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Accounts and Notes Receivable
9 Months Ended
Sep. 30, 2022
Receivables [Abstract]  
Accounts and Notes Receivable
Note 3—Accounts and Notes Receivable

The Company’s accounts and notes receivable balances consisted of the following as of September 30, 2022 and December 31, 2021:
September 30, 2022December 31, 2021
(in thousands)
Short-term
Accounts and notes receivable - gross$415,593 $352,659 
Accounts and notes receivable - allowance(68,099)(59,271)
Total net short-term accounts and notes receivable$347,494 $293,388 
Long-term
Notes receivable$29,230 $35,571 
Allowance for doubtful accounts(2,376)(6,312)
Total net long-term notes receivable$26,854 $29,259 
Total net accounts and notes receivable$374,348 $322,647 

The Company makes credit decisions on a case-by-case basis after reviewing a number of qualitative and quantitative factors related to the specific customer as well as current industry variables that may impact that customer. There are a variety of factors that impact a customer’s ability to pay in accordance with the Company’s contracts. These factors include, but are not limited to, fluctuating census numbers, litigation costs and the customer’s participation in programs funded by federal and state governmental agencies. Deviations in the timing or amounts of reimbursements under those programs can impact the customer’s cash flows and its ability to make timely payments. However, the customer’s obligation to pay the Company in accordance with the contracts is not contingent upon the customer’s cash flow. Notwithstanding the Company’s efforts to minimize its credit risk exposure, the aforementioned factors, as well as other factors that impact customer cash flows or ability to make timely payments, could have an indirect, yet material adverse effect on the Company’s results of operations and financial condition.

Fluctuations in net accounts and notes receivable are generally attributable to a variety of factors including, but not limited to, the timing of cash receipts from customers, the quarterly analysis of the Company's internally developed credit quality indicators and the inception, transition, modification or termination of customer relationships. The Company deploys significant resources and has invested in tools and processes to optimize Management’s credit and collections efforts. When appropriate, the Company utilizes interest-bearing promissory notes to enhance the collectability of amounts due, by instituting definitive repayment plans and providing a means by which to further evidence the amounts owed. In addition, the Company may amend contracts from full service to management-only arrangements, or adjust contractual payment terms, to accommodate customers who have in good faith established clearly-defined plans for addressing cash flow issues. These efforts are intended to minimize the Company’s collections risk.