Business and Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2018

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, 2018, 2017 and 2016:

	(dollar amounts in thousands)
	2018					2017					2016
	Amount		%			Amount		%			Amount		%
Charity care	$	761,783		40	%	$	887,136		50	%	$	733,585		50	%
Uninsured discounts		1,132,811		60	%		881,265		50	%		720,205		50	%
Total uncompensated care	$	1,894,594		100	%	$	1,768,401		100	%	$	1,453,790		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)
	2018		2017		2016
Estimated cost of providing charity care	$	94,088	$	120,208	$	107,887
Estimated cost of providing uninsured discounts related care		139,913		119,412		105,920
Estimated cost of providing uncompensated care	$	234,001	$	239,620	$	213,807

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)
	2018		2017		2016
Cash and cash equivalents	$	105,220	$	74,423	$	33,747
Restricted cash (a)		94,465		92,874		88,203
Total cash, cash equivalents and restricted cash	$	199,685	$	167,297	$	121,950

(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.

Summary of Changes in Carrying Amount of Goodwill

Changes in the carrying amount of goodwill for the two years ended December 31, 2018 were as follows (in thousands):

	Acute Care Services		Behavioral Health Services			Total Consolidated
Balance, January 1, 2017	$	440,294	$	3,343,812		$	3,784,106
Goodwill acquired during the period		80		0			80
Adjustments to goodwill (a)		1,137		39,834			40,971
Balance, December 31, 2017		441,511		3,383,646			3,825,157
Goodwill acquired during the period		917		44,173			45,090
Goodwill divested during the period		0		(2,135	)		(2,135	)
Adjustments to goodwill (a)		34		(23,518	)		(23,484	)
Balance, December 31, 2018	$	442,462	$	3,402,166		$	3,844,628

(a) The increase/(decrease) 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, 2018 and 2017:

	(amounts in millions)
	2018		2017
Foundations tradename	$	75	$	124
Medicare licenses		57		57
Certificates of need		21		12
	20		27
Net Intangible Assets	$	173	$	220

Amounts Recognized in AOCI

The amounts recognized in AOCI for the two years ended December 31, 2018 were as follows (in thousands):

	Net Unrealized Gains (Losses)on Effective Cash Flow Hedges			Foreign Currency Translation Adjustment			Unrealized loss on marketable security			Minimum Pension Liability			Total AOCI
Balance, January 1, 2017, net of income tax	$	19		$	(14,197	)	$	(1,398	)	$	(9,841	)	$	(25,417	)
2017 activity:
Pretax amount		6,679			26,678			(2,169	)		4,070			35,258
Income tax effect		(2,490	)		—			809			(983	)		(2,664	)
Change, net of income tax		4,189			26,678			(1,360	)		3,087			32,594
Balance, January 1, 2018, net of income tax		4,208			12,481			(2,758	)		(6,754	)		7,177
2018 activity:
Pretax amount		(2,805	)		9,718			4,398			(6,892	)		4,419
Income tax effect, net of adoption of ASU 2018-02		1,577			(6,824	)		(1,640	)		(467	)		(7,354	)
Change, net of income tax		(1,228	)		2,894			2,758			(7,359	)		(2,935	)
Balance, December 31, 2018, net of income tax	$	2,980		$	15,375		$	—		$	(14,113	)	$	4,242

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,
	2018			2017			2016
Basic and diluted:
Net Income	$	797,883		$	771,312		$	747,171
Less: Net income attributable to noncontrolling interest		(18,178	)		(19,009	)		(44,762	)
Less: Net income attributable to unvested restricted share    grants		(1,091	)		(362	)		(314	)
Net income attributable to UHS—basic and diluted	$	778,614		$	751,941		$	702,095
Basic earnings per share attributable to UHS:
Weighted average number of common shares—basic		93,276			95,652			97,208
Total basic earnings per share	$	8.35		$	7.86		$	7.22
Diluted earnings per share attributable to UHS:
Weighted average number of common shares		93,276			95,652			97,208
Net effect of dilutive stock options and grants based    on the treasury stock method		474			673			1,172
Weighted average number of common shares and    equivalents—diluted		93,750			96,325			98,380
Total diluted earnings per share	$	8.31		$	7.81		$	7.14