Business and Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2020

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, 2020, 2019 and 2018:

	(dollar amounts in thousands)
	2020					2019					2018
	Amount		%			Amount		%			Amount		%
Charity care	$	622,668		28	%	$	672,326		31	%	$	761,783		40	%
Uninsured discounts		1,578,470		72	%		1,511,738		69	%		1,132,811		60	%
Total uncompensated care	$	2,201,138		100	%	$	2,184,064		100	%	$	1,894,594		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)
	2020		2019		2018
Estimated cost of providing charity care	$	73,690	$	77,886	$	94,088
Estimated cost of providing uninsured discounts related care		186,804		175,128		139,913
Estimated cost of providing uncompensated care	$	260,494	$	253,014	$	234,001

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)
	2020		2019		2018
Cash and cash equivalents	$	1,224,490	$	61,268	$	105,220
Restricted cash (a)		54,664		44,399		94,465
Total cash, cash equivalents and restricted cash	$	1,279,154	$	105,667	$	199,685

(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, 2020 were as follows (in thousands):

	Acute Care Services			Behavioral Health Services		Total Consolidated
Balance, January 1, 2019	$	442,462		$	3,402,166	$	3,844,628
Goodwill acquired during the period		5,926			0		5,926
Goodwill divested during the period		0			0		0
Adjustments to goodwill (a)		27			19,179		19,206
Balance, December 31, 2019		448,415			3,421,345		3,869,760
Goodwill acquired during the period		127			0		127
Goodwill divested during the period		0			0		0
Adjustments to goodwill (a)		(1,521	)		14,349		12,828
Balance, December 31, 2020	$	447,021		$	3,435,694	$	3,882,715

(a)The increases 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, 2020 and 2019:

	(amounts in thousands)
	2020		2019
Medicare licenses	$	57,226	$	57,226
Certificates of need		8,253		8,267
Contract relationships and other (net of $52,804 and $50,273 of accumulated amortization for 2020 and 2019, respectively)		17,107		18,164
Net Intangible Assets	$	82,586	$	83,657

Amounts Recognized in AOCI

The amounts recognized in AOCI for the two years ended December 31, 2020 were as follows (in thousands):

	Net Unrealized Gains (Losses) on Effective Cash Flow Hedges			Foreign Currency Translation Adjustment			Minimum Pension Liability			Total AOCI
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, January 1, 2020, net of income tax		(17	)		39,568			(7,658	)		31,893
2020 activity:
Pretax amount		0			13,619			4,428			18,047
Income tax effect		0			(749	)		(1,071	)		(1,820	)
Change, net of income tax		0			12,870			3,357			16,227
Balance, December 31, 2020, net of income tax	$	(17	)	$	52,438		$	(4,301	)	$	48,120

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,
	2020			2019			2018
Basic and diluted:
Net Income	$	952,790		$	827,543		$	797,883
Less: Net income attributable to noncontrolling interest		(8,837	)		(12,689	)		(18,178	)
Less: Net income attributable to unvested restricted share    grants		(2,981	)		(2,028	)		(1,091	)
Net income attributable to UHS—basic and diluted	$	940,972		$	812,826		$	778,614
Basic earnings per share attributable to UHS:
Weighted average number of common shares—basic		85,061			88,762			93,276
Total basic earnings per share	$	11.06		$	9.16		$	8.35
Diluted earnings per share attributable to UHS:
Weighted average number of common shares		85,061			88,762			93,276
Net effect of dilutive stock options and grants based    on the treasury stock method		526			278			474
Weighted average number of common shares and    equivalents—diluted		85,587			89,040			93,750
Total diluted earnings per share	$	10.99		$	9.13		$	8.31