Business and Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2019

Accounting Policies [Abstract]

Uncompensated Care

The following table shows the amounts recorded at our acute care hospitals for charity care and uninsured discounts, based on charges at established rates, for the years ended December 31, 2019, 2018 and 2017:

	(dollar amounts in thousands)
	2019					2018					2017
	Amount		%			Amount		%			Amount		%
Charity care	$	672,326		31	%	$	761,783		40	%	$	887,136		50	%
Uninsured discounts		1,511,738		69	%		1,132,811		60	%		881,265		50	%
Total uncompensated care	$	2,184,064		100	%	$	1,894,594		100	%	$	1,768,401		100	%

Estimated Cost of Providing Uncompensated Care

The estimated cost of providing uncompensated care, as reflected below, were based on a calculation which multiplied the percentage of operating expenses for our acute care hospitals to gross charges for those hospitals by the above-mentioned total uncompensated care amounts. The percentage of cost to gross charges is calculated based on the total operating expenses for our acute care facilities divided by gross patient service revenue for those facilities. An increase in the level of uninsured patients to our facilities and the resulting adverse trends in the adjustments to net revenues and uncompensated care provided could have a material unfavorable impact on our future operating results.

	(amounts in thousands)
	2019		2018		2017
Estimated cost of providing charity care	$	77,886	$	94,088	$	120,208
Estimated cost of providing uninsured discounts related care		175,128		139,913		119,412
Estimated cost of providing uncompensated care	$	253,014	$	234,001	$	239,620

Summary of Cash, Cash Equivalents and Restricted Cash Reported In Consolidated Statements of Cash Flows

Cash, cash equivalents, and restricted cash as reported in the consolidated statements of cash flows are presented separately on our consolidated balance sheets as follow:

	(amounts in thousands)
	2019		2018		2017
Cash and cash equivalents	$	61,268	$	105,220	$	74,423
Restricted cash (a)		44,399		94,465		92,874
Total cash, cash equivalents and restricted cash	$	105,667	$	199,685	$	167,297

(a)Restricted cash is included in other assets on the accompanying consolidated balance sheet and consists of statutorily required capital reserves related to our commercial insurance subsidiary.

Summary of Changes in Carrying Amount of Goodwill

Changes in the carrying amount of goodwill for the two years ended December 31, 2019 were as follows (in thousands):

	Acute Care Services		Behavioral Health Services			Total Consolidated
Balance, January 1, 2018	$	441,511	$	3,383,646		$	3,825,157
Goodwill acquired during the period		917		44,173			45,090
Goodwill divested during the period		—		(2,135	)		(2,135	)
Adjustments to goodwill (a)		34		(23,518	)		(23,484	)
Balance, December 31, 2018		442,462		3,402,166			3,844,628
Goodwill acquired during the period		5,926		-			5,926
Goodwill divested during the period		-		-			-
Adjustments to goodwill (a)		27		19,179			19,206
Balance, December 31, 2019	$	448,415	$	3,421,345		$	3,869,760

(a) The increase/(decrease) in the Behavioral Health Services’ goodwill consists primarily of foreign currency translation adjustments.

Summary of Net Intangible Assets

The following table shows the amounts recorded as net intangible assets for the years ended December 31, 2019 and 2018:

	(amounts in thousands)
	2019		2018
Tradenames	$	—	$	74,903
Medicare licenses		57,226		57,226
Certificates of need		8,267		21,101
Contract relationships and other (net of $50,273 and $48,705 of accumulated amortization for 2019 and 2018, respectively)		18,164		19,732
Net Intangible Assets	$	83,657	$	172,962

Amounts Recognized in AOCI

The amounts recognized in AOCI for the two years ended December 31, 2019 were as follows (in thousands):

	Net Unrealized Gains (Losses) on Effective Cash Flow Hedges			Foreign Currency Translation Adjustment			Unrealized loss on marketable security			Minimum Pension Liability			Total AOCI
Balance, January 1, 2018, net of income tax	$	4,208		$	12,481		$	(2,758	)	$	(6,754	)	$	7,177
2018 activity:
Pretax amount		(2,805	)		9,718			4,398			(6,892	)		4,419
Income tax effect, net of adoption of ASU 2018-02		1,577			(6,824	)		(1,640	)		(467	)		(7,354	)
Change, net of income tax		(1,228	)		2,894			2,758			(7,359	)		(2,935	)
Balance, January 1, 2019, net of income tax		2,980			15,375			-			(14,113	)		4,242
2019 activity:
Pretax amount		(3,925	)		27,886			-			8,503			32,464
Income tax effect		928			(3,693	)		-			(2,048	)		(4,813	)
Change, net of income tax		(2,997	)		24,193			-			6,455			27,651
Balance, December 31, 2019, net of income tax	$	(17	)	$	39,568			-		$	(7,658	)	$	31,893

Computation of Basic and Diluted Earnings Per Share

The following table sets forth the computation of basic and diluted earnings per share, for the periods indicated:

	Twelve Months Ended December 31,
	2019			2018			2017
Basic and diluted:
Net Income	$	827,543		$	797,883		$	771,312
Less: Net income attributable to noncontrolling interest		(12,689	)		(18,178	)		(19,009	)
Less: Net income attributable to unvested restricted share    grants		(2,028	)		(1,091	)		(362	)
Net income attributable to UHS—basic and diluted	$	812,826		$	778,614		$	751,941
Basic earnings per share attributable to UHS:
Weighted average number of common shares—basic		88,762			93,276			95,652
Total basic earnings per share	$	9.16		$	8.35		$	7.86
Diluted earnings per share attributable to UHS:
Weighted average number of common shares		88,762			93,276			95,652
Net effect of dilutive stock options and grants based    on the treasury stock method		278			474			673
Weighted average number of common shares and    equivalents—diluted		89,040			93,750			96,325
Total diluted earnings per share	$	9.13		$	8.31		$	7.81