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Pay vs Performance Disclosure - USD ($)
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Pay vs Performance Disclosure        
Pay vs Performance Disclosure, Table
Pay Versus Performance
Tabular Disclosures of Pay and Performance
Our CEO is the principal executive officer (“PEO”). The following table sets forth information concerning the compensation of our PEO(s) and other NEOs for each of the years ending December 31, 2023, 2022, 2021 and 2020 as well as our financial performance for each year.
 
                           
 
Value of Initial Fixed $100
Investment Based On:
              
Year
 (a)
  
Summary
Compensation
Table Total for
PEO ($)

(b)
    
Compensation
Actually Paid
to

PEO ($)

(c)
    
Average
Summary
Compensation
Table Total

for
Non-PEO

NEO’s ($)

(d)
    
Average
Compensation
Actually Paid
to
Non-PEO

NEO’s ($)

(e)
    
Total
Shareholder
Return ($)
(f)
    
Peer Group
Total
Shareholder
Return ($)
(g)
    
Net
Income
(h)

($ in
millions)
    
Adjusted
EBITDA
(i)

($ in
millions)
  
2023
     8,348,223       5,923,701       2,288,615       1,779,564       108       131       16       1,453  
2022
     6,302,542       159,239       3,694,426       (236,524 )      149       131       179       1,466  
2021
     9,526,625       15,121,986       5,415,424       7,635,715       459       139       368       1,969  
2020
     9,066,419       10,617,549       3,717,051       4,332,808       256       114       607       1,809  
 
Column (b)
  
Reflects compensation amounts reported in the “Summary Compensation Table” (“SCT”) for Tim L. Hingtgen, our CEO for 2023, 2022 and 2021 and Wayne T. Smith, our CEO for 2020.
 
Column (c)
   “Compensation actually paid” (“CAP”) to our CEO in each of 2023, 2022, 2021 and 2020 (individually referred to as “Covered Year”) reflects the respective amounts set forth in column (b) of the table above, adjusted as set forth in the table below, as determined in accordance with SEC rules.
 
   
2023
    
2022
    
2021
    
2020
  
CEO
  
Tim L.
Hingtgen
    
Tim L.
Hingtgen
    
Tim L.
Hingtgen
    
Wayne T.
Smith
  
Total Compensation per the SCT
     $8,348,223       $6,302,542       $9,526,625       $9,066,419  
Less: Stock and Option Award values reported in the SCT
     ($4,612,000)       ($3,779,000)       ($3,265,000)       ($1,929,375)  
Plus: Fair Value of Stock and Option Awards Granted during the Covered Year
     $2,334,000       $1,620,000       $4,924,000       $2,958,750  
Change in Fair Value of Outstanding Unvested Stock and Option Awards from Prior Years
     ($771,001)       ($4,931,670)       $2,818,729       $1,721,475  
Change in Fair Value of Stock and Option Awards from Prior Years that Vested in the Covered Year
     $73,332       ($24,582)       $1,200,313       $218,400  
Less: Fair Value of Stock and Option Awards Forfeited during the Covered Year
     ($172,800)       ($3,110)       ($5,000)       ($288,500)  
Less: Aggregate Change in Actuarial Present Value of Defined Benefit Plans
     ($347,168)       ($499,859)       ($1,520,328)       ($1,129,620)  
Plus: Aggregate Service Cost and Prior Service Cost for Pension Plans
     $1,071,115       $1,474,917       $1,442,647       -  
 
 
 
    
 
 
    
 
 
    
 
 
  
Compensation Actually Paid
     $5,923,701       $159,239       $15,121,986       $10,617,549  
 
Column (d)
  
Reflects the average compensation amounts reported in the SCT for our
Non-PEO
NEOs.
 
Column (e)
  
The following
Non-PEO
NEOs are included in the average figures shown below:
 
2023 – Kevin J. Hammons, Lynn T. Simon, Kevin A. Stockton and Chad A. Campbell
 
2022 – Wayne T. Smith, Kevin J. Hammons, Lynn T. Simon, and Mark B. Medley
 
2021 – Wayne T. Smith, Kevin J. Hammons, Lynn T. Simon and Benjamin Fordham
 
2020 – Tim L. Hingtgen, Kevin J. Hammons, Benjamin Fordham and Lynn T. Simon
 
    
2023
     
2022
     
2021
     
2020
  
Total Compensation per the SCT
      $2,288,615        $3,694,426        $5,415,424        $3,717,051  
Less: Stock and Option Award values reported in the SCT
      ($1,037,700)        ($2,138,500)        ($1,850,378)        ($938,934)  
Plus: Fair Value of Stock and Option Awards Granted during the Covered Year
      $525,150        $917,325        $2,785,947        $1,437,441  
Change in Fair Value of Outstanding Unvested Stock and Option Awards from Prior Years
      ($293,630)        ($2,595,277)        $1,489,657        $672,792  
Change in Fair Value of Stock and Option Awards from Prior Years that Vested in the Covered Year
      $63,966        $86,796        $632,161        $84,144  
Less: Fair Value of Stock and Option Awards Forfeited during the Covered Year
      ($32,400)        ($90,820)        ($57,500)        ($68,470)  
Less: Aggregate Change in Actuarial Present Value of Defined Benefit Plans
      ($56,263)        ($440,806)        ($1,002,492)        ($978,380)  
Plus: Aggregate Service Cost and Prior Service Cost for Pension Plans
      $321,826        $330,333        $222,897        $407,164  
  
 
 
     
 
 
     
 
 
     
 
 
  
Compensation Actually Paid
      $1,779,564        ($236,524)        $7,635,715        $4,332,808  
 
Column (f)
  
Represents the cumulative total shareholder return for the Company for the measurement periods beginning December 31, 2019 and ending on December 31, 2023, 2022, 2021 and 2020, respectively.
 
Column (g)
  
Represents the cumulative total shareholder return of the Dow Jones U.S. Healthcare Index (“Peer Group Total Shareholder Return”) for the measurement periods beginning December 31, 2019 and ending on December 31, 2023, 2022, 2021 and 2020, respectively.
 
Column (h)
  
Reflects Net Income as included in the Company’s Annual Reports on Form
10-K
for each of the years ended December 31, 2023, 2022, 2021 and 2020.
 
Column (i)
  
The Company-Selected Measure is Adjusted EBITDA, a
non-GAAP
financial measure. See Annex A —
Non-GAAP
Financial Measures for additional information regarding Adjusted EBITDA, including how Adjusted EBITDA is calculated from the Company’s financial statements.
 
      
Company Selected Measure Name Adjusted EBITDA      
Named Executive Officers, Footnote
The following
Non-PEO
NEOs are included in the average figures shown below:
 
2023 – Kevin J. Hammons, Lynn T. Simon, Kevin A. Stockton and Chad A. Campbell
 
2022 – Wayne T. Smith, Kevin J. Hammons, Lynn T. Simon, and Mark B. Medley
 
2021 – Wayne T. Smith, Kevin J. Hammons, Lynn T. Simon and Benjamin Fordham
 
2020 – Tim L. Hingtgen, Kevin J. Hammons, Benjamin Fordham and Lynn T. Simon
      
Peer Group Issuers, Footnote Represents the cumulative total shareholder return of the Dow Jones U.S. Healthcare Index (“Peer Group Total Shareholder Return”) for the measurement periods beginning December 31, 2019 and ending on December 31, 2023, 2022, 2021 and 2020, respectively.      
PEO Total Compensation Amount $ 8,348,223 $ 6,302,542 $ 9,526,625 $ 9,066,419
PEO Actually Paid Compensation Amount $ 5,923,701 159,239 15,121,986 10,617,549
Adjustment To PEO Compensation, Footnote “Compensation actually paid” (“CAP”) to our CEO in each of 2023, 2022, 2021 and 2020 (individually referred to as “Covered Year”) reflects the respective amounts set forth in column (b) of the table above, adjusted as set forth in the table below, as determined in accordance with SEC rules.
 
   
2023
    
2022
    
2021
    
2020
  
CEO
  
Tim L.
Hingtgen
    
Tim L.
Hingtgen
    
Tim L.
Hingtgen
    
Wayne T.
Smith
  
Total Compensation per the SCT
     $8,348,223       $6,302,542       $9,526,625       $9,066,419  
Less: Stock and Option Award values reported in the SCT
     ($4,612,000)       ($3,779,000)       ($3,265,000)       ($1,929,375)  
Plus: Fair Value of Stock and Option Awards Granted during the Covered Year
     $2,334,000       $1,620,000       $4,924,000       $2,958,750  
Change in Fair Value of Outstanding Unvested Stock and Option Awards from Prior Years
     ($771,001)       ($4,931,670)       $2,818,729       $1,721,475  
Change in Fair Value of Stock and Option Awards from Prior Years that Vested in the Covered Year
     $73,332       ($24,582)       $1,200,313       $218,400  
Less: Fair Value of Stock and Option Awards Forfeited during the Covered Year
     ($172,800)       ($3,110)       ($5,000)       ($288,500)  
Less: Aggregate Change in Actuarial Present Value of Defined Benefit Plans
     ($347,168)       ($499,859)       ($1,520,328)       ($1,129,620)  
Plus: Aggregate Service Cost and Prior Service Cost for Pension Plans
     $1,071,115       $1,474,917       $1,442,647       -  
 
 
 
    
 
 
    
 
 
    
 
 
  
Compensation Actually Paid
     $5,923,701       $159,239       $15,121,986       $10,617,549  
      
Non-PEO NEO Average Total Compensation Amount $ 2,288,615 3,694,426 5,415,424 3,717,051
Non-PEO NEO Average Compensation Actually Paid Amount $ 1,779,564 (236,524) 7,635,715 4,332,808
Adjustment to Non-PEO NEO Compensation Footnote
    
2023
     
2022
     
2021
     
2020
  
Total Compensation per the SCT
      $2,288,615        $3,694,426        $5,415,424        $3,717,051  
Less: Stock and Option Award values reported in the SCT
      ($1,037,700)        ($2,138,500)        ($1,850,378)        ($938,934)  
Plus: Fair Value of Stock and Option Awards Granted during the Covered Year
      $525,150        $917,325        $2,785,947        $1,437,441  
Change in Fair Value of Outstanding Unvested Stock and Option Awards from Prior Years
      ($293,630)        ($2,595,277)        $1,489,657        $672,792  
Change in Fair Value of Stock and Option Awards from Prior Years that Vested in the Covered Year
      $63,966        $86,796        $632,161        $84,144  
Less: Fair Value of Stock and Option Awards Forfeited during the Covered Year
      ($32,400)        ($90,820)        ($57,500)        ($68,470)  
Less: Aggregate Change in Actuarial Present Value of Defined Benefit Plans
      ($56,263)        ($440,806)        ($1,002,492)        ($978,380)  
Plus: Aggregate Service Cost and Prior Service Cost for Pension Plans
      $321,826        $330,333        $222,897        $407,164  
  
 
 
     
 
 
     
 
 
     
 
 
  
Compensation Actually Paid
      $1,779,564        ($236,524)        $7,635,715        $4,332,808  
      
Compensation Actually Paid vs. Total Shareholder Return
LOGO
     
Compensation Actually Paid vs. Net Income
     
Compensation Actually Paid vs. Company Selected Measure
LOGO
     
Total Shareholder Return Vs Peer Group
LOGO
     
Tabular List, Table
Listed below, in no specific order, are the performance measures which in our assessment represent the most important measures we used to link compensation actually paid to our NEOs for 2023 to the Company’s performance:
Adjusted EBITDA
 - - - - - 
Cumulative Consolidated Adjusted EBITDA Growth
 - - - - - 
Net Revenues
 - - - - - 
Consolidated Adjusted EBITDA Margin Improvement
 - - - - - 
Adjusted (Loss) Earnings per Share
     
Total Shareholder Return Amount $ 108 149 459 256
Peer Group Total Shareholder Return Amount 131 131 139 114
Net Income (Loss) $ 16,000,000 $ 179,000,000 $ 368,000,000 $ 607,000,000
Company Selected Measure Amount 1,453,000,000 1,466,000,000 1,969,000,000 1,809,000,000
Measure:: 1        
Pay vs Performance Disclosure        
Name Adjusted EBITDA      
Non-GAAP Measure Description The Company-Selected Measure is Adjusted EBITDA, a
non-GAAP
financial measure. See Annex A —
Non-GAAP
Financial Measures for additional information regarding Adjusted EBITDA, including how Adjusted EBITDA is calculated from the Company’s financial statements. 		     
Measure:: 2        
Pay vs Performance Disclosure        
Name Cumulative Consolidated Adjusted EBITDA Growth      
Measure:: 3        
Pay vs Performance Disclosure        
Name Net Revenues      
Measure:: 4        
Pay vs Performance Disclosure        
Name Consolidated Adjusted EBITDA Margin Improvement      
Measure:: 5        
Pay vs Performance Disclosure        
Name Adjusted (Loss) Earnings per Share      
Tim Hingtgen [Member]        
Pay vs Performance Disclosure        
PEO Total Compensation Amount $ 8,348,223 $ 6,302,542 $ 9,526,625  
PEO Actually Paid Compensation Amount $ 5,923,701 $ 159,239 $ 15,121,986  
PEO Name Tim L. Hingtgen Tim L. Hingtgen Tim L. Hingtgen  
Wayne Smith [Member]        
Pay vs Performance Disclosure        
PEO Total Compensation Amount       $ 9,066,419
PEO Actually Paid Compensation Amount       $ 10,617,549
PEO Name       Wayne T. Smith
PEO | Tim Hingtgen [Member] | Stock and Option Award values reported in the SCT [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount $ (4,612,000) $ (3,779,000) $ (3,265,000)  
PEO | Tim Hingtgen [Member] | Fair Value of Stock and Option Awards Granted during the Covered Year [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount 2,334,000 1,620,000 4,924,000  
PEO | Tim Hingtgen [Member] | Change in Fair Value of Outstanding Unvested Stock and Option Awards from Prior Years [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount (771,001) (4,931,670) 2,818,729  
PEO | Tim Hingtgen [Member] | Change in Fair Value of Stock and Option Awards from Prior Years that Vested in the Covered Year [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount 73,332 (24,582) 1,200,313  
PEO | Tim Hingtgen [Member] | Fair Value of Stock and Option Awards Forfeited during the Covered Year [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount (172,800) (3,110) (5,000)  
PEO | Tim Hingtgen [Member] | Aggregate Change in Actuarial Present Value of Defined Benefit Plans [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount (347,168) (499,859) (1,520,328)  
PEO | Tim Hingtgen [Member] | Aggregate Service Cost and Prior Service Cost for Pension Plans [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount 1,071,115 1,474,917 1,442,647  
PEO | Wayne Smith [Member] | Stock and Option Award values reported in the SCT [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount       $ (1,929,375)
PEO | Wayne Smith [Member] | Fair Value of Stock and Option Awards Granted during the Covered Year [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount       2,958,750
PEO | Wayne Smith [Member] | Change in Fair Value of Outstanding Unvested Stock and Option Awards from Prior Years [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount       1,721,475
PEO | Wayne Smith [Member] | Change in Fair Value of Stock and Option Awards from Prior Years that Vested in the Covered Year [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount       218,400
PEO | Wayne Smith [Member] | Fair Value of Stock and Option Awards Forfeited during the Covered Year [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount       (288,500)
PEO | Wayne Smith [Member] | Aggregate Change in Actuarial Present Value of Defined Benefit Plans [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount       (1,129,620)
Non-PEO NEO | Stock and Option Award values reported in the SCT [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount (1,037,700) (2,138,500) (1,850,378) (938,934)
Non-PEO NEO | Fair Value of Stock and Option Awards Granted during the Covered Year [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount 525,150 917,325 2,785,947 1,437,441
Non-PEO NEO | Change in Fair Value of Outstanding Unvested Stock and Option Awards from Prior Years [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount (293,630) (2,595,277) 1,489,657 672,792
Non-PEO NEO | Change in Fair Value of Stock and Option Awards from Prior Years that Vested in the Covered Year [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount 63,966 86,796 632,161 84,144
Non-PEO NEO | Fair Value of Stock and Option Awards Forfeited during the Covered Year [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount (32,400) (90,820) (57,500) (68,470)
Non-PEO NEO | Aggregate Change in Actuarial Present Value of Defined Benefit Plans [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount (56,263) (440,806) (1,002,492) (978,380)
Non-PEO NEO | Aggregate Service Cost and Prior Service Cost for Pension Plans [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount $ 321,826 $ 330,333 $ 222,897 $ 407,164