0000950170-24-124103 | 10-Q | XBRL Viewer | Universal Health Services INC

Segment Reporting

9 Months Ended

Sep. 30, 2024

(7) Segment Reporting

Our reportable operating segments consist of acute care hospital services and behavioral health care services. The “Other” segment column below includes centralized services including, but not limited to, information technology, purchasing, reimbursement, accounting and finance, taxation, legal, advertising and design and construction. The chief operating decision making group for our acute care services and behavioral health care services is comprised of our Chief Executive Officer and the Presidents of each operating segment. The Presidents for each operating segment also manage the profitability of each respective segment’s various facilities. The operating segments are managed separately because each operating segment represents a business unit that offers different types of healthcare services or operates in different healthcare environments. The accounting policies of the operating segments are the same as those described in the summary of significant accounting policies included in our Annual Report on Form 10-K for the year ended December 31, 2023. The corporate overhead allocations, as reflected below, are utilized for internal reporting purposes and are comprised of each period’s projected corporate-level operating expenses (excluding interest expense). The overhead expenses are captured and allocated directly to each segment, to the extent possible, based upon each segment’s respective percentage of total operating expenses.


	Three months ended September 30, 2024
	Acute Care Hospital Services			Behavioral Health Services (a)			Other			Total Consolidated
	(Dollar amounts in thousands)
Gross inpatient revenues	$	12,277,563		$	2,835,301					$	15,112,864
Gross outpatient revenues	$	8,573,270		$	268,182					$	8,841,452
Total net revenues	$	2,245,517		$	1,714,914		$	2,596		$	3,963,027
Income/(loss) before allocation of corporate overhead and income taxes	$	199,316		$	318,864		$	(176,647	)	$	341,533
Allocation of corporate overhead	$	(64,883	)	$	(46,898	)	$	111,781		$	0
Income/(loss) after allocation of corporate overhead and before income taxes	$	134,433		$	271,966		$	(64,866	)	$	341,533
Total assets as of September 30, 2024	$	6,481,922		$	7,631,827		$	240,099		$	14,353,848

	Nine months ended September 30, 2024
	Acute Care Hospital Services			Behavioral Health Services (a)			Other			Total Consolidated
	(Dollar amounts in thousands)
Gross inpatient revenues	$	37,522,395		$	8,375,470					$	45,897,865
Gross outpatient revenues	$	25,553,451		$	833,260					$	26,386,711
Total net revenues	$	6,604,007		$	5,102,290		$	7,916		$	11,714,213
Income/(loss) before allocation of corporate overhead and income taxes	$	616,503		$	999,282		$	(556,160	)	$	1,059,625
Allocation of corporate overhead	$	(194,616	)	$	(140,808	)	$	335,424		$	0
Income/(loss) after allocation of corporate overhead and before income taxes	$	421,887		$	858,474		$	(220,736	)	$	1,059,625
Total assets as of September 30, 2024	$	6,481,922		$	7,631,827		$	240,099		$	14,353,848

	Three months ended September 30, 2023
	Acute Care Hospital Services			Behavioral Health Services (a)			Other			Total Consolidated
	(Dollar amounts in thousands)
Gross inpatient revenues	$	10,916,060		$	2,703,478					$	13,619,538
Gross outpatient revenues	$	7,480,353		$	259,060					$	7,739,413
Total net revenues	$	2,017,288		$	1,542,695		$	2,791		$	3,562,774
Income/(loss) before allocation of corporate overhead and income taxes	$	132,406		$	262,168		$	(174,067	)	$	220,507
Allocation of corporate overhead	$	(66,355	)	$	(46,677	)	$	113,032		$	0
Income/(loss) after allocation of corporate overhead and before income taxes	$	66,051		$	215,491		$	(61,035	)	$	220,507
Total assets as of September 30, 2023	$	6,252,434		$	7,372,995		$	248,041		$	13,873,470

	Nine months ended September 30, 2023
	Acute Care Hospital Services			Behavioral Health Services (a)			Other			Total Consolidated
	(Dollar amounts in thousands)
Gross inpatient revenues	$	33,278,396		$	8,001,838					$	41,280,234
Gross outpatient revenues	$	22,292,249		$	812,467					$	23,104,716
Total net revenues	$	5,993,899		$	4,575,378		$	9,153		$	10,578,430
Income/(loss) before allocation of corporate overhead and income taxes	$	396,229		$	792,217		$	(529,143	)	$	659,303
Allocation of corporate overhead	$	(199,943	)	$	(139,998	)	$	339,941		$	0
Income/(loss) after allocation of corporate overhead and before income taxes	$	196,286		$	652,219		$	(189,202	)	$	659,303
Total assets as of September 30, 2023	$	6,252,434		$	7,372,995		$	248,041		$	13,873,470

(a)

Includes net revenues generated from our behavioral health care facilities located in the U.K. amounting to approximately $230 million and $203 million for the three-month periods ended September 30, 2024 and 2023, respectively, and approximately $651 million and $561 million for the nine-month periods ended September 30, 2024 and 2023, respectively. Total assets at our U.K. behavioral health care facilities were approximately $1.442 billion and $1.260 billion as of September 30, 2024 and 2023, respectively.

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

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+ Details

Treasury (Tables)

9 Months Ended

Sep. 30, 2024

Equity [Abstract]

Summary of Effects of Foreign Currency Forward Exchange Contracts on Result of Operations

The following table presents the effects of our foreign currency forward exchange contracts on our results of operations for the three and nine-month periods ended September 30, 2024 and 2023 (in thousands):


	Gain/(Loss) recognized in AOCI
	Three months ended					Nine months ended
	September 30,			September 30,		September 30,			September 30,
	2024			2023		2024			2023
Net Investment Hedge relationships
Foreign currency forward exchange contracts	$	(43,490	)	$	19,619	$	(35,289	)	$	(10,781	)

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

Cash, cash equivalents, and restricted cash as reported in the condensed consolidated statements of cash flows are presented separately on our condensed consolidated balance sheets as follows (in thousands):


	September 30,		September 30,		December 31,
	2024		2023		2023
Cash and cash equivalents	$	106,077	$	80,768	$	119,439
Restricted cash (a)		98,520		99,871		95,031
Total cash, cash equivalents and restricted cash	$	204,597	$	180,639	$	214,470

(a) Restricted cash is included in other noncurrent assets on the accompanying condensed consolidated balance sheets.

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Cash Flows from Operating Activities:
Net income	$ 826,062	$ 499,685
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation & amortization	438,050	422,560
Gain on sale of assets and businesses	(5,124)	(6,250)
Costs related to extinguishment of debt	3,158	0
Stock-based compensation expense	72,727	65,702
Changes in assets & liabilities, net of effects from acquisitions and dispositions:
Accounts receivable	11,703	(193,108)
Accrued interest	(1,762)	60
Accrued and deferred income taxes	(10,949)	(33,240)
Other working capital accounts	1,329	(65,062)
Medicare accelerated payments and deferred CARES Act and other grants	0	1,764
Other assets and deferred charges	(5,621)	48,985
Other	25,732	13,717
Accrued insurance expense, net of commercial premiums paid	175,104	141,414
Payments made in settlement of self-insurance claims	(121,745)	(80,861)
Net cash provided by operating activities	1,408,664	815,366
Cash Flows from Investing Activities:
Property and equipment additions	(697,865)	(536,665)
Proceeds received from sales of assets and businesses	30,219	23,688
Acquisition of businesses and property	0	(3,728)
Outflows from foreign exchange contracts that hedge our net U.K. investment	(35,667)	(7,723)
Decrease in capital reserves of commercial insurance subsidiary	197	0
Net cash used in investing activities	(703,116)	(524,428)
Cash Flows from Financing Activities:
Repayments of long-term debt	(2,471,515)	(54,009)
Additional borrowings, net	2,210,248	165,000
Financing costs	(9,992)	(308)
Repurchase of common shares	(420,588)	(385,339)
Dividends paid	(40,302)	(41,964)
Issuance of common stock	10,864	9,841
Profit distributions to noncontrolling interests	(5,791)	(5,258)
Sale of ownership interests to minority members	8,959	408
Net cash used in financing activities	(718,117)	(311,629)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	2,696	493
Decrease in cash, cash equivalents and restricted cash	(9,873)	(20,198)
Cash, cash equivalents and restricted cash, beginning of period	214,470	200,837
Cash, cash equivalents and restricted cash, end of period	204,597	180,639
Supplemental Disclosures of Cash Flow Information:
Interest paid	144,378	149,247
Income taxes paid, net of refunds	236,975	191,189
Noncash purchases of property and equipment	$ 87,333	$ 108,412

Lease Accounting

9 Months Ended

Sep. 30, 2024

Leases [Abstract]

Lease Accounting

(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 ten years. These real estate leases may include one or more options to renew, with renewals that can extend the lease term from five to ten 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.

Five of our hospital facilities are held under operating leases with Universal Health Realty Income Trust with two leases expiring in 2026, two expiring in 2033 and one expiring in 2040 (for additional disclosure, see Note 2 to the Consolidated Financial Statements-Relationship with Universal Health Realty Income Trust and Other Related Party Transactions). We are also the lessee of the real property of certain facilities from unrelated third parties.

Supplemental cash flow information related to leases for the nine-month period ended September 30, 2024 and 2023 are as follows (in thousands):


	Nine months ended September 30,
	2024		2023

Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	99,526	$	96,922
Operating cash flows from finance leases	$	2,756	$	2,890
Financing cash flows from finance leases	$	3,167	$	2,910

Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	50,696	$	50,940
Finance leases	$	8,441	$	452

Relationship with Universal Health Realty Income Trust and Other Related Party Transactions - Additional Information 4 (Detail) - USD ($)	3 Months Ended			9 Months Ended		12 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2013	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2024	Dec. 31, 2023
Chief Executive Officer
Related Party Transaction [Line Items]
Estimated payments to acquire life insurance policies				$ 28,000,000
Payments to acquire life insurance policies, net							$ 1,000,000
Trust Owned by CEO \| Chief Executive Officer
Related Party Transaction [Line Items]
Estimated payments to acquire life insurance policies				9,000,000
Minimum \| Chief Executive Officer
Related Party Transaction [Line Items]
Estimated death benefit proceeds				37,000,000
Premier, Inc. \| Group Purchasing Organization Agreement \| Restricted Stock
Related Party Transaction [Line Items]
Shares vesting period			7 years
Shares vesting period start year			2014
Shares vesting period end year			2020
Market value of retained vested shares				45,000,000			$ 50,000,000
Other (Income) Expense, Net \| Premier, Inc.
Related Party Transaction [Line Items]
Dividend	$ 470,000	$ 470,000		$ 1,400,000	$ 1,400,000
Scenario Forecast \| Chief Executive Officer
Related Party Transaction [Line Items]
Payments to acquire life insurance policies, net						$ 1,000,000

Dividends

9 Months Ended

Sep. 30, 2024

Earnings Per Share [Abstract]

Dividends

(10) Dividends

We declared and paid dividends of $13.3 million, or $.20 per share, during the third quarter of 2024 and $13.8 million, or $.20 per share, during the third quarter of 2023. We declared and paid dividends of $40.3 million, or $.60 per share, during the nine-month period ended September 30, 2024 and $42.2 million, or $.60 per share, during the nine-month period ended September 30, 2023. Included in the amounts above were dividend equivalents applicable to unvested restricted stock units which were accrued during 2024 and 2023 and will be, or were, paid upon vesting of the restricted stock unit.

Summary of Assets and Liabilities Recorded at Fair Value on Recurring Basis (Detail) - Recurring - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Assets:
Assets, fair value	$ 211,330	$ 206,412
Liabilities:
Liabilities, fair value	50,803	44,971
Money Market Mutual Funds \| Other Noncurrent Assets
Assets:
Assets, fair value	115,205	111,129
Certificates of Deposit \| Other Noncurrent Assets
Assets:
Assets, fair value	2,201	2,300
Equity Securities \| Other Noncurrent Assets
Assets:
Assets, fair value	44,654	49,923
Deferred Compensation Assets \| Other Noncurrent Assets
Assets:
Assets, fair value	49,270	43,060
Foreign Currency Forward Exchange Contracts \| Accrued Liabilities Other
Liabilities:
Liabilities, fair value	1,533	1,911
Deferred Compensation Liability \| Other Noncurrent Liabilities
Liabilities:
Liabilities, fair value	49,270	43,060
Basis of Fair Value Measurement, Level 1
Assets:
Assets, fair value	209,129	204,112
Liabilities:
Liabilities, fair value	49,270	43,060
Basis of Fair Value Measurement, Level 1 \| Money Market Mutual Funds \| Other Noncurrent Assets
Assets:
Assets, fair value	115,205	111,129
Basis of Fair Value Measurement, Level 1 \| Equity Securities \| Other Noncurrent Assets
Assets:
Assets, fair value	44,654	49,923
Basis of Fair Value Measurement, Level 1 \| Deferred Compensation Assets \| Other Noncurrent Assets
Assets:
Assets, fair value	49,270	43,060
Basis of Fair Value Measurement, Level 1 \| Deferred Compensation Liability \| Other Noncurrent Liabilities
Liabilities:
Liabilities, fair value	49,270	43,060
Basis of Fair Value Measurement, Level 2
Assets:
Assets, fair value	2,201	2,300
Liabilities:
Liabilities, fair value	1,533	1,911
Basis of Fair Value Measurement, Level 2 \| Certificates of Deposit \| Other Noncurrent Assets
Assets:
Assets, fair value	2,201	2,300
Basis of Fair Value Measurement, Level 2 \| Foreign Currency Forward Exchange Contracts \| Accrued Liabilities Other
Liabilities:
Liabilities, fair value	$ 1,533	$ 1,911

Commitments and Contingencies

9 Months Ended

Sep. 30, 2024

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

(6) Commitments and Contingencies

Professional and General Liability, Workers’ Compensation Liability

The vast majority of our subsidiaries are self-insured for professional and general liability exposure up to: (i) $20 million for professional liability and $3 million for general liability per occurrence in 2024, 2023, 2022 and 2021; (ii) $10 million and $3 million per occurrence, respectively, in 2020; (iii) $5 million and $3 million per occurrence, respectively, during 2019, 2018 and 2017, and; (iv) $10 million and $3 million per occurrence, respectively, prior to 2017.

These subsidiaries are provided with several excess policies through commercial insurance carriers which provide for coverage in excess of the applicable per occurrence and aggregate self-insured retention or underlying policy limits up to approximately $175 million in 2024; $165 million in 2023; $162 million in 2022; $155 million in 2021 and $250 million during each of 2014 through 2020. In addition, from time to time based upon marketplace conditions, we may elect to purchase additional commercial coverage for certain of our facilities or businesses. Our behavioral health care facilities located in the U.K. have policies through a commercial insurance carrier located in the U.K. that provides for £18.5 million of professional liability coverage, and £25 million of general liability coverage. The commercial insurance limits indicated above for each policy year may have been reduced due to payment of covered claims or suits, subject to the policy terms and conditions.

As of September 30, 2024, the total net accrual for our self-insured professional and general liability claims was $480 million, of which $70 million was included in current liabilities. As of December 31, 2023, the total net accrual for our self-insured professional and general liability claims was $431 million, of which $70 million was included in current liabilities.

As a result of unfavorable trends experienced during the past several years, included in our results of operations were increases to our reserves for self-insured professional and general liability claims amounting to approximately $30 million and $44 million during the three and nine-month periods ended September 30, 2024, respectively, and $5 million and $25 million during the three and nine-month periods ended September 30, 2023. Our estimated liability for self-insured professional and general liability claims is based on a number of factors including, among other things, the number of asserted claims and reported incidents, estimates of losses for these

claims based on recent and historical settlement amounts, estimates of incurred but not reported claims based on historical experience, and estimates of amounts recoverable under our commercial insurance policies. While we continuously monitor these factors, our ultimate liability for professional and general liability claims could change materially from our current estimates due to inherent uncertainties involved in making this estimate. Given our significant self-insured exposure for professional and general liability claims, there can be no assurance that a sharp increase in the number and/or severity of claims asserted against us will not have a material adverse effect on our future results of operations.

As of September 30, 2024, the total accrual for our workers’ compensation liability claims was $136 million, $58 million of which was included in current liabilities. As of December 31, 2023, the total accrual for our workers’ compensation liability claims was $130 million, $55 million of which was included in current liabilities. As a result of favorable trends experienced in prior years, included in our results of operations during the nine-month period ended September 30, 2023, was a pre-tax decrease to our reserves for self-insured workers' compensation liability claims of approximately $10 million (recorded during the second quarter of 2023).

Although we are unable to predict whether or not our future financial statements will require updates to estimates for our prior year reserves for self-insured general and professional and workers’ compensation claims, given the relatively unpredictable nature of these potential liabilities and the factors impacting these reserves, as discussed above, it is reasonably likely that our future financial results may include material adjustments to prior period reserves.

As disclosed below in Legal Proceedings:

•

On March 28, 2024, a jury returned a verdict for compensatory damages of $60 million and punitive damages of $475 million and a related judgment was entered against The Pavilion Behavioral Health System (the “Pavilion”), an indirect subsidiary of the Company. In an order dated October 10, 2024, the trial court ordered a remittitur of punitive damages from $475 million to $120 million. The court denied the Pavilion’s request for reduction of compensatory damages. The Pavilion intends to appeal the remaining judgment.

•

Cumberland Hospital for Children and Adolescents (“Cumberland”), an indirect subsidiary of the Company, is a defendant in multi-plaintiff lawsuits filed in the Circuit Court for Richmond, Virginia (the “Cumberland Litigation”), relating to allegations of inappropriate sexual contact during medical examinations by Dr. Daniel Davidow, an independent contractor and the former medical director for Cumberland. The Company and UHS of Delaware, Inc., our administrative services subsidiary (“UHS Delaware”), were also named as co-defendants in the Cumberland Litigation. Plaintiffs have asserted claims of negligence, assault and battery (against Dr. Davidow), false imprisonment, violations of the Virginia Consumer Protection Act (“VCPA”), and vicarious liability for Dr. Davidow’s conduct against Cumberland, the Company, and UHS Delaware. The Company and UHS Delaware were dismissed from the action during the trial, which occurred in September, 2024. On September 27, 2024, a jury entered a verdict finding Dr. Davidow and Cumberland liable and awarded these three plaintiffs combined compensatory damages of $60 million for all liability theories, an additional combined $180 million in trebled damages for violation of the VCPA, and an additional combined $120 million in punitive damages. Cumberland is evaluating all legal options and intends to challenge this verdict, including the amounts awarded in the verdict, in post-trial proceedings and on appeal. Based upon Virginia law, we expect that the punitive damage amount should be reduced to a combined maximum of $1.05 million as a matter of law. There are approximately 40 additional plaintiffs making similar allegations with claims pending in the Cumberland Litigation.

We are uncertain as to the ultimate financial exposure related to the above-mentioned Cumberland and Pavilion matters and we can make no assurances regarding their outcomes, or the amounts of damages that may be held recoverable after post-judgment proceedings and appeals. While Cumberland and Pavilion have professional liability insurance to cover a portion of these amounts, the resolution of these matters may have a material adverse effect on the Company. Without reduction for any potential amounts related to the above-mentioned Cumberland and Pavilion matters, the Company and its subsidiaries have aggregate insurance coverage of approximately $221 million remaining under commercial policies for matters applicable to the 2020 policy year (in excess of the applicable self-insured retention amounts of $10 million per occurrence for professional liability claims and $3 million per occurrence for general liability claims).

In the event the resolution of the Cumberland and/or Pavilion matters exhausts all or a significant portion of the remaining commercial insurance coverage available to the Company and its subsidiaries for claims that occurred in 2020 (the applicable year for the Pavilion matter and substantially all of the Cumberland matters, as discussed above), or it requires the posting of large bonds or other collateral during appeal processes, our future results of operations and capital resources could be materially adversely impacted.

Property Insurance

We have commercial property insurance policies for our properties, covering the period of June 1, 2024 to June 1, 2025, providing property and business interruption coverage for losses in excess of $15 million per occurrence or per location (as applicable based upon the event) up to a $1 billion annual policy limitation for certain catastrophic events or perils. These commercial policies provide for coverage of up to $250 million of annual aggregate coverage for losses resulting from windstorm damage. Losses resulting from named windstorms are subject to deductibles between 3% and 5% of the total insurable value of the property. In addition, we have

commercial property insurance policies covering catastrophic losses resulting from earthquake and flood damage, each subject to aggregated loss limits (as opposed to per occurrence losses). Commercially insured earthquake coverage for our facilities is subject to various deductibles and limitations including: (i) $100 million limitation for our facilities located in California, New Madrid Seismic Zone, Pacific Northwest Seismic Zone, Alaska and certain counties in Nevada; (ii) $100 million limitation for our facilities located in fault zones within the United States; (iii) $40 million limitation for our facilities located in Puerto Rico, and; (iv) $250 million limitation for many of our facilities located in other states. Our commercially insured flood coverage has a limit of $100 million annually. There is also a $10 million sublimit for one of our facilities located in Houston, Texas, and a $1 million sublimit for our facilities located in Puerto Rico. In addition, subject to the underlying policies' deductible provisions, our facilities located in California, New Madrid Seismic Zone, Pacific Northwest Seismic Zone, Alaska and certain counties in Nevada, have $50 million of excess commercial property insurance coverage for earthquake losses in excess of $100 million. Property insurance for our behavioral health facilities located in the U.K. are provided on an all risk basis up to a £1.5 billion policy limit, with coverage caps per location, that includes coverage for real and personal property as well as business interruption losses.

These commercial policies are subject to a deductible of: (i) $5 million per location for damage resulting from earthquake, wind, hail and flood, and; (ii) $5 million per occurrence for all other events. For per location or per occurrence losses in excess of the applicable deductible, we are self-insured, through our wholly-owned captive insurance company, for up to $10 million of annual aggregate losses. Should the $10 million self-insured annual aggregate limitation be exhausted during the policy year, we have commercial insurance coverage for the next $30 million of annual aggregate losses in excess of the applicable deductible. In the event the $30 million of commercial coverage is also exhausted, we are self-insured for all per location or per occurrence losses up to $25 million, including the $5 million deductible.

Commitment to Develop, Lease and Operate an Acute Care Hospital in Washington, D.C.

During 2020, we entered into various agreements with the District of Columbia (the “District”) related to the development, leasing and operation of an acute care hospital and certain other facilities/structures on land owned by the District (“District Facilities”). The agreements contemplate that we will serve as manager for development and construction of the District Facilities on behalf of the District, with a projected aggregate cost of approximately $439 million, approximately $295 million of which was incurred as of September 30, 2024, which will be entirely funded by the District. Construction of the District Facilities is expected to be completed in the Spring of 2025.

Upon completion of the District Facilities, we will lease the District Facilities for a nominal rental amount for a period of 75 years and are obligated to operate the District Facilities during the lease term. We have certain lease termination rights in connection with the District Facilities beginning on the tenth anniversary of the lease commencement date for various and decreasing amounts as provided for in the agreements. Additionally, any time after the 10th anniversary of the lease term, we have a right to purchase the District Facilities for a price equal to the greater of fair market value of the District Facilities or the amount necessary to defease the bonds issued by the District to fund the construction of the District Facilities. The lease agreement also entitles the District to participation rent should certain specified earnings before interest, taxes, depreciation and amortization thresholds be achieved by the acute care hospital.

Additionally, we have committed to expend no less than $75 million (approximately $12 million of which has been incurred as of September 30, 2024), over a projected 12-year period, in healthcare infrastructure including expenditures related to the District Facilities as well as other healthcare related expenditures in certain specified areas of Washington, D.C. Pursuant to the agreements, the District is entitled to certain termination fees and other amounts as specified in the agreements in the event we, within certain specified periods of time, cease to operate the acute care hospital or there is a transfer of control of us or our subsidiary operating the hospital.

Legal Proceedings

We operate in a highly regulated and litigious industry which subjects us to various claims and lawsuits in the ordinary course of business as well as regulatory proceedings and government investigations. These claims or suits include claims for damages for personal injuries, medical malpractice, commercial/contractual disputes, wrongful restriction of, or interference with, physicians’ staff privileges, and employment related claims. In addition, health care companies are subject to investigations and/or actions by various state and federal governmental agencies or those bringing claims on their behalf. Government action has increased with respect to investigations and/or allegations against healthcare providers concerning possible violations of fraud and abuse and false claims statutes as well as compliance with clinical and operational regulations. Currently, and from time to time, we and some of our facilities are subjected to inquiries in the form of subpoenas, Civil Investigative Demands, audits and other document requests from various federal and state agencies. These inquiries can lead to notices and/or actions including repayment obligations from state and federal government agencies associated with potential non-compliance with laws and regulations. Further, the federal False Claims Act allows private individuals to bring lawsuits (qui tam actions) against healthcare providers that submit claims for payments to the government. Various states have also adopted similar statutes. When such a claim is filed, the government will investigate the matter and decide if they are going to intervene in the pending case. These qui tam lawsuits are placed under seal by the court to comply with the False Claims Act’s requirements. If the government chooses not to intervene, the private individual(s) can proceed independently on behalf

of the government. Health care providers that are found to violate the False Claims Act may be subject to substantial monetary fines/penalties as well as face potential exclusion from participating in government health care programs or be required to comply with Corporate Integrity Agreements as a condition of a settlement of a False Claims Act matter. In September 2014, the Criminal Division of the Department of Justice (“DOJ”) announced that all qui tam cases will be shared with their Division to determine if a parallel criminal investigation should be opened. The DOJ has also announced an intention to pursue civil and criminal actions against individuals within a company as well as the corporate entity or entities. In addition, health care facilities are subject to monitoring by state and federal surveyors to ensure compliance with program Conditions of Participation. In the event a facility is found to be out of compliance with a Condition of Participation and unable to remedy the alleged deficiency(s), the facility faces termination from the Medicare and Medicaid programs or compliance with a System Improvement Agreement to remedy deficiencies and ensure compliance.

The laws and regulations governing the healthcare industry are complex covering, among other things, government healthcare participation requirements, licensure, certification and accreditation, privacy of patient information, reimbursement for patient services as well as fraud and abuse compliance. These laws and regulations are constantly evolving and expanding. Further, the original Patient Protection and Affordable Care Act, as amended by the Health and Education Reconciliation Act, has added additional obligations on healthcare providers to report and refund overpayments by government healthcare programs and authorizes the suspension of Medicare and Medicaid payments “pending an investigation of a credible allegation of fraud.” We monitor our business and have developed an ethics and compliance program with respect to these complex laws, rules and regulations. Although we believe our policies, procedures and practices comply with government regulations, there is no assurance that we will not be faced with the sanctions referenced above which include fines, penalties and/or substantial damages, repayment obligations, payment suspensions, licensure revocation, and expulsion from government healthcare programs. Even if we were to ultimately prevail in any action brought against us or our facilities or in responding to any inquiry, such action or inquiry could have a material adverse effect on us.

Certain legal matters are described below:

Knight v. Miller, et. al.

In July 2021, a shareholder derivative lawsuit was filed by plaintiff, Robin Knight, in the Chancery Court in Delaware against the members of the Board of Directors of the Company as well as certain officers (C.A. No.: 2021-0581-SG). The Company was named as a nominal defendant. The lawsuit alleged that in March 2020 stock options were awarded with exercise prices that did not reflect the Company’s fundamentals and business prospects, and in anticipation of future market rebound resulting in excessive gains. The lawsuit made claims of breaches of fiduciary duties, waste of corporate assets, and unjust enrichment. The lawsuit sought monetary damages allegedly incurred by the Company, disgorgement of the March 2020 stock awards as well as any proceeds derived therefrom and unspecified equitable relief. Defendants denied the allegations. We filed a motion to dismiss the complaint and the court granted part and denied part of our motion. During the third quarter of 2022, we reached a preliminary settlement, which would not have had a material impact on our consolidated financial statements. The settlement required court approval which the court declined to provide. Our Board of Directors authorized the formation of a Special Litigation Committee ("SLC") to review the matter and determine whether it was in the best interests of the Company to pursue this claim. The court stayed the litigation while the SLC conducted their review. According to the SLC’s status letter to the Court of Chancery, dated April 15, 2024, after a thorough examination of documentary evidence, interviews with relevant persons, and a review of the applicable law, the SLC determined that the claims asserted in the shareholder derivative lawsuit did not have merit and that pursuing them would not be in the interest of the Company. The SLC further advised the court that the SLC concluded that the claims should be dismissed. The parties jointly filed a stipulation with the court requesting dismissal of the case. After a preliminary hearing on the matter, the court requested a revised stipulation be filed which was prepared and filed with the court. During the third quarter of 2024, the court entered the stipulation dismissing the case and the matter has been concluded.

Disproportionate Share Hospital Payment Matter:

In late September, 2015, many hospitals in Pennsylvania, including certain of our behavioral health care hospitals located in the state, received letters from the Pennsylvania Department of Human Services (the “Department”) demanding repayment of allegedly excess Medicaid Disproportionate Share Hospital payments (“DSH”), primarily consisting of managed care payments characterized as DSH payments, for the federal fiscal year (“FFY”) 2011 amounting to approximately $4 million in the aggregate. Since that time, certain of our behavioral health care hospitals in Pennsylvania have received similar requests for repayment for alleged DSH overpayments for FFYs 2012 through 2015. For FFY 2012, the claimed overpayment amounts to approximately $4 million. For FY 2013, FY 2014 and FY 2015 the initial claimed overpayments and attempted recoupment by the Department were approximately $7 million, $8 million and $7 million, respectively. The Department has agreed to a change in methodology which, upon confirmation of the underlying data being accepted by the Department, could reduce the initial claimed overpayments for FY 2013, FY 2014 and FY 2015 to approximately $2 million, $2 million and $3 million, respectively. We filed administrative appeals for all of our facilities contesting the recoupment efforts for FFYs 2011 through 2015 as we believe the Department’s calculation methodology is inaccurate and conflicts with applicable federal and state laws and regulations. The Department agreed to postpone the recoupment of the state’s share for FFY 2011 to 2013 until all hospital appeals are resolved but recouped the federal share. For FFY 2014 and FFY 2015, the Department initiated the recoupment of the alleged overpayments (both federal and state shares). Starting in FY 2016, the first full

fiscal year after the January 1, 2015 effective date of Medicaid expansion in Pennsylvania, the Department no longer characterized managed care payments received by the hospitals as DSH payments. While the administrative appeals on the disputed DSH payments remain pending, we have been in continued settlement discussions with the Department. As a part of these discussions, we have presented certain calculation errors that we believe, if corrected, could materially reduce the alleged overpayments. We have recently reached a settlement in principle with the Department that will result in a partial repayment to us of amounts previously recouped. The parties are in the process of drafting a definitive settlement agreement codifying our agreement to conclude this matter. In the event that we are unable to complete the settlement agreement, we will continue with our administrative appeals. We can provide no assurance that we will ultimately be successful in our legal and administrative appeals related to the Department’s repayment demands in the event the pending settlement is not finalized and we are unable to assess liability or damages with certainty at this time. If our legal and administrative appeals are unsuccessful, our future consolidated results of operations and financial condition could be adversely impacted by these repayments.

Rachel Capriglione, as natural mother and Next Friend of A.T., a minor, Plaintiff, v. The Pavilion Foundation d/b/a The Pavilion Behavioral Health System

As previously reported on Form 8-K, as filed on April 1, 2024, the Pavilion Behavioral Health System (the “Pavilion”), an indirect subsidiary of the Company, is the sole defendant in a lawsuit filed in Champaign County, Illinois, relating to the sexual assault of one minor patient by another minor patient in 2020. Plaintiff asserted claims of negligence and misrepresentation. The Pavilion denied any liability.

The case went to trial in March of 2024. On March 28, 2024, a jury rejected the misrepresentation claim, returned a verdict for ordinary negligence, and awarded compensatory damages of $60 million and punitive damages of $475 million. Based on a search of verdicts in comparable cases, the magnitude of this verdict was unexpected and is unprecedented for a single-plaintiff injury case of this type in Champaign County, Illinois. The Pavilion filed post-trial motions, among other items, contesting the excessiveness of the damage awards.

As previously reported on Form 8-K, as filed on October 11, 2024, in an order dated October 10, 2024, the trial court ordered a remittitur of punitive damages from $475 million to $120 million. The court denied the Pavilion’s request for reduction of compensatory damages. Pursuant to Illinois law and procedure, plaintiff had 21 days from the date of the order to either accept the remittitur of the punitive damages or refuse the remittitur, which would have resulted in further legal proceedings. Plaintiff accepted the remittitur by the trial court while reserving all rights to appeal the remittitur. The Pavilion intends to appeal the remaining judgment. Although we can make no assurances regarding the ultimate outcome of this matter, or what damages will ultimately be awarded, its final resolution could have a material adverse effect on the Company

K.E.E., et al., Plaintiffs v. Cumberland Hospital, LLC d/b/a Cumberland Hospital for Children and Adolescents, et al. (and related lawsuits)

The claims asserted by three of the plaintiffs in the Cumberland Litigation were consolidated for trial in September of 2024. The Company and UHS Delaware were dismissed from the action during trial. As previously reported on Form 8-K, as filed on September 30, 2024, on September 27, 2024, a jury entered a verdict finding Dr. Davidow and Cumberland liable and awarded these three plaintiffs combined compensatory damages of $60 million for all liability theories, an additional combined $180 million in trebled damages for violation of the VCPA, and an additional combined $120 million in punitive damages. Cumberland is evaluating all legal options and intends to challenge this verdict, including the amounts awarded in the verdict, in post-trial proceedings and on appeal. Based upon Virginia law, we expect that the punitive damage amount should be reduced to a combined maximum of $1.05 million as a matter of law.

There are approximately 40 additional plaintiffs making similar allegations with claims pending in the Cumberland Litigation.

Although we can make no assurances regarding the ultimate outcomes of the various claims made in connection with the Cumberland Litigation, or what damages will ultimately be awarded, the final resolution of these matters could have a material adverse effect on the Company

Other Matters:

Various other suits, claims and investigations, including government subpoenas, arising against, or issued to, us are pending and additional such matters may arise in the future. Management will consider additional disclosure from time to time to the extent it

believes such matters may be or become material. The outcome of any current or future litigation or governmental or internal investigations, including the matters described above, cannot be accurately predicted, nor can we predict any resulting penalties, fines or other sanctions that may be imposed at the discretion of federal or state regulatory authorities. We record accruals for such contingencies to the extent that we conclude it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. No estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made at this time regarding the matters described above or that are otherwise pending because the inherently unpredictable nature of legal proceedings may be exacerbated by various factors, including, but not limited to: (i) the damages sought in the proceedings are unsubstantiated or indeterminate; (ii) discovery is not complete; (iii) the matter is in its early stages; (iv) the matters present legal uncertainties; (v) there are significant facts in dispute; (vi) there are a large number of parties, or; (vii) there is a wide range of potential outcomes. It is possible that the outcome of these matters could have a material adverse impact on our future results of operations, financial position, cash flows and, potentially, our reputation.

Relationship with Universal Health Realty Income Trust and Other Related Party Transactions - Additional Information (Detail) - USD ($)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Related Party Transaction [Line Items]
Net revenues	$ 3,963,027,000	$ 3,562,774,000	$ 11,714,213,000	$ 10,578,430,000
Acute Care Hospital Services
Related Party Transaction [Line Items]
Net revenues	2,245,517,000	2,017,288,000	$ 6,604,007,000	5,993,899,000
Relationship with Universal Health Realty Income Trust
Related Party Transaction [Line Items]
Percentage of advisory fee on average invested real estate assets			0.70%		0.70%	0.70%	0.70%
Pre-tax share of income from the Trust	300,000	100,000	$ 914,000	670,000
Dividends received from the Trust	575,000	567,000	1,700,000	1,700,000
Carrying value of investment in Trust	6,200,000		6,200,000		$ 7,000,000
Market value of investment in Trust	$ 36,000,000.0		$ 36,000,000.0		$ 34,100,000
Relationship with Universal Health Realty Income Trust \| Other Related Party Transactions
Related Party Transaction [Line Items]
Trust outstanding shares held, percentage	5.70%		5.70%
Relationship with Universal Health Realty Income Trust \| Advisory Fee
Related Party Transaction [Line Items]
Net revenues	$ 1,400,000	$ 1,300,000	$ 4,100,000	$ 4,000,000

Earnings Per Share Data and Stock Based Compensation (Tables)

9 Months Ended

Sep. 30, 2024

Share-Based Payment Arrangement [Abstract]

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 (in thousands, except per share data):


	Three months ended September 30,					Nine months ended September 30,
	2024		2023			2024			2023
Basic and Diluted:
Net income attributable to UHS	$	258,714	$	166,989		$	809,700		$	501,417
Less: Net income attributable to unvested restricted share grants		-		(52	)		(50	)		(242	)
Net income attributable to UHS – basic and diluted	$	258,714	$	166,937		$	809,650		$	501,175

Weighted average number of common shares - basic		66,537		68,867			66,873			69,825
Net effect of dilutive stock options and grants based on the treasury stock method		1,571		757			1,297			825
Weighted average number of common shares and equivalents - diluted		68,108		69,624			68,170			70,650
Earnings per basic share attributable to UHS:	$	3.89	$	2.42		$	12.11		$	7.18
Earnings per diluted share attributable to UHS:	$	3.80	$	2.40		$	11.88		$	7.09

General

9 Months Ended

Sep. 30, 2024

Organization, Consolidation and Presentation of Financial Statements [Abstract]

General

(1) General

This Quarterly Report on Form 10-Q is for the quarterly period ended September 30, 2024. In this Quarterly Report, “we,” “us,” “our” “UHS” and the “Company” refer to Universal Health Services, Inc. and its subsidiaries.

The condensed consolidated interim financial statements include the accounts of our majority-owned subsidiaries and partnerships and limited liability companies controlled by us, or our subsidiaries, as managing general partner or managing member. The condensed consolidated interim financial statements included herein have been prepared by us, without audit, pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”) and reflect all adjustments (consisting only of normal recurring adjustments) which, in our opinion, are necessary to fairly state results for the interim periods. Certain information and footnote disclosures normally included in audited consolidated financial statements prepared in accordance with accounting principles generally accepted in the United States of America have been condensed or omitted pursuant to such rules and regulations, although we believe that the accompanying disclosures are adequate to make the information presented not misleading. These condensed consolidated interim financial statements should be read in conjunction with the audited consolidated financial statements, significant accounting policies and the notes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2023.

Segment Reporting (Parenthetical) (Detail) - USD ($)
$ in Thousands

3 Months Ended

9 Months Ended

Sep. 30, 2024

Sep. 30, 2023

Sep. 30, 2024

Sep. 30, 2023

Dec. 31, 2023

Segment Reporting Information [Line Items]

Net revenues

$ 3,963,027

$ 3,562,774

$ 11,714,213

$ 10,578,430

Total assets

14,353,848

13,873,470

14,353,848

13,873,470

$ 13,967,602

Behavioral Health Services

Segment Reporting Information [Line Items]

Net revenues

^[1]

1,714,914

1,542,695

5,102,290

4,575,378

Total assets

^[1]

7,631,827

7,372,995

7,631,827

7,372,995

Behavioral Health Services | Located in U.K.

Segment Reporting Information [Line Items]

Net revenues

230,000

203,000

651,000

561,000

Total assets

$ 1,442,000

$ 1,260,000

$ 1,442,000

$ 1,260,000

[1]

- Definition

Amount of asset recognized for present right to economic benefit.

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+ Details

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

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-Subparagraph (a)
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+ Details

Summary of Details of Hospitals Leased from Trust (Detail) - USD ($)

3 Months Ended

9 Months Ended

Sep. 30, 2024

Sep. 30, 2023

Sep. 30, 2024

Sep. 30, 2023

Property Subject to or Available for Operating Lease [Line Items]

Annual Minimum Rent

$ 36,540,000

$ 35,466,000

$ 108,165,000

$ 105,775,000

McAllen Medical Center

Property Subject to or Available for Operating Lease [Line Items]

Annual Minimum Rent

$ 5,485,000

End of Lease Term

2026-12

Renewal Term (years)

^[1]

5 years

Wellington Regional Medical Center

Property Subject to or Available for Operating Lease [Line Items]

Annual Minimum Rent

$ 6,639,000

End of Lease Term

2026-12

Renewal Term (years)

^[2]

5 years

Aiken Regional Medical Center/Aurora Pavilion Behavioral Health Services

Property Subject to or Available for Operating Lease [Line Items]

Annual Minimum Rent

$ 4,072,000

End of Lease Term

2033-12

Renewal Term (years)

^[3]

35 years

Canyon Creek Behavioral Health

Property Subject to or Available for Operating Lease [Line Items]

Annual Minimum Rent

$ 1,841,000

End of Lease Term

2033-12

Renewal Term (years)

^[3]

35 years

Clive Behavioral Health Hospital

Property Subject to or Available for Operating Lease [Line Items]

Annual Minimum Rent

$ 2,775,000

End of Lease Term

2040-12

Renewal Term (years)

^[4]

50 years

[1]	We have one 5-year renewal option at existing lease rates (through 2031).
[2]	We have one 5-year renewal option at fair market value lease rates (through 2031). On each January 1st through 2026, the annual rent will increase by 2.5% on a cumulative and compounded basis.
[3]	We have seven 5-year renewal options at fair market value lease rates (2034 through 2068). On each January 1st through 2033, the annual rent will increase by 2.25% on a cumulative and compounded basis.
[4]	This facility is operated by a joint venture in which we are the managing, majority member and an unrelated third-party holds a minority ownership interest. The joint venture has three, 10-year renewal options at computed lease rates as stipulated in the lease (2041 through 2070) and two additional, 10-year renewal options at fair market value lease rates (2071 through 2090). In each January through 2040 (and potentially through 2070 if three, 10-year renewal options are exercised), the annual rental will increase by 2.75% on a cumulative and compounded basis.

Commitments and Contingencies - Additional Information (Detail) £ in Millions				3 Months Ended		9 Months Ended			12 Months Ended
	Oct. 10, 2024 USD ($)	Sep. 27, 2024 USD ($) Plaintiffs	Mar. 28, 2024 USD ($)	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Sep. 30, 2024 GBP (£)	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)	Dec. 31, 2013 USD ($)	Sep. 30, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)	Dec. 31, 2019 USD ($)	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)
Commitments and Contingencies Disclosure [Line Items]
Purchased several excess policies through commercial insurance carriers per occurrence excess claim amount													$ 30,000,000
Self-insured for professional and general liability, current													70,000,000	$ 70,000,000
Compensation liability claims													136,000,000	130,000,000
Pre-tax decrease to reserves for self-insured workers' compensation liability claims								$ 10,000,000
Compensation and related benefits													58,000,000	55,000,000
Maximum insurance deductible													5,000,000
Self insurance reserve amount exhausted													10,000,000
Purchased several excess policies through commercial insurance amount exhausted													30,000,000
District Facilities
Commitments and Contingencies Disclosure [Line Items]
Projected aggregate development and construction cost													439,000,000
Development and construction cost incurred													$ 295,000,000
Lease initial terms						75 years							75 years
Committment to expend							$ 12,000,000
Projected commitment expend period						12 years	12 years
Department of Human Services
Commitments and Contingencies Disclosure [Line Items]
Repayment of legal settlement amount on demand							$ 4,000,000
Amount claimed from over payments of legal settlements									$ 4,000,000	$ 7,000,000	$ 8,000,000	$ 7,000,000
Amount claimed from over payments of legal settlements due to change in calculations										$ 3,000,000	2,000,000	$ 2,000,000
The Pavilion Behavioral Health System
Commitments and Contingencies Disclosure [Line Items]
Aggregate insurance coverage													$ 221,000,000
The Pavilion Behavioral Health System \| Compensatory Damages
Commitments and Contingencies Disclosure [Line Items]
Damages awarded	$ 475,000,000		$ 60,000,000
The Pavilion Behavioral Health System \| Punitive Damages
Commitments and Contingencies Disclosure [Line Items]
Damages awarded	$ 120,000,000		$ 475,000,000
Cumberland Hospital for Children and Adolescents
Commitments and Contingencies Disclosure [Line Items]
Number of plaintiffs \| Plaintiffs		40
Cumberland Hospital for Children and Adolescents \| Compensatory Damages
Commitments and Contingencies Disclosure [Line Items]
Damages awarded		$ 60,000,000
Cumberland Hospital for Children and Adolescents \| Trebled Damages
Commitments and Contingencies Disclosure [Line Items]
Damages awarded		180,000,000
Cumberland Hospital for Children and Adolescents \| Punitive Damages
Commitments and Contingencies Disclosure [Line Items]
Damages awarded		$ 120,000,000
Cumberland Hospital for Children and Adolescents \| Compensatory Damages, Trebled Damages And Punitive Damages
Commitments and Contingencies Disclosure [Line Items]
Number of plaintiffs \| Plaintiffs		3
Subsequent Event \| The Pavilion Behavioral Health System \| Punitive Damages
Commitments and Contingencies Disclosure [Line Items]
Timeline of remittitur	21 days
Wind Storms
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses													250,000,000
Earthquake \| California, New Madrid Seismic Zone, Pacific Northwest Seismic Zone, Alaska and certain counties in Nevada
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses													50,000,000
Earthquake Wind Hail and Flood
Commitments and Contingencies Disclosure [Line Items]
Maximum insurance deductible													5,000,000
All Other Events
Commitments and Contingencies Disclosure [Line Items]
Maximum insurance deductible													5,000,000
Cygnet Health Care Limited
Commitments and Contingencies Disclosure [Line Items]
Property insurance \| £						£ 1,500.0
Maximum
Commitments and Contingencies Disclosure [Line Items]
Self-insured for professional and general liability													10,000,000
Purchased several excess policies through commercial insurance carriers per occurrence													25,000,000
Commercial property insurance policies covering catastrophic losses													$ 1,000,000,000
Lease initial terms						10 years							10 years
Maximum \| Cumberland Hospital for Children and Adolescents \| Punitive Damages
Commitments and Contingencies Disclosure [Line Items]
Damages awarded		$ 1,050,000.00
Maximum \| Subsequent Event \| The Pavilion Behavioral Health System \| Punitive Damages
Commitments and Contingencies Disclosure [Line Items]
Damages awarded	$ 475,000,000
Maximum \| Wind Storms
Commitments and Contingencies Disclosure [Line Items]
Percentage of insurance deductible						5.00%							5.00%
Maximum \| Earthquake \| CALIFORNIA
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses													$ 100,000,000
Maximum \| Earthquake \| Faulty Zones of UNITED STATES
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses													100,000,000
Maximum \| Earthquake \| PUERTO RICO
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses													40,000,000
Maximum \| Earthquake \| OTHER STATES
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses													250,000,000
Maximum \| Earthquake \| California, New Madrid Seismic Zone, Pacific Northwest Seismic Zone, Alaska and certain counties in Nevada
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses													100,000,000
Maximum \| Flood
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses													100,000,000
Maximum \| Flood \| PUERTO RICO
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses													1,000,000
Maximum \| Flood \| Texas
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses													$ 10,000,000
Minimum
Commitments and Contingencies Disclosure [Line Items]
Lease initial terms						5 years							5 years
Loss on business interruption insurance recovery							15,000,000
Minimum \| District Facilities
Commitments and Contingencies Disclosure [Line Items]
Committment to expend							75,000,000
Minimum \| Subsequent Event \| The Pavilion Behavioral Health System \| Punitive Damages
Commitments and Contingencies Disclosure [Line Items]
Damages awarded	$ 120,000,000
Minimum \| Wind Storms
Commitments and Contingencies Disclosure [Line Items]
Percentage of insurance deductible						3.00%							3.00%
Professional Liability \| The Pavilion Behavioral Health System
Commitments and Contingencies Disclosure [Line Items]
Self-insured retention amounts													$ 10,000,000
Professional Liability \| Cumberland Hospital for Children and Adolescents
Commitments and Contingencies Disclosure [Line Items]
Self-insured retention amounts													10,000,000
General Liability \| The Pavilion Behavioral Health System
Commitments and Contingencies Disclosure [Line Items]
Self-insured retention amounts													3,000,000
General Liability \| Cumberland Hospital for Children and Adolescents
Commitments and Contingencies Disclosure [Line Items]
Self-insured retention amounts													3,000,000
General And Professional Liability Insurance Policies
Commitments and Contingencies Disclosure [Line Items]
Self-insured for professional and general liability				$ 30,000,000	$ 5,000,000		$ 44,000,000	$ 25,000,000
General and Professional Liability
Commitments and Contingencies Disclosure [Line Items]
Self-insured for professional and general liability													480,000,000	431,000,000
Subsidiaries \| Professional Liability \| Cygnet Health Care Limited
Commitments and Contingencies Disclosure [Line Items]
Self-insured for professional and general liability \| £						£ 18.5
Subsidiaries \| Professional Liability \| Maximum
Commitments and Contingencies Disclosure [Line Items]
Self-insured for professional and general liability									20,000,000				20,000,000	20,000,000	$ 20,000,000	$ 10,000,000	$ 5,000,000	$ 5,000,000	$ 5,000,000	$ 10,000,000
Subsidiaries \| General Liability \| Cygnet Health Care Limited
Commitments and Contingencies Disclosure [Line Items]
Self-insured for professional and general liability \| £						£ 25.0
Subsidiaries \| General Liability \| Maximum
Commitments and Contingencies Disclosure [Line Items]
Self-insured for professional and general liability									3,000,000				3,000,000	3,000,000	3,000,000	$ 3,000,000	$ 3,000,000	$ 3,000,000	$ 3,000,000	$ 3,000,000
Subsidiaries \| General And Professional Liability Insurance Policies \| Maximum
Commitments and Contingencies Disclosure [Line Items]
Purchased several excess policies through commercial insurance carriers per occurrence									$ 162,000,000		$ 250,000,000		$ 175,000,000	$ 165,000,000	$ 155,000,000

Revenue (Tables)

9 Months Ended

Sep. 30, 2024

Revenue from Contract with Customer [Abstract]

Schedule of Disaggregates Revenue by Major Source

The following table disaggregates our revenue by major source for the three and nine-month periods ended September 30, 2024 and 2023 (in thousands):


	For the three months ended September 30, 2024
	Acute Care				Behavioral Health				Other		Total
Medicare	$	322,466	14	%	$	81,148	5	%			$	403,614	10	%
Managed Medicare		361,804	16	%		107,910	6	%				469,714	12	%
Medicaid		296,966	13	%		262,393	15	%				559,359	14	%
Managed Medicaid		154,762	7	%		422,563	25	%				577,325	15	%
Managed Care (HMO and PPOs)		725,014	32	%		401,004	23	%				1,126,018	28	%
UK Revenue		0	0	%		230,153	13	%				230,153	6	%
Other patient revenue and adjustments, net		117,679	5	%		155,332	9	%				273,011	7	%
Other non-patient revenue		266,826	12	%		54,411	3	%		2,596		323,833	8	%
Total Net Revenue	$	2,245,517	100	%	$	1,714,914	100	%	$	2,596		3,963,027	100	%

	For the nine months ended September 30, 2024
	Acute Care				Behavioral Health				Other		Total
Medicare	$	1,009,630	15	%	$	234,295	5	%			$	1,243,925	11	%
Managed Medicare		1,104,493	17	%		307,388	6	%				1,411,881	12	%
Medicaid		771,298	12	%		804,254	16	%				1,575,552	13	%
Managed Medicaid		466,881	7	%		1,262,108	25	%				1,728,989	15	%
Managed Care (HMO and PPOs)		2,129,117	32	%		1,227,056	24	%				3,356,173	29	%
UK Revenue		0	0	%		650,655	13	%				650,655	6	%
Other patient revenue and adjustments, net		375,161	6	%		449,609	9	%				824,770	7	%
Other non-patient revenue		747,427	11	%		166,925	3	%		7,916		922,268	8	%
Total Net Revenue	$	6,604,007	100	%	$	5,102,290	100	%	$	7,916	$	11,714,213	100	%

	For the three months ended September 30, 2023
	Acute Care				Behavioral Health				Other		Total
Medicare	$	298,121	15	%	$	81,689	5	%			$	379,810	11	%
Managed Medicare		324,486	16	%		95,094	6	%				419,580	12	%
Medicaid		201,148	10	%		204,154	13	%				405,302	11	%
Managed Medicaid		181,051	9	%		387,975	25	%				569,026	16	%
Managed Care (HMO and PPOs)		651,816	32	%		383,146	25	%				1,034,962	29	%
UK Revenue		0	0	%		202,994	13	%				202,994	6	%
Other patient revenue and adjustments, net		108,676	5	%		129,492	8	%				238,168	7	%
Other non-patient revenue		251,990	12	%		58,151	4	%		2,791		312,932	9	%
Total Net Revenue	$	2,017,288	100	%	$	1,542,695	100	%	$	2,791	$	3,562,774	100	%

	For the nine months ended September 30, 2023
	Acute Care				Behavioral Health				Other		Total
Medicare	$	961,640	16	%	$	233,930	5	%			$	1,195,570	11	%
Managed Medicare		1,013,493	17	%		255,782	6	%				1,269,275	12	%
Medicaid		445,678	7	%		625,956	14	%				1,071,634	10	%
Managed Medicaid		545,173	9	%		1,184,315	26	%				1,729,488	16	%
Managed Care (HMO and PPOs)		2,009,110	34	%		1,160,820	25	%				3,169,930	30	%
UK Revenue		0	0	%		560,897	12	%				560,897	5	%
Other patient revenue and adjustments, net		303,923	5	%		387,327	8	%				691,250	7	%
Other non-patient revenue		714,882	12	%		166,351	4	%		9,153		890,386	8	%
Total Net Revenue	$	5,993,899	100	%	$	4,575,378	100	%	$	9,153	$	10,578,430	100	%

Treasury

9 Months Ended

Sep. 30, 2024

Equity [Abstract]

Treasury

(4) Treasury

In September, 2024, we completed the following financing transactions:

•

The public offering of $500 million of aggregate principal amount of 4.625% senior secured notes due on October 15, 2029 ("2029 Notes");

•

The public offering of $500 million of aggregate principal amount of 5.050% senior secured notes due on October 15, 2034 ("2034 Notes");

•

Amended our credit agreement to:

Extend the maturity date to September, 2029 (from August, 2026 previously);

Increase the revolving credit facility to $1.3 billion (from $1.2 billion previously), and;

reduce the outstanding borrowings pursuant to the tranche term loan A facility by approximately $1.0 billion, to $1.2 billion, utilizing the proceeds generated from the issuance of the above-mentioned 2029 Notes and 2034 Notes.

On September 26, 2024, we entered into a tenth amendment ("Tenth Amendment") to our credit agreement ("Credit Agreement"), dated as of November 15, 2010, as amended and restated at various times from March, 2011 to June, 2022, among UHS, as borrower, the several banks and other financial institutions or entities from time to time parties thereto, as lenders, and JPMorgan Chase Bank, N.A., as administrative agent. The Tenth Amendment provided for: (i) an extension of the maturity date to September 26, 2029; (ii) a new revolving credit facility of up to $1.3 billion (which as of September 30, 2024, had $1.01 billion of aggregate available borrowing capacity, net of $288 million of outstanding borrowings and $3 million of letters of credit), and; (iii) a new replacement tranche A term loan facility ("Tranche A Term Loan") of up to $1.2 billion (which had $1.2 billion of outstanding borrowings as of September 30, 2024).

Pursuant to the terms of the Tenth Amendment, the Tranche A Term Loan provides for installment payments of $7.5 million per quarter commencing on December 31, 2024 through September 30, 2026, and $15.0 million per quarter commencing on December 31, 2026 through June 30, 2029. The unpaid principal balance at June 30, 2029 (scheduled to be $975.0 million) is payable on the September 26, 2029 scheduled maturity date of the Credit Agreement.

Revolving credit and Tranche A Term Loan borrowings under the Credit Agreement bear interest at our election at either (1) the ABR rate which is defined as the rate per annum equal to the greatest of (a) the lender’s prime rate, (b) the weighted average of the federal funds rate, plus 0.5% and (c) one month term SOFR rate plus 1%, in each case, plus an applicable margin based upon our consolidated leverage ratio at the end of each quarter ranging from 0.25% to 0.625%, or (2) the one, three or six month term SOFR rate plus 0.1% (at our election), plus an applicable margin based upon our consolidated leverage ratio at the end of each quarter ranging from 1.25% to 1.625%. As of September 30, 2024, the applicable margins were 0.375% for ABR-based loans and 1.375% for SOFR-based loans under the revolving credit and term loan A facilities. The revolving credit facility includes a $125 million sub-limit for letters of credit. The Credit Agreement is secured by certain assets of the Company and our material subsidiaries (which generally excludes asset classes such as substantially all of the patient-related accounts receivable of our acute care hospitals, if sold to a receivables facility pursuant to the Credit Agreement, and certain real estate assets and assets held in joint-ventures with third parties) and is guaranteed by our material subsidiaries.

The Credit Agreement includes a material adverse change clause that must be represented at each draw. The Credit Agreement also contains covenants that include a limitation on sales of assets, mergers, change of ownership, liens, indebtedness, transactions with affiliates, dividends and stock repurchases; and requires compliance with financial covenants including maximum leverage. We were in compliance with all required covenants as of September 30, 2024 pursuant to the terms of the Credit Agreement, as amended on September 26, 2024, and as of December 31, 2023 pursuant to the terms of the previous credit agreement.

As mentioned above, on September 26, 2024, we completed the public offering of: (i) $500,000,000 aggregate principal amount of the 4.625%, 2029 Notes, and; (ii) $500,000,000 aggregate principal amount of the 5.050%, 2034 Notes (and together with the 2029 Notes, the "2029 and 2034 Notes"), each guaranteed on a senior secured basis by all of our existing and future direct and indirect subsidiaries that guarantee our senior secured credit facility or our other first lien obligations or any junior lien obligations (the “Subsidiary Guarantors”). The 2029 and 2034 Notes have been registered under the Securities Act of 1933, as amended (the “Securities Act”), pursuant to the Issuer’s and the Subsidiary Guarantors’ registration statement on Form S-3 (File No. 333-282135), including the prospectus dated September 16, 2024, and a related prospectus supplement dated September 17, 2024, as filed with the Securities and Exchange Commission on September 19, 2024.

As of September 30, 2024, including the above-mentioned newly issued Notes, we had combined aggregate principal of $3.0 billion from the following senior secured notes:

•

$700 million aggregate principal amount of 1.65% senior secured notes due in September, 2026 ("2026 Notes") which were issued on August 24, 2021. Interest on the 2026 Notes is payable on March 1st and September 1st until the maturity date of September 1, 2026.

•

$500 million of aggregate principal amount of 4.625% senior secured notes due in October, 2029 ("2029 Notes") which were issued on September 26, 2024. Interest on the 2029 Notes is payable on April 15th and October 15th, commencing April 15, 2025 until the maturity date of October 15, 2029.

•

$800 million aggregate principal amount of 2.65% senior secured notes due in October, 2030 ("2030 Notes") which were issued on September 21, 2020. Interest on the 2030 Notes is payable on April 15th and October 15th, until the maturity date of October 15, 2030.

•

$500 million of aggregate principal amount of 2.65% senior secured notes due in January, 2032 ("2032 Notes") which were issued on August 24, 2021. Interest on the 2032 Notes is payable on January 15th and July 15th until the maturity date of January 15, 2032.

•

$500 million of aggregate principal amount of 5.050% senior secured notes due in October, 2034 ("2034 Notes") which were issued on September 26, 2024. Interest on the 2034 Notes is payable on April 15th and October 15th, commencing on April 15, 2025 until the maturity date of October 15, 2034.

The 2026 Notes, 2030 Notes and 2032 Notes (collectively the "2026, 2030 and 2032 Notes") were initially issued only to qualified institutional buyers under Rule 144A and to non-U.S. persons outside the United States in reliance on Regulation S under the Securities Act. In December, 2022, we completed a registered exchange offer in which virtually all previously outstanding 2026, 2030 and 2032 Notes were exchanged for identical 2026, 2030 and 2032 Notes that were registered under the Securities Act, and thereby became freely transferable (subject to certain restrictions applicable to affiliates and broker dealers). 2026, 2030 and 2032 Notes originally issued under Rule 144A or Regulation S that were not exchanged remain outstanding and may not be offered or sold in the United States absent registration under the Securities Act or an applicable exemption from registration requirements thereunder.

The 2026, 2030 and 2032 Notes, and the 2029 and 2034 Notes (collectively "All the Notes") are guaranteed (the “Guarantees”) on a senior secured basis by our Subsidiary Guarantors that guarantee our Credit Agreement, or other first lien obligations or any junior lien obligations. All the Notes and the Guarantees are secured by first-priority liens, subject to permitted liens, on certain of the Company’s and the Subsidiary Guarantors’ assets now owned or acquired in the future by the Company or the Subsidiary Guarantors (other than real property, accounts receivable sold pursuant to a Company-related receivables facility (as defined in the Indenture pursuant to which All The Notes were issued (the “Indentures”), and certain other excluded assets). The Company’s obligations with respect to All the Notes, the obligations of the Subsidiary Guarantors under the Guarantees, and the performance of all of the Company’s and the Subsidiary Guarantors’ other obligations under the Indentures, are secured equally and ratably with the Company’s and the Subsidiary Guarantors’ obligations under the Credit Agreement. However, the liens on the collateral securing All the Notes and the Guarantees will be released if: (i) All the Notes have investment grade ratings; (ii) no default has occurred and is continuing, and; (iii) the liens on the collateral securing all first lien obligations (including the Credit Agreement and All the Notes) and any junior lien obligations are released or the collateral under the Credit Agreement, any other first lien obligations and any junior lien obligations is released or no longer required to be pledged. The liens on any collateral securing All the Notes and the Guarantees will also be released if the liens on that collateral securing the Credit Agreement, other first lien obligations and any junior lien obligations are released.

As discussed in Note 2 to the Condensed Consolidated Financial Statements-Relationship with Universal Health Realty Income Trust and Other Related Party Transactions, on December 31, 2021, we (through wholly-owned subsidiaries of ours) entered into an asset purchase and sale agreement with Universal Health Realty Income Trust (the “Trust”). Pursuant to the terms of the agreement, which was amended during the first quarter of 2022, we, among other things, transferred to the Trust, the real estate assets of Aiken Regional Medical Center (“Aiken”) and Canyon Creek Behavioral Health (“Canyon Creek”). In connection with this transaction, Aiken and Canyon Creek (as lessees), entered into a master lease and individual property leases, as amended, (with the Trust as lessor), for initial lease terms on each property of approximately twelve years, ending on December 31, 2033. As a result of our purchase option within

the Aiken and Canyon Creek lease agreements, this asset purchase and sale transaction is accounted for as a failed sale leaseback in accordance with U.S. GAAP and we have accounted for the transaction as a financing arrangement. Our lease payments payable to the Trust are recorded to interest expense and as a reduction of the outstanding financial liability, and the amount allocated to interest expense is determined based upon our incremental borrowing rate and the outstanding financial liability. In connection with this transaction, our consolidated balance sheets at September 30, 2024 and December 31, 2023 reflect financial liabilities, which are included in debt, of approximately $75 million and $77 million, respectively.

At September 30, 2024, the carrying value and fair value of our debt were approximately $4.7 billion and $4.4 billion, respectively. At December 31, 2023, the carrying value and fair value of our debt were approximately $4.9 billion and $4.6 billion, respectively. The fair value of our debt was computed based upon quotes received from financial institutions. We consider these to be “level 2” in the fair value hierarchy as outlined in the authoritative guidance for disclosures in connection with debt instruments.

The aggregate scheduled maturities of our $4.7 billion total debt outstanding as of September 30, 2024 (before $21 million of unamortized financing costs), are as follows: (i) $38 million due during the next 12 months; (ii) $738 million due during months 13 to 24; (iii) $69 million due during months 25 to 36; (iv) $70 million due during months 37 to 48; (v) $1.3 billion due during months 49 to 60, and; (vi) $2.4 billion due in greater than 60 months.

Foreign Currency Forward Exchange Contracts:

We use forward exchange contracts to hedge our net investment in foreign operations against movements in exchange rates. The effective portion of the unrealized gains or losses on these contracts is recorded in foreign currency translation adjustment within accumulated other comprehensive income and remains there until either the sale or liquidation of the subsidiary. In connection with these forward exchange contracts, we recorded net cash outflows of $36 million during the nine-month period ended September 30, 2024 and net cash outflows of $8 million during the nine-month period ended September 30, 2023.

Derivatives Hedging Relationships:


	Gain/(Loss) recognized in AOCI
	Three months ended					Nine months ended
	September 30,			September 30,		September 30,			September 30,
	2024			2023		2024			2023
Net Investment Hedge relationships
Foreign currency forward exchange contracts	$	(43,490	)	$	19,619	$	(35,289	)	$	(10,781	)

No other gains or losses were recognized in income related to derivatives in Subtopic 815-20.

Cash, Cash Equivalents and Restricted Cash:


	September 30,		September 30,		December 31,
	2024		2023		2023
Cash and cash equivalents	$	106,077	$	80,768	$	119,439
Restricted cash (a)		98,520		99,871		95,031
Total cash, cash equivalents and restricted cash	$	204,597	$	180,639	$	214,470

(a) Restricted cash is included in other noncurrent assets on the accompanying condensed consolidated balance sheets.

Relationship with Universal Health Realty Income Trust and Other Related Party Transactions - Additional Information 1 (Detail) - Relationship with Universal Health Realty Income Trust $ in Millions	3 Months Ended	9 Months Ended	12 Months Ended
	Mar. 31, 2023 Bed	Sep. 30, 2024 Bed	Dec. 31, 2021 USD ($) Bed
Related Party Transaction [Line Items]
Number of beds available in acute care hospital	170
Behavioral Health Care Facility
Related Party Transaction [Line Items]
Number of bed available in behavioral health care facility		100
Asset Purchase and Sale Agreement \| Subsidiaries
Related Party Transaction [Line Items]
Cash received for sale of real estate asset \| $			$ 4.1
Aiken South Carolina \| Aiken Regional Medical Center \| Asset Purchase and Sale Agreement \| Subsidiaries \| Acute Care Hospital Services
Related Party Transaction [Line Items]
Number of beds available in acute care hospital			211
Aiken South Carolina \| Aiken Regional Medical Center \| Asset Purchase and Sale Agreement \| Subsidiaries \| Behavioral Health Care Facility
Related Party Transaction [Line Items]
Number of bed available in behavioral health care facility			62

Dividends - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Dividends [Abstract]
Dividends declared and paid	$ 13.3	$ 13.8	$ 40.3	$ 42.2
Dividends declared and paid, per share	$ 0.2	$ 0.2	$ 0.6	$ 0.6

Recent Accounting Standards

9 Months Ended

Sep. 30, 2024

Accounting Changes and Error Corrections [Abstract]

Recent Accounting Standards

(14) Recent Accounting Standards

In November 2024, the FASB issued ASU 2024-03, “Income Statement-Reporting Comprehensive Income-Expense Disaggregation Disclosures (subtopic 220-40)". ASU 2024-03 requires disclosures, in the notes to financial statements, of specified information about certain costs and expenses. This ASU is effective for fiscal years beginning after December 15, 2026, with early adoption permitted. We are currently evaluating the impact this new standard will have on the related disclosures in the consolidated financial statements.

In November 2023, the FASB issued ASU 2023-07, “Improvements to Reportable Segment Disclosures (Topic 280)”. ASU 2023-07 modifies reportable segment disclosure requirements, primarily through enhanced disclosures about segment expenses categorized as significant or regularly provided to the Chief Operating Decision Maker (CODM). In addition, the amendments enhance interim disclosure requirements, clarify circumstances in which an entity can disclose multiple segment measures of profit or loss, and contain other disclosure requirements. The purpose of the amendments is to enable investors to better understand an entity’s overall performance and assess potential future cash flows. This ASU is effective for annual periods beginning after December 15, 2023, and interim periods within annual periods beginning after December 15, 2024, with early adoption permitted. We are currently evaluating the impact this new standard will have on the related disclosures in the consolidated financial statements, but do not believe there will be a material impact.

In December 2023, the FASB issued ASU 2023-09, “Improvements to Income Tax Disclosures (Topic 740)”. ASU 2023-09 requires enhanced disclosures on income taxes paid, adds disaggregation of continuing operations before income taxes between foreign and domestic earnings and defines specific categories for the reconciliation of jurisdictional tax rate to effective tax rate. This ASU is effective for fiscal years beginning after December 15, 2024, and can be applied on a prospective basis. We are currently evaluating the impact this new standard will have on the related disclosures in the consolidated financial statements.

From time to time, new accounting guidance is issued by the FASB or other standard setting bodies that is adopted by the Company as of the effective date or, in some cases where early adoption is permitted, in advance of the effective date. The Company has assessed the recently issued guidance that is not yet effective and believes the new guidance will not have a material impact on our results of operations, cash flows or financial position.

- Definition

The entire disclosure for change in accounting principle. Includes, but is not limited to, nature, reason, and method of adopting amendment to accounting standards or other change in accounting principle.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-Name Accounting Standards Codification
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-Paragraph 1
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-Publisher FASB
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/1943274/2147483443/250-10-50-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 65
-Paragraph 2
-Subparagraph (g)(2)
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-URI https://asc.fasb.org/1943274/2147478666/740-323-65-2

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/1943274/2147480016/944-40-65-2

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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Reference 16: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 17: http://www.xbrl.org/2003/role/disclosureRef
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Reference 18: http://www.xbrl.org/2003/role/disclosureRef
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Reference 19: http://www.xbrl.org/2003/role/disclosureRef
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Reference 20: http://www.xbrl.org/2003/role/disclosureRef
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Reference 21: http://www.xbrl.org/2003/role/disclosureRef
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Reference 22: http://www.xbrl.org/2003/role/disclosureRef
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Reference 23: http://www.xbrl.org/2003/role/disclosureRef
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Reference 24: http://www.xbrl.org/2003/role/disclosureRef
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Reference 25: http://www.xbrl.org/2003/role/disclosureRef
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Reference 26: http://www.xbrl.org/2003/role/disclosureRef
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Reference 27: http://www.xbrl.org/2003/role/disclosureRef
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Reference 28: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/1943274/2147480175/815-40-65-1

+ Details

Condensed Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Statement of Comprehensive Income [Abstract]
Net income	$ 265,910	$ 168,008	$ 826,062	$ 499,685
Other comprehensive income (loss):
Foreign currency translation adjustment	29,221	(24,631)	29,155	(703)
Other			17
Other comprehensive income (loss) before tax	29,221	(24,631)	29,172	(703)
Income tax expense (benefit) related to items of other comprehensive income (loss)	(140)	(926)	288	(95)
Total other comprehensive (loss) income, net of tax	29,361	(23,705)	28,884	(608)
Comprehensive income	295,271	144,303	854,946	499,077
Less: Comprehensive income (loss) attributable to noncontrolling interests	7,196	1,019	16,362	(1,732)
Comprehensive income attributable to UHS	$ 288,075	$ 143,284	$ 838,584	$ 500,809

Lease Accounting - Additional Information (Detail)	9 Months Ended
Lease Accounting - Additional Information (Detail)	Sep. 30, 2024 Hospital
Lessee Lease Description [Line Items]
Lessee, operating lease, existence of option to extend [true false]	true
Number of hospital facilities	5
Two Hospital Facilities
Lessee Lease Description [Line Items]
Lease expiration term	2026
Another Two Hospital Facilities
Lessee Lease Description [Line Items]
Lease expiration term	2033
One Hospital Facility
Lessee Lease Description [Line Items]
Lease expiration term	2040
Minimum
Lessee Lease Description [Line Items]
Initial term of real estate lease	5 years
Real estate leases option to extend lease term	5 years
Maximum
Lessee Lease Description [Line Items]
Initial term of real estate lease	10 years
Real estate leases option to extend lease term	10 years

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 106,077	$ 119,439
Accounts receivable, net	2,214,268	2,238,265
Supplies	220,062	216,988
Other current assets	261,549	236,658
Total current assets	2,801,956	2,811,350
Property and equipment	12,448,230	11,777,047
Less: accumulated depreciation	(6,005,664)	(5,652,518)
Property, plant and equipment, net, Total	6,442,566	6,124,529
Other assets:
Goodwill	3,965,492	3,932,407
Deferred income taxes	121,904	85,626
Right of use assets-operating leases	421,441	433,962
Deferred charges	9,705	6,974
Other	590,784	572,754
Total Assets	14,353,848	13,967,602
Current liabilities:
Current maturities of long-term debt	38,351	126,686
Accounts payable and other liabilities	1,896,234	1,813,015
Operating lease liabilities	72,801	71,600
Federal and state taxes	3,802	2,046
Total current liabilities	2,011,188	2,013,347
Other noncurrent liabilities	660,247	584,007
Operating lease liabilities noncurrent	377,644	382,559
Long-term debt	4,618,060	4,785,783
Redeemable noncontrolling interests	5,623	5,191
Equity:
UHS common stockholders’ equity	6,605,696	6,149,001
Noncontrolling interest	75,390	47,714
Total equity	6,681,086	6,196,715
Total Liabilities and Stockholders’ Equity	$ 14,353,848	$ 13,967,602

Dispositions and Acquisitions - Additional Information (Detail) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Business Acquisition [Line Items]
Acquisition, cash paid		$ 4
Aggregate cash proceeds from divestiture of businesses	$ 30	$ 24

Relationship with Universal Health Realty Income Trust and Other Related Party Transactions - Additional Information 2 (Detail) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Sep. 30, 2024 USD ($) Bed	Sep. 30, 2023 USD ($)	Dec. 31, 2023 USD ($)
Related Party Transaction [Line Items]
Lease and rental expense	$ 36,540	$ 35,466	$ 108,165	$ 105,775
Relationship with Universal Health Realty Income Trust
Related Party Transaction [Line Items]
Financial liability included in debt	74,800		74,800		$ 77,500
Lease and rental expense	$ 5,000	$ 5,000	$ 16,000	15,000
Notice period on renewal of lease			90 days
Behavioral Health Care Facility \| Relationship with Universal Health Realty Income Trust
Related Party Transaction [Line Items]
Lease and rental expense			$ 2,800	$ 2,700
Notice period on renewal of lease			270 days
Number of bed available in behavioral health care facility \| Bed			100
Period of rights of refusal to leased facilities			30 days

Other Noncurrent Liabilities and Redeemable/Noncontrolling Interests - Additional Information (Detail) $ in Millions	Sep. 30, 2024 USD ($) Facility
Minority Interest [Line Items]
Behavioral health care facilities with outside owners holding non-controlling minority interest \| Facility	6
Non-controlling interest balances \| $	$ 5
Redeemable non-controlling interest balances \| $	$ 6
Michigan
Minority Interest [Line Items]
Behavioral health care facilities with outside owners holding non-controlling minority interest \| Facility	2
Outside Owners \| Acute Care Facility \| Texas
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	7.00%
Outside Owners \| Acute Care Facility \| Nevada
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	5.00%
Outside Owners \| Behavioral Health Care Facility \| Arizona
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	49.00%
Outside Owners \| Behavioral Health Care Facility \| Pennsylvania
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	20.00%
Outside Owners \| Behavioral Health Care Facility \| Ohio
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	30.00%
Outside Owners \| Behavioral Health Care Facility \| Washington
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	20.00%
Outside Owners \| Behavioral Health Care Facility \| Missouri
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	25.00%
Outside Owners \| Behavioral Health Care Facility \| Iowa
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	48.00%
Outside Owners \| Behavioral Health Care Facility One \| Michigan
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	26.00%
Outside Owners \| Behavioral Health Care Facility Two \| Michigan
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	49.00%
Outside Owners \| Surgery center \| Nevada
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	49.00%

Schedule of Disaggregates Revenue by Major Source (Detail) - USD ($)
$ in Thousands

3 Months Ended

9 Months Ended

Sep. 30, 2024

Sep. 30, 2023

Sep. 30, 2024

Sep. 30, 2023

Disaggregation Of Revenue [Line Items]

Net revenues

$ 3,963,027

$ 3,562,774

$ 11,714,213

$ 10,578,430

Percentage of Net Revenue

100.00%

Medicare

Disaggregation Of Revenue [Line Items]

Net revenues

$ 403,614

$ 379,810

$ 1,243,925

$ 1,195,570

Percentage of Net Revenue

10.00%

11.00%

Managed Medicare

Disaggregation Of Revenue [Line Items]

Net revenues

$ 469,714

$ 419,580

$ 1,411,881

$ 1,269,275

Percentage of Net Revenue

12.00%

Medicaid

Disaggregation Of Revenue [Line Items]

Net revenues

$ 559,359

$ 405,302

$ 1,575,552

$ 1,071,634

Percentage of Net Revenue

14.00%

11.00%

13.00%

10.00%

Managed Medicaid

Disaggregation Of Revenue [Line Items]

Net revenues

$ 577,325

$ 569,026

$ 1,728,989

$ 1,729,488

Percentage of Net Revenue

15.00%

16.00%

15.00%

16.00%

Managed Care (HMO and PPOs)

Disaggregation Of Revenue [Line Items]

Net revenues

$ 1,126,018

$ 1,034,962

$ 3,356,173

$ 3,169,930

Percentage of Net Revenue

28.00%

29.00%

30.00%

UK Revenue

Disaggregation Of Revenue [Line Items]

Net revenues

$ 230,153

$ 202,994

$ 650,655

$ 560,897

Percentage of Net Revenue

6.00%

5.00%

Other Patient Revenue and Adjustments, Net

Disaggregation Of Revenue [Line Items]

Net revenues

$ 273,011

$ 238,168

$ 824,770

$ 691,250

Percentage of Net Revenue

7.00%

Other Non-patient Revenue

Disaggregation Of Revenue [Line Items]

Net revenues

$ 323,833

$ 312,932

$ 922,268

$ 890,386

Percentage of Net Revenue

8.00%

9.00%

8.00%

Acute Care Hospital Services

Disaggregation Of Revenue [Line Items]

Net revenues

$ 2,245,517

$ 2,017,288

$ 6,604,007

$ 5,993,899

Percentage of Net Revenue

100.00%

Acute Care Hospital Services | Medicare

Disaggregation Of Revenue [Line Items]

Net revenues

$ 322,466

$ 298,121

$ 1,009,630

$ 961,640

Percentage of Net Revenue

14.00%

15.00%

16.00%

Acute Care Hospital Services | Managed Medicare

Disaggregation Of Revenue [Line Items]

Net revenues

$ 361,804

$ 324,486

$ 1,104,493

$ 1,013,493

Percentage of Net Revenue

16.00%

17.00%

Acute Care Hospital Services | Medicaid

Disaggregation Of Revenue [Line Items]

Net revenues

$ 296,966

$ 201,148

$ 771,298

$ 445,678

Percentage of Net Revenue

13.00%

10.00%

12.00%

7.00%

Acute Care Hospital Services | Managed Medicaid

Disaggregation Of Revenue [Line Items]

Net revenues

$ 154,762

$ 181,051

$ 466,881

$ 545,173

Percentage of Net Revenue

7.00%

9.00%

7.00%

9.00%

Acute Care Hospital Services | Managed Care (HMO and PPOs)

Disaggregation Of Revenue [Line Items]

Net revenues

$ 725,014

$ 651,816

$ 2,129,117

$ 2,009,110

Percentage of Net Revenue

32.00%

34.00%

Acute Care Hospital Services | UK Revenue

Disaggregation Of Revenue [Line Items]

Net revenues

$ 0

Percentage of Net Revenue

0.00%

Acute Care Hospital Services | Other Patient Revenue and Adjustments, Net

Disaggregation Of Revenue [Line Items]

Net revenues

$ 117,679

$ 108,676

$ 375,161

$ 303,923

Percentage of Net Revenue

5.00%

6.00%

5.00%

Acute Care Hospital Services | Other Non-patient Revenue

Disaggregation Of Revenue [Line Items]

Net revenues

$ 266,826

$ 251,990

$ 747,427

$ 714,882

Percentage of Net Revenue

12.00%

11.00%

12.00%

Behavioral Health Services

Disaggregation Of Revenue [Line Items]

Net revenues

^[1]

$ 1,714,914

$ 1,542,695

$ 5,102,290

$ 4,575,378

Percentage of Net Revenue

100.00%

Behavioral Health Services | Medicare

Disaggregation Of Revenue [Line Items]

Net revenues

$ 81,148

$ 81,689

$ 234,295

$ 233,930

Percentage of Net Revenue

5.00%

Behavioral Health Services | Managed Medicare

Disaggregation Of Revenue [Line Items]

Net revenues

$ 107,910

$ 95,094

$ 307,388

$ 255,782

Percentage of Net Revenue

6.00%

Behavioral Health Services | Medicaid

Disaggregation Of Revenue [Line Items]

Net revenues

$ 262,393

$ 204,154

$ 804,254

$ 625,956

Percentage of Net Revenue

15.00%

13.00%

16.00%

14.00%

Behavioral Health Services | Managed Medicaid

Disaggregation Of Revenue [Line Items]

Net revenues

$ 422,563

$ 387,975

$ 1,262,108

$ 1,184,315

Percentage of Net Revenue

25.00%

26.00%

Behavioral Health Services | Managed Care (HMO and PPOs)

Disaggregation Of Revenue [Line Items]

Net revenues

$ 401,004

$ 383,146

$ 1,227,056

$ 1,160,820

Percentage of Net Revenue

23.00%

25.00%

24.00%

25.00%

Behavioral Health Services | UK Revenue

Disaggregation Of Revenue [Line Items]

Net revenues

$ 230,153

$ 202,994

$ 650,655

$ 560,897

Percentage of Net Revenue

13.00%

12.00%

Behavioral Health Services | Other Patient Revenue and Adjustments, Net

Disaggregation Of Revenue [Line Items]

Net revenues

$ 155,332

$ 129,492

$ 449,609

$ 387,327

Percentage of Net Revenue

9.00%

8.00%

9.00%

8.00%

Behavioral Health Services | Other Non-patient Revenue

Disaggregation Of Revenue [Line Items]

Net revenues

$ 54,411

$ 58,151

$ 166,925

$ 166,351

Percentage of Net Revenue

3.00%

4.00%

3.00%

4.00%

Other

Disaggregation Of Revenue [Line Items]

Net revenues

$ 2,596

$ 2,791

$ 7,916

$ 9,153

Other | Other Non-patient Revenue

Disaggregation Of Revenue [Line Items]

Net revenues

$ 2,596

$ 2,791

$ 7,916

$ 9,153

[1]

Document and Entity Information - shares	9 Months Ended
Document and Entity Information - shares	Sep. 30, 2024	Oct. 31, 2024
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2024
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q3
Trading Symbol	UHS
Entity Registrant Name	UNIVERSAL HEALTH SERVICES, INC.
Entity Central Index Key	0000352915
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Current Reporting Status	Yes
Entity Shell Company	false
Entity File Number	1-10765
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	23-2077891
Entity Address, Address Line One	UNIVERSAL CORPORATE CENTER
Entity Address, Address Line Two	367 SOUTH GULPH ROAD
Entity Address, City or Town	KING OF PRUSSIA
Entity Address, State or Province	PA
Entity Address, Postal Zip Code	19406
City Area Code	610
Local Phone Number	768-3300
Entity Interactive Data Current	Yes
Security Exchange Name	NYSE
Title of 12(b) Security	Class B Common Stock, $0.01 par value
Document Quarterly Report	true
Document Transition Report	false
Class A
Document Information [Line Items]
Entity Common Stock, Shares Outstanding		6,576,475
Class B
Document Information [Line Items]
Entity Common Stock, Shares Outstanding		58,714,711
Class C
Document Information [Line Items]
Entity Common Stock, Shares Outstanding		661,688
Class D
Document Information [Line Items]
Entity Common Stock, Shares Outstanding		12,774

Revenue

9 Months Ended

Sep. 30, 2024

Revenue from Contract with Customer [Abstract]

Revenue

(12) Revenue

We recognize revenue when we transfer promised goods or services to customers in an amount that reflects the consideration to which we expect to be entitled in exchange for those goods or services. Our estimate for amounts not expected to be collected based on historical experience will continue to be recognized as a reduction to net revenue. However, subsequent changes in estimate of collectability due to a change in the financial status of a payer, for example a bankruptcy, will be recognized as bad debt expense in operating charges.

The performance obligation is separately identifiable from other promises in the customer contract. As the performance obligations are met (i.e. room, board, ancillary services, level of care), revenue is recognized based upon allocated transaction price. The transaction price is allocated to separate performance obligations based upon the relative standalone selling price. In instances where we determine there are multiple performance obligations across multiple months, the transaction price will be allocated by applying an estimated implicit and explicit rate to gross charges based on the separate performance obligations.

In assessing collectability, we have elected the portfolio approach. This portfolio approach is being used as we have large volume of similar contracts with similar classes of customers. We reasonably expect that the effect of applying a portfolio approach to a group of contracts would not differ materially from considering each contract separately. Management’s judgment to group the contracts by portfolio is based on the payment behavior expected in each portfolio category. As a result, aggregating all of the contracts (which are at the patient level) by the particular payer or group of payers, will result in the recognition of the same amount of revenue as applying the analysis at the individual patient level.

We group our revenues into categories based on payment behaviors. Each component has its own reimbursement structure which allows us to disaggregate the revenue into categories that share the nature and timing of payments. The other patient revenue consists primarily of self-pay, government-funded non-Medicaid, and other.

The following table disaggregates our revenue by major source for the three and nine-month periods ended September 30, 2024 and 2023 (in thousands):


	For the three months ended September 30, 2024
	Acute Care				Behavioral Health				Other		Total
Medicare	$	322,466	14	%	$	81,148	5	%			$	403,614	10	%
Managed Medicare		361,804	16	%		107,910	6	%				469,714	12	%
Medicaid		296,966	13	%		262,393	15	%				559,359	14	%
Managed Medicaid		154,762	7	%		422,563	25	%				577,325	15	%
Managed Care (HMO and PPOs)		725,014	32	%		401,004	23	%				1,126,018	28	%
UK Revenue		0	0	%		230,153	13	%				230,153	6	%
Other patient revenue and adjustments, net		117,679	5	%		155,332	9	%				273,011	7	%
Other non-patient revenue		266,826	12	%		54,411	3	%		2,596		323,833	8	%
Total Net Revenue	$	2,245,517	100	%	$	1,714,914	100	%	$	2,596		3,963,027	100	%

	For the nine months ended September 30, 2024
	Acute Care				Behavioral Health				Other		Total
Medicare	$	1,009,630	15	%	$	234,295	5	%			$	1,243,925	11	%
Managed Medicare		1,104,493	17	%		307,388	6	%				1,411,881	12	%
Medicaid		771,298	12	%		804,254	16	%				1,575,552	13	%
Managed Medicaid		466,881	7	%		1,262,108	25	%				1,728,989	15	%
Managed Care (HMO and PPOs)		2,129,117	32	%		1,227,056	24	%				3,356,173	29	%
UK Revenue		0	0	%		650,655	13	%				650,655	6	%
Other patient revenue and adjustments, net		375,161	6	%		449,609	9	%				824,770	7	%
Other non-patient revenue		747,427	11	%		166,925	3	%		7,916		922,268	8	%
Total Net Revenue	$	6,604,007	100	%	$	5,102,290	100	%	$	7,916	$	11,714,213	100	%

	For the three months ended September 30, 2023
	Acute Care				Behavioral Health				Other		Total
Medicare	$	298,121	15	%	$	81,689	5	%			$	379,810	11	%
Managed Medicare		324,486	16	%		95,094	6	%				419,580	12	%
Medicaid		201,148	10	%		204,154	13	%				405,302	11	%
Managed Medicaid		181,051	9	%		387,975	25	%				569,026	16	%
Managed Care (HMO and PPOs)		651,816	32	%		383,146	25	%				1,034,962	29	%
UK Revenue		0	0	%		202,994	13	%				202,994	6	%
Other patient revenue and adjustments, net		108,676	5	%		129,492	8	%				238,168	7	%
Other non-patient revenue		251,990	12	%		58,151	4	%		2,791		312,932	9	%
Total Net Revenue	$	2,017,288	100	%	$	1,542,695	100	%	$	2,791	$	3,562,774	100	%

	For the nine months ended September 30, 2023
	Acute Care				Behavioral Health				Other		Total
Medicare	$	961,640	16	%	$	233,930	5	%			$	1,195,570	11	%
Managed Medicare		1,013,493	17	%		255,782	6	%				1,269,275	12	%
Medicaid		445,678	7	%		625,956	14	%				1,071,634	10	%
Managed Medicaid		545,173	9	%		1,184,315	26	%				1,729,488	16	%
Managed Care (HMO and PPOs)		2,009,110	34	%		1,160,820	25	%				3,169,930	30	%
UK Revenue		0	0	%		560,897	12	%				560,897	5	%
Other patient revenue and adjustments, net		303,923	5	%		387,327	8	%				691,250	7	%
Other non-patient revenue		714,882	12	%		166,351	4	%		9,153		890,386	8	%
Total Net Revenue	$	5,993,899	100	%	$	4,575,378	100	%	$	9,153	$	10,578,430	100	%

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-9

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-10

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 15
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-15

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-12

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-12

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-12

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-12

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-12

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-13

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Topic 606
-Publisher FASB
-URI https://asc.fasb.org/606/tableOfContent

+ Details

Earnings Per Share Data and Stock Based Compensation

9 Months Ended

Sep. 30, 2024

Share-Based Payment Arrangement [Abstract]

Earnings Per Share Data and Stock Based Compensation

(8) Earnings Per Share Data and Stock Based Compensation

Basic earnings per share are based on the weighted average number of common shares outstanding during the period. Diluted earnings per share are based on the weighted average number of common shares outstanding during the period adjusted to give effect to common stock equivalents.

The following table sets forth the computation of basic and diluted earnings per share for the periods indicated (in thousands, except per share data):


	Three months ended September 30,					Nine months ended September 30,
	2024		2023			2024			2023
Basic and Diluted:
Net income attributable to UHS	$	258,714	$	166,989		$	809,700		$	501,417
Less: Net income attributable to unvested restricted share grants		-		(52	)		(50	)		(242	)
Net income attributable to UHS – basic and diluted	$	258,714	$	166,937		$	809,650		$	501,175

Weighted average number of common shares - basic		66,537		68,867			66,873			69,825
Net effect of dilutive stock options and grants based on the treasury stock method		1,571		757			1,297			825
Weighted average number of common shares and equivalents - diluted		68,108		69,624			68,170			70,650
Earnings per basic share attributable to UHS:	$	3.89	$	2.42		$	12.11		$	7.18
Earnings per diluted share attributable to UHS:	$	3.80	$	2.40		$	11.88		$	7.09

The “Net effect of dilutive stock options and grants based on the treasury stock method”, for all periods presented above, excludes certain outstanding stock options applicable to each period since the effect would have been anti-dilutive. There were no excluded weighted-average stock options for the three-months ended September 30, 2024 and 799,000 for the nine-months ended September 30, 2024. The excluded weighted-average stock options totaled 5.0 million for the three months ended September 30, 2023 and 5.1 million for the nine months ended September 30, 2023. All classes of our common stock have the same dividend rights.

Stock-Based Compensation:

During the three-month periods ended September 30, 2024 and 2023, pre-tax compensation costs of $13.4 million and $16.2 million, respectively, was recognized related to outstanding stock options. During the nine-month periods ended September 30, 2024 and 2023, pre-tax compensation costs of $41.0 million and $48.3 million, respectively, was recognized related to outstanding stock options. In addition, during the three-month periods ended September 30, 2024 and 2023, pre-tax compensation cost of approximately $12.9 million and $6.1 million, respectively, was recognized related to restricted stock awards, restricted stock units and performance based restricted stock units. During the nine-month periods ended September 30, 2024 and 2023, pre-tax compensation costs of approximately $30.7 million and $16.4 million, respectively, was recognized related to restricted stock awards, restricted stock units and performance based restricted stock units. As of September 30, 2024 there was approximately $177.9 million of unrecognized compensation cost related to unvested options, restricted stock awards, restricted stock units and performance based restricted stock units which is expected to be recognized over the remaining weighted average vesting period of 2.5 years. There were 3,000 stock options granted during the first nine months of 2024 under the 2020 Stock Incentive Plan with a weighted-average grant date fair value of $44.58 per option. There were an aggregate of 501,290 restricted units, net of cancellations, granted during the first nine months of 2024 under the 2020 Stock Incentive Plan, including 63,362 performance based restricted stock units, with a weighted-average grant date fair value of $181.05 per share.

The expense associated with stock-based compensation arrangements is a non-cash charge. In the condensed consolidated statements of cash flows, stock-based compensation expense is an adjustment to reconcile net income to cash provided by operating activities and aggregated to $72.7 million and $65.7 million during the nine-month periods ended September 30, 2024 and 2023, respectively.

Relationship with Universal Health Realty Income Trust and Other Related Party Transactions (Tables)

9 Months Ended

Sep. 30, 2024

Remaining Renewal Options and Terms for Each of Three Hospital Facilities Leased from Trust

The table below provides certain details for each of the hospitals leased from the Trust as of September 30, 2024:


Hospital Name	Annual Minimum Rent		End of Lease Term	Renewal Term (years)
McAllen Medical Center	$	5,485,000	December, 2026		5	(a)
Wellington Regional Medical Center	$	6,639,000	December, 2026		5	(b)
Aiken Regional Medical Center/Aurora Pavilion Behavioral Health Services	$	4,072,000	December, 2033		35	(c)
Canyon Creek Behavioral Health	$	1,841,000	December, 2033		35	(c)
Clive Behavioral Health Hospital	$	2,775,000	December, 2040		50	(d)

(a)

We have one 5-year renewal option at existing lease rates (through 2031).

(b)

We have one 5-year renewal option at fair market value lease rates (through 2031). On each January 1st through 2026, the annual rent will increase by 2.5% on a cumulative and compounded basis.

(c)

We have seven 5-year renewal options at fair market value lease rates (2034 through 2068). On each January 1st through 2033, the annual rent will increase by 2.25% on a cumulative and compounded basis.

(d)

This facility is operated by a joint venture in which we are the managing, majority member and an unrelated third-party holds a minority ownership interest. The joint venture has three, 10-year renewal options at computed lease rates as stipulated in the lease (2041 through 2070) and two additional, 10-year renewal options at fair market value lease rates (2071 through 2090). In each January through 2040 (and potentially through 2070 if three, 10-year renewal options are exercised), the annual rental will increase by 2.75% on a cumulative and compounded basis.

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ 258,714	$ 166,989	$ 809,700	$ 501,417

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483443/250-10-50-6

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483443/250-10-50-9

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 805
-SubTopic 60
-Name Accounting Standards Codification
-Section 65
-Paragraph 1
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147476176/805-60-65-1

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 323
-Name Accounting Standards Codification
-Section 65
-Paragraph 2
-Subparagraph (g)(3)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478666/740-323-65-2

Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(20))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483621/220-10-S99-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
-Publisher FASB
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481687/323-10-50-3

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 28
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482907/825-10-50-28

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
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-Publisher FASB
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483443/250-10-50-3

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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-SubTopic 40
-Name Accounting Standards Codification
-Section 65
-Paragraph 1
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480175/815-40-65-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 8
-Publisher FASB
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 11
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483443/250-10-50-11

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 11
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483443/250-10-50-11

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 4
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483443/250-10-50-4

Reference 17: http://www.xbrl.org/2003/role/exampleRef
-Topic 946
-SubTopic 830
-Name Accounting Standards Codification
-Section 55
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479168/946-830-55-10

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section 45
-Paragraph 7
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479105/946-220-45-7

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Topic 944
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.7-04(18))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477250/944-220-S99-1

Reference 20: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(9))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 21: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 3
-Subparagraph (SX 210.6-09(1)(d))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-3

Reference 22: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(i))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480097/470-10-S99-1A

Reference 23: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 470
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(ii))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480097/470-10-S99-1A

Reference 24: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(iii)(A))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480097/470-10-S99-1A

Reference 25: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(iv))
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-URI https://asc.fasb.org/1943274/2147480097/470-10-S99-1A

Reference 26: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(5))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480097/470-10-S99-1A

Reference 27: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(i))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480097/470-10-S99-1B

Reference 28: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(iii)(A))
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Reference 29: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(iii)(B))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480097/470-10-S99-1B

Reference 30: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(iv))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480097/470-10-S99-1B

Reference 31: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(5))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480097/470-10-S99-1B

Reference 32: http://www.xbrl.org/2003/role/disclosureRef
-Topic 260
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 60B
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482689/260-10-45-60B

Reference 33: http://www.xbrl.org/2003/role/disclosureRef
-Topic 205
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 7
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483499/205-20-50-7

Reference 34: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 230
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 28
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482740/230-10-45-28

Reference 35: http://www.xbrl.org/2003/role/disclosureRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 1A
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482790/220-10-45-1A

Reference 36: http://www.xbrl.org/2003/role/disclosureRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 1B
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482790/220-10-45-1B

Reference 37: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 942
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-04(22))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478524/942-220-S99-1

+ Details

Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Jan. 01, 2024
Income Taxes [Line Items]
Effective income tax rate	22.10%	23.80%	22.00%	24.20%
Decrease in provision for income taxes	$ 4		$ 16
Unrecognized tax benefits					$ 2
Impact of unrecognized tax benefits if recognized					$ 2
Period of expiration of the statute of limitations for certain jurisdictions			expire within the next twelve months
Jurisdictions statutes of limitations expiration period			12 months
Maximum
Income Taxes [Line Items]
Accrued interest and penalties	$ 1		$ 1
Foreign and U.S. state and local jurisdictions have statutes of limitations, in years			4 years
Minimum
Income Taxes [Line Items]
Foreign and U.S. state and local jurisdictions have statutes of limitations, in years			3 years

Computation of Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Basic and Diluted:
Net Income (Loss)	$ 258,714	$ 166,989	$ 809,700	$ 501,417
Less: Net income attributable to unvested restricted share grants		(52)	(50)	(242)
Net income attributable to UHS - basic	258,714	166,937	809,650	501,175
Net income attributable to UHS - diluted	$ 258,714	$ 166,937	$ 809,650	$ 501,175
Weighted average number of common shares - basic	66,537	68,867	66,873	69,825
Net effect of dilutive stock options and grants based on the treasury stock method	1,571	757	1,297	825
Weighted average number of common shares and equivalents - diluted	68,108	69,624	68,170	70,650
Earnings per basic share attributable to UHS:	$ 3.89	$ 2.42	$ 12.11	$ 7.18
Earnings per diluted share attributable to UHS:	$ 3.80	$ 2.40	$ 11.88	$ 7.09

Summary of Details of Hospitals Leased from Trust (Parenthetical) (Detail) - RenewalOption		9 Months Ended
	Jan. 01, 2024	Sep. 30, 2024
Maximum
Property Subject to or Available for Operating Lease [Line Items]
Real estate leases option to extend lease term		10 years
Minimum
Property Subject to or Available for Operating Lease [Line Items]
Real estate leases option to extend lease term		5 years
McAllen Medical Center
Property Subject to or Available for Operating Lease [Line Items]
Renewal options term at existing lease rates		5 years
McAllen Medical Center \| Maximum
Property Subject to or Available for Operating Lease [Line Items]
Renewal options at existing lease rates expiration year		2031
Wellington Regional Medical Center
Property Subject to or Available for Operating Lease [Line Items]
Renewal options term at fair market lease rates		5 years
Percentage of annual rental increase on cumulative and compound basis	2.50%
Wellington Regional Medical Center \| Maximum
Property Subject to or Available for Operating Lease [Line Items]
Renewal options at fair market value lease rates expiration year		2031
Aiken Regional Medical Center/Aurora Pavilion Behavioral Health Services
Property Subject to or Available for Operating Lease [Line Items]
Renewal options term at fair market lease rates		5 years
Aiken Regional Medical Center/Aurora Pavilion Behavioral Health Services \| Maximum
Property Subject to or Available for Operating Lease [Line Items]
Renewal options at fair market value lease rates expiration year		2068
Aiken Regional Medical Center/Aurora Pavilion Behavioral Health Services \| Minimum
Property Subject to or Available for Operating Lease [Line Items]
Renewal options at fair market value lease rates expiration year		2034
Canyon Creek Behavioral Health
Property Subject to or Available for Operating Lease [Line Items]
Renewal options term at fair market lease rates		5 years
Percentage of annual rental increase on cumulative and compound basis	2.25%
Canyon Creek Behavioral Health \| Maximum
Property Subject to or Available for Operating Lease [Line Items]
Renewal options at fair market value lease rates expiration year		2068
Canyon Creek Behavioral Health \| Minimum
Property Subject to or Available for Operating Lease [Line Items]
Renewal options at fair market value lease rates expiration year		2034
Clive Behavioral Health Hospital
Property Subject to or Available for Operating Lease [Line Items]
Renewal options term at fair market lease rates		10 years
Percentage of annual rental increase on cumulative and compound basis		2.75%
Operating leases additional renewal options term at fair market value lease rates		10 years
Number of lease renewal option exercised		3
Clive Behavioral Health Hospital \| Maximum
Property Subject to or Available for Operating Lease [Line Items]
Renewal options at fair market value lease rates expiration year		2070
Operating leases additional renewal options at fair market value lease rates expiration year		2090
Clive Behavioral Health Hospital \| Minimum
Property Subject to or Available for Operating Lease [Line Items]
Renewal options at fair market value lease rates expiration year		2041
Operating leases additional renewal options at fair market value lease rates expiration year		2071

Relationship with Universal Health Realty Income Trust and Other Related Party Transactions - Additional Information 3 (Detail)	1 Months Ended	3 Months Ended			9 Months Ended
	Oct. 31, 2024 USD ($)	Sep. 30, 2024 USD ($) Facility	Sep. 30, 2023 USD ($) SquareFoot	Mar. 31, 2023 USD ($) Bed SquareFoot	Sep. 30, 2024 USD ($) Facility	Sep. 30, 2023 USD ($)
Related Party Transaction [Line Items]
Lease and rental expense		$ 36,540,000	$ 35,466,000		$ 108,165,000	$ 105,775,000
Relationship with Universal Health Realty Income Trust
Related Party Transaction [Line Items]
Number of free-standing emergency departments to be acquired \| Facility		2			2
Number of square feet to be acquired \| SquareFoot			79,500
Percentage of master lease rentable square feet			100.00%	68.00%
Lease and rental expense		$ 5,000,000	$ 5,000,000		$ 16,000,000	$ 15,000,000
Number of square feet to be constructed \| SquareFoot				86,000
Number of beds available in acute care hospital \| Bed				170
Two Free-standing Emergency Departments
Related Party Transaction [Line Items]
Renewal options term at fair market lease rates	5 years
Lease expiration date	Jan. 31, 2025
Lease and rental expense	$ 979,000
Percentage of annual rental increase on cumulative and compound basis	2.00%
Two Free-standing Emergency Departments \| First Three Renewal Options
Related Party Transaction [Line Items]
Percentage of annual rental increase on cumulative and compound basis					2.00%
Minimum \| Relationship with Universal Health Realty Income Trust
Related Party Transaction [Line Items]
Lease and rental expense			$ 624,000	$ 1,300,000
Minimum \| Two Free-standing Emergency Departments
Related Party Transaction [Line Items]
Operating leases additional renewal options at fair market value lease rates expiration date	Feb. 01, 2025
Minimum \| Two Free-standing Emergency Departments \| First Three Renewal Options
Related Party Transaction [Line Items]
Operating leases additional renewal options at fair market value lease rates expiration year					2030
Minimum \| Two Free-standing Emergency Departments \| Remaining Two Renewal Options
Related Party Transaction [Line Items]
Operating leases additional renewal options at fair market value lease rates expiration year					2045
Maximum \| Two Free-standing Emergency Departments
Related Party Transaction [Line Items]
Operating leases additional renewal options at fair market value lease rates expiration date	Jan. 31, 2030
Maximum \| Two Free-standing Emergency Departments \| First Three Renewal Options
Related Party Transaction [Line Items]
Operating leases additional renewal options at fair market value lease rates expiration year					2044
Maximum \| Two Free-standing Emergency Departments \| Remaining Two Renewal Options
Related Party Transaction [Line Items]
Operating leases additional renewal options at fair market value lease rates expiration year					2054
Limited Liability Companies \| Minimum \| Relationship with Universal Health Realty Income Trust
Related Party Transaction [Line Items]
Non-controlling ownership interests		95.00%			95.00%
Limited Liability Companies \| Maximum \| Relationship with Universal Health Realty Income Trust
Related Party Transaction [Line Items]
Non-controlling ownership interests		100.00%			100.00%

Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement [Abstract]
Net revenues	$ 3,963,027	$ 3,562,774	$ 11,714,213	$ 10,578,430
Operating charges:
Salaries, wages and benefits	1,912,308	1,784,870	5,611,304	5,308,476
Other operating expenses	1,090,197	941,219	3,165,483	2,758,484
Supplies expense	390,250	378,667	1,181,886	1,138,950
Depreciation and amortization	149,567	137,195	438,050	422,560
Lease and rental expense	36,540	35,466	108,165	105,775
Operating Expenses, Total	3,578,862	3,277,417	10,504,888	9,734,245
Income from operations	384,165	285,357	1,209,325	844,185
Interest expense, net	44,660	53,378	146,385	153,085
Other (income) expense, net	(2,028)	11,472	3,315	31,797
Income before income taxes	341,533	220,507	1,059,625	659,303
Provision for income taxes	75,623	52,499	233,563	159,618
Net income	265,910	168,008	826,062	499,685
Less: Net income (loss) attributable to noncontrolling interests	7,196	1,019	16,362	(1,732)
Net income attributable to UHS	$ 258,714	$ 166,989	$ 809,700	$ 501,417
Basic earnings per share attributable to UHS	$ 3.89	$ 2.42	$ 12.11	$ 7.18
Diluted earnings per share attributable to UHS	$ 3.80	$ 2.40	$ 11.88	$ 7.09
Weighted average number of common shares - basic	66,537	68,867	66,873	69,825
Add: Other share equivalents	1,571	757	1,297	825
Weighted average number of common shares and equivalents - diluted	68,108	69,624	68,170	70,650

Segment Reporting (Detail) - USD ($)
$ in Thousands

3 Months Ended

9 Months Ended

Sep. 30, 2024

Sep. 30, 2023

Sep. 30, 2024

Sep. 30, 2023

Dec. 31, 2023

Segment Reporting Information [Line Items]

Gross inpatient revenues

$ 15,112,864

$ 13,619,538

$ 45,897,865

$ 41,280,234

Gross outpatient revenues

8,841,452

7,739,413

26,386,711

23,104,716

Total net revenues

3,963,027

3,562,774

11,714,213

10,578,430

Income/(loss) before allocation of corporate overhead and income taxes

341,533

220,507

1,059,625

659,303

Allocation of corporate overhead

Income before income taxes

341,533

220,507

1,059,625

659,303

Total assets

14,353,848

13,873,470

14,353,848

13,873,470

$ 13,967,602

Acute Care Hospital Services

Segment Reporting Information [Line Items]

Gross inpatient revenues

12,277,563

10,916,060

37,522,395

33,278,396

Gross outpatient revenues

8,573,270

7,480,353

25,553,451

22,292,249

Total net revenues

2,245,517

2,017,288

6,604,007

5,993,899

Income/(loss) before allocation of corporate overhead and income taxes

199,316

132,406

616,503

396,229

Allocation of corporate overhead

(64,883)

(66,355)

(194,616)

(199,943)

Income before income taxes

134,433

66,051

421,887

196,286

Total assets

6,481,922

6,252,434

6,481,922

6,252,434

Behavioral Health Services

Segment Reporting Information [Line Items]

Gross inpatient revenues

^[1]

2,835,301

2,703,478

8,375,470

8,001,838

Gross outpatient revenues

^[1]

268,182

259,060

833,260

812,467

Total net revenues

^[1]

1,714,914

1,542,695

5,102,290

4,575,378

Income/(loss) before allocation of corporate overhead and income taxes

^[1]

318,864

262,168

999,282

792,217

Allocation of corporate overhead

^[1]

(46,898)

(46,677)

(140,808)

(139,998)

Income before income taxes

^[1]

271,966

215,491

858,474

652,219

Total assets

^[1]

7,631,827

7,372,995

7,631,827

7,372,995

Other

Segment Reporting Information [Line Items]

Total net revenues

2,596

2,791

7,916

9,153

Income/(loss) before allocation of corporate overhead and income taxes

(176,647)

(174,067)

(556,160)

(529,143)

Allocation of corporate overhead

111,781

113,032

335,424

339,941

Income before income taxes

(64,866)

(61,035)

(220,736)

(189,202)

Total assets

$ 240,099

$ 248,041

$ 240,099

$ 248,041

[1]

Treasury - Additional Information (Detail) - USD ($)		9 Months Ended
Treasury - Additional Information (Detail) - USD ($)	Sep. 26, 2024	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023	Aug. 24, 2021	Sep. 21, 2020
Equity Class Of Treasury Stock [Line Items]
Rate adjustment to one month Eurodollar rate on credit facility borrowings		1.00%
Debt instrument carrying amount		$ 4,700,000,000		$ 4,900,000,000
Unamortized financing costs		21,000,000
Debt, due during the next 12 month		38,000,000
Debt, due during months 13 to 24		738,000,000
Debt, due during months 25 to 36		69,000,000
Debt, due during months 37 to 48		70,000,000
Debt, due during months 49 to 60		1,300,000,000
Debt, due in greater than 60 months		2,400,000,000
Fair value of debt		4,400,000,000		4,600,000,000
Foreign Currency Forward Exchange Contracts
Equity Class Of Treasury Stock [Line Items]
Net cash outflows		(36,000,000)	$ (8,000,000)
Debt
Equity Class Of Treasury Stock [Line Items]
Financial liabilities		$ 75,000,000		$ 77,000,000
ABR-based loans
Equity Class Of Treasury Stock [Line Items]
Rate adjustment to weighted average federal funds rate for credit facility borrowings		0.50%
4.625% Senior Secured Notes due 2029
Equity Class Of Treasury Stock [Line Items]
Senior notes, issued	$ 500,000,000
Senior notes, interest rate	4.625%
5.050% Senior Secured Notes due 2034
Equity Class Of Treasury Stock [Line Items]
Senior notes, issued	$ 500,000,000
Senior notes, interest rate	5.05%
Revolving Credit Facility
Equity Class Of Treasury Stock [Line Items]
Line of credit facility, borrowing capacity		$ 1,200,000,000
Line of credit facility, maturity date		Aug. 31, 2026
Revolving Credit Facility \| One Three Six Month SOFR Rate Plus Index Based Loans
Equity Class Of Treasury Stock [Line Items]
Rate adjustment to one month Eurodollar rate on credit facility borrowings		0.10%
Revolving Credit Facility \| Letter of Credit
Equity Class Of Treasury Stock [Line Items]
Line of credit facility, borrowing capacity		$ 125,000,000
Amended Revolving Credit Facility
Equity Class Of Treasury Stock [Line Items]
Line of credit facility, borrowing capacity		$ 1,300,000,000
Line of credit facility, maturity date	Sep. 26, 2029	Sep. 26, 2029
Line of credit facility amount outstanding		$ 3,000,000
Line of credit facility, available borrowing capacity		1,010,000,000.00
Amended Revolving Credit Facility \| Letter of Credit
Equity Class Of Treasury Stock [Line Items]
Letters of credit, outstanding		288,000,000
Amended Revolving Credit Facility \| Maximum
Equity Class Of Treasury Stock [Line Items]
Line of credit facility, borrowing capacity		1,300,000,000
Tranche A Term Loan
Equity Class Of Treasury Stock [Line Items]
Decrease in outstanding borrowings		1,000,000,000
Line of credit facility amount outstanding		1,200,000,000
Tranche A Term Loan \| Quarterly Payment Beginning on December 31, 2026 Through June 30, 2029
Equity Class Of Treasury Stock [Line Items]
Scheduled principal payments per quarter		15,000,000
Tranche A Term Loan \| Quarterly Payment Beginning on December 31,204 Through September 30, 2026
Equity Class Of Treasury Stock [Line Items]
Scheduled principal payments per quarter		7,500,000
Tranche A Term Loan \| Payment on September 26, 2029
Equity Class Of Treasury Stock [Line Items]
Scheduled principal payments per quarter		975,000,000
Tranche A Term Loan \| Maximum
Equity Class Of Treasury Stock [Line Items]
Line of credit facility, available borrowing capacity	$ 1,200,000,000
New Senior Secured Notes
Equity Class Of Treasury Stock [Line Items]
Senior notes, issued		$ 3,000,000,000
New Senior Secured Notes \| 4.625% Senior Secured Notes due 2029
Equity Class Of Treasury Stock [Line Items]
Line of credit facility, maturity date		Oct. 15, 2029
Senior notes, issued	$ 500,000,000
Senior notes, interest rate	4.625%
New Senior Secured Notes \| 5.050% Senior Secured Notes due 2034
Equity Class Of Treasury Stock [Line Items]
Line of credit facility, maturity date		Oct. 15, 2034
Senior notes, issued	$ 500,000,000
Senior notes, interest rate	5.05%
New Senior Secured Notes \| 1.65% Senior Secured Notes due 2026
Equity Class Of Treasury Stock [Line Items]
Line of credit facility, maturity date		Sep. 01, 2026
Senior notes, issued					$ 700,000,000
Senior notes, interest rate					1.65%
New Senior Secured Notes \| 2.65% Senior Secured Notes due 2030
Equity Class Of Treasury Stock [Line Items]
Line of credit facility, maturity date		Oct. 15, 2030
Senior notes, issued						$ 800,000,000
Senior notes, interest rate						2.65%
New Senior Secured Notes \| 2.65% Senior Secured Notes due 2032
Equity Class Of Treasury Stock [Line Items]
Line of credit facility, maturity date		Jan. 15, 2032
Senior notes, issued					$ 500,000,000
Senior notes, interest rate					2.65%
Term Loan A \| ABR-based loans
Equity Class Of Treasury Stock [Line Items]
Current applicable margins		0.375%
Term Loan A \| One Month SOFR Rate Plus Index Based Loans
Equity Class Of Treasury Stock [Line Items]
Current applicable margins		1.375%
Term Loan A \| Minimum \| One Month SOFR Rate Plus Index Based Loans
Equity Class Of Treasury Stock [Line Items]
Consolidated Leverage Ratio		0.25%
Term Loan A \| Minimum \| One Three Six Month SOFR Rate Plus Index Based Loans
Equity Class Of Treasury Stock [Line Items]
Consolidated Leverage Ratio		1.25%
Term Loan A \| Maximum \| One Month SOFR Rate Plus Index Based Loans
Equity Class Of Treasury Stock [Line Items]
Consolidated Leverage Ratio		0.625%
Term Loan A \| Maximum \| One Three Six Month SOFR Rate Plus Index Based Loans
Equity Class Of Treasury Stock [Line Items]
Consolidated Leverage Ratio		1.625%

Earnings Per Share Data and Stock Based Compensation - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Anti-dilutive weighted average stock options excluded from computation of earnings per share	0	5,000,000	799,000	5,100,000
Compensation cost recognized			$ 72,727	$ 65,702
2020 Stock Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options granted during period			3,000
Weighted-average grant date fair value, per option			$ 44.58
Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Compensation cost recognized, pre-tax charge	$ 13,400	$ 16,200	$ 41,000	48,300
Restricted Stock Awards, Restricted Stock Units and Performance Based Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Compensation cost recognized, pre-tax charge	12,900	$ 6,100	$ 30,700	$ 16,400
Unrecognized compensation cost vesting period			2 years 6 months
Unvested Stock option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost related to unvested options and restricted stock	$ 177,900		$ 177,900
Restricted Stock \| 2020 Stock Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted shares and restricted units, net of cancellations, granted during period			501,290
Weighted-average grant date fair value, per share			$ 181.05
Performance Based Restricted Stock Units \| 2020 Stock Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted shares and restricted units, net of cancellations, granted during period			63,362

Fair Value Measurement

9 Months Ended

Sep. 30, 2024

Fair Value Disclosures [Abstract]

Fair Value Measurement

(5) Fair Value Measurement

Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. The following fair value hierarchy classifies the inputs to valuation techniques used to measure fair value into one of three levels:

•

Level 1: Unadjusted quoted prices in active markets for identical assets or liabilities.

•

Level 2: Inputs other than quoted prices that are observable for the asset or liability, either directly or indirectly. These included quoted prices for similar assets or liabilities in active markets and quoted prices for identical or similar assets or liabilities in markets that are not active.

•

Level 3: Unobservable inputs that reflect the reporting entity’s own assumptions.

The following tables present the assets and liabilities recorded at fair value on a recurring basis:


	Balance at		Balance Sheet	Basis of Fair Value Measurement
(in thousands)	September 30, 2024		Location	Level 1		Level 2		Level 3
Assets:
Money market mutual funds	$	115,205	Other noncurrent assets	$	115,205
Certificates of deposit		2,201	Other noncurrent assets				2,201
Equity securities		44,654	Other noncurrent assets		44,654
Deferred compensation assets		49,270	Other noncurrent assets		49,270
	$	211,330		$	209,129	$	2,201		-
Liabilities:
Foreign currency forward exchange contracts	$	1,533	Accounts payable and other liabilities			$	1,533
Deferred compensation liability		49,270	Other noncurrent liabilities		49,270
	$	50,803		$	49,270	$	1,533		-

	Balance at		Balance Sheet	Basis of Fair Value Measurement
(in thousands)	December 31, 2023		Location	Level 1		Level 2		Level 3
Assets:
Money market mutual funds	$	111,129	Other noncurrent assets	$	111,129
Certificates of deposit		2,300	Other noncurrent assets				2,300
Equity securities		49,923	Other noncurrent assets		49,923
Deferred compensation assets		43,060	Other noncurrent assets		43,060
	$	206,412		$	204,112	$	2,300		-
Liabilities:
Foreign currency forward exchange contracts	$	1,911	Accounts payable and other liabilities			$	1,911
Deferred compensation liability		43,060	Other noncurrent liabilities		43,060
	$	44,971		$	43,060	$	1,911		-

The fair value of our money market mutual funds, certificates of deposit and equity securities with a readily determinable fair value are computed based upon quoted market prices in an active market. The fair value of deferred compensation assets and the offsetting liability are computed based on market prices in an active market held in a rabbi trust. The fair value of our foreign currency exchange contracts is determined using quoted forward exchange rates and spot rates at the reporting date.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 107
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482078/820-10-55-107

Reference 2: http://www.xbrl.org/2003/role/exampleRef
-Topic 820
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-Name Accounting Standards Codification
-Section 55
-Paragraph 100
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482078/820-10-55-100

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(3)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 6A
-Subparagraph (a)
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-URI https://asc.fasb.org/1943274/2147482106/820-10-50-6A

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2E

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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 940
-SubTopic 820
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478119/940-820-50-1

+ Details

Supplemental Cash Flow Information Related to Leases (Detail) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 99,526	$ 96,922
Operating cash flows from finance leases	2,756	2,890
Financing cash flows from finance leases	3,167	2,910
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	50,696	50,940
Finance leases	$ 8,441	$ 452

Segment Reporting (Tables)

9 Months Ended

Sep. 30, 2024

Segment Reporting [Abstract]

Segment Reporting


	Three months ended September 30, 2024
	Acute Care Hospital Services			Behavioral Health Services (a)			Other			Total Consolidated
	(Dollar amounts in thousands)
Gross inpatient revenues	$	12,277,563		$	2,835,301					$	15,112,864
Gross outpatient revenues	$	8,573,270		$	268,182					$	8,841,452
Total net revenues	$	2,245,517		$	1,714,914		$	2,596		$	3,963,027
Income/(loss) before allocation of corporate overhead and income taxes	$	199,316		$	318,864		$	(176,647	)	$	341,533
Allocation of corporate overhead	$	(64,883	)	$	(46,898	)	$	111,781		$	0
Income/(loss) after allocation of corporate overhead and before income taxes	$	134,433		$	271,966		$	(64,866	)	$	341,533
Total assets as of September 30, 2024	$	6,481,922		$	7,631,827		$	240,099		$	14,353,848

	Nine months ended September 30, 2024
	Acute Care Hospital Services			Behavioral Health Services (a)			Other			Total Consolidated
	(Dollar amounts in thousands)
Gross inpatient revenues	$	37,522,395		$	8,375,470					$	45,897,865
Gross outpatient revenues	$	25,553,451		$	833,260					$	26,386,711
Total net revenues	$	6,604,007		$	5,102,290		$	7,916		$	11,714,213
Income/(loss) before allocation of corporate overhead and income taxes	$	616,503		$	999,282		$	(556,160	)	$	1,059,625
Allocation of corporate overhead	$	(194,616	)	$	(140,808	)	$	335,424		$	0
Income/(loss) after allocation of corporate overhead and before income taxes	$	421,887		$	858,474		$	(220,736	)	$	1,059,625
Total assets as of September 30, 2024	$	6,481,922		$	7,631,827		$	240,099		$	14,353,848

	Three months ended September 30, 2023
	Acute Care Hospital Services			Behavioral Health Services (a)			Other			Total Consolidated
	(Dollar amounts in thousands)
Gross inpatient revenues	$	10,916,060		$	2,703,478					$	13,619,538
Gross outpatient revenues	$	7,480,353		$	259,060					$	7,739,413
Total net revenues	$	2,017,288		$	1,542,695		$	2,791		$	3,562,774
Income/(loss) before allocation of corporate overhead and income taxes	$	132,406		$	262,168		$	(174,067	)	$	220,507
Allocation of corporate overhead	$	(66,355	)	$	(46,677	)	$	113,032		$	0
Income/(loss) after allocation of corporate overhead and before income taxes	$	66,051		$	215,491		$	(61,035	)	$	220,507
Total assets as of September 30, 2023	$	6,252,434		$	7,372,995		$	248,041		$	13,873,470

	Nine months ended September 30, 2023
	Acute Care Hospital Services			Behavioral Health Services (a)			Other			Total Consolidated
	(Dollar amounts in thousands)
Gross inpatient revenues	$	33,278,396		$	8,001,838					$	41,280,234
Gross outpatient revenues	$	22,292,249		$	812,467					$	23,104,716
Total net revenues	$	5,993,899		$	4,575,378		$	9,153		$	10,578,430
Income/(loss) before allocation of corporate overhead and income taxes	$	396,229		$	792,217		$	(529,143	)	$	659,303
Allocation of corporate overhead	$	(199,943	)	$	(139,998	)	$	339,941		$	0
Income/(loss) after allocation of corporate overhead and before income taxes	$	196,286		$	652,219		$	(189,202	)	$	659,303
Total assets as of September 30, 2023	$	6,252,434		$	7,372,995		$	248,041		$	13,873,470

(a)

Summary of Effects of Foreign Currency Forward Exchange Contracts on Result of Operations (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Designated As Hedging Instrument \| Net Investment Hedge \| Foreign Currency Forward Exchange Contracts
Derivative Instruments Gain Loss [Line Items]
Gain/(Loss) recognized in AOCI	$ (43,490)	$ 19,619	$ (35,289)	$ (10,781)

Summary of Cash, Cash Equivalents and Restricted Cash Reported In Condensed Consolidated Statements of Cash Flows (Detail) - USD ($)
$ in Thousands

Sep. 30, 2024

Dec. 31, 2023

Sep. 30, 2023

Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Period Increase (Decrease), Including Exchange Rate Effect [Abstract]

Cash and cash equivalents

$ 106,077

$ 119,439

$ 80,768

Restricted cash

^[1]

$ 98,520

$ 95,031

$ 99,871

Restricted Cash, Statement of Financial Position [Extensible Enumeration]

Other

Total cash, cash equivalents and restricted cash

$ 204,597

$ 214,470

$ 180,639

[1]	Restricted cash is included in other noncurrent assets on the accompanying condensed consolidated balance sheets.

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Sep. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Modified	false
Rule 10b5-1 Arrangement Modified	false

Fair Value Measurement (Tables)

9 Months Ended

Sep. 30, 2024

Fair Value Disclosures [Abstract]

Summary of Assets and Liabilities Recorded at Fair Value on Recurring Basis

The following tables present the assets and liabilities recorded at fair value on a recurring basis:


	Balance at		Balance Sheet	Basis of Fair Value Measurement
(in thousands)	September 30, 2024		Location	Level 1		Level 2		Level 3
Assets:
Money market mutual funds	$	115,205	Other noncurrent assets	$	115,205
Certificates of deposit		2,201	Other noncurrent assets				2,201
Equity securities		44,654	Other noncurrent assets		44,654
Deferred compensation assets		49,270	Other noncurrent assets		49,270
	$	211,330		$	209,129	$	2,201		-
Liabilities:
Foreign currency forward exchange contracts	$	1,533	Accounts payable and other liabilities			$	1,533
Deferred compensation liability		49,270	Other noncurrent liabilities		49,270
	$	50,803		$	49,270	$	1,533		-

	Balance at		Balance Sheet	Basis of Fair Value Measurement
(in thousands)	December 31, 2023		Location	Level 1		Level 2		Level 3
Assets:
Money market mutual funds	$	111,129	Other noncurrent assets	$	111,129
Certificates of deposit		2,300	Other noncurrent assets				2,300
Equity securities		49,923	Other noncurrent assets		49,923
Deferred compensation assets		43,060	Other noncurrent assets		43,060
	$	206,412		$	204,112	$	2,300		-
Liabilities:
Foreign currency forward exchange contracts	$	1,911	Accounts payable and other liabilities			$	1,911
Deferred compensation liability		43,060	Other noncurrent liabilities		43,060
	$	44,971		$	43,060	$	1,911		-

Income Taxes

9 Months Ended

Sep. 30, 2024

Income Tax Disclosure [Abstract]

Income Taxes

(11) Income Taxes

Our effective income tax rates were 22.1% and 23.8% during the three-month periods ended September 30, 2024 and 2023, respectively, and 22.0% and 24.2% during the nine-month periods ended September 30, 2024, and 2023, respectively. The decrease in the effective tax rates during the three and nine-month period ended September 30, 2024, as compared to the comparable periods of 2023, was primarily due to favorable changes of $4 million and $16 million, respectively, in the net tax benefit recognized from employee share-based payments, net of the impact of executive compensation limitations pursuant to IRC section 162(m).

As of January 1, 2024, our unrecognized tax benefits were approximately $2 million. The amount, if recognized, that would favorably affect the effective tax rate is approximately $2 million. During the nine months ended September 30, 2024, changes to the estimated liabilities for uncertain tax positions (including accrued interest) relating to tax positions taken during prior and current periods did not have a material impact on our financial statements.

We recognize accrued interest and penalties associated with uncertain tax positions as part of the tax provision. As of September 30, 2024, we have less than $1 million of accrued interest and penalties. The U.S. federal statute of limitations remains open for 2020 and subsequent years. Foreign and U.S. state and local jurisdictions have statutes of limitations generally ranging from 3 to 4 years. The statute of limitations on certain jurisdictions could expire within the next twelve months. It is reasonably possible that the amount of uncertain tax benefits will change during the next 12 months, however, it is anticipated that any such change, if it were to occur, would not have a material impact on our results of operations.

We operate in multiple jurisdictions with varying tax laws. We are subject to audits by any of these taxing authorities. We believe that adequate accruals have been provided for federal, foreign and state taxes.

- Definition

The entire disclosure for income tax.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-12

Reference 2: http://www.xbrl.org/2003/role/exampleRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (SAB Topic 11.C)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479360/740-10-S99-2

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482603/740-30-50-2

+ Details

Lease Accounting (Tables)

9 Months Ended

Sep. 30, 2024

Leases [Abstract]

Supplemental Cash Flow Information Related to Leases

Supplemental cash flow information related to leases for the nine-month period ended September 30, 2024 and 2023 are as follows (in thousands):


	Nine months ended September 30,
	2024		2023

Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	99,526	$	96,922
Operating cash flows from finance leases	$	2,756	$	2,890
Financing cash flows from finance leases	$	3,167	$	2,910

Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	50,696	$	50,940
Finance leases	$	8,441	$	452

Condensed Consolidated Statements of Changes in Equity - USD ($) $ in Thousands	Total	Redeemable Noncontrolling Interest	Common Stock Class A	Common Stock Class B	Common Stock Class C	Common Stock Class D	Cumulative Dividends	Retained Earnings	Accumulated Other Comprehensive Income (Loss)	UHS Common Stockholders' Equity	Noncontrolling Interest
Balance at Dec. 31, 2022	$ 5,965,350		$ 66	$ 637	$ 7	$ 0	$ (604,127)	$ 6,533,667	$ (9,668)	$ 5,920,582	$ 44,768
Balance at Dec. 31, 2022		$ 4,695
Common Stock
Issued/(converted)	9,950			7				9,943		9,950
Repurchased, including excise tax	(389,011)			(29)				(388,982)		(389,011)
Restricted share-based compensation expense	16,395							16,395		16,395
Dividends paid and accrued	(42,147)						(42,147)			(42,147)
Stock option expense	48,337							48,337		48,337
Distributions to noncontrolling interests	(4,208)	(1,050)									(4,208)
Purchase (sale) of ownership interests by (from) minority members	3,814										3,814
Comprehensive income:
Net income (loss) to UHS / noncontrolling interests	498,611	1,074						501,417		501,417	(2,806)
Foreign currency translation adjustments, net of income tax	(608)								(608)	(608)
Subtotal - comprehensive income	498,003							501,417	(608)	500,809	(2,806)
Subtotal attributable to redeemable noncontrolling interest		1,074
Balance at Sep. 30, 2023	6,106,483		66	615	7	0	(646,274)	6,720,777	(10,276)	6,064,915	41,568
Balance at Sep. 30, 2023		4,719
Balance at Jun. 30, 2023	6,128,759		66	628	7	0	(632,473)	6,705,525	13,429	6,087,182	41,577
Balance at Jun. 30, 2023		4,213
Common Stock
Issued/(converted)	3,244			1				3,243		3,244
Repurchased, including excise tax	(177,334)			(14)				(177,320)		(177,334)
Restricted share-based compensation expense	6,132							6,132		6,132
Dividends paid and accrued	(13,801)						(13,801)			(13,801)
Stock option expense	16,208							16,208		16,208
Distributions to noncontrolling interests	(523)										(523)
Comprehensive income:
Net income (loss) to UHS / noncontrolling interests	167,503	506						166,989		166,989	514
Foreign currency translation adjustments, net of income tax	(23,705)								(23,705)	(23,705)
Subtotal - comprehensive income	143,798							166,989	(23,705)	143,284	514
Subtotal attributable to redeemable noncontrolling interest		506
Balance at Sep. 30, 2023	6,106,483		66	615	7	0	(646,274)	6,720,777	(10,276)	6,064,915	41,568
Balance at Sep. 30, 2023		4,719
Balance at Dec. 31, 2023	6,196,715		66	599	7	0	(659,890)	6,798,930	9,289	6,149,001	47,714
Balance at Dec. 31, 2023		5,191
Common Stock
Issued/(converted)	11,031			11				11,020		11,031
Repurchased, including excise tax	(424,077)			(21)				(424,056)		(424,077)
Restricted share-based compensation expense	30,746							30,746		30,746
Dividends paid and accrued	(40,597)						(40,597)			(40,597)
Stock option expense	41,025							41,025		41,025
Distributions to noncontrolling interests		(649)
Distributions to noncontrolling interests	(5,142)										(5,142)
Purchase (sale) of ownership interests by (from) minority members	17,537										17,537
Comprehensive income:
Net income (loss) to UHS / noncontrolling interests	824,981	1,081						809,700		809,700	15,281
Other								(17)	17
Foreign currency translation adjustments, net of income tax	28,867								28,867	28,867
Subtotal - comprehensive income	853,848							809,683	28,884	838,567	15,281
Subtotal attributable to redeemable noncontrolling interest		1,081
Balance at Sep. 30, 2024	6,681,086		66	589	7	0	(700,487)	7,267,348	38,173	6,605,696	75,390
Balance at Sep. 30, 2024	6,000	5,623
Balance at Jun. 30, 2024	6,550,805		66	594	7	0	(687,015)	7,162,908	8,812	6,485,372	65,433
Balance at Jun. 30, 2024		5,418
Common Stock
Issued/(converted)	3,637			3				3,634		3,637
Repurchased, including excise tax	(184,139)			(8)				(184,131)		(184,139)
Restricted share-based compensation expense	12,867							12,867		12,867
Dividends paid and accrued	(13,472)						(13,472)			(13,472)
Stock option expense	13,356							13,356		13,356
Distributions to noncontrolling interests	(702)										(702)
Purchase (sale) of ownership interests by (from) minority members	3,668										3,668
Comprehensive income:
Net income (loss) to UHS / noncontrolling interests	265,705	205						258,714		258,714	6,991
Foreign currency translation adjustments, net of income tax	29,361								29,361	29,361
Subtotal - comprehensive income	295,066							258,714	29,361	288,075	6,991
Subtotal attributable to redeemable noncontrolling interest		205
Balance at Sep. 30, 2024	6,681,086		$ 66	$ 589	$ 7	$ 0	$ (700,487)	$ 7,267,348	$ 38,173	$ 6,605,696	$ 75,390
Balance at Sep. 30, 2024	$ 6,000	$ 5,623

Relationship with Universal Health Realty Income Trust and Other Related Party Transactions

9 Months Ended

Sep. 30, 2024

Relationship with Universal Health Realty Income Trust and Other Related Party Transactions

(2) Relationship with Universal Health Realty Income Trust and Other Related Party Transactions

Relationship with Universal Health Realty Income Trust:

At September 30, 2024, we held approximately 5.7% of the outstanding shares of Universal Health Realty Income Trust (the “Trust”). We serve as Advisor to the Trust under an annually renewable advisory agreement, which is scheduled to expire on December 31st of each year, pursuant to the terms of which we conduct the Trust’s day-to-day affairs, provide administrative services and present investment opportunities. The advisory agreement was renewed by the Trust for 2024 at the same rate in place for 2023, 2022 and 2021, providing for an advisory fee computation at 0.70% of the Trust’s average invested real estate assets. We earned an advisory fee from the Trust, which is included in net revenues in the accompanying consolidated statements of income, of approximately $1.4 million and $1.3 million during the three-month periods ended September 30, 2024 and 2023, respectively, and approximately $4.1 million and $4.0 million during the nine-month periods ended September 30, 2024 and 2023, respectively.

In addition, certain of our officers and directors are also officers and/or directors of the Trust. Management believes that it has the ability to exercise significant influence over the Trust, therefore we account for our investment in the Trust using the equity method of accounting.

Our pre-tax share of income from the Trust was approximately $300,000 and $100,000 during the three-month periods ended September 30, 2024 and 2023, respectively, and approximately $914,000 and $670,000 during the nine-month periods ended September 30, 2024 and 2023, respectively, and is included in other (income) expense, net, on the accompanying consolidated statements of income for each period. We received dividends from the Trust amounting to $575,000 and $567,000 during the three-month periods ended September 30, 2024 and 2023, respectively, and $1.7 million during each of the nine-month periods ended September 30, 2024 and 2023. The carrying value of our investment in the Trust was approximately $6.2 million and $7.0 million at September 30, 2024 and December 31, 2023, respectively, and is included in other assets in the accompanying condensed consolidated balance sheets. The market value of our investment in the Trust was $36.0 million at September 30, 2024 and $34.1 million at December 31, 2023, based on the closing price of the Trust’s stock on the respective dates.

The Trust commenced operations in 1986 by purchasing certain properties from us and immediately leasing the properties back to our respective subsidiaries. The base rents are paid monthly and the bonus rent, which as of January 1, 2022 is applicable only to McAllen Medical Center, is computed and paid on a quarterly basis, based upon a computation that compares current quarter revenue to a corresponding quarter in the base year. The leases with those subsidiaries are unconditionally guaranteed by us and are cross-defaulted with one another.

On December 31, 2021, we entered into an asset purchase and sale agreement with the Trust, which was amended during the first quarter of 2022, pursuant to the terms of which: (i) a wholly-owned subsidiary of ours purchased from the Trust the real estate assets of the Inland Valley Campus of Southwest Healthcare System located in Wildomar, California, at its fair market value; (ii) two wholly-owned subsidiaries of ours transferred to the Trust, at their respective fair-market values, the real estate assets of Aiken Regional Medical Center (“Aiken”), located in Aiken, South Carolina (which includes a 211-bed acute care hospital and a 62-bed behavioral health facility), and Canyon Creek Behavioral Health (“Canyon Creek”), located in Temple, Texas, and; (iii) we received approximately $4.1 million in cash from the Trust.

As a result of the purchase options within the lease agreements for Aiken and Canyon Creek, the asset purchase and sale transaction is accounted for as a failed sale leaseback in accordance with U.S. GAAP. We have accounted for the asset exchange and substitution

transaction with the Trust as a financing arrangement and, since we did not derecognize the real property related to Aiken and Canyon Creek, we will continue to depreciate the assets. Our condensed consolidated balance sheets as of September 30, 2024 and December 31, 2023 reflects a financial liability of $74.8 million and $77.5 million, respectively, which is included in debt, for the fair value of real estate assets that we exchanged as part of the transaction. Our monthly lease payments payable to the Trust will be recorded to interest expense and as a reduction to the outstanding financial liability. The amount allocated to interest expense is determined using our incremental borrowing rate and is based on the outstanding financial liability.

The aggregate rent payable to the Trust in connection with the leases on McAllen Medical Center, Wellington Regional Medical Center, Aiken Regional Medical Center and Canyon Creek Behavioral Health was approximately $5 million during each of the three months ended September 30, 2024 and 2023, and approximately $16 million and $15 million during the nine months ended September 30, 2024 and 2023, respectively.

Pursuant to the Master Leases by certain subsidiaries of ours and the Trust as described in the table below, dated 1986 and 2021 (“the Master Leases”) which govern the leases of McAllen Medical Center and Wellington Regional Medical Center (each of which is governed by the Master Lease dated 1986), and Aiken Regional Medical Center and Canyon Creek Behavioral Health (each of which is governed by the Master Lease dated 2021), we have the option to renew the leases at the lease terms described above and below by providing notice to the Trust at least 90 days prior to the termination of the then current term. We also have the right to purchase the respective leased hospitals at their appraised fair market value upon any of the following: (i) at the end of the lease terms or any renewal terms; (ii) upon one month’s notice should a change of control of the Trust occur, or; (iii) within the time period as specified in the lease in the event that we provide notice to the Trust of our intent to offer a substitution property/properties in exchange for one (or more) of the hospital properties leased from the Trust should we be unable to reach an agreement with the Trust on the properties to be substituted. In addition, we have rights of first refusal to: (i) purchase the respective leased facilities during and for a specified period after the lease terms at the same price, terms and conditions of any third-party offer, or; (ii) renew the lease on the respective leased facility at the end of, and for a specified period after, the lease term at the same terms and conditions pursuant to any third-party offer.

In addition, we are the managing, majority member in a joint venture with an unrelated third-party that operates Clive Behavioral Health, a 100-bed behavioral health care facility located in Clive, Iowa. The real property of this facility, which was completed and opened in late 2020, is also leased from the Trust (annual rental of approximately $2.8 million and $2.7 million during 2024 and 2023, respectively) pursuant to the lease terms as provided in the table below. In connection with the lease on this facility, the joint venture has the right to purchase the leased facility from the Trust at its appraised fair market value upon either of the following: (i) by providing notice at least 270 days prior to the end of the lease terms or any renewal terms, or; (ii) upon 30 days' notice anytime within 12 months of a change of control of the Trust (UHS also has this right should the joint venture decline to exercise its purchase right). Additionally, the joint venture has rights of first offer to purchase the facility prior to any third-party sale.

The table below provides certain details for each of the hospitals leased from the Trust as of September 30, 2024:


Hospital Name	Annual Minimum Rent		End of Lease Term	Renewal Term (years)
McAllen Medical Center	$	5,485,000	December, 2026		5	(a)
Wellington Regional Medical Center	$	6,639,000	December, 2026		5	(b)
Aiken Regional Medical Center/Aurora Pavilion Behavioral Health Services	$	4,072,000	December, 2033		35	(c)
Canyon Creek Behavioral Health	$	1,841,000	December, 2033		35	(c)
Clive Behavioral Health Hospital	$	2,775,000	December, 2040		50	(d)

(a)

We have one 5-year renewal option at existing lease rates (through 2031).

(b)

We have one 5-year renewal option at fair market value lease rates (through 2031). On each January 1st through 2026, the annual rent will increase by 2.5% on a cumulative and compounded basis.

(c)

(d)

In addition, certain of our subsidiaries are tenants in several medical office buildings (“MOBs”) and two free-standing emergency departments ("FED") owned by the Trust or by limited liability companies in which the Trust holds 95% to 100% of the ownership

interest. In connection with these two FEDs, in October, 2024, our subsidiaries exercised their 5-year renewal options on the facilities which are located in Weslaco and Mission, Texas. Each renewal option covers the period of February 1, 2025 through January 31, 2030 (the current lease terms were scheduled to expire on January 31, 2025; with aggregate annual lease rates of approximately $979,000). Pursuant to terms of the leases, and consistent with the terms of the leases currently in effect for each property, the lease rates are scheduled to increase 2% per year through the end of the renewed lease terms. Our subsidiaries have five, 5-year renewal options remaining on each of these FEDs, with the first three renewal options (covering the years 2030 through 2044) providing for 2% annual increases to the lease rates, and the remaining two, 5-year renewal options (covering the years 2045 through 2054) providing for lease rates at the then fair market value. These leases are cross-defaulted with one another and our subsidiaries have the option to purchase the leased properties upon the expiration of each five-year extended term at the fair market value at that time.

During the third quarter of 2023, the Trust acquired the McAllen Doctor's Center, a 79,500 rentable square feet medical office building located in McAllen, Texas. A master lease was executed between a wholly-owned subsidiary of ours and the Trust, pursuant to the terms of which our subsidiary will master lease 100% of the rentable square feet of the MOB at an initial minimum rent of $624,000 annually. The master lease commenced during August, 2023 and is scheduled to expire in twelve years.

During the first quarter of 2023, the Trust substantially completed construction on a new 86,000 rentable square feet multi-tenant MOB that is located on the campus of Northern Nevada Sierra Medical Center in Reno, Nevada. Northern Nevada Sierra Medical Center, a 170-bed newly constructed acute care hospital owned and operated by a wholly-owned subsidiary of ours, was completed and opened in April, 2022. In connection with this MOB, a ground lease and a master flex lease was executed between a wholly-owned subsidiary of ours and the Trust, pursuant to the terms of which our subsidiary will master lease approximately 68% of the rentable square feet of the MOB at an initial minimum rent of $1.3 million annually plus a pro-rata share of the common area maintenance expenses. The master flex lease could be reduced during the term if certain conditions are met. The ground lease and master flex lease each commenced during the first quarter of 2023.

Other Related Party Transactions:

In December, 2010, our Board of Directors approved the Company’s entering into supplemental life insurance plans and agreements on the lives of Alan B. Miller (our Executive Chairman of the Board) and his wife. As a result of these agreements, as amended in October, 2016, based on actuarial tables and other assumptions, during the life expectancies of the insureds, we would pay approximately $28 million in premiums, and certain trusts owned by our Executive Chairman of the Board, would pay approximately $9 million in premiums. Based on the projected premiums mentioned above, and assuming the policies remain in effect until the death of the insureds, we will be entitled to receive death benefit proceeds of no less than approximately $37 million representing the $28 million of aggregate premiums paid by us as well as the $9 million of aggregate premiums paid by the trusts. In connection with these policies, we will pay or have paid approximately $1.0 million, net, in premium payments during 2024 and 2023.

In August, 2015, Marc D. Miller, our President and Chief Executive Officer and member of our Board of Directors, was appointed to the Board of Directors of Premier, Inc. (“Premier”), a healthcare performance improvement alliance. During 2013, we entered into a new group purchasing organization agreement (“GPO”) with Premier. In conjunction with the GPO agreement, we acquired a minority interest in Premier for a nominal amount. During the fourth quarter of 2013, in connection with the completion of an initial public offering of the stock of Premier, we received cash proceeds for the sale of a portion of our ownership interest in the GPO. Also in connection with this GPO agreement, we received shares of restricted stock of Premier which vested ratably over a seven-year period (2014 through 2020), contingent upon our continued participation and minority ownership interest in the GPO. During the third quarter of 2020, we entered into an agreement with Premier pursuant to the terms of which, among other things, our ownership interest in Premier was converted into shares of Class A Common Stock of Premier. We have elected to retain a portion of the previously vested shares of Premier, the market value of which is included in other assets on our condensed consolidated balance sheets. Based upon the closing price of Premier’s stock on each respective date, the market value of our shares of Premier was approximately $45 million and $50 million as of September 30, 2024 and December 31, 2023, respectively. Any change in market value of our Premier shares since December 31, 2023 was recorded as an unrealized gain/loss in “Other (income) expense, net” in our condensed consolidated statements of income for the three and nine-month period ended September 30, 2024. Additionally, we received cash dividends from Premier amounting to approximately $470,000 for each of the three-month periods ended September 30, 2024 and 2023, and approximately $1.4 million for each of the nine-month periods ended September 30, 2024 and 2023. The dividends are included in “Other (income) expense, net” in our condensed consolidated statements of income.

A member of our Board of Directors, Executive Committee and Finance Committee is a partner in Norton Rose Fulbright US LLP, a law firm engaged by us for a variety of legal services. The Board member and his law firm also provide personal legal services to our Executive Chairman and he acts as trustee of certain trusts for the benefit of our Executive Chairman and his family.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-5

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-6

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(g)(3))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(c))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(e))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org/850/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-6

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

+ Details

Dispositions and acquisitions

9 Months Ended

Sep. 30, 2024

Business Combinations [Abstract]

Dispositions and acquisitions

(9) Dispositions and acquisitions

Nine-month period ended September 30, 2024:

Acquisitions:

During the first nine months of 2024, there were no acquisitions.

Divestitures:

During the first nine months of 2024, we received $30 million from the sales of assets and businesses.

Nine-month period ended September 30, 2023:

Acquisitions:

During the first nine months of 2023, we spent $4 million on the acquisition of businesses and property.

Divestitures:

During the first nine months of 2023, we received $24 million from the sales of assets and businesses.

Other Noncurrent liabilities and Redeemable/Noncontrolling Interests

9 Months Ended

Sep. 30, 2024

Noncontrolling Interest [Abstract]

Other Noncurrent liabilities and Redeemable/Noncontrolling Interests

(3) Other Noncurrent liabilities and Redeemable/Noncontrolling Interests

Other noncurrent liabilities include the long-term portion of our professional and general liability, workers’ compensation reserves, pension and deferred compensation liabilities, and liabilities incurred in connection with split-dollar life insurance agreements on the lives of our chief executive officer and his wife.

As of September 30, 2024, outside owners held noncontrolling, minority ownership interests of: (i) approximately 7% in an acute care facility located in Texas; (ii) 49%, 20%, 30%, 20%, 25%, and 48% in six behavioral health care facilities located in Arizona, Pennsylvania, Ohio, Washington, Missouri, and Iowa, respectively, (iii) 26% and 49% in two behavioral health care facilities located in Michigan (one currently under construction with an expected opening in the second quarter of 2025) and; (iv) approximately 5% in an acute care facility and 49% in a surgery center, located in Nevada. The noncontrolling interest and redeemable noncontrolling interest balances of $75 million and $6 million, respectively, as of September 30, 2024, consist primarily of the third-party ownership interests in these hospitals.

In connection with the two behavioral health care facilities located in Pennsylvania and Ohio, the minority ownership interests of which are reflected as redeemable noncontrolling interests on our consolidated balance sheets, the outside owners have “put options” to put their entire ownership interest to us at any time. If exercised, the put option requires us to purchase the minority member’s interest at fair market value. Accordingly, the amounts recorded as redeemable noncontrolling interests on our consolidated balance sheets reflect the estimated fair market value of these ownership interests.