Business and Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2021

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, 2021, 2020 and 2019:

	(dollar amounts in thousands)
	2021					2020					2019
	Amount		%			Amount		%			Amount		%
Charity care	$	661,965		33	%	$	622,668		28	%	$	672,326		31	%
Uninsured discounts		1,336,319		67	%		1,578,470		72	%		1,511,738		69	%
Total uncompensated care	$	1,998,284		100	%	$	2,201,138		100	%	$	2,184,064		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)
	2021		2020		2019
Estimated cost of providing charity care	$	72,095	$	73,690	$	77,886
Estimated cost of providing uninsured discounts related care		145,538		186,804		175,128
Estimated cost of providing uncompensated care	$	217,633	$	260,494	$	253,014

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)
	2021		2020		2019
Cash and cash equivalents	$	115,301	$	1,224,490	$	61,268
Restricted cash (a)		63,633		54,664		44,399
Total cash, cash equivalents and restricted cash	$	178,934	$	1,279,154	$	105,667

(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, 2021 were as follows (in thousands):

	Acute Care Services			Behavioral Health Services		Total Consolidated
Balance, January 1, 2020	$	448,415		$	3,421,345	$	3,869,760
Goodwill acquired during the period		127			0		127
Goodwill divested during the period		0			0		0
Adjustments to goodwill (a)		(1,521	)		14,349		12,828
Balance, December 31, 2020		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 (b)		13,509			10,994		24,503
Balance, December 31, 2021	$	515,936		$	3,446,688	$	3,962,624

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

(b) 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.      

Summary of Net Intangible Assets

The following table shows the amounts recorded as net intangible assets for the years ended December 31, 2021 and 2020:

	(amounts in thousands)
	2021		2020
Medicare licenses	$	57,226	$	57,226
Certificates of need		8,239		8,253
Contract relationships and other (net of $54,134 and $52,804 of accumulated amortization for 2021 and 2020, respectively)		15,576		17,107
Net Intangible Assets	$	81,041	$	82,586

Amounts Recognized in AOCI

The amounts recognized in AOCI for the two years ended December 31, 2021 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, 2020, net of income tax	$	(17	)	$	39,568		$	(7,658	)	$	31,893
2020 activity:
Pretax amount		0			13,619			4,428			18,047
Income tax effect		0			(749	)		(1,071	)		(1,820	)
Change, net of income tax		0			12,870			3,357			16,227
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, December 31, 2021, net of income tax	$	(17	)	$	33,524		$	(3,216	)	$	30,291

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,
	2021			2020			2019
Basic and diluted:
Net Income	$	987,632		$	952,790		$	827,543
Less: Net (income) loss attributable to noncontrolling interest		3,958			(8,837	)		(12,689	)
Less: Net income attributable to unvested restricted share    grants		(2,059	)		(2,981	)		(2,028	)
Net income attributable to UHS—basic and diluted	$	989,531		$	940,972		$	812,826
Basic earnings per share attributable to UHS:
Weighted average number of common shares—basic		82,519			85,061			88,762
Total basic earnings per share	$	11.99		$	11.06		$	9.16
Diluted earnings per share attributable to UHS:
Weighted average number of common shares		82,519			85,061			88,762
Net effect of dilutive stock options and grants based    on the treasury stock method		1,173			526			278
Weighted average number of common shares and    equivalents—diluted		83,692			85,587			89,040
Total diluted earnings per share	$	11.82		$	10.99		$	9.13