Leases (Notes)

9 Months Ended

Sep. 30, 2019

Leases of Lessee Disclosure [Text Block]

LEASES

The Company has operating and finance leases for patient service centers, laboratories and testing facilities, clinical facilities, general office spaces, vehicles, and office and laboratory equipment. Leases have remaining lease terms of less than a year to 15 years, some of which include options to extend the leases for up to 15 years.

The components of lease expense were as follows:



	For the Three Months Ended September 30, 2019		For the Nine Months Ended September 30, 2019
Operating lease cost	$	58.9	$	169.7

Finance lease cost:
Amortization of right-of-use assets	$	2.0	$	6.5
Interest on lease liabilities	1.6		4.8
Total finance lease cost	$	3.6	$	11.3

Supplemental cash flow information related to leases was as follows:



	For the Nine Months Ended September 30, 2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	(174.3	)
Operating cash flows from finance leases	(4.8		)
Financing cash flows from finance leases	(6.7		)

ROU assets obtained in exchange for lease obligations:
Operating leases	$	50.8
Finance leases	0.2

Supplemental balance sheet information related to leases was as follows:



	September 30, 2019
Operating Leases
Operating lease ROU assets (included in Property, plant and equipment, net)	$	681.1

Short-term operating lease liabilities	202.1
Operating lease liabilities	530.7
Total operating lease liabilities	$	732.8



	September 30, 2019
Finance Leases
Finance lease ROU assets (included in Other assets)	$	85.6

Short-term finance lease liabilities	$	8.3
Other long-term liabilities	92.8
Total finance lease liabilities	$	101.1

Weighted Average Remaining Lease Term
Operating leases	7.4
Finance leases	16.5

Weighted Average Discount Rate
Operating leases	4.3		%
Finance leases	5.3		%

Maturities of lease liabilities are as follows:



Nine months ended September 30, 2019	Operating Leases			Finance Leases

2019	$	181.8		$	3.6
2020	146.3			13.8
2021	105.2			12.0
2022	77.7			10.8
2023	57.4			10.7
Thereafter	277.5			107.2
Total lease payments	845.9			158.1
Less imputed interest	(113.1		)	(57.0		)
Total	$	732.8		$	101.1

Rental expense for short term leases with a term less than one year for the three and nine months ended September 30, 2019, amounted to $1.5 and $7.4, respectively. The Company has variable lease payments that do not depend on a rate or index, primarily for purchase volume commitments, which are recorded as variable cost when incurred. Total variable payments for the three and nine months ended September 30, 2019, were $5.1 and $14.3, respectively. As of September 30, 2019, the Company has entered into approximately 20 additional operating leases, primarily for patient service centers, that have not yet commenced and are not significant to the overall lease portfolio. These operating leases will commence later in 2019 with lease terms ranging from less than a year to 5 years.

The Company leases various facilities and equipment under non-cancelable lease arrangements. Future minimum rental commitments for leases with non-cancelable terms of one year or more at December 31, 2018 under Accounting Standards Codification 840 are as follows:



Year Ended December 31, 2018	Operating Leases		Finance Leases

2019	$	191.1	$	8.6
2020	145.4		8.0
2021	107.0		6.7
2022	80.9		6.0
2023	61.5		6.5
Thereafter	155.6		23.1

Rental expense, which includes rent for real estate, equipment and automobiles under operating leases, amounted to $100.0 and $291.5, respectively, for the three and nine months ended September 30, 2019.