INVESTMENTS

12 Months Ended

Dec. 31, 2024

Investments, All Other Investments [Abstract]

We consolidate investments when the entity is a variable interest entity ("VIE") and we are the primary beneficiary or if we have controlling interests in the entity, which is generally ownership in excess of 50%. Third-party equity interests in our consolidated joint ventures are reflected as noncontrolling interests in our consolidated financial statements.

We account for investments in entities in which we have the ability to exercise significant influence under the equity method if we hold 50% or less of the voting stock and the entity is not a VIE in which we are the primary beneficiary. The book value of investments that we account for under the equity method of accounting totaled $49.8 million and $46.1 million as of December 31, 2024 and 2023, respectively, and is reflected in other assets within our consolidated balance sheets.

We account for investments in entities in which we have less than 20% ownership interest under the cost method of accounting if we do not have the ability to exercise significant influence over the investee. During 2022, we made a $15.0 million investment in a home health benefit manager, which is accounted for under the cost method. The book value of investments that we account for under the cost method of accounting was $20.0 million as of December 31, 2024 and 2023 and is reflected in other assets within our consolidated balance sheets.

Our high acuity care segment includes interests in several joint ventures with health system partners and a professional corporation that employs clinicians. Each of these entities meets the criteria to be classified as a VIE. We have management agreements in place whereby we manage the entities and run the day-to-day operations. As such, we possess the power to direct the activities that most significantly impact the economic performance of the VIEs. The significant activities include, but are not limited to, negotiating provider and payor contracts, establishing patient care policies and protocols, making employment and compensation decisions, developing the operating and capital budgets, performing marketing activities and providing accounting support. We also have the obligation to absorb any expected losses and the right to receive benefits. Additionally, from time to time we may be required to provide joint venture funding.

During 2024, we consolidated all but one of our joint ventures with health system partners as well as the professional corporation as we have concluded that we are the primary beneficiary of these VIEs; the joint venture that is not consolidated was accounted for under the equity method of accounting. During the three-month period ended March 31, 2024, we entered into an agreement to wind-down and dissolve the operations of the unconsolidated joint venture. We completed the wind-down during the third quarter.

During the three-month period ended December 31, 2024, we entered into an agreement to wind-down and dissolve the operations of one of our consolidated joint ventures. As a result, we adjusted the carrying value of the noncontrolling interest established upon the acquisition of the joint venture. The adjustment, which totaled $1.6 million, was recorded to miscellaneous, net within other income (expense) in our consolidated statement of operations during the three-month period ended December 31, 2024.

During the year ended December 31, 2022, we recorded a $3.0 million impairment charge in connection with the wind down of operations of one of our high acuity care joint ventures accounted for under the equity method of accounting.

The terms of the agreements with each VIE prohibit us from using the assets of the VIE to satisfy the obligations of other entities. The carrying amount of the VIEs’ assets and liabilities included in our consolidated balance sheets are as follows (amounts in millions):


	As of December 31,
	2024		2023
ASSETS
Current assets:
Cash and cash equivalents	$	10.0	$	8.8
Patient accounts receivable	8.1		9.0
Other current assets	—		0.1
Total current assets	18.1		17.9
Property and equipment	—		0.1
Operating lease right of use assets	—		0.1
Goodwill	8.5		8.5
Intangible assets	0.4		0.4
Other assets	0.3		0.3
Total assets	$	27.3	$	27.3
LIABILITIES
Current liabilities:
Accounts payable	$	0.6	$	0.5
Payroll and employee benefits	1.2		0.9
Accrued expenses	9.4		7.9
Operating lease liabilities	0.1		—
Total liabilities	$	11.3	$	9.3