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Restructuring (Tables)
9 Months Ended
Sep. 30, 2020
Restructuring and Related Activities [Abstract]  
Restructuring and Related Costs The following table summarizes the activity related to the restructuring reserves for the Operation Simplification and Optimization Program:
Operation Simplification and Optimization ProgramSeverance and Related Benefit Costs
Costs Associated with Exit and Disposal Costs (1)
Total
Reserve Balance as of December 31, 2019$9,506 $— $9,506 
Expenses recorded6,574 1,180 7,754 
Payments made(6,647)— (6,647)
Reserve Balance as of March 31, 20209,433 1,180 10,613 
Expenses recorded4,865 2,749 7,614 
Payments made(4,297)(199)(4,496)
Reserve Balance as of June 30, 202010,001 3,730 13,731 
Expenses recorded472 1,361 1,833 
Payments made(2,939)(2,448)(5,387)
Reserve Balance as of September 30, 2020$7,534 $2,643 $10,177 
(1) Relates primarily to location exit costs, legal and advisory fees.

The following table is a summary of charges incurred related to the Operation Simplification and Optimization Program in the three and nine months ended September 30, 2020.

Three Months Ended September 30,
20202019
Severance and related benefit costs$472 $— 
Costs associated with exit and disposal activities(1)
506 — 
Costs associated with lease exit costs including impairment855 — 
Total$1,833 $— 
Nine Months Ended September 30,
20202019
Severance and related benefit costs$11,911 $— 
Costs associated with exit and disposal activities(1)
4,435 — 
Costs associated with lease exit costs including impairment(2)
5,763 — 
Total$22,109 $— 
  (1) Relates primarily to contract exit costs, legal and advisory fees.
  (2) Includes $4,880 of charges related to impairment of leases and $882 of lease exit costs.
The following table summarizes the activity related to the restructuring reserves for the DRG Acquisition Integration:
DRG Acquisition IntegrationSeverance and Related Benefit Costs
Costs Associated with Exit and Disposal Costs(1)
Total
Reserve balance as of December 31, 2019
$— $— $— 
Expenses recorded3,312 12 3,324 
Payments made(1,252)— (1,252)
Reserve balance as of June 30, 20202,060 12 2,072 
Expenses recorded 1,210 149 1,359 
Payments made(1,013)(144)(1,157)
Reserve balance as of September 30, 2020$2,257 $17 $2,274 
(1) Relates primarily to lease exit costs and legal and advisory fees.

The following table is a summary of charges incurred related to the DRG Acquisition Integration in the three and nine months ended September 30, 2020.
Three Months Ended September 30
2020
Severance and related benefit costs$1,210 
Costs associated with exit and disposal activities(1)
149 
Total $1,359 
Nine Months Ended September 30,
2020
Severance and related benefit costs$4,522 
Costs associated with exit and disposal activities(1)
161 
Total$4,683 
  (1) Relates primary to lease exit costs and legal and advisory fees.