Organization, Consolidation and Presentation of Financial Statements [Abstract] | Period [Axis] |
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2016-01-01 - 2016-12-31 |
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Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Schedule of Rollforward of Non-Controlling Interests - Redeemable | A summary of activity related to the non-controlling interests—redeemable follows (in thousands): | | | | | | Balance at December 31, 2014 | | $ | 192,589 |
| Net income attributable to non-controlling interests—redeemable | | 17,616 |
| Acquisition and disposal of shares of non-controlling interests, net—redeemable | | (6,830 | ) | Distributions to non-controlling interest —redeemable holders | | (19,936 | ) | Balance at December 31, 2015 | | 183,439 |
| Net income attributable to non-controlling interests—redeemable | | 18,023 |
| Acquisition and disposal of shares of non-controlling interests, net—redeemable | | (3,781 | ) | Distributions to non-controlling interest —redeemable holders | | (17,160 | ) | Balance at December 31, 2016 | | $ | 180,521 |
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Schedule of Carrying Values and Estimated Fair Values of Debt Instruments | A summary of the carrying amounts and fair values of the Company's long-term debt follows (in thousands): | | | | | | | | | | | | | | | | | | | | Carrying Amount | | Fair Value | | | December 31, 2016 | | December 31, 2015 | | December 31, 2016 | | December 31, 2015 | | | | | | | | | | 2014 First Lien Credit Agreement, net of debt issuance and discount | | $ | 911,784 |
| | $ | 839,701 |
| | $ | 917,528 |
| | $ | 827,458 |
| 2014 Second Lien Credit Agreement, net of debt issuance and discount | | $ | — |
| | $ | 237,532 |
| | $ | — |
| | $ | 224,617 |
| Senior Unsecured Notes, net of debt issuance costs and discount | | $ | 387,942 |
| | $ | — |
| | $ | 412,189 |
| | $ | — |
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Schedule of Revenues by Service Type | A summary of revenues by service type as a percentage of total revenues follows: | | | | | | | | | | | | | Year Ended December 31, | | | 2016 | | 2015 | | 2014 | Patient service revenues: | | | | | | | Surgical facilities revenues | | 90.3 | % | | 91.6 | % | | 83.9 | % | Ancillary services revenues | | 7.9 | % | | 6.4 | % | | 12.3 | % | | | 98.2 | % | | 98.0 | % | | 96.2 | % | Other service revenues: | | | | | | | Optical services revenues | | 1.1 | % | | 1.5 | % | | 3.5 | % | Other | | 0.7 | % | | 0.5 | % | | 0.3 | % | | | 1.8 | % | | 2.0 | % | | 3.8 | % | Total revenues | | 100.0 | % | | 100.0 | % | | 100.0 | % | | | | | | | |
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Schedule of Revenue Sources for Patient Service Revenues | The following table sets forth patient service revenues by type of payor and as a percentage of total patient service revenues for the Company's consolidated surgical facilities (dollars in thousands): | | | | | | | | | | | | | | | | | | | | | | | | | Year Ended December 31, | | | 2016 | | 2015 | | 2014 | | | Amount | | % | | Amount | | % | | Amount | | % | Patient service revenues: | | | | | | | | | | | | | Private insurance | | $ | 579,662 |
| | 51.5 | % | | $ | 516,739 |
| | 55.0 | % | | $ | 202,172 |
| | 52.1 | % | Government | | 448,953 |
| | 39.9 | % | | 359,471 |
| | 38.2 | % | | 134,041 |
| | 34.5 | % | Self-pay | | 19,817 |
| | 1.8 | % | | 16,190 |
| | 1.7 | % | | 13,645 |
| | 3.5 | % | Other | | 76,172 |
| | 6.8 | % | | 48,311 |
| | 5.1 | % | | 38,215 |
| | 9.9 | % | Total patient service revenues | | $ | 1,124,604 |
| | 100.0 | % | | $ | 940,711 |
| | 100.0 | % | | $ | 388,073 |
| | 100.0 | % | Other service revenues: | | | | | | | | | | | | | Optical service revenues | | $ | 12,505 |
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| | $ | 14,572 |
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| | $ | 14,193 |
| | | Other revenues | | 8,329 |
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| | 4,608 |
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| | 1,023 |
| | | Total net revenues | | $ | 1,145,438 |
| | | | $ | 959,891 |
| | | | $ | 403,289 |
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Schedules of Accounts Receivable | A summary of the changes in the allowance for doubtful accounts receivable follows (in thousands): | | | | | | Balance at December 31, 2013 | | $ | 5,028 |
| Provision for doubtful accounts | | 9,509 |
| Accounts written off, net of recoveries | | (9,208 | ) | Balance at December 31, 2014 | | 5,329 |
| Provision for doubtful accounts | | 23,578 |
| Accounts written off, net of recoveries | | (10,585 | ) | Balance at December 31, 2015 | | 18,322 |
| Provision for doubtful accounts | | 24,212 |
| Accounts written off, net of recoveries | | (12,662 | ) | Balance at December 31, 2016 | | $ | 29,872 |
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Schedule of Prepaid Expenses and Other Current Assets | A summary of prepaid expenses and other current assets follows (in thousands): | | | | | | | | | | | | December 31, | | | 2016 | | 2015 | | | | | | Prepaid expenses | | $ | 11,158 |
| | $ | 7,409 |
| Receivables - optical product purchasing organization | | 7,042 |
| | 8,434 |
| Acquisition escrow receivable | | — |
| | 8,000 |
| Insurance recoveries | | 2,476 |
| | 2,363 |
| Other current assets | | 11,338 |
| | 8,414 |
| Total | | $ | 32,014 |
| | $ | 34,620 |
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Schedule of Other Long-Term Assets | A summary of other long-term assets follows (in thousands): | | | | | | | | | | | | December 31, | | | 2016 | | 2015 | | | | | | Notes receivable | | $ | 716 |
| | $ | 212 |
| Deposits | | 4,196 |
| | 2,475 |
| Assets of SERP | | 1,725 |
| | 1,606 |
| Debt issuance costs | | 1,488 |
| | 2,005 |
| Insurance recoveries | | 6,835 |
| | 3,976 |
| Other | | 1,475 |
| | 235 |
| Total | | $ | 16,435 |
| | $ | 10,509 |
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Schedule of Other Current Liabilities | A summary of other current liabilities follows (in thousands): | | | | | | | | | | | | December 31, | | | 2016 | | 2015 | | | | | | Interest payable | | $ | 19,206 |
| | $ | 5,410 |
| Current taxes payable | | 2,622 |
| | 1,977 |
| Insurance liabilities | | 6,625 |
| | 5,476 |
| Third-party settlements | | 179 |
| | 5,222 |
| Acquisition consideration payable | | — |
| | 16,768 |
| Amounts due to patients and payors | | 12,221 |
| | 11,424 |
| Tax receivable agreement liability | | 999 |
| | — |
| Contingent acquisition compensation liability | | 4,589 |
| | — |
| Other accrued expenses | | 22,552 |
| | 22,133 |
| Total | | $ | 68,993 |
| | $ | 68,410 |
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Schedule of Other Long-Term Liabilities | A summary of other long-term liabilities follows (in thousands): | | | | | | | | | | | | December 31, | | | 2016 | | 2015 | | | | | | Facility lease obligations | | $ | 52,653 |
| | $ | 53,927 |
| Medical malpractice liability | | 10,453 |
| | 6,339 |
| Liability of SERP | | 1,725 |
| | 1,608 |
| Contingent consideration obligation | | — |
| | 14,049 |
| Unfavorable lease liability | | 1,671 |
| | 1,996 |
| Other long-term liabilities | | 9,764 |
| | 7,694 |
| Total | | $ | 76,266 |
| | $ | 85,613 |
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