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Segment Information (Tables)
9 Months Ended
Sep. 30, 2021
Segment Reporting [Abstract]  
Schedule of selected financial data for the Company's reportable segments
The following tables summarize selected financial data for the Company’s reportable segments.
 Three Months Ended September 30,Nine Months Ended September 30,
 2020202120202021
 (in thousands)
Revenue:    
Critical illness recovery hospital$519,454 $530,646 $1,539,601 $1,669,577 
Rehabilitation hospital188,075 212,434 538,761 632,904 
Outpatient rehabilitation240,042 274,540 662,429 806,910 
Concentra391,859 442,190 1,102,732 1,321,402 
Other84,439 74,411 227,696 213,911 
Total Company$1,423,869 $1,534,221 $4,071,219 $4,644,704 
Adjusted EBITDA:    
Critical illness recovery hospital$88,830 $57,245 $267,143 $243,421 
Rehabilitation hospital44,637 44,076 110,811 145,378 
Outpatient rehabilitation30,623 38,762 51,463 110,724 
Concentra80,547 99,832 183,510 318,907 
Other(31,433)(31,338)(33,638)(9,491)
Total Company$213,204 $208,577 $579,289 $808,939 
Total assets:    
Critical illness recovery hospital$2,160,157 $2,181,405 $2,160,157 $2,181,405 
Rehabilitation hospital1,144,436 1,191,093 1,144,436 1,191,093 
Outpatient rehabilitation1,298,938 1,339,452 1,298,938 1,339,452 
Concentra2,355,644 2,609,361 2,355,644 2,609,361 
Other700,702 578,162 700,702 578,162 
Total Company$7,659,877 $7,899,473 $7,659,877 $7,899,473 
Purchases of property and equipment:    
Critical illness recovery hospital$11,126 $12,365 $35,061 $43,249 
Rehabilitation hospital1,636 4,366 6,884 8,288 
Outpatient rehabilitation7,268 9,481 22,245 24,264 
Concentra11,985 11,353 34,391 31,624 
Other2,304 11,379 6,991 17,961 
Total Company$34,319 $48,944 $105,572 $125,386 
Schedule of reconciliation of Adjusted EBITDA to income before income taxes
A reconciliation of Adjusted EBITDA to income before income taxes is as follows:
 Three Months Ended September 30, 2020
 Critical Illness Recovery HospitalRehabilitation HospitalOutpatient
Rehabilitation
ConcentraOtherTotal
 (in thousands)
Adjusted EBITDA$88,830 $44,637 $30,623 $80,547 $(31,433) 
Depreciation and amortization(12,521)(6,910)(7,231)(21,083)(2,365) 
Stock compensation expense— — — (506)(6,456) 
Income (loss) from operations$76,309 $37,727 $23,392 $58,958 $(40,254)$156,132 
Equity in earnings of unconsolidated subsidiaries    8,765 
Gain on sale of businesses5,143 
Interest expense    (34,026)
Income before income taxes    $136,014 
 Three Months Ended September 30, 2021
 Critical Illness Recovery HospitalRehabilitation HospitalOutpatient
Rehabilitation
ConcentraOtherTotal
 (in thousands)
Adjusted EBITDA$57,245 $44,076 $38,762 $99,832 $(31,338) 
Depreciation and amortization(12,972)(6,869)(7,319)(20,419)(2,549) 
Stock compensation expense— — — (535)(7,659) 
Income (loss) from operations$44,273 $37,207 $31,443 $78,878 $(41,546)$150,255 
Equity in earnings of unconsolidated subsidiaries    11,452 
Interest expense    (33,825)
Income before income taxes    $127,882 
 Nine Months Ended September 30, 2020
 Critical Illness Recovery HospitalRehabilitation HospitalOutpatient
Rehabilitation
ConcentraOtherTotal
 (in thousands)
Adjusted EBITDA$267,143 $110,811 $51,463 $183,510 $(33,638) 
Depreciation and amortization(38,749)(20,704)(21,643)(65,827)(7,210) 
Stock compensation expense— — — (1,974)(18,854) 
Income (loss) from operations$228,394 $90,107 $29,820 $115,709 $(59,702)$404,328 
Equity in earnings of unconsolidated subsidiaries    19,677 
Gain on sale of businesses12,690 
Interest expense    (117,499)
Income before income taxes    $319,196 
 Nine Months Ended September 30, 2021
 Critical Illness Recovery HospitalRehabilitation HospitalOutpatient
Rehabilitation
ConcentraOtherTotal
 (in thousands)
Adjusted EBITDA$243,421 $145,378 $110,724 $318,907 $(9,491) 
Depreciation and amortization(38,958)(20,868)(21,855)(61,547)(7,474) 
Stock compensation expense— — — (1,606)(20,396) 
Income (loss) from operations$204,463 $124,510 $88,869 $255,754 $(37,361)$636,235 
Equity in earnings of unconsolidated subsidiaries    33,180 
Interest income4,749 
Interest expense    (102,115)
Income before income taxes    $572,049