Lease Accounting

9 Months Ended

Sep. 30, 2021

Leases [Abstract]

Lease Accounting

(13) Lease Accounting

Our operating leases are primarily for real estate, including certain acute care facilities, off-campus outpatient facilities, medical office buildings, and corporate and other administrative offices.  Our real estate lease agreements typically have initial terms of five to 10 years.  These real estate leases may include one or more options to renew, with renewals that can extend the lease term from five to 10 years. The exercise of lease renewal options is at our sole discretion. When determining the lease term, we included options to extend or terminate the lease when it is reasonably certain that we will exercise that option.

Three of our hospital facilities are held under operating leases with Universal Health Realty Income Trust with terms of the leases with respect to two hospital properties expiring in 2021 and the third expiring in 2026 (see Note 2 for additional disclosure). We are also the lessee of the real property of certain facilities from unrelated third parties.

Supplemental cash flow information related to leases for the nine-month periods ended September 30, 2021 and 2020 are as follows (in thousands):

	Nine months ended September 30,
	2021		2020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	88,113	$	84,351
Operating cash flows from finance leases	$	3,507	$	1,431
Financing cash flows from finance leases	$	2,315	$	1,918
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	20,292	$	47,679
Finance leases	$	7,690	$	-