Business and Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2022

Accounting Policies [Abstract]

Uncompensated Care

The following table shows the amounts recorded at our acute care hospitals for charity care and uninsured discounts, based on charges at established rates, for the years ended December 31, 2022, 2021 and 2020:

	(dollar amounts in thousands)
	2022					2021					2020
	Amount		%			Amount		%			Amount		%
Charity care	$	786,962		35	%	$	661,965		33	%	$	622,668		28	%
Uninsured discounts		1,474,933		65	%		1,336,319		67	%		1,578,470		72	%
Total uncompensated care	$	2,261,895		100	%	$	1,998,284		100	%	$	2,201,138		100	%

Estimated Cost of Providing Uncompensated Care

The estimated cost of providing uncompensated care, as reflected below, were based on a calculation which multiplied the percentage of operating expenses for our acute care hospitals to gross charges for those hospitals by the above-mentioned total uncompensated care amounts. The percentage of cost to gross charges is calculated based on the total operating expenses for our acute care facilities divided by gross patient service revenue for those facilities. An increase in the level of uninsured patients to our facilities and the resulting adverse trends in the adjustments to net revenues and uncompensated care provided could have a material unfavorable impact on our future operating results.

	(amounts in thousands)
	2022		2021		2020
Estimated cost of providing charity care	$	85,434	$	72,095	$	73,690
Estimated cost of providing uninsured discounts related care		160,122		145,538		186,804
Estimated cost of providing uncompensated care	$	245,556	$	217,633	$	260,494

Summary of Cash, Cash Equivalents and Restricted Cash Reported In Consolidated Statements of Cash Flows

Cash, cash equivalents, and restricted cash as reported in the consolidated statements of cash flows are presented separately on our consolidated balance sheets as follow:

	(amounts in thousands)
	2022		2021		2020
Cash and cash equivalents	$	102,818	$	115,301	$	1,224,490
Restricted cash (a)		98,019		63,633		54,664
Total cash, cash equivalents and restricted cash	$	200,837	$	178,934	$	1,279,154

(a)Restricted cash is included in other assets on the accompanying consolidated balance sheet and consists of statutorily required capital reserves related to our commercial insurance subsidiary.

The fair value of our restricted cash was computed based upon quotes received from financial institutions. We consider these to be “level 1” in the fair value hierarchy as outlined in the authoritative guidance for disclosures in connection with financial securities.

Summary of Changes in Carrying Amount of Goodwill

Changes in the carrying amount of goodwill for the two years ended December 31, 2022 were as follows (in thousands):

	Acute Care Services		Behavioral Health Services			Total Consolidated
Balance, January 1, 2021	$	447,021	$	3,435,694		$	3,882,715
Goodwill acquired during the period		55,406		0			55,406
Goodwill divested during the period		0		0			0
Adjustments to goodwill (a)		13,509		10,994			24,503
Balance, December 31, 2021		515,936		3,446,688			3,962,624
Goodwill acquired during the period		0		0			0
Goodwill divested during the period		0		0			0
Adjustments to goodwill (b)		690		(53,858	)		(53,168	)
Balance, December 31, 2022	$	516,626	$	3,392,830		$	3,909,456

Adjustments to goodwill during 2021 consist of the following: $13.5 million in Acute Care Services consists primarily of a measurement period adjustment to the preliminary purchase price allocation related to a 2020 acquisition; and the $11.0 million in Behavioral Health Services consists of $16.3 million recorded in connection with a third party minority ownership interest in a majority owned joint venture that constructed and owns a recently opened behavioral health facility, partially offset by a $5.3 million decrease related to foreign currency translation adjustments.

(b)The changes in the Behavioral Health Services’ goodwill consists primarily of foreign currency translation adjustments.

Summary of Net Intangible Assets

The following table shows the amounts recorded as net intangible assets for the years ended December 31, 2022 and 2021:

	(amounts in thousands)
	2022		2021
Medicare licenses	$	57,226	$	57,226
Certificates of need		7,989		8,239
Contract relationships and other (net of $55,353 and $54,134 of accumulated amortization for 2022 and 2021, respectively)		12,887		15,576
Net Intangible Assets	$	78,102	$	81,041

Amounts Recognized in AOCI

The amounts recognized in AOCI for the two years ended December 31, 2022 were as follows (in thousands):

	Net Unrealized Gains (Losses) on Effective Cash Flow Hedges			Foreign Currency Translation Adjustment			Minimum Pension Liability			Total AOCI
Balance, January 1, 2021, net of income tax	$	(17	)	$	52,438		$	(4,301	)	$	48,120
2021 activity:
Pretax amount		0			(20,743	)		1,427			(19,316	)
Income tax effect		0			1,829			(342	)		1,487
Change, net of income tax		0			(18,914	)		1,085			(17,829	)
Balance, January 1, 2022, net of income tax		(17	)		33,524			(3,216	)		30,291
2022 activity:
Pretax amount		0			(37,310	)		(2,869	)		(40,179	)
Income tax effect		0			(469	)		689			220
Change, net of income tax		0			(37,779	)		(2,180	)		(39,959	)
Balance, December 31, 2022, net of income tax	$	(17	)	$	(4,255	)	$	(5,396	)	$	(9,668	)

Computation of Basic and Diluted Earnings Per Share

The following table sets forth the computation of basic and diluted earnings per share, for the periods indicated:

	Twelve Months Ended December 31,
	2022			2021			2020
Basic and diluted:
Net Income	$	656,982		$	987,632		$	952,790
Less: Net (income) loss attributable to noncontrolling    interest ("NCI")		18,627			3,958			(8,837	)
Less: Net income attributable to unvested restricted share    grants		(748	)		(2,059	)		(2,981	)
Net income attributable to UHS—basic and diluted	$	674,861		$	989,531		$	940,972
Basic earnings per share attributable to UHS:
Weighted average number of common shares—basic		73,118			82,519			85,061
Total basic earnings per share	$	9.23		$	11.99		$	11.06
Diluted earnings per share attributable to UHS:
Weighted average number of common shares		73,118			82,519			85,061
Net effect of dilutive stock options and grants based    on the treasury stock method		714			1,173			526
Weighted average number of common shares and    equivalents—diluted		73,832			83,692			85,587
Total diluted earnings per share	$	9.14		$	11.82		$	10.99