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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
(Mark One)
| | | | | |
☒ | QUARTERLY REPORT PURSUANT TO SECTION 13 or 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
For the Quarterly Period Ended June 30, 2020
OR
| | | | | |
☐ | TRANSITION REPORT PURSUANT TO SECTION 13 or 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
For the transition period from to
Commission file numbers: 001-34465
SELECT MEDICAL HOLDINGS CORPORATION
(Exact name of Registrant as specified in its Charter)
| | | | | | | | |
Delaware | | 20-1764048 |
(State or Other Jurisdiction of Incorporation or Organization) | | (I.R.S. Employer Identification Number) |
4714 Gettysburg Road, P.O. Box 2034
Mechanicsburg, PA 17055
(Address of Principal Executive Offices and Zip code)
(717) 972-1100
(Registrant’s telephone number, including area code)
Securities registered pursuant to Section 12(b) of the Act:
| | | | | | | | |
Title of each class | Trading Symbol(s) | Name of each exchange on which registered |
Common Stock, par value $0.001 per share | SEM | New York Stock Exchange |
| | (NYSE) |
Indicate by check mark whether the Registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter periods as such Registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐
Indicate by check mark whether the Registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the Registrant was required to submit such files). Yes ☒ No ☐
Indicate by check mark whether the Registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act. (Check one):
| | | | | | | | | | | |
Large accelerated filer | ☒ | Accelerated filer | ☐ |
Non-accelerated filer | ☐ | Smaller reporting company | ☐ |
| | Emerging Growth Company | ☐ |
If an emerging growth company, indicate by check mark if the Registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate by check mark whether the Registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No ☒
As of June 30, 2020, Select Medical Holdings Corporation had outstanding 133,970,064 shares of common stock.
Unless the context indicates otherwise, any reference in this report to “Holdings” refers to Select Medical Holdings Corporation and any reference to “Select” refers to Select Medical Corporation, the wholly owned operating subsidiary of Holdings, and any of Select’s subsidiaries. Any reference to “Concentra” refers to Concentra Group Holdings Parent, LLC (“Concentra Group Holdings Parent”) and its subsidiaries, including Concentra Inc. References to the “Company,” “we,” “us,” and “our” refer collectively to Holdings, Select, and Concentra.
TABLE OF CONTENTS
PART I: FINANCIAL INFORMATION
ITEM 1. CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
Select Medical Holdings Corporation
Condensed Consolidated Balance Sheets
(unaudited)
(in thousands, except share and per share amounts)
| | | | | | | | | | | |
| | | |
| December 31, 2019 | | June 30, 2020 |
ASSETS | | | |
Current Assets: | | | |
Cash and cash equivalents | $ | 335,882 | | | $ | 509,737 | |
Accounts receivable | 762,677 | | | 749,245 | |
Prepaid income taxes | 18,585 | | | 9,204 | |
Other current assets | 95,848 | | | 95,143 | |
Total Current Assets | 1,212,992 | | | 1,363,329 | |
Operating lease right-of-use assets | 1,003,986 | | | 1,022,721 | |
Property and equipment, net | 998,406 | | | 959,086 | |
Goodwill | 3,391,955 | | | 3,391,196 | |
Identifiable intangible assets, net | 409,068 | | | 398,266 | |
Other assets | 323,881 | | | 333,860 | |
Total Assets | $ | 7,340,288 | | | $ | 7,468,458 | |
LIABILITIES AND EQUITY | | | |
Current Liabilities: | | | |
| | | |
Current operating lease liabilities | $ | 207,950 | | | $ | 216,689 | |
Current portion of long-term debt and notes payable | 25,167 | | | 13,435 | |
Accounts payable | 145,731 | | | 142,946 | |
Accrued payroll | 183,754 | | | 125,109 | |
Accrued vacation | 124,111 | | | 124,624 | |
Accrued interest | 33,853 | | | 29,610 | |
Accrued other | 191,076 | | | 204,074 | |
Government advances (Note 12) | — | | | 316,992 | |
Unearned government assistance (Note 12) | — | | | 45,505 | |
| | | |
Income taxes payable | 2,638 | | | 36,985 | |
Total Current Liabilities | 914,280 | | | 1,255,969 | |
Non-current operating lease liabilities | 852,897 | | | 866,097 | |
Long-term debt, net of current portion | 3,419,943 | | | 3,390,417 | |
Non-current deferred tax liability | 148,258 | | | 144,697 | |
Other non-current liabilities | 101,334 | | | 142,861 | |
Total Liabilities | 5,436,712 | | | 5,800,041 | |
Commitments and contingencies (Note 11) | | | |
Redeemable non-controlling interests | 974,541 | | | 495,987 | |
Stockholders’ Equity: | | | |
Common stock, $0.001 par value, 700,000,000 shares authorized, 134,328,112 and 133,970,064 shares issued and outstanding at 2019 and 2020, respectively | 134 | | | 134 | |
Capital in excess of par | 491,038 | | | 496,785 | |
Retained earnings | 279,800 | | | 495,964 | |
Total Stockholders’ Equity | 770,972 | | | 992,883 | |
Non-controlling interests | 158,063 | | | 179,547 | |
Total Equity | 929,035 | | | 1,172,430 | |
Total Liabilities and Equity | $ | 7,340,288 | | | $ | 7,468,458 | |
The accompanying notes are an integral part of these condensed consolidated financial statements.
Select Medical Holdings Corporation
Condensed Consolidated Statements of Operations
(unaudited)
(in thousands, except per share amounts)
| | | | | | | | | | | |
| For the Three Months Ended June 30, | | |
| 2019 | | 2020 |
Net operating revenues | $ | 1,361,364 | | | $ | 1,232,718 | |
Costs and expenses: | | | |
Cost of services, exclusive of depreciation and amortization | 1,150,150 | | | 1,082,456 | |
General and administrative | 31,339 | | | 33,461 | |
Depreciation and amortization | 54,993 | | | 52,271 | |
Total costs and expenses | 1,236,482 | | | 1,168,188 | |
Other operating income (Note 12) | — | | | 54,988 | |
Income from operations | 124,882 | | | 119,518 | |
Other income and expense: | | | |
| | | |
Equity in earnings of unconsolidated subsidiaries | 7,394 | | | 8,324 | |
Gain on sale of businesses | — | | | 346 | |
Interest expense | (51,464) | | | (37,366) | |
Income before income taxes | 80,812 | | | 90,822 | |
Income tax expense | 20,826 | | | 23,336 | |
Net income | 59,986 | | | 67,486 | |
Less: Net income attributable to non-controlling interests | 15,170 | | | 15,836 | |
Net income attributable to Select Medical Holdings Corporation | $ | 44,816 | | | $ | 51,650 | |
Earnings per common share (Note 10): | | | |
Basic | $ | 0.33 | | | $ | 0.39 | |
Diluted | $ | 0.33 | | | $ | 0.39 | |
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| | | |
The accompanying notes are an integral part of these condensed consolidated financial statements.
Select Medical Holdings Corporation
Condensed Consolidated Statements of Operations
(unaudited)
(in thousands, except per share amounts)
| | | | | | | | | | | |
| For the Six Months Ended June 30, | | |
| 2019 | | 2020 |
Net operating revenues | $ | 2,685,995 | | | $ | 2,647,350 | |
Costs and expenses: | | | |
Cost of services, exclusive of depreciation and amortization | 2,282,242 | | | 2,282,827 | |
General and administrative | 60,016 | | | 67,292 | |
Depreciation and amortization | 107,131 | | | 104,023 | |
Total costs and expenses | 2,449,389 | | | 2,454,142 | |
Other operating income (Note 12) | — | | | 54,988 | |
Income from operations | 236,606 | | | 248,196 | |
Other income and expense: | | | |
| | | |
Equity in earnings of unconsolidated subsidiaries | 11,760 | | | 10,912 | |
Gain on sale of businesses | 6,532 | | | 7,547 | |
Interest expense | (102,275) | | | (83,473) | |
Income before income taxes | 152,623 | | | 183,182 | |
Income tax expense | 39,293 | | | 45,248 | |
Net income | 113,330 | | | 137,934 | |
Less: Net income attributable to non-controlling interests | 27,680 | | | 33,159 | |
Net income attributable to Select Medical Holdings Corporation | $ | 85,650 | | | $ | 104,775 | |
Earnings per common share (Note 10): | | | |
Basic | $ | 0.63 | | | $ | 0.78 | |
Diluted | $ | 0.63 | | | $ | 0.78 | |
| | | |
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The accompanying notes are an integral part of these condensed consolidated financial statements.
Select Medical Holdings Corporation
Condensed Consolidated Statements of Changes in Equity and Income
(unaudited)
(in thousands)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| For the Six Months Ended June 30, 2020 | | | | | | | | | | | | |
| | | | | | | | | | | | | |
| | | Total Stockholders’ Equity | | | | | | | | | | |
| Common Stock Issued | | Common Stock Par Value | | Capital in Excess of Par | | Retained Earnings | | Total Stockholders’ Equity | | Non-controlling Interests | | Total Equity |
Balance at December 31, 2019 | 134,328 | | | $ | 134 | | | $ | 491,038 | | | $ | 279,800 | | | $ | 770,972 | | | $ | 158,063 | | | $ | 929,035 | |
Net income attributable to Select Medical Holdings Corporation | | | | | | | 53,125 | | | 53,125 | | | | | 53,125 | |
Net income attributable to non-controlling interests | | | | | | | | | — | | | 10,067 | | | 10,067 | |
Issuance of restricted stock | 2 | | | 0 | | | 0 | | | | | — | | | | | — | |
Forfeitures of unvested restricted stock | (15) | | | 0 | | | 0 | | | | | — | | | | | — | |
Vesting of restricted stock | | | | | 6,136 | | | | | 6,136 | | | | | 6,136 | |
Repurchase of common shares | (492) | | | 0 | | | (5,350) | | | (3,341) | | | (8,691) | | | | | (8,691) | |
Issuance of non-controlling interests | | | | | | | | | — | | | 1,679 | | | 1,679 | |
Distributions to and purchases of non-controlling interests | | | | | | | (2,726) | | | (2,726) | | | (4,048) | | | (6,774) | |
Redemption adjustment on non-controlling interests | | | | | | | (10,123) | | | (10,123) | | | | | (10,123) | |
Other | | | | | | | (55) | | | (55) | | | 420 | | | 365 | |
Balance at March 31, 2020 | 133,823 | | | $ | 134 | | | $ | 491,824 | | | $ | 316,680 | | | $ | 808,638 | | | $ | 166,181 | | | $ | 974,819 | |
Net income attributable to Select Medical Holdings Corporation | | | | | | | 51,650 | | | 51,650 | | | | | 51,650 | |
Net income attributable to non-controlling interests | | | | | | | | | — | | | 12,572 | | | 12,572 | |
Issuance of restricted stock | 200 | | | 0 | | | 0 | | | | | — | | | | | — | |
Forfeitures of unvested restricted stock | (7) | | | 0 | | | 0 | | | | | — | | | | | — | |
Vesting of restricted stock | | | | | 6,262 | | | | | 6,262 | | | | | 6,262 | |
Repurchase of common shares | (46) | | | 0 | | | (441) | | | (283) | | | (724) | | | | | (724) | |
Issuance of non-controlling interests | | | | | | | | | — | | | 7 | | | 7 | |
Distributions to and purchases of non-controlling interests | | | | | (65) | | | | | (65) | | | (418) | | | (483) | |
Redemption adjustment on non-controlling interests | | | | | | | 127,916 | | | 127,916 | | | | | 127,916 | |
Other | | | | | (795) | | | 1 | | | (794) | | | 1,205 | | | 411 | |
Balance at June 30, 2020 | 133,970 | | | $ | 134 | | | $ | 496,785 | | | $ | 495,964 | | | $ | 992,883 | | | $ | 179,547 | | | $ | 1,172,430 | |
The accompanying notes are an integral part of these condensed consolidated financial statements.
Select Medical Holdings Corporation
Condensed Consolidated Statements of Changes in Equity and Income
(unaudited)
(in thousands)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| For the Six Months Ended June 30, 2019 | | | | | | | | | | | | |
| | | | | | | | | | | | | |
| | | Total Stockholders’ Equity | | | | | | | | | | |
| Common Stock Issued | | Common Stock Par Value | | Capital in Excess of Par | | Retained Earnings | | Total Stockholders’ Equity | | Non-controlling Interests | | Total Equity |
Balance at December 31, 2018 | 135,266 | | | $ | 135 | | | $ | 482,556 | | | $ | 320,351 | | | $ | 803,042 | | | $ | 113,198 | | | $ | 916,240 | |
Net income attributable to Select Medical Holdings Corporation | | | | | | | 40,834 | | | 40,834 | | | | | 40,834 | |
Net income attributable to non-controlling interests | | | | | | | | | — | | | 4,810 | | | 4,810 | |
Issuance of restricted stock | 21 | | | 0 | | | 0 | | | | | — | | | | | — | |
Forfeitures of unvested restricted stock | (24) | | | 0 | | | 0 | | | | | — | | | | | — | |
Vesting of restricted stock | | | | | 5,488 | | | | | 5,488 | | | | | 5,488 | |
Issuance of non-controlling interests | | | | | | | | | — | | | 6,837 | | | 6,837 | |
Distributions to and purchases of non-controlling interests | | | | | 259 | | | | | 259 | | | (2,739) | | | (2,480) | |
Redemption adjustment on non-controlling interests | | | | | | | (47,470) | | | (47,470) | | | | | (47,470) | |
Other | | | | | | | (122) | | | (122) | | | 413 | | | 291 | |
Balance at March 31, 2019 | 135,263 | | | $ | 135 | | | $ | 488,303 | | | $ | 313,593 | | | $ | 802,031 | | | $ | 122,519 | | | $ | 924,550 | |
Net income attributable to Select Medical Holdings Corporation | | | | | | | 44,816 | | | 44,816 | | | | | 44,816 | |
Net income attributable to non-controlling interests | | | | | | | | | — | | | 3,663 | | | 3,663 | |
Issuance of restricted stock | 187 | | | 0 | | | 0 | | | | | — | | | | | — | |
Vesting of restricted stock | | | | | 5,591 | | | | | 5,591 | | | | | 5,591 | |
Repurchase of common shares | (936) | | | 0 | | | (8,164) | | | (5,456) | | | (13,620) | | | | | (13,620) | |
Exercise of stock options | 50 | | | 0 | | | 459 | | | | | 459 | | | | | 459 | |
Issuance of non-controlling interests | | | | | 6,366 | | | | | 6,366 | | | 24,761 | | | 31,127 | |
Distributions to and purchases of non-controlling interests | | | | | 14 | | | | | 14 | | | (1,430) | | | (1,416) | |
Redemption adjustment on non-controlling interests | | | | | | | 270 | | | 270 | | | | | 270 | |
Other | | | | | | | 82 | | | 82 | | | 428 | | | 510 | |
Balance at June 30, 2019 | 134,564 | | | $ | 135 | | | $ | 492,569 | | | $ | 353,305 | | | $ | 846,009 | | | $ | 149,941 | | | $ | 995,950 | |
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The accompanying notes are an integral part of these condensed consolidated financial statements.
Select Medical Holdings Corporation
Condensed Consolidated Statements of Cash Flows
(unaudited)
(in thousands)
| | | | | | | | | | | |
| For the Six Months Ended June 30, | | |
| 2019 | | 2020 |
Operating activities | | | |
Net income | $ | 113,330 | | | $ | 137,934 | |
Adjustments to reconcile net income to net cash provided by operating activities: | | | |
Distributions from unconsolidated subsidiaries | 11,148 | | | 11,223 | |
Depreciation and amortization | 107,131 | | | 104,023 | |
Provision for expected credit losses | 1,958 | | | 253 | |
Equity in earnings of unconsolidated subsidiaries | (11,760) | | | (10,912) | |
| | | |
Gain on sale of assets and businesses | (6,354) | | | (7,881) | |
Stock compensation expense | 12,613 | | | 13,866 | |
Amortization of debt discount, premium and issuance costs | 6,326 | | | 1,093 | |
Deferred income taxes | (6,290) | | | (3,416) | |
Changes in operating assets and liabilities, net of effects of business combinations: | | | |
Accounts receivable | (85,873) | | | 13,179 | |
Other current assets | (9,236) | | | 713 | |
Other assets | (939) | | | 11,504 | |
Accounts payable | 2,670 | | | 4,251 | |
Accrued expenses | (18,156) | | | 4,028 | |
Government advances | — | | | 316,992 | |
Unearned government assistance | — | | | 45,505 | |
| | | |
Income taxes | 16,346 | | | 43,743 | |
Net cash provided by operating activities | 132,914 | | | 686,098 | |
Investing activities | | | |
Business combinations, net of cash acquired | (86,062) | | | (6,961) | |
Purchases of property and equipment | (89,285) | | | (71,253) | |
Investment in businesses | (52,257) | | | (14,749) | |
Proceeds from sale of assets and businesses | 125 | | | 12,401 | |
Net cash used in investing activities | (227,479) | | | (80,562) | |
Financing activities | | | |
Borrowings on revolving facilities | 635,000 | | | 470,000 | |
Payments on revolving facilities | (460,000) | | | (470,000) | |
| | | |
Payments on term loans | (132,685) | | | (39,843) | |
| | | |
| | | |
| | | |
Borrowings of other debt | 14,230 | | | 31,487 | |
Principal payments on other debt | (12,680) | | | (35,733) | |
Repurchase of common stock | (13,620) | | | (9,415) | |
Proceeds from exercise of stock options | 459 | | | — | |
Increase in overdrafts | 2,176 | | | — | |
Proceeds from issuance of non-controlling interests | 18,288 | | | 1,686 | |
Distributions to and purchases of non-controlling interests | (7,745) | | | (13,660) | |
Purchase of membership interests of Concentra Group Holdings Parent (Note 4) | — | | | (366,203) | |
Net cash provided by (used in) financing activities | 43,423 | | | (431,681) | |
Net increase (decrease) in cash and cash equivalents | (51,142) | | | 173,855 | |
Cash and cash equivalents at beginning of period | 175,178 | | | 335,882 | |
Cash and cash equivalents at end of period | $ | 124,036 | | | $ | 509,737 | |
Supplemental Information | | | |
Cash paid for interest | $ | 97,909 | | | $ | 86,124 | |
Cash paid for taxes | 29,241 | | | 4,920 | |
Operating lease right-of-use assets obtained in exchange for lease liabilities, excluding adoption impact of ASC Topic 842 at January 1, 2019 | 66,977 | | | 132,125 | |
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The accompanying notes are an integral part of these condensed consolidated financial statements.
SELECT MEDICAL HOLDINGS CORPORATION
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)
1. Basis of Presentation
The unaudited condensed consolidated financial statements of Select Medical Holdings Corporation (“Holdings”) include the accounts of its wholly owned subsidiary, Select Medical Corporation (“Select”). Holdings conducts substantially all of its business through Select and its subsidiaries. Holdings and Select and its subsidiaries are collectively referred to as the “Company.” The unaudited condensed consolidated financial statements of the Company as of June 30, 2020, and for the three and six month periods ended June 30, 2019 and 2020, have been prepared pursuant to the rules and regulations of the Securities Exchange Commission (the “SEC”) for interim reporting and accounting principles generally accepted in the United States of America (“GAAP”). Accordingly, certain information and disclosures required by GAAP, which are normally included in the notes to consolidated financial statements, have been condensed or omitted pursuant to those rules and regulations, although the Company believes the disclosure is adequate to make the information presented not misleading. In the opinion of management, such information contains all adjustments, which are normal and recurring in nature, necessary for a fair statement of the financial position, results of operations and cash flow for such periods. All significant intercompany transactions and balances have been eliminated.
The results of operations for the three and six months ended June 30, 2020, are not necessarily indicative of the results to be expected for the full fiscal year ending December 31, 2020. These unaudited condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto for the year ended December 31, 2019, contained in the Company’s Annual Report on Form 10-K filed with the SEC on February 20, 2020.
2. Accounting Policies
Use of Estimates
The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, including disclosure of contingencies, at the date of the financial statements and reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.
Recently Adopted Accounting Pronouncements
Financial Instruments
On January 1, 2020, the Company adopted Accounting Standards Update (“ASU”) 2016-13, Financial Instruments - Credit Losses: Measurement of Credit Losses on Financial Instruments (Topic 326), which replaced the incurred loss approach for recognizing credit losses on financial instruments with an expected loss approach. The expected loss approach is subject to management judgments using assessments of incurred credit losses, assessments of current conditions, and forecasts using reasonable and supportable assumptions. The standard was required to be applied using the modified retrospective approach with a cumulative-effect adjustment to retained earnings, if any, upon adoption.
The Company’s primary financial instrument subject to the standard is its accounts receivable derived from contracts with patients. Historically, the Company has experienced infrequent, immaterial credit losses related to its accounts receivable and, based on its experience, believes the risk of material defaults is low. The Company experienced credit losses of $1.1 million for the year ended December 31, 2017, credit loss recoveries of $0.1 million for the year ended December 31, 2018, and credit losses of $3.0 million for the year ended December 31, 2019. The Company’s historical credit losses have been infrequent and immaterial largely because the Company’s accounts receivable are typically paid for by highly-solvent, creditworthy payors such as Medicare, other governmental programs, and highly-regulated commercial insurers, on behalf of the patient. The Company believes it has moderate credit risk related to defaults on self-pay amounts in accounts receivable; however, these amounts represented less than 1.0% of the Company’s accounts receivable at January 1, 2020.
In estimating the Company’s expected credit losses under Topic 326, the Company considers its incurred loss experience and adjusts for known and expected events and other circumstances, identified using periodic assessments implemented by the Company, which management believes are relevant in assessing the collectability of its accounts receivable. Because of the infrequent and insignificant nature of the Company’s historical credit losses, forecasts of expected credit losses are generally unnecessary. Expected credit losses are recognized by the Company through an allowance for credit losses and related credit loss expense.
As of January 1, 2020, the Company completed its expected credit loss assessment for its financial instruments subject to Topic 326. The Company’s estimate of expected credit losses as of January 1, 2020, resulted in no adjustments to the allowance for credit losses and no cumulative-effect adjustment to retained earnings on the adoption date of the standard.
3. Credit Risk Concentrations
Financial instruments that potentially subject the Company to concentrations of credit risk consist primarily of cash balances and accounts receivables. The Company’s excess cash is held with large financial institutions. The Company grants unsecured credit to its patients, most of whom reside in the service area of the Company’s facilities and are insured under third-party payor agreements. The Company’s general policy is to verify insurance coverage prior to the date of admission for patients admitted to its critical illness recovery hospitals and rehabilitation hospitals. Within the Company’s outpatient rehabilitation clinics, insurance coverage is verified prior to the patient’s visit. Within the Company’s Concentra centers, insurance coverage is verified or an authorization is received from the patient’s employer prior to the patient’s visit.
Because of the diversity in the Company’s non-governmental third-party payor base, as well as their geographic dispersion, patient accounts receivable which are due from the Medicare program represent the Company’s only significant concentration of credit risk. Approximately 15% and 13% of the Company’s accounts receivable is from Medicare at December 31, 2019, and June 30, 2020, respectively.
4. Redeemable Non-Controlling Interests
The ownership interests held by outside parties in subsidiaries, limited liability companies, and limited partnerships controlled by the Company are classified as non-controlling interests. Some of the Company’s non-controlling ownership interests consist of outside parties that have certain redemption rights that, if exercised, require the Company to purchase the parties’ ownership interests. These interests are classified and reported as redeemable non-controlling interests and have been adjusted to their approximate redemption values.
On January 1, 2020, Select acquired approximately 17.2% of the outstanding membership interests of Concentra Group Holdings Parent on a fully diluted basis from Welsh, Carson, Anderson & Stowe XII, L.P. (“WCAS”), Dignity Health Holding Corporation (“DHHC”), and certain other sellers in exchange for an aggregate purchase price of approximately $338.4 million. On February 1, 2020, Select acquired an additional 1.4% of the outstanding membership interests of Concentra Group Holdings Parent on a fully diluted basis from WCAS, DHHC, and certain other sellers in exchange for an aggregate purchase price of approximately $27.8 million. These purchases were in lieu of, and are considered to be, the exercise of the first put right provided to certain equity holders under the terms of the Amended and Restated Limited Liability Company Agreement of Concentra Group Holdings Parent, dated as of February 1, 2018, as amended (the “Concentra LLC Agreement”).
Following these purchases, Select owns approximately 66.6% of the outstanding membership interests of Concentra Group Holdings Parent on a fully diluted basis and approximately 68.8% of the outstanding Class A membership interests of Concentra Group Holdings Parent.
The changes in redeemable non-controlling interests are as follows (in thousands):
| | | | | | | | | | | |
| Six Months Ended June 30, | | |
| 2019 | | 2020 |
Balance as of January 1 | $ | 780,488 | | | $ | 974,541 | |
Net income attributable to redeemable non-controlling interests | 7,700 | | | 7,256 | |
| | | |
Distributions to and purchases of redeemable non-controlling interests | (2,771) | | | (5,687) | |
Purchase of membership interests of Concentra Group Holdings Parent | — | | | (366,203) | |
Redemption adjustment on redeemable non-controlling interests | 47,470 | | | 10,123 | |
Other | 354 | | | 347 | |
Balance as of March 31 | $ | 833,241 | | | $ | 620,377 | |
Net income attributable to redeemable non-controlling interests | 11,507 | | | 3,264 | |
Distributions to and purchases of redeemable non-controlling interests | (395) | | | (30) | |
Redemption adjustment on redeemable non-controlling interests | (270) | | | (127,916) | |
Other | 339 | | | 292 | |
Balance as of June 30 | $ | 844,422 | | | $ | 495,987 | |
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5. Variable Interest Entities
Concentra does not own many of its medical practices, as certain states prohibit the “corporate practice of medicine,” which restricts business corporations from practicing medicine through the direct employment of physicians or from exercising control over medical decisions by physicians. In these states, Concentra typically enters into long-term management agreements with professional corporations or associations that are owned by licensed physicians, which, in turn, employ or contract with physicians who provide professional medical services in Concentra’s occupational health centers.
The management agreements have terms that provide for Concentra to conduct, supervise, and manage the day-to-day non-medical operations of the occupational health centers and provide all management and administrative services. Concentra receives a management fee for these services, which is based, in part, on the performance of the professional corporation or association. Additionally, the outstanding voting equity interests of the professional corporations or associations are typically owned by licensed physicians appointed at Concentra’s discretion. Concentra has the ability to direct the transfer of ownership of the professional corporation or association to a new licensed physician at any time.
The total assets of Concentra’s variable interest entities, which are comprised principally of accounts receivable, were $178.4 million and $153.2 million at December 31, 2019, and June 30, 2020, respectively. The total liabilities of Concentra’s variable interest entities, which are comprised principally of accounts payable, accrued expenses, and obligations payable for services received under the aforementioned management agreements, were $176.7 million and $151.9 million at December 31, 2019, and June 30, 2020, respectively.
6. Intangible Assets
Goodwill
The following table shows changes in the carrying amounts of goodwill by reporting unit for the six months ended June 30, 2020:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| Critical Illness Recovery Hospital | | Rehabilitation Hospital | | Outpatient Rehabilitation | | Concentra | | Total |
| (in thousands) | | | | | | | | |
Balance as of December 31, 2019 | $ | 1,078,804 | | | $ | 430,900 | | | $ | 649,763 | | | $ | 1,232,488 | | | $ | 3,391,955 | |
Acquired | — | | | — | | | 728 | | | 4,567 | | | 5,295 | |
Sold | — | | | — | | | (6,034) | | | — | | | (6,034) | |
Measurement period adjustment | — | | | — | | | — | | | (20) | | | (20) | |
Balance as of June 30, 2020 | $ | 1,078,804 | | | $ | 430,900 | | | $ | 644,457 | | | $ | 1,237,035 | | | $ | 3,391,196 | |
Identifiable Intangible Assets
The following table provides the gross carrying amounts, accumulated amortization, and net carrying amounts for the Company’s identifiable intangible assets: