Lease Accounting

9 Months Ended

Sep. 30, 2020

(13) Lease Accounting

Our operating leases are primarily for real estate, including certain acute care facilities, off-campus outpatient facilities, medical office buildings, and corporate and other administrative offices. Our real estate lease agreements typically have initial terms of five to 10 years. These real estate leases may include one or more options to renew, with renewals that can extend the lease term from five to 10 years. The exercise of lease renewal options is at our sole discretion. When determining the lease term, we included options to extend or terminate the lease when it is reasonably certain that we will exercise that option.

Three of our hospital facilities are held under operating leases with Universal Health Realty Income Trust with two hospital terms expiring in 2021 and the third expiring in 2026 (see Note 2 for additional disclosure). We are also the lessee of the real property of certain facilities.

Supplemental cash flow information related to leases for the nine-month periods ended September 30, 2020 and 2019 are as follows (in thousands):

	Nine months ended September 30,
	2020		2019

Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	84,351	$	79,598
Operating cash flows from finance leases	$	1,431	$	1,589
Financing cash flows from finance leases	$	1,918	$	1,435

Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	47,679	$	364,453

Included in the $364 million of right-of-use assets obtained in exchange for operating lease obligations is $14.0 million new operating leases entered into during the nine-month period ended September 30, 2019.