Document and Entity Information
Document and Entity Information - shares | 6 Months Ended | |
Jun. 30, 2017 | Jul. 31, 2017 | |
Document Information [Line Items] | ||
Document Type | 10-Q | |
Amendment Flag | false | |
Document Period End Date | Jun. 30, 2017 | |
Document Fiscal Year Focus | 2,017 | |
Document Fiscal Period Focus | Q2 | |
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 | 88,376,195 | |
Class C | ||
Document Information [Line Items] | ||
Entity Common Stock, Shares Outstanding | 663,940 | |
Class D | ||
Document Information [Line Items] | ||
Entity Common Stock, Shares Outstanding | 21,844 |
Condensed Consolidated Statemen
Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2017 | Jun. 30, 2016 | Jun. 30, 2017 | Jun. 30, 2016 | |
Income Statement [Abstract] | ||||
Net revenues before provision for doubtful accounts | $ 2,827,709 | $ 2,638,848 | $ 5,653,181 | $ 5,258,441 |
Less: Provision for doubtful accounts | 215,353 | 207,993 | 427,967 | 377,788 |
Net revenues | 2,612,356 | 2,430,855 | 5,225,214 | 4,880,653 |
Operating charges: | ||||
Salaries, wages and benefits | 1,236,294 | 1,130,933 | 2,474,258 | 2,279,072 |
Other operating expenses | 632,193 | 585,995 | 1,239,553 | 1,147,579 |
Supplies expense | 274,539 | 254,422 | 552,153 | 509,672 |
Depreciation and amortization | 113,112 | 101,411 | 223,910 | 205,460 |
Lease and rental expense | 26,027 | 24,806 | 51,216 | 49,258 |
Operating Expenses, Total | 2,282,165 | 2,097,567 | 4,541,090 | 4,191,041 |
Income from operations | 330,191 | 333,288 | 684,124 | 689,612 |
Interest expense, net | 35,920 | 30,442 | 71,427 | 60,042 |
Income before income taxes | 294,271 | 302,846 | 612,697 | 629,570 |
Provision for income taxes | 103,883 | 107,397 | 211,782 | 218,402 |
Net income | 190,388 | 195,449 | 400,915 | 411,168 |
Less: Net income attributable to noncontrolling interests | 4,994 | 9,872 | 9,466 | 34,832 |
Net income attributable to UHS | $ 185,394 | $ 185,577 | $ 391,449 | $ 376,336 |
Basic earnings per share attributable to UHS | $ 1.93 | $ 1.91 | $ 4.06 | $ 3.86 |
Diluted earnings per share attributable to UHS | $ 1.91 | $ 1.89 | $ 4.03 | $ 3.81 |
Weighted average number of common shares - basic | 96,247 | 97,109 | 96,416 | 97,358 |
Add: Other share equivalents | 795 | 1,280 | 791 | 1,284 |
Weighted average number of common shares and equivalents - diluted | 97,042 | 98,389 | 97,207 | 98,642 |
Condensed Consolidated Stateme3
Condensed Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2017 | Jun. 30, 2016 | Jun. 30, 2017 | Jun. 30, 2016 | |
Statement Of Income And Comprehensive Income [Abstract] | ||||
Net income | $ 190,388 | $ 195,449 | $ 400,915 | $ 411,168 |
Other comprehensive income (loss): | ||||
Unrealized derivative gains (losses) on cash flow hedges | (129) | (3,769) | 2,937 | (18,068) |
Amortization of terminated hedge | 0 | (83) | 0 | (167) |
Unrealized gain (loss) on marketable security | 3,066 | (621) | 4,160 | (621) |
Foreign currency translation adjustment | 1,713 | (4,163) | 8,949 | 1,823 |
Other comprehensive income (loss) before tax | 4,650 | (8,636) | 16,046 | (17,033) |
Income tax expense (benefit) related to items of other comprehensive income (loss) | 1,095 | (1,667) | 2,646 | (7,027) |
Total other comprehensive income (loss), net of tax | 3,555 | (6,969) | 13,400 | (10,006) |
Comprehensive income | 193,943 | 188,480 | 414,315 | 401,162 |
Less: Comprehensive income attributable to noncontrolling interests | 4,994 | 9,872 | 9,466 | 34,832 |
Comprehensive income attributable to UHS | $ 188,949 | $ 178,608 | $ 404,849 | $ 366,330 |
Condensed Consolidated Balance
Condensed Consolidated Balance Sheets - USD ($) $ in Thousands | Jun. 30, 2017 | Dec. 31, 2016 |
Current assets: | ||
Cash and cash equivalents | $ 66,446 | $ 33,747 |
Accounts receivable, net | 1,456,999 | 1,439,553 |
Supplies | 130,698 | 125,365 |
Other current assets | 109,017 | 82,706 |
Total current assets | 1,763,160 | 1,681,371 |
Property and equipment | 7,604,631 | 7,314,437 |
Less: accumulated depreciation | (3,162,756) | (2,983,481) |
Property, plant and equipment, net, Total | 4,441,875 | 4,330,956 |
Other assets: | ||
Goodwill | 3,803,386 | 3,784,106 |
Deferred charges | 11,720 | 13,520 |
Deferred income taxes | 1,301 | 1,234 |
Other | 531,045 | 506,615 |
Total Assets | 10,552,487 | 10,317,802 |
Current liabilities: | ||
Current maturities of long-term debt | 126,109 | 105,895 |
Accounts payable and accrued liabilities | 1,182,396 | 1,209,329 |
Federal and state taxes | 13,724 | 2,149 |
Total current liabilities | 1,322,229 | 1,317,373 |
Other noncurrent liabilities | 282,732 | 275,167 |
Long-term debt | 3,988,912 | 4,030,230 |
Deferred income taxes | 73,813 | 88,119 |
Redeemable noncontrolling interests | 6,974 | 9,319 |
Equity: | ||
UHS common stockholders’ equity | 4,812,854 | 4,533,220 |
Noncontrolling interest | 64,973 | 64,374 |
Total equity | 4,877,827 | 4,597,594 |
Total Liabilities and Stockholders’ Equity | $ 10,552,487 | $ 10,317,802 |
Condensed Consolidated Stateme5
Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2017 | Jun. 30, 2016 | |
Cash Flows from Operating Activities: | ||
Net income | $ 400,915 | $ 411,168 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation & amortization | 223,910 | 205,460 |
Stock-based compensation expense | 29,053 | 24,693 |
Changes in assets & liabilities, net of effects from acquisitions and dispositions: | ||
Accounts receivable | 941 | (45,729) |
Accrued interest | 211 | 9,158 |
Accrued and deferred income taxes | (5,529) | 17,997 |
Other working capital accounts | (93,715) | 123,315 |
Other assets and deferred charges | (19,927) | (8,149) |
Other | (23,411) | 52,050 |
Excess income tax benefits related to stock-based compensation | 0 | 35,247 |
Accrued insurance expense, net of commercial premiums paid | 58,903 | 44,231 |
Payments made in settlement of self-insurance claims | (37,759) | (33,012) |
Net cash provided by operating activities | 533,592 | 836,429 |
Cash Flows from Investing Activities: | ||
Property and equipment additions, net of disposals | (262,452) | (247,715) |
Acquisition of property and businesses | (19,610) | (27,525) |
Increase in capital reserves of commercial insurance subsidiary | (3,000) | 0 |
Costs incurred for purchase and implementation of information technology application | (19,448) | 0 |
Net cash used in investing activities | (304,510) | (275,240) |
Cash Flows from Financing Activities: | ||
Reduction of long-term debt | (45,675) | (843,351) |
Additional borrowings | 21,600 | 1,022,239 |
Acquisition of noncontrolling interests in majority owned businesses | 0 | (418,000) |
Financing costs | 0 | (10,734) |
Repurchase of common shares | (147,463) | (239,139) |
Dividends paid | (19,280) | (19,484) |
Issuance of common stock | 4,927 | 4,362 |
Profit distributions to noncontrolling interests | (11,430) | (59,615) |
Net cash used in financing activities | (197,321) | (563,722) |
Effect of exchange rate changes on cash and cash equivalents | 938 | (2,422) |
Increase (decrease) in cash and cash equivalents | 32,699 | (4,955) |
Cash and cash equivalents, beginning of period | 33,747 | 61,228 |
Cash and cash equivalents, end of period | 66,446 | 56,273 |
Supplemental Disclosures of Cash Flow Information: | ||
Interest paid | 66,765 | 53,558 |
Income taxes paid, net of refunds | 216,214 | 165,947 |
Noncash purchases of property and equipment | $ 63,089 | $ 42,747 |
General
General | 6 Months Ended |
Jun. 30, 2017 | |
Organization Consolidation And Presentation Of Financial Statements [Abstract] | |
General | (1) General This Quarterly Report on Form 10-Q is for the quarterly period ended June 30, 2017. 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, 2016. |
Relationship with Universal Hea
Relationship with Universal Health Realty Income Trust and Related Party Transactions | 6 Months Ended |
Jun. 30, 2017 | |
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: At June 30, 2017, we held approximately 5.8% of the outstanding shares of Universal Health Realty Income Trust (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 $900,000 and $800,000 during the three-month periods ended June 30, 2017 and 2016, respectively and approximately $1.7 million and $1.5 million during the six-month periods ended June 30, 2017 and 2016, respectively. Our pre-tax share of income from the Trust was approximately $236,000 and $250,000 during the three-month periods ended June 30, 2017 and 2016, respectively, and approximately $2.1 million and $500,000 for the six-month periods ended June 30, 2017 and 2016, respectively. Included in our share of the Trust’s income for the six months ended June 30, 2017, is our share of a gain realized by the Trust in connection with the divestiture of property that was completed during the first quarter of 2017. The carrying value of this investment was approximately $8.7 million and $7.7 million at June 30, 2017 and December 31, 2016, respectively, and is included in other assets in the accompanying consolidated balance sheets. The market value of our investment in the Trust was $62.6 million at June 30, 2017 and $51.7 million at December 31, 2016, based on the closing price of the Trust’s stock on the respective dates. Total rent expense under the operating leases on the three hospital facilities reflected in the table below was approximately $4 million during each of the three months ended June 30, 2017 and 2016, and approximately $8 million for each of the six-month periods ended June 30, 2017 and 2016. In addition, certain of our subsidiaries are tenants in several medical office buildings and two FEDs owned by the Trust or by limited liability companies in which the Trust holds 95% to 100% of the ownership interest. 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 those subsidiaries are unconditionally guaranteed by us and are cross-defaulted with one another. The table below details the renewal options and terms for each of our three acute care hospital facilities leased from the Trust: Hospital Name Annual Minimum Rent End of Lease Term Renewal Term (years) McAllen Medical Center $ 5,485,000 December, 2021 10(a) Wellington Regional Medical Center $ 3,030,000 December, 2021 10(b) Southwest Healthcare System, Inland Valley Campus $ 2,648,000 December, 2021 10(b) (a) We have two 5-year renewal options at existing lease rates (through 2031). (b) We have two 5-year renewal options at fair market value lease rates (2022 through 2031). 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 the 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, as amended in October, 2016, based on actuarial tables and other assumptions, during the life expectancies of the insureds, we would pay approximately $28 million in premiums, and certain trusts owned by our CEO, would pay approximately $9 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 approximately $37 million representing the $28 million of aggregate premiums paid by us as well as the $9 million of aggregate premiums paid by the trusts. In connection with these policies, we will pay/we paid approximately $1.2 million $1.3 million in premium payments during each of 2017 and 2016, respectively. In August, 2015, Marc D. Miller, our President and member of our Board of Directors, was appointed to the Board of Directors of Premier, Inc. (“Premier”), a healthcare performance improvement alliance. During 2013, we entered into a new group purchasing organization agreement (“GPO”) with Premier. In conjunction with the GPO agreement, we acquired a minority interest in Premier for a nominal amount. During the fourth quarter of 2013, in connection with the completion of an initial public offering of the stock of Premier, we received cash proceeds for the sale of a portion of our ownership interest in the GPO. Also in connection with this GPO agreement, we received shares of restricted stock of Premier which vest ratably over a seven-year period (2014 through 2020), contingent upon our continued participation and minority ownership interest in the GPO. We have elected to retain a portion of the previously vested shares of Premier, the market value of which is included in other assets on our consolidated balance sheet. Based upon the closing price of Premier’s stock on each respective date, the market value of our shares of Premier on which the restrictions have lapsed was $27 million as of June 30, 2017 and $23 million as of December 31, 2016. 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 | 6 Months Ended |
Jun. 30, 2017 | |
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. As of June 30, 2017, outside owners held noncontrolling, minority ownership interests of: (i) 20% in an acute care facility located in Washington, D.C.; (ii) approximately 11% in an acute care facility located in Texas; (iii) 20% and 30% in two behavioral health care facilities located in Pennsylvania and Ohio, respectively, and; (iv) approximately 5% in an acute care facility located in Nevada. The noncontrolling interest and redeemable noncontrolling interest balances of $65 million and $7 million, respectively, as of June 30, 2017, consist primarily of the third-party ownership interests in these hospitals. In connection with the two behavioral health care facilities located in Pennsylvania and Ohio, the minority ownership interests of which are reflected as redeemable noncontrolling interests on our Condensed Consolidated Balance Sheet, the outside owners have “put options” to put their 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. In May, 2016, we purchased the minority ownership interests held by a third-party in our six acute care hospitals located in Las Vegas, Nevada for an aggregate cash payment of $445 million which included both the purchase price ($418 million) and the return of reserve capital ($27 million). The ownership interests purchased ranged from 26.1% to 27.5%. |
Long-term debt, Cash Flow Hedge
Long-term debt, Cash Flow Hedges and Foreign Currency Forward Exchange Contracts | 6 Months Ended |
Jun. 30, 2017 | |
Debt Disclosure [Abstract] | |
Long-term debt, Cash Flow Hedges and Foreign Currency Forward Exchange Contracts | (4) Long-term debt, Cash Flow Hedges and Foreign Currency Forward Exchange Contracts Debt: On June 7, 2016, we entered into a Fifth Amendment (the “Fifth Amendment”) to our credit agreement dated as of November 15, 2010, as amended on March 15, 2011, September 21, 2012, May 16, 2013 and August 7, 2014, among UHS, as borrower, the several banks and other financial institutions from time to time parties thereto, as lenders (“Credit Agreement”). The Fifth Amendment increased the size of the term loan A facility by $200 million and those proceeds were utilized to repay outstanding borrowings under the revolving credit facility of the Credit Agreement. The Credit Agreement, as amended, which is scheduled to mature in August, 2019, consists of: (i) an $800 million revolving credit facility ($455 million of borrowings outstanding as of June 30, 2017), and; (ii) a term loan A facility with $1.820 billion of borrowings outstanding as of June 30, 2017. Borrowings under the Credit Agreement bear interest at our election at either (1) the ABR rate which is defined as the rate per annum equal to 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 June 30, 2017, the applicable margins were 0.50% for ABR-based loans and 1.50% for LIBOR-based loans under the revolving credit and term loan-A facilities. As of June 30, 2017, we had $455 million of borrowings outstanding pursuant to the terms of our $800 million revolving credit facility and we had $277 million of available borrowing capacity net of $33 million of outstanding letters of credit and $35 million of outstanding borrowings pursuant to a short-term, on demand-credit facility. 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 (which generally excludes asset classes such as substantially all of the patient-related accounts receivable of our acute care hospitals, certain real estate assets and assets held in joint-ventures with third-parties) 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 $22 million are scheduled from the fourth quarter of 2016 through June, 2019. Previously, approximately $11 million of quarterly installment payments were made from the fourth quarter of 2014 through the third quarter of 2016. In July, 2017, we amended our accounts receivable securitization program (“Securitization”) with a group of conduit lenders and liquidity banks to increase the borrowing capacity to $440 million from $400 million previously. Pursuant to the terms of our Securitization program, on which the scheduled maturity date of December, 2018 remained unchanged, 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 June 30, 2017, we had $400 million of outstanding borrowings pursuant to the terms of the Securitization. As of June 30, 2017, we had combined aggregate principal of $1.4 billion from the following senior secured notes: • $300 million aggregate principal amount of 3.75% senior secured notes due in 2019 (“2019 Notes”) which were issued on August 7, 2014. • $700 million aggregate principal amount of 4.75% senior secured notes due in 2022 (“2022 Notes”) which were issued as follows: o $300 million aggregate principal amount issued on August 7, 2014 at par. o $400 million aggregate principal amount issued on June 3, 2016 at 101.5% to yield 4.35%. • $400 million aggregate principal amount of 5.00% senior secured notes due in 2026 (“2026 Notes”) which were issued on June 3, 2016. Interest is payable on the 2019 Notes and the 2022 Notes on February 1 and August 1 of each year until the maturity date of August 1, 2019 for the 2019 Notes and August 1, 2022 for the 2022 Notes. Interest on the 2026 Notes is payable on June 1 and December 1 until the maturity date of June 1, 2026. The 2019 Notes, 2022 Notes and 2026 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 2019 Notes, 2022 Notes and 2026 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. In June, 2016, we repaid the $400 million, 7.125% senior secured notes which matured on June 30, 2016. 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 June 30, 2017. At June 30, 2017, the carrying value and fair value of our debt were approximately $4.1 billion and $4.2 billion, respectively. At December 31, 2016, the carrying value and fair value of our debt were each approximately $4.1 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 2016 and the first six months of 2017 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. We do not anticipate nonperformance by our counterparties. We do not hold or issue derivative financial instruments for trading purposes. Seven previously outstanding interest rate swaps on a total notional amount of $825 million matured in May, 2015. During 2015, we entered into nine forward starting interest rate swaps whereby we pay a fixed rate on a total notional amount of $1.0 billion and receive one-month LIBOR. The average fixed rate payable on these swaps, which are scheduled to mature on April 15, 2019, is 1.31%. These interest rates swaps consist of: • Four forward starting interest rate swaps, entered into during the second quarter of 2015, 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%; • Four forward starting interest rate swaps, entered into during the third quarter of 2015, 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 became 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%, and; • One interest rate swap, entered into during the fourth quarter of 2015, whereby we pay a fixed rate on a total notional amount of $100 million and receive one-month LIBOR. The swap became effective on December 15, 2015 and is scheduled to mature on April 15, 2019. The fixed rate payable on this swap is 1.21%. We measure our interest rate swaps at fair value on a recurring basis. The fair value of our interest rate swaps is based on quotes from our counterparties. 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. At June 30, 2017, the fair value of our interest rate swaps was a net asset of $3 million the majority of which is included in other assets on the accompanying balance sheet. At December 31, 2016, the fair value of our interest rate swaps was de minimis on a net basis comprised of a $4 million asset which is included in other assets offset by a $4 million liability which is included in other current liabilities on the accompanying consolidated balance sheet. Foreign Currency Forward Exchange Contracts: We use forward exchange contracts to hedge our net investment in foreign operations against movements in exchange rates. The effective portion of the unrealized gains or losses on these contracts is recorded in foreign currency translation adjustment within accumulated other comprehensive income and remains there until either the sale or liquidation of the subsidiary. The cash flows from these contracts are reported as operating activities in the consolidated statements of cash flows. In connection with these forward exchange contracts, we recorded net cash outflows of $42 million during the six-month period ended June 30, 2017 and net cash inflows of $50 million during the six-month period ended June 30, 2016. |
Commitments and Contingencies
Commitments and Contingencies | 6 Months Ended |
Jun. 30, 2017 | |
Commitments And Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | (5) Commitments and Contingencies Professional and General Liability, Workers’ Compensation Liability Effective January, 2017, the vast majority of our subsidiaries are self-insured for professional and general liability exposure up to $5 million and $3 million per occurrence, respectively, subject to certain aggregate limitations. Prior to January, 2017, the vast majority of our subsidiaries were self-insured for professional and general liability exposure up to $10 million and $3 million per occurrence, respectively. These subsidiaries are provided with several excess policies through commercial insurance carriers which provide for coverage in excess of the applicable per occurrence self-insured retention or underlying policy limits incurred after 2013 a 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. Included in our financial results during the three and six-month periods ended June 30, 2017, pursuant to a reserve analysis which indicated unfavorable changes in our estimated future claims payments relating to prior years, we recorded a $15 million increase to our professional and general liability self-insurance reserves. As of June 30, 2017, the total accrual for our professional and general liability claims was $228 million, of which $66 million is included in current liabilities. As of December 31, 2016, the total accrual for our professional and general liability claims was $207 million, of which $48 million is included in current liabilities. As of June 30, 2017, the total accrual for our workers’ compensation liability claims was $68 million, of which $33 million is included in current liabilities. As of December 31, 2016, the total accrual for our workers’ compensation liability claims was $67 million, of which $33 million is included in current liabilities. Although we are unable to predict whether or not our future financial statements will include adjustments to our prior year reserves for self-insured general and professional and workers’ compensation claims, given the relatively unpredictable nature of the these potential liabilities and the factors impacting these reserves, as discussed above, it is reasonably likely that our future financial results may include material adjustments to prior period reserves. Property Insurance: We have commercial property insurance policies for our properties covering catastrophic losses, including windstorm damage, up to a $1 billion policy limit, 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 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). Commercially insured earthquake coverage for our facilities is subject to various deductibles and limitations including: (i) $500 million limitation for our facilities located in Nevada; (ii) $130 million limitation for our facilities located in California; (iii) $100 million limitation for our facilities located in fault zones within the United States; (iv) $40 million limitation for our facility located in Puerto Rico, and; (v) $250 million limitation for many of our facilities located in other states. Deductibles for flood losses vary in amount, up to a maximum of $500,000, based upon 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 our behavioral health facilities located in the U.K. are provided on an all risk basis up to a £1.29 billion policy limit, with coverage caps per location, that includes coverage for real and personal property as well as business interruption losses. Other Our accounts receivable as of June 30, 2017 and December 31, 2016 include amounts due from Illinois of approximately $49 million and $38 million, respectively. Collection of the outstanding receivables continues to be delayed due to state budgetary and funding pressures. Approximately $31 million as of June 30, 2017 and $25 million as of December 31, 2016, of the receivables due from Illinois were outstanding in excess of 60 days, as of each respective date. Although the accounts receivable due from Illinois 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. Failure to ultimately collect all outstanding amounts due to us from Illinois would have an adverse impact on our future consolidated results of operations and cash flows. As of June 30, 2017 we were party to certain off balance sheet arrangements consisting of standby letters of credit and surety bonds which totaled $122 million consisting of: (i) $114 million related to our self-insurance programs, and; (ii) $8 million of other debt and public utility guarantees. Legal Proceedings 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 Department of Justice (“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. Certain legal matters are described below: Government Investigations: UHS Behavioral Health 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 certain 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 receipt of this subpoena, some of these facilities had received independent subpoenas from state or federal agencies. Subsequent to the February 2013 subpoenas, some of the facilities above have received additional, specific subpoenas or other document and information requests. In addition to the OIG, the DOJ and various U.S. Attorneys’ and state Attorneys’ General Offices are also involved in this matter. Since February 2013, additional facilities have also received subpoenas and/or document and information requests or we have been notified are included in the omnibus investigation. Those facilities include: National Deaf Academy, Arbour-HRI Hospital, Behavioral Hospital of Bellaire, St. Simons By the Sea, Turning Point Care Center, Salt Lake Behavioral Health, Central Florida Behavioral Hospital, University Behavioral Center, Arbour Hospital, Arbour-Fuller Hospital, Pembroke Hospital, Westwood Lodge, Coastal Harbor Health System and Shadow Mountain Behavioral Health. In October, 2013, we were advised that the DOJ’s Criminal Frauds Section had opened an investigation of River Point Behavioral Health and Wekiva Springs Center. Since that time, we have been notified that the Criminal Frauds section has opened investigations of National Deaf Academy, Hartgrove Hospital and UHS as a corporate entity. In April 2017, the DOJ’s Criminal Division issued a subpoena requesting documentation from Shadow Mountain Behavioral Health. 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 (“AHCA”) 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 Medicare suspension remains in effect. In June 2017, AHCA advised that while they were maintaining the suspension for dual eligible and cross-over Medicare beneficiaries, the Medicaid payment suspension was lifted effective June 27, 2017. We cannot predict if and/or when the facility’s remaining suspended payments will resume in total. Although the operating results of River Point Behavioral Health did not have a material impact on our consolidated results of operations during the three and six-month periods ended June 30, 2017 or the year ended December 31, 2016, the payment suspension has had a material adverse effect on the facility’s results of operations and financial condition. The DOJ has advised us that the civil aspect of the coordinated investigation referenced above is a False Claims 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 individual facilities, if any, in connection with these matters. Litigation: U.S. ex rel Escobar v. Universal Health Services, Inc. et.al. This is a False Claims Act case filed against Universal Health Services, Inc., UHS of Delaware, Inc. and HRI Clinics, Inc. d/b/a Arbour Counseling Services in U.S. District Court for the District of Massachusetts. This qui tam action primarily alleges that Arbour Counseling Services failed to appropriately supervise certain clinical providers in contravention of regulatory requirements and the submission of claims to Medicaid were subsequently improper. Relators make other claims of improper billing to Medicaid associated with alleged failures of Arbour Counseling to comply with state regulations. The U.S. Attorney’s Office and the Massachusetts Attorney General’s Office initially declined to intervene. UHS filed a motion to dismiss and the trial court originally granted the motion dismissing the case. The First Circuit Court of Appeals (“First Circuit”) reversed the trial court’s dismissal of the case. The United States Supreme Court subsequently vacated the First Circuit’s opinion and remanded the case for further consideration under the new legal standards established by the Supreme Court for False Claims Act cases. During the 4 th Shareholder Class Action In December 2016 a purported shareholder class action lawsuit was filed in U.S. District Court for the Central District of California against UHS, and certain UHS officers alleging violations of the federal securities laws. Plaintiff alleges that defendants violated federal securities laws relating to the disclosures made in public filings associated with practices at our behavioral health facilities. The case was originally filed as Heed v. Universal Health Services, Inc. et. al. (Case No. 2:16-CV-09499-PSG-JC). The court subsequently appointed Teamsters Local 456 Pension Fund and Teamsters Local 456 Annuity Fund to serve as lead plaintiffs. The case has been transferred to the U.S. District Court for the Eastern District of Pennsylvania and the style of the case has been changed to Teamsters Local 456 Pension Fund, et. al. v. Universal Health Services, Inc. et.al. (Case No. 2:17-CV-02817-LS). We deny liability and intend to defend ourselves vigorously. At this time, we are uncertain as to potential liability or financial exposure, if any, which may be associated with this matter. Shareholder Derivative Cases In March 2017, a shareholder derivative suit was filed by plaintiff David Heed in the Court of Common Pleas of Philadelphia County. A notice of removal to the United States District Court for the Eastern District of Pennsylvania has been filed. Plaintiff has filed a motion to remand. The suit alleges breaches of fiduciary duties and other allegedly wrongful conduct by the members of the Board of Directors and certain officers of Universal Health Services, Inc. relating to practices at our behavioral health facilities. UHS has been named as a nominal defendant in the case. (Case No. 2:17-cv-01476-LS). In May, June and July 2017, additional shareholder derivative suits were filed in the United States District Court for the Eastern District of Pennsylvania. The plaintiffs in those cases are: Central Laborers’ Pension Fund (Case No. 17-cv-02187-LS); Firemen’s Retirement System of St. Louis (Case No. 17-cv-02317-LS); Waterford Township Police & Fire Retirement System (Case No. 17-cv-02595-LS); and Amalgamated Bank Longview Funds (Case No. 17-cv-03404-LS). The Fireman’s Retirement System case has since been voluntarily dismissed. In addition, a shareholder derivative case was filed in Chancery Court in Delaware by the Delaware County Employees’ Retirement Fund (Case No. 2017-0475-JTL). These additional cases make substantially similar allegations and claims based upon alleged violations of federal securities laws as well common law causes of action against the individual defendants. All of these additional cases have also named all members of the UHS Board of Directors as well as certain officers of the Company. The defendants deny liability and intend to defend these cases vigorously. At this time, we are uncertain as to potential liability or financial exposure, if any, which may be associated with these matters. Disproportionate Share Hospital Payment Matter: 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 Human Services (the “Department”) 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. In September, 2016, we received similar requests for repayment for alleged DSH overpayments for FFY2012. We filed administrative appeals for all of our facilities contesting the recoupment efforts for FFYs 2011 and 2012 as we believe the Department’s calculation methodology is inaccurate and conflicts with applicable federal and state laws and regulations. The Department has agreed to postpone the recoupment of the state’s share of the DSH payments until all hospital appeals are resolved but started recoupment of the federal share. If the Department is ultimately successful in its demand related to FFY2011 and FFY2012, it could take similar action with regards to FFY2013 and FFY2014. In July 2017, we began receiving similar requests for repayment of alleged DSH overpayments for FFY 2013. We will be filing administrative appeals consistent with those filed for FFYs 2011 and 2012. 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 the Department to FFY2011 and FFY2012 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 the Department’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 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. 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. Other Matters: Various other suits, claims and investigations, including government subpoenas, arising against, or issued to, us are pending and additional such matters may arise in the future. Management will consider additional disclosure from time to time to the extent it believes such matters may be or become material. 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 described above or that are otherwise pending 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 matter 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. |
Segment Reporting
Segment Reporting | 6 Months Ended |
Jun. 30, 2017 | |
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, but not limited to, information technology, purchasing, reimbursement, accounting and finance, taxation, legal, advertising and design and construction. The chief operating decision making group for our acute care services and behavioral health care services is comprised of our Chief Executive Officer, the President and the Presidents of each operating segment. The Presidents for 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, 2016. The corporate overhead allocations, as reflected below, are utilized for internal reporting purposes and are comprised of each period’s projected corporate-level operating expenses (excluding interest expense). The overhead expenses are captured and allocated directly to each segment, to the extent possible, based upon each segment’s respective percentage of total operating expenses. Three months ended June 30, 2017 Acute Care Hospital Services Behavioral Health Services (a) Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 5,430,997 $ 2,249,135 $ 0 $ 7,680,132 Gross outpatient revenues $ 3,286,930 $ 257,312 $ 0 $ 3,544,242 Total net revenues $ 1,366,457 $ 1,242,561 $ 3,338 $ 2,612,356 Income/(loss) before allocation of corporate overhead and income taxes $ 157,877 $ 252,146 $ (115,752 ) $ 294,271 Allocation of corporate overhead $ (45,675 ) $ (39,653 ) $ 85,328 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 112,202 $ 212,493 $ (30,424 ) $ 294,271 Total assets as of June 30, 2017 $ 3,754,983 $ 6,541,328 $ 256,176 $ 10,552,487 Six months ended June 30, 2017 Acute Care Hospital Services Behavioral Health Services (a) Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 11,028,847 $ 4,432,137 $ 0 $ 15,460,984 Gross outpatient revenues $ 6,581,107 $ 503,772 $ 0 $ 7,084,879 Total net revenues $ 2,756,004 $ 2,460,683 $ 8,527 $ 5,225,214 Income/(loss) before allocation of corporate overhead and income taxes $ 345,681 $ 504,077 $ (237,061 ) $ 612,697 Allocation of corporate overhead $ (91,351 ) $ (79,314 ) $ 170,665 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 254,330 $ 424,763 $ (66,396 ) $ 612,697 Total assets as of June 30, 2017 $ 3,754,983 $ 6,541,328 $ 256,176 $ 10,552,487 Three months ended June 30, 2016 Acute Care Hospital Services Behavioral Health Services (a) Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 4,682,682 $ 1,995,992 $ 0 $ 6,678,674 Gross outpatient revenues $ 2,838,852 $ 229,243 $ 0 $ 3,068,095 Total net revenues $ 1,253,328 $ 1,174,755 $ 2,772 $ 2,430,855 Income/(loss) before allocation of corporate overhead and income taxes $ 137,372 $ 272,916 $ (107,442 ) $ 302,846 Allocation of corporate overhead $ (42,691 ) $ (38,726 ) $ 81,417 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 94,681 $ 234,190 $ (26,025 ) $ 302,846 Total assets as of June 30, 2016 $ 3,497,571 $ 5,920,483 $ 122,876 $ 9,540,930 Six months ended June 30, 2016 Acute Care Hospital Services Behavioral Health Services (a) Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 9,648,219 $ 3,955,562 $ 0 $ 13,603,781 Gross outpatient revenues $ 5,606,181 $ 450,886 $ 0 $ 6,057,067 Total net revenues $ 2,540,475 $ 2,335,801 $ 4,377 $ 4,880,653 Income/(loss) before allocation of corporate overhead and income taxes $ 323,290 $ 538,501 $ (232,221 ) $ 629,570 Allocation of corporate overhead $ (85,340 ) $ (77,442 ) $ 162,782 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 237,950 $ 461,059 $ (69,439 ) $ 629,570 Total assets as of June 30, 2016 $ 3,497,571 $ 5,920,483 $ 122,876 $ 9,540,930 (a) Includes net revenues generated from our behavioral health care facilities located in the U.K. amounting to approximately $106 million and $64 million for the three-month periods ended June 30, 2017 and 2016, respectively, and approximately $206 million and $125 million for the six-month periods ended June 30, 2017 and 2016, respectively. Total assets at our U.K. behavioral health care facilities were approximately $1,028 million and $490 million as of June 30, 2017 and 2016, respectively. |
Earnings Per Share Data ("EPS")
Earnings Per Share Data ("EPS") and Stock Based Compensation | 6 Months Ended |
Jun. 30, 2017 | |
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 June 30, Six months ended June 30, 2017 2016 2017 2016 Basic and Diluted: Net income attributable to UHS $ 185,394 $ 185,577 $ 391,449 $ 376,336 Less: Net income attributable to unvested restricted share grants (82 ) (84 ) (176 ) (173 ) Net income attributable to UHS – basic and diluted $ 185,312 $ 185,493 $ 391,273 $ 376,163 Weighted average number of common shares - basic 96,247 97,109 96,416 97,358 Net effect of dilutive stock options and grants based on the treasury stock method 795 1,280 791 1,284 Weighted average number of common shares and equivalents - diluted 97,042 98,389 97,207 98,642 Earnings per basic share attributable to UHS: $ 1.93 $ 1.91 $ 4.06 $ 3.86 Earnings per diluted share attributable to UHS: $ 1.91 $ 1.89 $ 4.03 $ 3.81 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. The excluded weighted-average stock options totaled 4.4 million for the six months ended June 30, 2017. The excluded weighted-average stock options totaled 3.0 million for the three months ended June 30, 2017. The excluded weighted-average stock options totaled 2.9 million for the six months ended June 30, 2016. There were no significant anti-dilutive stock options during the three months ended June 30, 2016. All classes of our common stock have the same dividend rights. Stock-Based Compensation: During the three-month periods ended June 30, 2017 and 2016, compensation cost of $13.0 million and $10.9 million, respectively, was recognized related to outstanding stock options. During the six-month periods ended June 30, 2017 and 2016, compensation costs of $27.9 million and $23.6 million, respectively, was recognized related to outstanding stock options. In addition, during the three-month periods ended June 30, 2017 and 2016, compensation cost of approximately $448,000 and $340,000, respectively, was recognized related to restricted stock. During the six-month periods ended June 30, 2017 and 2016, compensation cost of approximately $599,000 (net of cancellations) and $659,000, respectively, was recognized related to restricted stock. As of June 30, 2017 there was $124.6 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 3.0 years. There were 2,980,725 stock options granted (net of cancellations) during the first six months of 2017 with a weighted-average grant date fair value of $27.07 per share. The expense associated with share-based compensation arrangements is a non-cash charge. In the Condensed 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 $29.1 million and $24.7 million during the six-month periods ended June 30, 2017 and 2016, respectively. |
Dispositions and acquisitions a
Dispositions and acquisitions and purchase of third-party ownership interests | 6 Months Ended |
Jun. 30, 2017 | |
Business Combinations [Abstract] | |
Dispositions and acquisitions and purchase of third-party ownership interests | (8) Dispositions and acquisitions and purchase of third-party ownership interests Six-month period ended June 30, 2017: Acquisitions: During the first six months of 2017, we paid approximately $20 million to acquire various property assets. Six-month period ended June 30, 2016: Acquisitions: During the first six months of 2016, we paid approximately $28 million to acquire various businesses and property. In May, 2016, we paid $445 million in connection with the purchase of the minority ownership interests held by a third-party in our six acute care hospitals located in the Las Vegas, Nevada market which includes both the purchase price ($418 million) and return of reserve capital ($27 million). The ownership interests purchased, which range from 26.1% to 27.5%, relate to Centennial Hills Hospital Medical Center, Desert Springs Hospital, Henderson Hospital, Spring Valley Hospital Medical Center, Summerlin Hospital Medical Center and Valley Hospital Medical Center. |
Dividends
Dividends | 6 Months Ended |
Jun. 30, 2017 | |
Earnings Per Share [Abstract] | |
Dividends | (9) Dividends We declared and paid dividends of $9.7 million, or $.10 per share, during the second quarter of 2017 and $9.7 million or $.10 per share during the second quarter of 2016. We declared and paid dividends of $19.3 million and $19.5 million during the six-month periods ended June 30, 2017 and 2016, respectively. |
Income Taxes
Income Taxes | 6 Months Ended |
Jun. 30, 2017 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | (10) Income Taxes As of January 1, 2017, our unrecognized tax benefits were approximately $1 million. The amount, if recognized, that would affect the effective tax rate is approximately $1 million. During the quarter ended June 30, 2017, 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 June 30, 2017, we have less than $1 million of accrued interest and penalties. The U.S. federal statute of limitations remains open for 2013 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. Our provision for income taxes for the quarter and six months ended June 30, 2017 included tax benefits of $1 million and $8 million, respectively, related to the adoption of ASU 2016-09, which changes how companies account for certain aspects of share-based payments to employees. Under ASU 2016-09, we no longer record excess tax benefits (when the deductible amount related to the settlement of employee equity awards for tax purposes exceeds the cumulative compensation cost recognized for financial reporting purposes) in equity. Instead, we recognize these tax benefits (and deficiencies, if applicable) as a component of our tax provision. This reporting change is applied prospectively and prior period amounts are not restated (the excess tax benefit for the quarter and six months ending June 30, 2016, related to the settlement of employee equity awards, were $24 million and $35 million, respectively, and were recorded in equity). ASU 2016-09 requires companies to present excess tax benefits as an operating activity on the Condensed Consolidated Statement of Cash Flows rather than as a financing activity, as previously required. We have elected to apply the change to the Condensed Consolidated Statement of Cash Flows on a modified retrospective basis resulting in a reclassification of the 2016 excess income tax benefits related to stock-based compensation from financing activities to operating activities. 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. |
Recent Accounting Standards
Recent Accounting Standards | 6 Months Ended |
Jun. 30, 2017 | |
Accounting Changes And Error Corrections [Abstract] | |
Recent Accounting Standards | (11) Recent Accounting Standards In August, 2016, the FASB issued ASU No. 2016-15, Classification of Certain Cash Receipts and Cash Payments, which adds or clarifies guidance of the classification of certain cash receipts and payments in the statement of cash flows with the intent to alleviate diversity in practice for classifying various types of cash flows. This ASU is effective for annual and interim reporting periods beginning after December 15, 2017, with early adoption permitted. We are currently evaluating the impact of this ASU on our statement of cash flows. In March, 2016, the FASB issued ASU 2016-09, “Compensation – Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting”, which amends the accounting for employee share-based payment transactions to require recognition of the tax effects resulting from the settlement of stock-based awards as income tax expense or benefit in the income statement in the reporting period in which they occur. We have adopted this new standard, which is effective for annual reporting periods beginning after December 15, 2016, as of January 1, 2017. The impact of ASU 2016-09 to date is explained above in Note 10-Income Taxes. In May 2014 and March 2016, the FASB issued ASU 2014-09 and ASU 2016-08, “Revenue from Contracts with Customers (Topic 606)” and “Revenue from Contracts with Customers: Principal versus Agent Considerations (Reporting Revenue Gross versus Net)”, respectively, 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. The FASB updated the new revenue standard by clarifying the principal versus agent implementation guidance, but does not change the core principle of the new standard. 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 assessing and analyzing the various sources of revenue and plan to use a portfolio approach as a practical expedient to account for patient contracts. We have a team in place to lead the implementation of the new standard, including the evaluation of our systems and internal controls to ensure adequacy of data and information needed for adoption, as well as assessing the potential impact of the new standard on various reimbursement programs in which our hospitals participate. We anticipate the most significant change will be how the estimate for the allowance for doubtful accounts will be recognized under the new standards. Under the current standards, our estimate for amounts not expected to be collected based upon our historical experience have been included within net revenue. Under the new standards, our estimate for amounts not expected to be collected based on historical experience will continue to be recognized as a reduction to net revenue. However, subsequent changes in estimate of collectability due to a change in the financial status of a payor, for example a bankruptcy, will be recognized as bad debt expense in operating charges. We will continue to evaluate the impact that the adoption of this ASU may have on our consolidated financial statements and related disclosures. In February, 2016, the FASB issued ASU 2016-02, “Leases (Topic 842): Amendments to the FASB Accounting Standards Codification (“Update 2016-02”) , In January, 2017, the FASB issued ASU No. 2017-04, “Intangibles-Goodwill and Other (Topic 350): Simplifying the Accounting for Goodwill Impairment” (“ASU 2017-04”), which removes the requirement to perform a hypothetical purchase price allocation to measure goodwill impairment. A goodwill impairment will now be the amount by which a reporting unit’s carrying value exceeds its fair value, not to exceed the carrying amount of goodwill. ASU 2017-04 is effective for the annual and interim periods beginning January 1, 2020 with early adoption permitted, and applied prospectively. We do not expect ASU 2017-04 to have a material impact on our financial statements. In January, 2017, the FASB issued ASU 2017-01, “Business Combinations (Topic 805) - Clarifying the Definition of a Business” to clarify the definition of a business in order to allow for the evaluation of whether transactions should be accounted for as acquisitions or disposals of assets or businesses. ASU 2017-01 is effective for fiscal years beginning after December 15, 2017, including interim periods within those fiscal years. Early adoption is permitted. The future impact of ASU 2017-01 will be dependent upon the nature of future acquisitions or dispositions made by us, if any. From time to time, new accounting guidance is issued by the FASB or other standard setting bodies that is adopted by the Company as of the effective date or, in some cases where early adoption is permitted, in advance of the effective date. The Company has assessed the recently issued guidance that is not yet effective and, unless otherwise indicated above, believes the new guidance will not have a material impact on our results of operations, cash flows or financial position. |
Relationship with Universal H17
Relationship with Universal Health Realty Income Trust and Related Party Transactions (Tables) | 6 Months Ended |
Jun. 30, 2017 | |
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: Hospital Name Annual Minimum Rent End of Lease Term Renewal Term (years) McAllen Medical Center $ 5,485,000 December, 2021 10(a) Wellington Regional Medical Center $ 3,030,000 December, 2021 10(b) Southwest Healthcare System, Inland Valley Campus $ 2,648,000 December, 2021 10(b) (a) We have two 5-year renewal options at existing lease rates (through 2031). (b) We have two 5-year renewal options at fair market value lease rates (2022 through 2031). |
Segment Reporting (Tables)
Segment Reporting (Tables) | 6 Months Ended |
Jun. 30, 2017 | |
Segment Reporting [Abstract] | |
Segment Reporting | Three months ended June 30, 2017 Acute Care Hospital Services Behavioral Health Services (a) Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 5,430,997 $ 2,249,135 $ 0 $ 7,680,132 Gross outpatient revenues $ 3,286,930 $ 257,312 $ 0 $ 3,544,242 Total net revenues $ 1,366,457 $ 1,242,561 $ 3,338 $ 2,612,356 Income/(loss) before allocation of corporate overhead and income taxes $ 157,877 $ 252,146 $ (115,752 ) $ 294,271 Allocation of corporate overhead $ (45,675 ) $ (39,653 ) $ 85,328 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 112,202 $ 212,493 $ (30,424 ) $ 294,271 Total assets as of June 30, 2017 $ 3,754,983 $ 6,541,328 $ 256,176 $ 10,552,487 Six months ended June 30, 2017 Acute Care Hospital Services Behavioral Health Services (a) Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 11,028,847 $ 4,432,137 $ 0 $ 15,460,984 Gross outpatient revenues $ 6,581,107 $ 503,772 $ 0 $ 7,084,879 Total net revenues $ 2,756,004 $ 2,460,683 $ 8,527 $ 5,225,214 Income/(loss) before allocation of corporate overhead and income taxes $ 345,681 $ 504,077 $ (237,061 ) $ 612,697 Allocation of corporate overhead $ (91,351 ) $ (79,314 ) $ 170,665 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 254,330 $ 424,763 $ (66,396 ) $ 612,697 Total assets as of June 30, 2017 $ 3,754,983 $ 6,541,328 $ 256,176 $ 10,552,487 Three months ended June 30, 2016 Acute Care Hospital Services Behavioral Health Services (a) Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 4,682,682 $ 1,995,992 $ 0 $ 6,678,674 Gross outpatient revenues $ 2,838,852 $ 229,243 $ 0 $ 3,068,095 Total net revenues $ 1,253,328 $ 1,174,755 $ 2,772 $ 2,430,855 Income/(loss) before allocation of corporate overhead and income taxes $ 137,372 $ 272,916 $ (107,442 ) $ 302,846 Allocation of corporate overhead $ (42,691 ) $ (38,726 ) $ 81,417 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 94,681 $ 234,190 $ (26,025 ) $ 302,846 Total assets as of June 30, 2016 $ 3,497,571 $ 5,920,483 $ 122,876 $ 9,540,930 Six months ended June 30, 2016 Acute Care Hospital Services Behavioral Health Services (a) Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 9,648,219 $ 3,955,562 $ 0 $ 13,603,781 Gross outpatient revenues $ 5,606,181 $ 450,886 $ 0 $ 6,057,067 Total net revenues $ 2,540,475 $ 2,335,801 $ 4,377 $ 4,880,653 Income/(loss) before allocation of corporate overhead and income taxes $ 323,290 $ 538,501 $ (232,221 ) $ 629,570 Allocation of corporate overhead $ (85,340 ) $ (77,442 ) $ 162,782 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 237,950 $ 461,059 $ (69,439 ) $ 629,570 Total assets as of June 30, 2016 $ 3,497,571 $ 5,920,483 $ 122,876 $ 9,540,930 (a) Includes net revenues generated from our behavioral health care facilities located in the U.K. amounting to approximately $106 million and $64 million for the three-month periods ended June 30, 2017 and 2016, respectively, and approximately $206 million and $125 million for the six-month periods ended June 30, 2017 and 2016, respectively. Total assets at our U.K. behavioral health care facilities were approximately $1,028 million and $490 million as of June 30, 2017 and 2016, respectively. |
Earnings Per Share Data ("EPS19
Earnings Per Share Data ("EPS") and Stock Based Compensation (Tables) | 6 Months Ended |
Jun. 30, 2017 | |
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 June 30, Six months ended June 30, 2017 2016 2017 2016 Basic and Diluted: Net income attributable to UHS $ 185,394 $ 185,577 $ 391,449 $ 376,336 Less: Net income attributable to unvested restricted share grants (82 ) (84 ) (176 ) (173 ) Net income attributable to UHS – basic and diluted $ 185,312 $ 185,493 $ 391,273 $ 376,163 Weighted average number of common shares - basic 96,247 97,109 96,416 97,358 Net effect of dilutive stock options and grants based on the treasury stock method 795 1,280 791 1,284 Weighted average number of common shares and equivalents - diluted 97,042 98,389 97,207 98,642 Earnings per basic share attributable to UHS: $ 1.93 $ 1.91 $ 4.06 $ 3.86 Earnings per diluted share attributable to UHS: $ 1.91 $ 1.89 $ 4.03 $ 3.81 |
Relationship with Universal H20
Relationship with Universal Health Realty Income Trust and Related Party Transactions - Additional Information (Detail) | 3 Months Ended | 6 Months Ended | 12 Months Ended | |||
Jun. 30, 2017USD ($)HospitalFacility | Jun. 30, 2016USD ($)Hospital | Dec. 31, 2013 | Jun. 30, 2017USD ($)HospitalFacility | Jun. 30, 2016USD ($)Hospital | Dec. 31, 2016USD ($) | |
Chief Executive Officer | ||||||
Related Party Transaction [Line Items] | ||||||
Estimated payments to acquire life insurance policies | $ 28,000,000 | |||||
Payments to acquire life insurance policies | 1,200,000 | $ 1,300,000 | ||||
Chief Executive Officer | Trust Owned by CEO | ||||||
Related Party Transaction [Line Items] | ||||||
Estimated payments to acquire life insurance policies | 9,000,000 | |||||
Minimum | Chief Executive Officer | ||||||
Related Party Transaction [Line Items] | ||||||
Estimated death benefit proceeds | $ 37,000,000 | |||||
Relationship with Universal Health Realty Income Trust | ||||||
Related Party Transaction [Line Items] | ||||||
Trust outstanding shares held, percentage | 5.80% | 5.80% | ||||
Advisory fee earned | $ 900,000 | $ 800,000 | $ 1,700,000 | 1,500,000 | ||
Pre-tax share of income from the Trust | 236,000 | 250,000 | 2,100,000 | 500,000 | ||
Carrying value of investment in Trust | 8,700,000 | 8,700,000 | $ 7,700,000 | |||
Market value of investment in Trust | 62,600,000 | 62,600,000 | 51,700,000 | |||
Rent expense under operating leases | $ 4,000,000 | $ 4,000,000 | $ 8,000,000 | $ 8,000,000 | ||
Number of hospital facilities | Hospital | 3 | 3 | 3 | 3 | ||
Number of free-standing emergency departments to be acquired | Facility | 2 | 2 | ||||
Lease renewal period, years | 5 years | |||||
Notice period on renewal of lease | 90 days | |||||
Period of rights of refusal to leased facilities | 180 days | |||||
Relationship with Universal Health Realty Income Trust | Minimum | ||||||
Related Party Transaction [Line Items] | ||||||
Non-controlling ownership interests by subsidiaries | 95.00% | 95.00% | ||||
Lease initial terms | 13 years | |||||
Relationship with Universal Health Realty Income Trust | Maximum | ||||||
Related Party Transaction [Line Items] | ||||||
Non-controlling ownership interests by subsidiaries | 100.00% | 100.00% | ||||
Lease initial terms | 15 years | |||||
Premier, Inc. | Group Purchasing Organization Agreement | Restricted Stock | ||||||
Related Party Transaction [Line Items] | ||||||
Shares vesting period | 7 years | |||||
Shares vesting period start year | 2,014 | |||||
Shares vesting period end year | 2,020 | |||||
Market value of retained vested shares | $ 27,000,000 | $ 23,000,000 |
Remaining Renewal Options and T
Remaining Renewal Options and Terms for Hospital Facilities Leased from Trust (Detail) | 6 Months Ended | |
Jun. 30, 2017USD ($) | ||
McAllen Medical Center | ||
Property Subject to or Available for Operating Lease [Line Items] | ||
Annual Minimum Rent | $ 5,485,000 | |
End of Lease Term | 2021-12 | |
Renewal Term (years) | 10 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 | 2021-12 | |
Renewal Term (years) | 10 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 | 2021-12 | |
Renewal Term (years) | 10 years | [2] |
[1] | We have two 5-year renewal options at existing lease rates (through 2031). | |
[2] | We have two 5-year renewal options at fair market value lease rates (2022 through 2031). |
Remaining Renewal Options and22
Remaining Renewal Options and Terms for Hospital Facilities Leased from Trust (Parenthetical) (Detail) | 6 Months Ended |
Jun. 30, 2017RenewalOption | |
McAllen Medical Center | |
Property Subject to or Available for Operating Lease [Line Items] | |
Number of renewal options at existing lease rates | 2 |
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 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 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 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 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 23
Other Noncurrent Liabilities and Redeemable/Noncontrolling Interests - Additional Information (Detail) $ in Millions | 1 Months Ended | |
May 31, 2016USD ($)Hospital | Jun. 30, 2017USD ($)Facility | |
Minority Interest [Line Items] | ||
Behavioral health care facilities with outside owners holding non-controlling minority interest | Facility | 2 | |
Non-controlling interest balances | $ 65 | |
Redeemable non-controlling interest balances | $ 7 | |
Acute Care Facilities | Washington, District of Columbia | ||
Minority Interest [Line Items] | ||
Percentage of non-controlling, minority ownership interests held by outside owners | 20.00% | |
Acute Care Facilities | Texas | ||
Minority Interest [Line Items] | ||
Percentage of non-controlling, minority ownership interests held by outside owners | 11.00% | |
Acute Care Facilities | Nevada | ||
Minority Interest [Line Items] | ||
Percentage of non-controlling, minority ownership interests held by outside owners | 5.00% | |
Behavioral Health Services | Pennsylvania | ||
Minority Interest [Line Items] | ||
Percentage of non-controlling, minority ownership interests held by outside owners | 20.00% | |
Behavioral Health Services | Ohio | ||
Minority Interest [Line Items] | ||
Percentage of non-controlling, minority ownership interests held by outside owners | 30.00% | |
Acute Care Hospital Services | Las Vegas, Nevada | ||
Minority Interest [Line Items] | ||
Number of hospital facilities | Hospital | 6 | |
Payments to purchase minority ownership interests | $ 445 | |
Purchase price of minority ownership interests | 418 | |
Return of reserve capital to purchase of minority ownership interests | $ 27 | |
Acute Care Hospital Services | Las Vegas, Nevada | Minimum | ||
Minority Interest [Line Items] | ||
Ownership interests purchased | 26.10% | |
Acute Care Hospital Services | Las Vegas, Nevada | Maximum | ||
Minority Interest [Line Items] | ||
Ownership interests purchased | 27.50% |
Long-term debt, Cash Flow Hed24
Long-term debt, Cash Flow Hedges and Foreign Currency Forward Exchange Contracts - Additional Information (Detail) | Jun. 07, 2016USD ($) | May 31, 2015USD ($)Derivative | Dec. 31, 2015USD ($)Derivative | Sep. 30, 2015USD ($)Derivative | Jun. 30, 2015USD ($)Derivative | Dec. 31, 2014USD ($) | Jun. 30, 2017USD ($) | Jun. 30, 2016USD ($) | Dec. 31, 2015USD ($)Derivative | Jul. 31, 2017USD ($) | Dec. 31, 2016USD ($) | Jun. 03, 2016USD ($) | Aug. 07, 2014USD ($) |
Debt Instrument [Line Items] | |||||||||||||
Line of credit facility, starting date | Jun. 7, 2016 | ||||||||||||
Line of credit facility, maturity month | 2019-08 | ||||||||||||
Rate adjustment to weighted average federal funds rate for credit facility borrowings | 0.50% | ||||||||||||
Rate adjustment to one month Eurodollar rate on credit facility borrowings | 1.00% | ||||||||||||
Accounts receivable securitization program credit facility, amount outstanding | $ 400,000,000 | ||||||||||||
Reduction of long-term debt | 45,675,000 | $ 843,351,000 | |||||||||||
Debt instrument carrying amount | 4,100,000,000 | $ 4,100,000,000 | |||||||||||
Fair value of debt | 4,200,000,000 | 4,100,000,000 | |||||||||||
Number of additional forward starting interest rate swaps | Derivative | 4 | ||||||||||||
Previously Outstanding Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Maturity date of interest rate cash flow hedges | May 31, 2015 | ||||||||||||
One Point Three One Percent Forward Starting Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Maturity date of interest rate cash flow hedges | Apr. 15, 2019 | ||||||||||||
Number of additional forward starting interest rate swaps | Derivative | 9 | ||||||||||||
Fixed rate payable on interest rate swap | 1.31% | ||||||||||||
One Point Four Zero Percent Forward Starting Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Maturity date of interest rate cash flow hedges | Apr. 15, 2019 | ||||||||||||
Number of additional forward starting interest rate swaps | Derivative | 4 | ||||||||||||
Average fixed rate payable on interest rate swap | 1.40% | ||||||||||||
One Point Two Three Percent Forward Starting Interest Rate Swaps One | |||||||||||||
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% | ||||||||||||
One Point Two One Percent Forward Starting Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Maturity date of interest rate cash flow hedges | Apr. 15, 2019 | ||||||||||||
Number of additional forward starting interest rate swaps | Derivative | 1 | ||||||||||||
Fixed rate payable on interest rate swap | 1.21% | 1.21% | |||||||||||
Interest Rate Swap | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Fair value of our interest rate swaps | 3,000,000 | ||||||||||||
Fair value of our interest rate swaps, assets | 4,000,000 | ||||||||||||
Fair value of our interest rate swaps, liability | $ 4,000,000 | ||||||||||||
Foreign Currency Forward Exchange Contracts | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Net cash (outflows) inflows | $ (42,000,000) | $ 50,000,000 | |||||||||||
Cash Flow Hedging | Previously Outstanding Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Number of previously outstanding interest rate swaps | Derivative | 7 | ||||||||||||
Notional amount of interest rate cash flow hedges | $ 825,000,000 | ||||||||||||
Cash Flow Hedging | One Point Three One Percent Forward Starting Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Notional amount of interest rate cash flow hedges | $ 1,000,000,000 | $ 1,000,000,000 | |||||||||||
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 | ||||||||||||
Cash Flow Hedging | One Point Two Three Percent Forward Starting Interest Rate Swaps One | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Notional amount of interest rate cash flow hedges | 100,000,000 | ||||||||||||
Cash Flow Hedging | One Point Two Three Percent Forward Starting Interest Rate Swaps Two | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Notional amount of interest rate cash flow hedges | 200,000,000 | ||||||||||||
Cash Flow Hedging | One Point Two Three Percent Forward Starting Interest Rate Swaps Three | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Notional amount of interest rate cash flow hedges | $ 100,000,000 | ||||||||||||
Cash Flow Hedging | One Point Two One Percent Forward Starting Interest Rate Swaps | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Notional amount of interest rate cash flow hedges | $ 100,000,000 | $ 100,000,000 | |||||||||||
Subsequent Event | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Accounts receivable securitization program credit facility, borrowing capacity | $ 440,000,000 | ||||||||||||
Accounts Receivable Securitization Facility | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Line of credit facility, maturity month | 2018-12 | ||||||||||||
Senior Notes 7.125% | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Senior notes, interest rate | 7.125% | ||||||||||||
Senior notes, maturity date | Jun. 30, 2016 | ||||||||||||
Reduction of long-term debt | $ 400,000,000 | ||||||||||||
Revolving Credit Facility | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Line of credit facility, borrowing capacity | $ 800,000,000 | $ 800,000,000 | |||||||||||
Line of credit facility amount outstanding | $ 455,000,000 | ||||||||||||
Current applicable margins | 1.50% | ||||||||||||
Line of credit facility, available borrowing capacity | $ 277,000,000 | ||||||||||||
Letters of credit, outstanding | 33,000,000 | ||||||||||||
Revolving Credit Facility | Short Term on Demand Credit Facility | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Line of credit facility amount outstanding | 35,000,000 | ||||||||||||
Revolving Credit Facility | Letter of Credit | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Line of credit facility, borrowing capacity | $ 125,000,000 | ||||||||||||
Revolving Credit Facility | ABR-based loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Current applicable margins | 0.50% | ||||||||||||
Revolving Credit Facility | Minimum | One Month Eurodollar Rate Plus Index Based Loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Consolidated Leverage Ratio | 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% | ||||||||||||
Revolving Credit Facility | Maximum | One Month Eurodollar Rate Plus Index Based Loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Consolidated Leverage Ratio | 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% | ||||||||||||
Term Loan A | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Line of credit facility amount outstanding | $ 1,820,000,000 | ||||||||||||
Line of credit facility increased amount | $ 200,000,000 | ||||||||||||
Current applicable margins | 1.50% | ||||||||||||
Term Loan A | Quarterly installment payments made from the fourth quarter of 2014 through third quarter of 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 | ABR-based loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Current applicable margins | 0.50% | ||||||||||||
Term Loan A | Minimum | One Month Eurodollar Rate Plus Index Based Loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Consolidated Leverage Ratio | 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% | ||||||||||||
Term Loan A | Maximum | One Month Eurodollar Rate Plus Index Based Loans | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Consolidated Leverage Ratio | 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% | ||||||||||||
New Senior Secured Notes | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Senior notes, issued | $ 1,400,000,000 | ||||||||||||
New Senior Secured Notes | 3.75% Senior Secured Notes due 2019 | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Senior notes, issued | $ 300,000,000 | ||||||||||||
Senior notes, interest rate | 3.75% | ||||||||||||
Senior notes, maturity date | Aug. 1, 2019 | ||||||||||||
New Senior Secured Notes | 4.75% Senior Secured Notes due 2022 | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Senior notes, issued | $ 700,000,000 | $ 400,000,000 | $ 300,000,000 | ||||||||||
Senior notes, interest rate | 4.75% | ||||||||||||
Senior notes issued percentage | 101.50% | ||||||||||||
Senior notes yield percentage | 4.35% | ||||||||||||
Senior notes, maturity date | Aug. 1, 2022 | ||||||||||||
New Senior Secured Notes | 5.00% Senior Secured Notes due 2026 | |||||||||||||
Debt Instrument [Line Items] | |||||||||||||
Senior notes, issued | $ 400,000,000 | ||||||||||||
Senior notes, interest rate | 5.00% | ||||||||||||
Senior notes, maturity date | Jun. 1, 2026 |
Commitments and Contingencies -
Commitments and Contingencies - Additional Information (Detail) £ in Millions | 3 Months Ended | 6 Months Ended | 12 Months Ended | |||||||
Jun. 30, 2017USD ($) | Jun. 30, 2017USD ($) | Jun. 30, 2017GBP (£) | Dec. 31, 2011USD ($)Hospital | Jan. 31, 2017USD ($) | Jan. 31, 2017GBP (£) | Dec. 31, 2016USD ($) | Dec. 31, 2015USD ($) | Dec. 31, 2014USD ($) | Dec. 31, 2013USD ($) | |
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Self-insured for professional and general liability, current | $ 66,000,000 | $ 66,000,000 | $ 48,000,000 | |||||||
Compensation liability claims | 68,000,000 | 68,000,000 | 67,000,000 | |||||||
Compensation and related benefits | 33,000,000 | 33,000,000 | 33,000,000 | |||||||
Accounts receivable, net | 1,456,999,000 | 1,456,999,000 | 1,439,553,000 | |||||||
Department of Human Services | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Repayment of legal settlement amount on demand | $ 4,000,000 | |||||||||
Letters of Credit and Surety Bonds | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Off-balance sheet contingent obligation | 122,000,000 | 122,000,000 | ||||||||
Location 1 | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Minimum Insurance Deductible | 50,000 | 50,000 | ||||||||
Location 2 | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Minimum Insurance Deductible | 250,000 | 250,000 | ||||||||
Illinois | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Accounts receivable, net | 49,000,000 | 49,000,000 | 38,000,000 | |||||||
Accounts receivable net greater than sixty days Past due | 31,000,000 | 31,000,000 | 25,000,000 | |||||||
Pennsylvania | Department of Human Services | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Number of behavioral health care hospitals | Hospital | 7 | |||||||||
Flood | Location 1 | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Maximum insurance deductible | 500,000 | 500,000 | ||||||||
Professional And General Liability | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Increase in professional and general liability self-insurance reserves relating to prior years | 15,000,000 | 15,000,000 | ||||||||
Self Insurance Programs | Letters of Credit and Surety Bonds | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Off-balance sheet contingent obligation | 114,000,000 | 114,000,000 | ||||||||
Other Debt Guarantees | Letters of Credit and Surety Bonds | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Off-balance sheet contingent obligation | 8,000,000 | 8,000,000 | ||||||||
Cygnet Health Care Limited | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Property insurance | £ | £ 1,290 | |||||||||
Maximum | Wind Storms | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Commercial property insurance policies covering catastrophic losses | $ 1,000,000,000 | $ 1,000,000,000 | ||||||||
Percentage of insurance deductible | 5.00% | 5.00% | ||||||||
Maximum | Earthquake | LAS VEGAS, NEVADA | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Commercial property insurance policies covering catastrophic losses | $ 500,000,000 | $ 500,000,000 | ||||||||
Maximum | Earthquake | CALIFORNIA | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Commercial property insurance policies covering catastrophic losses | 130,000,000 | 130,000,000 | ||||||||
Maximum | Earthquake | UNITED STATES | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Commercial property insurance policies covering catastrophic losses | 100,000,000 | 100,000,000 | ||||||||
Maximum | Earthquake | PUERTO RICO | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Commercial property insurance policies covering catastrophic losses | 40,000,000 | 40,000,000 | ||||||||
Maximum | Earthquake | OTHER STATES | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Commercial property insurance policies covering catastrophic losses | $ 250,000,000 | $ 250,000,000 | ||||||||
Minimum | Wind Storms | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Percentage of insurance deductible | 3.00% | 3.00% | ||||||||
General and Professional Liability | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Self-insured for professional and general liability | $ 228,000,000 | $ 228,000,000 | 207,000,000 | |||||||
Subsidiaries | Professional Liability | Cygnet Health Care Limited | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Self-insured for professional and general liability | £ | £ 10 | |||||||||
Subsidiaries | Professional Liability | Maximum | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Self-insured for professional and general liability | $ 5,000,000 | 10,000,000 | ||||||||
Subsidiaries | General Liability | Cygnet Health Care Limited | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Self-insured for professional and general liability | £ | £ 25 | |||||||||
Subsidiaries | General Liability | Maximum | ||||||||||
Commitments and Contingencies Disclosure [Line Items] | ||||||||||
Self-insured for professional and general liability | $ 3,000,000 | 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% | 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 | $ 250,000,000 | $ 250,000,000 | $ 200,000,000 | ||||||
Liability for claims paid under commercially insured coverage | $ 50,000,000 | $ 50,000,000 |
Segment Reporting (Detail)
Segment Reporting (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||||
Jun. 30, 2017 | Jun. 30, 2016 | Jun. 30, 2017 | Jun. 30, 2016 | Dec. 31, 2016 | ||
Segment Reporting Information [Line Items] | ||||||
Gross inpatient revenues | $ 7,680,132 | $ 6,678,674 | $ 15,460,984 | $ 13,603,781 | ||
Gross outpatient revenues | 3,544,242 | 3,068,095 | 7,084,879 | 6,057,067 | ||
Total net revenues | 2,612,356 | 2,430,855 | 5,225,214 | 4,880,653 | ||
Income/(loss) before allocation of corporate overhead and income taxes | 294,271 | 302,846 | 612,697 | 629,570 | ||
Allocation of corporate overhead | 0 | 0 | 0 | 0 | ||
Income/(loss) after allocation of corporate overhead and before income taxes | 294,271 | 302,846 | 612,697 | 629,570 | ||
Total assets | 10,552,487 | 9,540,930 | 10,552,487 | 9,540,930 | $ 10,317,802 | |
Acute Care Hospital Services | ||||||
Segment Reporting Information [Line Items] | ||||||
Gross inpatient revenues | 5,430,997 | 4,682,682 | 11,028,847 | 9,648,219 | ||
Gross outpatient revenues | 3,286,930 | 2,838,852 | 6,581,107 | 5,606,181 | ||
Total net revenues | 1,366,457 | 1,253,328 | 2,756,004 | 2,540,475 | ||
Income/(loss) before allocation of corporate overhead and income taxes | 157,877 | 137,372 | 345,681 | 323,290 | ||
Allocation of corporate overhead | (45,675) | (42,691) | (91,351) | (85,340) | ||
Income/(loss) after allocation of corporate overhead and before income taxes | 112,202 | 94,681 | 254,330 | 237,950 | ||
Total assets | 3,754,983 | 3,497,571 | 3,754,983 | 3,497,571 | ||
Behavioral Health Services | ||||||
Segment Reporting Information [Line Items] | ||||||
Gross inpatient revenues | [1] | 2,249,135 | 1,995,992 | 4,432,137 | 3,955,562 | |
Gross outpatient revenues | [1] | 257,312 | 229,243 | 503,772 | 450,886 | |
Total net revenues | [1] | 1,242,561 | 1,174,755 | 2,460,683 | 2,335,801 | |
Income/(loss) before allocation of corporate overhead and income taxes | [1] | 252,146 | 272,916 | 504,077 | 538,501 | |
Allocation of corporate overhead | [1] | (39,653) | (38,726) | (79,314) | (77,442) | |
Income/(loss) after allocation of corporate overhead and before income taxes | [1] | 212,493 | 234,190 | 424,763 | 461,059 | |
Total assets | [1] | 6,541,328 | 5,920,483 | 6,541,328 | 5,920,483 | |
Other | ||||||
Segment Reporting Information [Line Items] | ||||||
Gross inpatient revenues | 0 | 0 | 0 | 0 | ||
Gross outpatient revenues | 0 | 0 | 0 | 0 | ||
Total net revenues | 3,338 | 2,772 | 8,527 | 4,377 | ||
Income/(loss) before allocation of corporate overhead and income taxes | (115,752) | (107,442) | (237,061) | (232,221) | ||
Allocation of corporate overhead | 85,328 | 81,417 | 170,665 | 162,782 | ||
Income/(loss) after allocation of corporate overhead and before income taxes | (30,424) | (26,025) | (66,396) | (69,439) | ||
Total assets | $ 256,176 | $ 122,876 | $ 256,176 | $ 122,876 | ||
[1] | Includes net revenues generated from our behavioral health care facilities located in the U.K. amounting to approximately $106 million and $64 million for the three-month periods ended June 30, 2017 and 2016, respectively, and approximately $206 million and $125 million for the six-month periods ended June 30, 2017 and 2016, respectively. Total assets at our U.K. behavioral health care facilities were approximately $1,028 million and $490 million as of June 30, 2017 and 2016, respectively. |
Segment Reporting (Parenthetica
Segment Reporting (Parenthetical) (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||||
Jun. 30, 2017 | Jun. 30, 2016 | Jun. 30, 2017 | Jun. 30, 2016 | Dec. 31, 2016 | ||
Segment Reporting Information [Line Items] | ||||||
Net revenues | $ 2,612,356 | $ 2,430,855 | $ 5,225,214 | $ 4,880,653 | ||
Total assets | 10,552,487 | 9,540,930 | 10,552,487 | 9,540,930 | $ 10,317,802 | |
Behavioral Health Services | ||||||
Segment Reporting Information [Line Items] | ||||||
Net revenues | [1] | 1,242,561 | 1,174,755 | 2,460,683 | 2,335,801 | |
Total assets | [1] | 6,541,328 | 5,920,483 | 6,541,328 | 5,920,483 | |
Behavioral Health Services | Located in U.K. | ||||||
Segment Reporting Information [Line Items] | ||||||
Net revenues | 106,000 | 64,000 | 206,000 | 125,000 | ||
Total assets | $ 1,028,000 | $ 490,000 | $ 1,028,000 | $ 490,000 | ||
[1] | Includes net revenues generated from our behavioral health care facilities located in the U.K. amounting to approximately $106 million and $64 million for the three-month periods ended June 30, 2017 and 2016, respectively, and approximately $206 million and $125 million for the six-month periods ended June 30, 2017 and 2016, respectively. Total assets at our U.K. behavioral health care facilities were approximately $1,028 million and $490 million as of June 30, 2017 and 2016, respectively. |
Computation of Basic and Dilute
Computation of Basic and Diluted Earnings Per Share for classes A, B, C and D Common Stockholders (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2017 | Jun. 30, 2016 | Jun. 30, 2017 | Jun. 30, 2016 | |
Basic and Diluted: | ||||
Net income attributable to UHS | $ 185,394 | $ 185,577 | $ 391,449 | $ 376,336 |
Less: Net income attributable to unvested restricted share grants | (82) | (84) | (176) | (173) |
Net income attributable to UHS – basic and diluted | $ 185,312 | $ 185,493 | $ 391,273 | $ 376,163 |
Weighted average number of common shares - basic | 96,247 | 97,109 | 96,416 | 97,358 |
Net effect of dilutive stock options and grants based on the treasury stock method | 795 | 1,280 | 791 | 1,284 |
Weighted average number of common shares and equivalents - diluted | 97,042 | 98,389 | 97,207 | 98,642 |
Earnings per basic share attributable to UHS: | $ 1.93 | $ 1.91 | $ 4.06 | $ 3.86 |
Earnings per diluted share attributable to UHS: | $ 1.91 | $ 1.89 | $ 4.03 | $ 3.81 |
Earnings Per Share Data ("EPS29
Earnings Per Share Data ("EPS") and Stock Based Compensation - Additional Information (Detail) - USD ($) | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2017 | Jun. 30, 2016 | Jun. 30, 2017 | Jun. 30, 2016 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||||
Anti-dilutive weighted average stock options excluded from computation of earnings per share | 3,000,000 | 0 | 4,400,000 | 2,900,000 |
Stock options granted during period (net of cancellations) | 2,980,725 | |||
Weighted-average grant date fair value, per share | $ 27.07 | |||
Compensation cost recognized | $ 29,053,000 | $ 24,693,000 | ||
Stock Options | ||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||||
Compensation cost recognized | $ 13,000,000 | $ 10,900,000 | 27,900,000 | 23,600,000 |
Restricted Stock | ||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||||
Compensation cost recognized | 448,000 | $ 340,000 | $ 599,000 | $ 659,000 |
Unrecognized compensation cost vesting period | 3 years | |||
Unvested Stock option | ||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||||
Unrecognized compensation cost | $ 124,600,000 | $ 124,600,000 | ||
Unrecognized compensation cost vesting period | 3 years |
Dispositions and Acquisitions30
Dispositions and Acquisitions and Purchase of Third-Party Ownership Interests - Additional Information (Detail) $ in Thousands | 1 Months Ended | 6 Months Ended | |
May 31, 2016USD ($)Hospital | Jun. 30, 2017USD ($) | Jun. 30, 2016USD ($) | |
Acquisitions And Divestitures [Line Items] | |||
Acquisition of property and businesses | $ 19,610 | $ 27,525 | |
Las Vegas, Nevada | Acute Care Hospital Services | |||
Acquisitions And Divestitures [Line Items] | |||
Payments to purchase minority ownership interests | $ 445,000 | ||
Number of hospital facilities | Hospital | 6 | ||
Purchase price of minority ownership interests | $ 418,000 | ||
Return of reserve capital to purchase of minority ownership interests | $ 27,000 | ||
Las Vegas, Nevada | Acute Care Hospital Services | Minimum | |||
Acquisitions And Divestitures [Line Items] | |||
Ownership interests purchased | 26.10% | ||
Las Vegas, Nevada | Acute Care Hospital Services | Maximum | |||
Acquisitions And Divestitures [Line Items] | |||
Ownership interests purchased | 27.50% |
Dividends - Additional Informat
Dividends - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2017 | Jun. 30, 2016 | Jun. 30, 2017 | Jun. 30, 2016 | |
Dividends [Abstract] | ||||
Dividends declared and paid | $ 9.7 | $ 9.7 | $ 19.3 | $ 19.5 |
Quarterly cash dividend | $ 0.10 | $ 0.10 |
Income Taxes - Additional Infor
Income Taxes - Additional Information (Detail) - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | |||
Jun. 30, 2017 | Jun. 30, 2016 | Jun. 30, 2017 | Jun. 30, 2016 | Jan. 01, 2017 | |
Income Taxes [Line Items] | |||||
Unrecognized tax benefits | $ 1 | ||||
Impact of unrecognized tax benefits if recognized | $ 1 | ||||
Period of expiration of the statute of limitations for certain jurisdictions | Within the next twelve months | ||||
Jurisdictions statutes of limitations expiration period | 12 months | ||||
ASU 2016-09 | |||||
Income Taxes [Line Items] | |||||
Excess tax benefit from share based compensation | $ 1 | $ 24 | $ 8 | $ 35 | |
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] | |||||
Accrued interest and penalties | $ 1 | $ 1 | |||
Foreign and U.S. state and local jurisdictions have statutes of limitations, in years | 4 years |