Disclosure [Line Items]	'	'	'	'	'
Remaining terms of guarantees	'	'	'	'65 months	'
Financial transactions amounts	'	'	'	$2,500,000	'

Future_Minimum_Lease_Commitmen

Future Minimum Lease Commitments Under Operating Leases (Detail) (USD $)	Sep. 30, 2014
In Thousands, unless otherwise specified	Sep. 30, 2014
Commitments and Contingencies Disclosure [Line Items]	'
Minimum Lease Commitments October through December 2014	$3,238
Minimum Lease Commitments 2015	12,649
Minimum Lease Commitments 2016	10,896
Minimum Lease Commitments 2017	8,963
Minimum Lease Commitments 2018	8,023
Minimum Lease Commitments 2019	7,315
Minimum Lease Commitments Thereafter	33,907
Minimum Lease Commitments Total	$84,991

Management_and_Other_Services_

Management and Other Services Revenue and Accounts Receivable (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013	Dec. 31, 2013
Related Party Transaction [Line Items]	'	'	'	'	'
Management and Other Services Revenue	$3,942	$4,119	$12,240	$11,954	'
Accounts Receivable	524	'	524	'	1,037
USMD Hospital at Arlington, L.P.	'	'	'	'	'
Related Party Transaction [Line Items]	'	'	'	'	'
Management and Other Services Revenue	2,689	2,624	7,855	7,797	'
Accounts Receivable	370	'	370	'	388
USMD Hospital at Fort Worth, L.P.	'	'	'	'	'
Related Party Transaction [Line Items]	'	'	'	'	'
Management and Other Services Revenue	847	1,082	2,987	3,213	'
Accounts Receivable	'	'	'	'	446
Other	'	'	'	'	'
Related Party Transaction [Line Items]	'	'	'	'	'
Management and Other Services Revenue	406	413	1,398	944	'
Accounts Receivable	$154	'	$154	'	$203

Related_Party_Transactions_Add

Related Party Transactions - Additional Information (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Related Party Transaction [Line Items]	'	'	'	'
Lithotripsy revenue	$5,742	$5,492	$15,930	$16,157
Leased space rent expense	4,105	3,770	11,780	10,945
USMD Arlington and USMD Fort Worth	'	'	'	'
Related Party Transaction [Line Items]	'	'	'	'
Lithotripsy revenue	500	600	1,600	1,600
USMD Hospital at Arlington, L.P.	'	'	'	'
Related Party Transaction [Line Items]	'	'	'	'
Leased space rent expense	$500	$400	$1,400	$1,300

Subsequent_Events_Additional_I

Subsequent Events - Additional Information (Detail) (Subsequent Event, One-time Termination Benefits, USD $)	1 Months Ended
In Millions, unless otherwise specified	Oct. 31, 2014
	Employee
First Group of Impacted Employees	'
Subsequent Event [Line Items]	'
Liability related to employees termination plan	$0.40
Number of employees terminated	67
Second Group of Impacted Employees	'
Subsequent Event [Line Items]	'
Expected remaining employees to be terminated	26
Expected remaining termination cost	$0.30