Business and Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2023

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, 2023, 2022 and 2021:

	(dollar amounts in thousands)
	2023					2022					2021
	Amount		%			Amount		%			Amount		%
Charity care	$	843,449		32	%	$	786,962		35	%	$	661,965		33	%
Uninsured discounts		1,792,493		68	%		1,474,933		65	%		1,336,319		67	%
Total uncompensated care	$	2,635,942		100	%	$	2,261,895		100	%	$	1,998,284		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)
	2023		2022		2021
Estimated cost of providing charity care	$	83,383	$	85,434	$	72,095
Estimated cost of providing uninsured discounts		177,206		160,122		145,538
Estimated cost of providing uncompensated care	$	260,589	$	245,556	$	217,633

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)
	2023		2022		2021
Cash and cash equivalents	$	119,439	$	102,818	$	115,301
Restricted cash (a)		95,031		98,019		63,633
Total cash, cash equivalents and restricted cash	$	214,470	$	200,837	$	178,934

(a)Restricted cash is included in other assets on the accompanying consolidated balance sheets 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, 2023 were as follows (in thousands):

	Acute Care Services		Behavioral Health Services			Total Consolidated
Balance, January 1, 2022	$	515,936	$	3,446,688		$	3,962,624
Goodwill acquired during the period		0		0			—
Goodwill divested during the period		0		0			0
Adjustments to goodwill (a)		690		(53,858	)		(53,168	)
Balance, December 31, 2022		516,626		3,392,830			3,909,456
Goodwill acquired during the period		0		4,598			4,598
Goodwill divested during the period		0		(6,062	)		(6,062	)
Adjustments to goodwill (a)		2		24,413			24,415
Balance, December 31, 2023	$	516,628	$	3,415,779		$	3,932,407

(a)The changes in the Behavioral Health Services’ goodwill consist 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, 2023 and 2022:

	(amounts in thousands)
	2023		2022
Medicare licenses (a)	$	57,226	$	57,226
Certificates of need		7,501		7,989
Contract relationships and other (net of $56,288 and $55,353 of accumulated amortization for 2023 and 2022, respectively)		12,291		12,887
Net Intangible Assets	$	77,018	$	78,102

(a) Indefinite lives.

Amounts Recognized in AOCI

The amounts recognized in AOCI for the two years ended December 31, 2023 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, 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, January 1, 2023, net of income tax		(17	)		(4,255	)		(5,396	)		(9,668	)
2023 activity:
Pretax amount		0			15,271			4,166			19,437
Income tax effect		0			520			(1,000	)		(480	)
Change, net of income tax		0			15,791			3,166			18,957
Balance, December 31, 2023, net of income tax	$	(17	)	$	11,536		$	(2,230	)	$	9,289

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 (in thousands, except per share data):

	Twelve Months Ended December 31,
	2023			2022			2021
Basic and diluted:
Net Income	$	719,307		$	656,982		$	987,632
Less: Net (income) loss attributable to noncontrolling    interest ("NCI")		(1,512	)		18,627			3,958
Less: Net income attributable to unvested restricted share    grants		(308	)		(748	)		(2,059	)
Net income attributable to UHS—basic and diluted	$	717,487		$	674,861		$	989,531
Basic earnings per share attributable to UHS:
Weighted average number of common shares—basic		69,321			73,118			82,519
Total basic earnings per share	$	10.35		$	9.23		$	11.99
Diluted earnings per share attributable to UHS:
Weighted average number of common shares		69,321			73,118			82,519
Net effect of dilutive stock options and grants based    on the treasury stock method		804			714			1,173
Weighted average number of common shares and    equivalents—diluted		70,125			73,832			83,692
Total diluted earnings per share	$	10.23		$	9.14		$	11.82