Restructuring (Tables) - USD ($)
$ in Thousands

3 Months Ended

Mar. 31, 2021

Mar. 31, 2020

Restructuring and Related Activities [Abstract]

Restructuring and Related Costs

The following table summarizes the activity related to the restructuring reserves for the Operation, Simplification and Optimization Program:

Operation Simplification and Optimization Program	Severance and Related Benefit Costs		Costs Associated with Exit and Disposal Costs (1)		Total
Reserve Balance as of December 31, 2019	$	9,506	$	—	$	9,506
Expenses recorded	6,574		1,180		7,754
Payments made	(6,647)		—		(6,647)
Reserve Balance as of March 31, 2020	$	9,433	$	1,180	$	10,613
Reserve Balance as of December 31, 2020	$	5,368	$	593	$	5,961
Expenses recorded	252		177		429
Payments made	(4,716)		(751)		(5,467)
Reserve Balance as of March 31, 2021	$	904	$	19	$	923
(1) Relates primary to lease exit costs and legal and advisory fees.

The following table is a summary of charges incurred related to the Operation, Simplification and Optimization Program for the three months ended March 31, 2021 and 2020.

	Three Months Ended March 31,
	2021		2020
Severance and related benefit costs	$	252	$	6,574
Costs associated with exit and disposal activities (1)	49		1,180
Costs associated with lease exit costs including impairment (2)	128		—
Total	$	429	$	7,754
(1) Relates primarily to contract exit costs, legal and advisory fees.
(2) Relates primary to lease exit costs.

The following table summarizes the activity related to the restructuring reserves for the DRG Acquisition Integration during the three months ended March 31, 2021:

DRG Acquisition Integration	Severance and Related Benefit Costs		Costs Associated with Exit and Disposal Costs (1)		Total
Reserve Balance as of December 31, 2020	$	741	$	240	$	981
Expenses recorded	192		75		267
Payments made	(439)		(99)		(538)
Noncash items and other adjustments	—		—		—
Reserve Balance as of March 31, 2021	$	494	$	216	$	710
(1) Relates primary to lease exit costs.

The following table is a summary of charges incurred related to the DRG Acquisition Integration in the three months ended March 31, 2021:

	Three months ended  March 31, 2021
Severance and related benefit costs	$	192
Costs associated with exit and disposal activities	—
Costs associated with lease exit costs including impairment (1)	75
Total	$	267
(1) Relates primarily to lease exit costs.

The following table summarizes the activity related to the restructuring reserves for the CPA Global Acquisition, Integration and Optimization Program:

CPA Global Acquisition Integration and Optimization Program	Severance and Related Benefit Costs		Costs Associated with Exit and Disposal Costs (1)		Total
Reserve Balance as of December 31, 2020	$	11,060	$	3,642	$	14,702
Expenses recorded	18,564		45,301		63,865
Payments made	(10,771)		(261)		(11,032)
Noncash items and other adjustments (2)	(1,409)		(40,806)		(42,215)
Reserve Balance as of March 31, 2021	$	17,444	$	7,876	$	25,320
(1) Relates primary to lease exit costs and legal and advisory fees.
(2) Includes a $1,409 bonus accrual for severed employees and $40,806 of lease impairment charges.

The following table is a summary of charges incurred related to the CPA Global Acquisition Integration in the three months ended March 31, 2021.

	Three months ended  March 31, 2021
Severance and related benefit costs	$	18,564
Costs associated with exit and disposal activities (1)	287
Costs associated with lease exit costs including impairment (2)	45,014
Total	$	63,865
(1) Relates primary to legal and advisory fees.
(2) Includes $40,806 of charges related to impairment of leases, and $4,208 of costs incurred from exiting leases.

Restructuring and impairment

$ 40,984

$ 0