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Segment Reporting
9 Months Ended
Sep. 30, 2017
Segment Reporting [Abstract]  
Segment Reporting
Segment Reporting
Our internal financial reporting and management structure is focused on the major types of services provided by HealthSouth. We manage our operations using two operating segments which are also our reportable segments: (1) inpatient rehabilitation and (2) home health and hospice. These reportable operating segments are consistent with information used by our chief executive officer, who is our chief operating decision maker, to assess performance and allocate resources. The following is a brief description of our reportable segments:
Inpatient Rehabilitation - Our national network of inpatient rehabilitation hospitals stretches across 31 states and Puerto Rico, with a concentration of hospitals in the eastern half of the United States and Texas. As of September 30, 2017, we operate 126 inpatient rehabilitation hospitals, including one hospital that operates as a joint venture which we account for using the equity method of accounting. In addition, we manage four inpatient rehabilitation units through management contracts. We provide specialized rehabilitative treatment on both an inpatient and outpatient basis. Our inpatient rehabilitation hospitals provide a higher level of rehabilitative care to patients who are recovering from conditions such as stroke and other neurological disorders, cardiac and pulmonary conditions, brain and spinal cord injuries, complex orthopedic conditions, and amputations.
Home Health and Hospice - As of September 30, 2017, we provide home health and hospice services in 235 locations across 28 states. Two of these home health locations operate as joint ventures which we account for using the equity method of accounting. Our home health services include a comprehensive range of Medicare-certified home nursing services to adult patients in need of care. These services include, among others, skilled nursing, physical, occupational, and speech therapy, medical social work, and home health aide services. Our hospice services primarily include in-home services to terminally ill patients and their families to address patients’ physical needs, including pain control and symptom management, and to provide emotional and spiritual support.
The accounting policies of our reportable segments are the same as those described in Note 1, Summary of Significant Accounting Policies, to the consolidated financial statements accompanying the 2016 Form 10-K. All revenues for our services are generated through external customers. See Note 1, Basis of Presentation, “Net Operating Revenues,” for the payor composition of our revenues. No corporate overhead is allocated to either of our reportable segments. Our chief operating decision maker evaluates the performance of our segments and allocates resources to them based on adjusted earnings before interest, taxes, depreciation, and amortization (“Segment Adjusted EBITDA”).
Selected financial information for our reportable segments is as follows (in millions):
 
Inpatient Rehabilitation
 
Home Health and Hospice
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2017
 
2016
 
2017
 
2016
 
2017
 
2016
 
2017
 
2016
Net operating revenues
$
794.8

 
$
751.7

 
$
2,377.3

 
$
2,253.5

 
$
200.8

 
$
175.1

 
$
574.4

 
$
503.8

Less: Provision for doubtful accounts
(11.3
)
 
(13.7
)
 
(38.4
)
 
(43.8
)
 
(1.3
)
 
(1.1
)
 
(4.3
)
 
(2.9
)
Net operating revenues less provision for doubtful accounts
783.5

 
738.0

 
2,338.9

 
2,209.7

 
199.5

 
174.0

 
570.1

 
500.9

Operating expenses:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Inpatient rehabilitation:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Salaries and benefits
403.2

 
371.2

 
1,195.7

 
1,107.2

 

 

 

 

Other operating expenses
117.4

 
110.1

 
342.1

 
321.7

 

 

 

 

Supplies
33.1

 
31.9

 
100.6

 
96.1

 

 

 

 

Occupancy costs
15.7

 
15.0

 
46.3

 
46.0

 

 

 

 

Home health and hospice:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Cost of services sold (excluding depreciation and amortization)

 

 

 

 
93.5

 
86.8

 
271.2

 
246.8

Support and overhead costs

 

 

 

 
68.9

 
59.5

 
203.4

 
174.5

 
569.4

 
528.2

 
1,684.7

 
1,571.0

 
162.4

 
146.3

 
474.6

 
421.3

Other income
(1.0
)
 
(0.8
)
 
(2.9
)
 
(2.1
)
 

 

 

 

Equity in net income of nonconsolidated affiliates
(1.9
)
 
(2.3
)
 
(5.6
)
 
(6.7
)
 
(0.2
)
 
(0.2
)
 
(0.6
)
 
(0.6
)
Noncontrolling interests
16.7

 
14.3

 
48.6

 
47.9

 
2.5

 
2.1

 
4.6

 
5.8

Segment Adjusted EBITDA
$
200.3

 
$
198.6

 
$
614.1

 
$
599.6

 
$
34.8

 
$
25.8

 
$
91.5

 
$
74.4

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Capital expenditures
$
59.1

 
$
42.7

 
$
164.7

 
$
128.9

 
$
1.7

 
$
2.2

 
$
5.6

 
$
4.6


 
Inpatient Rehabilitation
 
Home Health and Hospice
 
HealthSouth Consolidated
As of September 30, 2017
 
 
 
 
 
Total assets
$
3,812.4

 
$
1,141.4

 
$
4,883.4

Investments in and advances to nonconsolidated affiliates
10.0

 
2.6

 
12.6

As of December 31, 2016
 
 
 
 
 
Total assets
$
3,629.6

 
$
1,123.7

 
$
4,681.9

Investments in and advances to nonconsolidated affiliates
10.6

 
2.4

 
13.0


Segment reconciliations (in millions):
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2017
 
2016
 
2017
 
2016
Total segment Adjusted EBITDA
$
235.1

 
$
224.4

 
$
705.6

 
$
674.0

General and administrative expenses
(39.7
)
 
(30.3
)
 
(128.6
)
 
(96.6
)
Depreciation and amortization
(46.2
)
 
(43.5
)
 
(137.2
)
 
(128.8
)
Loss on disposal of assets
(3.0
)
 
(1.6
)
 
(3.3
)
 
(2.0
)
Professional fees—accounting, tax, and legal

 

 

 
(1.9
)
Loss on early extinguishment of debt
(0.3
)
 
(2.6
)
 
(10.7
)
 
(7.4
)
Interest expense and amortization of debt discounts and fees
(36.8
)
 
(42.5
)
 
(118.5
)
 
(130.5
)
Net income attributable to noncontrolling interests
19.2

 
16.4

 
53.2

 
53.7

Income from continuing operations before income tax expense
$
128.3

 
$
120.3

 
$
360.5

 
$
360.5


 
September 30, 2017
 
December 31, 2016
Total assets for reportable segments
$
4,953.8

 
$
4,753.3

Reclassification of deferred income tax liabilities to net deferred income tax assets
(70.4
)
 
(71.4
)
Total consolidated assets
$
4,883.4

 
$
4,681.9


Additional detail regarding the revenues of our operating segments by service line follows (in millions):
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2017
 
2016
 
2017
 
2016
Inpatient rehabilitation:
 
 
 
 
 
 
 
Inpatient
$
768.6

 
$
724.1

 
$
2,297.7

 
$
2,164.6

Outpatient and other
26.2

 
27.6

 
79.6

 
88.9

Total inpatient rehabilitation
794.8

 
751.7

 
2,377.3

 
2,253.5

Home health and hospice:
 
 
 
 
 
 
 
Home health
181.2

 
162.0

 
519.4

 
470.0

Hospice
19.6

 
13.1

 
55.0

 
33.8

Total home health and hospice
200.8

 
175.1

 
574.4

 
503.8

Total net operating revenues
$
995.6

 
$
926.8

 
$
2,951.7

 
$
2,757.3