Document and Entity Information
Document and Entity Information - shares | 9 Months Ended | |
Sep. 30, 2015 | Oct. 31, 2015 | |
Document Information [Line Items] | ||
Document Type | 10-Q | |
Amendment Flag | false | |
Document Period End Date | Sep. 30, 2015 | |
Document Fiscal Year Focus | 2,015 | |
Document Fiscal Period Focus | Q3 | |
Trading Symbol | UHS | |
Entity Registrant Name | UNIVERSAL HEALTH SERVICES INC | |
Entity Central Index Key | 352,915 | |
Current Fiscal Year End Date | --12-31 | |
Entity Filer Category | Large Accelerated Filer | |
Class A | ||
Document Information [Line Items] | ||
Entity Common Stock, Shares Outstanding | 6,595,308 | |
Class B | ||
Document Information [Line Items] | ||
Entity Common Stock, Shares Outstanding | 91,189,549 | |
Class C | ||
Document Information [Line Items] | ||
Entity Common Stock, Shares Outstanding | 663,940 | |
Class D | ||
Document Information [Line Items] | ||
Entity Common Stock, Shares Outstanding | 23,742 |
Condensed Consolidated Statemen
Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2015 | Sep. 30, 2014 | Sep. 30, 2015 | Sep. 30, 2014 | |
Income Statement [Abstract] | ||||
Net revenues before provision for doubtful accounts | $ 2,439,071 | $ 2,196,513 | $ 7,271,852 | $ 6,570,732 |
Less: Provision for doubtful accounts | 211,416 | 157,796 | 543,640 | 541,935 |
Net revenues | 2,227,655 | 2,038,717 | 6,728,212 | 6,028,797 |
Operating charges: | ||||
Salaries, wages and benefits | 1,057,226 | 953,583 | 3,132,993 | 2,850,868 |
Other operating expenses | 529,383 | 533,753 | 1,571,060 | 1,394,326 |
Supplies expense | 242,259 | 222,708 | 721,979 | 662,280 |
Depreciation and amortization | 99,442 | 93,456 | 295,697 | 277,506 |
Lease and rental expense | 24,544 | 23,860 | 70,631 | 70,656 |
Electronic health records incentive income | (356) | (1,425) | (1,751) | (4,029) |
Costs related to extinguishment of debt | 0 | 36,171 | 0 | 36,171 |
Operating Expenses, Total | 1,952,498 | 1,862,106 | 5,790,609 | 5,287,778 |
Income from operations | 275,157 | 176,611 | 937,603 | 741,019 |
Interest expense, net | 27,130 | 32,133 | 84,851 | 102,413 |
Income before income taxes | 248,027 | 144,478 | 852,752 | 638,606 |
Provision for income taxes | 84,373 | 48,440 | 293,371 | 224,102 |
Net income | 163,654 | 96,038 | 559,381 | 414,504 |
Less: Income attributable to noncontrolling interests | 13,367 | 13,241 | 52,602 | 41,958 |
Net income attributable to UHS | $ 150,287 | $ 82,797 | $ 506,779 | $ 372,546 |
Basic earnings per share attributable to UHS | $ 1.52 | $ 0.84 | $ 5.12 | $ 3.77 |
Diluted earnings per share attributable to UHS | $ 1.48 | $ 0.82 | $ 5.02 | $ 3.71 |
Weighted average number of common shares - basic | 98,858 | 99,052 | 98,924 | 98,832 |
Add: Other share equivalents | 2,301 | 1,981 | 1,987 | 1,643 |
Weighted average number of common shares and equivalents - diluted | 101,159 | 101,033 | 100,911 | 100,475 |
Condensed Consolidated Stateme3
Condensed Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2015 | Sep. 30, 2014 | Sep. 30, 2015 | Sep. 30, 2014 | |
Statement Of Income And Comprehensive Income [Abstract] | ||||
Net income | $ 163,654 | $ 96,038 | $ 559,381 | $ 414,504 |
Other comprehensive income (loss): | ||||
Unrealized derivative gains (losses) on cash flow hedges | (9,888) | 4,712 | (4,950) | 12,922 |
Amortization of terminated hedge | (84) | (84) | (252) | (252) |
Foreign currency translation adjustment | (2,304) | (2,506) | (96) | (2,506) |
Other comprehensive income before tax | (12,276) | 2,122 | (5,298) | 10,164 |
Income tax expense related to items of other comprehensive income | (3,742) | 1,620 | (1,530) | 4,685 |
Total other comprehensive income, net of tax | (8,534) | 502 | (3,768) | 5,479 |
Comprehensive income | 155,120 | 96,540 | 555,613 | 419,983 |
Less: Comprehensive income attributable to noncontrolling interests | 13,367 | 13,241 | 52,602 | 41,958 |
Comprehensive income attributable to UHS | $ 141,753 | $ 83,299 | $ 503,011 | $ 378,025 |
Condensed Consolidated Balance
Condensed Consolidated Balance Sheets - USD ($) $ in Thousands | Sep. 30, 2015 | Dec. 31, 2014 | Sep. 30, 2014 | Dec. 31, 2013 |
Current assets: | ||||
Cash and cash equivalents | $ 39,523 | $ 32,069 | $ 39,711 | $ 17,238 |
Accounts receivable, net | 1,328,300 | 1,282,735 | ||
Supplies | 112,718 | 108,115 | ||
Deferred income taxes | 134,554 | 114,565 | ||
Other current assets | 81,459 | 77,654 | ||
Total current assets | 1,696,554 | 1,615,138 | ||
Property and equipment | 6,515,914 | 6,212,030 | ||
Less: accumulated depreciation | (2,739,822) | (2,532,341) | ||
Property, plant and equipment, net, Total | 3,776,092 | 3,679,689 | ||
Other assets: | ||||
Goodwill | 3,388,378 | 3,291,213 | ||
Deferred charges | 35,113 | 40,319 | ||
Other | 310,741 | 348,084 | ||
Total assets | 9,206,878 | 8,974,443 | $ 8,961,592 | |
Current liabilities: | ||||
Current maturities of long-term debt | 84,883 | 68,319 | ||
Accounts payable and accrued liabilities | 1,102,616 | 1,113,062 | ||
Federal and state taxes | 8,697 | 1,446 | ||
Total current liabilities | 1,196,196 | 1,182,827 | ||
Other noncurrent liabilities | 292,441 | 268,555 | ||
Long-term debt | 3,009,954 | 3,210,215 | ||
Deferred income taxes | 264,358 | 282,214 | ||
Redeemable noncontrolling interests | 250,213 | 239,552 | ||
Equity: | ||||
UHS common stockholders’ equity | 4,133,099 | 3,735,946 | ||
Noncontrolling interest | 60,617 | 55,134 | ||
Total equity | 4,193,716 | 3,791,080 | ||
Liabilities and Equity, Total | $ 9,206,878 | $ 8,974,443 |
Condensed Consolidated Stateme5
Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 9 Months Ended | |
Sep. 30, 2015 | Sep. 30, 2014 | |
Cash Flows from Operating Activities: | ||
Net income | $ 559,381 | $ 414,504 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation & amortization | 295,697 | 277,506 |
Stock-based compensation expense | 30,145 | 22,713 |
Gains on sales of assets and businesses, net of losses | (1,037) | (7,837) |
Write-off of deferred financing costs related to extinguishment of debt | 0 | 19,730 |
Changes in assets & liabilities, net of effects from acquisitions and dispositions: | ||
Accounts receivable | (60,877) | (98,193) |
Accrued interest | (297) | 6,547 |
Accrued and deferred income taxes | (12,568) | (18,392) |
Other working capital accounts | (54,018) | 59,613 |
Other assets and deferred charges | 6,629 | 15,868 |
Other | 13,140 | (7,000) |
Accrued insurance expense, net of commercial premiums paid | 75,715 | 57,729 |
Payments made in settlement of self-insurance claims | (55,411) | (53,234) |
Net cash provided by operating activities | 796,499 | 689,554 |
Cash Flows from Investing Activities: | ||
Property and equipment additions, net of disposals | (269,578) | (309,361) |
Proceeds received from sale of assets and businesses | 2,744 | 15,178 |
Acquisition of property and businesses | (183,103) | (402,405) |
Costs incurred for purchase and implementation of electronic health records application | 0 | (11,204) |
Net cash used in investing activities | (449,937) | (707,792) |
Cash Flows from Financing Activities: | ||
Reduction of long-term debt | (207,371) | (842,543) |
Additional borrowings | 16,300 | 969,800 |
Financing costs | 0 | (13,413) |
Repurchase of common shares | (129,862) | (63,292) |
Dividends paid | (29,696) | (19,794) |
Issuance of common stock | 6,030 | 4,907 |
Excess income tax benefits related to stock-based compensation | 29,287 | 30,242 |
Profit distributions to noncontrolling interests | (35,965) | (25,074) |
Proceeds received from sale/leaseback of real property | 12,765 | 0 |
Net cash (used in) provided by financing activities | (338,512) | 40,833 |
Effect of exchange rate changes on cash and cash equivalents | (596) | (122) |
Increase in cash and cash equivalents | 7,454 | 22,473 |
Cash and cash equivalents, beginning of period | 32,069 | 17,238 |
Cash and cash equivalents, end of period | 39,523 | 39,711 |
Supplemental Disclosures of Cash Flow Information: | ||
Interest paid, including early redemption premium and original issue discount write-off in 2014 | 79,866 | 98,670 |
Income taxes paid, net of refunds | 274,124 | 212,148 |
Noncash purchases of property and equipment | $ 37,228 | $ 25,326 |
General
General | 9 Months Ended |
Sep. 30, 2015 | |
Organization Consolidation And Presentation Of Financial Statements [Abstract] | |
General | (1) General This Quarterly Report on Form 10-Q is for the quarterly period ended September 30, 2015. In this Quarterly Report, “we,” “us,” “our” “UHS” and the “Company” refer to Universal Health Services, Inc. and its subsidiaries. The condensed consolidated financial statements include the accounts of our majority-owned subsidiaries and partnerships and limited liability companies controlled by us, or our subsidiaries, as managing general partner or managing member. The condensed consolidated financial statements included herein have been prepared by us, without audit, pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”) and reflect all adjustments (consisting only of normal recurring adjustments) which, in our opinion, are necessary to fairly state results for the interim periods. Certain information and footnote disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States of America have been condensed or omitted pursuant to such rules and regulations, although we believe that the accompanying disclosures are adequate to make the information presented not misleading. These condensed consolidated financial statements should be read in conjunction with the consolidated financial statements, significant accounting policies and the notes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2014. Provider Taxes: We incur health-care related taxes (“Provider Taxes”) imposed by states in the form of a licensing fee, assessment or other mandatory payment which are related to: (i) healthcare items or services; (ii) the provision of, or the authority to provide, the health care items or services, or; (iii) the payment for the health care items or services. Such Provider Taxes are subject to various federal regulations that limit the scope and amount of the taxes that can be levied by states in order to secure federal matching funds as part of their respective state Medicaid programs. We derive a related Medicaid reimbursement benefit from assessed Provider Taxes in the form of Medicaid claims based payment increases and/or lump sum Medicaid supplemental payments. Under these programs, including the impact of Uncompensated Care and Upper Payment Limit programs, and the Texas Delivery System Reform Incentive program, we earned revenues (before Provider Taxes) of approximately $62 million and $53 million during the three-month periods ended September 30, 2015 and 2014, respectively, and approximately $221 million and $180 million during the nine-month periods ended September 30, 2015 and 2014, respectively. These revenues were offset by Provider Taxes of approximately $30 million and $21 million during the three-month periods ended September 30, 2015 and 2014, respectively, and approximately $97 million and $71 million during the nine-month periods ended September 30, 2015 and 2014, respectively, which are recorded in other operating expenses on the Condensed Consolidated Statements of Income as included herein. Prior to 2015, these Provider Taxes were recorded as a reduction to our net revenues. Accordingly, the unaudited Condensed Consolidated Statements of Income for the three and nine-month periods ended September 30, 2014 have been revised to reflect the current period classification, resulting in an increase in net revenue and an increase in other operating expenses of $21 million and $71 million, respectively. We assessed this adjustment to the classification and concluded that it was not material to our previously issued annual and quarterly Consolidated Statements of Income, which will be revised in future filings. Goodwill and Intangible Assets: During the quarter-ended September 30, 2015, we changed our annual goodwill and indefinite-lived intangibles testing date from September 1st to October 1st. Management believes that this voluntary change in accounting method is preferable as it aligns the annual impairment testing date with our annual budgeting process. In connection with this change, we first performed an impairment test as of September 1, 2015, which indicated no impairment of goodwill or indefinite-lived intangible assets, and will perform an additional impairment test as of October 1, 2015. This change in annual testing date does not delay, accelerate or avoid an impairment charge. |
Relationship with Universal Hea
Relationship with Universal Health Realty Income Trust and Related Party Transactions | 9 Months Ended |
Sep. 30, 2015 | |
Related Party Transactions [Abstract] | |
Relationship with Universal Health Realty Income Trust and Related Party Transactions | (2) Relationship with Universal Health Realty Income Trust and Related Party Transactions Relationship with Universal Health Realty Income Trust: Universal Health Realty Income Trust (the “Trust”) commenced operations in 1986 by purchasing certain properties from us and immediately leasing the properties back to our respective subsidiaries. Most of the leases were entered into at the time the Trust commenced operations and provided for initial terms of 13 to 15 years with up to six additional 5-year renewal terms. Each lease also provided for additional or bonus rental, as discussed below. The base rents are paid monthly and the bonus rents are computed and paid on a quarterly basis, based upon a computation that compares current quarter revenue to a corresponding quarter in the base year. The leases with our subsidiaries are unconditionally guaranteed by us and are cross-defaulted with one another. At September 30, 2015, we held approximately 5.9% of the outstanding shares of the Trust. We serve as Advisor to the Trust under an annually renewable advisory agreement pursuant to the terms of which we conduct the Trust’s day-to-day affairs, provide administrative services and present investment opportunities. In addition, certain of our officers and directors are also officers and/or directors of the Trust. Management believes that it has the ability to exercise significant influence over the Trust, therefore we account for our investment in the Trust using the equity method of accounting. We earned an advisory fee from the Trust, which is included in net revenues in the accompanying consolidated statements of income, of approximately $700,000 during each of the three-month periods ended September 30, 2015 and 2014, and approximately $2.1 million and $1.9 million during the nine-month periods ended September 30, 2015 and 2014, respectively. Our pre-tax share of income from the Trust was approximately $100,000 and $1.7 million during the three-month periods ended September 30, 2015 and 2014, respectively, and approximately $1.1 million and $2.1 million for the nine-month periods ended September 30, 2015 and 2014, respectively. Included in our share of the Trust’s income for the nine months ended September 30, 2015, is our share of a gain realized by the Trust in connection with a property exchange transaction completed during the second quarter of 2015. Included in our share of the Trust’s income for the three and nine-month periods ended September 30, 2014, was approximately $1.6 million related to our share of an aggregate gain on fair value recognition recorded by the Trust during the first and third quarters of 2014 in connection with its purchase of third-party minority ownership interests in various limited liability companies at which the Trust formerly held noncontrolling majority ownership interests (the Trust now owns 100% of each of these entities). The carrying value of this investment was approximately $9.0 million and $9.3 million at September 30, 2015 and December 31, 2014, respectively, and is included in other assets in the accompanying consolidated balance sheets. The market value of our investment in the Trust was $37.0 million at September 30, 2015 and $37.9 million at December 31, 2014, based on the closing price of the Trust’s stock on the respective dates. During the first quarter of 2015, wholly-owned subsidiaries of ours sold to and leased back from the Trust, two recently constructed free-standing emergency departments (“FEDs”) located in Texas which were completed and opened during the first quarter of 2015. In conjunction with these transactions, ten-year lease agreements with six, five-year renewal options have been executed with the Trust. We have the option to purchase the properties upon the expiration of the fixed terms and each five-year renewal terms at the fair market value of the property. The aggregate construction cost/sales proceeds of these facilities was approximately $13 million, and the aggregate rent expense paid to the Trust at the commencement of the leases will approximate $900,000 annually. In December, 2014, upon the expiration of the lease term, we elected to purchase from the Trust for $17.3 million, the real property of The Bridgeway, a 103-bed behavioral health care facility located in North Little Rock, Arkansas. Pursuant to the terms of the lease, we and the Trust were both required to obtain appraisals of the property to determine its fair market value/purchase price. The rent expense paid by us to the Trust, prior to our purchase of The Bridgeway’s real property in December, 2014, was approximately $1.1 million annually. The table below details the renewal options and terms for each of our three acute care hospital facilities leased from the Trust as of September 30, 2015: Hospital Name Annual Minimum Rent End of Lease Term Renewal Term (years) McAllen Medical Center $ 5,485,000 December, 2016 15(a) Wellington Regional Medical Center $ 3,030,000 December, 2016 15(b) Southwest Healthcare System, Inland Valley Campus $ 2,648,000 December, 2016 15(b) (a) We have three 5-year renewal options at existing lease rates (through 2031). (b) We have one 5-year renewal option at existing lease rates (through 2021) and two 5-year renewal options at fair market value lease rates (2022 through 2031). Total rent expense under the operating leases on these three hospital facilities was approximately $4 million during each of the three months ended September 30, 2015 and 2014, and approximately $12 million for each of the nine-month periods ended September 30, 2015 and 2014. In addition, certain of our subsidiaries are tenants in several medical office buildings and two FEDs (as discussed above) owned by the Trust or by limited liability companies in which the Trust holds 100% of the ownership interest. Pursuant to the terms of the three hospital leases with the Trust, we have the option to renew the leases at the lease terms described above by providing notice to the Trust at least 90 days prior to the termination of the then current term. We also have the right to purchase the respective leased hospitals at the end of the lease terms or any renewal terms at their appraised fair market value as well as purchase any or all of the three leased hospital properties at their appraised fair market value upon one month’s notice should a change of control of the Trust occur. In addition, we have rights of first refusal to: (i) purchase the respective leased facilities during and for 180 days after the lease terms at the same price, terms and conditions of any third-party offer, or; (ii) renew the lease on the respective leased facility at the end of, and for 180 days after, the lease term at the same terms and conditions pursuant to any third-party offer. Other Related Party Transactions: In December, 2010, our Board of Directors approved the Company’s entering into supplemental life insurance plans and agreements on the lives of our chief executive officer (“CEO”) and his wife. As a result of these agreements, based on actuarial tables and other assumptions, during the life expectancies of the insureds, we would pay approximately $25 million in premiums, and certain trusts owned by our chief executive officer, would pay approximately $8 million in premiums. Based on the projected premiums mentioned above, and assuming the policies remain in effect until the death of the insureds, we will be entitled to receive death benefit proceeds of no less than $33 million representing the $25 million of aggregate premiums paid by us as well as the $8 million of aggregate premiums paid by the trusts. In connection with these policies, we paid approximately $1.3 million in annual premium payments during each of 2015 and 2014. A member of our Board of Directors and member of the Executive Committee is Of Counsel to the law firm used by us as our principal outside counsel. This Board member is also the trustee of certain trusts for the benefit of our CEO and his family. This law firm also provides personal legal services to our CEO. |
Other Noncurrent liabilities an
Other Noncurrent liabilities and Redeemable/Noncontrolling Interests | 9 Months Ended |
Sep. 30, 2015 | |
Noncontrolling Interest [Abstract] | |
Other Noncurrent liabilities and Redeemable/Noncontrolling Interests | (3) Other Noncurrent liabilities and Redeemable/Noncontrolling Interests Other noncurrent liabilities include the long-term portion of our professional and general liability, workers’ compensation reserves, pension and deferred compensation liabilities, and liabilities incurred in connection with split-dollar life insurance agreements on the lives of our chief executive officer and his wife. Outside owners hold noncontrolling, minority ownership interests of: (i) approximately 28% in our six acute care facilities located in Las Vegas, Nevada (including one facility currently under construction); (ii) 20% in an acute care facility located in Washington, D.C.; (iii) approximately 11% in an acute care facility located in Laredo, Texas, and; (iv) 20% in a behavioral health care facility located in Philadelphia, Pennsylvania. The redeemable noncontrolling interest balances of $250 million as of September 30, 2015 and $240 million as of December 31, 2014, and the noncontrolling interest balances of $61 million as of September 30, 2015 and $55 million as of December 31, 2014, consist primarily of the third-party ownership interests in these hospitals. In connection with six acute care facilities located in Las Vegas, Nevada (including one facility currently under construction), the minority ownership interests of which are reflected as redeemable noncontrolling interests on our Consolidated Balance Sheet, the outside owners have certain “put rights” that, if exercisable, and if exercised, require us to purchase the minority member’s interests at fair market value. The put rights are exercisable upon the occurrence of: (i) certain specified financial conditions falling below established thresholds; (ii) breach of the management contract by the managing member (a subsidiary of ours), or; (iii) if the minority member’s ownership percentage is reduced to less than certain thresholds. In connection with a behavioral health care facility located in Philadelphia, Pennsylvania and acquired by us as part of the PSI acquisition, the minority ownership interest of which is also reflected as redeemable noncontrolling interests on our Consolidated Balance Sheet, the outside owner has a “put option” to put its entire ownership interest to us at any time. If exercised, the put option requires us to purchase the minority member’s interest at fair market value. |
Long-term debt and cash flow he
Long-term debt and cash flow hedges | 9 Months Ended |
Sep. 30, 2015 | |
Debt Disclosure [Abstract] | |
Long-term debt and cash flow hedges | (4) Long-term debt and cash flow hedges Debt: During the third quarter of 2014, we completed the following financing transactions: · In August, 2014, we entered into a fourth amendment to our credit agreement dated as of November 15, 2010, as amended (“Credit Agreement”). The Credit Agreement, which is scheduled to mature in August, 2019, consists of: (i) an $800 million revolving credit facility (no borrowings outstanding as of September 30, 2015), and; (ii) a $1.775 billion term loan A facility ($1.731 billion of borrowings outstanding as of September 30, 2015) which combined our previously outstanding term loan A and term loan A2 facilities which were scheduled to mature in 2016; · Repaid $550 million of outstanding borrowings pursuant to our previously outstanding term loan B facility which was scheduled to mature in 2016; · Increased the borrowing capacity on our existing accounts receivable securitization program (“Securitization”) to $360 million from $275 million, effective August 1, 2014. The Securitization, the terms of which remain the same as the previous agreement, as discussed below, is scheduled to mature in October, 2016; · Issued $300 million aggregate principal amount of 3.750% senior secured notes due in 2019 (see below for additional disclosure); · Issued $300 million aggregate principal amount of 4.750% senior secured notes due in 2022 (see below for additional disclosure); · Redeemed our previously outstanding $250 million, 7.00% senior unsecured notes due in 2018 on July 31, 2014 for an aggregate price equal to 104.56% of the principal amount. Borrowings under the Credit Agreement bear interest at either (1) the ABR rate which is defined as the rate per annum equal to, at our election: the greatest of (a) the lender’s prime rate, (b) the weighted average of the federal funds rate, plus 0.5% and (c) one month LIBOR rate plus 1%, in each case, plus an applicable margin based upon our consolidated leverage ratio at the end of each quarter ranging from 0.50% to 1.25% for revolving credit and term loan-A borrowings, or (2) the one, two, three or six month LIBOR rate (at our election), plus an applicable margin based upon our consolidated leverage ratio at the end of each quarter ranging from 1.50% to 2.25% for revolving credit and term loan-A borrowings. As of September 30, 2015, the applicable margins were 0.50% for ABR-based loans, 1.50% for LIBOR-based loans under the revolving credit and term loan-A facilities. As of September 30, 2015, we had no borrowings outstanding pursuant to the terms of our $800 million revolving credit facility and we had $744 million of available borrowing capacity, net of $17 million of outstanding borrowings pursuant to a short-term, on-demand credit facility and $39 million of outstanding letters of credit. The revolving credit facility includes a $125 million sub-limit for letters of credit. The Credit Agreement is secured by certain assets of the Company and our material subsidiaries and guaranteed by our material subsidiaries. Pursuant to the terms of the Credit Agreement, term loan-A quarterly installment payments of approximately: (i) $11 million commenced during the fourth quarter of 2014 and are scheduled to continue through September, 2016, and; (ii) $22 million are scheduled from the fourth quarter of 2016 through June, 2019. As discussed above, on August 1, 2014, our accounts receivable securitization program (“Securitization”), with a group of conduit lenders and liquidity banks which is scheduled to mature in October, 2016, was amended to increase the borrowing capacity to $360 million from $275 million. Substantially all of the patient-related accounts receivable of our acute care hospitals (“Receivables”) serve as collateral for the outstanding borrowings. We have accounted for this Securitization as borrowings. We maintain effective control over the Receivables since, pursuant to the terms of the Securitization, the Receivables are sold from certain of our subsidiaries to special purpose entities that are wholly-owned by us. The Receivables, however, are owned by the special purpose entities, can be used only to satisfy the debts of the wholly-owned special purpose entities, and thus are not available to us except through our ownership interest in the special purpose entities. The wholly-owned special purpose entities use the Receivables to collateralize the loans obtained from the group of third-party conduit lenders and liquidity banks. The group of third-party conduit lenders and liquidity banks do not have recourse to us beyond the assets of the wholly-owned special purpose entities that securitize the loans. At September 30, 2015, we had $300 million of outstanding borrowings and $60 million of additional capacity pursuant to the terms of our accounts receivable securitization program. On August 7, 2014, we issued $300 million aggregate principal amount of 3.750% Senior Secured Notes due 2019 (the “2019 Notes”) and $300 million aggregate principal amount of 4.750% Senior Secured Notes due 2022 (the “2022 Notes”, and together with the 2019 Notes, the “New Senior Secured Notes”). The New Senior Secured Notes were offered only to qualified institutional buyers under Rule 144A and to non-U.S. persons outside the United States in reliance on Regulation S under the Securities Act of 1933, as amended (the “Securities Act”). The New Senior Secured Notes have not been registered under the Securities Act and may not be offered or sold in the United States absent registration or an applicable exemption from registration requirements. Interest is payable on the New Senior Secured Notes on February 1 and August 1 of each year to the holders of record at the close of business on the January 15 and July 15 immediately preceding the related interest payment dates, commencing on February 1, 2015 until the maturity date of August 1, 2019 for the 2019 Notes and August 1, 2022 for the 2022 Notes. On June 30, 2006, we issued $250 million of senior secured notes which have a 7.125% coupon rate and mature on June 30, 2016 (the “7.125% Notes”). Interest on the 7.125% Notes is payable semiannually in arrears on June 30th and December 30th of each year. In June, 2008, we issued an additional $150 million of 7.125% Notes which formed a single series with the original 7.125% Notes issued in June, 2006. Other than their date of issuance and initial price to the public, the terms of the 7.125% Notes issued in June, 2008 are identical to and trade interchangeably with, the 7.125% Notes which were originally issued in June, 2006. Since we have the ability and intent to refinance the 7.125% Notes on or before the scheduled maturity date (June 30, 2016) either through the issuance of new long-term notes, a new long-term debt facility, or utilizing funds borrowed pursuant to our revolving credit facility, the 7.125% Notes are classified as long-term on our Consolidated Balance Sheet as of September 30, 2015. On July 31, 2014, we redeemed the $250 million, 7.00% senior unsecured notes (the “Unsecured Notes”), which were scheduled to mature on October 1, 2018, at a redemption price equal to 104.56% of the principal amount of the Unsecured Notes resulting in a make-whole premium payment of approximately $11 million. The Unsecured Notes were issued on September 29, 2010 and registered in April, 2011. Interest on the Unsecured Note was payable semiannually in arrears on April 1st and October 1st of each year. In connection with entering into the previous Credit Agreement on November 15, 2010, and in accordance with the Indenture dated January 20, 2000 governing the rights of our existing notes, we entered into a supplemental indenture pursuant to which our 7.125% Notes (due in 2016) were equally and ratably secured with the lenders under the Credit Agreement with respect to the collateral for so long as the lenders under the Credit Agreement are so secured. Our Credit Agreement includes a material adverse change clause that must be represented at each draw. The Credit Agreement contains covenants that include a limitation on sales of assets, mergers, change of ownership, liens and indebtedness, transactions with affiliates, dividends and stock repurchases; and requires compliance with financial covenants including maximum leverage and minimum interest coverage ratios. We are in compliance with all required covenants as of September 30, 2015. As of September 30, 2015, the carrying value of our debt was $3.1 billion and the fair-value of our debt was $3.1 billion. The fair value of our debt was computed based upon quotes received from financial institutions. We consider these to be “level 2” in the fair value hierarchy as outlined in the authoritative guidance for disclosures in connection with debt instruments. Cash Flow Hedges: We manage our ratio of fixed and floating rate debt with the objective of achieving a mix that management believes is appropriate. To manage this risk in a cost-effective manner, we, from time to time, enter into interest rate swap agreements in which we agree to exchange various combinations of fixed and/or variable interest rates based on agreed upon notional amounts. We account for our derivative and hedging activities using the Financial Accounting Standard Board’s (“FASB”) guidance which requires all derivative instruments, including certain derivative instruments embedded in other contracts, to be carried at fair value on the balance sheet. For derivative transactions designated as hedges, we formally document all relationships between the hedging instrument and the related hedged item, as well as its risk-management objective and strategy for undertaking each hedge transaction. Derivative instruments designated in a hedge relationship to mitigate exposure to variability in expected future cash flows, or other types of forecasted transactions, are considered cash flow hedges. Cash flow hedges are accounted for by recording the fair value of the derivative instrument on the balance sheet as either an asset or liability, with a corresponding amount recorded in accumulated other comprehensive income (“AOCI”) within shareholders’ equity. Amounts are reclassified from AOCI to the income statement in the period or periods the hedged transaction affects earnings. We use interest rate derivatives in our cash flow hedge transactions. Such derivatives are designed to be highly effective in offsetting changes in the cash flows related to the hedged liability. For derivative instruments designated as cash flow hedges, the ineffective portion of the change in expected cash flows of the hedged item are recognized currently in the income statement. For hedge transactions that do not qualify for the short-cut method, at the hedge’s inception and on a regular basis thereafter, a formal assessment is performed to determine whether changes in the fair values or cash flows of the derivative instruments have been highly effective in offsetting changes in cash flows of the hedged items and whether they are expected to be highly effective in the future. The fair value of interest rate swap agreements approximates the amount at which they could be settled, based on estimates obtained from the counterparties. We assess the effectiveness of our hedge instruments on a quarterly basis. We performed periodic assessments of the cash flow hedge instruments during 2014 and the first nine months of 2015 and determined the hedges to be highly effective. We also determined that any portion of the hedges deemed to be ineffective was de minimis and therefore there was no material effect on our consolidated financial position, operations or cash flows. The counterparties to the interest rate swap agreements expose us to credit risk in the event of nonperformance. However, at September 30, 2015 and December 31, 2014, each swap agreement entered into by us was in a net liability position which would require us to make the settlement payments to the counterparties. We do not anticipate nonperformance by our counterparties. We do not hold or issue derivative financial instruments for trading purposes. Seven interest rate swaps on a total notional amount of $825 million matured in May, 2015. Four of these swaps, with a total notional amount of $600 million, became effective in December, 2011 and provided that we receive three-month LIBOR while the average fixed rate payable was 2.38%. The remaining three swaps, with a total notional amount of $225 million, became effective in March, 2011 and provided that we receive three-month LIBOR while the average fixed rate payable was 1.91%. During the second quarter of 2015, we entered into four forward starting interest rate swaps whereby we pay a fixed rate on a total notional amount of $500 million and receive one-month LIBOR. Each of the four swaps became effective on July 15, 2015 and are scheduled to mature on April 15, 2019. The average fixed rate payable on these swaps is 1.40%. During the third quarter of 2015, we entered into four additional forward starting interest rate swaps whereby we pay a fixed rate on a total notional amount of $400 million and receive one-month LIBOR. One swap on a notional amount of $100 million became effective on July 15, 2015, two swaps on a total notional amount of $200 million became effective on September 15, 2015 and another swap on a notional amount of $100 million becomes effective on December 15, 2015. All of these swaps are scheduled to mature on April 15, 2019. The average fixed rate payable on these four swaps is 1.23%. We measure our interest rate swaps at fair value on a recurring basis. The fair value of our interest rate swaps is based primarily on quotes from banks. We consider those inputs to be “level 2” in the fair value hierarchy as outlined in the authoritative guidance for disclosures in connection with derivative instruments and hedging activities. The fair value of our interest rate swaps was a liability of $11 million at September 30, 2015, of which $8 million is included in other current liabilities and $3 million is included in other noncurrent liabilities. The fair value of our interest rate swaps was a liability of $6 million at December 31, 2014, all of which is included in other current liabilities. |
Commitments and Contingencies
Commitments and Contingencies | 9 Months Ended |
Sep. 30, 2015 | |
Commitments And Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | (5) Commitments and Contingencies Professional and General Liability and Workers Compensation Liability: Effective November, 2010, excluding certain subsidiaries acquired since 2010 as discussed below, the vast majority of our subsidiaries are self-insured for professional and general liability exposure up to $10 million and $3 million per occurrence, respectively. Our subsidiaries were provided with several excess policies through commercial insurance carriers which provide for coverage in excess of the applicable per occurrence self-insured retention (either $3 million or $10 million) up to $250 million per occurrence and in the aggregate for claims incurred in 2015 and 2014 and up to $200 million per occurrence and in the aggregate for claims incurred from 2011 through 2013. We remain liable for 10% of the claims paid pursuant to the commercially insured coverage in excess of $10 million up to $60 million per occurrence and in the aggregate. Since our acquisition of Psychiatric Solutions, Inc. (“PSI”) in November, 2010, the former PSI subsidiaries are self-insured for professional and general liability exposure up to $3 million per occurrence. The nine behavioral health facilities acquired from Ascend Health Corporation (“Ascend”) in October, 2012 have general and professional liability policies through commercial insurance carriers which provide for up to $12 million of aggregate coverage, subject to a $100,000 per occurrence deductible. The 21 behavioral health care facilities located in the U.K. have policies through a commercial insurance carrier located in the U. K. that provides for £10 million of professional liability coverage and £25 million of general liability coverage. The facilities acquired from PSI, Ascend and the facilities located in the U.K., like our other facilities, are also provided excess coverage through commercial insurance carriers for coverage in excess of the underlying commercial policy limitations, as mentioned above. Our estimated liability for self-insured professional and general liability claims is based on a number of factors including, among other things, the number of asserted claims and reported incidents, estimates of losses for these claims based on recent and historical settlement amounts, estimates of incurred but not reported claims based on historical experience, and estimates of amounts recoverable under our commercial insurance policies. While we continuously monitor these factors, our ultimate liability for professional and general liability claims could change materially from our current estimates due to inherent uncertainties involved in making this estimate. Given our significant self-insured exposure for professional and general liability claims, there can be no assurance that a sharp increase in the number and/or severity of claims asserted against us will not have a material adverse effect on our future results of operations. As of September 30, 2015, the total accrual for our professional and general liability claims was $210 million, of which $51 million is included in current liabilities. As of December 31, 2014, the total accrual for our professional and general liability claims was $193 million, of which $51 million is included in current liabilities. As of September 30, 2015, the total accrual for our workers’ compensation liability claims was $70 million, of which $32 million is included in current liabilities. As of December 31, 2014, the total accrual for our workers’ compensation liability claims was $67 million, of which $32 million is included in current liabilities. Property Insurance: We have commercial property insurance policies for our properties covering catastrophic losses, including windstorm damage, up to a $1 billion policy limit per occurrence, subject to a deductible ranging from $50,000 to $250,000 per occurrence. Losses resulting from named windstorms are subject to deductibles between 3% and 5% of the declared total insurable value of the property. In addition, we have commercial property insurance policies covering catastrophic losses resulting from earthquake and flood damage, each subject to aggregated loss limits (as opposed to per occurrence losses). Our earthquake limit is $250 million, subject to a deductible of $250,000, except for facilities located within documented fault zones. Earthquake losses that affect facilities located in fault zones within the United States are subject to a $100 million limit and will have applied deductibles ranging from 1% to 5% of the declared total insurable value of the property. The earthquake limit in Puerto Rico is $25 million, subject to a $25,000 deductible. Non-critical flood losses have either a $250,000 or $500,000 deductible, based upon the location of the facility. Since certain of our facilities have been designated by our insurer as flood prone, we have elected to purchase policies from The National Flood Insurance Program to cover a substantial portion of the applicable deductible. Property insurance for the facilities acquired from Cygnet are provided on an all risk basis up to a £180 million limit that includes coverage for real and personal property as well as business interruption losses. Other Our accounts receivable as of September 30, 2015 and December 31, 2014 include amounts due from Illinois of approximately $24 million and $44 million, respectively. Collection of the outstanding receivables continues to be delayed due to state budgetary and funding pressures. Approximately $8 million as of September 30, 2015 and $23 million as of December 31, 2014, of the receivables due from Illinois were outstanding in excess of 60 days, as of each respective date. In addition, our accounts receivable as of September 30, 2015 and December 31, 2014 includes approximately $83 million and $102 million, respectively, due from Texas in connection with Medicaid supplemental payment programs. The $83 million due from Texas as of September 30, 2015 consists of $63 million related to uncompensated care program revenues ($31 million of which was subsequently received in October, 2015) and $20 million related to Delivery Service Reform Incentive Payment program revenues. Although the accounts receivable due from Illinois and Texas could remain outstanding for the foreseeable future, since we expect to eventually collect all amounts due to us, no related reserves have been established in our consolidated financial statements. However, we can provide no assurance that we will eventually collect all amounts due to us from Illinois and/or Texas. Failure to ultimately collect all outstanding amounts due from these states would have an adverse impact on our future consolidated results of operations and cash flows. As of September 30, 2015 we were party to certain off balance sheet arrangements consisting of standby letters of credit and surety bonds which totaled $125 million consisting of: (i) $96 million related to our self-insurance programs, and; (ii) $29 million of other debt and public utility guarantees. Legal Proceedings We are subject to claims and suits in the ordinary course of business, including those arising from care and treatment afforded by our hospitals and are party to various government investigations, regulatory matters and litigation, as outlined below. Office of Inspector General (“OIG”) and Government Investigations: In February, 2013, the Office of Inspector General for the United States Department of Health and Human Services (“OIG”) served a subpoena requesting various documents from January, 2008 to the date of the subpoena directed at Universal Health Services, Inc. (“UHS”) concerning it and UHS of Delaware, Inc., and several UHS owned behavioral health facilities including: Keys of Carolina, Old Vineyard Behavioral Health, The Meadows Psychiatric Center, Streamwood Behavioral Health, Hartgrove Hospital, Rock River Academy and Residential Treatment Center, Roxbury Treatment Center, Harbor Point Behavioral Health Center, f/k/a The Pines Residential Treatment Center, including the Crawford, Brighton and Kempsville campuses, Wekiva Springs Center and River Point Behavioral Health. Prior to receiving this subpoena: (i) the Keys of Carolina and Old Vineyard received notification during the second half of 2012 from the DOJ of its intent to proceed with an investigation following requests for documents for the period of January, 2007 to the date of the subpoenas from the North Carolina state Attorney General’s Office; (ii) Harbor Point Behavioral Health Center received a subpoena in December, 2012 from the Attorney General of the Commonwealth of Virginia requesting various documents from July, 2006 to the date of the subpoena, and; (iii) The Meadows Psychiatric Center received a subpoena from the OIG in February, 2013 requesting certain documents from 2008 to the date of the subpoena. Unrelated to these matters, the Keys of Carolina was closed and the real property was sold in January, 2013. We were advised that a qui tam action had been filed against Roxbury Treatment Center but the government declined to intervene and the case was dismissed. In April, 2013, the OIG served facility specific subpoenas on Wekiva Springs Center and River Point Behavioral Health requesting various documents from January, 2005 to the date of the subpoenas. In July, 2013, another subpoena was issued to Wekiva Springs Center and River Point Behavioral Health requesting additional records. In October, 2013, we were advised by the DOJ’s Criminal Frauds Section that they received a referral from the DOJ Civil Division and opened an investigation of River Point Behavioral Health and Wekiva Springs Center. Subsequent subpoenas have since been issued to River Point Behavioral Health and Wekiva Springs Center requesting additional documentation. In April, 2014, the Centers for Medicare and Medicaid Services (“CMS”) instituted a Medicare payment suspension at River Point Behavioral Health in accordance with federal regulations regarding suspension of payments during certain investigations. The Florida Agency for Health Care Administration subsequently issued a Medicaid payment suspension for the facility. River Point Behavioral Health submitted a rebuttal statement disputing the basis of the suspension and requesting revocation of the suspension. Notwithstanding, CMS continued the payment suspension. River Point Behavioral Health provided additional information to CMS in an effort to obtain relief from the payment suspension but the suspension remains in effect. In August, 2015, we received notification from CMS that the payment suspension will be continued for another 180 days. We cannot predict if and/or when the facility’s suspended payments will resume. Although the operating results of River Point Behavioral Health did not have a material impact on our consolidated results of operations during the nine-month period ended September 30, 2015 or the year ended December 31, 2014, the payment suspension has had a material adverse effect on the facility’s results of operations and financial condition. In June, 2013, the OIG served a subpoena on Coastal Harbor Health System in Savannah, Georgia requesting documents from January, 2009 to the date of the subpoena. In February, 2014, we were notified that the investigation conducted by the Criminal Frauds Section had been expanded to include the National Deaf Academy. In March, 2014, a Civil Investigative Demand (“CID”) was served on the National Deaf Academy requesting documents and information from the facility from January 1, 2008 through the date of the CID. We have been advised by the government that the National Deaf Academy has been added to the facilities which are the subject of the coordinated investigation referenced above. In March, 2014, CIDs were served on Hartgrove Hospital, Rock River Academy and Streamwood Behavioral Health requesting documents and information from those facilities from January, 2008 through the date of the CID. In September, 2014, the DOJ Civil Division advised us that they were expanding their investigation to include four additional facilities and were requesting production of documents from these facilities. These facilities are Arbour-HRI Hospital, Behavioral Hospital of Bellaire, St. Simons by the Sea, and Turning Point Care Center. In December 2014, the DOJ Civil Division requested that Salt Lake Behavioral Health produce documents responsive to the original subpoenas issued in February, 2013. In March, 2015, the OIG issued subpoenas to Central Florida Behavioral Hospital and University Behavioral Center requesting certain documents from January, 2008 to the date of the subpoena. In late March, 2015, we were notified that the investigation conducted by the Criminal Frauds Section has been expanded to include UHS as a corporate entity arising out of the coordinated investigation of the facilities described above and, in particular, Hartgrove Hospital. The DOJ has advised us that the civil aspect of the coordinated investigation referenced above is a False Claim Act investigation focused on billings submitted to government payers in relation to services provided at those facilities. At present, we are uncertain as to potential liability and/or financial exposure of the Company and/or named facilities, if any, in connection with these matters. Regulatory Matters: On July 23, 2015, Timberlawn Mental Health System (“Timberlawn”) received notification from CMS of its intent to terminate Timberlawn’s Medicare provider agreement effective August 7, 2015. This notification resulted from surveys conducted which alleged that Timberlawn was out of compliance with conditions of participation required for participation in the Medicare/Medicaid program. We filed a request for expedited administrative appeal with the U.S. Department of Health and Human Services, Departmental Appeals Board, Civil Remedies Division, seeking review and reversal of the termination action. In conjunction with the administrative appeal, we filed litigation in the U.S District Court for the Northern District of Texas seeking a temporary restraining order and preliminary injunction to have the termination stayed pending the conclusion of the administrative appeal. The trial court denied Timberlawn’s request for a temporary restraining order and dismissed the case. Timberlawn’s provider agreement was terminated effective August 14, 2015. In September, 2015 Timberlawn reached an agreement with CMS relative to its reapplication to the Medicare/Medicaid program. In exchange, Timberlawn agreed to dismiss its administrative appeal as well as not to pursue an appeal of the decision of the trial court. During this time, Timberlawn has remained open. Although the operating results of Timberlawn did not have a material impact on our consolidated results of operations or financial condition for the nine-month period ended September 30, 2015 or the year ended December 31, 2014, the termination of Timberlawn’s provider agreement has had a material adverse effect on the facility’s results of operations and financial condition. During the second quarter of 2015, Texoma Medical Center (“Texoma”), which includes TMC Behavioral Health Center, entered into a Systems Improvement Agreement (“SIA”) with CMS. The SIA abated a termination action from CMS following surveys which identified alleged failures to comply with conditions of participation primarily involving Texoma’s behavioral health operations. The terms of the SIA required Texoma to engage independent consultants/experts approved by CMS to analyze and develop implementation plans at Texoma to meet Medicare conditions of participation. At the conclusion of the SIA, CMS will conduct a full certification survey to determine if Texoma is in substantial compliance with the Medicare conditions of participation. The term of agreement is set to conclude October 2, 2016 unless the terms of the agreement are fulfilled earlier. During the term of the SIA, Texoma remains eligible to receive reimbursements from Medicare and Medicaid for services rendered to Medicare and Medicaid beneficiaries. Other Matters: In late September, 2015, many hospitals in Pennsylvania, including seven of our behavioral health care hospitals located in the state, received letters from the Pennsylvania Department of Public Welfare (“DPW”) demanding repayment of allegedly excess Medicaid Disproportionate Share Hospital payments (“DSH”) for the federal fiscal year 2011 (“FFY2011”) amounting to approximately $4 million in the aggregate. We have engaged legal counsel to pursue all available legal and administrative remedies to appeal and contest the repayments since we believe DPW’s calculation methodology is inaccurate and conflicts with applicable federal and state laws and regulations. However, if DPW is ultimately successful in its demand related to FFY2011, it could take similar action with regards to FFY2012 through FFY2014. Due to a change in the Pennsylvania Medicaid State Plan and implementation of a CMS-approved Medicaid Section 1115 Waiver, we do not believe the methodology applied by DPW to FFY2011 is applicable to reimbursements received for Medicaid services provided after January 1, 2015 by our behavioral health care facilities located in Pennsylvania. We can provide no assurance that we will ultimately be successful in our legal and administrative appeals related to DPW’s repayment demands. If our legal and administrative appeals are unsuccessful, our future consolidated results of operations and financial condition could be adversely impacted by these repayments. Matters Relating to Psychiatric Solutions, Inc. (“PSI”): The following matters pertain to PSI or former PSI facilities (owned by subsidiaries of PSI) which were in existence prior to the acquisition of PSI and for which we have assumed the defense as a result of our acquisition which was completed in November, 2010. Department of Justice Investigation of Friends Hospital: In October, 2010, Friends Hospital in Philadelphia, Pennsylvania, received a subpoena from the DOJ requesting certain documents from the facility. The requested documents were collected and provided to the DOJ for review and examination. Another subpoena was issued to the facility in July, 2011 requesting additional documents, which have also been delivered to the DOJ. All documents requested and produced pertained to the operations of the facility while under PSI’s ownership prior to our acquisition. At present, we are uncertain as to the focus, scope or extent of the investigation, liability of the facility and/or potential financial exposure, if any, in connection with this matter. Department of Justice Investigation of Riveredge Hospital: In 2008, Riveredge Hospital in Chicago, Illinois received a subpoena from the DOJ requesting certain information from the facility. Additional requests for documents were also received from the DOJ in 2009 and 2010. The requested documents have been provided to the DOJ. All documents requested and produced pertained to the operations of the facility while under PSI’s ownership prior to our acquisition. At present, we are uncertain as to the focus, scope or extent of the investigation, liability of the facility and/or potential financial exposure, if any, in connection with this matter. General: We operate in a highly regulated and litigious industry which subjects us to various claims and lawsuits in the ordinary course of business as well as regulatory proceedings and government investigations. These claims or suits include claims for damages for personal injuries, medical malpractice, commercial/contractual disputes, wrongful restriction of, or interference with, physicians’ staff privileges, and employment related claims, In addition, health care companies are subject to investigations and/or actions by various state and federal governmental agencies or those bringing claims on their behalf. Government action has increased with respect to investigations and/or allegations against healthcare providers concerning possible violations of fraud and abuse and false claims statutes as well as compliance with clinical and operational regulations. Currently, and from time to time, we and some of our facilities are subjected to inquiries in the form of subpoenas, Civil Investigative Demands, audits and other document requests from various federal and state agencies. These inquiries can lead to notices and/or actions including repayment obligations from state and federal government agencies associated with potential non-compliance with laws and regulations. Further, the federal False Claim Act allows private individuals to bring lawsuits (qui tam actions) against healthcare providers that submit claims for payments to the government. Various states have also adopted similar statutes. When such a claim is filed, the government will investigate the matter and decide if they are going to intervene in the pending case. These qui tam lawsuits are placed under seal by the court to comply with the False Claims Act’s requirements. If the government chooses not to intervene, the private individual(s) can proceed independently on behalf of the government. Health care providers that are found to violate the False Claims Act may be subject to substantial monetary fines/penalties as well as face potential exclusion from participating in government health care programs or be required to comply with Corporate Integrity Agreements as a condition of a settlement of a False Claim Act matter. In September 2014, the Criminal Division of the DOJ, announced that all qui tam cases will be shared with their Division to determine if a parallel criminal investigation should be opened. The DOJ has also announced an intention to pursue civil and criminal actions against individuals within a company as well as the corporate entity or entities. In addition, health care facilities are subject to monitoring by state and federal surveyors to ensure compliance with program Conditions of Participation. In the event a facility is found to be out of compliance with a Condition of Participation and unable to remedy the alleged deficiency(s), the facility faces termination from the Medicare and Medicaid programs or compliance with a System Improvement Agreement to remedy deficiencies and ensure compliance. The laws and regulations governing the healthcare industry are complex covering, among other things, government healthcare participation requirements, licensure, certification and accreditation, privacy of patient information, reimbursement for patient services as well as fraud and abuse compliance. These laws and regulations are constantly evolving and expanding. Further, the Affordable Care Act has added additional obligations on healthcare providers to report and refund overpayments by government healthcare programs and authorizes the suspension of Medicare and Medicaid payments “pending an investigation of a credible allegation of fraud.” We monitor our business and have developed an ethics and compliance program with respect to these complex laws, rules and regulations. Although we believe our policies, procedures and practices comply with government regulations, there is no assurance that we will not be faced with the sanctions referenced above which include fines, penalties and/or substantial damages, repayment obligations, payment suspensions, licensure revocation, and expulsion from government healthcare programs. Even if we were to ultimately prevail in any action brought against us or our facilities or in responding to any inquiry, such action or inquiry could have a material adverse effect on us. The outcome of any current or future litigation or governmental or internal investigations, including the matters described above, cannot be accurately predicted, nor can we predict any resulting penalties, fines or other sanctions that may be imposed at the discretion of federal or state regulatory authorities. We record accruals for such contingencies to the extent that we conclude it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. No estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made at this time regarding the matters specifically described above because the inherently unpredictable nature of legal proceedings may be exacerbated by various factors, including, but not limited to: (i) the damages sought in the proceedings are unsubstantiated or indeterminate; (ii) discovery is not complete; (iii) the proceeding is in its early stages; (iv) the matters present legal uncertainties; (v) there are significant facts in dispute; (vi) there are a large number of parties, or; (vii) there is a wide range of potential outcomes. It is possible that the outcome of these matters could have a material adverse impact on our future results of operations, financial position, cash flows and, potentially, our reputation. In addition, various suits and claims arising against us in the ordinary course of business are pending. In the opinion of management, the outcome of such claims and litigation will not materially affect our consolidated financial position or results of operations. |
Segment Reporting
Segment Reporting | 9 Months Ended |
Sep. 30, 2015 | |
Segment Reporting [Abstract] | |
Segment Reporting | (6) Segment Reporting Our reportable operating segments consist of acute care hospital services and behavioral health care services. The “Other” segment column below includes centralized services including information services, purchasing, reimbursement, accounting, taxation, legal, advertising, design and construction and patient accounting as well as the operating results for our other operating entities including outpatient surgery and radiation centers. The chief operating decision making group for our acute care hospital services and behavioral health care services is comprised of the Chief Executive Officer, the President and the Presidents of each operating segment. The Presidents of each operating segment also manage the profitability of each respective segment’s various facilities. The operating segments are managed separately because each operating segment represents a business unit that offers different types of healthcare services or operates in different healthcare environments. The accounting policies of the operating segments are the same as those described in the summary of significant accounting policies included in our Annual Report on Form 10-K for the year ended December 31, 2014. Three months ended September 30, 2015 Acute Care Hospital Services Behavioral Health Services Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 4,115,598 $ 1,876,896 $ - $ 5,992,494 Gross outpatient revenues $ 2,444,456 $ 202,333 $ - $ 2,646,789 Total net revenues $ 1,136,341 $ 1,089,509 $ 1,805 $ 2,227,655 Income/(loss) before allocation of corporate overhead and income taxes $ 91,784 $ 249,812 $ (93,569 ) $ 248,027 Allocation of corporate overhead $ (49,426 ) $ (29,526 ) $ 78,952 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 42,358 $ 220,286 $ (14,617 ) $ 248,027 Total assets as of September 30, 2015 $ 3,391,193 $ 5,458,647 $ 357,038 $ 9,206,878 Nine months ended September 30, 2015 Acute Care Hospital Services Behavioral Health Services Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 12,633,298 $ 5,565,391 $ - $ 18,198,689 Gross outpatient revenues $ 7,132,212 $ 623,915 $ 16,111 $ 7,772,238 Total net revenues $ 3,446,797 $ 3,272,714 $ 8,701 $ 6,728,212 Income/(loss) before allocation of corporate overhead and income taxes $ 387,568 $ 771,667 $ (306,483 ) $ 852,752 Allocation of corporate overhead $ (148,274 ) $ (88,913 ) $ 237,187 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 239,294 $ 682,754 $ (69,296 ) $ 852,752 Total assets as of September 30, 2015 $ 3,391,193 $ 5,458,647 $ 357,038 $ 9,206,878 Three months ended September 30, 2014 Acute Care Hospital Services Behavioral Health Services Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 3,616,647 $ 1,678,222 $ - $ 5,294,869 Gross outpatient revenues $ 2,058,148 $ 192,032 $ 8,972 $ 2,259,152 Total net revenues $ 1,042,647 $ 992,461 $ 3,609 $ 2,038,717 Income/(loss) before allocation of corporate overhead and income taxes $ 100,388 $ 228,710 $ (184,620 ) $ 144,478 Allocation of corporate overhead $ (44,698 ) $ (24,750 ) $ 69,448 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 55,690 $ 203,960 $ (115,172 ) $ 144,478 Total assets as of September 30, 2014 $ 3,321,166 $ 5,429,453 $ 210,973 $ 8,961,592 Nine months ended September 30, 2014 Acute Care Hospital Services Behavioral Health Services Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 11,217,320 $ 4,973,633 $ - $ 16,190,953 Gross outpatient revenues $ 6,083,715 $ 580,627 $ 25,821 $ 6,690,163 Total net revenues $ 3,054,359 $ 2,964,047 $ 10,391 $ 6,028,797 Income/(loss) before allocation of corporate overhead and income taxes $ 330,382 $ 693,399 $ (385,175 ) $ 638,606 Allocation of corporate overhead $ (134,088 ) $ (74,055 ) $ 208,143 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 196,294 $ 619,344 $ (177,032 ) $ 638,606 Total assets as of September 30, 2014 $ 3,321,166 $ 5,429,453 $ 210,973 $ 8,961,592 |
Earnings Per Share Data ("EPS")
Earnings Per Share Data ("EPS") and Stock Based Compensation | 9 Months Ended |
Sep. 30, 2015 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | |
Earnings Per Share Data ("EPS") and Stock Based Compensation | (7) Earnings Per Share Data (“EPS”) and Stock Based Compensation Basic earnings per share are based on the weighted average number of common shares outstanding during the period. Diluted earnings per share are based on the weighted average number of common shares outstanding during the period adjusted to give effect to common stock equivalents. The following table sets forth the computation of basic and diluted earnings per share for classes A, B, C and D common stockholders for the periods indicated (in thousands, except per share data): Three months ended September 30, Nine months ended September 30, (amounts in thousands) 2015 2014 2015 2014 Basic and Diluted: Net income attributable to UHS $ 150,287 $ 82,797 $ 506,779 $ 372,546 Less: Net income attributable to unvested restricted share grants (82 ) (17 ) (221 ) (164 ) Net income attributable to UHS – basic and diluted $ 150,205 $ 82,780 $ 506,558 $ 372,382 Weighted average number of common shares - basic 98,858 99,052 98,924 98,832 Net effect of dilutive stock options and grants based on the treasury stock method 2,301 1,981 1,987 1,643 Weighted average number of common shares and equivalents - diluted 101,159 101,033 100,911 100,475 Earnings per basic share attributable to UHS: $ 1.52 $ 0.84 $ 5.12 $ 3.77 Earnings per diluted share attributable to UHS: $ 1.48 $ 0.82 $ 5.02 $ 3.71 The “Net effect of dilutive stock options and grants based on the treasury stock method”, for all periods presented above, excludes certain outstanding stock options applicable to each period since the effect would have been anti-dilutive. There were no significant anti-dilutive stock options during the three months ended September 30, 2015. The excluded weighted-average stock options totaled 987,000 for the nine months ended September 30, 2015. There were no significant anti-dilutive stock options during the three and nine months ended September 30, 2014. All classes of our common stock have the same dividend rights. Stock-Based Compensation: During the three-month periods ended September 30, 2015 and 2014, compensation cost of $9.2 million and $7.5 million, respectively, was recognized related to outstanding stock options. During the nine-month periods ended September 30, 2015 and 2014, compensation cost of $28.7 million and $21.7 million, respectively, was recognized related to outstanding stock options. In addition, during the three-month periods ended September 30, 2015 and 2014, compensation cost of approximately $304,000 and $274,000, respectively, was recognized related to restricted stock. During the nine-month periods ended September 30, 2015 and 2014, compensation cost of approximately $796,000 and $921,000, respectively, was recognized related to restricted stock. As of September 30, 2015 there was $76.4 million of unrecognized compensation cost related to unvested options and restricted stock which is expected to be recognized over the remaining weighted average vesting period of 2.9 years. There were 2,940,850 stock options granted (net of cancellations) during the first nine months of 2015 with a weighted-average grant date fair value of $21.33 per share. The expense associated with share-based compensation arrangements is a non-cash charge. In the Consolidated Statements of Cash Flows, share-based compensation expense is an adjustment to reconcile net income to cash provided by operating activities and aggregated to $30.1 million and $22.7 million during the nine-month periods ended September 30, 2015 and 2014, respectively. In accordance with ASC 718, excess income tax benefits related to stock based compensation are classified as cash inflows from financing activities on the Consolidated Statement of Cash Flows. During the first nine months of 2015 and 2014, we generated $29.3 million and $30.2 million, respectively, of excess income tax benefits related to stock based compensation which are reflected as cash inflows from financing activities in our Consolidated Statements of Cash Flows. |
Dispositions and acquisitions
Dispositions and acquisitions | 9 Months Ended |
Sep. 30, 2015 | |
Business Combinations [Abstract] | |
Dispositions and acquisitions | (8) Dispositions and acquisitions Acquisition subsequent to September 30, 2015: In October, 2015, we completed the acquisition of Foundations Recovery Network, LLC (“Foundations”) for a purchase price of approximately $350 million. Through this acquisition, we have added 4 inpatient facilities consisting of 322 beds as well as 8 outpatient centers. In addition, there are over 140 expansion beds in progress. Foundations is focused on treating adults with co-occurring addiction and mental health disorders through an evidence-based, integrated treatment model in residential and outpatient settings. Nine-month period ended September 30, 2015: Acquisitions: During the first nine months of 2015, we paid approximately $183 million to acquire: (i) a 46-bed behavioral health care facility located in the U.K. (acquired during the first quarter); (ii) Alpha Hospitals Holdings Limited consisting of four behavioral health care hospitals with 305 beds located in the U.K. (acquired during the third quarter), and; (iii) various other businesses, a management contract and real property assets. Divestitures: During the first nine months of 2015, we received approximately $3 million related to the divestiture of a small operator of behavioral health care services (sold during the third quarter). The pre-tax gain realized on this divestiture did not have a material impact on our consolidated financial statements. Nine-month period ended September 30, 2014: Acquisitions: During the first nine months of 2014, we spent $402 million to: (i) acquire the stock of Cygnet Health Care Limited (16 behavioral health care facilities located throughout the U.K.); (ii) acquire and fund the required capital reserves related to a commercial health insurer headquartered in Reno, Nevada; (iii) acquire a 124-bed behavioral health care facility and outpatient treatment center located in Washington, D.C., and; (iv) acquire a 48-bed behavioral health facility in Tucson, Arizona. Divestitures: During the first nine months of 2014, we received approximately $15 million of cash proceeds for the divestiture of a non-operating investment and the real property of a closed behavioral health care facility. The divestiture of the non-operating investment (sold during the first quarter of 2014) resulted in a pre-tax gain of approximately $10 million which is included in our consolidated results of operations during the nine-month period ended September 30, 2014. |
Dividends
Dividends | 9 Months Ended |
Sep. 30, 2015 | |
Earnings Per Share [Abstract] | |
Dividends | (9) Dividends We declared and paid dividends of $9.9 million, or $.10 per share, during each of the three-month periods ended September 30, 2015 and 2014. We declared and paid dividends of $29.7 million and $19.8 million during the nine-month periods ended September 30, 2015 and 2014, respectively. |
Income Taxes
Income Taxes | 9 Months Ended |
Sep. 30, 2015 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | (10) Income Taxes As of January 1, 2015, our unrecognized tax benefits were approximately $2 million. The amount, if recognized, that would affect the effective tax rate is approximately $2 million. During the quarter ended September 30, 2015, changes to the estimated liabilities for uncertain tax positions (including accrued interest) relating to tax positions taken during prior and current periods did not have a material impact on our financial statements. We recognize accrued interest and penalties associated with uncertain tax positions as part of the tax provision. As of September 30, 2015, we have less than $1 million of accrued interest and penalties. The U.S. federal statute of limitations remains open for the 2012 and subsequent years. Foreign and U.S. state and local jurisdictions have statutes of limitations generally ranging from 3 to 4 years. The statute of limitations on certain jurisdictions could expire within the next twelve months. It is reasonably possible that the amount of uncertain tax benefits will change during the next 12 months, however, it is anticipated that any such change, if it were to occur, would not have a material impact on our results of operations. We operate in multiple jurisdictions with varying tax laws. We are subject to audits by any of these taxing authorities. Our tax returns have been examined by the Internal Revenue Service (“IRS”) through the year ended December 31, 2006. We believe that adequate accruals have been provided for federal, foreign and state taxes. |
Supplemental Condensed Consolid
Supplemental Condensed Consolidating Financial Information | 9 Months Ended |
Sep. 30, 2015 | |
Condensed Financial Information Of Parent Company Only Disclosure [Abstract] | |
Supplemental Condensed Consolidating Financial Information | (11) Supplemental Condensed Consolidating Financial Information Certain of our senior notes are guaranteed by a group of subsidiaries (the “Guarantors”). The Guarantors, each of which is a 100% directly owned subsidiary of Universal Health Services, Inc., fully and unconditionally guarantee the senior notes on a joint and several basis, subject to certain customary release provisions. The following financial statements present condensed consolidating financial data for (i) Universal Health Services, Inc. (on a parent company only basis), (ii) the combined Guarantors, (iii) the combined non guarantor subsidiaries (all other subsidiaries), (iv) an elimination column for adjustments to arrive at the information for the parent company, Guarantors, and non guarantors on a consolidated basis, and (v) the parent company and our subsidiaries on a consolidated basis. Investments in subsidiaries are accounted for by the parent company and the Guarantors using the equity method for this presentation. Results of operations of subsidiaries are therefore classified in the parent company’s and Guarantors’ investment in subsidiaries accounts. The elimination entries set forth in the following condensed consolidating financial statements eliminate distributed and undistributed income of subsidiaries, investments in subsidiaries, and intercompany balances and transactions between the parent, Guarantors, and non guarantors. UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF INCOME FOR THE THREE MONTHS ENDED SEPTEMBER 30, 2015 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net revenues before provision for doubtful accounts $ 0 $ 1,688,939 $ 758,095 $ (7,963 ) $ 2,439,071 Less: Provision for doubtful accounts 0 135,897 75,519 0 211,416 Net revenues 0 1,553,042 682,576 (7,963 ) 2,227,655 Operating charges: Salaries, wages and benefits 0 754,069 303,157 0 1,057,226 Other operating expenses 0 361,965 174,947 (7,529 ) 529,383 Supplies expense 0 143,296 98,963 0 242,259 Depreciation and amortization 0 69,875 29,567 0 99,442 Lease and rental expense 0 15,261 9,717 (434 ) 24,544 Electronic health records incentive income 0 (356 ) 0 0 (356 ) 0 1,344,110 616,351 (7,963 ) 1,952,498 Income from operations 0 208,932 66,225 0 275,157 Interest expense 25,543 1,173 414 0 27,130 Interest (income) expense, affiliate 0 23,054 (23,054 ) 0 0 Equity in net income of consolidated affiliates (166,054 ) (40,178 ) 0 206,232 0 Income before income taxes 140,511 224,883 88,865 (206,232 ) 248,027 Provision for income taxes (9,776 ) 74,531 19,618 0 84,373 Net income 150,287 150,352 69,247 (206,232 ) 163,654 Less: Income attributable to noncontrolling interests 0 0 13,367 0 13,367 Net income attributable to UHS $ 150,287 $ 150,352 $ 55,880 $ (206,232 ) $ 150,287 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF INCOME FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2015 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net revenues before provision for doubtful accounts $ 0 $ 5,040,823 $ 2,254,656 $ (23,627 ) $ 7,271,852 Less: Provision for doubtful accounts 0 357,095 186,545 0 543,640 Net revenues 0 4,683,728 2,068,111 (23,627 ) 6,728,212 Operating charges: Salaries, wages and benefits 0 2,239,853 893,140 0 3,132,993 Other operating expenses 0 1,080,690 512,869 (22,499 ) 1,571,060 Supplies expense 0 430,288 291,691 0 721,979 Depreciation and amortization 0 208,577 87,120 0 295,697 Lease and rental expense 0 43,160 28,599 (1,128 ) 70,631 Electronic health records incentive income 0 (1,751 ) 0 0 (1,751 ) 0 4,000,817 1,813,419 (23,627 ) 5,790,609 Income from operations 0 682,911 254,692 0 937,603 Interest expense 80,087 3,566 1,198 0 84,851 Interest (income) expense, affiliate 0 69,163 (69,163 ) 0 0 Equity in net income of consolidated affiliates (556,213 ) (160,481 ) 0 716,694 0 Income before income taxes 476,126 770,663 322,657 (716,694 ) 852,752 Provision for income taxes (30,653 ) 257,400 66,624 0 293,371 Net income 506,779 513,263 256,033 (716,694 ) 559,381 Less: Income attributable to noncontrolling interests 0 0 52,602 0 52,602 Net income attributable to UHS $ 506,779 $ 513,263 $ 203,431 $ (716,694 ) $ 506,779 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF INCOME FOR THE THREE MONTHS ENDED SEPTEMBER 30, 2014 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net revenues before provision for doubtful accounts $ 0 $ 1,548,315 $ 655,321 $ (7,123 ) $ 2,196,513 Less: Provision for doubtful accounts 0 109,858 47,938 0 157,796 Net revenues 0 1,438,457 607,383 (7,123 ) 2,038,717 Operating charges: Salaries, wages and benefits 0 680,877 272,706 0 953,583 Other operating expenses 0 384,689 155,758 (6,694 ) 533,753 Supplies expense 0 134,966 87,742 0 222,708 Depreciation and amortization 0 67,204 26,252 0 93,456 Lease and rental expense 0 15,034 9,255 (429 ) 23,860 Electronic health records incentive income 0 (531 ) (894 ) 0 (1,425 ) Costs related to extinguishment of debt 36,171 0 0 0 36,171 36,171 1,282,239 550,819 (7,123 ) 1,862,106 Income from operations (36,171 ) 156,218 56,564 0 176,611 Interest expense 30,503 1,277 353 0 32,133 Interest (income) expense, affiliate 0 22,113 (22,113 ) 0 0 Equity in net income of consolidated affiliates (123,951 ) (32,595 ) 0 156,546 0 Income before income taxes 57,277 165,423 78,324 (156,546 ) 144,478 Provision for income taxes (25,520 ) 54,139 19,821 0 48,440 Net income 82,797 111,284 58,503 (156,546 ) 96,038 Less: Income attributable to noncontrolling interests 0 0 13,241 0 13,241 Net income attributable to UHS $ 82,797 $ 111,284 $ 45,262 $ (156,546 ) $ 82,797 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF INCOME FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2014 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net revenues before provision for doubtful accounts $ 0 $ 4,574,273 $ 2,018,260 $ (21,801 ) $ 6,570,732 Less: Provision for doubtful accounts 0 367,375 174,560 0 541,935 Net revenues 0 4,206,898 1,843,700 (21,801 ) 6,028,797 Operating charges: Salaries, wages and benefits 0 2,038,171 812,697 0 2,850,868 Other operating expenses 0 950,549 464,488 (20,711 ) 1,394,326 Supplies expense 0 403,195 259,085 0 662,280 Depreciation and amortization 0 199,540 77,966 0 277,506 Lease and rental expense 0 43,827 27,919 (1,090 ) 70,656 Electronic health records incentive income 0 (2,665 ) (1,364 ) 0 (4,029 ) Costs related to extinguishment of debt 36,171 0 0 0 36,171 36,171 3,632,617 1,640,791 (21,801 ) 5,287,778 Income from operations (36,171 ) 574,281 202,909 0 741,019 Interest expense 97,665 3,248 1,500 0 102,413 Interest (income) expense, affiliate 0 66,337 (66,337 ) 0 0 Equity in net income of consolidated affiliates (455,156 ) (125,458 ) 0 580,614 0 Income before income taxes 321,320 630,154 267,746 (580,614 ) 638,606 Provision for income taxes (51,226 ) 217,340 57,988 0 224,102 Net income 372,546 412,814 209,758 (580,614 ) 414,504 Less: Income attributable to noncontrolling interests 0 0 41,958 0 41,958 Net income attributable to UHS $ 372,546 $ 412,814 $ 167,800 $ (580,614 ) $ 372,546 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME FOR THE THREE MONTHS ENDED SEPTEMBER 30, 2015 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net income $ 150,287 $ 150,352 $ 69,247 $ (206,232 ) $ 163,654 Other comprehensive income (loss): Unrealized derivative gains on cash flow hedges (9,888 ) 0 0 0 (9,888 ) Amortization of terminated hedge (84 ) 0 0 0 (84 ) Foreign currency translation adjustment (2,304 ) (2,304 ) 0 2,304 (2,304 ) Other comprehensive income before tax (12,276 ) (2,304 ) 0 2,304 (12,276 ) Income tax expense related to items of other comprehensive income (3,742 ) 0 0 0 (3,742 ) Total other comprehensive income, net of tax (8,534 ) (2,304 ) 0 2,304 (8,534 ) Comprehensive income 141,753 148,048 69,247 (203,928 ) 155,120 Less: Comprehensive income attributable to noncontrolling interests 0 0 13,367 0 13,367 Comprehensive income attributable to UHS $ 141,753 $ 148,048 $ 55,880 $ (203,928 ) $ 141,753 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2015 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net income $ 506,779 $ 513,263 $ 256,033 $ (716,694 ) $ 559,381 Other comprehensive income (loss): Unrealized derivative gains on cash flow hedges (4,950 ) 0 0 0 (4,950 ) Amortization of terminated hedge (252 ) 0 0 0 (252 ) Foreign currency translation adjustment (96 ) (96 ) 0 96 (96 ) Other comprehensive income before tax (5,298 ) (96 ) 0 96 (5,298 ) Income tax expense related to items of other comprehensive income (1,530 ) 0 0 0 (1,530 ) Total other comprehensive income, net of tax (3,768 ) (96 ) 0 96 (3,768 ) Comprehensive income 503,011 513,167 256,033 (716,598 ) 555,613 Less: Comprehensive income attributable to noncontrolling interests 0 0 52,602 0 52,602 Comprehensive income attributable to UHS $ 503,011 $ 513,167 $ 203,431 $ (716,598 ) $ 503,011 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME FOR THE THREE MONTHS ENDED SEPTEMBER 30, 2014 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net income $ 82,797 $ 111,284 $ 58,503 $ (156,546 ) $ 96,038 Other comprehensive income (loss): Unrealized derivative gains on cash flow hedges 4,712 0 0 0 4,712 Amortization of terminated hedge (84 ) 0 0 0 (84 ) Currency translation adjustment (2,506 ) 0 0 0 (2,506 ) Other comprehensive income before tax 2,122 0 0 0 2,122 Income tax expense related to items of other comprehensive income 1,620 0 0 0 1,620 Total other comprehensive income, net of tax 502 0 0 0 502 Comprehensive income 83,299 111,284 58,503 (156,546 ) 96,540 Less: Comprehensive income attributable to noncontrolling interests 0 0 13,241 0 13,241 Comprehensive income attributable to UHS $ 83,299 $ 111,284 $ 45,262 $ (156,546 ) $ 83,299 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2014 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net income $ 372,546 $ 412,814 $ 209,758 $ (580,614 ) $ 414,504 Other comprehensive income (loss): Unrealized derivative gains on cash flow hedges 12,922 0 0 0 12,922 Amortization of terminated hedge (252 ) 0 0 0 (252 ) Currency translation adjustment (2,506 ) 0 0 0 (2,506 ) Other comprehensive income before tax 10,164 0 0 0 10,164 Income tax expense related to items of other comprehensive income 4,685 0 0 0 4,685 Total other comprehensive income, net of tax 5,479 0 0 0 5,479 Comprehensive income 378,025 412,814 209,758 (580,614 ) 419,983 Less: Comprehensive income attributable to noncontrolling interests 0 0 41,958 0 41,958 Comprehensive income attributable to UHS $ 378,025 $ 412,814 $ 167,800 $ (580,614 ) $ 378,025 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING BALANCE SHEET AS OF SEPTEMBER 30, 2015 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Assets Current assets: Cash and cash equivalents $ 0 $ 27,934 $ 11,589 $ 0 $ 39,523 Accounts receivable, net 0 940,262 388,038 0 1,328,300 Supplies 0 69,744 42,974 0 112,718 Deferred income taxes 132,407 2,147 0 0 134,554 Other current assets 0 69,304 12,155 0 81,459 Total current assets 132,407 1,109,391 454,756 0 1,696,554 Investments in subsidiaries 7,569,657 1,821,777 0 (9,391,434 ) 0 Intercompany receivable 0 0 507,740 (507,740 ) 0 Intercompany note receivable 0 0 1,267,637 (1,267,637 ) 0 Property and equipment 0 4,664,695 1,851,219 0 6,515,914 Less: accumulated depreciation 0 (1,828,173 ) (911,649 ) 0 (2,739,822 ) 0 2,836,522 939,570 0 3,776,092 Other assets: Goodwill 0 2,862,325 526,053 0 3,388,378 Deferred charges 27,171 5,641 2,301 0 35,113 Other 8,031 259,784 42,926 0 310,741 $ 7,737,266 $ 8,895,440 $ 3,740,983 $ (11,166,811 ) $ 9,206,878 Liabilities and Stockholders’ Equity Current liabilities: Current maturities of long-term debt $ 61,177 $ 1,214 $ 22,492 $ 0 $ 84,883 Accounts payable and accrued liabilities 22,084 1,018,055 62,477 0 1,102,616 Federal and state taxes 8,697 0 0 0 8,697 Total current liabilities 91,958 1,019,269 84,969 0 1,196,196 Intercompany payable 259,415 248,325 0 (507,740 ) 0 Intercompany note payable 0 1,267,637 0 (1,267,637 ) 0 Other noncurrent liabilities 4,236 217,605 70,600 0 292,441 Long-term debt 2,984,200 17,095 8,659 0 3,009,954 Deferred income taxes 264,358 0 0 0 264,358 Redeemable noncontrolling interests 0 0 250,213 0 250,213 Equity: UHS common stockholders’ equity 4,133,099 6,125,509 3,265,925 (9,391,434 ) 4,133,099 Noncontrolling interest 0 0 60,617 0 60,617 Total equity 4,133,099 6,125,509 3,326,542 (9,391,434 ) 4,193,716 $ 7,737,266 $ 8,895,440 $ 3,740,983 $ (11,166,811 ) $ 9,206,878 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING BALANCE SHEET AS OF DECEMBER 31, 2014 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Assets Current assets: Cash and cash equivalents $ 0 $ 21,784 $ 10,285 $ 0 $ 32,069 Accounts receivable, net 0 933,971 348,764 0 1,282,735 Supplies 0 67,847 40,268 0 108,115 Deferred income taxes 113,822 743 0 0 114,565 Other current assets 0 62,431 15,223 0 77,654 Total current assets 113,822 1,086,776 414,540 0 1,615,138 Investments in subsidiaries 7,013,540 1,661,296 0 (8,674,836 ) 0 Intercompany receivable 103,808 0 408,682 (512,490 ) 0 Intercompany note receivable 0 0 1,222,637 (1,222,637 ) 0 Property and equipment 0 4,494,567 1,717,463 0 6,212,030 Less: accumulated depreciation 0 (1,686,192 ) (846,149 ) 0 (2,532,341 ) 0 2,808,375 871,314 0 3,679,689 Other assets: Goodwill 0 2,764,555 526,658 0 3,291,213 Deferred charges 32,379 5,402 2,538 0 40,319 Other 9,601 283,302 55,181 0 348,084 $ 7,273,150 $ 8,609,706 $ 3,501,550 $ (10,409,963 ) $ 8,974,443 Liabilities and Stockholders’ Equity Current liabilities: Current maturities of long-term debt $ 44,874 $ 1,260 $ 22,185 $ 0 $ 68,319 Accounts payable and accrued liabilities 20,245 1,051,309 41,508 0 1,113,062 Federal and state taxes 1,446 0 0 0 1,446 Total current liabilities 66,565 1,052,569 63,693 0 1,182,827 Intercompany payable 0 512,490 0 (512,490 ) 0 Intercompany note payable 0 1,222,637 0 (1,222,637 ) 0 Other noncurrent liabilities 1,322 189,456 77,777 0 268,555 Long-term debt 3,187,103 20,212 2,900 0 3,210,215 Deferred income taxes 282,214 0 0 0 282,214 Redeemable noncontrolling interests 0 0 239,552 0 239,552 Equity: UHS common stockholders’ equity 3,735,946 5,612,342 3,062,494 (8,674,836 ) 3,735,946 Noncontrolling interest 0 0 55,134 0 55,134 Total equity 3,735,946 5,612,342 3,117,628 (8,674,836 ) 3,791,080 $ 7,273,150 $ 8,609,706 $ 3,501,550 $ (10,409,963 ) $ 8,974,443 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF CASH FLOWS FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2015 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net cash (used in) provided by operating activities $ (51,998 ) $ 554,650 $ 293,847 $ 0 $ 796,499 Cash Flows from Investing Activities: Property and equipment additions, net of disposals 0 (154,460 ) (115,118 ) 0 (269,578 ) Proceeds received from sale of assets and businesses 0 0 2,744 0 2,744 Cash paid/reserved related to acquisition of property and businesses 0 (171,116 ) (11,987 ) 0 (183,103 ) Net cash used in investing activities 0 (325,576 ) (124,361 ) 0 (449,937 ) Cash Flows from Financing Activities: Reduction of long-term debt (203,284 ) (3,163 ) (924 ) 0 (207,371 ) Additional borrowings 16,300 0 0 0 16,300 Repurchase of common shares (129,862 ) 0 0 0 (129,862 ) Dividends paid (29,696 ) 0 0 0 (29,696 ) Issuance of common stock 6,030 0 0 0 6,030 Excess income tax benefits related to stock-based compensation 29,287 0 0 0 29,287 Profit distributions to noncontrolling interests 0 0 (35,965 ) 0 (35,965 ) Proceeds received from sale/leaseback of real property 0 0 12,765 0 12,765 Changes in intercompany balances with affiliates, net 363,223 (219,165 ) (144,058 ) 0 0 Net cash provided by (used in) financing activities 51,998 (222,328 ) (168,182 ) 0 (338,512 ) Effect of exchange rate changes on cash and cash equivalents 0 (596 ) 0 0 (596 ) Increase in cash and cash equivalents 0 6,150 1,304 0 7,454 Cash and cash equivalents, beginning of period 0 21,784 10,285 0 32,069 Cash and cash equivalents, end of period $ 0 $ 27,934 $ 11,589 $ 0 $ 39,523 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF CASH FLOWS FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2014 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net cash provided by operating activities $ 8,445 $ 431,986 $ 249,123 $ 0 $ 689,554 Cash Flows from Investing Activities: Property and equipment additions, net of disposals 0 (205,455 ) (103,906 ) 0 (309,361 ) Proceeds received from sale of assets and businesses 0 11,450 3,728 0 15,178 Cash paid/reserved related to acquisition of property and businesses 0 (394,854 ) (7,551 ) 0 (402,405 ) Costs incurred for purchase and implementation of electronic health records application 0 (11,204 ) 0 0 (11,204 ) Net cash used in investing activities 0 (600,063 ) (107,729 ) 0 (707,792 ) Cash Flows from Financing Activities: Reduction of long-term debt (830,680 ) (609 ) (11,254 ) 0 (842,543 ) Additional borrowings 969,800 0 0 0 969,800 Financing costs (13,413 ) 0 0 0 (13,413 ) Repurchase of common shares (63,292 ) 0 0 0 (63,292 ) Dividends paid (19,794 ) 0 0 0 (19,794 ) Issuance of common stock 4,907 0 0 0 4,907 Excess income tax benefits related to stock-based compensation 30,242 0 0 0 30,242 Profit distributions to noncontrolling interests 0 0 (25,074 ) 0 (25,074 ) Changes in intercompany balances with affiliates, net (86,215 ) 190,021 (103,806 ) 0 0 Net cash (used in) provided by financing activities (8,445 ) 189,412 (140,134 ) 0 40,833 Effect of exchange rate changes on cash and cash equivalents 0 (122 ) 0 0 (122 ) Increase in cash and cash equivalents 0 21,213 1,260 0 22,473 Cash and cash equivalents, beginning of period 0 7,990 9,248 0 17,238 Cash and cash equivalents, end of period $ 0 $ 29,203 $ 10,508 $ 0 $ 39,711 |
Recent Accounting Standards
Recent Accounting Standards | 9 Months Ended |
Sep. 30, 2015 | |
Accounting Changes And Error Corrections [Abstract] | |
Recent Accounting Standards | (12) Recent Accounting Standards In September 2015, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2015-16, “Simplifying the Accounting for Measurement-Period Adjustments,” which changes the reporting requirement for retrospective adjustments to provisional amounts in the measurement period. The amendments in this update require an entity to present separately on the face of the income statement or disclose in the notes, the portion of the amount recorded in current-period earnings by line item that would have been recorded in previous reporting periods if the adjustment to the provisional amounts had been recognized as of the acquisition date. The revised guidance is effective for annual fiscal periods beginning after December 15, 2015. We are currently in the process of evaluating the impact of adoption of this ASU on our consolidated financial statements. In May 2014, the FASB issued ASU 2014-09, “Revenue from Contracts with Customers”, which provides guidance for revenue recognition. The standard’s core principle is that a company will recognize revenue when it transfers promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. This ASU also requires additional disclosures. ASU 2014-09 is effective for annual reporting periods beginning after December 15, 2016; however, in July 2015, the FASB approved a one-year deferral of this standard, with a new effective date for fiscal years beginning after December 15, 2017. We are currently in the process of evaluating the impact of adoption of this ASU on our consolidated financial statements. In August 2014, FASB issued ASU No. 2014-15, “Preparation 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). Continuation of a reporting entity as a going concern is presumed as the basis for preparing financial statements unless and until the entity’s liquidation becomes imminent. Preparation of financial statements under this presumption is commonly referred to as the going concern basis of accounting. If and when an entity’s liquidation becomes imminent, financial statements should be prepared under the liquidation basis of accounting in accordance with Subtopic 205-30, “Presentation of Financial Statements—Liquidation Basis of Accounting”. Even when an entity’s liquidation is not imminent, there may be conditions or events that raise substantial doubt about the entity’s ability to continue as a going concern. In those situations, financial statements should continue to be prepared under the going concern basis of accounting, but the new criteria in ASU 2014-15 should be followed to determine whether to disclose information about the relevant conditions and events. The amendments in ASU 2014-15 are effective for the annual period ending after December 15, 2016, and for annual periods and interim periods thereafter. Early application is permitted. We will evaluate the going concern considerations in this ASU. In April and August 2015, the FASB issued ASU No. 2015-03 and ASU No. 2015-15, “Interest- Imputation of Interest,” respectively, to simplify the presentation of debt issuance costs. The standard requires debt issuance costs be presented in the balance sheet as a direct deduction from the carrying value of the debt liability. The FASB clarified that debt issuance costs related to line-of-credit arrangements can be presented as an asset and amortized over the term of the arrangement. The guidance is effective for annual fiscal periods beginning after December 15, 2015; however, early adoption is permitted. We do not expect the adoption of this guidance to have a material impact on our condensed consolidated financial statements. |
General (Policies)
General (Policies) | 9 Months Ended |
Sep. 30, 2015 | |
Accounting Policies [Abstract] | |
Provider Taxes | Provider Taxes: We incur health-care related taxes (“Provider Taxes”) imposed by states in the form of a licensing fee, assessment or other mandatory payment which are related to: (i) healthcare items or services; (ii) the provision of, or the authority to provide, the health care items or services, or; (iii) the payment for the health care items or services. Such Provider Taxes are subject to various federal regulations that limit the scope and amount of the taxes that can be levied by states in order to secure federal matching funds as part of their respective state Medicaid programs. We derive a related Medicaid reimbursement benefit from assessed Provider Taxes in the form of Medicaid claims based payment increases and/or lump sum Medicaid supplemental payments. Under these programs, including the impact of Uncompensated Care and Upper Payment Limit programs, and the Texas Delivery System Reform Incentive program, we earned revenues (before Provider Taxes) of approximately $62 million and $53 million during the three-month periods ended September 30, 2015 and 2014, respectively, and approximately $221 million and $180 million during the nine-month periods ended September 30, 2015 and 2014, respectively. These revenues were offset by Provider Taxes of approximately $30 million and $21 million during the three-month periods ended September 30, 2015 and 2014, respectively, and approximately $97 million and $71 million during the nine-month periods ended September 30, 2015 and 2014, respectively, which are recorded in other operating expenses on the Condensed Consolidated Statements of Income as included herein. Prior to 2015, these Provider Taxes were recorded as a reduction to our net revenues. Accordingly, the unaudited Condensed Consolidated Statements of Income for the three and nine-month periods ended September 30, 2014 have been revised to reflect the current period classification, resulting in an increase in net revenue and an increase in other operating expenses of $21 million and $71 million, respectively. We assessed this adjustment to the classification and concluded that it was not material to our previously issued annual and quarterly Consolidated Statements of Income, which will be revised in future filings. |
Goodwill and Intangible Assets | Goodwill and Intangible Assets: During the quarter-ended September 30, 2015, we changed our annual goodwill and indefinite-lived intangibles testing date from September 1st to October 1st. Management believes that this voluntary change in accounting method is preferable as it aligns the annual impairment testing date with our annual budgeting process. In connection with this change, we first performed an impairment test as of September 1, 2015, which indicated no impairment of goodwill or indefinite-lived intangible assets, and will perform an additional impairment test as of October 1, 2015. This change in annual testing date does not delay, accelerate or avoid an impairment charge. |
Relationship with Universal H19
Relationship with Universal Health Realty Income Trust and Related Party Transactions (Tables) | 9 Months Ended |
Sep. 30, 2015 | |
Related Party Transactions [Abstract] | |
Remaining Renewal Options and Terms for Each of Three Hospital Facilities Leased from Trust | The table below details the renewal options and terms for each of our three acute care hospital facilities leased from the Trust as of September 30, 2015: Hospital Name Annual Minimum Rent End of Lease Term Renewal Term (years) McAllen Medical Center $ 5,485,000 December, 2016 15(a) Wellington Regional Medical Center $ 3,030,000 December, 2016 15(b) Southwest Healthcare System, Inland Valley Campus $ 2,648,000 December, 2016 15(b) (a) We have three 5-year renewal options at existing lease rates (through 2031). (b) We have one 5-year renewal option at existing lease rates (through 2021) and two 5-year renewal options at fair market value lease rates (2022 through 2031). |
Segment Reporting (Tables)
Segment Reporting (Tables) | 9 Months Ended |
Sep. 30, 2015 | |
Segment Reporting [Abstract] | |
Segment Reporting | Three months ended September 30, 2015 Acute Care Hospital Services Behavioral Health Services Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 4,115,598 $ 1,876,896 $ - $ 5,992,494 Gross outpatient revenues $ 2,444,456 $ 202,333 $ - $ 2,646,789 Total net revenues $ 1,136,341 $ 1,089,509 $ 1,805 $ 2,227,655 Income/(loss) before allocation of corporate overhead and income taxes $ 91,784 $ 249,812 $ (93,569 ) $ 248,027 Allocation of corporate overhead $ (49,426 ) $ (29,526 ) $ 78,952 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 42,358 $ 220,286 $ (14,617 ) $ 248,027 Total assets as of September 30, 2015 $ 3,391,193 $ 5,458,647 $ 357,038 $ 9,206,878 Nine months ended September 30, 2015 Acute Care Hospital Services Behavioral Health Services Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 12,633,298 $ 5,565,391 $ - $ 18,198,689 Gross outpatient revenues $ 7,132,212 $ 623,915 $ 16,111 $ 7,772,238 Total net revenues $ 3,446,797 $ 3,272,714 $ 8,701 $ 6,728,212 Income/(loss) before allocation of corporate overhead and income taxes $ 387,568 $ 771,667 $ (306,483 ) $ 852,752 Allocation of corporate overhead $ (148,274 ) $ (88,913 ) $ 237,187 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 239,294 $ 682,754 $ (69,296 ) $ 852,752 Total assets as of September 30, 2015 $ 3,391,193 $ 5,458,647 $ 357,038 $ 9,206,878 Three months ended September 30, 2014 Acute Care Hospital Services Behavioral Health Services Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 3,616,647 $ 1,678,222 $ - $ 5,294,869 Gross outpatient revenues $ 2,058,148 $ 192,032 $ 8,972 $ 2,259,152 Total net revenues $ 1,042,647 $ 992,461 $ 3,609 $ 2,038,717 Income/(loss) before allocation of corporate overhead and income taxes $ 100,388 $ 228,710 $ (184,620 ) $ 144,478 Allocation of corporate overhead $ (44,698 ) $ (24,750 ) $ 69,448 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 55,690 $ 203,960 $ (115,172 ) $ 144,478 Total assets as of September 30, 2014 $ 3,321,166 $ 5,429,453 $ 210,973 $ 8,961,592 Nine months ended September 30, 2014 Acute Care Hospital Services Behavioral Health Services Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 11,217,320 $ 4,973,633 $ - $ 16,190,953 Gross outpatient revenues $ 6,083,715 $ 580,627 $ 25,821 $ 6,690,163 Total net revenues $ 3,054,359 $ 2,964,047 $ 10,391 $ 6,028,797 Income/(loss) before allocation of corporate overhead and income taxes $ 330,382 $ 693,399 $ (385,175 ) $ 638,606 Allocation of corporate overhead $ (134,088 ) $ (74,055 ) $ 208,143 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 196,294 $ 619,344 $ (177,032 ) $ 638,606 Total assets as of September 30, 2014 $ 3,321,166 $ 5,429,453 $ 210,973 $ 8,961,592 |
Earnings Per Share Data ("EPS21
Earnings Per Share Data ("EPS") and Stock Based Compensation (Tables) | 9 Months Ended |
Sep. 30, 2015 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | |
Computation of Basic and Diluted Earnings per Share for Classes A, B, C and D Common Stockholders | The following table sets forth the computation of basic and diluted earnings per share for classes A, B, C and D common stockholders for the periods indicated (in thousands, except per share data): Three months ended September 30, Nine months ended September 30, (amounts in thousands) 2015 2014 2015 2014 Basic and Diluted: Net income attributable to UHS $ 150,287 $ 82,797 $ 506,779 $ 372,546 Less: Net income attributable to unvested restricted share grants (82 ) (17 ) (221 ) (164 ) Net income attributable to UHS – basic and diluted $ 150,205 $ 82,780 $ 506,558 $ 372,382 Weighted average number of common shares - basic 98,858 99,052 98,924 98,832 Net effect of dilutive stock options and grants based on the treasury stock method 2,301 1,981 1,987 1,643 Weighted average number of common shares and equivalents - diluted 101,159 101,033 100,911 100,475 Earnings per basic share attributable to UHS: $ 1.52 $ 0.84 $ 5.12 $ 3.77 Earnings per diluted share attributable to UHS: $ 1.48 $ 0.82 $ 5.02 $ 3.71 |
Supplemental Condensed Consol22
Supplemental Condensed Consolidating Financial Information (Tables) | 9 Months Ended |
Sep. 30, 2015 | |
Condensed Financial Information Of Parent Company Only Disclosure [Abstract] | |
Condensed Consolidating Statements of Income | UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF INCOME FOR THE THREE MONTHS ENDED SEPTEMBER 30, 2015 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net revenues before provision for doubtful accounts $ 0 $ 1,688,939 $ 758,095 $ (7,963 ) $ 2,439,071 Less: Provision for doubtful accounts 0 135,897 75,519 0 211,416 Net revenues 0 1,553,042 682,576 (7,963 ) 2,227,655 Operating charges: Salaries, wages and benefits 0 754,069 303,157 0 1,057,226 Other operating expenses 0 361,965 174,947 (7,529 ) 529,383 Supplies expense 0 143,296 98,963 0 242,259 Depreciation and amortization 0 69,875 29,567 0 99,442 Lease and rental expense 0 15,261 9,717 (434 ) 24,544 Electronic health records incentive income 0 (356 ) 0 0 (356 ) 0 1,344,110 616,351 (7,963 ) 1,952,498 Income from operations 0 208,932 66,225 0 275,157 Interest expense 25,543 1,173 414 0 27,130 Interest (income) expense, affiliate 0 23,054 (23,054 ) 0 0 Equity in net income of consolidated affiliates (166,054 ) (40,178 ) 0 206,232 0 Income before income taxes 140,511 224,883 88,865 (206,232 ) 248,027 Provision for income taxes (9,776 ) 74,531 19,618 0 84,373 Net income 150,287 150,352 69,247 (206,232 ) 163,654 Less: Income attributable to noncontrolling interests 0 0 13,367 0 13,367 Net income attributable to UHS $ 150,287 $ 150,352 $ 55,880 $ (206,232 ) $ 150,287 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF INCOME FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2015 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net revenues before provision for doubtful accounts $ 0 $ 5,040,823 $ 2,254,656 $ (23,627 ) $ 7,271,852 Less: Provision for doubtful accounts 0 357,095 186,545 0 543,640 Net revenues 0 4,683,728 2,068,111 (23,627 ) 6,728,212 Operating charges: Salaries, wages and benefits 0 2,239,853 893,140 0 3,132,993 Other operating expenses 0 1,080,690 512,869 (22,499 ) 1,571,060 Supplies expense 0 430,288 291,691 0 721,979 Depreciation and amortization 0 208,577 87,120 0 295,697 Lease and rental expense 0 43,160 28,599 (1,128 ) 70,631 Electronic health records incentive income 0 (1,751 ) 0 0 (1,751 ) 0 4,000,817 1,813,419 (23,627 ) 5,790,609 Income from operations 0 682,911 254,692 0 937,603 Interest expense 80,087 3,566 1,198 0 84,851 Interest (income) expense, affiliate 0 69,163 (69,163 ) 0 0 Equity in net income of consolidated affiliates (556,213 ) (160,481 ) 0 716,694 0 Income before income taxes 476,126 770,663 322,657 (716,694 ) 852,752 Provision for income taxes (30,653 ) 257,400 66,624 0 293,371 Net income 506,779 513,263 256,033 (716,694 ) 559,381 Less: Income attributable to noncontrolling interests 0 0 52,602 0 52,602 Net income attributable to UHS $ 506,779 $ 513,263 $ 203,431 $ (716,694 ) $ 506,779 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF INCOME FOR THE THREE MONTHS ENDED SEPTEMBER 30, 2014 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net revenues before provision for doubtful accounts $ 0 $ 1,548,315 $ 655,321 $ (7,123 ) $ 2,196,513 Less: Provision for doubtful accounts 0 109,858 47,938 0 157,796 Net revenues 0 1,438,457 607,383 (7,123 ) 2,038,717 Operating charges: Salaries, wages and benefits 0 680,877 272,706 0 953,583 Other operating expenses 0 384,689 155,758 (6,694 ) 533,753 Supplies expense 0 134,966 87,742 0 222,708 Depreciation and amortization 0 67,204 26,252 0 93,456 Lease and rental expense 0 15,034 9,255 (429 ) 23,860 Electronic health records incentive income 0 (531 ) (894 ) 0 (1,425 ) Costs related to extinguishment of debt 36,171 0 0 0 36,171 36,171 1,282,239 550,819 (7,123 ) 1,862,106 Income from operations (36,171 ) 156,218 56,564 0 176,611 Interest expense 30,503 1,277 353 0 32,133 Interest (income) expense, affiliate 0 22,113 (22,113 ) 0 0 Equity in net income of consolidated affiliates (123,951 ) (32,595 ) 0 156,546 0 Income before income taxes 57,277 165,423 78,324 (156,546 ) 144,478 Provision for income taxes (25,520 ) 54,139 19,821 0 48,440 Net income 82,797 111,284 58,503 (156,546 ) 96,038 Less: Income attributable to noncontrolling interests 0 0 13,241 0 13,241 Net income attributable to UHS $ 82,797 $ 111,284 $ 45,262 $ (156,546 ) $ 82,797 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF INCOME FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2014 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net revenues before provision for doubtful accounts $ 0 $ 4,574,273 $ 2,018,260 $ (21,801 ) $ 6,570,732 Less: Provision for doubtful accounts 0 367,375 174,560 0 541,935 Net revenues 0 4,206,898 1,843,700 (21,801 ) 6,028,797 Operating charges: Salaries, wages and benefits 0 2,038,171 812,697 0 2,850,868 Other operating expenses 0 950,549 464,488 (20,711 ) 1,394,326 Supplies expense 0 403,195 259,085 0 662,280 Depreciation and amortization 0 199,540 77,966 0 277,506 Lease and rental expense 0 43,827 27,919 (1,090 ) 70,656 Electronic health records incentive income 0 (2,665 ) (1,364 ) 0 (4,029 ) Costs related to extinguishment of debt 36,171 0 0 0 36,171 36,171 3,632,617 1,640,791 (21,801 ) 5,287,778 Income from operations (36,171 ) 574,281 202,909 0 741,019 Interest expense 97,665 3,248 1,500 0 102,413 Interest (income) expense, affiliate 0 66,337 (66,337 ) 0 0 Equity in net income of consolidated affiliates (455,156 ) (125,458 ) 0 580,614 0 Income before income taxes 321,320 630,154 267,746 (580,614 ) 638,606 Provision for income taxes (51,226 ) 217,340 57,988 0 224,102 Net income 372,546 412,814 209,758 (580,614 ) 414,504 Less: Income attributable to noncontrolling interests 0 0 41,958 0 41,958 Net income attributable to UHS $ 372,546 $ 412,814 $ 167,800 $ (580,614 ) $ 372,546 |
Condensed Consolidating Statements of Comprehensive Income | UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME FOR THE THREE MONTHS ENDED SEPTEMBER 30, 2015 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net income $ 150,287 $ 150,352 $ 69,247 $ (206,232 ) $ 163,654 Other comprehensive income (loss): Unrealized derivative gains on cash flow hedges (9,888 ) 0 0 0 (9,888 ) Amortization of terminated hedge (84 ) 0 0 0 (84 ) Foreign currency translation adjustment (2,304 ) (2,304 ) 0 2,304 (2,304 ) Other comprehensive income before tax (12,276 ) (2,304 ) 0 2,304 (12,276 ) Income tax expense related to items of other comprehensive income (3,742 ) 0 0 0 (3,742 ) Total other comprehensive income, net of tax (8,534 ) (2,304 ) 0 2,304 (8,534 ) Comprehensive income 141,753 148,048 69,247 (203,928 ) 155,120 Less: Comprehensive income attributable to noncontrolling interests 0 0 13,367 0 13,367 Comprehensive income attributable to UHS $ 141,753 $ 148,048 $ 55,880 $ (203,928 ) $ 141,753 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2015 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net income $ 506,779 $ 513,263 $ 256,033 $ (716,694 ) $ 559,381 Other comprehensive income (loss): Unrealized derivative gains on cash flow hedges (4,950 ) 0 0 0 (4,950 ) Amortization of terminated hedge (252 ) 0 0 0 (252 ) Foreign currency translation adjustment (96 ) (96 ) 0 96 (96 ) Other comprehensive income before tax (5,298 ) (96 ) 0 96 (5,298 ) Income tax expense related to items of other comprehensive income (1,530 ) 0 0 0 (1,530 ) Total other comprehensive income, net of tax (3,768 ) (96 ) 0 96 (3,768 ) Comprehensive income 503,011 513,167 256,033 (716,598 ) 555,613 Less: Comprehensive income attributable to noncontrolling interests 0 0 52,602 0 52,602 Comprehensive income attributable to UHS $ 503,011 $ 513,167 $ 203,431 $ (716,598 ) $ 503,011 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME FOR THE THREE MONTHS ENDED SEPTEMBER 30, 2014 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net income $ 82,797 $ 111,284 $ 58,503 $ (156,546 ) $ 96,038 Other comprehensive income (loss): Unrealized derivative gains on cash flow hedges 4,712 0 0 0 4,712 Amortization of terminated hedge (84 ) 0 0 0 (84 ) Currency translation adjustment (2,506 ) 0 0 0 (2,506 ) Other comprehensive income before tax 2,122 0 0 0 2,122 Income tax expense related to items of other comprehensive income 1,620 0 0 0 1,620 Total other comprehensive income, net of tax 502 0 0 0 502 Comprehensive income 83,299 111,284 58,503 (156,546 ) 96,540 Less: Comprehensive income attributable to noncontrolling interests 0 0 13,241 0 13,241 Comprehensive income attributable to UHS $ 83,299 $ 111,284 $ 45,262 $ (156,546 ) $ 83,299 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2014 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net income $ 372,546 $ 412,814 $ 209,758 $ (580,614 ) $ 414,504 Other comprehensive income (loss): Unrealized derivative gains on cash flow hedges 12,922 0 0 0 12,922 Amortization of terminated hedge (252 ) 0 0 0 (252 ) Currency translation adjustment (2,506 ) 0 0 0 (2,506 ) Other comprehensive income before tax 10,164 0 0 0 10,164 Income tax expense related to items of other comprehensive income 4,685 0 0 0 4,685 Total other comprehensive income, net of tax 5,479 0 0 0 5,479 Comprehensive income 378,025 412,814 209,758 (580,614 ) 419,983 Less: Comprehensive income attributable to noncontrolling interests 0 0 41,958 0 41,958 Comprehensive income attributable to UHS $ 378,025 $ 412,814 $ 167,800 $ (580,614 ) $ 378,025 |
Condensed Consolidating Balance Sheet | UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING BALANCE SHEET AS OF SEPTEMBER 30, 2015 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Assets Current assets: Cash and cash equivalents $ 0 $ 27,934 $ 11,589 $ 0 $ 39,523 Accounts receivable, net 0 940,262 388,038 0 1,328,300 Supplies 0 69,744 42,974 0 112,718 Deferred income taxes 132,407 2,147 0 0 134,554 Other current assets 0 69,304 12,155 0 81,459 Total current assets 132,407 1,109,391 454,756 0 1,696,554 Investments in subsidiaries 7,569,657 1,821,777 0 (9,391,434 ) 0 Intercompany receivable 0 0 507,740 (507,740 ) 0 Intercompany note receivable 0 0 1,267,637 (1,267,637 ) 0 Property and equipment 0 4,664,695 1,851,219 0 6,515,914 Less: accumulated depreciation 0 (1,828,173 ) (911,649 ) 0 (2,739,822 ) 0 2,836,522 939,570 0 3,776,092 Other assets: Goodwill 0 2,862,325 526,053 0 3,388,378 Deferred charges 27,171 5,641 2,301 0 35,113 Other 8,031 259,784 42,926 0 310,741 $ 7,737,266 $ 8,895,440 $ 3,740,983 $ (11,166,811 ) $ 9,206,878 Liabilities and Stockholders’ Equity Current liabilities: Current maturities of long-term debt $ 61,177 $ 1,214 $ 22,492 $ 0 $ 84,883 Accounts payable and accrued liabilities 22,084 1,018,055 62,477 0 1,102,616 Federal and state taxes 8,697 0 0 0 8,697 Total current liabilities 91,958 1,019,269 84,969 0 1,196,196 Intercompany payable 259,415 248,325 0 (507,740 ) 0 Intercompany note payable 0 1,267,637 0 (1,267,637 ) 0 Other noncurrent liabilities 4,236 217,605 70,600 0 292,441 Long-term debt 2,984,200 17,095 8,659 0 3,009,954 Deferred income taxes 264,358 0 0 0 264,358 Redeemable noncontrolling interests 0 0 250,213 0 250,213 Equity: UHS common stockholders’ equity 4,133,099 6,125,509 3,265,925 (9,391,434 ) 4,133,099 Noncontrolling interest 0 0 60,617 0 60,617 Total equity 4,133,099 6,125,509 3,326,542 (9,391,434 ) 4,193,716 $ 7,737,266 $ 8,895,440 $ 3,740,983 $ (11,166,811 ) $ 9,206,878 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING BALANCE SHEET AS OF DECEMBER 31, 2014 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Assets Current assets: Cash and cash equivalents $ 0 $ 21,784 $ 10,285 $ 0 $ 32,069 Accounts receivable, net 0 933,971 348,764 0 1,282,735 Supplies 0 67,847 40,268 0 108,115 Deferred income taxes 113,822 743 0 0 114,565 Other current assets 0 62,431 15,223 0 77,654 Total current assets 113,822 1,086,776 414,540 0 1,615,138 Investments in subsidiaries 7,013,540 1,661,296 0 (8,674,836 ) 0 Intercompany receivable 103,808 0 408,682 (512,490 ) 0 Intercompany note receivable 0 0 1,222,637 (1,222,637 ) 0 Property and equipment 0 4,494,567 1,717,463 0 6,212,030 Less: accumulated depreciation 0 (1,686,192 ) (846,149 ) 0 (2,532,341 ) 0 2,808,375 871,314 0 3,679,689 Other assets: Goodwill 0 2,764,555 526,658 0 3,291,213 Deferred charges 32,379 5,402 2,538 0 40,319 Other 9,601 283,302 55,181 0 348,084 $ 7,273,150 $ 8,609,706 $ 3,501,550 $ (10,409,963 ) $ 8,974,443 Liabilities and Stockholders’ Equity Current liabilities: Current maturities of long-term debt $ 44,874 $ 1,260 $ 22,185 $ 0 $ 68,319 Accounts payable and accrued liabilities 20,245 1,051,309 41,508 0 1,113,062 Federal and state taxes 1,446 0 0 0 1,446 Total current liabilities 66,565 1,052,569 63,693 0 1,182,827 Intercompany payable 0 512,490 0 (512,490 ) 0 Intercompany note payable 0 1,222,637 0 (1,222,637 ) 0 Other noncurrent liabilities 1,322 189,456 77,777 0 268,555 Long-term debt 3,187,103 20,212 2,900 0 3,210,215 Deferred income taxes 282,214 0 0 0 282,214 Redeemable noncontrolling interests 0 0 239,552 0 239,552 Equity: UHS common stockholders’ equity 3,735,946 5,612,342 3,062,494 (8,674,836 ) 3,735,946 Noncontrolling interest 0 0 55,134 0 55,134 Total equity 3,735,946 5,612,342 3,117,628 (8,674,836 ) 3,791,080 $ 7,273,150 $ 8,609,706 $ 3,501,550 $ (10,409,963 ) $ 8,974,443 |
Condensed Consolidating Statements of Cash Flows | UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF CASH FLOWS FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2015 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net cash (used in) provided by operating activities $ (51,998 ) $ 554,650 $ 293,847 $ 0 $ 796,499 Cash Flows from Investing Activities: Property and equipment additions, net of disposals 0 (154,460 ) (115,118 ) 0 (269,578 ) Proceeds received from sale of assets and businesses 0 0 2,744 0 2,744 Cash paid/reserved related to acquisition of property and businesses 0 (171,116 ) (11,987 ) 0 (183,103 ) Net cash used in investing activities 0 (325,576 ) (124,361 ) 0 (449,937 ) Cash Flows from Financing Activities: Reduction of long-term debt (203,284 ) (3,163 ) (924 ) 0 (207,371 ) Additional borrowings 16,300 0 0 0 16,300 Repurchase of common shares (129,862 ) 0 0 0 (129,862 ) Dividends paid (29,696 ) 0 0 0 (29,696 ) Issuance of common stock 6,030 0 0 0 6,030 Excess income tax benefits related to stock-based compensation 29,287 0 0 0 29,287 Profit distributions to noncontrolling interests 0 0 (35,965 ) 0 (35,965 ) Proceeds received from sale/leaseback of real property 0 0 12,765 0 12,765 Changes in intercompany balances with affiliates, net 363,223 (219,165 ) (144,058 ) 0 0 Net cash provided by (used in) financing activities 51,998 (222,328 ) (168,182 ) 0 (338,512 ) Effect of exchange rate changes on cash and cash equivalents 0 (596 ) 0 0 (596 ) Increase in cash and cash equivalents 0 6,150 1,304 0 7,454 Cash and cash equivalents, beginning of period 0 21,784 10,285 0 32,069 Cash and cash equivalents, end of period $ 0 $ 27,934 $ 11,589 $ 0 $ 39,523 UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATING STATEMENTS OF CASH FLOWS FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2014 (amounts in thousands) Parent Guarantors Non Guarantors Consolidating Adjustments Total Consolidated Amounts Net cash provided by operating activities $ 8,445 $ 431,986 $ 249,123 $ 0 $ 689,554 Cash Flows from Investing Activities: Property and equipment additions, net of disposals 0 (205,455 ) (103,906 ) 0 (309,361 ) Proceeds received from sale of assets and businesses 0 11,450 3,728 0 15,178 Cash paid/reserved related to acquisition of property and businesses 0 (394,854 ) (7,551 ) 0 (402,405 ) Costs incurred for purchase and implementation of electronic health records application 0 (11,204 ) 0 0 (11,204 ) Net cash used in investing activities 0 (600,063 ) (107,729 ) 0 (707,792 ) Cash Flows from Financing Activities: Reduction of long-term debt (830,680 ) (609 ) (11,254 ) 0 (842,543 ) Additional borrowings 969,800 0 0 0 969,800 Financing costs (13,413 ) 0 0 0 (13,413 ) Repurchase of common shares (63,292 ) 0 0 0 (63,292 ) Dividends paid (19,794 ) 0 0 0 (19,794 ) Issuance of common stock 4,907 0 0 0 4,907 Excess income tax benefits related to stock-based compensation 30,242 0 0 0 30,242 Profit distributions to noncontrolling interests 0 0 (25,074 ) 0 (25,074 ) Changes in intercompany balances with affiliates, net (86,215 ) 190,021 (103,806 ) 0 0 Net cash (used in) provided by financing activities (8,445 ) 189,412 (140,134 ) 0 40,833 Effect of exchange rate changes on cash and cash equivalents 0 (122 ) 0 0 (122 ) Increase in cash and cash equivalents 0 21,213 1,260 0 22,473 Cash and cash equivalents, beginning of period 0 7,990 9,248 0 17,238 Cash and cash equivalents, end of period $ 0 $ 29,203 $ 10,508 $ 0 $ 39,711 |
Dispositions and Acquisitions -
Dispositions and Acquisitions - Additional Information (Detail) $ in Thousands | 1 Months Ended | 3 Months Ended | 9 Months Ended | ||
Oct. 31, 2015USD ($)FacilityBed | Sep. 30, 2015BedHospital | Mar. 31, 2015Bed | Sep. 30, 2015USD ($) | Sep. 30, 2014USD ($)FacilityBed | |
Acquisitions And Divestitures [Line Items] | |||||
Cash paid/reserved related to acquisition of property and businesses | $ | $ 183,103 | $ 402,405 | |||
Pre-tax gain (loss) proceeds from divestiture of businesses | $ | $ 10,000 | ||||
Alpha Hospitals Holdings Limited | |||||
Acquisitions And Divestitures [Line Items] | |||||
Number of beds | 305 | ||||
Number of hospitals | Hospital | 4 | ||||
Behavioral Health Services | |||||
Acquisitions And Divestitures [Line Items] | |||||
Number of beds | 46 | 48 | |||
Aggregate cash proceeds from divestiture of businesses | $ | $ 3,000 | $ 15,000 | |||
Behavioral Health Services | Cygnet Health Care Limited | |||||
Acquisitions And Divestitures [Line Items] | |||||
Number of facilities | Facility | 16 | ||||
Behavioral Health Services and Outpatient Treatment Center | |||||
Acquisitions And Divestitures [Line Items] | |||||
Number of beds | 124 | ||||
Subsequent Event | |||||
Acquisitions And Divestitures [Line Items] | |||||
Cash paid/reserved related to acquisition of property and businesses | $ | $ 350,000 | ||||
Number of facilities | Facility | 4 | ||||
Number of beds | 322 | ||||
Number of outpatient centers | Facility | 8 | ||||
Number of expansion beds in progress | 140 |
General (Detail)
General (Detail) - USD ($) | 3 Months Ended | 9 Months Ended | |||
Sep. 30, 2015 | Sep. 30, 2014 | Sep. 30, 2015 | Sep. 30, 2014 | Sep. 01, 2015 | |
Organization And Description Of Business [Line Items] | |||||
Revenue from Medicaid programs | $ 2,439,071,000 | $ 2,196,513,000 | $ 7,271,852,000 | $ 6,570,732,000 | |
Increase (decrease) in net revenue | 21,000,000 | ||||
Increase (decrease) in other operating expense | 71,000,000 | ||||
Impairment of goodwill or indefinite-lived intangible assets | $ 0 | ||||
State Medicaid programs | |||||
Organization And Description Of Business [Line Items] | |||||
Revenue from Medicaid programs | 62,000,000 | 53,000,000 | 221,000,000 | 180,000,000 | |
Revenue offset amount | $ 30,000,000 | $ 21,000,000 | $ 97,000,000 | $ 71,000,000 |
Relationship with Universal H25
Relationship with Universal Health Realty Income Trust and Related Party Transactions - Additional Information (Detail) | 3 Months Ended | 9 Months Ended | 12 Months Ended | |||
Sep. 30, 2015USD ($) | Mar. 31, 2015USD ($)FacilityRenewalOption | Sep. 30, 2014USD ($) | Sep. 30, 2015USD ($) | Sep. 30, 2014USD ($) | Dec. 31, 2014USD ($) | |
Related Party Transaction [Line Items] | ||||||
Lease renewal period, years | 5 years | |||||
Notice period on renewal of lease | 90 days | |||||
Period of rights of refusal to leased facilities | 180 days | |||||
Chief Executive Officer | ||||||
Related Party Transaction [Line Items] | ||||||
Estimated payments to acquire life insurance policies | $ 25,000,000 | |||||
Payments to acquire life insurance policies | 1,300,000 | $ 1,300,000 | ||||
Chief Executive Officer | Trust Owned by Chief Executive Officer | ||||||
Related Party Transaction [Line Items] | ||||||
Estimated payments to acquire life insurance policies | $ 8,000,000 | |||||
Relationship with Universal Health Realty Income Trust | ||||||
Related Party Transaction [Line Items] | ||||||
Trust outstanding shares held, percentage | 5.90% | 5.90% | ||||
Advisory fee earned | $ 700,000 | $ 700,000 | $ 2,100,000 | 1,900,000 | ||
Pre-tax share of income from the Trust | 100,000 | 1,700,000 | 1,100,000 | 2,100,000 | ||
Share of aggregate gain on fair value recognition included in the share of trust | 1,600,000 | 1,600,000 | ||||
Carrying value of investment in Trust | 9,000,000 | 9,000,000 | $ 9,300,000 | |||
Market value of investment in Trust | 37,000,000 | 37,000,000 | 37,900,000 | |||
Aggregate construction cost/sales proceeds | $ 13,000,000 | |||||
Aggregate rent expense paid | $ 900,000 | 1,100,000 | ||||
Estimated purchase price of The Bridgeway's real property | $ 17,300,000 | |||||
Rent expense under operating leases | $ 4,000,000 | $ 4,000,000 | $ 12,000,000 | $ 12,000,000 | ||
Non-controlling ownership interests by subsidiaries | 100.00% | 100.00% | ||||
Relationship with Universal Health Realty Income Trust | Texas | ||||||
Related Party Transaction [Line Items] | ||||||
Number of free-standing emergency departments to be acquired | Facility | 2 | |||||
Lease agreement term | 10 years | |||||
Number of renewal options at existing lease rates | RenewalOption | 6 | |||||
Renewal options term at existing lease rates | 5 years | |||||
Renewal options term at fair market lease rates | 5 years | |||||
Minimum | ||||||
Related Party Transaction [Line Items] | ||||||
Lease initial terms | 13 years | |||||
Minimum | Chief Executive Officer | ||||||
Related Party Transaction [Line Items] | ||||||
Estimated death benefit proceeds | $ 33,000,000 | |||||
Maximum | ||||||
Related Party Transaction [Line Items] | ||||||
Lease initial terms | 15 years |
Remaining Renewal Options and T
Remaining Renewal Options and Terms for Hospital Facilities Leased from Trust (Detail) | 9 Months Ended | |
Sep. 30, 2015USD ($) | ||
McAllen Medical Center | ||
Property Subject to or Available for Operating Lease [Line Items] | ||
Annual Minimum Rent | $ 5,485,000 | |
End of Lease Term | 2016-12 | |
Renewal Term (years) | 15 years | [1] |
Wellington Regional Medical Center | ||
Property Subject to or Available for Operating Lease [Line Items] | ||
Annual Minimum Rent | $ 3,030,000 | |
End of Lease Term | 2016-12 | |
Renewal Term (years) | 15 years | [2] |
Southwest Healthcare System, Inland Valley Campus | ||
Property Subject to or Available for Operating Lease [Line Items] | ||
Annual Minimum Rent | $ 2,648,000 | |
End of Lease Term | 2016-12 | |
Renewal Term (years) | 15 years | [2] |
[1] | We have three 5-year renewal options at existing lease rates (through 2031). | |
[2] | We have one 5-year renewal option at existing lease rates (through 2021) and two 5-year renewal options at fair market value lease rates (2022 through 2031). |
Remaining Renewal Options and27
Remaining Renewal Options and Terms for Hospital Facilities Leased from Trust (Parenthetical) (Detail) | 9 Months Ended |
Sep. 30, 2015RenewalOption | |
McAllen Medical Center | |
Property Subject to or Available for Operating Lease [Line Items] | |
Number of renewal options at existing lease rates | 3 |
Renewal options term at existing lease rates | 5 years |
McAllen Medical Center | Maximum | |
Property Subject to or Available for Operating Lease [Line Items] | |
Renewal options at existing lease rates expiration year | 2,031 |
Wellington Regional Medical Center | |
Property Subject to or Available for Operating Lease [Line Items] | |
Number of renewal options at existing lease rates | 1 |
Renewal options term at existing lease rates | 5 years |
Number of renewal options at fair market lease rates | 2 |
Renewal options term at fair market lease rates | 5 years |
Wellington Regional Medical Center | Maximum | |
Property Subject to or Available for Operating Lease [Line Items] | |
Renewal options at existing lease rates expiration year | 2,021 |
Renewal options at fair market value lease rates expiration year | 2,031 |
Wellington Regional Medical Center | Minimum | |
Property Subject to or Available for Operating Lease [Line Items] | |
Renewal options at fair market value lease rates expiration year | 2,022 |
Southwest Healthcare System, Inland Valley Campus | |
Property Subject to or Available for Operating Lease [Line Items] | |
Number of renewal options at existing lease rates | 1 |
Renewal options term at existing lease rates | 5 years |
Number of renewal options at fair market lease rates | 2 |
Renewal options term at fair market lease rates | 5 years |
Southwest Healthcare System, Inland Valley Campus | Maximum | |
Property Subject to or Available for Operating Lease [Line Items] | |
Renewal options at existing lease rates expiration year | 2,021 |
Renewal options at fair market value lease rates expiration year | 2,031 |
Southwest Healthcare System, Inland Valley Campus | Minimum | |
Property Subject to or Available for Operating Lease [Line Items] | |
Renewal options at fair market value lease rates expiration year | 2,022 |
Other Noncurrent Liabilities 28
Other Noncurrent Liabilities and Redeemable/Noncontrolling Interests - Additional Information (Detail) $ in Millions | 9 Months Ended | |
Sep. 30, 2015USD ($)Facility | Dec. 31, 2014USD ($) | |
Noncontrolling Interest [Line Items] | ||
Redeemable non-controlling interest balances | $ | $ 250 | $ 240 |
Non-controlling interest balances | $ | $ 61 | $ 55 |
Acute Care Hospital Services | Las Vegas, Nevada | ||
Noncontrolling Interest [Line Items] | ||
Percentage of noncontrolling, minority ownership interests held by outside owners | 28.00% | |
Acute care facilities with outside owners holding non-controlling minority interest | 6 | |
Number of facility currently under construction | 1 | |
Acute Care Hospital Services | Washington, District of Columbia | ||
Noncontrolling Interest [Line Items] | ||
Percentage of noncontrolling, minority ownership interests held by outside owners | 20.00% | |
Acute Care Hospital Services | Laredo, Texas | ||
Noncontrolling Interest [Line Items] | ||
Percentage of noncontrolling, minority ownership interests held by outside owners | 11.00% | |
Behavioral Health Services | Philadelphia, Pennsylvania | ||
Noncontrolling Interest [Line Items] | ||
Percentage of noncontrolling, minority ownership interests held by outside owners | 20.00% |
Long-term debt and cash flow 29
Long-term debt and cash flow hedges - Additional Information (Detail) | Jul. 31, 2014USD ($) | Sep. 30, 2015USD ($)Derivative | Jun. 30, 2015USD ($)Derivative | Dec. 31, 2014USD ($) | Mar. 31, 2011USD ($)Derivative | Sep. 30, 2015USD ($) | Sep. 30, 2014USD ($) | Aug. 31, 2014USD ($) | Aug. 07, 2014USD ($) | Aug. 01, 2014USD ($) | Oct. 31, 2013USD ($) | Jun. 30, 2008USD ($) | Jun. 30, 2006USD ($) |
Debt Instrument [Line Items] | |||||||||||||
Reduction of long-term debt | $ 207,371,000 | $ 842,543,000 | |||||||||||
Rate adjustment to weighted average federal funds rate for credit facility borrowings | 0.50% | 0.50% | |||||||||||
Rate adjustment to one month Eurodollar rate on credit facility borrowings | 1.00% | ||||||||||||
Accounts receivable securitization program credit facility, amount outstanding | $ 300,000,000 | $ 300,000,000 | |||||||||||
Long-term debt | 3,009,954,000 | $ 3,210,215,000 | 3,009,954,000 | ||||||||||
Fair value of debt | $ 3,100,000,000 | $ 3,100,000,000 | |||||||||||
Number of additional forward starting interest rate swaps | Derivative | 4 | ||||||||||||
Maturity date of interest rate cash flow hedges | May 31, 2015 | ||||||||||||
Two Point Three Eight Percent Forward Starting Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Number of additional forward starting interest rate swaps | Derivative | 4 | ||||||||||||
Fixed rate payable on interest rate swap | 2.38% | ||||||||||||
One Point Nine One Percent Forward Starting Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Number of additional forward starting interest rate swaps | Derivative | 3 | ||||||||||||
Fixed rate payable on interest rate swap | 1.91% | ||||||||||||
One Point Four Zero Percent Forward Starting Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Number of additional forward starting interest rate swaps | Derivative | 4 | ||||||||||||
Maturity date of interest rate cash flow hedges | Apr. 15, 2019 | ||||||||||||
Fixed rate payable on interest rate swap | 1.40% | ||||||||||||
One Point Two Three Percent Forward Starting Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Maturity date of interest rate cash flow hedges | Apr. 15, 2019 | ||||||||||||
Average fixed rate payable on interest rate swap | 1.23% | 1.23% | |||||||||||
Interest Rate Swap | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Fair value of our interest rate swaps | $ 11,000,000 | $ 11,000,000 | |||||||||||
Fair value of our interest rate swaps, liability | 8,000,000 | 6,000,000 | 8,000,000 | ||||||||||
Interest Rate Swap | Other Noncurrent Liabilities | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Fair value of our interest rate swaps, liability | 3,000,000 | 3,000,000 | |||||||||||
Cash Flow Hedging | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Number of additional forward starting interest rate swaps | Derivative | 7 | ||||||||||||
Notional amount of interest rate cash flow hedges | $ 825,000,000 | ||||||||||||
Cash Flow Hedging | Two Point Three Eight Percent Forward Starting Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Notional amount of interest rate cash flow hedges | 600,000,000 | ||||||||||||
Cash Flow Hedging | One Point Nine One Percent Forward Starting Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Notional amount of interest rate cash flow hedges | $ 225,000,000 | ||||||||||||
Cash Flow Hedging | One Point Four Zero Percent Forward Starting Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Notional amount of interest rate cash flow hedges | $ 500,000,000 | ||||||||||||
Cash Flow Hedging | Forward Starting Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Notional amount of interest rate cash flow hedges | 400,000,000 | 400,000,000 | |||||||||||
Cash Flow Hedging | One Point Two Three Percent Forward Starting Interest Rate Swaps | One Point Two Three Percent Forward Starting Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Notional amount of interest rate cash flow hedges | 100,000,000 | 100,000,000 | |||||||||||
Cash Flow Hedging | One Point Two Three Percent Forward Starting Interest Rate Swaps | One Point Two Three Percent Forward Starting Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Notional amount of interest rate cash flow hedges | 200,000,000 | $ 200,000,000 | |||||||||||
7.00% Senior Unsecured Notes | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Reduction of long-term debt | $ 250,000,000 | ||||||||||||
Senior notes, interest rate | 7.00% | ||||||||||||
Debt instrument redemption, date | Jul. 31, 2014 | ||||||||||||
Unsecured notes make-whole redemption price | 104.56% | ||||||||||||
Senior notes, maturity date | Oct. 1, 2018 | ||||||||||||
Write-off deferred charges, original issue discount and make-whole premiums paid | $ 11,000,000 | ||||||||||||
Accounts Receivable Securitization Facility | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Accounts receivable securitization program, additional capacity | 60,000,000 | $ 60,000,000 | |||||||||||
Senior Notes 7.125% | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Senior notes, interest rate | 7.125% | ||||||||||||
Senior notes, issued | $ 250,000,000 | ||||||||||||
Senior notes, maturity date | Jun. 30, 2016 | ||||||||||||
Senior notes, repayment terms | Interest on the 7.125% Notes is payable semiannually in arrears on June 30th and December 30th of each year. | ||||||||||||
Line of credit facility additional borrowing capacity | $ 150,000,000 | ||||||||||||
Amendment of Credit Facility | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Line of credit facility, starting date | Aug. 7, 2014 | ||||||||||||
Line of credit facility, maturity | 2019-08 | ||||||||||||
Accounts receivable securitization program credit facility, borrowing capacity | $ 360,000,000 | $ 275,000,000 | |||||||||||
Amendment of Credit Facility | Accounts Receivable Securitization Facility | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Line of credit facility, starting date | Aug. 1, 2014 | ||||||||||||
Line of credit facility, maturity | 2016-10 | ||||||||||||
Revolving Credit Facility | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Line of credit facility, borrowing capacity | 800,000,000 | $ 800,000,000 | $ 800,000,000 | ||||||||||
Line of credit facility amount outstanding | $ 0 | $ 0 | |||||||||||
Current applicable margins | 1.50% | 1.50% | |||||||||||
Line of credit facility, available borrowing capacity | $ 744,000,000 | $ 744,000,000 | |||||||||||
Letters of credit, outstanding | 39,000,000 | 39,000,000 | |||||||||||
Revolving Credit Facility | Short Term on Demand Credit Facility | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Line of credit facility amount outstanding | 17,000,000 | 17,000,000 | |||||||||||
Revolving Credit Facility | Letter of Credit | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Line of credit facility, borrowing capacity | $ 125,000,000 | $ 125,000,000 | |||||||||||
Revolving Credit Facility | ABR-based loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Current applicable margins | 0.50% | 0.50% | |||||||||||
Revolving Credit Facility | Minimum | One Month Eurodollar Rate Plus Index Based Loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Consolidated leverage ratio | 0.50% | 0.50% | |||||||||||
Revolving Credit Facility | Minimum | One Two Three Six Month Eurodollar Rate Plus Index Based Loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Consolidated leverage ratio | 1.50% | 1.50% | |||||||||||
Revolving Credit Facility | Maximum | One Month Eurodollar Rate Plus Index Based Loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Consolidated leverage ratio | 1.25% | 1.25% | |||||||||||
Revolving Credit Facility | Maximum | One Two Three Six Month Eurodollar Rate Plus Index Based Loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Consolidated leverage ratio | 2.25% | 2.25% | |||||||||||
Term Loan A | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Current applicable margins | 1.50% | 1.50% | |||||||||||
Term Loan A | ABR-based loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Current applicable margins | 0.50% | 0.50% | |||||||||||
Term Loan A | Minimum | One Month Eurodollar Rate Plus Index Based Loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Consolidated leverage ratio | 0.50% | 0.50% | |||||||||||
Term Loan A | Minimum | One Two Three Six Month Eurodollar Rate Plus Index Based Loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Consolidated leverage ratio | 1.50% | 1.50% | |||||||||||
Term Loan A | Maximum | One Month Eurodollar Rate Plus Index Based Loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Consolidated leverage ratio | 1.25% | 1.25% | |||||||||||
Term Loan A | Maximum | One Two Three Six Month Eurodollar Rate Plus Index Based Loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Consolidated leverage ratio | 2.25% | 2.25% | |||||||||||
Term Loan A | Quarterly installment payments commence in the fourth quarter of 2014 through September, 2016 | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Scheduled principal payments made | 11,000,000 | ||||||||||||
Term Loan A | Quarterly installment payments after September, 2016 | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Scheduled principal payments made | $ 22,000,000 | ||||||||||||
Term Loan A | Amendment of Credit Facility | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Line of credit facility, borrowing capacity | $ 1,775,000,000 | ||||||||||||
Line of credit facility amount outstanding | $ 1,731,000,000 | $ 1,731,000,000 | |||||||||||
Term Loan B Facility | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Reduction of long-term debt | $ 550,000,000 | ||||||||||||
Line of credit facility, maturity year | 2,016 | ||||||||||||
New Senior Secured Notes | 3.750% Senior Secured Notes due 2019 | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Senior notes, interest rate | 3.75% | ||||||||||||
Senior notes, issued | $ 300,000,000 | ||||||||||||
Senior notes, maturity date | Aug. 1, 2019 | ||||||||||||
Senior notes, interest payment, commencement date | Feb. 1, 2015 | ||||||||||||
New Senior Secured Notes | 4.750% Senior Secured Notes due 2022 | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Senior notes, interest rate | 4.75% | ||||||||||||
Senior notes, issued | $ 300,000,000 | ||||||||||||
Senior notes, maturity date | Aug. 1, 2022 |
Commitments and Contingencies -
Commitments and Contingencies - Additional Information (Detail) £ in Millions | 1 Months Ended | 9 Months Ended | |||||||
Aug. 31, 2015 | Nov. 30, 2010USD ($)Facility | Sep. 30, 2015GBP (£) | Oct. 31, 2015USD ($) | Sep. 30, 2015USD ($) | Dec. 31, 2014USD ($) | Dec. 31, 2013USD ($) | Oct. 31, 2012USD ($) | Nov. 30, 2010GBP (£) | |
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Self-insured for professional and general liability | $ 210,000,000 | $ 193,000,000 | |||||||
Self-insured for professional and general liability, current | 51,000,000 | 51,000,000 | |||||||
Compensation liability claims | 70,000,000 | 67,000,000 | |||||||
Compensation and related benefits | 32,000,000 | 32,000,000 | |||||||
Accounts receivable, net | 1,328,300,000 | 1,282,735,000 | |||||||
Payment suspension period increased | 180 days | ||||||||
Letters of Credit and Surety Bonds | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Off-balance sheet contingent obligation | 125,000,000 | ||||||||
Self Insurance Programs | Letters of Credit and Surety Bonds | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Off-balance sheet contingent obligation | 96,000,000 | ||||||||
Other Debt Guarantees | Letters of Credit and Surety Bonds | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Off-balance sheet contingent obligation | 29,000,000 | ||||||||
Location 1 | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Minimum Insurance Deductible | 50,000 | ||||||||
Location 2 | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Minimum Insurance Deductible | 250,000 | ||||||||
Illinois | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Accounts receivable, net | 24,000,000 | 44,000,000 | |||||||
Accounts receivable net greater than sixty days Past due | 8,000,000 | 23,000,000 | |||||||
Accounts receivable | 83,000,000 | $ 102,000,000 | |||||||
Illinois | Subsequent Event | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Accounts receivable | $ 31,000,000 | ||||||||
Illinois | Uncompensated Care Program Revenues | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Accounts receivable | 63,000,000 | ||||||||
Illinois | Delivery System Reform Incentive Pool | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Accounts receivable | 20,000,000 | ||||||||
Earthquake | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Minimum Insurance Deductible | 250,000 | ||||||||
Earthquake | PUERTO RICO | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Commercial property insurance policies covering catastrophic losses | 25,000,000 | ||||||||
Maximum insurance deductible | 25,000 | ||||||||
Flood | Location 1 | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Maximum insurance deductible | 500,000 | ||||||||
Flood | Location 2 | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Maximum insurance deductible | 250,000 | ||||||||
Cygnet Health Care Limited | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Number of inpatient behavioral health hospitals | Facility | 21 | ||||||||
Property insurance | £ | £ 180 | ||||||||
Maximum | Wind Storms | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Commercial property insurance policies covering catastrophic losses | $ 1,000,000,000 | ||||||||
Percentage of insurance deductible | 5.00% | ||||||||
Maximum | Earthquake | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Commercial property insurance policies covering catastrophic losses | $ 250,000,000 | ||||||||
Maximum | Earthquake | UNITED STATES | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Commercial property insurance policies covering catastrophic losses | $ 100,000,000 | ||||||||
Percentage of insurance deductible | 5.00% | ||||||||
Minimum | Wind Storms | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Percentage of insurance deductible | 3.00% | ||||||||
Minimum | Earthquake | UNITED STATES | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Percentage of insurance deductible | 1.00% | ||||||||
Professional Liability | Cygnet Health Care Limited | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Self-insured for professional and general liability | £ | £ 10 | ||||||||
General Liability | Cygnet Health Care Limited | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Self-insured for professional and general liability | £ | £ 25 | ||||||||
Subsidiaries | Professional Liability | Maximum | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Self-insured for professional and general liability | $ 10,000,000 | ||||||||
Subsidiaries | General Liability | Maximum | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Self-insured for professional and general liability | $ 3,000,000 | ||||||||
Subsidiaries | General and Professional Liability Insurance Policies | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Percentage of liability for claims paid under commercially insured coverage | 10.00% | ||||||||
Subsidiaries | General and Professional Liability Insurance Policies | Maximum | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Purchased several excess policies through commercial insurance carriers per occurrence | $ 250,000,000 | $ 200,000,000 | |||||||
Liability for claims paid under commercially insured coverage | 60,000,000 | ||||||||
Subsidiaries | General and Professional Liability Insurance Policies | Minimum | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Liability for claims paid under commercially insured coverage | 10,000,000 | ||||||||
Psychiatric Solutions Inc | General and Professional Liability Insurance Policies | Maximum | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Self-insured for professional and general liability | $ 3,000,000 | ||||||||
Behavioral Health Facilities Acquired from Ascend Health Corporation | General and Professional Liability Insurance Policies | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Minimum Insurance Deductible | $ 100,000 | ||||||||
Behavioral Health Facilities Acquired from Ascend Health Corporation | General and Professional Liability Insurance Policies | Maximum | |||||||||
Commitments and Contingencies Disclosure [Line Items] | |||||||||
Self-insured for professional and general liability | $ 12,000,000 |
Segment Reporting (Detail)
Segment Reporting (Detail) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | |||
Sep. 30, 2015 | Sep. 30, 2014 | Sep. 30, 2015 | Sep. 30, 2014 | Dec. 31, 2014 | |
Segment Reporting Information [Line Items] | |||||
Gross inpatient revenues | $ 5,992,494 | $ 5,294,869 | $ 18,198,689 | $ 16,190,953 | |
Gross outpatient revenues | 2,646,789 | 2,259,152 | 7,772,238 | 6,690,163 | |
Total net revenues | 2,227,655 | 2,038,717 | 6,728,212 | 6,028,797 | |
Income/(loss) before allocation of corporate overhead and income taxes | 248,027 | 144,478 | 852,752 | 638,606 | |
Allocation of corporate overhead | 0 | 0 | 0 | 0 | |
Income/(loss) after allocation of corporate overhead and before income taxes | 248,027 | 144,478 | 852,752 | 638,606 | |
Total assets | 9,206,878 | 8,961,592 | 9,206,878 | 8,961,592 | $ 8,974,443 |
Acute Care Hospital Services | |||||
Segment Reporting Information [Line Items] | |||||
Gross inpatient revenues | 4,115,598 | 3,616,647 | 12,633,298 | 11,217,320 | |
Gross outpatient revenues | 2,444,456 | 2,058,148 | 7,132,212 | 6,083,715 | |
Total net revenues | 1,136,341 | 1,042,647 | 3,446,797 | 3,054,359 | |
Income/(loss) before allocation of corporate overhead and income taxes | 91,784 | 100,388 | 387,568 | 330,382 | |
Allocation of corporate overhead | (49,426) | (44,698) | (148,274) | (134,088) | |
Income/(loss) after allocation of corporate overhead and before income taxes | 42,358 | 55,690 | 239,294 | 196,294 | |
Total assets | 3,391,193 | 3,321,166 | 3,391,193 | 3,321,166 | |
Behavioral Health Services | |||||
Segment Reporting Information [Line Items] | |||||
Gross inpatient revenues | 1,876,896 | 1,678,222 | 5,565,391 | 4,973,633 | |
Gross outpatient revenues | 202,333 | 192,032 | 623,915 | 580,627 | |
Total net revenues | 1,089,509 | 992,461 | 3,272,714 | 2,964,047 | |
Income/(loss) before allocation of corporate overhead and income taxes | 249,812 | 228,710 | 771,667 | 693,399 | |
Allocation of corporate overhead | (29,526) | (24,750) | (88,913) | (74,055) | |
Income/(loss) after allocation of corporate overhead and before income taxes | 220,286 | 203,960 | 682,754 | 619,344 | |
Total assets | 5,458,647 | 5,429,453 | 5,458,647 | 5,429,453 | |
Other | |||||
Segment Reporting Information [Line Items] | |||||
Gross outpatient revenues | 8,972 | 16,111 | 25,821 | ||
Total net revenues | 1,805 | 3,609 | 8,701 | 10,391 | |
Income/(loss) before allocation of corporate overhead and income taxes | (93,569) | (184,620) | (306,483) | (385,175) | |
Allocation of corporate overhead | 78,952 | 69,448 | 237,187 | 208,143 | |
Income/(loss) after allocation of corporate overhead and before income taxes | (14,617) | (115,172) | (69,296) | (177,032) | |
Total assets | $ 357,038 | $ 210,973 | $ 357,038 | $ 210,973 |
Computation of Basic and Dilute
Computation of Basic and Diluted Earnings Per Share for classes A, B, C and D Common Stockholders (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2015 | Sep. 30, 2014 | Sep. 30, 2015 | Sep. 30, 2014 | |
Basic and Diluted: | ||||
Net income attributable to UHS | $ 150,287 | $ 82,797 | $ 506,779 | $ 372,546 |
Less: Net income attributable to unvested restricted share grants | (82) | (17) | (221) | (164) |
Net income attributable to UHS – basic and diluted | $ 150,205 | $ 82,780 | $ 506,558 | $ 372,382 |
Weighted average number of common shares - basic | 98,858 | 99,052 | 98,924 | 98,832 |
Net effect of dilutive stock options and grants based on the treasury stock method | 2,301 | 1,981 | 1,987 | 1,643 |
Weighted average number of common shares and equivalents - diluted | 101,159 | 101,033 | 100,911 | 100,475 |
Earnings per basic share attributable to UHS: | $ 1.52 | $ 0.84 | $ 5.12 | $ 3.77 |
Earnings per diluted share attributable to UHS: | $ 1.48 | $ 0.82 | $ 5.02 | $ 3.71 |
Earnings Per Share Data ("EPS33
Earnings Per Share Data ("EPS") and Stock Based Compensation - Additional Information (Detail) - USD ($) | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2015 | Sep. 30, 2014 | Sep. 30, 2015 | Sep. 30, 2014 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||||
Anti-dilutive weighted average stock options excluded from computation of earnings per share | 0 | 0 | 987,000 | 0 |
Unrecognized compensation cost related to unvested options and restricted stock | $ 76,400,000 | $ 76,400,000 | ||
Unrecognized compensation cost, remaining weighted average vesting period in years | 2 years 10 months 24 days | |||
Stock options granted during period (net of cancellations) | 2,940,850 | |||
Weighted-average grant date fair value, per share | $ 21.33 | |||
Stock-based compensation expense | $ 30,145,000 | $ 22,713,000 | ||
Excess income tax benefits related to stock-based compensation | 29,287,000 | 30,242,000 | ||
Stock Options | ||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||||
Compensation cost recognized | 9,200,000 | $ 7,500,000 | 28,700,000 | 21,700,000 |
Restricted Stock | ||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||||
Compensation cost recognized | $ 304,000 | $ 274,000 | $ 796,000 | $ 921,000 |
Dividends - Additional Informat
Dividends - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2015 | Sep. 30, 2014 | Sep. 30, 2015 | Sep. 30, 2014 | |
Dividends [Abstract] | ||||
Dividends declared and paid | $ 9.9 | $ 9.9 | $ 29.7 | $ 19.8 |
Quarterly cash dividend | $ 0.10 | $ 0.10 |
Income Taxes - Additional Infor
Income Taxes - Additional Information (Detail) - USD ($) | 9 Months Ended | |
Sep. 30, 2015 | Jan. 01, 2015 | |
Income Taxes [Line Items] | ||
Unrecognized tax benefits | $ 2,000,000 | |
Impact of unrecognized tax benefits if recognized | $ 2,000,000 | |
Jurisdictions statutes of limitations expiration period | 12 months | |
Period of expiration of the statute of limitations for certain jurisdictions | within the next twelve months | |
Minimum | ||
Income Taxes [Line Items] | ||
Foreign and U.S. state and local jurisdictions have statutes of limitations, in years | 3 years | |
Maximum | ||
Income Taxes [Line Items] | ||
Foreign and U.S. state and local jurisdictions have statutes of limitations, in years | 4 years | |
Accrued interest and penalties | $ 1,000,000 |
Supplemental Condensed Consol36
Supplemental Condensed Consolidating Financial Information - Additional Information (Detail) | Sep. 30, 2015 |
Guarantors | |
Supplementary Information [Line Items] | |
Percentage of ownership interests | 100.00% |
Supplemental Condensed Consol37
Supplemental Condensed Consolidating Statements of Income (Detail) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2015 | Sep. 30, 2014 | Sep. 30, 2015 | Sep. 30, 2014 | |
Condensed Financial Statements, Captions [Line Items] | ||||
Net revenues before provision for doubtful accounts | $ 2,439,071 | $ 2,196,513 | $ 7,271,852 | $ 6,570,732 |
Less: Provision for doubtful accounts | 211,416 | 157,796 | 543,640 | 541,935 |
Net revenues | 2,227,655 | 2,038,717 | 6,728,212 | 6,028,797 |
Operating charges: | ||||
Salaries, wages and benefits | 1,057,226 | 953,583 | 3,132,993 | 2,850,868 |
Other operating expenses | 529,383 | 533,753 | 1,571,060 | 1,394,326 |
Supplies expense | 242,259 | 222,708 | 721,979 | 662,280 |
Depreciation and amortization | 99,442 | 93,456 | 295,697 | 277,506 |
Lease and rental expense | 24,544 | 23,860 | 70,631 | 70,656 |
Electronic health records incentive income | (356) | (1,425) | (1,751) | (4,029) |
Costs related to extinguishment of debt | 0 | 36,171 | 0 | 36,171 |
Operating Expenses, Total | 1,952,498 | 1,862,106 | 5,790,609 | 5,287,778 |
Income from operations | 275,157 | 176,611 | 937,603 | 741,019 |
Interest expense | 27,130 | 32,133 | 84,851 | 102,413 |
Interest (income) expense, affiliate | 0 | 0 | 0 | 0 |
Equity in net income of consolidated affiliates | 0 | 0 | 0 | 0 |
Income before income taxes | 248,027 | 144,478 | 852,752 | 638,606 |
Provision for income taxes | 84,373 | 48,440 | 293,371 | 224,102 |
Net income | 163,654 | 96,038 | 559,381 | 414,504 |
Less: Income attributable to noncontrolling interests | 13,367 | 13,241 | 52,602 | 41,958 |
Net income attributable to UHS | 150,287 | 82,797 | 506,779 | 372,546 |
Parent | ||||
Condensed Financial Statements, Captions [Line Items] | ||||
Net revenues before provision for doubtful accounts | 0 | 0 | 0 | 0 |
Less: Provision for doubtful accounts | 0 | 0 | 0 | 0 |
Net revenues | 0 | 0 | 0 | 0 |
Operating charges: | ||||
Salaries, wages and benefits | 0 | 0 | 0 | 0 |
Other operating expenses | 0 | 0 | 0 | 0 |
Supplies expense | 0 | 0 | 0 | 0 |
Depreciation and amortization | 0 | 0 | 0 | 0 |
Lease and rental expense | 0 | 0 | 0 | 0 |
Electronic health records incentive income | 0 | 0 | 0 | 0 |
Costs related to extinguishment of debt | 36,171 | 36,171 | ||
Operating Expenses, Total | 0 | 36,171 | 0 | 36,171 |
Income from operations | 0 | (36,171) | 0 | (36,171) |
Interest expense | 25,543 | 30,503 | 80,087 | 97,665 |
Interest (income) expense, affiliate | 0 | 0 | 0 | 0 |
Equity in net income of consolidated affiliates | (166,054) | (123,951) | (556,213) | (455,156) |
Income before income taxes | 140,511 | 57,277 | 476,126 | 321,320 |
Provision for income taxes | (9,776) | (25,520) | (30,653) | (51,226) |
Net income | 150,287 | 82,797 | 506,779 | 372,546 |
Less: Income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Net income attributable to UHS | 150,287 | 82,797 | 506,779 | 372,546 |
Guarantors | ||||
Condensed Financial Statements, Captions [Line Items] | ||||
Net revenues before provision for doubtful accounts | 1,688,939 | 1,548,315 | 5,040,823 | 4,574,273 |
Less: Provision for doubtful accounts | 135,897 | 109,858 | 357,095 | 367,375 |
Net revenues | 1,553,042 | 1,438,457 | 4,683,728 | 4,206,898 |
Operating charges: | ||||
Salaries, wages and benefits | 754,069 | 680,877 | 2,239,853 | 2,038,171 |
Other operating expenses | 361,965 | 384,689 | 1,080,690 | 950,549 |
Supplies expense | 143,296 | 134,966 | 430,288 | 403,195 |
Depreciation and amortization | 69,875 | 67,204 | 208,577 | 199,540 |
Lease and rental expense | 15,261 | 15,034 | 43,160 | 43,827 |
Electronic health records incentive income | (356) | (531) | (1,751) | (2,665) |
Costs related to extinguishment of debt | 0 | 0 | ||
Operating Expenses, Total | 1,344,110 | 1,282,239 | 4,000,817 | 3,632,617 |
Income from operations | 208,932 | 156,218 | 682,911 | 574,281 |
Interest expense | 1,173 | 1,277 | 3,566 | 3,248 |
Interest (income) expense, affiliate | 23,054 | 22,113 | 69,163 | 66,337 |
Equity in net income of consolidated affiliates | (40,178) | (32,595) | (160,481) | (125,458) |
Income before income taxes | 224,883 | 165,423 | 770,663 | 630,154 |
Provision for income taxes | 74,531 | 54,139 | 257,400 | 217,340 |
Net income | 150,352 | 111,284 | 513,263 | 412,814 |
Less: Income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Net income attributable to UHS | 150,352 | 111,284 | 513,263 | 412,814 |
Non Guarantors | ||||
Condensed Financial Statements, Captions [Line Items] | ||||
Net revenues before provision for doubtful accounts | 758,095 | 655,321 | 2,254,656 | 2,018,260 |
Less: Provision for doubtful accounts | 75,519 | 47,938 | 186,545 | 174,560 |
Net revenues | 682,576 | 607,383 | 2,068,111 | 1,843,700 |
Operating charges: | ||||
Salaries, wages and benefits | 303,157 | 272,706 | 893,140 | 812,697 |
Other operating expenses | 174,947 | 155,758 | 512,869 | 464,488 |
Supplies expense | 98,963 | 87,742 | 291,691 | 259,085 |
Depreciation and amortization | 29,567 | 26,252 | 87,120 | 77,966 |
Lease and rental expense | 9,717 | 9,255 | 28,599 | 27,919 |
Electronic health records incentive income | 0 | (894) | 0 | (1,364) |
Costs related to extinguishment of debt | 0 | 0 | ||
Operating Expenses, Total | 616,351 | 550,819 | 1,813,419 | 1,640,791 |
Income from operations | 66,225 | 56,564 | 254,692 | 202,909 |
Interest expense | 414 | 353 | 1,198 | 1,500 |
Interest (income) expense, affiliate | (23,054) | (22,113) | (69,163) | (66,337) |
Equity in net income of consolidated affiliates | 0 | 0 | 0 | 0 |
Income before income taxes | 88,865 | 78,324 | 322,657 | 267,746 |
Provision for income taxes | 19,618 | 19,821 | 66,624 | 57,988 |
Net income | 69,247 | 58,503 | 256,033 | 209,758 |
Less: Income attributable to noncontrolling interests | 13,367 | 13,241 | 52,602 | 41,958 |
Net income attributable to UHS | 55,880 | 45,262 | 203,431 | 167,800 |
Consolidating Adjustments | ||||
Condensed Financial Statements, Captions [Line Items] | ||||
Net revenues before provision for doubtful accounts | (7,963) | (7,123) | (23,627) | (21,801) |
Less: Provision for doubtful accounts | 0 | 0 | 0 | 0 |
Net revenues | (7,963) | (7,123) | (23,627) | (21,801) |
Operating charges: | ||||
Salaries, wages and benefits | 0 | 0 | 0 | 0 |
Other operating expenses | (7,529) | (6,694) | (22,499) | (20,711) |
Supplies expense | 0 | 0 | 0 | 0 |
Depreciation and amortization | 0 | 0 | 0 | 0 |
Lease and rental expense | (434) | (429) | (1,128) | (1,090) |
Electronic health records incentive income | 0 | 0 | 0 | 0 |
Costs related to extinguishment of debt | 0 | 0 | ||
Operating Expenses, Total | (7,963) | (7,123) | (23,627) | (21,801) |
Income from operations | 0 | 0 | 0 | 0 |
Interest expense | 0 | 0 | 0 | 0 |
Interest (income) expense, affiliate | 0 | 0 | 0 | 0 |
Equity in net income of consolidated affiliates | 206,232 | 156,546 | 716,694 | 580,614 |
Income before income taxes | (206,232) | (156,546) | (716,694) | (580,614) |
Provision for income taxes | 0 | 0 | 0 | 0 |
Net income | (206,232) | (156,546) | (716,694) | (580,614) |
Less: Income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Net income attributable to UHS | $ (206,232) | $ (156,546) | $ (716,694) | $ (580,614) |
Supplemental Condensed Consol38
Supplemental Condensed Consolidating Comprehensive Income (Detail) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2015 | Sep. 30, 2014 | Sep. 30, 2015 | Sep. 30, 2014 | |
Condensed Statement of Income Captions [Line Items] | ||||
Net income | $ 163,654 | $ 96,038 | $ 559,381 | $ 414,504 |
Other comprehensive income (loss): | ||||
Unrealized derivative gains on cash flow hedges | (9,888) | 4,712 | (4,950) | 12,922 |
Amortization of terminated hedge | (84) | (84) | (252) | (252) |
Foreign currency translation adjustment | (2,304) | (2,506) | (96) | (2,506) |
Other comprehensive income before tax | (12,276) | 2,122 | (5,298) | 10,164 |
Income tax expense related to items of other comprehensive income | (3,742) | 1,620 | (1,530) | 4,685 |
Total other comprehensive income, net of tax | (8,534) | 502 | (3,768) | 5,479 |
Comprehensive income | 155,120 | 96,540 | 555,613 | 419,983 |
Less: Comprehensive income attributable to noncontrolling interests | 13,367 | 13,241 | 52,602 | 41,958 |
Comprehensive income attributable to UHS | 141,753 | 83,299 | 503,011 | 378,025 |
Parent | ||||
Condensed Statement of Income Captions [Line Items] | ||||
Net income | 150,287 | 82,797 | 506,779 | 372,546 |
Other comprehensive income (loss): | ||||
Unrealized derivative gains on cash flow hedges | (9,888) | 4,712 | (4,950) | 12,922 |
Amortization of terminated hedge | (84) | (84) | (252) | (252) |
Foreign currency translation adjustment | (2,304) | (2,506) | (96) | (2,506) |
Other comprehensive income before tax | (12,276) | 2,122 | (5,298) | 10,164 |
Income tax expense related to items of other comprehensive income | (3,742) | 1,620 | (1,530) | 4,685 |
Total other comprehensive income, net of tax | (8,534) | 502 | (3,768) | 5,479 |
Comprehensive income | 141,753 | 83,299 | 503,011 | 378,025 |
Less: Comprehensive income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Comprehensive income attributable to UHS | 141,753 | 83,299 | 503,011 | 378,025 |
Guarantors | ||||
Condensed Statement of Income Captions [Line Items] | ||||
Net income | 150,352 | 111,284 | 513,263 | 412,814 |
Other comprehensive income (loss): | ||||
Unrealized derivative gains on cash flow hedges | 0 | 0 | 0 | 0 |
Amortization of terminated hedge | 0 | 0 | 0 | 0 |
Foreign currency translation adjustment | (2,304) | 0 | (96) | 0 |
Other comprehensive income before tax | (2,304) | 0 | (96) | 0 |
Income tax expense related to items of other comprehensive income | 0 | 0 | 0 | 0 |
Total other comprehensive income, net of tax | (2,304) | 0 | (96) | 0 |
Comprehensive income | 148,048 | 111,284 | 513,167 | 412,814 |
Less: Comprehensive income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Comprehensive income attributable to UHS | 148,048 | 111,284 | 513,167 | 412,814 |
Non Guarantors | ||||
Condensed Statement of Income Captions [Line Items] | ||||
Net income | 69,247 | 58,503 | 256,033 | 209,758 |
Other comprehensive income (loss): | ||||
Unrealized derivative gains on cash flow hedges | 0 | 0 | 0 | 0 |
Amortization of terminated hedge | 0 | 0 | 0 | 0 |
Foreign currency translation adjustment | 0 | 0 | 0 | 0 |
Other comprehensive income before tax | 0 | 0 | 0 | 0 |
Income tax expense related to items of other comprehensive income | 0 | 0 | 0 | 0 |
Total other comprehensive income, net of tax | 0 | 0 | 0 | 0 |
Comprehensive income | 69,247 | 58,503 | 256,033 | 209,758 |
Less: Comprehensive income attributable to noncontrolling interests | 13,367 | 13,241 | 52,602 | 41,958 |
Comprehensive income attributable to UHS | 55,880 | 45,262 | 203,431 | 167,800 |
Consolidating Adjustments | ||||
Condensed Statement of Income Captions [Line Items] | ||||
Net income | (206,232) | (156,546) | (716,694) | (580,614) |
Other comprehensive income (loss): | ||||
Unrealized derivative gains on cash flow hedges | 0 | 0 | 0 | 0 |
Amortization of terminated hedge | 0 | 0 | 0 | 0 |
Foreign currency translation adjustment | 2,304 | 0 | 96 | 0 |
Other comprehensive income before tax | 2,304 | 0 | 96 | 0 |
Income tax expense related to items of other comprehensive income | 0 | 0 | 0 | 0 |
Total other comprehensive income, net of tax | 2,304 | 0 | 96 | 0 |
Comprehensive income | (203,928) | (156,546) | (716,598) | (580,614) |
Less: Comprehensive income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Comprehensive income attributable to UHS | $ (203,928) | $ (156,546) | $ (716,598) | $ (580,614) |
Supplemental Condensed Consol39
Supplemental Condensed Consolidating Balance Sheet (Detail) - USD ($) $ in Thousands | Sep. 30, 2015 | Dec. 31, 2014 | Sep. 30, 2014 | Dec. 31, 2013 |
Current assets: | ||||
Cash and cash equivalents | $ 39,523 | $ 32,069 | $ 39,711 | $ 17,238 |
Accounts receivable, net | 1,328,300 | 1,282,735 | ||
Supplies | 112,718 | 108,115 | ||
Deferred income taxes | 134,554 | 114,565 | ||
Other current assets | 81,459 | 77,654 | ||
Total current assets | 1,696,554 | 1,615,138 | ||
Investments in subsidiaries | 0 | 0 | ||
Intercompany receivable | 0 | 0 | ||
Intercompany note receivable | 0 | 0 | ||
Property and equipment | 6,515,914 | 6,212,030 | ||
Less: accumulated depreciation | (2,739,822) | (2,532,341) | ||
Property, plant and equipment, net, Total | 3,776,092 | 3,679,689 | ||
Other assets: | ||||
Goodwill | 3,388,378 | 3,291,213 | ||
Deferred charges | 35,113 | 40,319 | ||
Other | 310,741 | 348,084 | ||
Total assets | 9,206,878 | 8,974,443 | 8,961,592 | |
Current liabilities: | ||||
Current maturities of long-term debt | 84,883 | 68,319 | ||
Accounts payable and accrued liabilities | 1,102,616 | 1,113,062 | ||
Federal and state taxes | 8,697 | 1,446 | ||
Total current liabilities | 1,196,196 | 1,182,827 | ||
Intercompany payable | 0 | 0 | ||
Intercompany note payable | 0 | 0 | ||
Other noncurrent liabilities | 292,441 | 268,555 | ||
Long-term debt | 3,009,954 | 3,210,215 | ||
Deferred income taxes | 264,358 | 282,214 | ||
Redeemable noncontrolling interests | 250,213 | 239,552 | ||
Equity: | ||||
UHS common stockholders’ equity | 4,133,099 | 3,735,946 | ||
Noncontrolling interest | 60,617 | 55,134 | ||
Total equity | 4,193,716 | 3,791,080 | ||
Liabilities and Equity, Total | 9,206,878 | 8,974,443 | ||
Parent | ||||
Current assets: | ||||
Cash and cash equivalents | 0 | 0 | 0 | 0 |
Accounts receivable, net | 0 | 0 | ||
Supplies | 0 | 0 | ||
Deferred income taxes | 132,407 | 113,822 | ||
Other current assets | 0 | 0 | ||
Total current assets | 132,407 | 113,822 | ||
Investments in subsidiaries | 7,569,657 | 7,013,540 | ||
Intercompany receivable | 0 | 103,808 | ||
Intercompany note receivable | 0 | 0 | ||
Property and equipment | 0 | 0 | ||
Less: accumulated depreciation | 0 | 0 | ||
Property, plant and equipment, net, Total | 0 | 0 | ||
Other assets: | ||||
Goodwill | 0 | 0 | ||
Deferred charges | 27,171 | 32,379 | ||
Other | 8,031 | 9,601 | ||
Total assets | 7,737,266 | 7,273,150 | ||
Current liabilities: | ||||
Current maturities of long-term debt | 61,177 | 44,874 | ||
Accounts payable and accrued liabilities | 22,084 | 20,245 | ||
Federal and state taxes | 8,697 | 1,446 | ||
Total current liabilities | 91,958 | 66,565 | ||
Intercompany payable | 259,415 | 0 | ||
Intercompany note payable | 0 | 0 | ||
Other noncurrent liabilities | 4,236 | 1,322 | ||
Long-term debt | 2,984,200 | 3,187,103 | ||
Deferred income taxes | 264,358 | 282,214 | ||
Redeemable noncontrolling interests | 0 | 0 | ||
Equity: | ||||
UHS common stockholders’ equity | 4,133,099 | 3,735,946 | ||
Noncontrolling interest | 0 | 0 | ||
Total equity | 4,133,099 | 3,735,946 | ||
Liabilities and Equity, Total | 7,737,266 | 7,273,150 | ||
Guarantors | ||||
Current assets: | ||||
Cash and cash equivalents | 27,934 | 21,784 | 29,203 | 7,990 |
Accounts receivable, net | 940,262 | 933,971 | ||
Supplies | 69,744 | 67,847 | ||
Deferred income taxes | 2,147 | 743 | ||
Other current assets | 69,304 | 62,431 | ||
Total current assets | 1,109,391 | 1,086,776 | ||
Investments in subsidiaries | 1,821,777 | 1,661,296 | ||
Intercompany receivable | 0 | 0 | ||
Intercompany note receivable | 0 | 0 | ||
Property and equipment | 4,664,695 | 4,494,567 | ||
Less: accumulated depreciation | (1,828,173) | (1,686,192) | ||
Property, plant and equipment, net, Total | 2,836,522 | 2,808,375 | ||
Other assets: | ||||
Goodwill | 2,862,325 | 2,764,555 | ||
Deferred charges | 5,641 | 5,402 | ||
Other | 259,784 | 283,302 | ||
Total assets | 8,895,440 | 8,609,706 | ||
Current liabilities: | ||||
Current maturities of long-term debt | 1,214 | 1,260 | ||
Accounts payable and accrued liabilities | 1,018,055 | 1,051,309 | ||
Federal and state taxes | 0 | 0 | ||
Total current liabilities | 1,019,269 | 1,052,569 | ||
Intercompany payable | 248,325 | 512,490 | ||
Intercompany note payable | 1,267,637 | 1,222,637 | ||
Other noncurrent liabilities | 217,605 | 189,456 | ||
Long-term debt | 17,095 | 20,212 | ||
Deferred income taxes | 0 | 0 | ||
Redeemable noncontrolling interests | 0 | 0 | ||
Equity: | ||||
UHS common stockholders’ equity | 6,125,509 | 5,612,342 | ||
Noncontrolling interest | 0 | 0 | ||
Total equity | 6,125,509 | 5,612,342 | ||
Liabilities and Equity, Total | 8,895,440 | 8,609,706 | ||
Non Guarantors | ||||
Current assets: | ||||
Cash and cash equivalents | 11,589 | 10,285 | 10,508 | 9,248 |
Accounts receivable, net | 388,038 | 348,764 | ||
Supplies | 42,974 | 40,268 | ||
Deferred income taxes | 0 | 0 | ||
Other current assets | 12,155 | 15,223 | ||
Total current assets | 454,756 | 414,540 | ||
Investments in subsidiaries | 0 | 0 | ||
Intercompany receivable | 507,740 | 408,682 | ||
Intercompany note receivable | 1,267,637 | 1,222,637 | ||
Property and equipment | 1,851,219 | 1,717,463 | ||
Less: accumulated depreciation | (911,649) | (846,149) | ||
Property, plant and equipment, net, Total | 939,570 | 871,314 | ||
Other assets: | ||||
Goodwill | 526,053 | 526,658 | ||
Deferred charges | 2,301 | 2,538 | ||
Other | 42,926 | 55,181 | ||
Total assets | 3,740,983 | 3,501,550 | ||
Current liabilities: | ||||
Current maturities of long-term debt | 22,492 | 22,185 | ||
Accounts payable and accrued liabilities | 62,477 | 41,508 | ||
Federal and state taxes | 0 | 0 | ||
Total current liabilities | 84,969 | 63,693 | ||
Intercompany payable | 0 | 0 | ||
Intercompany note payable | 0 | 0 | ||
Other noncurrent liabilities | 70,600 | 77,777 | ||
Long-term debt | 8,659 | 2,900 | ||
Deferred income taxes | 0 | 0 | ||
Redeemable noncontrolling interests | 250,213 | 239,552 | ||
Equity: | ||||
UHS common stockholders’ equity | 3,265,925 | 3,062,494 | ||
Noncontrolling interest | 60,617 | 55,134 | ||
Total equity | 3,326,542 | 3,117,628 | ||
Liabilities and Equity, Total | 3,740,983 | 3,501,550 | ||
Consolidating Adjustments | ||||
Current assets: | ||||
Cash and cash equivalents | 0 | 0 | $ 0 | $ 0 |
Accounts receivable, net | 0 | 0 | ||
Supplies | 0 | 0 | ||
Deferred income taxes | 0 | 0 | ||
Other current assets | 0 | 0 | ||
Total current assets | 0 | 0 | ||
Investments in subsidiaries | (9,391,434) | (8,674,836) | ||
Intercompany receivable | (507,740) | (512,490) | ||
Intercompany note receivable | (1,267,637) | (1,222,637) | ||
Property and equipment | 0 | 0 | ||
Less: accumulated depreciation | 0 | 0 | ||
Property, plant and equipment, net, Total | 0 | 0 | ||
Other assets: | ||||
Goodwill | 0 | 0 | ||
Deferred charges | 0 | 0 | ||
Other | 0 | 0 | ||
Total assets | (11,166,811) | (10,409,963) | ||
Current liabilities: | ||||
Current maturities of long-term debt | 0 | 0 | ||
Accounts payable and accrued liabilities | 0 | 0 | ||
Federal and state taxes | 0 | 0 | ||
Total current liabilities | 0 | 0 | ||
Intercompany payable | (507,740) | (512,490) | ||
Intercompany note payable | (1,267,637) | (1,222,637) | ||
Other noncurrent liabilities | 0 | 0 | ||
Long-term debt | 0 | 0 | ||
Deferred income taxes | 0 | 0 | ||
Redeemable noncontrolling interests | 0 | 0 | ||
Equity: | ||||
UHS common stockholders’ equity | (9,391,434) | (8,674,836) | ||
Noncontrolling interest | 0 | 0 | ||
Total equity | (9,391,434) | (8,674,836) | ||
Liabilities and Equity, Total | $ (11,166,811) | $ (10,409,963) |
Supplemental Condensed Consol40
Supplemental Condensed Consolidating Statements of Cash flows (Detail) - USD ($) $ in Thousands | 9 Months Ended | |
Sep. 30, 2015 | Sep. 30, 2014 | |
Condensed Financial Statements, Captions [Line Items] | ||
Net cash (used in) provided by operating activities | $ 796,499 | $ 689,554 |
Cash Flows from Investing Activities: | ||
Property and equipment additions, net of disposals | (269,578) | (309,361) |
Proceeds received from sale of assets and businesses | 2,744 | 15,178 |
Acquisition of property and businesses | (183,103) | (402,405) |
Costs incurred for purchase and implementation of electronic health records application | 0 | (11,204) |
Net cash used in investing activities | (449,937) | (707,792) |
Cash Flows from Financing Activities: | ||
Reduction of long-term debt | (207,371) | (842,543) |
Additional borrowings | 16,300 | 969,800 |
Financing costs | 0 | (13,413) |
Repurchase of common shares | (129,862) | (63,292) |
Dividends paid | (29,696) | (19,794) |
Issuance of common stock | 6,030 | 4,907 |
Excess income tax benefits related to stock-based compensation | 29,287 | 30,242 |
Profit distributions to noncontrolling interests | (35,965) | (25,074) |
Proceeds received from sale/leaseback of real property | 12,765 | 0 |
Changes in intercompany balances with affiliates, net | 0 | 0 |
Net cash (used in) provided by financing activities | (338,512) | 40,833 |
Effect of exchange rate changes on cash and cash equivalents | (596) | (122) |
Increase in cash and cash equivalents | 7,454 | 22,473 |
Cash and cash equivalents, beginning of period | 32,069 | 17,238 |
Cash and cash equivalents, end of period | 39,523 | 39,711 |
Parent | ||
Condensed Financial Statements, Captions [Line Items] | ||
Net cash (used in) provided by operating activities | (51,998) | 8,445 |
Cash Flows from Investing Activities: | ||
Property and equipment additions, net of disposals | 0 | 0 |
Proceeds received from sale of assets and businesses | 0 | 0 |
Acquisition of property and businesses | 0 | 0 |
Costs incurred for purchase and implementation of electronic health records application | 0 | |
Net cash used in investing activities | 0 | 0 |
Cash Flows from Financing Activities: | ||
Reduction of long-term debt | (203,284) | (830,680) |
Additional borrowings | 16,300 | 969,800 |
Financing costs | (13,413) | |
Repurchase of common shares | (129,862) | (63,292) |
Dividends paid | (29,696) | (19,794) |
Issuance of common stock | 6,030 | 4,907 |
Excess income tax benefits related to stock-based compensation | 29,287 | 30,242 |
Profit distributions to noncontrolling interests | 0 | 0 |
Proceeds received from sale/leaseback of real property | 0 | |
Changes in intercompany balances with affiliates, net | 363,223 | (86,215) |
Net cash (used in) provided by financing activities | 51,998 | (8,445) |
Effect of exchange rate changes on cash and cash equivalents | 0 | 0 |
Increase in cash and cash equivalents | 0 | 0 |
Cash and cash equivalents, beginning of period | 0 | 0 |
Cash and cash equivalents, end of period | 0 | 0 |
Guarantors | ||
Condensed Financial Statements, Captions [Line Items] | ||
Net cash (used in) provided by operating activities | 554,650 | 431,986 |
Cash Flows from Investing Activities: | ||
Property and equipment additions, net of disposals | (154,460) | (205,455) |
Proceeds received from sale of assets and businesses | 0 | 11,450 |
Acquisition of property and businesses | (171,116) | (394,854) |
Costs incurred for purchase and implementation of electronic health records application | (11,204) | |
Net cash used in investing activities | (325,576) | (600,063) |
Cash Flows from Financing Activities: | ||
Reduction of long-term debt | (3,163) | (609) |
Additional borrowings | 0 | 0 |
Financing costs | 0 | |
Repurchase of common shares | 0 | 0 |
Dividends paid | 0 | 0 |
Issuance of common stock | 0 | 0 |
Excess income tax benefits related to stock-based compensation | 0 | 0 |
Profit distributions to noncontrolling interests | 0 | 0 |
Proceeds received from sale/leaseback of real property | 0 | |
Changes in intercompany balances with affiliates, net | (219,165) | 190,021 |
Net cash (used in) provided by financing activities | (222,328) | 189,412 |
Effect of exchange rate changes on cash and cash equivalents | (596) | (122) |
Increase in cash and cash equivalents | 6,150 | 21,213 |
Cash and cash equivalents, beginning of period | 21,784 | 7,990 |
Cash and cash equivalents, end of period | 27,934 | 29,203 |
Non Guarantors | ||
Condensed Financial Statements, Captions [Line Items] | ||
Net cash (used in) provided by operating activities | 293,847 | 249,123 |
Cash Flows from Investing Activities: | ||
Property and equipment additions, net of disposals | (115,118) | (103,906) |
Proceeds received from sale of assets and businesses | 2,744 | 3,728 |
Acquisition of property and businesses | (11,987) | (7,551) |
Costs incurred for purchase and implementation of electronic health records application | 0 | |
Net cash used in investing activities | (124,361) | (107,729) |
Cash Flows from Financing Activities: | ||
Reduction of long-term debt | (924) | (11,254) |
Additional borrowings | 0 | 0 |
Financing costs | 0 | |
Repurchase of common shares | 0 | 0 |
Dividends paid | 0 | 0 |
Issuance of common stock | 0 | 0 |
Excess income tax benefits related to stock-based compensation | 0 | 0 |
Profit distributions to noncontrolling interests | (35,965) | (25,074) |
Proceeds received from sale/leaseback of real property | 12,765 | |
Changes in intercompany balances with affiliates, net | (144,058) | (103,806) |
Net cash (used in) provided by financing activities | (168,182) | (140,134) |
Effect of exchange rate changes on cash and cash equivalents | 0 | 0 |
Increase in cash and cash equivalents | 1,304 | 1,260 |
Cash and cash equivalents, beginning of period | 10,285 | 9,248 |
Cash and cash equivalents, end of period | 11,589 | 10,508 |
Consolidating Adjustments | ||
Condensed Financial Statements, Captions [Line Items] | ||
Net cash (used in) provided by operating activities | 0 | 0 |
Cash Flows from Investing Activities: | ||
Property and equipment additions, net of disposals | 0 | 0 |
Proceeds received from sale of assets and businesses | 0 | 0 |
Acquisition of property and businesses | 0 | 0 |
Costs incurred for purchase and implementation of electronic health records application | 0 | |
Net cash used in investing activities | 0 | 0 |
Cash Flows from Financing Activities: | ||
Reduction of long-term debt | 0 | 0 |
Additional borrowings | 0 | 0 |
Financing costs | 0 | |
Repurchase of common shares | 0 | 0 |
Dividends paid | 0 | 0 |
Issuance of common stock | 0 | 0 |
Excess income tax benefits related to stock-based compensation | 0 | 0 |
Profit distributions to noncontrolling interests | 0 | 0 |
Proceeds received from sale/leaseback of real property | 0 | |
Changes in intercompany balances with affiliates, net | 0 | 0 |
Net cash (used in) provided by financing activities | 0 | 0 |
Effect of exchange rate changes on cash and cash equivalents | 0 | 0 |
Increase in cash and cash equivalents | 0 | 0 |
Cash and cash equivalents, beginning of period | 0 | 0 |
Cash and cash equivalents, end of period | $ 0 | $ 0 |