XML 63 R35.htm IDEA: XBRL DOCUMENT v3.22.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details - Narrative)
3 Months Ended 12 Months Ended 24 Months Ended 40 Months Ended
Nov. 01, 2022
USD ($)
center
Jan. 20, 2022
USD ($)
loan
shares
Nov. 05, 2019
USD ($)
Feb. 01, 2018
USD ($)
shares
Sep. 30, 2021
USD ($)
Dec. 31, 2022
USD ($)
incentivePlan
investment
jointVenture
Dec. 31, 2021
USD ($)
Dec. 31, 2020
USD ($)
Oct. 31, 2025
USD ($)
Dec. 31, 2021
USD ($)
Oct. 31, 2023
USD ($)
Oct. 01, 2022
USD ($)
Apr. 15, 2021
shares
Jul. 01, 2020
USD ($)
Oct. 11, 2019
shares
Jun. 30, 2019
USD ($)
agreement
Jan. 01, 2019
USD ($)
Dec. 31, 2016
USD ($)
agreement
Property, Plant and Equipment [Line Items]                                    
Government Assistance, Statement of Financial Position [Extensible Enumeration]           Deferred revenue                        
Factoring receivable           $ 15,400,000 $ 17,700,000     $ 17,700,000                
Service fee revenue           1,430,061,000 1,315,077,000 $ 1,071,840,000                    
Deferred financing costs, net of accumulated amortization           2,300,000 2,100,000     2,100,000                
Goodwill           677,665,000 513,820,000 472,879,000   513,820,000                
Indefinite lived intangible assets           24,100,000 20,600,000     20,600,000                
Loss on impairment           0 $ 0 4,170,000                    
Impairment, Long-Lived Asset, Held-for-Use, Statement of Income or Comprehensive Income [Extensible Enumeration]             Gain (Loss) on Termination of Lease                      
Lease abandonment charges             $ 12,600,000                      
Workers' compensation liability, current           3,900,000 3,500,000     3,500,000                
Medical malpractice deductible per incidence           $ 10,000                        
Employer matching contribution, percent           1.00%                        
Employee contribution, percent           4.00%                        
Expected employee contribution           $ 3,000,000   0                    
Number of plans | incentivePlan           1                        
Shares authorized (in shares) | shares                         16,500,000          
Accumulated other comprehensive income           $ 332,995,000 228,904,000     228,904,000                
Number of investments | investment           3                        
Number of unconsolidated joint ventures | jointVenture           13                        
Management service fees           $ 22,200,000 19,600,000 11,300,000                    
Medic Vision                                    
Property, Plant and Equipment [Line Items]                                    
Total net assets           $ 1,200,000                        
Equity interest percentage           14.21%                        
Turner Imaging Systems                                    
Property, Plant and Equipment [Line Items]                                    
Investment at cost       $ 2,000,000                            
Shares purchased (in shares) | shares       2,100,000                            
Preferred stock issued upon conversion (in shares) | shares                             80,000      
Turner Imaging Systems | Promissory note                                    
Property, Plant and Equipment [Line Items]                                    
Convertible promissory note                                 $ 100,000  
WhiteRabbit.ai Inc.                                    
Property, Plant and Equipment [Line Items]                                    
Investment at cost     $ 1,000,000                              
Payments to fund loan to related parties     $ 2,500,000                              
Arizona Diagnostics Group                                    
Property, Plant and Equipment [Line Items]                                    
Equity interest percentage 49.00%                                  
Investment at cost $ 12,700,000                                  
Additional contribution           $ 1,400,000                        
Number of assets sold | center 8                                  
Different between the sales price and carrying value $ (500,000)                                  
Received a dividend from the partnership 4,500,000                                  
Book value of RadNet joint venture interests 8,300,000                                  
Forecast                                    
Property, Plant and Equipment [Line Items]                                    
Monthly amortization of deferred hedge gains                 $ 300,000                  
Forecast | Subsequent Event                                    
Property, Plant and Equipment [Line Items]                                    
Monthly amortization of deferred hedge gains                     $ 400,000              
Accumulated Gain (Loss), Net, Cash Flow Hedge, Parent                                    
Property, Plant and Equipment [Line Items]                                    
Accumulated other comprehensive income                           $ 24,400,000        
2016 Caps | LIBOR                                    
Property, Plant and Equipment [Line Items]                                    
Basis spread on variable rate                                   2.00%
September 2020                                    
Property, Plant and Equipment [Line Items]                                    
Notional amounts                                   $ 150,000,000
October 2020                                    
Property, Plant and Equipment [Line Items]                                    
Notional amounts                                   $ 350,000,000
2016 Caps                                    
Property, Plant and Equipment [Line Items]                                    
Number of forward interest rate cap agreements | agreement                                   2,000
Interest rate caps premium liability                                   $ 5,300,000
2019 SWAPS                                    
Property, Plant and Equipment [Line Items]                                    
Number of forward interest rate cap agreements | agreement                               4,000    
Notional amounts                               $ 500,000,000    
2019 SWAPS | 2019 SWAPS - Interest Rate Contracts                                    
Property, Plant and Equipment [Line Items]                                    
Notional amounts                               $ 100,000,000    
2019 SWAPS | 2019 SWAPS - Interest Rate Contracts | LIBOR                                    
Property, Plant and Equipment [Line Items]                                    
Basis spread on variable rate                               1.96%    
2019 SWAPS | October 2023                                    
Property, Plant and Equipment [Line Items]                                    
Number of forward interest rate cap agreements | agreement                               2    
Notional amounts                               $ 50,000,000    
2019 SWAPS | October 2025                                    
Property, Plant and Equipment [Line Items]                                    
Number of forward interest rate cap agreements | agreement                               2    
Notional amounts                               $ 200,000,000    
2019 SWAPS1 | 2019 SWAPS - Interest Rate Contracts                                    
Property, Plant and Equipment [Line Items]                                    
Notional amounts                               $ 400,000,000    
2019 SWAPS1 | 2019 SWAPS - Interest Rate Contracts | LIBOR                                    
Property, Plant and Equipment [Line Items]                                    
Basis spread on variable rate                               2.05%    
Quantib                                    
Property, Plant and Equipment [Line Items]                                    
Goodwill   $ 26,400,000                                
Contingent consideration to guarantee share value issued           3,709,000 0     0                
Business combination, contingent consideration, liability, period   18 months                                
Business acquisition, equity interest issued or issuable, additional number of shares | shares   113,303                                
Business acquisition, equity interest issued or issuable, fair value of additional shares issued after execution   $ 3,000,000                                
Quantib | Contingent Milestone Consideration                                    
Property, Plant and Equipment [Line Items]                                    
Contingent consideration to guarantee share value issued           2,100,000                        
Quantib | Cash Holdback                                    
Property, Plant and Equipment [Line Items]                                    
Contingent consideration to guarantee share value issued   1,600,000       1,600,000                        
Montclair                                    
Property, Plant and Equipment [Line Items]                                    
Contingent consideration to guarantee share value issued           1,200,000 0     0   $ 1,200,000            
Heart and Lung Imaging Limited                                    
Property, Plant and Equipment [Line Items]                                    
Goodwill 16,200,000                                  
Contingent consideration to guarantee share value issued $ 10,800,000         11,656,000 0     0                
Business combination, contingent consideration, liability, period 24 months                                  
Heart and Lung Imaging Limited | Contingent Milestone Consideration                                    
Property, Plant and Equipment [Line Items]                                    
Contingent consideration to guarantee share value issued $ 10,200,000         11,100,000                        
Heart and Lung Imaging Limited | Cash Holdback                                    
Property, Plant and Equipment [Line Items]                                    
Contingent consideration to guarantee share value issued $ 600,000                                  
Aidence                                    
Property, Plant and Equipment [Line Items]                                    
Goodwill   22,900,000                                
Purchase agreements   $ 10,000,000                                
Number of identified milestones | loan   2                                
Contingent consideration to guarantee share value issued   $ 11,900,000       11,158,000 0     0                
Percent of FDA approval and payout, milestone one   80.00%                                
Percent of FDA approval and payout, milestone two   70.00%                                
Aidence | Contingent Milestone Consideration                                    
Property, Plant and Equipment [Line Items]                                    
Contingent consideration to guarantee share value issued   $ 7,400,000       7,200,000                        
Aidence | Cash Holdback                                    
Property, Plant and Equipment [Line Items]                                    
Contingent consideration to guarantee share value issued   $ 4,500,000       4,000,000                        
Reinsurance Policy, Type [Axis]: Health Insurance Member                                    
Property, Plant and Equipment [Line Items]                                    
Self-insurance accrual           7,400,000 6,300,000     6,300,000                
Trade Names                                    
Property, Plant and Equipment [Line Items]                                    
Indefinite lived intangible assets           $ 7,100,000                        
Loss on impairment               4,200,000                    
Leasehold improvements                                    
Property, Plant and Equipment [Line Items]                                    
Impairment of long lived asset             7,100,000                      
Minimum                                    
Property, Plant and Equipment [Line Items]                                    
Share-based payment award, award vesting period           3 years                        
Share-based payment award, expiration period           5 years                        
Minimum | Restated Plan                                    
Property, Plant and Equipment [Line Items]                                    
Share-based payment award, award vesting period           3 years                        
Share-based payment award, expiration period           5 years                        
Minimum | Blue Shield                                    
Property, Plant and Equipment [Line Items]                                    
Stop loss policy claim amount           $ 250,000                        
Minimum | Dignity Health | Glendale Advanced Imaging | Joint Venture                                    
Property, Plant and Equipment [Line Items]                                    
Economic interest           35.00%                        
Minimum | Propery and equipment, net                                    
Property, Plant and Equipment [Line Items]                                    
PP&E useful life           3 years                        
Minimum | Leasehold improvements                                    
Property, Plant and Equipment [Line Items]                                    
PP&E useful life           3 years                        
Maximum                                    
Property, Plant and Equipment [Line Items]                                    
Share-based payment award, award vesting period           5 years                        
Share-based payment award, expiration period           10 years                        
Maximum | Restated Plan                                    
Property, Plant and Equipment [Line Items]                                    
Share-based payment award, award vesting period           5 years                        
Share-based payment award, expiration period           10 years                        
Maximum | Blue Shield                                    
Property, Plant and Equipment [Line Items]                                    
Stop loss policy claim amount           $ 1,000,000                        
Maximum | Dignity Health | Glendale Advanced Imaging | Joint Venture                                    
Property, Plant and Equipment [Line Items]                                    
Economic interest           55.00%                        
Maximum | Propery and equipment, net                                    
Property, Plant and Equipment [Line Items]                                    
PP&E useful life           15 years                        
Maximum | Leasehold improvements                                    
Property, Plant and Equipment [Line Items]                                    
PP&E useful life           15 years                        
Imaging Centers                                    
Property, Plant and Equipment [Line Items]                                    
Goodwill           $ 606,483,000 489,210,000 448,269,000   489,210,000                
Net service fee revenue | eRAD                                    
Property, Plant and Equipment [Line Items]                                    
Service fee revenue           13,200,000 10,500,000 8,600,000                    
Barclays                                    
Property, Plant and Equipment [Line Items]                                    
Total credit facilities outstanding           0 0     0                
Truist                                    
Property, Plant and Equipment [Line Items]                                    
Total credit facilities outstanding           0 0     0                
C O V I D19 Pandemic                                    
Property, Plant and Equipment [Line Items]                                    
Advance medicare payments             100,000 39,500,000   39,600,000                
Proceeds from provider relief funding           0 9,100,000 $ 26,300,000   $ 35,400,000                
Repayment of advance medicare payments           30,200,000 $ 8,400,000                      
Amount in deferred revenue           $ 1,000,000                        
Refundable claim percentage           50.00% 50.00% 50.00%   50.00%                
Deferred social security taxes               $ 16,300,000                    
Reduction in deferred social security taxes         $ 7,700,000                          
C O V I D19 Pandemic | Paycheck Protection Program Loans                                    
Property, Plant and Equipment [Line Items]                                    
Proceeds from loans               $ 4,000,000