View Filing Data

Professional and medical fees

$ 592,604

$ 748,615

$ 1,771,456

$ 1,145,438

Operating expenses:

Salaries and benefits

175,403

534,740

Supplies

161,015

490,251

45,061

145,461

Lease expense

27,868

86,673

Other operating expenses

32,281

104,306

General and administrative expenses

441,628

1,361,431

29,153

93,558

Depreciation and amortization

21,804

67,440

Provision for doubtful accounts (see Note 1)

12,455

Income from equity investments

(3,319)

(8,898)

Loss on disposals and deconsolidations, net

31,822

Transaction and integration costs

7,470

31,665

Impairment charges

74,359

Loss on debt refinancing

Loss (gain) on litigation settlements

(8,740)

46,009

Gain on acquisition escrow release

(167)

Other (income) expense

(3,768)

Total operating expenses

500,334

1,693,618

Operating income

92,270

77,838

Gain on amendment to tax receivable agreement

1,098

Tax receivable agreement benefit (expense)

25,329

Interest expense, net

(48,740)

(147,003)

(Loss) income before income taxes

69,957

(69,165)

Income tax expense (benefit)

71,639

26,461

Less: Net income attributable to non-controlling interests

(1,682)

(95,626)

(39,634)

(110,080)

Net (loss) income attributable to Surgery Partners, Inc.

(41,316)

(205,706)

Less: Amounts attributable to participating securities

(26,047)

(32,426)

Net (loss) income attributable to common stockholders

$ (67,363)

$ (238,132)

Net (loss) income per share attributable to common stockholders

$ (1.39)

$ (4.96)

Weighted average common shares outstanding

^[1]

$ (1.39)

$ (4.96)

Basic (in shares)

48,319,193

48,027,875

Diluted (in shares)

^[1]

48,319,193

48,027,875

Predecessor

Professional and medical fees

748,615

1,145,438

Operating expenses:

Salaries and benefits

241,149

357,175

Supplies

193,322

269,239

57,931

81,185

Lease expense

36,503

52,147

Other operating expenses

43,267

61,450

General and administrative expenses

572,172

821,196

46,797

60,246

Depreciation and amortization

30,124

39,551

Provision for doubtful accounts (see Note 1)

16,297

24,212

Income from equity investments

(3,148)

(4,764)

Loss on disposals and deconsolidations, net

1,715

2,355

Transaction and integration costs

5,584

8,738

Impairment charges

Loss on debt refinancing

18,211

11,876

Loss (gain) on litigation settlements

(3,794)

(14,101)

Gain on acquisition escrow release

(1,000)

Other (income) expense

(307)

(353)

Total operating expenses

682,651

948,956

Operating income

65,964

196,482

Gain on amendment to tax receivable agreement

15,294

Tax receivable agreement benefit (expense)

(3,733)

Interest expense, net

(68,929)

(100,571)

(Loss) income before income taxes

12,329

92,178

Income tax expense (benefit)

(18,089)

7,095

Less: Net income attributable to non-controlling interests

30,418

85,083

(42,087)

(75,630)

Net (loss) income attributable to Surgery Partners, Inc.

(11,669)

9,453

Less: Amounts attributable to participating securities

Net (loss) income attributable to common stockholders

$ (11,669)

$ 9,453

Net (loss) income per share attributable to common stockholders

$ (0.24)

$ 0.20

Weighted average common shares outstanding

^[1]

$ (0.24)

$ 0.20

Basic (in shares)

48,121,404

48,018,944

Diluted (in shares)

^[1]

48,121,404

48,190,738

[1]	The impact of potentially dilutive securities for the year ended December 31, 2018 (Successor), the four months ended December 31, 2017 (Successor) and the eight months ended August 31, 2017 (Predecessor) were not considered because the effect would be anti-dilutive in those periods.

Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Thousands	4 Months Ended	8 Months Ended	12 Months Ended
	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2016
Net (loss) income	$ (1,682)		$ (95,626)
Derivative activity	0		(22,446)
Comprehensive (loss) income	(1,682)		(118,072)
Less: Comprehensive income attributable to non-controlling interests	(39,634)		(110,080)
Comprehensive (loss) income attributable to Surgery Partners, Inc.	$ (41,316)		$ (228,152)
Predecessor
Net (loss) income		$ 30,418		$ 85,083
Derivative activity		0		0
Comprehensive (loss) income		30,418		85,083
Less: Comprehensive income attributable to non-controlling interests		(42,087)		(75,630)
Comprehensive (loss) income attributable to Surgery Partners, Inc.		$ (11,669)		$ 9,453

The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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-SubTopic 10
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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/exampleRef
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Reference 7: 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/exampleRef
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Beginning Balance, stockholders' equity (in shares) (Predecessor) at Dec. 31, 2015

Consolidated Statements of Stockholders' Equity - USD ($)
$ in Thousands

Total

Common Stock

Additional Paid-in Capital

Accumulated Other Comprehensive Loss

Retained Deficit

Non-Controlling Interests— Non-Redeemable

^[1]

48,156,990

Beginning Balance, stockholders' equity (Predecessor) at Dec. 31, 2015

$ 297,927

$ 482

^[1]

$ 316,294

$ 0

$ (320,804)

$ 301,955

Increase (Decrease) in Stockholders' Equity [Roll Forward]

Net (loss) income | Predecessor

67,060

9,453

57,607

Equity-based compensation | Predecessor

2,021

Issuance of restricted and unrestricted shares (in shares) | Predecessor

^[1]

331,626

Issuance of restricted and unrestricted shares | Predecessor

$ 3

^[1]

(3)

Acquisition and disposal of shares of non-controlling interests, net | Predecessor

6,284

2,231

4,053

Distributions to non-controlling interests—non-redeemable holders | Predecessor

(48,618)

Ending Balance, stockholders' equity (in shares) (Predecessor) at Dec. 31, 2016

^[1]

48,488,616

Ending Balance, stockholders' equity (Predecessor) at Dec. 31, 2016

324,674

$ 485

^[1]

320,543

(311,351)

314,997

Increase (Decrease) in Stockholders' Equity [Roll Forward]

Net (loss) income | Predecessor

20,803

(11,669)

32,472

Equity-based compensation | Predecessor

3,697

Issuance of restricted and unrestricted shares (in shares) | Predecessor

^[1]

355,607

Issuance of restricted and unrestricted shares | Predecessor

$ 3

^[1]

(3)

Cancellation of restricted shares (in shares) | Predecessor

^[1]

(33,908)

Cancellation of restricted shares | Predecessor

(790)

Acquisition of NSH | Predecessor

172,645

Acquisition and disposal of shares of non-controlling interests, net | Predecessor

^[1]

(2,146)

3,483

(5,629)

Distributions to non-controlling interests—non-redeemable holders | Predecessor

(38,875)

Ending Balance, stockholders' equity (in shares) (Predecessor) at Aug. 31, 2017

^[1]

48,810,315

Ending Balance, stockholders' equity (in shares) at Aug. 31, 2017

^[1]

48,810,315

Ending Balance, stockholders' equity (Predecessor) at Aug. 31, 2017

480,008

$ 488

^[1]

326,930

(323,020)

475,610

Ending Balance, stockholders' equity at Aug. 31, 2017

1,405,086

$ 488

^[1]

720,118

684,480

Increase (Decrease) in Stockholders' Equity [Roll Forward]

Equity-based compensation

(14,613)

(41,316)

26,703

1,887

Preferred dividends

(10,481)

Mark to redemption adjustment

(15,566)

Issuance of restricted and unrestricted shares (in shares)

^[1]

112,107

Issuance of restricted and unrestricted shares

$ 1

^[1]

(1)

Cancellation of restricted shares (in shares)

^[1]

(54,622)

Cancellation of restricted shares

(585)

Repurchase of shares (in shares)

^[1]

(180,664)

Repurchase of shares

(2,009)

$ (2)

^[1]

(2,007)

Acquisition and disposal of shares of non-controlling interests, net

^[1]

(1,847)

2,195

(4,042)

Distributions to non-controlling interests—non-redeemable holders

$ (25,262)

(25,262)

Ending Balance, stockholders' equity (in shares) at Dec. 31, 2017

48,687,136

^[1]

Ending Balance, stockholders' equity at Dec. 31, 2017

$ 1,336,610

$ 487

^[1]

695,560

(41,316)

681,879

Increase (Decrease) in Stockholders' Equity [Roll Forward]

Equity-based compensation

(130,172)

(205,706)

75,534

9,344

Preferred dividends

(32,426)

Other comprehensive loss

(22,446)

Issuance of restricted and unrestricted shares (in shares)

^[1]

519,605

Issuance of restricted and unrestricted shares

$ 5

^[1]

(5)

Cancellation of restricted shares (in shares)

^[1]

(180,719)

Cancellation of restricted shares

(1,226)

$ (1)

^[1]

(1,225)

Repurchase of shares (in shares)

^[1]

(156,818)

Repurchase of shares

(1,982)

$ (2)

^[1]

(1,980)

Acquisition and disposal of shares of non-controlling interests, net

^[1]

20,152

4,351

15,801

Distributions to non-controlling interests—non-redeemable holders

(78,287)

Other

$ (622)

(622)

Ending Balance, stockholders' equity (in shares) at Dec. 31, 2018

48,869,204

^[1]

Ending Balance, stockholders' equity at Dec. 31, 2018

$ 1,098,945

$ 489

^[1]

$ 673,619

$ (22,446)

$ (247,022)

$ 694,305

[1]	Includes post acquisition date adjustments in all periods, including reallocation in application of pushdown accounting in the 2017 successor period.

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	4 Months Ended	8 Months Ended	12 Months Ended
	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2016
Cash flows from operating activities:
Net (loss) income	$ (1,682)		$ (95,626)
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization	21,804		67,440
Non-cash interest (income) expense, net	(780)		(1,415)
Equity-based compensation	1,887		9,344
Loss on disposals and deconsolidations, net	5		31,822
Impairment charges	0		74,359
Gain on legal settlements	(8,740)		0
Loss on debt refinancing	0		0
Gain on amendment to tax receivable agreement	(1,098)		0
Tax receivable agreement (benefit) expense	(25,329)		0
Deferred income taxes	71,031		25,272
Provision for doubtful accounts (see Note 1)	12,455		0
Income from equity investments, net of distributions received	678		243
Changes in operating assets and liabilities, net of acquisitions and divestitures:
Accounts receivable	(31,500)		(22,819)
Other operating assets and liabilities	14,494		55,980
Net cash provided by operating activities	53,225		144,600
Cash flows from investing activities:
Purchases of property and equipment, net	(10,827)		(39,805)
Payments for acquisitions, net of cash acquired	(29,249)		(106,772)
Proceeds from divestitures	1,183		19,170
Other investing activities	0		(1,455)
Net cash used in investing activities	(38,893)		(128,862)
Cash flows from financing activities:
Principal payments on long-term debt	(18,629)		(157,587)
Borrowings of long-term debt	409		282,741
Payments of debt issuance costs	(4)		(2,990)
Penalty on prepayment of debt	0		0
Proceeds from preferred stock issuance	0		0
Payments of stock issuance costs	0		0
Payments of preferred dividends	(1,316)		(7,810)
Distributions to non-controlling interest holders	(33,490)		(109,024)
(Payments) proceeds related to ownership transactions with non-controlling interest holders, net	998		(2,210)
Repurchase of shares	(2,009)		(1,982)
Financing lease obligation activity	1,007		(6,256)
Other financing activities	(590)		(1,226)
Net cash (used in) provided by financing activities	(53,624)		(6,344)
Net increase (decrease) in cash, cash equivalents and restricted cash	(39,292)		9,394
Cash, cash equivalents and restricted cash at beginning of period	214,521		175,229
Cash, cash equivalents and restricted cash at end of period	175,229	$ 214,521	184,623
Supplemental cash flow information:
Interest paid, net of interest income received	40,872		145,370
Cash paid for income taxes	485		2,226
Non-cash purchases of property and equipment under capital leases and financing activities	14,872		$ 61,005
Predecessor
Cash flows from operating activities:
Net (loss) income		30,418		$ 85,083
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization		30,124		39,551
Non-cash interest (income) expense, net		4,874		7,892
Equity-based compensation		3,697		2,021
Loss on disposals and deconsolidations, net		1,715		2,355
Impairment charges		0		0
Gain on legal settlements		0		(14,101)
Loss on debt refinancing		18,211		11,876
Gain on amendment to tax receivable agreement		(15,294)		0
Tax receivable agreement (benefit) expense		0		3,733
Deferred income taxes		(18,703)		6,882
Provision for doubtful accounts (see Note 1)		16,297		24,212
Income from equity investments, net of distributions received		489		(846)
Changes in operating assets and liabilities, net of acquisitions and divestitures:
Accounts receivable		8,837		(60,622)
Other operating assets and liabilities		(12,947)		17,203
Net cash provided by operating activities		67,718		125,239
Cash flows from investing activities:
Purchases of property and equipment, net		(18,773)		(39,109)
Payments for acquisitions, net of cash acquired		(725,853)		(146,405)
Proceeds from divestitures		70		765
Other investing activities		0		0
Net cash used in investing activities		(744,556)		(184,749)
Cash flows from financing activities:
Principal payments on long-term debt		(1,164,237)		(473,437)
Borrowings of long-term debt		1,805,966		650,707
Payments of debt issuance costs		(58,591)		(14,296)
Penalty on prepayment of debt		0		(4,900)
Proceeds from preferred stock issuance		310,000		0
Payments of stock issuance costs		(18,347)		0
Payments of preferred dividends		0		0
Distributions to non-controlling interest holders		(50,343)		(65,778)
(Payments) proceeds related to ownership transactions with non-controlling interest holders, net		(1,518)		(20,096)
Repurchase of shares		0		0
Financing lease obligation activity		(796)		(924)
Other financing activities		(789)
Net cash (used in) provided by financing activities		821,345		71,276
Net increase (decrease) in cash, cash equivalents and restricted cash		144,507		11,766
Cash, cash equivalents and restricted cash at beginning of period	$ 214,521	70,014		58,248
Cash, cash equivalents and restricted cash at end of period		214,521		70,014
Supplemental cash flow information:
Interest paid, net of interest income received		68,646		79,262
Cash paid for income taxes		598		661
Non-cash purchases of property and equipment under capital leases and financing activities		$ 8,469		$ 9,226

Organization and Summary of Accounting Policies

12 Months Ended

Dec. 31, 2018

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Organization and Summary of Accounting Policies

Summary of Accounting Policies

Organization

Surgery Partners, Inc., a Delaware corporation (together with its subsidiaries, the “Company”), was formed April 2, 2015. On August 31, 2017, a fund advised by an affiliate of Bain Capital Private Equity ("Bain Capital"), purchased approximately 54.2% of the Company’s outstanding common stock. As a result, Bain became the controlling stockholder of the Company, holding Series A Preferred Stock (as defined in Note 7. "Redeemable Preferred Stock") and common stock that collectively represent approximately 65.7% of the voting power of all classes of capital stock of the Company.

As of December 31, 2018 (Successor), the Company owned and operated a national network of surgical facilities and ancillary services in 31 states. The surgical facilities, which include ambulatory surgery centers ("ASCs") and surgical hospitals, primarily provide non-emergency surgical procedures across many specialties, including, among others, gastroenterology, general surgery, ophthalmology, orthopedics and pain management. The Company's surgical hospitals also provide services such as diagnostic imaging, laboratory, obstetrics, oncology, pharmacy, physical therapy and wound care. Ancillary services are comprised of a diagnostic laboratory, multi-specialty physician practices, urgent care facilities, anesthesia services and optical services.

As of December 31, 2018 (Successor), the Company owned or operated a portfolio of 123 surgical facilities, comprised of 108 ASCs and 15 surgical hospitals. The Company owns these facilities in partnership with physicians and, in some cases, healthcare systems in the markets and communities it serves. The Company owned a majority interest in 84 of the surgical facilities and consolidated 106 of these facilities for financial reporting purposes.

Basis of Presentation

The preparation of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and footnotes. Examples include, but are not limited to, estimates of accounts receivable allowances, professional and general liabilities and the estimate of deferred tax assets or liabilities. Actual results could differ from those estimates.

The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries, as well as interests in partnerships and limited liability companies controlled by the Company through its ownership of a majority voting interest or other rights granted to the Company by contract to manage and control the affiliate's business. All significant intercompany balances and transactions are eliminated in consolidation.

In connection with the change of control effective August 31, 2017, the Company elected to apply “pushdown” accounting by applying the guidance in Financial Accounting Standards Board ("FASB") Accounting Standards Codification Topic 805, Business Combinations. Accordingly, the consolidated financial statements of the Company for periods before and after August 31, 2017 reflect different bases of accounting, and the financial positions and results of operations of those periods are not comparable. Throughout the Company's consolidated financial statements and the accompanying notes herein, periods prior to August 31, 2017 (the date of the change of control) are identified as "Predecessor" and periods after the change of control are identified as "Successor." See Note 2. "Acquisitions and Disposals" for further discussion of the change of control.

Variable Interest Entities

The consolidated financial statements include the accounts of variable interest entities ("VIE") in which the Company is the primary beneficiary under the provisions of Accounting Standards Codification 810, Consolidation. The Company has the power to direct the activities that most significantly impact a variable interest entity's economic performance. Additionally, the Company would absorb the majority of the expected losses from any of these entities should such expected losses occur. At December 31, 2018 (Successor), the variable interest entities include four surgical facilities, three anesthesia practices and four physician practices. In 2018 (Successor), the Company divested of one surgical facility and acquired a physician practice, which were classified as VIEs.

The total assets (excluding goodwill and intangible assets, net) of the consolidated VIEs included in the accompanying consolidated balance sheets as of December 31, 2018 (Successor) and 2017 (Successor), were $11.2 million and $13.1 million, respectively, and the total liabilities of the consolidated VIEs were $3.6 million and $5.8 million, respectively.

Equity Method Investments

The Company has non-consolidating investments in surgical facilities and management companies that own or manage surgical facilities. These investments are accounted for using the equity method of accounting.

Fair Value of Financial Instruments

The fair value of a financial instrument is the amount at which the instrument could be exchanged in an orderly transaction between market participants to sell the asset or transfer the liability. The Company uses fair value measurements based on quoted prices in active markets for identical assets or liabilities (Level 1), inputs other than quoted prices in active markets that are either directly or indirectly observable (Level 2), or unobservable inputs in which little or no market data exists, therefore requiring an entity to develop its own assumptions (Level 3), depending on the nature of the item being valued.

The carrying amounts reported in the consolidated balance sheets for cash and cash equivalents, accounts receivable, restricted invested assets and accounts payable approximate their fair values under Level 3 calculations.

A summary of the carrying amounts and fair values of the Company's long-term debt follows (in thousands):



	Successor
	Carrying Amount				Fair Value
	December 31, 2018		December 31, 2017		December 31, 2018		December 31, 2017

Term Loan	$	1,447,931	$	1,280,532	$	1,382,774	$	1,267,189
Senior Unsecured Notes due 2021	$	406,719	$	409,235	$	407,227	$	422,535
Senior Unsecured Notes due 2025	$	370,000	$	370,000	$	320,513	$	346,413

The fair values of the Term Loan, Senior Unsecured Notes due 2021 and the Senior Unsecured Notes due 2025 were based on a Level 2 inputs using quoted prices for identical liabilities in inactive markets at both December 31, 2018 (Successor) and 2017 (Predecessor). The carrying amounts related to the Company's other long-term debt obligations approximate their fair values under Level 3 calculations.

In 2018 (Successor), the Company entered into certain interest rate swap agreements (see Note 8. Derivatives and Hedging Activity). At December 31, 2018 (Successor), the fair value of these derivative instruments was $22.4 million, and was included in other long-term liabilities in the consolidated balance sheet. The fair value of these derivative financial instruments was based on a quoted market price, or a Level 2 computation. The Company had no derivative financial instruments as of December 31, 2017 (Successor).

The Company maintains a supplemental executive retirement savings plan (the "SERP") for certain executive officers. The SERP is a non-qualified deferred compensation plan for eligible executive officers and other key employees of the Company that allows participants to defer portions of their compensation. The fair value of the SERP asset and liability was based on a quoted market price, or a Level 1 computation. As of December 31, 2018 (Successor) and 2017 (Predecessor), the fair value of both the assets and liabilities in the SERP were $1.4 million and $1.9 million, respectively, and were included in other long-term assets and other long-term liabilities in the consolidated balance sheets.

Revenues

In May 2014, the FASB issued Accounting Standards Update ("ASU") 2014-09, Revenue from Contracts with Customers. The Company adopted the new standard effective January 1, 2018, using the modified retrospective method. The presentation of the amount of earnings from operations and net earnings were unchanged upon adoption of the new standard; however, during the year of adoption, the Company determined that amounts historically considered to be bad debt should be considered an implicit price concession, as defined in FASB Accounting Standards Codification 606, “Revenue From Contracts With Customers”. This resulted in changes to the presentation of revenues and the provision for bad debts in the consolidated statements of operations. Previously, the estimate for unrealizable amounts was recorded to the provision for bad debts and presented as a component of operating expenses. Upon reassessment during the year of adoption, the estimate for unrealizable amounts is now reflected as an implicit price concession as a reduction to arrive at net revenue.

The Company's revenues generally relate to contracts with patients in which the performance obligations are to provide healthcare services. The Company recognizes revenues in the period in which our obligations to provide health care services are satisfied and reports the amount that reflects the consideration the Company expects to be entitled to. The Company's performance obligations are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (e.g., Medicare, Medicaid, managed care health plans, employers and commercial insurance companies, including plans offered through the health insurance exchanges) and the transaction prices for the services provided are dependent upon the terms provided by or negotiated with the third-party payers. The payment arrangements with third-party payers for the services provided to the related patients typically specify payments at amounts less than the Company's standard charges. The Company continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals.

A summary of revenues by service type as a percentage of total revenues follows:



	Successor				Predecessor
	Year Ended December 31,		September 1 to December 31,		January 1 to August 31,		Year Ended December 31,
	2018		2017		2017		2016
Patient service revenues:
Surgical facilities revenues	93.6	%	94.3	%	91.4	%	90.3	%
Ancillary services revenues	4.5	%	4.2	%	7.0	%	7.9	%
	98.1	%	98.5	%	98.4	%	98.2	%
Other service revenues:
Optical services revenues	0.5	%	0.6	%	1.0	%	1.1	%
Other	1.4	%	0.9	%	0.6	%	0.7	%
	1.9	%	1.5	%	1.6	%	1.8	%
Total revenues	100.0	%	100.0	%	100.0	%	100.0	%

Patient service revenues. This includes revenue related to charging facility fees in exchange for providing patient care. The fee charged for healthcare procedures performed in surgical facilities varies depending on the type of service provided, but usually includes all charges for usage of an operating room, a recovery room, special equipment, medical supplies, nursing staff and medications. The fee does not normally include professional fees charged by the patient’s surgeon, anesthesiologist or other attending physician, which are billed directly by such physicians to the patient or third-party payor. However, in several surgical facilities, the Company charges for anesthesia services. Ancillary service revenues include fees for patient visits to the Company's physician practices, pharmacy services and diagnostic tests ordered by physicians.

Patient service revenues are recognized as performance obligations are satisfied. Performance obligations are based on the nature of services provided. Typically, the Company recognizes revenue at a point in time in which services are rendered and the Company has no obligation to provide further patient services. As the Company primarily performs outpatient procedures, performance obligations are generally satisfied same day and revenue is recognized on the date of service.

The Company determines the transaction price based on gross charges for services provided, net of estimated contractual adjustments, discounts from third-party payors. The Company estimates its contractual adjustments and discounts based on contractual agreements, its discount policies and historical experience. Changes in estimated contractual adjustments and discounts are recorded in the period of change. As a result of changes in estimates to third-party settlements related to prior years the Company recognized an increase to patient service revenues of $2.1 million for the year ended December 31, 2018 (Successor), no adjustments for the four months ended December 31, 2017 (Successor), and an increase to patient service revenues of approximately $1.1 million and $6.8 million during the eight months ended August 31, 2017 (Predecessor) and the year ended December 31, 2016 (Predecessor), respectively.

Other service revenues. Optical service revenues consist of product sales from the Company's optical laboratories as well as handling charges billed to the members of the Company's optical products purchasing organization. The Company's optical products purchasing organization negotiates volume buying discounts with optical products manufacturers. The buying discounts and any handling charges billed to the members of the buying group represent the revenue recognized for financial reporting purposes. The Company satisfies the performance obligation and recognizes revenue when the orders are shipped to members. The Company bases its estimates for sales returns and discounts on historical experience and has not experienced significant fluctuations between estimated and actual return activity and discounts given. The Company's optical laboratories manufacture and distribute corrective lenses and eyeglasses to ophthalmologists and optometrists. The Company satisfies the performance obligation and recognize revenue when the product is shipped, net of allowance for discounts.

Other revenues include management and administrative service fees derived from the non-consolidated facilities that the Company accounts for under the equity method, management of surgical facilities in which it does not own an interest, and management services provided to physician practices for which the Company is not required to provide capital or additional assets. These agreements typically require the Company to provide recurring management services over a multi-year period which are billed and collected on a monthly basis. The fees derived from these management arrangements are based on a predetermined percentage of the revenues of each facility or practice and are recognized in the period in which management services are rendered and billed.

The following table sets forth patient service revenues by type of payor and as a percentage of total patient service revenues for the Company's consolidated surgical facilities (dollars in thousands):



	Successor								Predecessor
	Year Ended December 31,				September 1 to December 31,				January 1 to August 31,				Year Ended December 31,
	2018				2017				2017				2016
	Amount		%		Amount		%		Amount		%		Amount		%
Patient service revenues:
Private insurance	$	948,870	54.6	%	$	347,801	59.6	%	$	360,092	48.9	%	$	579,662	51.5	%
Government	653,332		37.6	%	196,926		33.7	%	308,993		42.0	%	448,953		39.9	%
Self-pay	49,985		2.9	%	15,233		2.6	%	15,949		2.2	%	19,817		1.8	%
Other ⁽¹⁾	84,788		4.9	%	23,843		4.1	%	51,374		6.9	%	76,172		6.8	%
Total patient service revenues	$	1,736,975	100.0	%	$	583,803	100.0	%	$	736,408	100.0	%	$	1,124,604	100.0	%
Other service revenues:
Optical service revenues	$	9,545			$	3,486			$	7,629			$	12,505
Other revenues	24,936				5,315				4,578				8,329
Total net revenues	$	1,771,456			$	592,604			$	748,615			$	1,145,438

(1) Other is comprised of anesthesia service agreements, auto liability, letters of protection and other payor types.

The increase in other revenues is primarily due to an increase in management and administrative service fees due to the acquisition of NSH. Total net revenues in 2018 additionally reflect the impact of the Company's adoption of ASU 2014-09 as discussed above.

Subsequent to the transactions on August 31, 2017 (Predecessor), the Company, as part of a review of operations undertaken to create a solid foundation to support the Company's long-term growth objectives, incurred a non-recurring adjustment to revenue of $15.6 million, which was attributable to an increase in reserves for certain accounts receivable during the eight months ended August 31, 2017 (Predecessor). The increase in reserves resulted from certain known events and actions during the eight months ended August 31, 2017 (Predecessor) related to select payors primarily in the Company’s ancillary services segment. Upon consideration of such additional information, related receivables were determined to have a low likelihood of collection. The majority of this adjustment related to receivables with balances from the first quarter of 2016 and prior.

Cash, Cash Equivalents and Restricted Cash

The Company considers all highly liquid investments with a maturity of three months or less when purchased to be cash equivalents. The Company maintains its cash and cash equivalent balances at high credit quality financial institutions.

Cash, cash equivalents and restricted cash reported within the consolidated statement of cash flows includes $0.3 million of restricted investments, which are reflected in other long-term assets in the consolidated balance sheet at both December 31, 2018 (Successor) and 2017 (Successor). These restricted investments represents restricted cash held in accordance with the provisions of a long-term operating lease agreement held as security for performance under the Company's covenants and obligations within the agreement through January 2024.

Accounts Receivable

Accounts receivable from third-party payors are recorded net of estimated implicit price concessions which are estimated based on the historical trend of the Company's surgical facilities’ cash collections and contractual write-offs, established fee schedules, relationships with payors and procedure statistics. While changes in estimated reimbursement from third-party payors remain a possibility, the Company expects that any such changes would be minimal and, therefore, would not have a material effect on its financial condition or results of operations.

Accounts receivable consists of receivables from federal and state agencies (under the Medicare and Medicaid programs), managed care health plans, commercial insurance companies, employers and patients. Management recognizes that revenues and receivables from government agencies are significant to the Company's operations, but it does not believe that there is significant credit risk associated with these government agencies. Concentration of credit risk with respect to other payors is limited because of the large number of such payors. As of December 31, 2018 (Successor) and December 31, 2017 (Successor), the Company had a net third-party Medicaid settlements liability of $4.8 million and $1.0 million, respectively.

The Company recognizes that final reimbursement of accounts receivable is subject to final approval by each third-party payor. However, because the Company has contracts with its third-party payors and also verifies insurance coverage of the patient before medical services are rendered, the amounts that are pending approval from third-party payors are not considered significant. Amounts are classified outside of self-pay if the Company has an agreement with the third-party payor or has verified a patient’s coverage prior to services rendered. The Company's policy is to collect co-payments and deductibles prior to providing medical services. It is also the Company's policy to verify a patient’s insurance prior to the patient’s procedure. Patient services of the Company are primarily non-emergency, which allows the surgical facilities to control the procedures for which third-party reimbursement is sought and obtained. The Company does not require collateral from self-pay patients.

The Company's collection policies and procedures are based on the type of payor, size of claim and estimated collection percentage for each patient account. The operating systems used to manage patient accounts provide for an aging schedule in 30-day increments, by payor, physician and patient. The Company analyzes accounts receivable at each of its surgical facilities to ensure the proper collection and aged category. The operating systems generate reports that assist in the collection efforts by prioritizing patient accounts. Collection efforts include direct contact with insurance carriers or patients, written correspondence and the use of legal or collection agency assistance, as required.

A summary of the changes in the allowance for doubtful accounts receivable follows (in thousands):



	Balance at Beginning of Period		Provision for Doubtful Accounts		Accounts Written off, Net of Recoveries			Impact of adoption of ASC 606			Balance at End of Period
Predecessor
Year ended December 31, 2016	$	18,322	$	24,212	$	(12,662	)	$	—		$	29,872
Eight months ended August 31, 2017	29,872		16,297		(14,096		)	—			32,073



Successor
Four months ended December 31, 2017	—		12,455		(10,429		)	—			2,026
Year ended December 31, 2018	2,026		—		—			(2,026		)	—

The receivables related to the Company's optical products purchasing organization are recognized separately from patient accounts receivable and are included in other current assets in the consolidated balance sheets. Such receivables were $8.5 million and $7.6 million at December 31, 2018 (Successor) and 2017 (Successor), respectively.

Impairment of Long-Lived Assets, Goodwill and Intangible Assets

The Company evaluates the carrying value of long-lived assets when impairment indicators are present or when circumstances indicate that impairment may exist. The Company performs an impairment test by preparing an expected undiscounted cash flow projection. If the projection indicates that the recorded amount of the long-lived asset is not expected to be recovered, the carrying value is reduced to estimated fair value. The cash flow projection and fair value represents management’s best estimate, using appropriate and customary assumptions, projections and methodologies, at the date of evaluation. For discussion on impairment for goodwill and indefinite-lived intangible assets, refer to Note 4. "Goodwill and Intangible Assets."

Professional and General and Workers' Compensation Insurance

The Company maintains general liability and professional liability insurance in excess of self-insured retentions through third party commercial insurance carriers in amounts that management believes is sufficient for the Company's operations, although, potentially, some claims may exceed the scope of coverage in effect. The professional and general insurance coverage is on a claims-made basis. The Company also maintains workers' compensation insurance, subject to a deductible.

The Company expenses the costs under the self-insured retention exposure for general and professional liability and workers' compensation claims which relate to (i) claims made during the policy period, which are offset by insurance recoveries and (ii) an estimate of claims incurred but not yet reported that are expected to be reported after the policy period expires. Reserves and provisions are based upon actuarially determined estimates using individual case-basis valuations and actuarial analysis. Reserves for professional, general and workers' compensation claim liabilities are determined with no regard for expected insurance recoveries and are presented gross on the consolidated balance sheets. Total professional, general and workers' compensation claim liabilities as of December 31, 2018 (Successor) and 2017 (Successor) were $18.2 million and $21.0 million, respectively. The balance includes expected insurance recoveries of $12.0 million and $12.8 million as of December 31, 2018 (Successor) and 2017 (Successor), respectively.

Derivative Instruments and Hedging Activities

In accordance with Accounting Standards Codification 815, Derivatives and Hedging, the Company records all derivatives on the balance sheet at fair value. The accounting for changes in the fair value of derivatives depends on the intended use of the derivative, whether the Company has elected to designate a derivative in a hedging relationship and apply hedge accounting and whether the hedging relationship has satisfied the criteria necessary to apply hedge accounting. Hedge accounting generally provides for the matching of the timing of gain or loss recognition on the hedging instrument with the recognition of the changes in the fair value of the hedged asset or liability that are attributable to the hedged risk in a fair value hedge or the earnings effect of the hedged forecasted transactions in a cash flow hedge. The Company may enter into derivative contracts that are intended to economically hedge certain of its risk, even though hedge accounting does not apply or the Company elects not to apply hedge accounting.

In accordance with the FASB’s fair value measurement guidance in ASU 2011-04, the Company made an accounting policy election to measure the credit risk of its derivative financial instruments that are subject to master netting agreements on a net basis by counterparty portfolio.

Non-Controlling Interests

The physician limited partners and physician minority members of the entities that the Company controls are responsible for the supervision and delivery of medical services. The governance rights of limited partners and minority members are restricted to those that protect their financial interests. Under certain partnership and operating agreements governing these partnerships and limited liability companies, the Company could be removed as the sole general partner or managing member for certain events such as material breach of the partnership or operating agreement, gross negligence or bankruptcy. These protective rights do not preclude consolidation of the respective partnerships and limited liability companies.

Ownership interests in consolidated subsidiaries held by parties other than the Company are identified and generally presented in the consolidated financial statements within the equity section but separate from the Company's equity. However, in instances in which certain redemption features that are not solely within the control of the Company are present, classification of non-controlling interests outside of permanent equity is required. Consolidated net income attributable to the Company and to the non-controlling interests are identified and presented on the consolidated statements of operations; changes in ownership interests in which the Company retains a controlling interest are accounted for as equity transactions assuming the Company continues to consolidate related entities. Certain transactions with non-controlling interests are classified within financing activities in the consolidated statements of cash flows.

The consolidated financial statements of the Company include all assets, liabilities, revenues and expenses of surgical facilities in which the Company has sufficient ownership and rights to allow the Company to consolidate the surgical facilities. Similar to its investments in non-consolidated affiliates, the Company regularly engages in the purchase and sale of ownership interests with respect to its consolidated subsidiaries that do not result in a change of control.

Non-Controlling Interests — Redeemable. Each partnership and limited liability company through which the Company owns and operates its surgical facilities is governed by a partnership or operating agreement. In certain circumstances, the applicable partnership or operating agreements for the Company's surgical facilities provide that the facilities will purchase all of the physician limited partners’ or physician minority members', as applicable, ownership if certain adverse regulatory events occur, such as it becoming illegal for the physician(s) to own an interest in a surgical facility, refer patients to a surgical facility or receive cash distributions from a surgical facility. The non-controlling interests — redeemable are reported outside of stockholders' equity in the consolidated balance sheets.

A summary of activity related to the non-controlling interests—redeemable follows (in thousands):



Predecessor
Balance at December 31, 2016	$	180,521
Net income attributable to non-controlling interests—redeemable	9,615
Acquisition and disposal of shares of non-controlling interests, net—redeemable ⁽¹⁾	(3,323		)
Distributions to non-controlling interest —redeemable holders	(11,468		)
Acquisition of NSH	153,320
Balance at August 31, 2017	$	328,665



Successor
Balance at September 1, 2017	$	271,001
Net income attributable to non-controlling interests—redeemable	12,931
Acquisition and disposal of shares of non-controlling interests, net—redeemable ⁽¹⁾	23,612
Distributions to non-controlling interest —redeemable holders	(8,228		)
Balance at December 31, 2017	299,316
Net income attributable to non-controlling interests—redeemable	34,546
Acquisition and disposal of shares of non-controlling interests, net—redeemable ⁽¹⁾	23,748
Distributions to non-controlling interest —redeemable holders	(30,737		)
Other	(281		)
Balance at December 31, 2018	$	326,592


⁽¹⁾	Includes post acquisition date adjustments in all periods, including reallocation in application of pushdown accounting in the 2017 successor period.

Inventories

Inventories, which consist primarily of medical and drug supplies, are stated at the lower of cost or market value. Cost is determined using the first-in, first-out method.

Recent Accounting Pronouncements

In May 2014, the FASB issued ASU 2014-09, "Revenue from Contracts with Customers," along with subsequent amendments, updates and an extension of the effective date (collectively the "New Revenue Standard"), which outlines a single comprehensive model for recognizing revenue and supersedes most existing revenue recognition guidance, including guidance specific to the healthcare industry. This five-step process requires significant management judgment in addition to changing the way many companies recognize revenue in their financial statements. The Company adopted this ASU on January 1, 2018 using the modified retrospective approach. During the initial year of adoption, the Company determined that amounts historically considered to be bad debt, and recognized as a component of operating expenses, are considered an implicit price concession, as defined in FASB Accounting Standards Codification 606, “Revenue From Contracts With Customers”. As a result, generally amounts previously reflected as a provision for bad debts in the consolidated income statements would be categorized as a component of revenues. This determination resulted in the reclassification of amounts previously disclosed in the Company's quarterly reports in the year as bad debt expense to net revenues for the year ended December 31, 2018 (refer to Note 16. "Quarterly Financial Information (Unaudited)" for reclassified quarterly results). This change had no impact on net income, income taxes or the balance sheet for the year ended and as of December 31, 2018, or any interim period therein. The adoption of this standard did not have a material impact on the Company's consolidated financial position, results of operations or cash flows. Adoption of the standard resulted in the Company revising its related disclosures.

In February 2016, the FASB issued ASU 2016-02, "Leases," which will require, among other items, lessees to recognize most leases as assets and liabilities on the balance sheet. Qualitative and quantitative disclosures will be enhanced to better understand the amount, timing and uncertainty of cash flows arising from leases. This guidance is effective for the Company's 2019 interim and annual financial statements. The Company plans to adopt ASU 2016-02 on January 1, 2019, using a modified retrospective transition approach for leases existing at, or entered into after, the beginning of the earliest comparative periods presented in the financial statements. The Company believes the primary effect of adopting the new standard will be to record right-of-use assets and obligations for current operating leases with material increases in reported property and equipment and liabilities. The Company is still finalizing its calculation of the cumulative effect of accounting change to be recognized upon adoption. The Company is currently working to complete the implementation of new processes and information technology tools to assist in its ongoing lease data collection and analysis, and updating accounting policies and internal controls in connection with the adoption of the new standard.

In November 2016, the FASB issued ASU 2016-18, "Statement of Cash Flows – Restricted Cash," which requires that a statement of cash flows explain the change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash or restricted cash equivalents. The Company adopted this ASU on January 1, 2018 and retrospectively applied the guidance to all periods presented in the consolidated statement of cash flows. The retrospective application to prior periods had no impact on the Company's cash flows from operating, investing and financing activities as previously disclosed. Refer to discussion of restricted cash under the heading "Cash, Cash Equivalents and Restricted Cash" above.

Acquisitions and Disposals

12 Months Ended

Dec. 31, 2018

Business Combinations And Disposals [Abstract]

Acquisitions and Disposals

The Company accounts for business combinations in accordance with the fundamental requirements of the acquisition method of accounting and under the premise that an acquirer can be identified for each business combination. The acquirer is the entity that obtains control of one or more businesses in the business combination and the acquisition date is the date the acquirer achieves control. The assets acquired, liabilities assumed and any non-controlling interests in the acquired business at the acquisition date are recognized at their fair values as of that date, and the direct costs incurred in connection with the business combination are recorded and expensed separately from the business combination. Any goodwill recognized is determined as the excess of the fair value of the consideration conveyed plus the fair value of any non-controlling interests in the acquisition over the fair value of the net assets acquired. Acquisitions in which the Company is able to exert significant influence but does not have control are accounted for using the equity method.

Acquired assets and assumed liabilities typically include, but are not limited to, fixed assets, intangible assets and professional liabilities. The valuations are based on appraisal reports, discounted cash flow analyses, actuarial analyses or other appropriate valuation techniques to determine the fair value of the assets acquired or liabilities assumed. Fair value attributable to non-controlling interests is based on a Level 3 computation using significant inputs that are not observable in the market. Key inputs used to determine the fair value include financial multiples used in the purchase of non-controlling interests, primarily from acquisitions of surgical facilities. Such multiples, based on earnings, are used as a benchmark for the discount to be applied for the lack of control or marketability. Fair value attributable to the property and equipment acquired is based on Level 3 computations using key inputs such as cost trend data and comparable asset sales. Fair value attributable to the intangible assets acquired is based on Level 3 computations using key inputs such as the Company's internally-prepared financial projections. Fair values assigned to acquired working capital are based on carrying amounts reported by the acquiree at the date of acquisition, which approximate their fair values.

Acquisitions

During the year ended December 31, 2018 (Successor), the Company acquired a controlling interest in five surgical facilities in new markets, two surgical facilities in existing markets, one of which was merged into an existing facility and multiple physician practices for a combined cash purchase price of $105.6 million, net of cash acquired. The 2018 acquisitions were funded through cash from operations. The total consideration related to these acquisitions was allocated to the assets acquired and liabilities assumed based upon their respective acquisition date fair values.

During the four months ended December 31, 2017 (Successor), the Company acquired a controlling interest in one surgical facility and one physician practice in existing markets for a combined cash purchase price of $29.4 million. The acquisitions were funded through cash from operations. During the eight months ended August 31, 2017 (Predecessor), the Company completed acquisitions in existing markets of three physician practices for a combined cash purchase price of $14.2 million. The acquisitions were funded through cash from operations and proceeds from the then existing revolver loan.

The aggregate amounts preliminarily recognized for each major class of assets acquired and liabilities assumed for acquisitions completed in 2018 and 2017, including post acquisition date adjustments, are as follows (in thousands):



	Successor						Predecessor
	Year Ended December 31,			September 1 to December 31,			January 1 to August 31,
	2018 ⁽¹⁾			2017			2017
Cash consideration	$	106,441		$	29,448		$	14,163
Fair value of non-controlling interests	63,774			21,893			105
Aggregate acquisition date fair value	$	170,215		$	51,341		$	14,268
Net assets acquired:
Current Assets	$	12,254		$	2,267		$	777
Property and equipment	5,033			248			696
Intangibles	—			41			1,101
Goodwill	156,529			49,368			12,167
Other long-term assets	6,575			—			—
Current liabilities	(6,061		)	(583		)	(287		)
Long-term liabilities	(4,115		)	—			(186		)
Aggregate acquisition date fair value	$	170,215		$	51,341		$	14,268


⁽¹⁾	The fair values assigned to certain assets acquired and liabilities assumed by the Company in 2018 have been estimated on a preliminary basis and are subject to change as new facts and circumstances emerge that were present at the date of acquisition.

During the year ended December 31, 2018 (Successor), no significant changes were made to the purchase price allocation of assets and liabilities, existing at the date of acquisition, related to individual acquisitions completed in 2017, excluding the acquisition of NSH as discussed below. The goodwill acquired in connection with the 2018 acquisitions was allocated to the Company's reportable segments as follows: $148.2 million to surgical facility services and $8.3 million to ancillary services. Approximately $93.9 million of goodwill recorded for the 2018 acquisitions is deductible for tax purposes. The results of operations of the 2018 acquisitions are included in the Company’s results of operations beginning on the dates of acquisitions, and were not considered significant for the year ended December 31, 2018 (Successor).

Acquisition of NSH

On August 31, 2017 (Predecessor), the Company completed its acquisition of NSH for total cash consideration of $711.7 million, net of cash acquired, including $19.6 million funded to an escrow account. During 2018 (Successor), information existing at the acquisition date became known to the Company as part of its continuing evaluation of the assets and liabilities existing at the date of acquisition, resulting in a net increase to goodwill of $1.1 million. The corresponding changes to certain classes of assets and liabilities from the preliminary allocation recorded at August 31, 2017 (Predecessor), are reflected in the table below, which was finalized as of August 31, 2018 (Successor). The increase to goodwill during the period includes a working capital settlement payment resulting in additional cash consideration of $1.2 million.

The acquisition date fair value for each major class of assets acquired and liabilities assumed, including post acquisition date adjustments, are as follows (in thousands):



Cash consideration	$	764,007
Fair value of non-controlling interests	325,965
Aggregate fair value of acquisition	$	1,089,972
Net assets acquired:
Cash and cash equivalents	$	51,159
Accounts receivable	71,639
Inventories	14,986
Prepaid expenses and other current assets	18,367
Property and equipment	174,100
Intangible assets	27,881
Goodwill	871,373
Investments in and advances to affiliates	29,737
Long-term deferred tax assets	20,212
Other long-term assets	26,988
Accounts payable	(29,652		)
Accrued payroll and benefits	(30,853		)
Other current liabilities	(23,937		)
Current maturities of long-term debt	(16,416		)
Long-term debt, less current maturities	(42,770		)
Other long-term liabilities	(72,842		)
Total fair value of net assets acquired	$	1,089,972

Change of Control - Pushdown Accounting

On August 31, 2017, Bain Capital became the controlling stockholder of the Company, holding preferred and common stock that collectively represent approximately 65.7% of the voting power of all classes of capital stock of the Company as of August 31, 2017. In connection with this change of control, the Company elected to apply “pushdown” accounting by applying the guidance in Accounting Standards Codification 805. In accordance with Accounting Standards Codification 805, all identifiable assets and liabilities of the Company were measured at and adjusted to fair value as of August 31, 2017, and similarly goodwill was recognized based on the terms of the transaction and the fair value of the new basis of the net assets of the Company.

During 2018 (Successor), information existing at the transaction date became known to the Company as part of its evaluation of the assets and liabilities existing at August 31, 2017, resulting in a net decrease to goodwill of $18.2 million and corresponding changes to certain classes of assets and liabilities from the preliminary allocation recorded, that are reflected in the table below, which was finalized as of August 31, 2018 (Successor). The post transaction date adjustments for pushdown accounting during the period includes a net increase of $3.9 million to the preliminary amounts assigned to intangible assets. The remaining adjustments to goodwill are attributable to a $17.9 million decrease to the preliminary fair value assigned to non-controlling interests, a $1.1 million increase related to the acquisition of NSH (discussed above), and a $2.5 million increase to other long-term liabilities.

The transaction date fair value recognized in connection with the application of pushdown accounting for each major class of assets and liabilities as of August 31, 2017, including post transaction date adjustments, are as follows (in thousands):



Equity attributable to Surgery Partners, Inc.	$	721,764
Redeemable preferred stock	310,000
Fair value of non-controlling interests	939,083
Aggregate fair value	$	1,970,847
Net assets:
Cash and cash equivalents	$	214,206
Accounts receivable	252,911
Inventories	44,310
Prepaid expenses and other current assets	61,438
Property and equipment	379,685
Intangible assets	63,978
Goodwill	3,281,728
Investments in and advances to affiliates	75,113
Restricted invested assets	315
Long-term deferred tax asset	206,073
Other long-term assets	50,666
Accounts payable	(64,921		)
Accrued payroll and benefits	(56,535		)
Other current liabilities	(97,617		)
Current maturities of long-term debt	(49,942		)
Long-term debt, less current maturities	(2,142,375		)
Long-term tax receivable agreement liability	(78,498		)
Other long-term liabilities	(169,688		)
Total fair value of net assets	$	1,970,847

Disposals and Deconsolidation

During the year ended December 31, 2018 (Successor), the Company disposed of four surgery centers, two surgical hospitals and its optical laboratory for net cash proceeds of $18.7 million, and recognized a net pretax loss of $21.2 million included in loss on disposals and deconsolidations, net in the consolidated statement of operations for the year ended December 31, 2018 (Successor). This non-cash loss was primarily a result of the write-off of the net assets of the facility (net of proceeds received) and was primarily driven by the write-off of the associated goodwill.

During the year ended December 31, 2018 (Successor), the Company sold a portion of its interest in one surgery center for net cash proceeds of $0.5 million. As a result of this transaction, the Company lost control of the previously controlled entity but retains a noncontrolling interest, resulting in the deconsolidation of the previously consolidated entity. The remaining noncontrolling interest was accounted for as an equity method investment, and initially measured and recorded at fair value as of the date of the transaction. The transaction resulted in a pretax gain on deconsolidation of $1.1 million, which is included in loss on disposals and deconsolidations, net, in the accompanying consolidated statement of operations for the year ended December 31, 2018 (Successor). The gain was determined based on the difference between the fair value of the Company's retained interest in the entity and the carrying value of both the tangible and intangible assets of the entity immediately prior to the transaction less cash proceeds received. The fair value measurement utilizes Level 3 inputs, which include unobservable data, to measure the fair value of the retained noncontrolling interest. The fair value determination was based on a combination of multiple valuation methods, which included discounted cash flow and market value approach, which incorporates estimates of future earnings and market valuation multiples for certain guideline companies. The fair value of the investment of $2.0 million was recorded as a component of investments in and advances to affiliates in the accompanying consolidated balance sheets.

During the four months ended December 31, 2017 (Successor), the Company disposed of one surgical facility for $1.3 million, resulting in a pre-tax gain of approximately $0.8 million. During the eight months ended August 31, 2017 (Predecessor), the Company disposed of one surgical facility. The proceeds and pre-tax gain for the sale were not significant.

Property and Equipment

12 Months Ended

Dec. 31, 2018

Property, Plant and Equipment [Abstract]

Property and Equipment

Property and equipment are stated at cost or, if obtained through acquisition, at fair value determined on the date of acquisition. Depreciation is recognized using the straight-line method over the estimated useful lives of the assets, generally 20 to 40 years for buildings and building improvements, three to five years for computers and software and five to seven years for furniture and equipment. Leasehold improvements are depreciated on a straight-line basis over the shorter of the lease term or the estimated useful life of the assets. Routine maintenance and repairs are expensed as incurred, while expenditures that increase capacities or extend useful lives are capitalized.

The Company also leases certain facilities and equipment under capital leases. Assets held under capital leases are stated at the present value of minimum lease payments at the inception of the related lease. Such assets are amortized on a straight-line basis over the lesser of the lease term or the remaining useful life of the leased asset.

A summary of property and equipment follows (in thousands):



	Successor
	December 31, 2018			December 31, 2017

Land	$	19,550		$	19,561
Buildings and improvements	200,390			188,571
Furniture and equipment	24,069			20,813
Computer and software	33,877			28,578
Medical equipment	139,571			138,112
Construction in progress	64,948			22,581
Property and equipment, at cost	482,405			418,216
Less: Accumulated depreciation	(56,119		)	(19,680		)
Property and equipment, net	$	426,286		$	398,536

Depreciation expense was $62.5 million for the year ended December 31, 2018 (Successor), $20.0 million for the four months ended December 31, 2017 (Successor), $24.1 million for the eight months ended August 31, 2017 (Predecessor) and $30.0 million for the year ended December 31, 2016 (Predecessor). Amortization expense related to assets under capital leases is included in depreciation expense. The carrying values of assets under capital lease were $22.7 million and $16.2 million as of December 31, 2018 (Successor) and 2017 (Successor), respectively, net of accumulated depreciation of $6.4 million and $5.8 million, respectively.

Goodwill and Intangible Assets

12 Months Ended

Dec. 31, 2018

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

Goodwill represents the fair value of the consideration provided in an acquisition over the fair value of net assets acquired and is not amortized. The Company has indefinite-lived intangible assets related to the certificates of need held in jurisdictions where certain of its surgical facilities are located and Medicare licenses. The Company also has finite-lived intangible assets related to physician guarantee agreements, non-compete agreements, management agreements and customer relationships. Physician income guarantees are amortized into salaries and benefits costs in the consolidated statements of operations over the commitment period of the contract, generally three to four years. Non-compete agreements and management rights agreements are amortized into depreciation and amortization expense in the consolidated statements of operations over the service lives of the agreements, typically ranging from two to five years for non-compete agreements and 15 years for the management rights agreements. Customer relationships are amortized into depreciation and amortization expense in the consolidated statements of operations over the estimated lives of the relationships, ranging from three to ten years.

The Company tests its goodwill and indefinite-lived intangible assets for impairment at least annually, as of October 1, or more frequently if certain indicators arise. The Company tests for goodwill impairment at the reporting unit level, which is defined as one level below an operating segment. As of October 1, 2018, the Company has identified three reporting units, which include the following: 1) Surgical Facilities, 2) Ancillary Services, and 3) The Alliance, including Optical Synergies ("Alliance"). The Alliance is a component of the Optical Services operating segment. In 2018, the Company disposed of two previously identified reporting units, Midwest Labs and Family Vision Care.

The Company compares the carrying value of the net assets of the reporting unit to the estimated fair value of the reporting unit. To determine the fair value of the reporting units, the Company obtained valuations at the reporting unit level prepared by third-party valuation specialists which utilized a combination of the income and market approaches. The discounted cash flow model is projected based on a year-by-year assessment that considers historical results, estimated market conditions, internal projections, and relevant publicly available statistics. Determining fair value requires the exercise of significant judgment, including assumptions about appropriate discount rates, perpetual growth rates and the amount and timing of expected future cash flows. The significant judgments are typically based upon Level 3 inputs, generally defined as unobservable inputs representing the Company's own assumptions. The cash flows employed in the discounted cash flow analysis are based on the Company's most recent budgets and business plans aligned with provided guidance and, when applicable, various growth rates are assumed for years beyond the current business plan period. Discount rate assumptions are based on an assessment of the risk inherent in the future cash flows of the respective reporting units. The variables within the discount rate, many of which are outside of the Company's control, provide the best estimate of all assumptions applied within the DCF model. There can be no assurance that operations will achieve the future cash flows reflected in the projections. In determining the fair value under the market approaches, the analysis includes a control premium, which was based on observable market data and a review of selected transactions of companies that operate in the Company's sector. While the Company believes that all assumptions utilized in the testing were appropriate, they may not reflect actual outcomes that could occur. Specific factors that could negatively impact the assumptions used include changes to the discount and growth rates and a change in the equity and enterprise premiums being realized in the market.

As of October 1, 2018 (Successor), prior to our impairment testing, the Company had three reporting units with allocated goodwill were as follows: 1) Surgical Facilities - $3.3 billion, 2) Ancillary Services - $80.0 million, and 3) The Alliance, including Optical Synergies ("Alliance") - $25.3 million. As of the October 1, 2018 (Successor) valuation, the fair value for the Surgical Facilities reporting unit was substantially in excess of its carrying value. For the Ancillary Services and Alliance reporting units, the carrying value exceeded the fair value, resulting in non-cash impairment charges of $60.7 million and $13.7 million, respectively, in accordance with ASU No. 2017-04.

As a result of the impairment charges, the fair value equaled carrying value as of October 1, 2018 (Successor) for the Ancillary Services and Alliance reporting units, any future adverse events or changes in the assumptions could require additional impairment. Subsequent to the date of our annual impairment test, the Company considered its operating results for the fourth quarter of 2018, macroeconomic, industry and market conditions, and other market indicators including its market capitalization. Based on its evaluation of all such factors, the Company concluded that an event had not occurred or circumstances had not changed that would more likely than not reduce the fair value of its reporting units below their carrying values.

In connection with the implementation of pushdown accounting, the Company performed its goodwill impairment test as of August 31, 2017 (Predecessor), then re-evaluated for impairment at October 1, 2017 (Successor). Both evaluations resulted in no impairment. There were also no impairment charges recorded during the year ended December 31, 2016 (Predecessor).

A summary of the changes in the carrying amount of goodwill for the years ended December 31, 2018 and 2017 follows (in thousands):



Predecessor
Balance at December 31, 2016	$	1,555,204
Acquisitions, including post acquisition adjustments	859,543
Divestitures and deconsolidations	(175		)
Balance at August 31, 2017	$	2,414,572



Successor
Balance at September 1, 2017	$	3,269,225
Acquisitions, including post acquisition adjustments	79,570
Divestitures and deconsolidations	(1,957		)
Balance at December 31, 2017	3,346,838
Acquisitions, including post acquisition adjustments	143,469
Divestitures and deconsolidations	(33,102		)
Impairment	(74,359		)
Balance at December 31, 2018	$	3,382,846

Additions to goodwill include new acquisitions and incremental ownership acquired in the Company's subsidiaries. A summary of the Company's acquisitions for the years ended December 31, 2018 and 2017 is included in Note 2. "Acquisitions and Disposals."

A summary of the components of intangible assets follows (in thousands):



	Successor
	December 31, 2018							December 31, 2017
	Gross Carrying Amount		Accumulated Amortization			Net		Gross Carrying Amount		Accumulated Amortization			Net

Finite-lived intangible assets:
Management rights agreements	$	41,600	$	(4,223	)	$	37,377	$	42,600	$	(1,058	)	$	41,542
Other	6,378		(2,738		)	3,640		5,752		(942		)	4,810
Total finite-lived intangible assets	47,978		(6,961		)	41,017		48,352		(2,000		)	46,352
Indefinite-lived intangible assets	13,276		—			13,276		12,556		—			12,556
Total intangible assets	$	61,254	$	(6,961	)	$	54,293	$	60,908	$	(2,000	)	$	58,908

Amortization expense for intangible assets was $4.9 million for the ended December 31, 2018 (Successor), $1.8 million for the four months ended December 31, 2017 (Successor), $6.0 million for the eight months ended August 31, 2017 (Predecessor) and $9.6 million for the year ended December 31, 2016 (Predecessor).

Total estimated amortization expense for the next five years and thereafter related to intangible assets follows (in thousands):



2019	$	4,617
2020	4,206
2021	3,647
2022	2,936
2023	2,144
Thereafter	23,467
Total	$	41,017

Long-Term Debt

12 Months Ended

Dec. 31, 2018

Debt Disclosure [Abstract]

Long-Term Debt

A summary of long-term debt follows (in thousands):



	Successor
	December 31, 2018			December 31, 2017

Revolver	$	—		$	—
Term Loan ⁽¹⁾	1,447,931			1,280,532
Senior Unsecured Notes due 2021 ⁽²⁾	406,719			409,235
Senior Unsecured Notes due 2025	370,000			370,000
Notes payable and secured loans	79,341			101,921
Capital lease obligations	25,374			27,594
Less: unamortized debt issuance costs and original issue discount	(2,915		)	—
Total debt	2,326,450			2,189,282
Less: Current maturities	55,552			58,726
Total long-term debt	$	2,270,898		$	2,130,556

⁽¹⁾ Includes unamortized fair value discount of $5.5 million and $6.2 million as of December 31, 2018 (Successor) and 2017 (Successor), respectively.

⁽²⁾ Includes unamortized fair value premium of $6.7 million and $9.2 million as of December 31, 2018 (Successor) and 2017 (Successor), respectively.

2017 Senior Secured Credit Facilities

On August 31, 2017 (Predecessor), the Company entered into a credit agreement (the “Credit Agreement”) providing for a $1.29 billion senior secured term loan (the “Term Loan”) and a $75.0 million revolving credit facility (the “Revolver” and, together with the Term Loan, the “2017 Senior Secured Credit Facilities”). The Term Loan was fully drawn on August 31, 2017 (Predecessor) and the proceeds thereof were used to finance the acquisition of NSH, to repay amounts outstanding under the Company’s then-existing 2014 First Lien Credit Agreement and 2014 Revolver Loan and amounts outstanding under the existing senior secured credit facilities of NSH, and to pay fees and expenses in connection with the foregoing and other previously disclosed transactions that occurred on August 31, 2017 (Predecessor). The Revolver may be utilized for working capital, capital expenditures and general corporate purposes. Subject to certain conditions and requirements set forth in the Credit Agreement, the Company may request one or more additional incremental term loan facilities or one or more increases in the commitments under the Revolver. As of December 31, 2018 (Successor), the Company's availability on the Revolver was $71.2 million (including outstanding letters of credit of $3.8 million).

On October 23, 2018, the Company entered into an incremental term loan amendment, which amended and supplemented the Credit Agreement, dated as of August 31, 2017, to provide for a $180.0 million senior secured incremental term loan. The incremental amounts were fully drawn on October 23, 2018, and the proceeds thereof were used to fund acquisitions and for other general corporate purposes. The incremental borrowing bears interest and is subject to maturity, amortization and other terms consistent with the existing term loans outstanding under the Credit Agreement as disclosed below.

The Term Loan will mature on August 31, 2024 and the Revolver will mature on August 31, 2022; however, both the Term Loan and the Revolver will mature on October 15, 2020 if at least 50.0% of the 2021 Unsecured Notes (defined below) have not been repaid or refinanced with permitted indebtedness with a maturity date six months after the of the original maturity date of the Term Loan.

The 2017 Senior Secured Credit Facilities bear interest at a rate per annum equal to (x) LIBOR plus a margin ranging from 3.00% to 3.25% per annum, depending on the Company's first lien net leverage ratio or (y) an alternate base rate (which will be the highest of (i) the prime rate, (ii) 0.5% per annum above the federal funds effective rate and (iii) one-month LIBOR plus 1.00% per annum (solely with respect to the Term Loan, the alternate base rate shall not be less than 2.00% per annum)) plus a margin ranging from 2.00% to 2.25% per annum. In addition, the Company is required to pay a commitment fee of 0.50% per annum in respect of unused commitments under the Revolver.

The Term Loan amortizes in equal quarterly installments of 0.25% of the aggregate original principal amount of the Term Loan. The Term Loan is subject to mandatory prepayments based on excess cash flow for the applicable fiscal year that will depend on the first lien net leverage ratio as of the last day of the applicable fiscal year, as well as upon the occurrence of certain other events, as described in the Credit Agreement. There were no excess cash flow payments required as of December 31, 2018 (Successor).

With respect to the Revolver, the Company is required to comply with a maximum consolidated total net leverage ratio of 9.50:1.00, which covenant will be tested quarterly on a trailing four quarter basis only if, as of the last day of the applicable fiscal quarter the Revolver is drawn in an aggregate amount greater than 35% of the total commitments under the Revolver. Such financial maintenance covenant is subject to an equity cure. The Credit Agreement includes customary negative covenants restricting or limiting the ability of the Company and its restricted subsidiaries, to, among other things, sell assets, alter its business, engage in mergers, acquisitions and other business combinations, declare dividends or redeem or repurchase equity interests, incur additional indebtedness or guarantees, make loans and investments, incur liens, enter into transactions with affiliates, prepay certain junior debt, and modify or waive certain material agreements and organizational documents, in each case, subject to customary and other agreed upon exceptions. The Credit Agreement also contains customary affirmative covenants and events of default. As of December 31, 2018 (Successor), the Company was in compliance with the covenants contained in the Credit Agreement.

The 2017 Senior Secured Credit Facilities are guaranteed, on a joint and several basis, by SP Holdco I, Inc. and each of Surgery Center Holdings, Inc.'s current and future wholly-owned domestic restricted subsidiaries (subject to certain exceptions) (the “Subsidiary Guarantors”) and are secured by a first priority security interest in substantially all of Surgery Center Holdings, Inc.'s, SP Holdco I, Inc.'s and the Subsidiary Guarantors’ assets (subject to certain exceptions).

In connection with the Term Loan and Revolver, the Company recorded debt issuance costs and discount of $28.2 million, in the Predecessor period of 2017, which were eliminated with the application of pushdown accounting. In connection with the repayment of the Company's 2014 First Lien Credit Agreement, the Company recorded a debt extinguishment loss of $18.2 million, included in the loss on debt refinancing in the consolidated statement of operations for the eight months ending August 31, 2017 (Predecessor). The loss includes the partial write-off of unamortized debt issuance costs and discount related to the 2014 Revolver Loan and 2014 First Lien Credit Agreement and a portion of costs incurred with the 2017 Senior Secured Credit Facilities.

In connection with the application of pushdown accounting, the Company remeasured and recorded the Term Loan at fair value using a measurement date of August 31, 2017. The fair value was based on a Level 2 computation using quoted prices for identical liabilities in inactive markets. As a result, the Company recorded a fair value discount of $6.5 million as of the measurement date, which is reported in the consolidated balance sheets as a direct deduction from the face amount the Term Loan. The Company amortizes the fair value discount to interest expense over the life of the Term Loan.

In connection with the incremental borrowings, the Company recorded debt issuance costs and discount of $3.0 million.

Senior Unsecured Notes due 2021

Effective March 31, 2016 (Predecessor), the Company issued $400.0 million in gross proceeds of senior unsecured notes due April 15, 2021 (the "2021 Unsecured Notes"). The 2021 Unsecured Notes bear interest at the rate of 8.875% per year, payable semi-annually on April 15 and October 15 of each year. The 2021 Unsecured Notes are a senior unsecured obligation of Surgery Center Holdings, Inc. and are guaranteed on a senior unsecured basis by each of Surgery Center Holdings, Inc.'s existing and future domestic wholly-owned restricted subsidiaries that guarantees the 2017 Senior Secured Credit Facilities (subject to certain exceptions).

The Company may redeem the 2021 Unsecured Notes, in whole or in part, at any time on or after April 15, 2018, at the redemption prices set forth below (expressed as a percentage of the principal amount to be redeemed), plus accrued and unpaid interest, if any, to the date of redemption:



April 15, 2018 to April 14, 2019	106.656	%
April 15, 2019 to April 14, 2020	104.438	%
April 15, 2020 and thereafter	100.000	%

If Surgery Center Holdings, Inc., experiences a change in control under certain circumstances, it must offer to purchase the notes at a purchase price equal to 101% of the principal amount, plus accrued and unpaid interest to, but excluding, the date of repurchase. The change of control as discussed in Note 1. "Organization and Summary of Accounting Policies", did not trigger repurchase.

The 2021 Unsecured Notes contain customary affirmative and negative covenants, which among other things, limit the Company’s ability to incur additional debt, pay dividends, create or assume liens, effect transactions with its affiliates, guarantee payment of certain debt securities, sell assets, merge, consolidate, enter into acquisitions and effect sale and leaseback transactions.

In connection with the offering of the 2021 Unsecured Notes, the Company recorded debt issuance costs of $8.4 million in the Predecessor period, which were eliminated with the application of pushdown accounting.

In connection with the application of pushdown accounting, the Company remeasured and recorded the 2021 Unsecured Notes at fair value using a measurement date of August 31, 2017. The fair value was based on a Level 2 computation using quoted prices for identical liabilities in inactive markets. As a result, the Company recorded a fair value premium of $10.0 million as of the measurement date, which is reported in the consolidated balance sheets as a direct addition to the face amount the notes. The Company amortizes the fair value premium to interest expense over the life of the 2021 Unsecured Notes.

Senior Unsecured Notes due 2025

Effective June 30, 2017 (Predecessor), the Company issued $370.0 million in gross proceeds of senior unsecured notes due July 1, 2025 (the "2025 Unsecured Notes"). The 2025 Unsecured Notes bear interest at the rate of 6.750% per year, payable semi-annually on January 1 and July 1 of each year. The 2025 Unsecured Notes are a senior unsecured obligation of Surgery Center Holdings, Inc. and are guaranteed on a senior unsecured basis by each of Surgery Center Holdings, Inc.'s existing and future domestic wholly-owned restricted subsidiaries that guarantees the 2017 Senior Secured Credit Facilities (subject to certain exceptions).

The Company may redeem up to 40% of the aggregate principal amount of the 2025 Unsecured Notes at any time prior to July 1, 2020, with the net cash proceeds of certain equity issuances at a redemption price equal to 106.75% of the principal amount to be redeemed, plus accrued and unpaid interest to, but excluding, the date of redemption, provided that at least 50% of the aggregate principal amount of the 2025 Unsecured Notes remain outstanding immediately after the occurrence of such redemption and such redemption occurs within 180 days of the date of the closing of the applicable equity offering.

The Company may redeem the 2025 Unsecured Notes, in whole or in part, at any time prior to July 1, 2020, at a price equal to 100% of the principal amount to be redeemed plus the applicable premium, plus accrued and unpaid interest, if any, to, but excluding, the date of redemption. The Company may redeem the 2025 Unsecured Notes, in whole or in part, at any time on or after July 1, 2020, at the redemption prices set forth below (expressed as a percentage of the principal amount to be redeemed), plus accrued and unpaid interest, if any, to, but excluding, the date of redemption:



July 1, 2020 to June 30, 2021	103.375	%
July 1, 2021 to June 30, 2022	101.688	%
July 1, 2022 and thereafter	100.000	%

If Surgery Center Holdings, Inc. experiences a change in control under certain circumstances, it must offer to purchase the 2025 Unsecured Notes at a purchase price equal to 101.000% of the principal amount, plus accrued and unpaid interest to, but excluding, the date of repurchase.

The 2025 Unsecured Notes contain customary affirmative and negative covenants, which, among other things, limit the Company’s ability to incur additional debt, pay dividends, create or assume liens, effect transactions with its affiliates, guarantee payment of certain debt securities, sell assets, merge, consolidate, enter into acquisitions and effect sale and leaseback transactions.

In connection with the offering of the 2025 Unsecured Notes, the Company recorded debt issuance costs of $17.3 million in the Predecessor period, which were eliminated with the application of pushdown accounting.

Notes Payable and Secured Loans

Certain of the Company’s subsidiaries have outstanding bank indebtedness, which is collateralized by the real estate and equipment owned by the surgical facilities to which the loans were made. The various bank indebtedness agreements contain covenants to maintain certain financial ratios and also restrict encumbrance of assets, creation of indebtedness, investing activities and payment of distributions. At December 31, 2018 (Successor), the Company was in compliance with its covenants contained in the credit agreements. The Company and its subsidiaries had notes payable to financial institutions of $79.3 million and $101.9 million as of December 31, 2018 (Successor) and 2017 (Successor), respectively.

Capital Lease Obligations

The Company is liable to various vendors for several property and equipment leases classified as capital leases. The carrying value of the leased assets was $22.7 million and $16.2 million as of December 31, 2018 (Successor) and 2017 (Successor), respectively.

Maturities

A summary of maturities for the Company's long-term debt, excluding unamortized fair value discount and premium discussed above, for the next five years and thereafter as of December 31, 2018 follows (in thousands):



2019	$	55,552
2020	1,459,069
2021	415,733
2022	11,079
2023	7,868
Thereafter	378,835
Total debt	$	2,328,136

Leases

12 Months Ended

Dec. 31, 2018

Leases [Abstract]

Leases

The Company leases office space and equipment for its surgical facilities, including surgical facilities under development. The lease agreements generally require the lessee, or the Company, to pay all maintenance, property taxes, utilities and insurance costs. The Company accounts for operating lease obligations and sublease income on a straight-line basis. Lease obligations paid in advance are recorded as prepaid rent and included in prepaid expenses and other current assets on the consolidated balance sheets. The difference between actual lease payments and straight-line lease expense over the initial lease term, excluding optional renewal periods, is recorded as deferred rent and included in other current liabilities and other long-term liabilities on the consolidated balance sheets.

Future minimum lease payments for non-cancellable operating and capital leases for the next five years and thereafter at December 31, 2018 follows (in thousands):



	Operating Leases		Capital Leases

2019	$	81,455	$	8,846
2020	75,649		6,680
2021	66,728		4,704
2022	61,261		2,907
2023	57,202		1,534
Thereafter	470,194		4,227
Total minimum payments	$	812,489	28,898
Less: imputed interest			(3,524		)
Capital lease obligations			$	25,374

The Company has various non-cancellable sub-lease arrangements. The total future minimum rentals to be received under these arrangements as of December 31, 2018 is estimated to be $3.4 million.

Rental expense for operating leases was $83.5 million for the year ended December 31, 2018 (Successor). $27.8 million for the four months ended December 31, 2017 (Successor), $39.2 million for the eight months ended August 31, 2017 (Predecessor) and $47.3 million for the year ended December 31, 2016 (Predecessor). Included in these amounts, the Company incurred lease expense under operating lease agreements with physician investors who are related parties of $20.2 million for the year ended December 31, 2018 (Successor), $7.5 million for the four months ended December 31, 2017 (Successor), $9.8 million for the eight months ended August 31, 2017 (Predecessor) and $14.4 million for year ended December 31, 2016 (Predecessor).

Redeemable Preferred Stock

12 Months Ended

Dec. 31, 2018

Temporary Equity Disclosure [Abstract]

Redeemable Preferred Stock

On August 31, 2017, the Company completed the sale issuance of 310,000 shares of the Company's preferred stock, par value $0.01 per share, designated as 10.00% Series A Convertible Perpetual Participating Preferred Stock (the “Series A Preferred Stock”) to Bain Capital at a purchase price of $1,000 per share for an aggregate purchase price of $310.0 million (the "Preferred Private Placement"). The net proceeds were used to finance a portion of the acquisition of NSH.

The accrued value of the Series A Preferred Stock is convertible into shares of common stock at a price per share of common stock equal to $19.00, subject to certain adjustments as provided in the Certificate of Designations, Preferences, Rights and Limitations of the 10.00% Series A Convertible Perpetual Participating Preferred Stock of Surgery Partners, Inc. (the “Series A Certificate of Designation”), at any time at the option of the holder. In addition, the Company may require the conversion of all, but not less than all, of the Series A Preferred Stock pursuant to the terms and conditions of the Series A Certificate of Designation, after the second anniversary of the date of issuance, if the volume weighted average closing price of the Common Stock for any 20 out of 30 consecutive trading days prior to such date, equals or exceeds $42.00 per share.

The Company cannot redeem the Series A Preferred Stock prior to the fifth anniversary of its issuance and thereafter, may redeem all, but not less than all, of the Series A Preferred Stock for cash pursuant to and subject to the terms and conditions of the Series A Certificate of Designation. The holders of Series A Preferred Stock may cause the Company to redeem the Series A Preferred Stock upon the occurrence of certain change of control transactions of the Company or the common stock ceasing to be listed or quoted on a trading market. The Company adjusts the carrying amount of the Series A Preferred Stock to equal the redemption value at the end of each reporting period as if it were also the redemption date. Changes in the redemption value are recognized immediately as they occur.

The Series A Preferred Stock ranks senior to the common stock and any other capital stock of the Company with respect to dividends, redemption and any other rights upon the liquidation, dissolution or winding up of the Company, and the holders thereof are entitled to vote with the holders of common stock, together as a single class, on all matters submitted to a vote of the Company’s stockholders. In addition to participating in any dividends that may be declared with respect to the common stock on an as-converted basis, each share of Series A Preferred Stock accrues dividends daily at a dividend rate of 10.00%, compounding quarterly, and in any given quarter, subject to certain conditions, the Board of Directors of the Company may declare a cash dividend in an amount up to 50% of the amount of the dividend that has accrued and accumulated during such quarter through the end of such quarter, and the amount of any quarterly dividend paid in cash shall not compound on the applicable date and shall not be included in the accrued value of the Series A Preferred Stock. In the event of the Company’s liquidation, dissolution or winding-up (whether voluntary of involuntary), holders of Series A Preferred Stock will be entitled to receive out of the assets of the Company available for distribution to shareholders, after satisfaction of any liabilities and obligations to creditors of the Company, with respect to each Series A Preferred Share, an amount equal to the greater of (i) $1,000.00 per share, plus dividends compounded to date, plus dividends accrued but not yet compounded and (ii) the amount that a holder of one share of common stock would receive, assuming the Series A Preferred Stock had converted into shares of common stock.

In connection with the issuance of Series A Preferred Stock, the Company incurred issuance costs of $18.3 million in the eight months ended August 31, 2017 (Predecessor), which were eliminated with the application of pushdown accounting.

A summary of activity related to the redeemable preferred stock for the year ended December 31, 2018 (Successor) follows (in thousands):



Successor
Balance at December 31, 2017	$	330,806
Dividends accrued	32,426
Cash dividends declared	(3,886		)
Balance at December 31, 2018	$	359,346

There were no unpaid cash dividends declared at December 31, 2018 (Successor). Cash dividends declared but unpaid at December 31, 2017 (Successor) were $3.9 million, and were included in other current liabilities in the consolidated balance sheet. The aggregate and per share amounts of unpaid cumulative preferred dividends as of December 31, 2018 (Successor) were $33.8 million and $108.97, respectively.

Derivatives and Hedging Activities	12 Months Ended
Derivatives and Hedging Activities	Dec. 31, 2018
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivatives and Hedging Activities	Derivatives and Hedging Activities Cash Flow Hedges of Interest Rate Risk The Company’s objectives in using interest rate derivatives are to add stability to interest expense and to manage its exposure to interest rate movements. To accomplish this objective, the Company primarily uses interest rate swaps as part of its interest rate risk management strategy. During 2018, such derivatives were used to hedge the variable cash flows associated with existing variable-rate debt. For derivatives designated and that qualify as cash flow hedges of interest rate risk, the gain or loss on the derivative is recorded in Accumulated Other Comprehensive Income and subsequently reclassified into interest expense in the same period(s) during which the hedged transaction affects earnings, as documented at hedge inception in accordance with the Company’s accounting policy election. Amounts reported in accumulated other comprehensive income related to derivatives will be reclassified to interest expense as interest payments are made on the Company’s variable-rate debt. Over the next 12 months, the Company estimates that $5.1 million will be reclassified as an increase to interest expense. As of December 31, 2018 (Successor), the Company had three interest rate swaps with a current notional amount of $900.0 million and a termination date of November 30, 2023. The Company classifies its derivative financial instruments as a long-term liability included in other long-term liabilities in the consolidated balance sheet as of December 31, 2018 (Successor). The Company had no derivative financial instruments as of December 31, 2017 (Successor). For the year ended December 31, 2018 (Successor), the Company incurred losses related to the effective portion of derivatives, which were recognized in accumulated other comprehensive income, gross of tax effect, of $23.1 million. For the year ended December 31, 2018 (Successor), the Company reclassified $0.6 million of losses from accumulated other comprehensive income to interest expense, gross of tax effect.

Earnings Per Share

12 Months Ended

Dec. 31, 2018

Earnings Per Share [Abstract]

Earnings Per Share

Basic and diluted earnings per share are calculated in accordance with Accounting Standards Codification 260, Earnings Per Share, based on the weighted-average number of shares outstanding in each period and dilutive stock options, unvested shares and warrants, to the extent such securities exist and have a dilutive effect on earnings per share. Beginning September 1, 2017 (Successor), in connection with the issuance of the Series A Preferred Stock, the Company began computing basic and diluted earnings per share using the two-class method. The two-class method of computing earnings per share is an earnings allocation method that determines earnings per share for common shares and participating securities according to their participation rights in dividends and undistributed earnings. Refer to Note 7. "Redeemable Preferred Stock", for further disclosure of the terms and conditions, including the participation rights, of the Series A Preferred Stock.

A reconciliation of the numerator and denominator of basic and diluted earnings per share follows (in thousands except share and per share amounts):



	Successor						Predecessor
	Year Ended December 31,			September 1 to December 31,			January 1 to August 31,			Year Ended December 31,
	2018			2017			2017			2016

Numerator:
Net (loss) income attributable to Surgery Partners, Inc.	$	(205,706	)	$	(41,316	)	$	(11,669	)	$	9,453
Less: amounts allocated to participating securities⁽¹⁾	32,426			10,481			—			—
Less: mark to redemption adjustment				15,566			—			—
Net (loss) income attributable to common stockholders	$	(238,132	)	$	(67,363	)	$	(11,669	)	$	9,453

Denominator:
Weighted average shares outstanding- basic	48,027,875			48,319,193			48,121,404			48,018,944
Effect of dilutive securities ⁽²⁾	—			—			—			171,794
Weighted average shares outstanding- diluted	48,027,875			48,319,193			48,121,404			48,190,738

(Loss) earnings per share:
Basic	$	(4.96	)	$	(1.39	)	$	(0.24	)	$	0.20
Diluted ⁽²⁾	$	(4.96	)	$	(1.39	)	$	(0.24	)	$	0.20

Securities outstanding not included in the computation of diluted (loss) earnings per share as their effect is antidilutive:
Stock options	82,602			—			—			—
Restricted shares	198,267			62,850			105,944			—
Convertible preferred stock	—			—			N/A			N/A

⁽¹⁾ Amounts allocated to participating securities includes dividends accrued during the Successor periods for the Series A Preferred Stock. The Series A Preferred Stock does not participate in undistributed losses. There were no participating securities during the Predecessor periods.

⁽²⁾The impact of potentially dilutive securities for the year ended December 31, 2018 (Successor), four months ended December 31, 2017 (Successor) and the eight months ended August 31, 2017 (Predecessor), were not considered because the effect would be anti-dilutive in each of those periods.

Share Repurchase Transactions

On December 15, 2017, the Board of Directors authorized a share repurchase program of up to $50.0 million of the Company's issued and outstanding common stock from time to time. The timing and size of repurchases will be determined based on market conditions and other factors. The authorization does not obligate the repurchase any shares and the Company may repurchase shares of common stock at any time without prior notice. The share repurchases will be made in accordance with applicable securities laws in open market or privately negotiated transactions. The authorization does not have a specified expiration date, and the share repurchase program may be suspended, recommenced or discontinued at any time or from time to time without prior notice.

In December 2017 (Successor), the Company repurchased 180,664 shares of its common stock at an average price of $11.12 per share through market purchases. In 2018 (Successor), the Company repurchased 156,818 shares of its common stock at an average price of $12.64 per share through market purchases, leaving approximately $46.0 million of repurchase authorization available under the December 2017 authorization at December 31, 2018 (Successor).

Income Taxes

12 Months Ended

Dec. 31, 2018

Income Tax Disclosure [Abstract]

Income Taxes

The Company uses the asset and liability method to account for income taxes. Under this method, deferred income tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. Any change in tax rates that could impact deferred tax assets or liabilities are recognized in the same period the change occurs. If a net operating loss ("NOL") carryforward exists, the Company makes a determination as to whether that NOL carryforward will be utilized in the future. A valuation allowance is established for certain net operating loss carryforwards when their recoverability is deemed to be uncertain. The carrying value of the net deferred tax assets assumes that the Company will be able to generate sufficient future taxable income in certain tax jurisdictions, based on estimates and assumptions. If these estimates and related assumptions change in the future, the Company may be required to adjust its deferred tax valuation allowances.

The Company, or one or more of its subsidiaries, files income tax returns in the U.S. federal jurisdiction and various state jurisdictions. With few exceptions, the Company is no longer subject to U.S. federal income tax examinations for years prior to 2015 or state income tax examinations for years prior to 2014.

The Company and certain of its subsidiaries file a consolidated federal income tax return. The partnerships, limited liability companies, and certain non-consolidated physician practice corporations also file separate income tax returns. The Company's allocable portion of each partnership's and limited liability company's income or loss is included in taxable income of the Company. The remaining income or loss of each partnership and limited liability company is allocated to the other owners.

The Company made income tax payments of $2.2 million for the year ended December 31, 2018 (Successor), $0.5 million and $0.6 million for the four months ended December 31, 2017 (Successor) and eight months ended August 31, 2017 (Predecessor), respectively and $0.7 million and for the year ended December 31, 2016 (Predecessor).

Income tax expense (benefit) is comprised of the following (in thousands):



	Successor						Predecessor
	Year Ended December 31,			September 1 to December 31,			January 1 to August 31,			Year Ended December 31,
	2018			2017			2017			2016

Current:
Federal	$	(324	)	$	(111	)	$	—		$	(31	)
State	1,511			990			614			244
Deferred:
Federal	16,525			77,472			(17,288		)	7,326
State	8,749			(6,712		)	(1,415		)	(444		)
Total income tax expense (benefit)	$	26,461		$	71,639		$	(18,089	)	$	7,095

A reconciliation of the provision for income taxes as reported in the consolidated statements of operations and the amount of income tax expense (benefit) computed by multiplying consolidated income (loss) in each year by the U.S. federal statutory rate of 21% (2018) and 35% (2017 and 2016) follows (in thousands):



	Successor						Predecessor
	Year Ended December 31,			September 1 to December 31,			January 1 to August 31,			Year Ended December 31,
	2018			2017			2017			2016

Tax expense (benefit) at U.S.federal statutory rate	$	(14,525	)	$	24,485		$	4,315		$	32,263
State income tax, net of U.S. federal tax benefit	9,955			1,685			(456		)	(86		)
Change in valuation allowance	26,946			529			1,324			354
Net income attributable to non-controlling interests	(23,117		)	(13,872		)	(14,731		)	(26,470		)
Changes in measurement of uncertain tax positions	(73		)	(191		)	20			(262		)
Stock option compensation	509			306			37			(200		)
Differences related to divested facilities	6,037			(429		)	(1,708		)	—
Nondeductible transaction costs	23			2,058			(977		)	—
Tax return reconciling differences	1,748			—			(316		)	1,635
Change in effective tax rate	493			64,343			(825		)	—
Tax Receivable Agreement liability	901			(7,404		)	(4,782		)	(327		)
Goodwill impairment	8,892			—			—			—
Litigation settlement	8,577			—			—			—
Other	95			129			10			188
Total income tax expense (benefit)	$	26,461		$	71,639		$	(18,089	)	$	7,095

The components of temporary differences and the approximate tax effects that give rise to the Company’s net deferred tax asset are as follows (in thousands):



	Successor
	December 31, 2018			December 31, 2017

Deferred tax assets:
Medical malpractice liability	$	3,456		$	3,236
Accrued vacation and incentive compensation	2,933			2,125
Net operating loss carryforwards	139,404			137,794
Allowance for bad debts	2,510			2,545
Capital loss carryforwards	3,701			3,024
Deferred rent	1,866			—
Amortization of intangible assets	2,437			—
Deferred financing costs	14,638			17,004
Section 163(j) interest	27,338
Interest rate swap liability	5,431
TRA liability	1,176			1,042
Other deferred assets	7,010			4,961
Total gross deferred tax assets	211,900			171,731
Less: Valuation allowance	(50,430		)	(11,032		)
Total deferred tax assets	161,470			160,699
Deferred tax liabilities:
Depreciation on property and equipment	(3,925		)	(12,098		)
Amortization of intangible assets	—			(12,441		)
Basis differences of partnerships and joint ventures	(47,749		)	(2,399		)
Deferred rent	—			(717		)
Other deferred liabilities	(603		)	(725		)
Total deferred tax liabilities	(52,277		)	(28,380		)
Net deferred tax assets	$	109,193		$	132,319

The Company had federal net operating loss carryforwards of $516.8 million as of December 31, 2018, which expire between 2025 and 2037 and state net operating loss carryforwards of $589.9 million as of December 31, 2018, which expire between 2019 and 2038. The Company had capital loss carryforwards of $14.8 million as of December 31, 2018, which expire between 2019 and 2023. The Company had federal and state credit carryforwards of $1.0 million as of December 31, 2018. The federal credits do not expire, and the state credits expire between 2019 and 2030.

The Company has recorded a valuation allowance against deferred tax assets at December 31, 2018 and 2017 totaling $50.4 million and $11.0 million, respectively, which represents an increase of $39.4 million. The valuation allowance continues to be provided for certain deferred tax assets for which the Company believes it is more likely than not that the tax benefits will not be realized, which are primarily Section 163(j) interest carryforwards, certain state net operating losses and capital loss carryforwards.

The Company has evaluated the realizability of its deferred tax assets based on sources of positive and negative evidence, and determined that it is more likely than not that the net operating loss carryforwards will be realized. The determination was made based upon projections of future book and taxable income. If the Company's expectations for future operating results on a consolidated basis or at the state jurisdiction level vary from actual results due to changes in healthcare regulations, general economic conditions, or other factors, the Company may need to adjust the valuation allowance, for all or a portion of its deferred tax assets. The Company's income tax expense in future periods will be reduced or increased to the extent of offsetting decreases or increases, respectively, in its valuation allowance in the period when the change in circumstances occurs. These changes could have a significant impact on the Company's future earnings.

Included in the increase in the valuation allowance for the year ended December 31, 2018 was an increase of approximately $6.3 million that was recorded to additional-paid-in-capital as the result of the tax effect of the disposals of shares of non-controlling interests and the interest rate swap liability. Also included in the increase in the valuation allowance was an increase of approximately $0.1 million that was recorded to goodwill related to certain deferred tax assets acquired during the year. Approximately $8.1 million of the valuation allowance as of December 31, 2018 is recorded against deferred tax assets that, if subsequently recognized, will be credited directly to contributed capital.

A reconciliation of the beginning and ending liability for gross unrecognized tax benefits for the years ended December 31, 2018 and 2017 is as follows (in thousands):



	Successor
	December 31, 2018			December 31, 2017

Unrecognized tax benefits at beginning of year	$	690		$	1,061
Additions for acquired positions	—			36
Additions for tax positions of prior years	7			—
Reductions for tax positions of prior year	(629		)	(407		)
Settlements	(7		)	—
Unrecognized tax benefits at end of year	$	61		$	690

The Company recognizes interest and penalties related to uncertain tax positions in its provision for income taxes in the consolidated statements of operations. For both the years ended December 31, 2018 and 2017, the Company had approximately $0.1 million of accrued interest and penalties related to uncertain tax positions. The total amount of accrued liabilities related to uncertain tax positions that would affect the Company's effective tax rate, if recognized, is $0.1 million and $0.2 million as of December 31, 2018 and 2017, respectively. The reserves are included in long-term taxes payable and long-term deferred tax assets in the consolidated balance sheet as of December 31, 2018.

The Tax Cuts and Jobs Act (the "Tax Act") was enacted on December 22, 2017. The Tax Act reduces the U.S. federal corporate tax rate from 35% to 21%, allows for 100% expensing of certain capital expenditures, and limits interest expense deductions beginning in 2018. The SEC staff issued SAB 118, which provides guidance on accounting for the tax effects of the Tax Act. SAB 118 provides a measurement period that should not extend beyond one year from the Tax Act enactment date for companies to complete the accounting under ASC 740. In accordance with SAB 118, a company must reflect the income tax effects of those aspects of the Tax Act for which the accounting under ASC 740 is complete. The Company's accounting for the following elements of the Tax Act is complete: reduction of U.S. federal corporate tax rate from 35% to 21%, 100% expensing of capital expenditures, and the interest expense limitation under Section 163j.

Equity-Based Compensation

12 Months Ended

Dec. 31, 2018

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Equity-Based Compensation

Transactions in which the Company receives employee and non-employee services in exchange for the Company’s equity instruments or liabilities that are based on the fair value of the Company’s equity securities or may be settled by the issuance of these securities are accounted for using a fair value method. The Company’s policy is to recognize compensation expense using the straight line method over the relevant vesting period for units that vest based on time.

In September 2015, the Company adopted the Surgery Partners, Inc. 2015 Omnibus Incentive Plan ("2015 Omnibus Incentive Plan") from which all equity-based awards will be granted. Under this plan, the Company can grant stock options, SARs, restricted stock, unrestricted stock, stock units, performance awards, cash awards and other awards convertible into or otherwise based on shares of its common stock. As of December 31, 2018, 4,815,700 shares were authorized to be granted under the 2015 Omnibus Incentive Plan and 3,377,923 were available for future equity grants.

Restricted Share-Based Awards

During the year ended December 31, 2018 (Successor), the Company granted 519,605 restricted stock awards ("RSAs") to certain officers, employees and non-employee directors in accordance with the 2015 Omnibus Incentive Plan. During the four months ended December 31, 2017 (Successor) and the eight months ended August 31, 2017 (Predecessor), the Company granted 112,107 and 251,904 RSAs, respectively. Vesting and payment of these RSAs are generally subject to continuing service of the employee or non-employee director over the ratable vesting periods beginning one year from the date of grant to three or five years after the date of grant. The fair values of these RSAs were determined based on the closing price of the Company’s common stock on the trading date immediately prior to the grant date.

During the year ended December 31, 2018 (Successor), the Company granted 335,074 performance-based restricted stock units ("PSUs") subject to the achievement of a combination of performance conditions. There were no grants during the four months ended December 31, 2017 (Successor). During the eight months ended August 31, 2017 (Predecessor) the Company granted 232,242 PSUs. In addition to the achievement of the performance conditions, these PSUs are generally subject to the continuing service of the employee over the ratable vesting period from the earned date continuing for two years. The performance condition for the targeted PSUs granted during the eight months ended August 31, 2017 (Predecessor) is based on the Company’s achievement of annually established targets for adjusted earnings per share for 2017. For these restricted stock units, the number of shares payable at the end of the performance periods ranges from 0% to 150% of the targeted units based on the Company’s actual performance and/or market conditions results as compared to the targets. These stock units are not considered outstanding until earned. During the year ended December 31, 2018 (Successor), none of the PSUs granted were deemed to have been earned. No units granted were deemed to have been earned during the four months ended December 31, 2017 (Successor). During the eight months ended August 31, 2017 (Predecessor), 136,550 of the PSUs granted were deemed to have been earned.

Additionally, during the year ended December 31, 2018 (Successor), the Company granted 127,292 leverage performance restricted stock units ("LPUs") subject to the achievement of a combination of market conditions. During the four months ended December 31, 2017 (Successor), the Company granted 215,823 LPUs. There were no grants during the eight months ended August 31, 2017 (Predecessor). In addition to the achievement of the market conditions, these LPUs are generally subject to the continuing service of the employee over the ratable vesting period from the performance period end date continuing for three years. The market condition for the LPUs granted during the four months ended December 31, 2017 (Successor) is based on the Company’s three-year annualized total shareholder return relative to the companies making up the S&P Composite 1500 Health Care Index as of the grant date. These stock units are not considered outstanding until earned. During the four months ended December 31, 2017 (Successor), none of the LPUs granted were deemed to have been earned.

For these restricted stock units, the number of shares payable at the end of the vesting periods ranges from 0% to 500% of the targeted units based on the Company’s actual performance and/or market conditions results as compared to the targets. The fair values of these restricted stock units were determined based on a combination, where applicable, of the closing price of the Company’s common stock on the trading date immediately prior to the grant date for units subject to performance conditions, or at its Monte-Carlo simulation value for units subject to market conditions. The Company recognizes compensation expense for the portion of the targeted performance-based restricted stock units subject to market conditions even if the condition is never satisfied. However, if the performance conditions are not met for the portion of the targeted performance-based restricted stock units subject to such performance conditions, no compensation expense will be recognized, and any previously recognized compensation expense will be reversed. Forfeitures are recognized as incurred.

Restricted Share-Based Activity

A summary of non-vested restricted share-based activity for the years ended December 31, 2018, 2017, and 2016 follows:



	Unvested Shares		Weighted Average Grant Date Fair Value
Predecessor
Outstanding at January 1, 2016	167,654		$	2.53
Granted/Earned	384,629		15.09
Forfeited/Cancelled	(53,003	)	11.85
Vested	(37,038	)	6.31
Outstanding at December 31, 2016	462,242		$	3.72
Granted/Earned	388,454		18.40
Forfeited/Cancelled	(67,771	)	18.01
Vested	(169,881	)	10.29
Outstanding at August 31, 2017	613,044		$	16.02



Successor
Outstanding at September 1, 2017	613,044		$	16.02
Granted/Earned	112,107		11.15
Forfeited/Cancelled	(54,622	)	10.94
Vested	(96,073	)	17.03
Outstanding at December 31, 2017	574,456		$	15.95
Granted/Earned	519,605		16.10
Forfeited/Cancelled	(180,719	)	15.09
Vested	(210,318	)	16.31
Outstanding at December 31, 2018	703,024		$	16.18

Stock Options and Stock Appreciation Rights

The Company granted 700,000 stock options during the year ended December 31, 2018. The Company did not grant any stock options during the year ended December 31, 2017. During the year ended December 31, 2016, the Company granted options to purchase shares of the Company’s common stock to certain directors in accordance the 2015 Omnibus Incentive Plan. Options to purchase shares are granted with an exercise price equal to the fair market value of the Company’s common stock on the day of grant, based on the closing price of the Company’s common stock on the trading date immediately prior to the grant date. Fifty percent (50%) of the Stock Option Awards will vest in five equal annual installments on each of the first five anniversaries of the date of grant, generally subject to continued employment on each vesting date. Twenty-five percent (25%) of the award will vest based on satisfaction of the time condition and the achievement by the Company of an average closing price of a share of Common Stock on the Nasdaq Stock Market of $25.00 over a period of sixty (60) consecutive trading days, and twenty-five percent (25%) of the award will vest based on satisfaction of the time condition and the achievement by the Company of an average closing price of a share of Common Stock on the Nasdaq Stock Market of $35.00 over a period of sixty (60) consecutive trading days, in each case, generally subject to continued employment on each vesting date. Forfeitures are recognized as incurred.

On December 16, 2018, the Company cancelled 200,000 stock options and replaced them with 200,000 stock-settled stock appreciation right awards (the "SAR Awards"). These were the only SAR Awards granted as of the year ended December 31, 2018. The Company did not grant any SAR Awards for the years ended December 31, 2017 and 2016. The SAR Awards had a base price equal to the exercise price of the cancelled stock options. Fifty percent (50%) of the SAR Awards will vest in five equal annual installments on each of the first five anniversaries of the date of grant, generally subject to continued employment on each vesting date. Twenty-five percent (25%) of the award will vest based on satisfaction of the time condition and the achievement by the Company of an average closing price of a share of Common Stock on the Nasdaq Stock Market of $25.00 over a period of sixty (60) consecutive trading days, and twenty-five percent (25%) of the award will vest based on satisfaction of the time condition and the achievement by the Company of an average closing price of a share of Common Stock on the Nasdaq Stock Market of $35.00 over a period of sixty (60) consecutive trading days, in each case, generally subject to continued employment on each vesting date. Forfeitures are recognized as incurred.

Option/SAR Valuation

In applying the Monte Carlo simulation model to value both the stock options and SAR Awards, the Company used the following assumptions:


▪	Risk-free interest rate. The risk-free interest rate is used as a component of the fair value of stock options to take into account the time value of money. For the risk-free interest rate, the Company uses the implied yield on United States Treasury zero-coupon issues with a remaining term equal to the expected life, in years, of the options granted.

▪

Expected volatility. Volatility, for the purpose of share-based compensation, is a measurement of the amount that a share price has fluctuated. Expected volatility involves reviewing historical volatility and determining what, if any, change the share price will have in the future. The Company used historical stock price information of certain peer group companies for a period of time equal to the expected option life period to determine estimated volatility.


▪	Expected life, in years. A clear distinction is made between the expected life of an option and the contractual term of the option. The expected life of an option is considered the amount of time, in years, that an option is expected to be outstanding before it is exercised. Whereas, the contractual term of the stock option is the term an option is valid before it expires.


▪	Expected dividend yield. Since issuing dividends will affect the fair value of a stock option, GAAP requires companies to estimate future dividend yields or payments. The Company has not historically issued dividends and does not intend to issue dividends in the future. As a result, the Company does not apply a dividend yield component to its valuation.

The following table sets forth the assumptions used by the Company to estimate the fair value of options and SAR Awards granted in 2018 under the 2015 Omnibus Incentive Plan:



Expected volatility		60% - 65%
Risk-free interest rate		2.50% - 2.90%
Expected dividends		—
Average expected term (years)		10
Fair value of stock options granted		$8.48 - $9.44

The following table sets forth the assumptions used by the Company to estimate the fair value of options granted in 2016 and 2015 under the 2015 Omnibus Incentive Plan:



Expected volatility		29% - 43%
Risk-free interest rate		0.54% - 1.36%
Expected dividends		—
Average expected term (years)		2.56
Fair value of stock options granted		$2.64 - $5.74

The estimated fair value of options is amortized to expense on a straight-line basis over the options’ vesting period.

Stock Option and Stock Appreciation Rights Activity

A summary of stock option and SAR Award activity for the years ended December 31, 2018, 2017, and 2016 follows:



	Options/SARs		Weighted Average Exercise Price		Weighted Average Remaining Contractual Term (years)
Predecessor
Outstanding at January 1, 2016	8,488		$	20.03	3.0
Granted	7,779		17.99		1.6
Exercised	—
Forfeited/Cancelled	—
Outstanding at December 31, 2016	16,267		$	19.05	1.8
Granted	—
Exercised	(3,580	)	15.36
Forfeited/Cancelled	—
Outstanding at August 31, 2017	12,687		$	20.10	1.5



Successor
Outstanding at September 1, 2017	12,687		$	20.10	1.5
Granted	—
Exercised	—
Forfeited/Cancelled	—
Outstanding at December 31, 2017	12,687		$	20.10	1.2
Granted	700,000		12.90		10.0
Exercised	—
Forfeited/Cancelled	(200,000	)	$	12.90	10.0
Outstanding at December 31, 2018 ⁽¹⁾	512,687		$	13.03	9.8

⁽¹⁾ Of the outstanding options, 11,287 were exercisable as of December 31, 2018 (Successor).

Other information pertaining to equity-based compensation

At December 31, 2018 (Successor), unrecognized compensation cost related to unvested shares was approximately $18.6 million. Unrecognized compensation cost will be expensed annually based on the number of shares that vest during the year.

The Company records equity-based compensation expense to recognize the fair value of the restricted shares that vest and stock options granted. The Company recorded equity-based compensation expense of $9.3 million for the year ended December 31, 2018 (Successor), $1.9 million for the four months ended December 31, 2017 (Successor), $3.7 million for the eight months ended August 31, 2017 (Predecessor) and $2.0 million for the year ended December 31, 2016 (Predecessor).

Employee Benefit Plans	12 Months Ended
Employee Benefit Plans	Dec. 31, 2018
Retirement Benefits [Abstract]
Employee Benefit Plans	Employee Benefit Plans Surgery Partners 401(k) Plan The Surgery Partners 401(k) Plan is a defined contribution plan whereby certain employees who have completed at least one month of service, including at least one hour of service during that period of time, are eligible to participate. Employees may enroll in the plan immediately upon completion of the minimum service requirement. The Surgery Partners 401(k) Plan allows eligible employees to make contributions of varying percentages or flat dollar amounts of their annual compensation, up to the maximum allowable amounts by the Internal Revenue Service ("IRS"). Eligible employees may or may not receive a match by the Company of their contributions. Employer contributions vest incrementally over a period of five years. The Company's contributions were $7.6 million for the year ended December 31, 2018 (Successor), $2.3 million for the four months ended December 31, 2017 (Successor), $2.8 million for the eight months ended August 31, 2017 (Predecessor) and $5.1 million for the year ended December 31, 2016 (Predecessor). Supplemental Executive Retirement Savings Plan In connection with the Symbion acquisition, the Company acquired and continues to maintain a supplemental executive retirement savings plan (the "SERP") for certain former executives of a prior business combination. The SERP provides supplemental retirement savings alternatives to eligible officers and key employees of the Company by allowing participants to defer portions of their compensation. Under the SERP, eligible employees may enroll in the plan before December 31 to be entered in the plan the following year. Eligible employees may defer into the SERP up to 25% of their normal period payroll and up to 50% of their annual bonus. If the enrolled employee contributes a minimum of 2% of his or her base salary into the SERP, the Company will contribute 2% of the enrolled employee’s base salary to the plan and has the option of contributing additional amounts. Periodically, the enrolled employee’s deferred amounts are transferred to a plan administrator. The plan administrator maintains separate non-qualified accounts for each enrolled employee to track deferred amounts. On May 1 of each year, the Company is required to make its contribution to each enrolled employee’s account. See Note 1. "Organization and Summary of Accounting Policies" for information about the fair value of the assets and liabilities in the SERP.

Other Current and Long-Term Liabilities

12 Months Ended

Dec. 31, 2018

Other Liabilities Disclosure [Abstract]

Other Current and Long-Term Liabilities

Other Current Liabilities

A summary of other current liabilities follows (in thousands):



	Successor
	December 31, 2018		December 31, 2017

Interest payable	$	20,755	$	20,537
Amounts due to patients and payors	20,053		18,096
Accrued legal settlement	42,342		—
Accrued expenses and other	72,093		71,311
Total	$	155,243	$	109,944

Other Long-Term Liabilities

A summary of other long-term liabilities follows (in thousands):



	Successor
	December 31, 2018		December 31, 2017

Facility lease obligations	$	149,811	$	121,627
Other	121,376		100,853
Total	$	271,187	$	222,480

At four of the Company's surgical facilities, the Company has financing obligations payable to the lessors of certain land, buildings and improvements. Payments are allocated to principal adjustments of the financing obligations and interest expense. The current portions of the financing obligations were $7.0 million and $6.3 million at December 31, 2018 (Successor) and 2017 (Predecessor), respectively, and were included in other current liabilities in the consolidated balance sheets. The long-term portions of the financing obligations are included as facility lease obligations in the table above.

In 2017, one of the Company's surgical facilities entered into a development agreement to construct a new hospital. Due to certain provisions of the agreement, the surgical facility is deemed the owner during construction, and as such, the Company records the ongoing costs as incurred as a deferred financing obligation. As of December 31, 2018 (Successor), the Company recorded a total of $50.2 million of costs for this project, of which $36.6 million and $13.6 million were recorded during the years ended December 31, 2018 (Successor) and 2017 (Successor), respectively. These project costs are included as non-cash additions to property and equipment, net in the consolidated balance sheet and as a component of facility lease obligations.

Commitments and Contingencies	12 Months Ended
Commitments and Contingencies	Dec. 31, 2018
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Professional and General Liability Risks The Company is subject to claims and legal actions in the ordinary course of business, including claims relating to patient treatment, employment practices and personal injuries. The Company maintains general liability and professional liability insurance in excess of self-insured retentions, on a claims-made basis through third party commercial insurance carriers. Although management believes the coverage is sufficient for the Company's operations, some claims may potentially exceed the scope of coverage in effect. The Company also maintains workers' compensation insurance, subject to a deductible. Plaintiffs in these matters may request punitive or other damages that may not be covered by insurance. Laws and Regulations Laws and regulations governing the Company's business, including those relating to the Medicare and Medicaid programs, are complex and subject to interpretation. These laws and regulations govern every aspect of how the Company's surgical facilities conduct their operations, from licensing requirements to how and whether the Company's facilities may receive payments pursuant to the Medicare and Medicaid programs. Compliance with such laws and regulations can be subject to future government agency review and interpretation as well as legislative changes to such laws. Noncompliance with such laws and regulations may subject the Company to significant regulatory action including fines, penalties, and exclusion from the Medicare, Medicaid and other federal healthcare programs. From time to time, governmental regulatory agencies will conduct inquiries of the Company's practices, including, but not limited to, the Company's compliance with federal and state fraud and abuse laws, billing practices and relationships with physicians. On October 23, 2017, the Company received several civil investigative demands (“CIDs”) from the federal government under the False Claims Act (“FCA”) for documents and information dating back to January 1, 2010 relating to the medical necessity of certain drug tests conducted by the Company’s physicians and submitted to laboratories owned and operated by the Company. In addition, the Company has been informed by CMS that payments to its diagnostic laboratory, Logan Laboratories, have been suspended pending further investigation by CMS. The Company has been providing information to the government in response to the CIDs and currently has a non-binding agreement in principle with the DOJ on the financial terms of a settlement with the goal of resolving these matters. Based on those discussions, which are still ongoing, The Company recorded a litigation-related charge of $46.0 million relating to these matters on the consolidated statements of operations. The Company believes that this reserve is sufficient to cover a potential resolution with the government relating to these matters, including legal expenses relating to the settlement that have not previously been recorded in operating expenses. The ultimate timing, amount and/or final terms of any such resolution may differ materially from those anticipated or the Company may not be able to reach a resolution at all. It is reasonably possible that the Company will incur additional losses above the amount reserved, but the Company is not able to estimate such amounts at this time. See Item 1A “Risk Factors” included elsewhere in this report under the heading “Risk Factors - Risks Related to Government Regulation - Companies within the healthcare industry, including us, continue to be the subject of federal and state audits and investigations, including actions for false and other improper claims.” Acquired Facilities The Company, through its wholly-owned subsidiaries or controlled partnerships and limited liability companies, has acquired and will continue to acquire surgical facilities with prior operating histories. Such facilities may have unknown or contingent liabilities, including liabilities for failure to comply with healthcare laws and regulations, such as billing and reimbursement, fraud and abuse and similar anti-referral laws. Although the Company attempts to assure that no such liabilities exist, obtain indemnification from prospective sellers covering such matters and institute policies designed to conform centers to its standards following completion of acquisitions, there can be no assurance that the Company will not become liable for past activities that may later be asserted to be improper by private plaintiffs or government agencies. There can be no assurance that any such matter will be covered by indemnification or, if covered, that the liability sustained will not exceed contractual limits or the financial capacity of the indemnifying party. The Company cannot predict whether federal or state statutory or regulatory provisions will be enacted that would prohibit or otherwise regulate relationships which the Company has established or may establish with other healthcare providers or have materially adverse effects on its business or revenues arising from such future actions. Management believes, however, that it will be able to adjust the Company's operations so as to be in compliance with any statutory or regulatory provision as may be applicable. Potential Physician Investor Liability A majority of the physician investors in the partnerships and limited liability companies which operate the Company's surgical facilities carry general and professional liability insurance on a claims-made basis. Each partnership or limited liability company may, however, be liable for damages to persons or property arising from occurrences at the surgical facilities. Although the various physician investors and other surgeons generally are required to obtain general and professional liability insurance with tail coverage that extends beyond the period of any claims-made policies, such individuals may not be able to obtain coverage in amounts sufficient to cover all potential liability. Since most insurance policies contain exclusions, the physician investors will not be insured against all possible occurrences. In the event of an uninsured or underinsured loss, the value of an investment in the partnership interests or limited liability company membership units and the amount of distributions could be adversely affected. Tax Receivable Agreement On May 9, 2017, the Company entered into an agreement to amend that certain Income Tax Receivable Agreement, dated September 30, 2015 (as amended, the “TRA”), by and between the Company, and the other parties referred to therein, which amendment became effective on August 31, 2017. Pursuant to the amendment to the TRA, the Company agreed to make payments to H.I.G., the Company's former controlling shareholder, in its capacity as the stockholders representative pursuant to a fixed payment schedule. The amounts payable under the TRA are calculated as the product of (i) an annual base amount and (ii) the maximum corporate federal income tax rate for the applicable year plus three percent. The amounts payable under the TRA are related to the Company’s projected realized tax savings over the next six years and are not dependent on the Company’s actual tax savings over such period. The calculation of amounts payable pursuant to the TRA is thus dependent on the maximum corporate federal income tax rate. To the extent that the Company is unable to make payments under the TRA and such inability is a result of the terms of credit agreements and other debt documents that are materially more restrictive than those existing as of September 30, 2015, such payments will be deferred and will accrue interest at a rate of LIBOR plus 500 basis points until paid. If the terms of such credit agreements and other debt documents cause the Company to be unable to make payments under the TRA and such terms are not materially more restrictive than those existing as of September 30, 2015, such payments will be deferred and will accrue interest at a rate of LIBOR plus 300 basis points until paid. As a result of the amendment to the TRA, the Company was required to value the liability under the TRA by discounting the fixed payment schedule using the Company’s incremental borrowing rate. During the eight months ended August 31, 2017 (Predecessor), the Company recognized a reduction in the carrying value of the liability under the TRA of $43.9 million, with $15.3 million of the reduction recorded to a gain on amendment of TRA and $28.6 million recorded as a reduction to the goodwill recorded in connection with the application of pushdown accounting related to the change of control. As a result of the reduction in the corporate tax rate from the Tax Cuts and Jobs Act, the Company remeasured the value of the liability under the TRA pursuant to the calculation terms as described above. During the four months ended December 31, 2017 (Successor), the Company recognized a reduction in the carrying value of the liability under the TRA of $25.3 million, included as a tax receivable agreement benefit in the consolidated statement of operations. Assuming the Company's tax rate is 24%, calculated as the maximum corporate federal tax rate plus three percent, throughout the remaining term of the TRA, the Company estimates the total remaining amounts payable under the TRA was approximately $64.6 million and $65.1 million as of December 31, 2018 (Successor) and 2017 (Successor), respectively. The carrying value of the liability under the TRA, reflecting the discount as discussed above, was $48.5 million and $44.3 million as of December 31, 2018 (Successor) and 2017 (Successor), respectively. The current portion of the liability was $7.6 million and $0.5 million as of December 31, 2018 (Successor) and 2017 (Successor), respectively, and is included as a component of other current liabilities in the consolidated balance sheet. The long-term portion is included as a component of other long-term liabilities in the consolidate balance sheet. Contingent Consideration In connection with certain prior period acquisitions, pursuant to the applicable purchase agreements, the Company was required to pay consideration to the prior owners of the applicable facilities should the requirements for continuing employment agreed to in the purchase agreements be met. In accordance with Accounting Standards Codification 805, Business Combinations, contingent consideration with a continuing employment provision is recognized ratably over the defined performance period as compensation expense. The Company recognized contingent acquisition compensation expense of $1.5 million for the year ended December 31, 2018 (Successor), $1.9 million for the four months ended December 31, 2017 (Successor) and $5.1 million for both the eight months ended August 31, 2017 (Predecessor) and the year ended December 31, 2016 (Predecessor). The Company recorded the expense as a component of general and administrative expenses in the consolidated statement of operations. The Company has no further contingent acquisition compensation expense obligations. Other In connection with the Company's integration of the corporate office functions related to the acquisition of NSH, the Company closed its Chicago, Illinois office on September 30, 2018 (Successor). As a result, the Company recognized a cease-use liability of $1.4 million, representing the estimated costs that will continue to be incurred under the office lease for its remaining term. The estimated costs were included as transaction and integration costs in the consolidated statement of operations for the year ended December 31, 2018 (Successor) and as a component of other current liabilities and other long-term liabilities in the consolidated balance sheet as of December 31, 2018 (Successor). In 2018 (Successor), the Company recognized a liability of $4.5 million for estimated severance costs in connection with the corporate office integration. The estimated costs were included as transaction and integration costs in the consolidated statement of operations for the year ended December 31, 2018 (Successor) and the unpaid severance was included as a component of accrued payroll and benefits in the consolidated balance sheet as of December 31, 2018 (Successor).

Segment Reporting

12 Months Ended

Dec. 31, 2018

Segment Reporting [Abstract]

Segment Reporting

The Company operates in three major lines of business that are also the Company's reportable operating segments - the operation of surgical facilities, the operation of ancillary services and the operation of optical services. The surgical facility services segment consists of the operation of ASCs and surgical hospitals, and includes anesthesia services. The ancillary services segment consists of a diagnostic laboratory and multi-specialty physician practices. The optical services segment consists of an optical products group purchasing organization, and until October 2018, an optical laboratory that manufactured eyewear.

"All other" primarily consists of the Company's corporate general and administrative functions. Prior to 2017, the all other component was disaggregated and presented below the reportable operating segments in the Adjusted EBITDA reconciliation table. The Company has conformed the prior periods to align to the current year presentation. These changes had no effect on the Company’s reportable operating segments, which are presented consistent with prior periods.

The following tables present financial information for each reportable segment (in thousands):



	Successor						Predecessor
	Year Ended December 31,			September 1 to December 31,			January 1 to August 31,			Year Ended December 31,
	2018			2017			2017			2016
Revenues:
Surgical facility services	$	1,682,278		$	564,458		$	688,725		$	1,042,097
Ancillary services	79,633			24,660			52,261			90,836
Optical services	9,545			3,486			7,629			12,505
Total	$	1,771,456		$	592,604		$	748,615		$	1,145,438

Adjusted EBITDA:
Surgical facility services	$	309,513		$	103,760		$	125,912		$	214,218
Ancillary services	3,008			(2,255		)	(6,526		)	12,685
Optical services	2,500			736			2,214			3,308
All other	(80,253		)	(23,504		)	(36,036		)	(50,948		)
Total	$	234,768		$	78,737		$	85,564		$	179,263

Cash purchases of property and equipment, net:
Surgical facility services	$	34,178		$	9,334		$	14,582		$	29,157
Ancillary services	419			191			1,875			5,388
Optical services	46			83			73			351
All other	5,162			1,219			2,243			4,213
Total	$	39,805		$	10,827		$	18,773		$	39,109

A reconciliation of Adjusted EBITDA to income before income taxes included in the condensed consolidated statement of operations is as follows:



	Successor						Predecessor
	Year Ended December 31,			September 1 to December 31,			January 1 to August 31,			Year Ended December 31,
	2018			2017			2017			2016

Adjusted EBITDA	$	234,768		$	78,737		$	85,564		$	179,263
Net income attributable to non-controlling interests	110,080			39,634			42,087			75,630
Depreciation and amortization	(67,440		)	(21,804		)	(30,124		)	(39,551		)
Interest expense, net	(147,003		)	(48,740		)	(68,929		)	(100,571		)
Equity-based compensation	(9,344		)	(1,887		)	(3,697		)	(2,021		)
Contingent acquisition compensation expense	(1,510		)	(1,982		)	(5,057		)	(5,092		)
Transaction, integration and acquisition costs ⁽¹⁾	(33,856		)	(9,330		)	(7,677		)	(11,617		)
Gain on litigation settlement	(46,009		)	8,740			3,794			14,101
Gain on acquisition escrow release	—			167			1,000			—
Loss on disposals and deconsolidations, net	(31,822		)	(5		)	(1,715		)	(2,355		)
Reserve adjustments ⁽²⁾	(2,670		)	—			—			—
Impairment charges	(74,359		)	—			—			—
Gain on amendment to tax receivable agreement	—			1,098			15,294			—
Tax receivable agreement benefit (expense)	—			25,329			—			(3,733		)
Loss on debt refinancing	—			—			(18,211		)	(11,876		)
(Loss) income before income taxes	$	(69,165	)	$	69,957		$	12,329		$	92,178

⁽¹⁾

This amount includes transaction and integration costs of $31.7 million for the year ended December 31, 2018 (Successor), $7.5 million for the four months ended December 31, 2017 (Successor), $5.6 million for the eight months ended August 31, 2017 (Predecessor), and $8.7 million for the year ended December 31, 2016 (Predecessor). This amount includes practice acquisition costs of $2.2 million for the year ended December 31, 2018 (Successor), $1.8 million for the four months ended December 31, 2017 (Successor), $2.1 million for the eight months ended August 31, 2017 (Predecessor), and $2.9 million for the year ended December 31, 2016 (Predecessor).


⁽²⁾	This amount represents adjustments to revenue in connection with applying consistent policies across the combined company as a result of the integration of Surgery Partners and NSH.



	Successor
	December 31, 2018		December 31, 2017
Assets:
Surgical facility services	$	4,204,344	$	4,072,521
Ancillary services	52,733		104,274
Optical services	20,084		48,309
All other	399,106		397,669
Total assets	$	4,676,267	$	4,622,773

Quarterly Financial Information (Unaudited)

12 Months Ended

Dec. 31, 2018

Quarterly Financial Information Disclosure [Abstract]

Quarterly Financial Information (Unaudited)

The following tables include a summary of certain information related to the Company's quarterly consolidated results of operations for each of the four quarters in the years ended December 31, 2018 and 2017. The timing of acquisitions and divestitures completed during the years presented affects the comparability of the quarterly financial information. The following should be read in conjunction with the audited consolidated financial statements included herein. The amounts are as follows (in thousands except per share amounts):



	2018
	Successor
	Q1			Q2			Q3			Q4

Revenues ⁽¹⁾	$	411,332		$	436,579		$	432,377		$	491,168
Cost of revenues	$	327,312		$	340,090		$	334,289		$	359,740
Net income (loss)	$	5,125		$	4,310		$	2,019		$	(107,080	)
Net income attributable to non-controlling interests	$	(22,646	)	$	(23,772	)	$	(23,000	)	$	(40,662	)
Net loss attributable to Surgery Partners, Inc.	$	(17,521	)	$	(19,462	)	$	(20,981	)	$	(147,742	)
Basic net loss per share attributable to common stockholders	$	(0.53	)	$	(0.57	)	$	(0.61	)	$	(3.25	)
Diluted net loss per share attributable to common stockholders	$	(0.53	)	$	(0.57	)	$	(0.61	)	$	(3.25	)


⁽¹⁾	Quarterly information herein reflects changes related to adoption of ASU 2014-09 as discussed in Note 1. "Organization and Summary of Accounting Policies.



	2017
	Predecessor									Successor
	Q1			Q2			Q3⁽²⁾			Q3⁽²⁾			Q4

Revenues	$	286,183		$	288,353		$	174,079		$	132,258		$	460,346
Cost of revenues	$	211,948		$	216,452		$	143,772		$	102,924		$	338,704
Net income (loss)	$	14,422		$	11,627		$	4,369		$	(2,648	)	$	966
Net income attributable to non-controlling interests	$	(17,176	)	$	(16,098	)	$	(8,813	)	$	(6,492	)	$	(33,142	)
Net loss attributable to Surgery Partners, Inc.	$	(2,754	)	$	(4,471	)	$	(4,444	)	$	(9,140	)	$	(32,176	)
Basic net loss per share attributable to common stockholders ⁽³⁾	$	(0.06	)	$	(0.09	)	$	(0.09	)	$	(0.57	)	$	(0.83	)
Diluted net loss per share attributable to common stockholders ⁽³⁾	$	(0.06	)	$	(0.09	)	$	(0.09	)	$	(0.57	)	$	(0.83	)

⁽²⁾The Predecessor period for Q3 includes the two months ended August 31, 2017. The Successor period for Q3 includes the one month ended September 30, 2017.

⁽³⁾ Beginning in the Successor period, per share amounts include the impact of amounts allocated to participating securities. Refer to Note 9. "Earnings Per Share" for further discussion.

Organization and Summary of Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2018

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Basis of Presentation

Principles of Consolidation

Pushdown Accounting

Variable Interest Entities

Equity Method Investments

Fair Value of Financial Instruments

The fair value of these derivative financial instruments was based on a quoted market price, or a Level 2 computation. The Company had no derivative financial instruments as of December 31, 2017 (Successor).

Fair Value of Financial Instruments

Cash, Cash Equivalents and Restricted Cash

Accounts Receivable and Allowances for Contractual Adjustments and Doubtful Accounts

Accounts Receivable

A summary of the changes in the allowance for doubtful accounts receivable follows (in thousands):



	Balance at Beginning of Period		Provision for Doubtful Accounts		Accounts Written off, Net of Recoveries			Impact of adoption of ASC 606			Balance at End of Period
Predecessor
Year ended December 31, 2016	$	18,322	$	24,212	$	(12,662	)	$	—		$	29,872
Eight months ended August 31, 2017	29,872		16,297		(14,096		)	—			32,073



Successor
Four months ended December 31, 2017	—		12,455		(10,429		)	—			2,026
Year ended December 31, 2018	2,026		—		—			(2,026		)	—

Impairment of Long-Lived Assets, Goodwill and Intangible Assets

Professional, General and Workers' Compensation Insurance

Professional and General and Workers' Compensation Insurance

Derivative Instruments and Hedging Activities

Cash Flow Hedges of Interest Rate Risk

The Company’s objectives in using interest rate derivatives are to add stability to interest expense and to manage its exposure to interest rate movements. To accomplish this objective, the Company primarily uses interest rate swaps as part of its interest rate risk management strategy. During 2018, such derivatives were used to hedge the variable cash flows associated with existing variable-rate debt.

For derivatives designated and that qualify as cash flow hedges of interest rate risk, the gain or loss on the derivative is recorded in Accumulated Other Comprehensive Income and subsequently reclassified into interest expense in the same period(s) during which the hedged transaction affects earnings, as documented at hedge inception in accordance with the Company’s accounting policy election. Amounts reported in accumulated other comprehensive income related to derivatives will be reclassified to interest expense as interest payments are made on the Company’s variable-rate debt.

Non-Controlling Interests

Inventories

Inventories, which consist primarily of medical and drug supplies, are stated at the lower of cost or market value. Cost is determined using the first-in, first-out method.

Recent Accounting Pronouncements

Business Combinations

Property and Equipment

Goodwill and Intangible Assets

Leases

Earnings Per Share

Income Taxes

Equity-Based Compensation

Organization and Summary of Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2018

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of Carrying Values and Estimated Fair Values of Debt Instruments

A summary of the carrying amounts and fair values of the Company's long-term debt follows (in thousands):



	Successor
	Carrying Amount				Fair Value
	December 31, 2018		December 31, 2017		December 31, 2018		December 31, 2017

Term Loan	$	1,447,931	$	1,280,532	$	1,382,774	$	1,267,189
Senior Unsecured Notes due 2021	$	406,719	$	409,235	$	407,227	$	422,535
Senior Unsecured Notes due 2025	$	370,000	$	370,000	$	320,513	$	346,413

Schedule of Revenues by Service Type

A summary of revenues by service type as a percentage of total revenues follows:



	Successor				Predecessor
	Year Ended December 31,		September 1 to December 31,		January 1 to August 31,		Year Ended December 31,
	2018		2017		2017		2016
Patient service revenues:
Surgical facilities revenues	93.6	%	94.3	%	91.4	%	90.3	%
Ancillary services revenues	4.5	%	4.2	%	7.0	%	7.9	%
	98.1	%	98.5	%	98.4	%	98.2	%
Other service revenues:
Optical services revenues	0.5	%	0.6	%	1.0	%	1.1	%
Other	1.4	%	0.9	%	0.6	%	0.7	%
	1.9	%	1.5	%	1.6	%	1.8	%
Total revenues	100.0	%	100.0	%	100.0	%	100.0	%

Schedule of Revenue Sources for Patient Service Revenues



	Successor								Predecessor
	Year Ended December 31,				September 1 to December 31,				January 1 to August 31,				Year Ended December 31,
	2018				2017				2017				2016
	Amount		%		Amount		%		Amount		%		Amount		%
Patient service revenues:
Private insurance	$	948,870	54.6	%	$	347,801	59.6	%	$	360,092	48.9	%	$	579,662	51.5	%
Government	653,332		37.6	%	196,926		33.7	%	308,993		42.0	%	448,953		39.9	%
Self-pay	49,985		2.9	%	15,233		2.6	%	15,949		2.2	%	19,817		1.8	%
Other ⁽¹⁾	84,788		4.9	%	23,843		4.1	%	51,374		6.9	%	76,172		6.8	%
Total patient service revenues	$	1,736,975	100.0	%	$	583,803	100.0	%	$	736,408	100.0	%	$	1,124,604	100.0	%
Other service revenues:
Optical service revenues	$	9,545			$	3,486			$	7,629			$	12,505
Other revenues	24,936				5,315				4,578				8,329
Total net revenues	$	1,771,456			$	592,604			$	748,615			$	1,145,438

(1) Other is comprised of anesthesia service agreements, auto liability, letters of protection and other payor types.

Allowance for Credit Losses on Financing Receivables

A summary of the changes in the allowance for doubtful accounts receivable follows (in thousands):



	Balance at Beginning of Period		Provision for Doubtful Accounts		Accounts Written off, Net of Recoveries			Impact of adoption of ASC 606			Balance at End of Period
Predecessor
Year ended December 31, 2016	$	18,322	$	24,212	$	(12,662	)	$	—		$	29,872
Eight months ended August 31, 2017	29,872		16,297		(14,096		)	—			32,073



Successor
Four months ended December 31, 2017	—		12,455		(10,429		)	—			2,026
Year ended December 31, 2018	2,026		—		—			(2,026		)	—

Schedule of Rollforward of Non-Controlling Interests - Redeemable

A summary of activity related to the non-controlling interests—redeemable follows (in thousands):



Predecessor
Balance at December 31, 2016	$	180,521
Net income attributable to non-controlling interests—redeemable	9,615
Acquisition and disposal of shares of non-controlling interests, net—redeemable ⁽¹⁾	(3,323		)
Distributions to non-controlling interest —redeemable holders	(11,468		)
Acquisition of NSH	153,320
Balance at August 31, 2017	$	328,665



Successor
Balance at September 1, 2017	$	271,001
Net income attributable to non-controlling interests—redeemable	12,931
Acquisition and disposal of shares of non-controlling interests, net—redeemable ⁽¹⁾	23,612
Distributions to non-controlling interest —redeemable holders	(8,228		)
Balance at December 31, 2017	299,316
Net income attributable to non-controlling interests—redeemable	34,546
Acquisition and disposal of shares of non-controlling interests, net—redeemable ⁽¹⁾	23,748
Distributions to non-controlling interest —redeemable holders	(30,737		)
Other	(281		)
Balance at December 31, 2018	$	326,592


⁽¹⁾	Includes post acquisition date adjustments in all periods, including reallocation in application of pushdown accounting in the 2017 successor period.

Acquisitions and Disposals (Tables)

12 Months Ended

Dec. 31, 2018

Business Combinations And Disposals [Abstract]

Schedule of recognized identified assets acquired and liabilities assumed

The acquisition date fair value for each major class of assets acquired and liabilities assumed, including post acquisition date adjustments, are as follows (in thousands):



Cash consideration	$	764,007
Fair value of non-controlling interests	325,965
Aggregate fair value of acquisition	$	1,089,972
Net assets acquired:
Cash and cash equivalents	$	51,159
Accounts receivable	71,639
Inventories	14,986
Prepaid expenses and other current assets	18,367
Property and equipment	174,100
Intangible assets	27,881
Goodwill	871,373
Investments in and advances to affiliates	29,737
Long-term deferred tax assets	20,212
Other long-term assets	26,988
Accounts payable	(29,652		)
Accrued payroll and benefits	(30,853		)
Other current liabilities	(23,937		)
Current maturities of long-term debt	(16,416		)
Long-term debt, less current maturities	(42,770		)
Other long-term liabilities	(72,842		)
Total fair value of net assets acquired	$	1,089,972



Equity attributable to Surgery Partners, Inc.	$	721,764
Redeemable preferred stock	310,000
Fair value of non-controlling interests	939,083
Aggregate fair value	$	1,970,847
Net assets:
Cash and cash equivalents	$	214,206
Accounts receivable	252,911
Inventories	44,310
Prepaid expenses and other current assets	61,438
Property and equipment	379,685
Intangible assets	63,978
Goodwill	3,281,728
Investments in and advances to affiliates	75,113
Restricted invested assets	315
Long-term deferred tax asset	206,073
Other long-term assets	50,666
Accounts payable	(64,921		)
Accrued payroll and benefits	(56,535		)
Other current liabilities	(97,617		)
Current maturities of long-term debt	(49,942		)
Long-term debt, less current maturities	(2,142,375		)
Long-term tax receivable agreement liability	(78,498		)
Other long-term liabilities	(169,688		)
Total fair value of net assets	$	1,970,847



	Successor						Predecessor
	Year Ended December 31,			September 1 to December 31,			January 1 to August 31,
	2018 ⁽¹⁾			2017			2017
Cash consideration	$	106,441		$	29,448		$	14,163
Fair value of non-controlling interests	63,774			21,893			105
Aggregate acquisition date fair value	$	170,215		$	51,341		$	14,268
Net assets acquired:
Current Assets	$	12,254		$	2,267		$	777
Property and equipment	5,033			248			696
Intangibles	—			41			1,101
Goodwill	156,529			49,368			12,167
Other long-term assets	6,575			—			—
Current liabilities	(6,061		)	(583		)	(287		)
Long-term liabilities	(4,115		)	—			(186		)
Aggregate acquisition date fair value	$	170,215		$	51,341		$	14,268


⁽¹⁾	The fair values assigned to certain assets acquired and liabilities assumed by the Company in 2018 have been estimated on a preliminary basis and are subject to change as new facts and circumstances emerge that were present at the date of acquisition.

Property and Equipment (Tables)

12 Months Ended

Dec. 31, 2018

Property, Plant and Equipment [Abstract]

Schedule of Property and Equipment

A summary of property and equipment follows (in thousands):



	Successor
	December 31, 2018			December 31, 2017

Land	$	19,550		$	19,561
Buildings and improvements	200,390			188,571
Furniture and equipment	24,069			20,813
Computer and software	33,877			28,578
Medical equipment	139,571			138,112
Construction in progress	64,948			22,581
Property and equipment, at cost	482,405			418,216
Less: Accumulated depreciation	(56,119		)	(19,680		)
Property and equipment, net	$	426,286		$	398,536

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2018

Goodwill and Intangible Assets Disclosure [Abstract]

Summary of activity related to goodwill

A summary of the changes in the carrying amount of goodwill for the years ended December 31, 2018 and 2017 follows (in thousands):



Predecessor
Balance at December 31, 2016	$	1,555,204
Acquisitions, including post acquisition adjustments	859,543
Divestitures and deconsolidations	(175		)
Balance at August 31, 2017	$	2,414,572



Successor
Balance at September 1, 2017	$	3,269,225
Acquisitions, including post acquisition adjustments	79,570
Divestitures and deconsolidations	(1,957		)
Balance at December 31, 2017	3,346,838
Acquisitions, including post acquisition adjustments	143,469
Divestitures and deconsolidations	(33,102		)
Impairment	(74,359		)
Balance at December 31, 2018	$	3,382,846

Summary of components of intangible assets

A summary of the components of intangible assets follows (in thousands):



	Successor
	December 31, 2018							December 31, 2017
	Gross Carrying Amount		Accumulated Amortization			Net		Gross Carrying Amount		Accumulated Amortization			Net

Finite-lived intangible assets:
Management rights agreements	$	41,600	$	(4,223	)	$	37,377	$	42,600	$	(1,058	)	$	41,542
Other	6,378		(2,738		)	3,640		5,752		(942		)	4,810
Total finite-lived intangible assets	47,978		(6,961		)	41,017		48,352		(2,000		)	46,352
Indefinite-lived intangible assets	13,276		—			13,276		12,556		—			12,556
Total intangible assets	$	61,254	$	(6,961	)	$	54,293	$	60,908	$	(2,000	)	$	58,908

Summary of components and activity related to intangible assets

A summary of the components of intangible assets follows (in thousands):



	Successor
	December 31, 2018							December 31, 2017
	Gross Carrying Amount		Accumulated Amortization			Net		Gross Carrying Amount		Accumulated Amortization			Net

Finite-lived intangible assets:
Management rights agreements	$	41,600	$	(4,223	)	$	37,377	$	42,600	$	(1,058	)	$	41,542
Other	6,378		(2,738		)	3,640		5,752		(942		)	4,810
Total finite-lived intangible assets	47,978		(6,961		)	41,017		48,352		(2,000		)	46,352
Indefinite-lived intangible assets	13,276		—			13,276		12,556		—			12,556
Total intangible assets	$	61,254	$	(6,961	)	$	54,293	$	60,908	$	(2,000	)	$	58,908

Summary of scheduled amortization

Total estimated amortization expense for the next five years and thereafter related to intangible assets follows (in thousands):



2019	$	4,617
2020	4,206
2021	3,647
2022	2,936
2023	2,144
Thereafter	23,467
Total	$	41,017

Long-Term Debt (Tables)

12 Months Ended

Dec. 31, 2018

Debt Disclosure [Abstract]

Schedule of long-term debt

A summary of long-term debt follows (in thousands):



	Successor
	December 31, 2018			December 31, 2017

Revolver	$	—		$	—
Term Loan ⁽¹⁾	1,447,931			1,280,532
Senior Unsecured Notes due 2021 ⁽²⁾	406,719			409,235
Senior Unsecured Notes due 2025	370,000			370,000
Notes payable and secured loans	79,341			101,921
Capital lease obligations	25,374			27,594
Less: unamortized debt issuance costs and original issue discount	(2,915		)	—
Total debt	2,326,450			2,189,282
Less: Current maturities	55,552			58,726
Total long-term debt	$	2,270,898		$	2,130,556

⁽¹⁾ Includes unamortized fair value discount of $5.5 million and $6.2 million as of December 31, 2018 (Successor) and 2017 (Successor), respectively.

⁽²⁾ Includes unamortized fair value premium of $6.7 million and $9.2 million as of December 31, 2018 (Successor) and 2017 (Successor), respectively.

Debt redemption percentages

The Company may redeem the 2025 Unsecured Notes, in whole or in part, at any time on or after July 1, 2020, at the redemption prices set forth below (expressed as a percentage of the principal amount to be redeemed), plus accrued and unpaid interest, if any, to, but excluding, the date of redemption:



July 1, 2020 to June 30, 2021	103.375	%
July 1, 2021 to June 30, 2022	101.688	%
July 1, 2022 and thereafter	100.000	%



April 15, 2018 to April 14, 2019	106.656	%
April 15, 2019 to April 14, 2020	104.438	%
April 15, 2020 and thereafter	100.000	%

Summary of scheduled maturities of debt



2019	$	55,552
2020	1,459,069
2021	415,733
2022	11,079
2023	7,868
Thereafter	378,835
Total debt	$	2,328,136

Leases (Tables)

12 Months Ended

Dec. 31, 2018

Leases [Abstract]

Future minimum operating lease payments

Future minimum lease payments for non-cancellable operating and capital leases for the next five years and thereafter at December 31, 2018 follows (in thousands):



	Operating Leases		Capital Leases

2019	$	81,455	$	8,846
2020	75,649		6,680
2021	66,728		4,704
2022	61,261		2,907
2023	57,202		1,534
Thereafter	470,194		4,227
Total minimum payments	$	812,489	28,898
Less: imputed interest			(3,524		)
Capital lease obligations			$	25,374

Future minimum capital lease payments

Future minimum lease payments for non-cancellable operating and capital leases for the next five years and thereafter at December 31, 2018 follows (in thousands):



	Operating Leases		Capital Leases

2019	$	81,455	$	8,846
2020	75,649		6,680
2021	66,728		4,704
2022	61,261		2,907
2023	57,202		1,534
Thereafter	470,194		4,227
Total minimum payments	$	812,489	28,898
Less: imputed interest			(3,524		)
Capital lease obligations			$	25,374

Redeemable Preferred Stock (Tables)

12 Months Ended

Dec. 31, 2018

Temporary Equity Disclosure [Abstract]

A summary of activity related to the redeemable preferred stock for the year ended December 31, 2018 (Successor) follows (in thousands):



Successor
Balance at December 31, 2017	$	330,806
Dividends accrued	32,426
Cash dividends declared	(3,886		)
Balance at December 31, 2018	$	359,346

Earnings Per Share (Tables)

12 Months Ended

Dec. 31, 2018

Earnings Per Share [Abstract]

Reconciliation of numerator and denominator of basic and diluted EPS

A reconciliation of the numerator and denominator of basic and diluted earnings per share follows (in thousands except share and per share amounts):



	Successor						Predecessor
	Year Ended December 31,			September 1 to December 31,			January 1 to August 31,			Year Ended December 31,
	2018			2017			2017			2016

Numerator:
Net (loss) income attributable to Surgery Partners, Inc.	$	(205,706	)	$	(41,316	)	$	(11,669	)	$	9,453
Less: amounts allocated to participating securities⁽¹⁾	32,426			10,481			—			—
Less: mark to redemption adjustment				15,566			—			—
Net (loss) income attributable to common stockholders	$	(238,132	)	$	(67,363	)	$	(11,669	)	$	9,453

Denominator:
Weighted average shares outstanding- basic	48,027,875			48,319,193			48,121,404			48,018,944
Effect of dilutive securities ⁽²⁾	—			—			—			171,794
Weighted average shares outstanding- diluted	48,027,875			48,319,193			48,121,404			48,190,738

(Loss) earnings per share:
Basic	$	(4.96	)	$	(1.39	)	$	(0.24	)	$	0.20
Diluted ⁽²⁾	$	(4.96	)	$	(1.39	)	$	(0.24	)	$	0.20

Securities outstanding not included in the computation of diluted (loss) earnings per share as their effect is antidilutive:
Stock options	82,602			—			—			—
Restricted shares	198,267			62,850			105,944			—
Convertible preferred stock	—			—			N/A			N/A

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2018

Income Tax Disclosure [Abstract]

Schedule of Income Tax Expense (Benefit)

Income tax expense (benefit) is comprised of the following (in thousands):



	Successor						Predecessor
	Year Ended December 31,			September 1 to December 31,			January 1 to August 31,			Year Ended December 31,
	2018			2017			2017			2016

Current:
Federal	$	(324	)	$	(111	)	$	—		$	(31	)
State	1,511			990			614			244
Deferred:
Federal	16,525			77,472			(17,288		)	7,326
State	8,749			(6,712		)	(1,415		)	(444		)
Total income tax expense (benefit)	$	26,461		$	71,639		$	(18,089	)	$	7,095

Schedule of Effective Income Tax Rate Reconciliation



	Successor						Predecessor
	Year Ended December 31,			September 1 to December 31,			January 1 to August 31,			Year Ended December 31,
	2018			2017			2017			2016

Tax expense (benefit) at U.S.federal statutory rate	$	(14,525	)	$	24,485		$	4,315		$	32,263
State income tax, net of U.S. federal tax benefit	9,955			1,685			(456		)	(86		)
Change in valuation allowance	26,946			529			1,324			354
Net income attributable to non-controlling interests	(23,117		)	(13,872		)	(14,731		)	(26,470		)
Changes in measurement of uncertain tax positions	(73		)	(191		)	20			(262		)
Stock option compensation	509			306			37			(200		)
Differences related to divested facilities	6,037			(429		)	(1,708		)	—
Nondeductible transaction costs	23			2,058			(977		)	—
Tax return reconciling differences	1,748			—			(316		)	1,635
Change in effective tax rate	493			64,343			(825		)	—
Tax Receivable Agreement liability	901			(7,404		)	(4,782		)	(327		)
Goodwill impairment	8,892			—			—			—
Litigation settlement	8,577			—			—			—
Other	95			129			10			188
Total income tax expense (benefit)	$	26,461		$	71,639		$	(18,089	)	$	7,095

Schedule of Deferred Tax Assets and Liabilities

The components of temporary differences and the approximate tax effects that give rise to the Company’s net deferred tax asset are as follows (in thousands):



	Successor
	December 31, 2018			December 31, 2017

Deferred tax assets:
Medical malpractice liability	$	3,456		$	3,236
Accrued vacation and incentive compensation	2,933			2,125
Net operating loss carryforwards	139,404			137,794
Allowance for bad debts	2,510			2,545
Capital loss carryforwards	3,701			3,024
Deferred rent	1,866			—
Amortization of intangible assets	2,437			—
Deferred financing costs	14,638			17,004
Section 163(j) interest	27,338
Interest rate swap liability	5,431
TRA liability	1,176			1,042
Other deferred assets	7,010			4,961
Total gross deferred tax assets	211,900			171,731
Less: Valuation allowance	(50,430		)	(11,032		)
Total deferred tax assets	161,470			160,699
Deferred tax liabilities:
Depreciation on property and equipment	(3,925		)	(12,098		)
Amortization of intangible assets	—			(12,441		)
Basis differences of partnerships and joint ventures	(47,749		)	(2,399		)
Deferred rent	—			(717		)
Other deferred liabilities	(603		)	(725		)
Total deferred tax liabilities	(52,277		)	(28,380		)
Net deferred tax assets	$	109,193		$	132,319

Schedule of Unrecognized Tax Benefits Roll Forward

A reconciliation of the beginning and ending liability for gross unrecognized tax benefits for the years ended December 31, 2018 and 2017 is as follows (in thousands):



	Successor
	December 31, 2018			December 31, 2017

Unrecognized tax benefits at beginning of year	$	690		$	1,061
Additions for acquired positions	—			36
Additions for tax positions of prior years	7			—
Reductions for tax positions of prior year	(629		)	(407		)
Settlements	(7		)	—
Unrecognized tax benefits at end of year	$	61		$	690

Equity-Based Compensation (Tables)

12 Months Ended

Dec. 31, 2018

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Schedule of Restricted Stock Activity

A summary of non-vested restricted share-based activity for the years ended December 31, 2018, 2017, and 2016 follows:



	Unvested Shares		Weighted Average Grant Date Fair Value
Predecessor
Outstanding at January 1, 2016	167,654		$	2.53
Granted/Earned	384,629		15.09
Forfeited/Cancelled	(53,003	)	11.85
Vested	(37,038	)	6.31
Outstanding at December 31, 2016	462,242		$	3.72
Granted/Earned	388,454		18.40
Forfeited/Cancelled	(67,771	)	18.01
Vested	(169,881	)	10.29
Outstanding at August 31, 2017	613,044		$	16.02



Successor
Outstanding at September 1, 2017	613,044		$	16.02
Granted/Earned	112,107		11.15
Forfeited/Cancelled	(54,622	)	10.94
Vested	(96,073	)	17.03
Outstanding at December 31, 2017	574,456		$	15.95
Granted/Earned	519,605		16.10
Forfeited/Cancelled	(180,719	)	15.09
Vested	(210,318	)	16.31
Outstanding at December 31, 2018	703,024		$	16.18

Schedule of Stock Options, Valuation Assumptions

The following table sets forth the assumptions used by the Company to estimate the fair value of options and SAR Awards granted in 2018 under the 2015 Omnibus Incentive Plan:



Expected volatility		60% - 65%
Risk-free interest rate		2.50% - 2.90%
Expected dividends		—
Average expected term (years)		10
Fair value of stock options granted		$8.48 - $9.44

The following table sets forth the assumptions used by the Company to estimate the fair value of options granted in 2016 and 2015 under the 2015 Omnibus Incentive Plan:



Expected volatility		29% - 43%
Risk-free interest rate		0.54% - 1.36%
Expected dividends		—
Average expected term (years)		2.56
Fair value of stock options granted		$2.64 - $5.74

Schedule of Stock Options Activity

A summary of stock option and SAR Award activity for the years ended December 31, 2018, 2017, and 2016 follows:



	Options/SARs		Weighted Average Exercise Price		Weighted Average Remaining Contractual Term (years)
Predecessor
Outstanding at January 1, 2016	8,488		$	20.03	3.0
Granted	7,779		17.99		1.6
Exercised	—
Forfeited/Cancelled	—
Outstanding at December 31, 2016	16,267		$	19.05	1.8
Granted	—
Exercised	(3,580	)	15.36
Forfeited/Cancelled	—
Outstanding at August 31, 2017	12,687		$	20.10	1.5



Successor
Outstanding at September 1, 2017	12,687		$	20.10	1.5
Granted	—
Exercised	—
Forfeited/Cancelled	—
Outstanding at December 31, 2017	12,687		$	20.10	1.2
Granted	700,000		12.90		10.0
Exercised	—
Forfeited/Cancelled	(200,000	)	$	12.90	10.0
Outstanding at December 31, 2018 ⁽¹⁾	512,687		$	13.03	9.8

⁽¹⁾ Of the outstanding options, 11,287 were exercisable as of December 31, 2018 (Successor).

Segment Reporting (Tables)

12 Months Ended

Dec. 31, 2018

Segment Reporting [Abstract]

Schedule of Financial Information by Reportable Segment

The following tables present financial information for each reportable segment (in thousands):



	Successor						Predecessor
	Year Ended December 31,			September 1 to December 31,			January 1 to August 31,			Year Ended December 31,
	2018			2017			2017			2016
Revenues:
Surgical facility services	$	1,682,278		$	564,458		$	688,725		$	1,042,097
Ancillary services	79,633			24,660			52,261			90,836
Optical services	9,545			3,486			7,629			12,505
Total	$	1,771,456		$	592,604		$	748,615		$	1,145,438

Adjusted EBITDA:
Surgical facility services	$	309,513		$	103,760		$	125,912		$	214,218
Ancillary services	3,008			(2,255		)	(6,526		)	12,685
Optical services	2,500			736			2,214			3,308
All other	(80,253		)	(23,504		)	(36,036		)	(50,948		)
Total	$	234,768		$	78,737		$	85,564		$	179,263

Cash purchases of property and equipment, net:
Surgical facility services	$	34,178		$	9,334		$	14,582		$	29,157
Ancillary services	419			191			1,875			5,388
Optical services	46			83			73			351
All other	5,162			1,219			2,243			4,213
Total	$	39,805		$	10,827		$	18,773		$	39,109

Schedule of Segment Operating Income

A reconciliation of Adjusted EBITDA to income before income taxes included in the condensed consolidated statement of operations is as follows:



	Successor						Predecessor
	Year Ended December 31,			September 1 to December 31,			January 1 to August 31,			Year Ended December 31,
	2018			2017			2017			2016

Adjusted EBITDA	$	234,768		$	78,737		$	85,564		$	179,263
Net income attributable to non-controlling interests	110,080			39,634			42,087			75,630
Depreciation and amortization	(67,440		)	(21,804		)	(30,124		)	(39,551		)
Interest expense, net	(147,003		)	(48,740		)	(68,929		)	(100,571		)
Equity-based compensation	(9,344		)	(1,887		)	(3,697		)	(2,021		)
Contingent acquisition compensation expense	(1,510		)	(1,982		)	(5,057		)	(5,092		)
Transaction, integration and acquisition costs ⁽¹⁾	(33,856		)	(9,330		)	(7,677		)	(11,617		)
Gain on litigation settlement	(46,009		)	8,740			3,794			14,101
Gain on acquisition escrow release	—			167			1,000			—
Loss on disposals and deconsolidations, net	(31,822		)	(5		)	(1,715		)	(2,355		)
Reserve adjustments ⁽²⁾	(2,670		)	—			—			—
Impairment charges	(74,359		)	—			—			—
Gain on amendment to tax receivable agreement	—			1,098			15,294			—
Tax receivable agreement benefit (expense)	—			25,329			—			(3,733		)
Loss on debt refinancing	—			—			(18,211		)	(11,876		)
(Loss) income before income taxes	$	(69,165	)	$	69,957		$	12,329		$	92,178

⁽¹⁾


⁽²⁾	This amount represents adjustments to revenue in connection with applying consistent policies across the combined company as a result of the integration of Surgery Partners and NSH.

Reconciliation of Assets from Segment to Consolidated



	Successor
	December 31, 2018		December 31, 2017
Assets:
Surgical facility services	$	4,204,344	$	4,072,521
Ancillary services	52,733		104,274
Optical services	20,084		48,309
All other	399,106		397,669
Total assets	$	4,676,267	$	4,622,773

Quarterly Financial Information (Unaudited) (Tables)

12 Months Ended

Dec. 31, 2018

Quarterly Financial Information Disclosure [Abstract]

Schedule of Quarterly Financial Information



	2018
	Successor
	Q1			Q2			Q3			Q4

Revenues ⁽¹⁾	$	411,332		$	436,579		$	432,377		$	491,168
Cost of revenues	$	327,312		$	340,090		$	334,289		$	359,740
Net income (loss)	$	5,125		$	4,310		$	2,019		$	(107,080	)
Net income attributable to non-controlling interests	$	(22,646	)	$	(23,772	)	$	(23,000	)	$	(40,662	)
Net loss attributable to Surgery Partners, Inc.	$	(17,521	)	$	(19,462	)	$	(20,981	)	$	(147,742	)
Basic net loss per share attributable to common stockholders	$	(0.53	)	$	(0.57	)	$	(0.61	)	$	(3.25	)
Diluted net loss per share attributable to common stockholders	$	(0.53	)	$	(0.57	)	$	(0.61	)	$	(3.25	)


⁽¹⁾	Quarterly information herein reflects changes related to adoption of ASU 2014-09 as discussed in Note 1. "Organization and Summary of Accounting Policies.



	2017
	Predecessor									Successor
	Q1			Q2			Q3⁽²⁾			Q3⁽²⁾			Q4

Revenues	$	286,183		$	288,353		$	174,079		$	132,258		$	460,346
Cost of revenues	$	211,948		$	216,452		$	143,772		$	102,924		$	338,704
Net income (loss)	$	14,422		$	11,627		$	4,369		$	(2,648	)	$	966
Net income attributable to non-controlling interests	$	(17,176	)	$	(16,098	)	$	(8,813	)	$	(6,492	)	$	(33,142	)
Net loss attributable to Surgery Partners, Inc.	$	(2,754	)	$	(4,471	)	$	(4,444	)	$	(9,140	)	$	(32,176	)
Basic net loss per share attributable to common stockholders ⁽³⁾	$	(0.06	)	$	(0.09	)	$	(0.09	)	$	(0.57	)	$	(0.83	)
Diluted net loss per share attributable to common stockholders ⁽³⁾	$	(0.06	)	$	(0.09	)	$	(0.09	)	$	(0.57	)	$	(0.83	)

⁽²⁾The Predecessor period for Q3 includes the two months ended August 31, 2017. The Successor period for Q3 includes the one month ended September 30, 2017.

⁽³⁾ Beginning in the Successor period, per share amounts include the impact of amounts allocated to participating securities. Refer to Note 9. "Earnings Per Share" for further discussion.

Organization and Summary of Accounting Policies - Organization (Details)	Dec. 31, 2018 surgical_facility state	Aug. 31, 2017
Product Information [Line Items]
Number of States in which entity operates \| state	31
Number of surgical facilities owned	123
Number of surgical facilities owned, majority interest	84
Number of surgical facilities owned, consolidated	106
Facilities, Ambulatory Surgery Centers
Product Information [Line Items]
Number of surgical facilities owned	108
Facilities, Surgical Hospitals
Product Information [Line Items]
Number of surgical facilities owned	15
Predecessor \| BCPE Seminole Holdings LP \| Majority Shareholder
Product Information [Line Items]
Percentage of voting interest acquired		65.70%
Predecessor \| BCPE Seminole Holdings LP \| Majority Shareholder \| Common Stock
Product Information [Line Items]
Percentage of voting interest acquired		54.20%

Organization and Summary of Accounting Policies - Variable Interest Entities (Details) $ in Millions	12 Months Ended
	Dec. 31, 2018 Anesthesia_Practice surgical_facility physician_practice	Dec. 31, 2018 surgical_facility	Dec. 31, 2018 physician_practice	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)
Variable Interest Entity [Line Items]
Number of facilities included in VIE	3	4	4
Number of facilities divested \| surgical_facility	1
Number of business entities acquired \| physician_practice	1
Variable Interest Entity Primary Beneficiary
Variable Interest Entity [Line Items]
Total assets related to VIE				$ 11.2	$ 13.1
Total liabilities related to VIE				$ 3.6	$ 5.8

Organization and Summary of Accounting Policies - Schedule of Carrying Amount and Fair Value of Financial Instruments (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	$ 2,328,136
2017 Term Loan, Maturing 2024 \| Senior Notes \| Revolving Credit Facility \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	1,447,931	$ 1,280,532
2017 Term Loan, Maturing 2024 \| Senior Notes \| Revolving Credit Facility \| Fair Value \| Fair Value, Inputs, Level 2
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	1,382,774	1,267,189
Senior Unsecured Notes Due 2021 \| Senior Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	406,719	409,235
Senior Unsecured Notes Due 2021 \| Senior Notes \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	406,719	409,235
Senior Unsecured Notes Due 2021 \| Senior Notes \| Fair Value \| Fair Value, Inputs, Level 2
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	407,227	422,535
Senior Unsecured Notes Due 2025 \| Senior Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	370,000	370,000
Senior Unsecured Notes Due 2025 \| Senior Notes \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	370,000	370,000
Senior Unsecured Notes Due 2025 \| Senior Notes \| Fair Value \| Fair Value, Inputs, Level 2
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	$ 320,513	$ 346,413

Organization and Summary of Accounting Policies - Fair Value of Financial Instruments (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Interest rate swap agreement	$ 22.4
Fair Value, Inputs, Level 1
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Assets in SERP	1.4
Liability in SERP	$ 1.4
Fair Value, Inputs, Level 1 \| Predecessor
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Assets in SERP		$ 1.9
Liability in SERP		$ 1.9

Organization and Summary of Accounting Policies - Schedule of Revenues by Service Type (Details) - Revenue Source - Revenue	4 Months Ended	8 Months Ended	12 Months Ended
	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2016
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues	100.00%		100.00%
Healthcare Organization, Patient Service
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues	98.50%		98.10%
Surgical facility services
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues	94.30%		93.60%
Ancillary services
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues	4.20%		4.50%
Healthcare Organization, Other Service
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues	1.50%		1.90%
Optical services
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues	0.60%		0.50%
Other
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues	0.90%		1.40%
Predecessor
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues		100.00%		100.00%
Predecessor \| Healthcare Organization, Patient Service
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues		98.40%		98.20%
Predecessor \| Surgical facility services
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues		91.40%		90.30%
Predecessor \| Ancillary services
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues		7.00%		7.90%
Predecessor \| Healthcare Organization, Other Service
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues		1.60%		1.80%
Predecessor \| Optical services
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues		1.00%		1.10%
Predecessor \| Other
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues		0.60%		0.70%

Organization and Summary of Accounting Policies - Schedule of Revenues by Sources (Details) - USD ($)	1 Months Ended	2 Months Ended	3 Months Ended							4 Months Ended	8 Months Ended	12 Months Ended
	Sep. 30, 2017	Aug. 31, 2017	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2016
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Increase of revenue as result of changes in estimates to third-party settlements										$ 0		$ 2,100,000
Total net revenues	$ 132,258,000		$ 491,168,000	$ 432,377,000	$ 436,579,000	$ 411,332,000	$ 460,346,000			592,604,000	$ 748,615,000	1,771,456,000	$ 1,145,438,000
Healthcare Organization, Patient Service
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Total net revenues										$ 583,803,000	736,408,000	$ 1,736,975,000	1,124,604,000
Healthcare Organization, Patient Service \| Customer \| Revenue
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue by service type as a percentage of total revenues										100.00%		100.00%
Optical services
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Total net revenues										$ 3,486,000	7,629,000	$ 9,545,000	12,505,000
Other
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Total net revenues										5,315,000	4,578,000	24,936,000	8,329,000
Private insurance \| Healthcare Organization, Patient Service
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Total net revenues										$ 347,801,000	360,092,000	$ 948,870,000	579,662,000
Private insurance \| Healthcare Organization, Patient Service \| Customer \| Revenue
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue by service type as a percentage of total revenues										59.60%		54.60%
Government \| Healthcare Organization, Patient Service
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Total net revenues										$ 196,926,000	308,993,000	$ 653,332,000	448,953,000
Government \| Healthcare Organization, Patient Service \| Customer \| Revenue
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue by service type as a percentage of total revenues										33.70%		37.60%
Self-pay \| Healthcare Organization, Patient Service
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Total net revenues										$ 15,233,000	15,949,000	$ 49,985,000	19,817,000
Self-pay \| Healthcare Organization, Patient Service \| Customer \| Revenue
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue by service type as a percentage of total revenues										2.60%		2.90%
Other \| Healthcare Organization, Patient Service
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Total net revenues										$ 23,843,000	51,374,000	$ 84,788,000	76,172,000
Other \| Healthcare Organization, Patient Service \| Customer \| Revenue
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue by service type as a percentage of total revenues										4.10%		4.90%
Predecessor
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Increase of revenue as result of changes in estimates to third-party settlements											1,100,000		6,800,000
Total net revenues		$ 174,079,000						$ 288,353,000	$ 286,183,000		748,615,000		$ 1,145,438,000
Increase in reserves for accounts receivable											$ 15,600,000
Predecessor \| Healthcare Organization, Patient Service \| Customer \| Revenue
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue by service type as a percentage of total revenues											100.00%		100.00%
Predecessor \| Private insurance \| Healthcare Organization, Patient Service \| Customer \| Revenue
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue by service type as a percentage of total revenues											48.90%		51.50%
Predecessor \| Government \| Healthcare Organization, Patient Service \| Customer \| Revenue
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue by service type as a percentage of total revenues											42.00%		39.90%
Predecessor \| Self-pay \| Healthcare Organization, Patient Service \| Customer \| Revenue
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue by service type as a percentage of total revenues											2.20%		1.80%
Predecessor \| Other \| Healthcare Organization, Patient Service \| Customer \| Revenue
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue by service type as a percentage of total revenues											6.90%		6.80%

Organization and Summary of Accounting Policies - Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Restricted invested assets included in other long-term assets	$ 0.3	$ 0.3

Organization and Summary of Accounting Policies - Accounts Receivable and Allowances for Contractual Adjustments and Doubtful Accounts (Details) - USD ($) $ in Thousands	4 Months Ended	8 Months Ended	12 Months Ended
	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2015
Accounts, Notes, Loans and Financing Receivable [Line Items]
Third-Party Medicaid settlements liability					$ 4,800
Optical products receivable					8,500
Allowance for Doubtful Accounts Receivable [Roll Forward]
Balance at Beginning of Period	$ 2,026	$ 0	$ 0		$ 0	$ 2,026
Provision for Doubtful Accounts	12,455		0
Accounts Written off, Net of Recoveries	(10,429)		0
Balance at End of Period	2,026	0	0
Predecessor
Accounts, Notes, Loans and Financing Receivable [Line Items]
Third-Party Medicaid settlements liability							$ 18,322
Third-Party Medicaid settlements receivable						1,000
Optical products receivable						$ 7,600
Allowance for Doubtful Accounts Receivable [Roll Forward]
Balance at Beginning of Period		32,073		$ 29,872
Provision for Doubtful Accounts		16,297		24,212
Accounts Written off, Net of Recoveries		(14,096)		(12,662)
Balance at End of Period		32,073		29,872
Accounting Standards Update 2014-09
Allowance for Doubtful Accounts Receivable [Roll Forward]
Impact of adoption of ASC 606	$ 0		$ (2,026)
Accounting Standards Update 2014-09 \| Predecessor
Allowance for Doubtful Accounts Receivable [Roll Forward]
Impact of adoption of ASC 606		$ 0		$ 0

Organization and Summary of Accounting Policies - Professional, General and Workers' Compensation Insurance (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Professional, general and workers' compensation insurance reserve	$ 18.2	$ 21.0
Estimated insurance recoveries	$ 12.0	$ 12.8

Organization and Summary of Accounting Policies - Schedule of Non-Controlling Interests - Redeemable (Details) - USD ($) $ in Thousands	4 Months Ended	8 Months Ended	12 Months Ended
	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018
Non-Controlling Interests - Redeemable [Roll Forward]
Non-controlling interest, beginning balance	$ 271,001		$ 299,316
Net income attributable to non-controlling interests—redeemable	12,931		34,546
Acquisition and disposal of shares of non-controlling interests, net—redeemable	23,612		23,748
Distributions to non-controlling interest —redeemable holders	(8,228)		(30,737)
Other			(281)
Non-controlling interest, ending balance	299,316	$ 271,001	$ 326,592
Predecessor
Non-Controlling Interests - Redeemable [Roll Forward]
Non-controlling interest, beginning balance	$ 328,665	180,521
Net income attributable to non-controlling interests—redeemable		9,615
Acquisition and disposal of shares of non-controlling interests, net—redeemable		(3,323)
Distributions to non-controlling interest —redeemable holders		(11,468)
Acquisition of NSH		153,320
Non-controlling interest, ending balance		$ 328,665

Acquisitions and Disposals - Additional Information (Details) $ in Thousands		4 Months Ended	8 Months Ended	12 Months Ended
	Aug. 31, 2017 USD ($)	Dec. 31, 2017 USD ($) surgical_facility physician_practice	Aug. 31, 2017 USD ($) surgical_facility physician_practice	Dec. 31, 2018 USD ($) surgical_facility	Dec. 31, 2018 USD ($) physician_practice	Dec. 31, 2018 USD ($)	Dec. 31, 2018 USD ($) surgical_hospital	Dec. 31, 2018 USD ($) optical_laboratory	Dec. 31, 2018 USD ($) surgery_center	Dec. 31, 2016 USD ($)
Business Acquisition [Line Items]
Number of business entities acquired \| physician_practice					1
Total cash consideration, net of cash acquired		$ 29,249				$ 106,772
Goodwill	$ 3,269,225	$ 3,346,838	$ 3,269,225	$ 3,382,846	$ 3,382,846	3,382,846	$ 3,382,846	$ 3,382,846	$ 3,382,846
Fair value of investment				$ 2,000	2,000	2,000	$ 2,000	$ 2,000	$ 2,000
Disposal Group One
Business Acquisition [Line Items]
Number of interests sold							2	1,000	4
Net cash proceeds from sale of interests						18,700
Net pre-tax gain (loss) on sale of interests						(21,200)
Surgery Center
Business Acquisition [Line Items]
Number of interests sold \| surgery_center									1
Net cash proceeds from sale of interests						500
Gain on deconsolidation						1,100
Surgical Facility
Business Acquisition [Line Items]
Number of interests sold \| surgical_facility		1	1
Net cash proceeds from sale of interests		$ 1,300
Net pre-tax gain (loss) on sale of interests		$ 800
BCPE Seminole Holdings LP
Business Acquisition [Line Items]
Net increase (decrease) in goodwill						(18,200)
Surgical Facility, New Market
Business Acquisition [Line Items]
Number of business entities acquired \| surgical_facility				5
Surgical Facility and Physician Practice Acquisitions
Business Acquisition [Line Items]
Total cash consideration, net of cash acquired						105,600
Surgical Facility, Existing Market
Business Acquisition [Line Items]
Number of business entities acquired \| surgical_facility		1		2,000
Physician Practice, Existing Market
Business Acquisition [Line Items]
Number of business entities acquired \| physician_practice		1
Total Acquisitions in 2017
Business Acquisition [Line Items]
Cash consideration		$ 29,448
Goodwill		$ 49,368
Total Acquisitions in 2018
Business Acquisition [Line Items]
Cash consideration						106,441
Goodwill				$ 156,529	156,529	156,529	$ 156,529	$ 156,529	$ 156,529
Goodwill, expected tax deductible amount				93,900	93,900	93,900	93,900	93,900	93,900
Total Acquisitions in 2018 \| Surgical facility services
Business Acquisition [Line Items]
Goodwill				148,200	148,200	148,200	148,200	148,200	148,200
Total Acquisitions in 2018 \| Ancillary services
Business Acquisition [Line Items]
Goodwill				$ 8,300	$ 8,300	8,300	$ 8,300	$ 8,300	$ 8,300
NSH
Business Acquisition [Line Items]
Purchase price adjustments						$ 1,200
Predecessor
Business Acquisition [Line Items]
Total cash consideration, net of cash acquired			$ 725,853							$ 146,405
Goodwill	$ 2,414,572		$ 2,414,572							$ 1,555,204
Predecessor \| BCPE Seminole Holdings LP
Business Acquisition [Line Items]
Percentage of voting interest acquired	65.70%		65.70%
Net increase to preliminary amounts assigned to intangible assets	$ 3,900
Increase to other long-term liabilities	2,500
Predecessor \| Physician Practice, Existing Market
Business Acquisition [Line Items]
Number of business entities acquired \| physician_practice			3
Predecessor \| Total Acquisitions in 2017
Business Acquisition [Line Items]
Cash consideration			$ 14,163
Goodwill	12,167		12,167
Predecessor \| NSH
Business Acquisition [Line Items]
Total cash consideration, net of cash acquired	711,700
Cash consideration	764,007
Goodwill	871,373		871,373
Escrow account	19,600		$ 19,600
Net increase (decrease) in goodwill	1,100
Decrease in preliminary fair value assigned to non-controlling interests	$ 17,900

Acquisitions and Disposals - Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands		4 Months Ended	8 Months Ended	12 Months Ended
	Aug. 31, 2017	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2016
Net assets acquired:
Goodwill	$ 3,269,225	$ 3,346,838	$ 3,269,225	$ 3,382,846
H.I.G Bayside Debt & LBO Fund II L.P. \| BCPE Seminole Holdings LP
Business Acquisition [Line Items]
Equity attributable to Surgery Partners, Inc.	721,764
Redeemable preferred stock	310,000
Fair value of non-controlling interests	939,083		939,083
Aggregate fair value of acquisition				1,970,847
Net assets acquired:
Cash and cash equivalents	214,206		214,206
Accounts receivable	252,911		252,911
Inventories	44,310		44,310
Prepaid expenses and other current assets	61,438		61,438
Property and equipment	379,685		379,685
Intangible assets	63,978		63,978
Goodwill	3,281,728		3,281,728
Investments in and advances to affiliates	75,113		75,113
Restricted invested assets	315		315
Long-term deferred tax assets	206,073		206,073
Other long-term assets	50,666		50,666
Accounts payable	(64,921)		(64,921)
Accrued payroll and benefits	(56,535)		(56,535)
Other current liabilities	(97,617)		(97,617)
Current maturities of long-term debt	(49,942)		(49,942)
Long-term debt, less current maturities	(2,142,375)		(2,142,375)
Long-term tax receivable agreement liability	(78,498)		(78,498)
Other long-term liabilities	(169,688)		(169,688)
Total fair value of net assets acquired	1,970,847		1,970,847
Total Acquisitions in 2018
Business Acquisition [Line Items]
Cash consideration				106,441
Fair value of non-controlling interests				63,774
Aggregate fair value of acquisition				170,215
Net assets acquired:
Current assets				12,254
Property and equipment				5,033
Intangible assets				0
Goodwill				156,529
Other long-term assets				6,575
Current liabilities				(6,061)
Long-term liabilities				(4,115)
Total fair value of net assets acquired				$ 170,215
Total Acquisitions in 2017
Business Acquisition [Line Items]
Cash consideration		29,448
Fair value of non-controlling interests		21,893
Aggregate fair value of acquisition		51,341
Net assets acquired:
Current assets		2,267
Property and equipment		248
Intangible assets		41
Goodwill		49,368
Other long-term assets		0
Current liabilities		(583)
Long-term liabilities		0
Total fair value of net assets acquired		$ 51,341
Predecessor
Net assets acquired:
Goodwill	2,414,572		2,414,572		$ 1,555,204
Predecessor \| Total Acquisitions in 2017
Business Acquisition [Line Items]
Cash consideration			14,163
Fair value of non-controlling interests	105		105
Aggregate fair value of acquisition	14,268		14,268
Net assets acquired:
Current assets	777		777
Property and equipment	696		696
Intangible assets	1,101		1,101
Goodwill	12,167		12,167
Other long-term assets	0		0
Current liabilities	(287)		(287)
Long-term liabilities	(186)		(186)
Total fair value of net assets acquired	14,268		14,268
Predecessor \| NSH
Business Acquisition [Line Items]
Cash consideration	764,007
Fair value of non-controlling interests	325,965		325,965
Aggregate fair value of acquisition	1,089,972		1,089,972
Net assets acquired:
Cash and cash equivalents	51,159		51,159
Accounts receivable	71,639		71,639
Inventories	14,986		14,986
Prepaid expenses and other current assets	18,367		18,367
Property and equipment	174,100		174,100
Intangible assets	27,881		27,881
Goodwill	871,373		871,373
Investments in and advances to affiliates	29,737		29,737
Long-term deferred tax assets	20,212		20,212
Other long-term assets	26,988		26,988
Accounts payable	(29,652)		(29,652)
Accrued payroll and benefits	(30,853)		(30,853)
Other current liabilities	(23,937)		(23,937)
Current maturities of long-term debt	(16,416)		(16,416)
Long-term debt, less current maturities	(42,770)		(42,770)
Other long-term liabilities	(72,842)		(72,842)
Total fair value of net assets acquired	$ 1,089,972		$ 1,089,972

Property and Equipment - Additional Information (Details) - USD ($) $ in Millions	4 Months Ended	8 Months Ended	12 Months Ended
	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2016
Property, Plant and Equipment [Line Items]
Depreciation	$ 20.0		$ 62.5
Carrying value of assets under capital lease	16.2		22.7
Accumulated depreciation of assets under capital lease			$ (6.4)
Buildings and improvements \| Minimum
Property, Plant and Equipment [Line Items]
Property, and equipment useful life			20 years
Buildings and improvements \| Maximum
Property, Plant and Equipment [Line Items]
Property, and equipment useful life			40 years
Computer and software \| Minimum
Property, Plant and Equipment [Line Items]
Property, and equipment useful life			3 years
Computer and software \| Maximum
Property, Plant and Equipment [Line Items]
Property, and equipment useful life			5 years
Furniture and equipment \| Minimum
Property, Plant and Equipment [Line Items]
Property, and equipment useful life			5 years
Furniture and equipment \| Maximum
Property, Plant and Equipment [Line Items]
Property, and equipment useful life			7 years
Predecessor
Property, Plant and Equipment [Line Items]
Depreciation		$ 24.1		$ 30.0
Accumulated depreciation of assets under capital lease	$ (5.8)

Property and Equipment - Summary of Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	$ 482,405	$ 418,216
Less: Accumulated depreciation	(56,119)	(19,680)
Property and equipment, net	426,286	398,536
Land
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	19,550	19,561
Buildings and improvements
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	200,390	188,571
Furniture and equipment
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	24,069	20,813
Computer and software
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	33,877	28,578
Medical equipment
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	139,571	138,112
Construction in progress
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	$ 64,948	$ 22,581

Goodwill and Intangible Assets - Additional Information (Details)				4 Months Ended	8 Months Ended	12 Months Ended
	Oct. 01, 2018 USD ($) reporting_unit	Oct. 01, 2017 USD ($)	Aug. 31, 2017 USD ($)	Dec. 31, 2017 USD ($)	Aug. 31, 2017 USD ($)	Dec. 31, 2018 USD ($) reporting_unit	Dec. 31, 2016 USD ($)
Finite-Lived Intangible Assets [Line Items]
Number of reporting units \| reporting_unit	3
Number of reporting units disposed of in 2018 \| reporting_unit						2
Goodwill			$ 3,269,225,000	$ 3,346,838,000	$ 3,269,225,000	$ 3,382,846,000
Goodwill impairment loss		$ 0	0				$ 0
Amortization expense				$ 1,800,000		$ 4,900,000
Physician income guarantees \| Minimum
Finite-Lived Intangible Assets [Line Items]
Useful lives of intangible assets						3 years
Physician income guarantees \| Maximum
Finite-Lived Intangible Assets [Line Items]
Useful lives of intangible assets						4 years
Non-compete agreements \| Minimum
Finite-Lived Intangible Assets [Line Items]
Useful lives of intangible assets						2 years
Non-compete agreements \| Maximum
Finite-Lived Intangible Assets [Line Items]
Useful lives of intangible assets						5 years
Management rights agreements
Finite-Lived Intangible Assets [Line Items]
Useful lives of intangible assets						15 years
Customer relationships \| Minimum
Finite-Lived Intangible Assets [Line Items]
Useful lives of intangible assets						3 years
Customer relationships \| Maximum
Finite-Lived Intangible Assets [Line Items]
Useful lives of intangible assets						10 years
Reporting Unit, Surgical Facilities
Finite-Lived Intangible Assets [Line Items]
Goodwill	$ 3,300,000,000
Reporting Unit, Ancillary Services
Finite-Lived Intangible Assets [Line Items]
Goodwill	80,000,000
Goodwill impairment loss	(60,700,000)
Reporting Unit, The Alliance
Finite-Lived Intangible Assets [Line Items]
Goodwill	25,300,000
Goodwill impairment loss	$ (13,700,000)
Predecessor
Finite-Lived Intangible Assets [Line Items]
Goodwill			$ 2,414,572,000		2,414,572,000		1,555,204,000
Amortization expense					$ 6,000,000		$ 9,600,000

Goodwill and Intangible Assets - Changes in Carrying Amount of Goodwill (Details) - USD ($) $ in Thousands	4 Months Ended	8 Months Ended	12 Months Ended
	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018
Goodwill [Roll Forward]
Goodwill, beginning of period	$ 3,269,225		$ 3,346,838
Acquisitions, including post acquisition adjustments	79,570		143,469
Divestitures and deconsolidations	(1,957)		(33,102)
Impairment			(74,359)
Goodwill, end of period	3,346,838	$ 3,269,225	$ 3,382,846
Predecessor
Goodwill [Roll Forward]
Goodwill, beginning of period	$ 2,414,572	1,555,204
Acquisitions, including post acquisition adjustments		859,543
Divestitures and deconsolidations		(175)
Goodwill, end of period		$ 2,414,572

Goodwill and Intangible Assets - Summary of Components of Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets, gross carrying amount	$ 47,978
Finite-lived intangible assets, accumulated amortization	(6,961)
Total	41,017
Indefinite-lived intangible assets	13,276
Total intangible assets, gross	61,254
Total intangible assets, net	54,293	$ 58,908
Management rights agreements
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets, gross carrying amount	41,600
Finite-lived intangible assets, accumulated amortization	(4,223)
Total	37,377
Other
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets, gross carrying amount	6,378
Finite-lived intangible assets, accumulated amortization	(2,738)
Total	$ 3,640
Predecessor
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets, gross carrying amount		48,352
Finite-lived intangible assets, accumulated amortization		(2,000)
Total		46,352
Indefinite-lived intangible assets		12,556
Total intangible assets, gross		60,908
Total intangible assets, net		58,908
Predecessor \| Management rights agreements
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets, gross carrying amount		42,600
Finite-lived intangible assets, accumulated amortization		(1,058)
Total		41,542
Predecessor \| Other
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets, gross carrying amount		5,752
Finite-lived intangible assets, accumulated amortization		(942)
Total		$ 4,810

Goodwill and Intangible Assets - Future Amortization of Intangible Assets (Details) $ in Thousands	Dec. 31, 2018 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
2019	$ 4,617
2020	4,206
2021	3,647
2022	2,936
2023	2,144
Thereafter	23,467
Total	$ 41,017

Long-Term Debt - Summary of Long-Term Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Long-term debt	$ 2,328,136
Capital lease obligations	25,374	$ 27,594
Less: unamortized debt issuance costs and original issue discount	(2,915)	0
Total debt	2,326,450	2,189,282
Less: Current maturities	55,552	58,726
Total long-term debt	2,270,898	2,130,556
Notes payable and secured loans
Debt Instrument [Line Items]
Long-term debt	79,341	101,921
2017 Revolver Loan, Maturing 2022 \| Secured Debt \| Revolving Credit Facility
Debt Instrument [Line Items]
Long-term debt	0	0
2017 Term Loan, Maturing 2024 \| Secured Debt
Debt Instrument [Line Items]
Long-term debt	1,447,931	1,280,532
Less: unamortized debt issuance costs and original issue discount	(3,000)
Senior Unsecured Notes Due 2021 \| Senior Notes
Debt Instrument [Line Items]
Long-term debt	406,719	409,235
Unamortized fair value discount	(5,500)	(6,200)
Unamortized fair value premium	6,700	9,200
Senior Unsecured Notes Due 2025 \| Senior Notes
Debt Instrument [Line Items]
Long-term debt	$ 370,000	$ 370,000

Long-Term Debt - 2017 Senior Secured Credit Facilities (Details) - USD ($)		4 Months Ended	8 Months Ended	12 Months Ended
	Aug. 31, 2017	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2016	Oct. 23, 2018	Mar. 31, 2016
Debt Instrument [Line Items]
Loss on debt refinancing		$ 0		$ 0
Debt issuance costs and discount		0		2,915,000
Revolving Credit Facility \| Line of Credit
Debt Instrument [Line Items]
Outstanding balance on debt				71,200,000
Letter of Credit \| Line of Credit
Debt Instrument [Line Items]
Outstanding balance on debt				$ 3,800,000
Predecessor
Debt Instrument [Line Items]
Loss on debt refinancing			$ (18,211,000)		$ (11,876,000)
2017 Term Loan, Maturing 2024 \| Secured Debt
Debt Instrument [Line Items]
Quarterly installment of original principal				0.25%
Debt issuance costs and discount				$ 3,000,000
2017 Term Loan, Maturing 2024 \| Predecessor \| Secured Debt
Debt Instrument [Line Items]
Original balance of debt	$ 1,290,000,000.00		1,290,000,000.00
Debt issuance costs	28,200,000		28,200,000
2017 Term Loan, Maturing 2024 \| Predecessor \| Fair Value, Inputs, Level 2 \| Secured Debt
Debt Instrument [Line Items]
Debt discount	6,500,000		6,500,000
2017 Revolver Loan, Maturing 2022 \| Revolving Credit Facility \| Secured Debt
Debt Instrument [Line Items]
Commitment fee				0.50%
Net leverage ratio				9.50
Commitment threshold				35.00%
2017 Revolver Loan, Maturing 2022 \| Predecessor \| Revolving Credit Facility \| Secured Debt
Debt Instrument [Line Items]
Original balance of debt	$ 75,000,000.0		75,000,000.0
Incremental Term Loan \| Senior Notes
Debt Instrument [Line Items]
Original balance of debt						$ 180,000,000.0
Senior Unsecured Notes Due 2021 \| Secured Debt
Debt Instrument [Line Items]
Repayment threshold	50.00%
Senior Unsecured Notes Due 2021 \| Senior Notes
Debt Instrument [Line Items]
Debt discount		$ 6,200,000		$ 5,500,000
Senior Unsecured Notes Due 2021 \| Predecessor \| Senior Notes
Debt Instrument [Line Items]
Original balance of debt							$ 400,000,000.0
FIrst Lien Credit Agreement, 2014 \| Predecessor \| Revolving Credit Facility
Debt Instrument [Line Items]
Loss on debt refinancing			$ 18,200,000
Federal Funds Effective Swap Rate \| 2017 Senior Secured Credit Facility \| Secured Debt
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate				0.50%
One Month LIBOR \| 2017 Senior Secured Credit Facility \| Secured Debt
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate				1.00%
Base Rate \| 2017 Senior Secured Credit Facility \| Secured Debt
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate				2.00%
Minimum \| LIBOR \| 2017 Senior Secured Credit Facility \| Secured Debt
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate				3.00%
Minimum \| Base Rate \| 2017 Senior Secured Credit Facility \| Secured Debt
Debt Instrument [Line Items]
Debt instrument, margin in addition to base rate				2.00%
Maximum \| LIBOR \| 2017 Senior Secured Credit Facility \| Secured Debt
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate				3.25%
Maximum \| Base Rate \| 2017 Senior Secured Credit Facility \| Secured Debt
Debt Instrument [Line Items]
Debt instrument, margin in addition to base rate				2.25%

Long-Term Debt - Senior Unsecured Notes due 2021 (Details) - Senior Notes - Senior Unsecured Notes Due 2021 - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Aug. 31, 2017	Mar. 31, 2016
Debt Instrument [Line Items]
Debt instrument, stated rate	8.875%
Unamortized premium	$ 6,700,000	$ 9,200,000
Redemption Period One
Debt Instrument [Line Items]
Redemption price, percentage	106.656%
Redemption Period Two
Debt Instrument [Line Items]
Redemption price, percentage	104.438%
Redemption Period Three
Debt Instrument [Line Items]
Redemption price, percentage	100.00%
Redemption Period Four
Debt Instrument [Line Items]
Redemption price, percentage	101.00%
Predecessor
Debt Instrument [Line Items]
Original balance of debt				$ 400,000,000.0
Debt issuance costs			$ 8,400,000
Unamortized premium			$ 10,000,000

Long-Term Debt - Senior Unsecured Notes due 2025 (Details) - Senior Notes - Senior Unsecured Notes Due 2025 - USD ($)	12 Months Ended
	Dec. 31, 2018	Aug. 31, 2017	Jun. 30, 2017
Debt Instrument [Line Items]
Debt instrument, stated rate	6.75%
Redemption Period One
Debt Instrument [Line Items]
Amount of principal available to be redeemed, percentage	40.00%
Cash proceeds of principal amount, percentage	106.75%
Minimum principal remaining, percentage	50.00%
Period after equity offering	180 days
Redemption price, percentage	100.00%
Redemption Period Two
Debt Instrument [Line Items]
Redemption price, percentage	103.375%
Redemption Period Three
Debt Instrument [Line Items]
Redemption price, percentage	101.688%
Redemption Period Four
Debt Instrument [Line Items]
Redemption price, percentage	100.00%
Redemption Period Five
Debt Instrument [Line Items]
Redemption price, percentage	101.00%
Predecessor
Debt Instrument [Line Items]
Original balance of debt			$ 370,000,000.0
Debt issuance costs		$ 17,300,000

Long-Term Debt - Notes Payable, Secured Loans, and Capital Lease Obligations (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Long-term debt	$ 2,328,136
Capital leased assets	22,700	$ 16,200
Notes payable and secured loans
Debt Instrument [Line Items]
Long-term debt	$ 79,341	$ 101,921

Long-Term Debt - Summary of Scheduled Maturities of Debt Obligations (Details) $ in Thousands	Dec. 31, 2018 USD ($)
Debt Disclosure [Abstract]
2019	$ 55,552
2020	1,459,069
2021	415,733
2022	11,079
2023	7,868
Thereafter	378,835
Total debt	$ 2,328,136

Leases (Details) - USD ($) $ in Thousands	4 Months Ended	8 Months Ended	12 Months Ended
Leases (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2016
Operating Leases
2019			$ 81,455
2020			75,649
2021			66,728
2022			61,261
2023			57,202
Thereafter			470,194
Total minimum payments			812,489
Capital Leases
2019			8,846
2020			6,680
2021			4,704
2022			2,907
2023			1,534
Thereafter			4,227
Total minimum payments			28,898
Less: imputed interest			(3,524)
Capital lease obligations			25,374
Total future minimum rental payments to be received			3,400
Operating Leased Assets [Line Items]
Operating leases expense	$ 27,800		83,500
Operating lease agreements, with physician investors
Operating Leased Assets [Line Items]
Operating leases expense	$ 7,500		$ 20,200
Predecessor
Operating Leased Assets [Line Items]
Operating leases expense		$ 39,200		$ 47,300
Predecessor \| Operating lease agreements, with physician investors
Operating Leased Assets [Line Items]
Operating leases expense		$ 9,800		$ 14,400

Redeemable Preferred Stock (Details)		4 Months Ended	12 Months Ended
Redeemable Preferred Stock (Details)	Aug. 31, 2017 USD ($) trading_day $ / shares shares	Dec. 31, 2017 USD ($) $ / shares	Dec. 31, 2018 USD ($) $ / shares
Temporary Equity [Line Items]
Preferred stock, par value (USD per share) \| $ / shares		$ 0.01	$ 0.01
Dividends declared but unpaid		$ 3,900,000	$ 0
Cumulative preferred dividends			$ 33,800,000
Cumulative preferred dividends (in USD per share) \| $ / shares			$ 108.97
Increase (Decrease) in Temporary Equity [Roll Forward]
Balance at beginning of period		330,806,000
Dividends accrued		32,426,000
Cash dividends declared		$ (3,886,000)
Balance at end of period	$ 330,806,000		$ 359,346,000
Series A Preferred Stock
Temporary Equity [Line Items]
Preferred stock dividend rate	10.00%
Trading days \| trading_day	20
Consecutive trading days \| trading_day	30
Threshold share price (in USD per share) \| $ / shares	$ 42.00
Maximum cash dividend declarable	50.00%
Redemption price (in USD per share) \| $ / shares	$ 1,000.00
Series A Preferred Stock \| Common Stock
Temporary Equity [Line Items]
Share price (in USD per share) \| $ / shares	$ 19.00
Predecessor \| NSH \| Series A Preferred Stock
Temporary Equity [Line Items]
Deferred equity issuance costs	$ 18,300,000
Majority Shareholder \| Series A Preferred Stock
Temporary Equity [Line Items]
Stock issued during period (in shares) \| shares	310,000
Preferred stock, par value (USD per share) \| $ / shares	$ 0.01
Purchase price per share (in USD per share) \| $ / shares	$ 1,000
Initial public offering	$ 310,000,000

Derivatives and Hedging Activities (Details)	12 Months Ended
Derivatives and Hedging Activities (Details)	Dec. 31, 2018 USD ($)	Sep. 30, 2018 USD ($) swap	Dec. 31, 2017 USD ($)
Derivative [Line Items]
Amount estimated to be reclassified as a reduction to interest expense over next 12 months	$ 5,100,000
Number of interest rate swaps held \| swap		3
Derivative financial instruments			$ 0
Losses related to effective portion of derivatives recognized in accumulated OCI, gross of tax effect	(23,100,000)
Loss related to effective portion of derivatives reclassified from accumulated OCI to interest expense, gross of tax effect	$ (600,000)
Interest Rate Swap
Derivative [Line Items]
Current notional amount		$ 900,000,000

Earnings Per Share (Details) - USD ($)

1 Months Ended

2 Months Ended

3 Months Ended

4 Months Ended

8 Months Ended

12 Months Ended

Dec. 31, 2017

Sep. 30, 2017

Aug. 31, 2017

Dec. 31, 2018

Sep. 30, 2018

Jun. 30, 2018

Mar. 31, 2018

Dec. 31, 2017

Jun. 30, 2017

Mar. 31, 2017

Dec. 31, 2017

Aug. 31, 2017

Dec. 31, 2018

Dec. 31, 2016

Dec. 15, 2017

Numerator:

Net (loss) income attributable to Surgery Partners, Inc.

$ (9,140,000)

$ (147,742,000)

$ (20,981,000)

$ (19,462,000)

$ (17,521,000)

$ (32,176,000)

$ (41,316,000)

$ (205,706,000)

Less: amounts allocated to participating securities

10,481,000

32,426,000

Less: mark to redemption adjustment

15,566,000

Net (loss) income attributable to common stockholders

$ (67,363,000)

$ (238,132,000)

Denominator:

Weighted average shares outstanding- basic (in shares)

48,319,193

48,027,875

Effect of dilutive securities (in shares)

Weighted average shares outstanding- diluted (in shares)

^[1]

48,319,193

48,027,875

$ (0.57)

$ (3.25)

$ (0.61)

$ (0.57)

$ (0.53)

$ (0.83)

$ (1.39)

$ (4.96)

Stock repurchase program, authorized amount

$ (0.57)

$ (3.25)

$ (0.61)

$ (0.57)

$ (0.53)

$ (0.83)

$ (1.39)

^[1]

$ (4.96)

^[1]

$ 50,000,000

Shares repurchased (in shares)

180,664

156,818

Shares repurchased, average price per share (in dollars per share)

$ 11.12

$ 12.64

Stock repurchase program, remaining authorized repurchase amount

$ 46,000,000

Stock options

Antidilutive securities excluded from computation of earnings per share (in shares)

82,602

Restricted shares

Antidilutive securities excluded from computation of earnings per share (in shares)

62,850

198,267

Convertible preferred stock

Antidilutive securities excluded from computation of earnings per share (in shares)

Predecessor

Numerator:

Net (loss) income attributable to Surgery Partners, Inc.

$ (4,444,000)

$ (4,471,000)

$ (2,754,000)

$ (11,669,000)

$ 9,453,000

Less: amounts allocated to participating securities

Less: mark to redemption adjustment

Net (loss) income attributable to common stockholders

$ (11,669,000)

$ 9,453,000

Denominator:

Weighted average shares outstanding- basic (in shares)

48,121,404

48,018,944

Effect of dilutive securities (in shares)

171,794

Weighted average shares outstanding- diluted (in shares)

^[1]

48,121,404

48,190,738

$ (0.09)

$ (0.06)

$ (0.24)

$ 0.20

Predecessor | Stock options

$ (0.09)

$ (0.06)

$ (0.24)

^[1]

$ 0.20

^[1]

Antidilutive securities excluded from computation of earnings per share (in shares)

Predecessor | Restricted shares

Antidilutive securities excluded from computation of earnings per share (in shares)

105,944

[1]	The impact of potentially dilutive securities for the year ended December 31, 2018 (Successor), the four months ended December 31, 2017 (Successor) and the eight months ended August 31, 2017 (Predecessor) were not considered because the effect would be anti-dilutive in those periods.

Income Taxes - Additional Information (Details) - USD ($) $ in Thousands	4 Months Ended	8 Months Ended	12 Months Ended
	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2016
Income Tax Contingency [Line Items]
Cash paid for income taxes	$ 485		$ 2,226
Valuation allowance	11,032		50,430
Increase in valuation allowance			39,400
Increase in valuation allowance recorded to goodwill			100
Valuation allowance that if recognized, would credit directly to contributed capital			8,100
Accrued interest and penalties related to uncertain tax positions			100
Uncertain tax positions that would impact effective tax rate	$ 200		100
Additional Paid-in Capital
Income Tax Contingency [Line Items]
Additional-paid-in-capital increase, due to tax effect of disposals of shares of noncontrolling interests			6,300
Capital Loss Carryforward
Income Tax Contingency [Line Items]
Capital loss carryforwards			14,800
Credit Carryforward
Income Tax Contingency [Line Items]
Capital loss carryforwards			1,000
Federal Tax Authority
Income Tax Contingency [Line Items]
Net operating loss carryforwards			516,800
State Tax Authority
Income Tax Contingency [Line Items]
Net operating loss carryforwards			$ 589,900
Predecessor
Income Tax Contingency [Line Items]
Cash paid for income taxes		$ 598		$ 661

Income Taxes - Income Tax Expense (Details) - USD ($) $ in Thousands	4 Months Ended	8 Months Ended	12 Months Ended
	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2016
Current:
Federal	$ (111)		$ (324)
State	990		1,511
Deferred:
Federal	77,472		16,525
State	(6,712)		8,749
Total income tax expense (benefit)	$ 71,639		$ 26,461
Predecessor
Current:
Federal		$ 0		$ (31)
State		614		244
Deferred:
Federal		(17,288)		7,326
State		(1,415)		(444)
Total income tax expense (benefit)		$ (18,089)		$ 7,095

Income Taxes - Income Tax Rate Reconciliation (Details) - USD ($) $ in Thousands	4 Months Ended	8 Months Ended	12 Months Ended
	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2016
Income Tax Contingency [Line Items]
Tax expense (benefit) at U.S.federal statutory rate	$ 24,485		$ (14,525)
State income tax, net of U.S. federal tax benefit	1,685		9,955
Change in valuation allowance	529		26,946
Net income attributable to non-controlling interests	(13,872)		(23,117)
Changes in measurement of uncertain tax positions	(191)		(73)
Stock option compensation	306		509
Differences related to divested facilities	(429)		6,037
Nondeductible transaction costs	2,058		23
Tax return reconciling differences	0		1,748
Change in effective tax rate	64,343		493
Tax Receivable Agreement liability	(7,404)		901
Goodwill impairment	0		8,892
Litigation settlement	0		8,577
Other	129		95
Total income tax expense (benefit)	$ 71,639		$ 26,461
Predecessor
Income Tax Contingency [Line Items]
Tax expense (benefit) at U.S.federal statutory rate		$ 4,315		$ 32,263
State income tax, net of U.S. federal tax benefit		(456)		(86)
Change in valuation allowance		1,324		354
Net income attributable to non-controlling interests		(14,731)		(26,470)
Changes in measurement of uncertain tax positions		20		(262)
Stock option compensation		37		(200)
Differences related to divested facilities		(1,708)		0
Nondeductible transaction costs		(977)		0
Tax return reconciling differences		(316)		1,635
Change in effective tax rate		(825)		0
Tax Receivable Agreement liability		(4,782)		(327)
Goodwill impairment		0		0
Litigation settlement		0		0
Other		10		188
Total income tax expense (benefit)		$ (18,089)		$ 7,095

Income Taxes - Approx. Tax Effects of Temporary Differences, Deferred Tax Asset and Liability (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Deferred tax assets:
Medical malpractice liability	$ 3,456	$ 3,236
Accrued vacation and incentive compensation	2,933	2,125
Net operating loss carryforwards	139,404	137,794
Allowance for bad debts	2,510	2,545
Capital loss carryforwards	3,701	3,024
Deferred rent	1,866	0
Amortization of intangible assets	2,437	0
Deferred financing costs	14,638	17,004
Section 163(j) interest	27,338
Interest rate swap liability	5,431
TRA liability	1,176	1,042
Other deferred assets	7,010	4,961
Total gross deferred tax assets	211,900	171,731
Less: Valuation allowance	(50,430)	(11,032)
Total deferred tax assets	161,470	160,699
Deferred tax liabilities:
Depreciation on property and equipment	(3,925)	(12,098)
Amortization of intangible assets	0	(12,441)
Basis differences of partnerships and joint ventures	(47,749)	(2,399)
Deferred rent	0	(717)
Other deferred liabilities	(603)	(725)
Total deferred tax liabilities	(52,277)	(28,380)
Net deferred tax assets	$ 109,193	$ 132,319

Income Taxes - Schedule of Gross Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Unrecognized tax benefits at beginning of year	$ 690	$ 1,061
Additions for acquired positions	0	36
Additions for tax positions of prior years	7	0
Reductions for tax positions of prior year	(629)	(407)
Settlements	(7)	0
Unrecognized tax benefits at end of year	$ 61	$ 690

Equity-Based Compensation - Additional Information (Details) $ / shares in Units, $ in Millions		4 Months Ended	8 Months Ended	12 Months Ended
	Dec. 16, 2018 trading_day installment $ / shares shares	Dec. 31, 2017 USD ($) shares	Aug. 31, 2017 USD ($) shares	Dec. 31, 2018 USD ($) trading_day installment $ / shares shares	Dec. 31, 2017 shares	Dec. 31, 2016 USD ($) shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options and rights granted (in shares)		0		700,000
Unrecognized compensation cost \| $				$ 18.6
Equity-based compensation \| $		$ 1.9		$ 9.3
Restricted Stock Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Awards granted during period (in shares)		112,107		519,605
Performance Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Awards granted during period (in shares)		0		335,074
Vesting period				2 years
Restricted units granted, earned during period (in shares)		0		0
Leverage Performance Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Awards granted during period (in shares)		215,823		127,292
Vesting period				3 years
Restricted units granted, earned during period (in shares)		0
Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options and rights granted (in shares)				700,000	0
Vesting percentage				25.00%
Stock Option \| Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage				50.00%
Number of annual installments \| installment				5
Stock Option \| Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage				25.00%
Share price (in USD per share) \| $ / shares				$ 25.00
Number of consecutive trading days, threshold \| trading_day				60
Stock Option \| Tranche Three
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share price (in USD per share) \| $ / shares				$ 35.00
Number of consecutive trading days, threshold \| trading_day				60
SAR Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options and rights granted (in shares)	200,000				0	0
Options cancelled (in shares)	200,000
SAR Awards \| Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage	50.00%
Number of annual installments \| installment	5
SAR Awards \| Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage	25.00%
Share price (in USD per share) \| $ / shares	$ 25.00
Number of consecutive trading days, threshold \| trading_day	60
SAR Awards \| Tranche Three
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage	25.00%
Share price (in USD per share) \| $ / shares	$ 35.00
Number of consecutive trading days, threshold \| trading_day	60
2015 Omnibus Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares authorized under plan (in shares)				4,815,700
Shares available for future grant (in shares)				3,377,923
Predecessor
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options and rights granted (in shares)			0			7,779
Equity-based compensation \| $			$ 3.7			$ 2.0
Predecessor \| Restricted Stock Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Awards granted during period (in shares)			251,904
Predecessor \| Performance Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Awards granted during period (in shares)			232,242
Restricted units granted, earned during period (in shares)			136,550
Predecessor \| Leverage Performance Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Awards granted during period (in shares)			0
Minimum \| Restricted Stock Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period				3 years
Minimum \| Predecessor \| Performance Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Payable at end of period			0.00%
Minimum \| Predecessor \| Leverage Performance Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Payable at end of period			0.00%
Maximum \| Restricted Stock Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period				5 years
Maximum \| Predecessor \| Performance Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Payable at end of period			150.00%
Maximum \| Predecessor \| Leverage Performance Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Payable at end of period			500.00%

Equity-Based Compensation - Summary of Restricted Share Activity (Details) - Restricted Shares - $ / shares	4 Months Ended	8 Months Ended	12 Months Ended
	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2016
Unvested Shares
Outstanding, beginning of the period (in shares)	613,044		574,456
Granted (in shares)	112,107		519,605
Forfeited/Terminated (in shares)	(54,622)		(180,719)
Vested (in shares)	(96,073)		(210,318)
Outstanding, end of the period (in shares)	574,456	613,044	703,024
Weighted Average Grant Date Fair Value
Outstanding, beginning of the period (in USD per share)	$ 16.02		$ 15.95
Granted (in USD per share)	11.15		16.10
Forfeited/Terminated (in USD per share)	10.94		15.09
Vested (in USD per share)	17.03		16.31
Outstanding, end of the period (in USD per share)	$ 15.95	$ 16.02	$ 16.18
Predecessor
Unvested Shares
Outstanding, beginning of the period (in shares)	613,044	462,242		167,654
Granted (in shares)		388,454		384,629
Forfeited/Terminated (in shares)		(67,771)		(53,003)
Vested (in shares)		(169,881)		(37,038)
Outstanding, end of the period (in shares)		613,044		462,242
Weighted Average Grant Date Fair Value
Outstanding, beginning of the period (in USD per share)	$ 16.02	$ 3.72		$ 2.53
Granted (in USD per share)		18.40		15.09
Forfeited/Terminated (in USD per share)		18.01		11.85
Vested (in USD per share)		10.29		6.31
Outstanding, end of the period (in USD per share)		$ 16.02		$ 3.72

Equity-Based Compensation - Fair Value Assumptions (Details)	12 Months Ended
	Dec. 31, 2018 $ / shares
Granted in 2018 \| Employee Stock Options and Stock Appreciation Rights
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected dividends	0.00%
Average expected term (years)	10 years
Granted in 2018 \| Employee Stock Options and Stock Appreciation Rights \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected volatility	60.00%
Risk-free interest rate	2.50%
Fair value of stock options granted (in USD per share)	$ 8.48
Granted in 2018 \| Employee Stock Options and Stock Appreciation Rights \| Maximum
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected volatility	65.00%
Risk-free interest rate	2.90%
Fair value of stock options granted (in USD per share)	$ 9.44
Granted in 2015 and 2016 \| Stock Option
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected dividends	0.00%
Average expected term (years)	2 years 6 months 22 days
Granted in 2015 and 2016 \| Stock Option \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected volatility	29.00%
Risk-free interest rate	0.54%
Fair value of stock options granted (in USD per share)	$ 2.64
Granted in 2015 and 2016 \| Stock Option \| Maximum
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected volatility	43.00%
Risk-free interest rate	1.36%
Fair value of stock options granted (in USD per share)	$ 5.74

Equity-Based Compensation - Summary of Options Activity (Details) - $ / shares	4 Months Ended	8 Months Ended	12 Months Ended
	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Options/SARs
Outstanding, beginning of period (in shares)	12,687		12,687
Granted (in shares)	0		700,000
Exercised (in shares)	0		0
Forfeited/Cancelled (in shares)	0		(200,000)
Outstanding, end of period (in shares)	12,687	12,687	512,687	12,687
Weighted Average Exercise Price
Outstanding, beginning of period (in USD per share)	$ 20.10		$ 20.10
Granted (in USD per share)			12.90
Forfeited/Cancelled (in USD per share)			12.90
Outstanding, end of period (in USD per share)	$ 20.10	$ 20.10	$ 13.03	$ 20.10
Weighted Average Remaining Contractual Term (years)
Outstanding	1 year 1 month 28 days	1 year 6 months	9 years 9 months 18 days
Granted			10 years
Forfeited/Cancelled			10 years
Outstanding options, exercisable (in shares)			11,287
Predecessor
Options/SARs
Outstanding, beginning of period (in shares)	12,687	16,267		16,267	8,488
Granted (in shares)		0			7,779
Exercised (in shares)		(3,580)			0
Forfeited/Cancelled (in shares)		0			0
Outstanding, end of period (in shares)		12,687			16,267	8,488
Weighted Average Exercise Price
Outstanding, beginning of period (in USD per share)	$ 20.10	$ 19.05		$ 19.05	$ 20.03
Granted (in USD per share)					17.99
Exercised (in USD per share)		15.36
Outstanding, end of period (in USD per share)		$ 20.10			$ 19.05	$ 20.03
Weighted Average Remaining Contractual Term (years)
Outstanding		1 year 6 months			1 year 9 months 18 days	3 years
Granted					1 year 7 months 6 days

Employee Benefit Plans (Details) - USD ($) $ in Millions	4 Months Ended	8 Months Ended	12 Months Ended
Employee Benefit Plans (Details) - USD ($) $ in Millions	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2017
Defined Contribution Plan Disclosure [Line Items]
Matching contribution expense	$ 2.3		$ 7.6
Supplemental Executive Retirement Savings Plan
Defined Contribution Plan Disclosure [Line Items]
Percent of payroll employee may defer			25.00%
Percent of bonus employee may defer			50.00%
Percent of base pay employee may contribute to receive employer match			2.00%
Employer matching contribution percentage of employee base salary			2.00%
Predecessor
Defined Contribution Plan Disclosure [Line Items]
Matching contribution expense		$ 2.8		$ 5.1

Other Current and Long-Term Liabilities - Schedule of Other Current Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Other Liabilities Disclosure [Abstract]
Interest payable	$ 20,755	$ 20,537
Amounts due to patients and payors	20,053	18,096
Amounts due to patients and payors	42,342	0
Accrued expenses and other	72,093	71,311
Total	$ 155,243	$ 109,944

Other Current and Long-Term Liabilities - Schedule of Other Long-Term Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Other Liabilities Disclosure [Abstract]
Facility lease obligations	$ 149,811	$ 121,627
Other	121,376	100,853
Total	$ 271,187	$ 222,480

Other Current and Long-Term Liabilities - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Other Liabilities [Line Items]
Current portion of financing obligations	$ 7.0
Deferred financing obligation	50.2
Project costs incurred as obligations	$ 36.6	$ 13.6
Predecessor
Other Liabilities [Line Items]
Current portion of financing obligations		$ 6.3

Commitments and Contingencies (Details) - USD ($)			4 Months Ended	8 Months Ended	12 Months Ended
Commitments and Contingencies (Details) - USD ($)	Oct. 01, 2017	Aug. 31, 2017	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2016	Sep. 30, 2018	Oct. 23, 2017
Guarantor Obligations [Line Items]
Litigation-related charges related to CIDs								$ 46,000,000
Gain on amendment to tax receivable agreement			$ 1,098,000		$ 0
Goodwill impairment loss	$ 0	$ 0				$ 0
Tax receivable agreement benefit			25,329,000		$ 0
Tax rate					24.00%
Remaining amounts payable under TRA			65,100,000		$ 64,600,000
Carrying value of liability, net of discount			44,300,000		48,500,000
Current portion of TRA liability			500,000		7,600,000
Contingent acquisition compensation expense			$ 1,900,000		1,500,000
Cease-use liability							$ 1,400,000
Estimated severance costs					$ 4,500,000
Predecessor
Guarantor Obligations [Line Items]
Reduction in carrying value of TRA				$ 43,900,000
Gain on amendment to tax receivable agreement				15,294,000		0
Tax receivable agreement benefit				0		(3,733,000)
Contingent acquisition compensation expense				5,100,000		$ 5,100,000
Pushdown Accounting \| Predecessor
Guarantor Obligations [Line Items]
Goodwill impairment loss				$ 28,600,000
LIBOR
Guarantor Obligations [Line Items]
Interest accrued on payment under Tax Receivable Agreement, basis spread on variable rate					3.00%
Materially More Restrictive \| LIBOR
Guarantor Obligations [Line Items]
Debt instrument, basis spread on variable rate					5.00%
Not Materially More Restrictive \| LIBOR
Guarantor Obligations [Line Items]
Debt instrument, basis spread on variable rate					3.00%

Segment Reporting - Financial Information by Reportable Segment (Details) $ in Thousands	1 Months Ended	2 Months Ended	3 Months Ended							4 Months Ended	8 Months Ended	12 Months Ended
	Sep. 30, 2017 USD ($)	Aug. 31, 2017 USD ($)	Dec. 31, 2018 USD ($)	Sep. 30, 2018 USD ($)	Jun. 30, 2018 USD ($)	Mar. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Jun. 30, 2017 USD ($)	Mar. 31, 2017 USD ($)	Dec. 31, 2017 USD ($)	Aug. 31, 2017 USD ($)	Dec. 31, 2018 USD ($) segment	Dec. 31, 2016 USD ($)
Segment Reporting [Abstract]
Number of operating segments \| segment												3
Segment Reporting Information [Line Items]
Revenues	$ 132,258		$ 491,168	$ 432,377	$ 436,579	$ 411,332	$ 460,346			$ 592,604	$ 748,615	$ 1,771,456	$ 1,145,438
Adjusted EBITDA										78,737		234,768
Cash purchases of property and equipment, net										10,827		39,805
Predecessor
Segment Reporting Information [Line Items]
Revenues		$ 174,079						$ 288,353	$ 286,183		748,615		1,145,438
Adjusted EBITDA											85,564		179,263
Cash purchases of property and equipment, net											18,773		39,109
Operating Segments \| Surgical facility services
Segment Reporting Information [Line Items]
Revenues										564,458		1,682,278
Adjusted EBITDA										103,760		309,513
Cash purchases of property and equipment, net										9,334		34,178
Operating Segments \| Ancillary services
Segment Reporting Information [Line Items]
Revenues										24,660		79,633
Adjusted EBITDA										(2,255)		3,008
Cash purchases of property and equipment, net										191		419
Operating Segments \| Optical services
Segment Reporting Information [Line Items]
Revenues										3,486		9,545
Adjusted EBITDA										736		2,500
Cash purchases of property and equipment, net										83		46
Operating Segments \| Predecessor \| Surgical facility services
Segment Reporting Information [Line Items]
Revenues											688,725		1,042,097
Adjusted EBITDA											125,912		214,218
Cash purchases of property and equipment, net											14,582		29,157
Operating Segments \| Predecessor \| Ancillary services
Segment Reporting Information [Line Items]
Revenues											52,261		90,836
Adjusted EBITDA											(6,526)		12,685
Cash purchases of property and equipment, net											1,875		5,388
Operating Segments \| Predecessor \| Optical services
Segment Reporting Information [Line Items]
Revenues											7,629		12,505
Adjusted EBITDA											2,214		3,308
Cash purchases of property and equipment, net											73		351
All other
Segment Reporting Information [Line Items]
Adjusted EBITDA										(23,504)		(80,253)
Cash purchases of property and equipment, net										$ 1,219		$ 5,162
All other \| Predecessor
Segment Reporting Information [Line Items]
Adjusted EBITDA											(36,036)		(50,948)
Cash purchases of property and equipment, net											$ 2,243		$ 4,213

Segment Reporting - Segment Operating Income (Details) - USD ($) $ in Thousands	1 Months Ended	2 Months Ended	3 Months Ended							4 Months Ended	8 Months Ended	12 Months Ended
	Sep. 30, 2017	Aug. 31, 2017	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2017	Aug. 31, 2017	Dec. 31, 2018	Dec. 31, 2016
Segment Reporting Information [Line Items]
Adjusted EBITDA										$ 78,737		$ 234,768
Net income attributable to non-controlling interests	$ 6,492		$ 40,662	$ 23,000	$ 23,772	$ 22,646	$ 33,142			39,634		110,080
Depreciation and amortization										(21,804)		(67,440)
Interest expense, net										(48,740)		(147,003)
Equity-based compensation										(1,887)		(9,344)
Contingent acquisition compensation expense										(1,982)		(1,510)
Transaction, integration and acquisition costs										(9,330)		(33,856)
Gain on litigation settlement										8,740		(46,009)
Gain on acquisition escrow release										167		0
Loss on disposals and deconsolidations, net										(5)		(31,822)
Reserve adjustments										0		(2,670)
Impairment charges										0		(74,359)
Gain on amendment to tax receivable agreement										1,098		0
Tax receivable agreement benefit (expense)										25,329		0
Loss on debt refinancing										0		0
(Loss) income before income taxes										69,957		(69,165)
Transaction and integration costs										7,470		31,665
Practice acquisition costs										$ 1,800		$ 2,200
Predecessor
Segment Reporting Information [Line Items]
Adjusted EBITDA											$ 85,564		$ 179,263
Net income attributable to non-controlling interests		$ 8,813						$ 16,098	$ 17,176		42,087		75,630
Depreciation and amortization											(30,124)		(39,551)
Interest expense, net											(68,929)		(100,571)
Equity-based compensation											(3,697)		(2,021)
Contingent acquisition compensation expense											(5,057)		(5,092)
Transaction, integration and acquisition costs											(7,677)		(11,617)
Gain on litigation settlement											3,794		14,101
Gain on acquisition escrow release											1,000		0
Loss on disposals and deconsolidations, net											(1,715)		(2,355)
Reserve adjustments											0		0
Impairment charges											0		0
Gain on amendment to tax receivable agreement											15,294		0
Tax receivable agreement benefit (expense)											0		(3,733)
Loss on debt refinancing											(18,211)		(11,876)
(Loss) income before income taxes											12,329		92,178
Transaction and integration costs											5,584		8,738
Practice acquisition costs											$ 2,100		$ 2,900

Segment Reporting - Assets by Operating Segment (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Segment Reporting Information [Line Items]
Total assets	$ 4,676,267	$ 4,622,773
Operating Segments \| Surgical facility services
Segment Reporting Information [Line Items]
Total assets	4,204,344
Operating Segments \| Ancillary services
Segment Reporting Information [Line Items]
Total assets	52,733
Operating Segments \| Optical services
Segment Reporting Information [Line Items]
Total assets	20,084
All other
Segment Reporting Information [Line Items]
Total assets	$ 399,106
Predecessor
Segment Reporting Information [Line Items]
Total assets		4,622,773
Predecessor \| Operating Segments \| Surgical facility services
Segment Reporting Information [Line Items]
Total assets		4,072,521
Predecessor \| Operating Segments \| Ancillary services
Segment Reporting Information [Line Items]
Total assets		104,274
Predecessor \| Operating Segments \| Optical services
Segment Reporting Information [Line Items]
Total assets		48,309
Predecessor \| All other
Segment Reporting Information [Line Items]
Total assets		$ 397,669

Quarterly Financial Information (Unaudited) (Details) - USD ($)
$ / shares in Units, $ in Thousands

1 Months Ended

2 Months Ended

3 Months Ended

4 Months Ended

8 Months Ended

12 Months Ended

Sep. 30, 2017

Aug. 31, 2017

Dec. 31, 2018

Sep. 30, 2018

Jun. 30, 2018

Mar. 31, 2018

Dec. 31, 2017

Jun. 30, 2017

Mar. 31, 2017

Dec. 31, 2017

Aug. 31, 2017

Dec. 31, 2018

Dec. 31, 2016

Schedule Of Quarterly Financial Information [Line Items]

$ 132,258

$ 491,168

$ 432,377

$ 436,579

$ 411,332

$ 460,346

$ 592,604

$ 748,615

$ 1,771,456

$ 1,145,438

Net income attributable to non-controlling interests

102,924

359,740

334,289

340,090

327,312

338,704

441,628

1,361,431

Net income (loss)

(2,648)

(107,080)

2,019

4,310

5,125

966

(1,682)

(95,626)

(6,492)

(40,662)

(23,000)

(23,772)

(22,646)

(33,142)

(39,634)

(110,080)

Net (loss) income attributable to Surgery Partners, Inc.

$ (9,140)

$ (147,742)

$ (20,981)

$ (19,462)

$ (17,521)

$ (32,176)

$ (41,316)

$ (205,706)

Basic net (loss) income per share (in USD per share)

$ (0.57)

$ (3.25)

$ (0.61)

$ (0.57)

$ (0.53)

$ (0.83)

$ (1.39)

$ (4.96)

Diluted net (loss) income per share (in USD per share)

$ (0.57)

$ (3.25)

$ (0.61)

$ (0.57)

$ (0.53)

$ (0.83)

$ (1.39)

^[1]

$ (4.96)

^[1]

Predecessor

Schedule Of Quarterly Financial Information [Line Items]

$ 174,079

$ 288,353

$ 286,183

748,615

1,145,438

Net income attributable to non-controlling interests

143,772

216,452

211,948

572,172

821,196

Net income (loss)

4,369

11,627

14,422

30,418

85,083

(8,813)

(16,098)

(17,176)

(42,087)

(75,630)

Net (loss) income attributable to Surgery Partners, Inc.

$ (4,444)

$ (4,471)

$ (2,754)

$ (11,669)

$ 9,453

Basic net (loss) income per share (in USD per share)

$ (0.09)

$ (0.06)

$ (0.24)

$ 0.20

Diluted net (loss) income per share (in USD per share)

$ (0.09)

$ (0.06)

$ (0.24)

^[1]

$ 0.20

^[1]

[1]	The impact of potentially dilutive securities for the year ended December 31, 2018 (Successor), the four months ended December 31, 2017 (Successor) and the eight months ended August 31, 2017 (Predecessor) were not considered because the effect would be anti-dilutive in those periods.

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

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-Name Accounting Standards Codification
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-Subparagraph (SX 210.7-04(19))
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-Subparagraph (d)
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The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

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

+ References + Details

The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.