$SEM
SELECT MEDICAL HOLDINGS CORP Stock $sem

$sem Overview Financials Valuation SEC Filings Company Website

2024 Q1 Form 10-K Financial Statement

#000162828024006385 Filed on February 22, 2024

Income Statement

Concept	2024 Q1	2023 Q4	2023
Revenue	$1.789B	$1.659B	$6.664B
YoY Change	7.44%	4.89%	5.22%
Cost Of Revenue	$1.495B	$1.447B	$5.732B
YoY Change	5.34%	2.72%	2.35%
Gross Profit	$294.2M	$211.8M	$932.0M
YoY Change	19.51%	22.64%	27.09%
Gross Profit Margin	16.45%	12.77%	13.99%
Selling, General & Admin	$48.45M	$44.09M	$170.2M
YoY Change	14.59%	13.74%	11.21%
% of Gross Profit	16.47%	20.82%	18.26%
Research & Development
YoY Change
% of Gross Profit
Depreciation & Amortization	$54.07M	$53.98M	$177.1M
YoY Change	3.14%	3.33%	1.32%
% of Gross Profit	18.38%	25.49%	19.0%
Operating Expenses	$100.2M	$97.52M	$377.2M
YoY Change	5.84%	13.65%	14.26%
Operating Profit	$194.0M	$114.3M	$554.9M
YoY Change	28.07%	31.53%	37.59%
Interest Expense	$50.76M	-$40.61M	$198.6M
YoY Change	4.51%	0.06%	17.46%
% of Operating Profit	26.17%	-35.54%	35.8%
Other Income/Expense, Net
YoY Change
Pretax Income	$153.6M	$73.65M	$382.4M
YoY Change	37.85%	59.13%	46.73%
Income Tax	$36.46M	$11.85M	$82.63M
% Of Pretax Income	23.73%	16.09%	21.61%
Net Earnings	$96.90M	$44.65M	$243.5M
YoY Change	36.85%	68.6%	53.14%
Net Earnings / Revenue	5.42%	2.69%	3.65%
Basic Earnings Per Share	$0.75		$1.91
Diluted Earnings Per Share	$0.75	$0.36	$1.91
COMMON SHARES
Basic Shares Outstanding	128.4M shares	128.2M shares	123.1M shares
Diluted Shares Outstanding	123.9M shares		123.1M shares

Balance Sheet

Concept	2024 Q1	2023 Q4	2023
SHORT-TERM ASSETS
Cash & Short-Term Investments	$92.62M	$84.01M	$84.01M
YoY Change	10.65%	-14.2%	-14.2%
Cash & Equivalents	$92.62M	$84.01M	$84.01M
Short-Term Investments
Other Short-Term Assets	$161.2M	$151.6M	$233.3M
YoY Change	12.18%	20.94%	0.52%
Inventory
Prepaid Expenses
Receivables	$1.135B	$940.3M	$940.3M
Other Receivables	$0.00	$0.00	$0.00
Total Short-Term Assets	$1.440B	$1.258B	$1.258B
YoY Change	9.64%	-1.08%	-1.08%
LONG-TERM ASSETS
Property, Plant & Equipment	$1.025B	$1.024B	$2.212B
YoY Change	3.78%	2.21%	1.89%
Goodwill	$3.517B	$3.513B
YoY Change	0.93%	0.83%
Intangibles	$324.1M	$329.9M
YoY Change	-6.49%	-6.18%
Long-Term Investments			$316.0M
YoY Change			8.0%
Other Assets	$375.4M	$376.7M	$376.7M
YoY Change	6.04%	10.24%	299.33%
Total Long-Term Assets	$6.418B	$6.432B	$6.432B
YoY Change	0.5%	0.59%	0.59%
TOTAL ASSETS
Total Short-Term Assets	$1.440B	$1.258B	$1.258B
Total Long-Term Assets	$6.418B	$6.432B	$6.432B
Total Assets	$7.858B	$7.690B	$7.690B
YoY Change	2.06%	0.32%	0.32%
SHORT-TERM LIABILITIES
YoY Change
Accounts Payable	$163.6M	$174.3M	$174.3M
YoY Change	-6.06%	-6.65%	-6.65%
Accrued Expenses	$245.6M	$972.1M	$972.1M
YoY Change	-71.2%	9.02%	9.02%
Deferred Revenue
YoY Change
Short-Term Debt	$28.53M	$30.27M	$30.27M
YoY Change	-8.65%	-5.28%	-5.28%
Long-Term Debt Due	$60.18M	$70.33M	$70.33M
YoY Change	-47.16%	58.57%	58.57%
Total Short-Term Liabilities	$1.184B	$1.248B	$1.248B
YoY Change	-0.11%	8.08%	8.08%
LONG-TERM LIABILITIES
Long-Term Debt	$3.759B	$3.588B	$3.588B
YoY Change	-0.22%	-6.45%	-6.45%
Other Long-Term Liabilities	$100.2M	$110.3M	$1.136B
YoY Change	-6.07%	3.93%	1.94%
Total Long-Term Liabilities	$100.2M	$110.3M	$4.724B
YoY Change	-6.07%	3.93%	-4.56%
TOTAL LIABILITIES
Total Short-Term Liabilities	$1.184B	$1.248B	$1.248B
Total Long-Term Liabilities	$100.2M	$110.3M	$4.724B
Total Liabilities	$6.192B	$6.116B	$6.401B
YoY Change	-0.87%	-2.54%	-2.17%
SHAREHOLDERS EQUITY
Retained Earnings	$830.8M	$751.9M
YoY Change	30.74%	29.41%
Common Stock	$505.5M	$493.5M
YoY Change	9.35%	9.12%
Preferred Stock
YoY Change
Treasury Stock (at cost)
YoY Change
Treasury Stock Shares
Shareholders Equity	$1.367B	$1.288B	$1.288B
YoY Change
Total Liabilities & Shareholders Equity	$7.858B	$7.690B	$7.690B
YoY Change	2.06%	0.32%	0.32%

Cashflow Statement

Concept	2024 Q1	2023 Q4	2023
OPERATING ACTIVITIES
Net Income	$96.90M	$44.65M	$243.5M
YoY Change	36.85%	68.6%	53.14%
Depreciation, Depletion And Amortization	$54.07M	$53.98M	$177.1M
YoY Change	3.14%	3.33%	1.32%
Cash From Operating Activities	-$66.69M	$179.4M	$582.1M
YoY Change	-229.64%	1330.5%	104.36%
INVESTING ACTIVITIES
Capital Expenditures	$52.52M	$60.60M	$229.2M
YoY Change	-10.81%	9.68%	20.4%
Acquisitions	$5.405M		$29.57M
YoY Change	1261.46%		9.56%
Other Investing Activities	-$5.140M	-$8.981M	-$39.28M
YoY Change	-49.49%	353.36%	9.2%
Cash From Investing Activities	-$57.66M	-$69.58M	-$268.5M
YoY Change	-16.51%	21.58%	18.62%
FINANCING ACTIVITIES
Cash Dividend Paid
YoY Change
Common Stock Issuance & Retirement, Net
YoY Change
Debt Paid & Issued, Net
YoY Change
Cash From Financing Activities	$133.0M	-103.3M	-$327.5M
YoY Change	3788.86%	-400.5%	838.61%
NET CHANGE
Cash From Operating Activities	-$66.69M	179.4M	$582.1M
Cash From Investing Activities	-$57.66M	-69.58M	-$268.5M
Cash From Financing Activities	$133.0M	-103.3M	-$327.5M
Net Change In Cash	$8.614M	6.566M	-$13.90M
YoY Change	-160.65%	-163.64%	-158.91%
FREE CASH FLOW
Cash From Operating Activities	-$66.69M	$179.4M	$582.1M
Capital Expenditures	$52.52M	$60.60M	$229.2M
Free Cash Flow	-$119.2M	$118.8M	$352.9M
YoY Change	1501.16%	-378.25%	273.58%

Facts In Submission

Frame	Concept Type	Concept / XBRL Key	Value	Unit
CY2021	us-gaap	Other Comprehensive Income Loss Cash Flow Hedge Gain Loss After Reclassification And Tax OtherComprehensiveIncomeLossCashFlowHedgeGainLossAfterReclassificationAndTax	14309000	usd
CY2021	us-gaap	Comprehensive Income Net Of Tax Including Portion Attributable To Noncontrolling Interest ComprehensiveIncomeNetOfTaxIncludingPortionAttributableToNoncontrollingInterest	514258000	usd
CY2022	us-gaap	Comprehensive Income Net Of Tax Including Portion Attributable To Noncontrolling Interest ComprehensiveIncomeNetOfTaxIncludingPortionAttributableToNoncontrollingInterest	274346000	usd
CY2023	us-gaap	Comprehensive Income Net Of Tax Including Portion Attributable To Noncontrolling Interest ComprehensiveIncomeNetOfTaxIncludingPortionAttributableToNoncontrollingInterest	254036000	usd
CY2021	us-gaap	Comprehensive Income Net Of Tax Attributable To Noncontrolling Interest ComprehensiveIncomeNetOfTaxAttributableToNoncontrollingInterest	97724000	usd
CY2022	us-gaap	Comprehensive Income Net Of Tax Attributable To Noncontrolling Interest ComprehensiveIncomeNetOfTaxAttributableToNoncontrollingInterest	39032000	usd
CY2023	us-gaap	Comprehensive Income Net Of Tax ComprehensiveIncomeNetOfTax	197796000	usd
CY2023	us-gaap	Repayments Of Long Term Lines Of Credit RepaymentsOfLongTermLinesOfCredit	1070000000	usd
CY2021	us-gaap	Earnings Per Share Basic EarningsPerShareBasic	2.98
CY2021	us-gaap	Profit Loss ProfitLoss	499949000	usd
CY2022	us-gaap	Profit Loss ProfitLoss	198026000	usd
CY2021	us-gaap	Other Comprehensive Income Loss Cash Flow Hedge Gain Loss Before Reclassification After Tax OtherComprehensiveIncomeLossCashFlowHedgeGainLossBeforeReclassificationAfterTax	14270000	usd
CY2022	us-gaap	Other Comprehensive Income Loss Cash Flow Hedge Gain Loss Before Reclassification After Tax OtherComprehensiveIncomeLossCashFlowHedgeGainLossBeforeReclassificationAfterTax	90730000	usd
CY2023	us-gaap	Other Comprehensive Income Loss Cash Flow Hedge Gain Loss Before Reclassification After Tax OtherComprehensiveIncomeLossCashFlowHedgeGainLossBeforeReclassificationAfterTax	15783000	usd
CY2021	us-gaap	Other Comprehensive Income Loss Cash Flow Hedge Gain Loss Reclassification After Tax OtherComprehensiveIncomeLossCashFlowHedgeGainLossReclassificationAfterTax	-39000	usd
CY2022	us-gaap	Other Comprehensive Income Loss Cash Flow Hedge Gain Loss Reclassification After Tax OtherComprehensiveIncomeLossCashFlowHedgeGainLossReclassificationAfterTax	14410000	usd
CY2023	us-gaap	Other Comprehensive Income Loss Cash Flow Hedge Gain Loss Reclassification After Tax OtherComprehensiveIncomeLossCashFlowHedgeGainLossReclassificationAfterTax	61478000	usd
CY2022	us-gaap	Other Comprehensive Income Loss Cash Flow Hedge Gain Loss After Reclassification Tax OtherComprehensiveIncomeLossCashFlowHedgeGainLossAfterReclassificationTax	24658000	usd
CY2023	us-gaap	Other Comprehensive Income Loss Cash Flow Hedge Gain Loss After Reclassification And Tax OtherComprehensiveIncomeLossCashFlowHedgeGainLossAfterReclassificationAndTax	-45695000	usd
CY2023	dei	Entity Central Index Key EntityCentralIndexKey	0001320414
CY2023	dei	Amendment Flag AmendmentFlag	false
CY2023	dei	Document Fiscal Year Focus DocumentFiscalYearFocus	2023
CY2023	dei	Document Fiscal Period Focus DocumentFiscalPeriodFocus	FY
CY2022Q4	us-gaap	Finance Lease Right Of Use Asset Statement Of Financial Position Extensible List FinanceLeaseRightOfUseAssetStatementOfFinancialPositionExtensibleList	http://fasb.org/us-gaap/2023#PropertyPlantAndEquipmentNet
CY2023Q4	us-gaap	Finance Lease Right Of Use Asset Statement Of Financial Position Extensible List FinanceLeaseRightOfUseAssetStatementOfFinancialPositionExtensibleList	http://fasb.org/us-gaap/2023#PropertyPlantAndEquipmentNet
CY2023Q4	us-gaap	Finance Lease Liability Current Statement Of Financial Position Extensible List FinanceLeaseLiabilityCurrentStatementOfFinancialPositionExtensibleList	http://fasb.org/us-gaap/2023#LongTermDebtAndCapitalLeaseObligationsCurrent
CY2022Q4	us-gaap	Finance Lease Liability Current Statement Of Financial Position Extensible List FinanceLeaseLiabilityCurrentStatementOfFinancialPositionExtensibleList	http://fasb.org/us-gaap/2023#LongTermDebtAndCapitalLeaseObligationsCurrent
CY2023Q4	us-gaap	Finance Lease Liability Noncurrent Statement Of Financial Position Extensible List FinanceLeaseLiabilityNoncurrentStatementOfFinancialPositionExtensibleList	http://fasb.org/us-gaap/2023#LongTermDebtAndCapitalLeaseObligations
CY2022Q4	us-gaap	Finance Lease Liability Noncurrent Statement Of Financial Position Extensible List FinanceLeaseLiabilityNoncurrentStatementOfFinancialPositionExtensibleList	http://fasb.org/us-gaap/2023#LongTermDebtAndCapitalLeaseObligations
CY2023	dei	Document Annual Report DocumentAnnualReport	true
CY2023	dei	Current Fiscal Year End Date CurrentFiscalYearEndDate	--12-31
CY2023	dei	Document Transition Report DocumentTransitionReport	false
CY2023	dei	Entity File Number EntityFileNumber	001-34465
CY2023	dei	Entity Registrant Name EntityRegistrantName	SELECT MEDICAL HOLDINGS CORP
CY2023	dei	Entity Incorporation State Country Code EntityIncorporationStateCountryCode	DE
CY2023	dei	Entity Tax Identification Number EntityTaxIdentificationNumber	20-1764048
CY2023	dei	Entity Address Address Line1 EntityAddressAddressLine1	4714 Gettysburg Road
CY2023	dei	Entity Address Address Line2 EntityAddressAddressLine2	P.O. Box 2034
CY2023	dei	Entity Address City Or Town EntityAddressCityOrTown	Mechanicsburg
CY2023	dei	Entity Address State Or Province EntityAddressStateOrProvince	PA
CY2023	dei	Entity Address Postal Zip Code EntityAddressPostalZipCode	17055
CY2023	dei	City Area Code CityAreaCode	717
CY2023	dei	Local Phone Number LocalPhoneNumber	972-1100
CY2023	dei	Security12b Title Security12bTitle	Common Stock, $0.001 par value per share
CY2023	dei	Trading Symbol TradingSymbol	SEM
CY2023	dei	Security Exchange Name SecurityExchangeName	NYSE
CY2023	dei	Entity Well Known Seasoned Issuer EntityWellKnownSeasonedIssuer	Yes
CY2023	dei	Entity Voluntary Filers EntityVoluntaryFilers	No
CY2023	dei	Entity Current Reporting Status EntityCurrentReportingStatus	Yes
CY2023	dei	Entity Interactive Data Current EntityInteractiveDataCurrent	Yes
CY2023	dei	Entity Filer Category EntityFilerCategory	Large Accelerated Filer
CY2023	dei	Entity Small Business EntitySmallBusiness	false
CY2023	dei	Entity Emerging Growth Company EntityEmergingGrowthCompany	false
CY2023	dei	Icfr Auditor Attestation Flag IcfrAuditorAttestationFlag	true
CY2023	dei	Document Fin Stmt Error Correction Flag DocumentFinStmtErrorCorrectionFlag	false
CY2023	dei	Entity Shell Company EntityShellCompany	false
CY2023Q2	dei	Entity Public Float EntityPublicFloat	3253662356	usd
CY2024Q1	dei	Entity Common Stock Shares Outstanding EntityCommonStockSharesOutstanding	128361492	shares
CY2023Q4	ecd	Non Rule10b51 Arr Adopted Flag NonRule10b51ArrAdoptedFlag	false
CY2023Q4	ecd	Rule10b51 Arr Adopted Flag Rule10b51ArrAdoptedFlag	false
CY2023Q4	ecd	Rule10b51 Arr Trmntd Flag Rule10b51ArrTrmntdFlag	false
CY2023Q4	ecd	Non Rule10b51 Arr Trmntd Flag NonRule10b51ArrTrmntdFlag	false
CY2023	dei	Auditor Firm AuditorFirmId	238
CY2023	dei	Auditor Name AuditorName	PricewaterhouseCoopers LLP
CY2023	dei	Auditor Location AuditorLocation	Philadelphia, Pennsylvania
CY2022Q4	us-gaap	Cash And Cash Equivalents At Carrying Value CashAndCashEquivalentsAtCarryingValue	97906000	usd
CY2023Q4	us-gaap	Cash And Cash Equivalents At Carrying Value CashAndCashEquivalentsAtCarryingValue	84006000	usd
CY2022Q4	us-gaap	Accounts Receivable Net Current AccountsReceivableNetCurrent	941312000	usd
CY2023Q4	us-gaap	Accounts Receivable Net Current AccountsReceivableNetCurrent	940335000	usd
CY2022Q4	us-gaap	Prepaid Taxes PrepaidTaxes	31868000	usd
CY2023Q4	us-gaap	Prepaid Taxes PrepaidTaxes	22726000	usd
CY2022Q4	us-gaap	Derivative Assets Current DerivativeAssetsCurrent	74857000	usd
CY2023Q4	us-gaap	Derivative Assets Current DerivativeAssetsCurrent	58962000	usd
CY2022Q4	us-gaap	Other Assets Current OtherAssetsCurrent	125370000	usd
CY2023Q4	us-gaap	Other Assets Current OtherAssetsCurrent	151617000	usd
CY2022Q4	us-gaap	Assets Current AssetsCurrent	1271313000	usd
CY2023Q4	us-gaap	Assets Current AssetsCurrent	1257646000	usd
CY2022Q4	us-gaap	Operating Lease Right Of Use Asset OperatingLeaseRightOfUseAsset	1169740000	usd
CY2023Q4	us-gaap	Operating Lease Right Of Use Asset OperatingLeaseRightOfUseAsset	1188616000	usd
CY2022Q4	us-gaap	Property Plant And Equipment Net PropertyPlantAndEquipmentNet	1001440000	usd
CY2023Q4	us-gaap	Property Plant And Equipment Net PropertyPlantAndEquipmentNet	1023561000	usd
CY2022Q4	us-gaap	Goodwill Goodwill	3484200000	usd
CY2023Q4	us-gaap	Goodwill Goodwill	3513170000	usd
CY2022Q4	us-gaap	Intangible Assets Net Excluding Goodwill IntangibleAssetsNetExcludingGoodwill	351662000	usd
CY2023Q4	us-gaap	Intangible Assets Net Excluding Goodwill IntangibleAssetsNetExcludingGoodwill	329916000	usd
CY2022Q4	us-gaap	Derivative Assets Noncurrent DerivativeAssetsNoncurrent	45200000	usd
CY2023Q4	us-gaap	Derivative Assets Noncurrent DerivativeAssetsNoncurrent	0	usd
CY2022Q4	us-gaap	Other Assets Noncurrent OtherAssetsNoncurrent	341738000	usd
CY2023Q4	us-gaap	Other Assets Noncurrent OtherAssetsNoncurrent	376722000	usd
CY2022Q4	us-gaap	Assets Assets	7665293000	usd
CY2023Q4	us-gaap	Assets Assets	7689631000	usd
CY2022Q4	sem	Book Overdrafts BookOverdrafts	31961000	usd
CY2023Q4	sem	Book Overdrafts BookOverdrafts	30274000	usd
CY2022Q4	us-gaap	Operating Lease Liability Current OperatingLeaseLiabilityCurrent	236784000	usd
CY2023Q4	us-gaap	Operating Lease Liability Current OperatingLeaseLiabilityCurrent	245400000	usd
CY2022Q4	us-gaap	Long Term Debt And Capital Lease Obligations Current LongTermDebtAndCapitalLeaseObligationsCurrent	44351000	usd
CY2023Q4	us-gaap	Long Term Debt And Capital Lease Obligations Current LongTermDebtAndCapitalLeaseObligationsCurrent	70329000	usd
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CY2023Q4	sem	Accrued Salaries Accrued Bonuses And Accrued Payroll Taxes Current AccruedSalariesAccruedBonusesAndAccruedPayrollTaxesCurrent	238768000	usd
CY2022Q4	us-gaap	Accrued Vacation Current AccruedVacationCurrent	150695000	usd
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CY2023Q4	us-gaap	Other Accrued Liabilities Current OtherAccruedLiabilitiesCurrent	297663000	usd
CY2022Q4	us-gaap	Taxes Payable Current TaxesPayableCurrent	480000	usd
CY2023Q4	us-gaap	Taxes Payable Current TaxesPayableCurrent	1499000	usd
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CY2023Q4	us-gaap	Liabilities Current LiabilitiesCurrent	1248465000	usd
CY2022Q4	us-gaap	Operating Lease Liability Noncurrent OperatingLeaseLiabilityNoncurrent	1008394000	usd
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CY2023Q4	us-gaap	Liabilities Liabilities	6115616000	usd
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CY2023Q4	us-gaap	Redeemable Noncontrolling Interest Equity Carrying Amount RedeemableNoncontrollingInterestEquityCarryingAmount	26297000	usd
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CY2023Q4	us-gaap	Common Stock Shares Outstanding CommonStockSharesOutstanding	128369492	shares
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CY2022Q4	us-gaap	Common Stock Value CommonStockValue	127000	usd
CY2023Q4	us-gaap	Common Stock Value CommonStockValue	128000	usd
CY2022Q4	us-gaap	Additional Paid In Capital Common Stock AdditionalPaidInCapitalCommonStock	452183000	usd
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CY2022Q4	us-gaap	Retained Earnings Accumulated Deficit RetainedEarningsAccumulatedDeficit	581010000	usd
CY2023Q4	us-gaap	Retained Earnings Accumulated Deficit RetainedEarningsAccumulatedDeficit	751856000	usd
CY2022Q4	us-gaap	Accumulated Other Comprehensive Income Loss Net Of Tax AccumulatedOtherComprehensiveIncomeLossNetOfTax	88602000	usd
CY2023Q4	us-gaap	Accumulated Other Comprehensive Income Loss Net Of Tax AccumulatedOtherComprehensiveIncomeLossNetOfTax	42907000	usd
CY2022Q4	us-gaap	Stockholders Equity StockholdersEquity	1121922000	usd
CY2023Q4	us-gaap	Stockholders Equity StockholdersEquity	1288304000	usd
CY2022Q4	us-gaap	Minority Interest MinorityInterest	234642000	usd
CY2023Q4	us-gaap	Minority Interest MinorityInterest	259414000	usd
CY2022Q4	us-gaap	Stockholders Equity Including Portion Attributable To Noncontrolling Interest StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest	1356564000	usd
CY2023Q4	us-gaap	Stockholders Equity Including Portion Attributable To Noncontrolling Interest StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest	1547718000	usd
CY2022Q4	us-gaap	Liabilities And Stockholders Equity LiabilitiesAndStockholdersEquity	7665293000	usd
CY2023Q4	us-gaap	Liabilities And Stockholders Equity LiabilitiesAndStockholdersEquity	7689631000	usd
CY2021	us-gaap	Revenue From Contract With Customer Excluding Assessed Tax RevenueFromContractWithCustomerExcludingAssessedTax	6204515000	usd
CY2022	us-gaap	Revenue From Contract With Customer Excluding Assessed Tax RevenueFromContractWithCustomerExcludingAssessedTax	6333538000	usd
CY2023	us-gaap	Revenue From Contract With Customer Excluding Assessed Tax RevenueFromContractWithCustomerExcludingAssessedTax	6664058000	usd
CY2021	us-gaap	Cost Of Goods And Service Excluding Depreciation Depletion And Amortization CostOfGoodsAndServiceExcludingDepreciationDepletionAndAmortization	5285149000	usd
CY2022	us-gaap	Cost Of Goods And Service Excluding Depreciation Depletion And Amortization CostOfGoodsAndServiceExcludingDepreciationDepletionAndAmortization	5600161000	usd
CY2023	us-gaap	Cost Of Goods And Service Excluding Depreciation Depletion And Amortization CostOfGoodsAndServiceExcludingDepreciationDepletionAndAmortization	5732017000	usd
CY2021	us-gaap	General And Administrative Expense GeneralAndAdministrativeExpense	146975000	usd
CY2022	us-gaap	General And Administrative Expense GeneralAndAdministrativeExpense	153035000	usd
CY2023	us-gaap	General And Administrative Expense GeneralAndAdministrativeExpense	170193000	usd
CY2021	us-gaap	Depreciation And Amortization DepreciationAndAmortization	202645000	usd
CY2022	us-gaap	Depreciation And Amortization DepreciationAndAmortization	205825000	usd
CY2023	us-gaap	Depreciation And Amortization DepreciationAndAmortization	208742000	usd
CY2021	us-gaap	Costs And Expenses CostsAndExpenses	5634769000	usd
CY2022	us-gaap	Costs And Expenses CostsAndExpenses	5959021000	usd
CY2023	us-gaap	Costs And Expenses CostsAndExpenses	6110952000	usd
CY2021	us-gaap	Other Operating Income Expense Net OtherOperatingIncomeExpenseNet	144028000	usd
CY2022	us-gaap	Other Operating Income Expense Net OtherOperatingIncomeExpenseNet	28766000	usd
CY2023	us-gaap	Other Operating Income Expense Net OtherOperatingIncomeExpenseNet	1768000	usd
CY2021	us-gaap	Operating Income Loss OperatingIncomeLoss	713774000	usd
CY2022	us-gaap	Operating Income Loss OperatingIncomeLoss	403283000	usd
CY2023	us-gaap	Operating Income Loss OperatingIncomeLoss	554874000	usd
CY2021	us-gaap	Gains Losses On Extinguishment Of Debt GainsLossesOnExtinguishmentOfDebt	0	usd
CY2022	us-gaap	Gains Losses On Extinguishment Of Debt GainsLossesOnExtinguishmentOfDebt	0	usd
CY2023	us-gaap	Gains Losses On Extinguishment Of Debt GainsLossesOnExtinguishmentOfDebt	-14692000	usd
CY2021	us-gaap	Income Loss From Equity Method Investments IncomeLossFromEquityMethodInvestments	44428000	usd
CY2022	us-gaap	Income Loss From Equity Method Investments IncomeLossFromEquityMethodInvestments	26407000	usd
CY2023	us-gaap	Income Loss From Equity Method Investments IncomeLossFromEquityMethodInvestments	40813000	usd
CY2021	us-gaap	Disposal Group Not Discontinued Operation Gain Loss On Disposal DisposalGroupNotDiscontinuedOperationGainLossOnDisposal	2155000	usd
CY2022	us-gaap	Disposal Group Not Discontinued Operation Gain Loss On Disposal DisposalGroupNotDiscontinuedOperationGainLossOnDisposal	0	usd
CY2023	us-gaap	Disposal Group Not Discontinued Operation Gain Loss On Disposal DisposalGroupNotDiscontinuedOperationGainLossOnDisposal	0	usd
CY2021	us-gaap	Litigation Settlement Interest LitigationSettlementInterest	-5350000	usd
CY2022	us-gaap	Litigation Settlement Interest LitigationSettlementInterest	0	usd
CY2023	us-gaap	Litigation Settlement Interest LitigationSettlementInterest	0	usd
CY2021	us-gaap	Interest Expense InterestExpense	135985000	usd
CY2022	us-gaap	Interest Expense InterestExpense	169111000	usd
CY2023	us-gaap	Interest Expense InterestExpense	198639000	usd
CY2021	us-gaap	Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest	629722000	usd
CY2022	us-gaap	Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest	260579000	usd
CY2023	us-gaap	Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest	382356000	usd
CY2021	us-gaap	Income Tax Expense Benefit IncomeTaxExpenseBenefit	129773000	usd
CY2022	us-gaap	Income Tax Expense Benefit IncomeTaxExpenseBenefit	62553000	usd
CY2023	us-gaap	Income Tax Expense Benefit IncomeTaxExpenseBenefit	82625000	usd
CY2021	us-gaap	Net Income Loss Attributable To Noncontrolling Interest NetIncomeLossAttributableToNoncontrollingInterest	97724000	usd
CY2022	us-gaap	Net Income Loss Attributable To Noncontrolling Interest NetIncomeLossAttributableToNoncontrollingInterest	39032000	usd
CY2023	us-gaap	Net Income Loss Attributable To Noncontrolling Interest NetIncomeLossAttributableToNoncontrollingInterest	56240000	usd
CY2021	us-gaap	Net Income Loss NetIncomeLoss	402225000	usd
CY2022	us-gaap	Net Income Loss NetIncomeLoss	158994000	usd
CY2023	us-gaap	Net Income Loss NetIncomeLoss	243491000	usd
CY2021	us-gaap	Earnings Per Share Diluted EarningsPerShareDiluted	2.98
CY2022	us-gaap	Earnings Per Share Diluted EarningsPerShareDiluted	1.23
CY2022	us-gaap	Earnings Per Share Basic EarningsPerShareBasic	1.23
CY2023	us-gaap	Earnings Per Share Basic EarningsPerShareBasic	1.91
CY2023	us-gaap	Earnings Per Share Diluted EarningsPerShareDiluted	1.91
CY2023	us-gaap	Profit Loss ProfitLoss	299731000	usd
CY2021	us-gaap	Other Comprehensive Income Loss Cash Flow Hedge Gain Loss After Reclassification Tax OtherComprehensiveIncomeLossCashFlowHedgeGainLossAfterReclassificationTax	4799000	usd
CY2023	us-gaap	Other Comprehensive Income Loss Cash Flow Hedge Gain Loss After Reclassification Tax OtherComprehensiveIncomeLossCashFlowHedgeGainLossAfterReclassificationTax	15202000	usd
CY2022	us-gaap	Other Comprehensive Income Loss Cash Flow Hedge Gain Loss After Reclassification And Tax OtherComprehensiveIncomeLossCashFlowHedgeGainLossAfterReclassificationAndTax	76320000	usd
CY2023	us-gaap	Comprehensive Income Net Of Tax Attributable To Noncontrolling Interest ComprehensiveIncomeNetOfTaxAttributableToNoncontrollingInterest	56240000	usd
CY2021	us-gaap	Comprehensive Income Net Of Tax ComprehensiveIncomeNetOfTax	416534000	usd
CY2022	us-gaap	Comprehensive Income Net Of Tax ComprehensiveIncomeNetOfTax	235314000	usd
CY2020Q4	us-gaap	Stockholders Equity Including Portion Attributable To Noncontrolling Interest StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest	1252973000	usd
CY2021	us-gaap	Net Income Loss NetIncomeLoss	402225000	usd
CY2021	us-gaap	Net Income Loss Attributable To Nonredeemable Noncontrolling Interest NetIncomeLossAttributableToNonredeemableNoncontrollingInterest	-47571000	usd
CY2021	us-gaap	Common Stock Dividends Per Share Declared CommonStockDividendsPerShareDeclared	0.375
CY2021	us-gaap	Dividends Common Stock DividendsCommonStock	50600000	usd
CY2021	us-gaap	Stock Issued During Period Value Restricted Stock Award Gross StockIssuedDuringPeriodValueRestrictedStockAwardGross	0	usd
CY2021	us-gaap	Stock Issued During Period Value Restricted Stock Award Forfeitures StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures	0	usd
CY2021	us-gaap	Adjustments To Additional Paid In Capital Sharebased Compensation Requisite Service Period Recognition Value AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	28798000	usd
CY2021	us-gaap	Stock Repurchased And Retired During Period Value StockRepurchasedAndRetiredDuringPeriodValue	79476000	usd
CY2021	us-gaap	Noncontrolling Interest Increase From Subsidiary Equity Issuance NoncontrollingInterestIncreaseFromSubsidiaryEquityIssuance	21186000	usd
CY2021	us-gaap	Noncontrolling Interest Increase From Business Combination NoncontrollingInterestIncreaseFromBusinessCombination	11153000	usd
CY2021	us-gaap	Minority Interest Decrease From Distributions To Noncontrolling Interest Holders MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	72158000	usd
CY2021	us-gaap	Minority Interest Change In Redemption Value MinorityInterestChangeInRedemptionValue	-250083000	usd
CY2021	us-gaap	Other Comprehensive Income Loss Cash Flow Hedge Gain Loss After Reclassification And Tax OtherComprehensiveIncomeLossCashFlowHedgeGainLossAfterReclassificationAndTax	14309000	usd
CY2021	us-gaap	Stockholders Equity Other StockholdersEquityOther	-4000	usd
CY2021Q4	us-gaap	Stockholders Equity Including Portion Attributable To Noncontrolling Interest StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest	1325902000	usd
CY2022	us-gaap	Net Income Loss NetIncomeLoss	158994000	usd
CY2022	us-gaap	Net Income Loss Attributable To Nonredeemable Noncontrolling Interest NetIncomeLossAttributableToNonredeemableNoncontrollingInterest	-31460000	usd
CY2022	us-gaap	Common Stock Dividends Per Share Declared CommonStockDividendsPerShareDeclared	0.50
CY2022	us-gaap	Dividends Common Stock DividendsCommonStock	64589000	usd
CY2022	us-gaap	Stock Issued During Period Value Restricted Stock Award Gross StockIssuedDuringPeriodValueRestrictedStockAwardGross	0	usd
CY2022	sem	Restricted Stock Award Forfeitures Par Value Of Shares Forfeited Including Effects Of Dividends Reclassified To Retained Earnings RestrictedStockAwardForfeituresParValueOfSharesForfeitedIncludingEffectsOfDividendsReclassifiedToRetainedEarnings	-64000	usd
CY2022	us-gaap	Adjustments To Additional Paid In Capital Sharebased Compensation Requisite Service Period Recognition Value AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	35550000	usd
CY2022	us-gaap	Stock Repurchased And Retired During Period Value StockRepurchasedAndRetiredDuringPeriodValue	195528000	usd
CY2022	us-gaap	Noncontrolling Interest Increase From Subsidiary Equity Issuance NoncontrollingInterestIncreaseFromSubsidiaryEquityIssuance	10170000	usd
CY2022	us-gaap	Noncontrolling Interest Increase From Business Combination NoncontrollingInterestIncreaseFromBusinessCombination	12463000	usd
CY2022	us-gaap	Minority Interest Decrease From Distributions To Noncontrolling Interest Holders MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	37664000	usd
CY2022	us-gaap	Minority Interest Change In Redemption Value MinorityInterestChangeInRedemptionValue	3385000	usd
CY2022	us-gaap	Other Comprehensive Income Loss Cash Flow Hedge Gain Loss After Reclassification And Tax OtherComprehensiveIncomeLossCashFlowHedgeGainLossAfterReclassificationAndTax	76320000	usd
CY2022	us-gaap	Stockholders Equity Other StockholdersEquityOther	-37000	usd
CY2022Q4	us-gaap	Stockholders Equity Including Portion Attributable To Noncontrolling Interest StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest	1356564000	usd
CY2023	us-gaap	Net Income Loss NetIncomeLoss	243491000	usd
CY2023	us-gaap	Net Income Loss Attributable To Nonredeemable Noncontrolling Interest NetIncomeLossAttributableToNonredeemableNoncontrollingInterest	-48153000	usd
CY2023	us-gaap	Common Stock Dividends Per Share Declared CommonStockDividendsPerShareDeclared	0.50
CY2023	us-gaap	Dividends Common Stock DividendsCommonStock	63904000	usd
CY2023	us-gaap	Stock Issued During Period Value Restricted Stock Award Gross StockIssuedDuringPeriodValueRestrictedStockAwardGross	0	usd
CY2023	sem	Restricted Stock Award Forfeitures Par Value Of Shares Forfeited Including Effects Of Dividends Reclassified To Retained Earnings RestrictedStockAwardForfeituresParValueOfSharesForfeitedIncludingEffectsOfDividendsReclassifiedToRetainedEarnings	-12000	usd
CY2023	us-gaap	Adjustments To Additional Paid In Capital Sharebased Compensation Requisite Service Period Recognition Value AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	43619000	usd
CY2023	us-gaap	Stock Repurchased And Retired During Period Value StockRepurchasedAndRetiredDuringPeriodValue	12759000	usd
CY2023	us-gaap	Noncontrolling Interest Increase From Subsidiary Equity Issuance NoncontrollingInterestIncreaseFromSubsidiaryEquityIssuance	23051000	usd
CY2023	us-gaap	Noncontrolling Interest Increase From Business Combination NoncontrollingInterestIncreaseFromBusinessCombination	9007000	usd
CY2023	us-gaap	Minority Interest Decrease From Distributions To Noncontrolling Interest Holders MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	55314000	usd
CY2023	us-gaap	Minority Interest Change In Redemption Value MinorityInterestChangeInRedemptionValue	1527000	usd
CY2023	us-gaap	Other Comprehensive Income Loss Cash Flow Hedge Gain Loss After Reclassification And Tax OtherComprehensiveIncomeLossCashFlowHedgeGainLossAfterReclassificationAndTax	-45695000	usd
CY2023	us-gaap	Stockholders Equity Other StockholdersEquityOther	34000	usd
CY2023Q4	us-gaap	Stockholders Equity Including Portion Attributable To Noncontrolling Interest StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest	1547718000	usd
CY2021	us-gaap	Profit Loss ProfitLoss	499949000	usd
CY2022	us-gaap	Profit Loss ProfitLoss	198026000	usd
CY2023	us-gaap	Profit Loss ProfitLoss	299731000	usd
CY2021	us-gaap	Equity Method Investment Dividends Or Distributions EquityMethodInvestmentDividendsOrDistributions	37002000	usd
CY2022	us-gaap	Equity Method Investment Dividends Or Distributions EquityMethodInvestmentDividendsOrDistributions	21911000	usd
CY2023	us-gaap	Equity Method Investment Dividends Or Distributions EquityMethodInvestmentDividendsOrDistributions	23417000	usd
CY2021	us-gaap	Depreciation And Amortization DepreciationAndAmortization	202645000	usd
CY2022	us-gaap	Depreciation And Amortization DepreciationAndAmortization	205825000	usd
CY2023	us-gaap	Depreciation And Amortization DepreciationAndAmortization	208742000	usd
CY2021	us-gaap	Provision For Doubtful Accounts ProvisionForDoubtfulAccounts	236000	usd
CY2022	us-gaap	Provision For Doubtful Accounts ProvisionForDoubtfulAccounts	174000	usd
CY2021	us-gaap	Income Loss From Equity Method Investments IncomeLossFromEquityMethodInvestments	44428000	usd
CY2021	us-gaap	Write Off Of Deferred Debt Issuance Cost WriteOffOfDeferredDebtIssuanceCost	0	usd
CY2022	us-gaap	Write Off Of Deferred Debt Issuance Cost WriteOffOfDeferredDebtIssuanceCost	0	usd
CY2023	us-gaap	Write Off Of Deferred Debt Issuance Cost WriteOffOfDeferredDebtIssuanceCost	175000	usd
CY2021	us-gaap	Gain Loss On Sale Of Business GainLossOnSaleOfBusiness	2409000	usd
CY2022	us-gaap	Gain Loss On Sale Of Business GainLossOnSaleOfBusiness	2714000	usd
CY2023	us-gaap	Gain Loss On Sale Of Business GainLossOnSaleOfBusiness	57000	usd
CY2021	us-gaap	Share Based Compensation ShareBasedCompensation	30940000	usd
CY2022	us-gaap	Share Based Compensation ShareBasedCompensation	37755000	usd
CY2023	us-gaap	Share Based Compensation ShareBasedCompensation	43809000	usd
CY2021	us-gaap	Amortization Of Financing Costs And Discounts AmortizationOfFinancingCostsAndDiscounts	2217000	usd
CY2022	us-gaap	Amortization Of Financing Costs And Discounts AmortizationOfFinancingCostsAndDiscounts	2272000	usd
CY2023	us-gaap	Amortization Of Financing Costs And Discounts AmortizationOfFinancingCostsAndDiscounts	2647000	usd
CY2021	us-gaap	Deferred Income Tax Expense Benefit DeferredIncomeTaxExpenseBenefit	5055000	usd
CY2022	us-gaap	Deferred Income Tax Expense Benefit DeferredIncomeTaxExpenseBenefit	7521000	usd
CY2023	us-gaap	Deferred Income Tax Expense Benefit DeferredIncomeTaxExpenseBenefit	-16119000	usd
CY2021	us-gaap	Increase Decrease In Accounts Receivable IncreaseDecreaseInAccountsReceivable	-23101000	usd
CY2022	us-gaap	Increase Decrease In Accounts Receivable IncreaseDecreaseInAccountsReceivable	52183000	usd
CY2023	us-gaap	Increase Decrease In Accounts Receivable IncreaseDecreaseInAccountsReceivable	-1156000	usd
CY2021	us-gaap	Increase Decrease In Other Current Assets IncreaseDecreaseInOtherCurrentAssets	2418000	usd
CY2022	us-gaap	Increase Decrease In Other Current Assets IncreaseDecreaseInOtherCurrentAssets	4866000	usd
CY2023	us-gaap	Increase Decrease In Other Current Assets IncreaseDecreaseInOtherCurrentAssets	29374000	usd
CY2021	us-gaap	Increase Decrease In Other Noncurrent Assets IncreaseDecreaseInOtherNoncurrentAssets	7196000	usd
CY2022	us-gaap	Increase Decrease In Other Noncurrent Assets IncreaseDecreaseInOtherNoncurrentAssets	-16491000	usd
CY2023	us-gaap	Increase Decrease In Other Noncurrent Assets IncreaseDecreaseInOtherNoncurrentAssets	-10031000	usd
CY2021	us-gaap	Increase Decrease In Accounts Payable IncreaseDecreaseInAccountsPayable	53392000	usd
CY2022	us-gaap	Increase Decrease In Accounts Payable IncreaseDecreaseInAccountsPayable	-48042000	usd
CY2023	us-gaap	Increase Decrease In Accounts Payable IncreaseDecreaseInAccountsPayable	-6412000	usd
CY2021	us-gaap	Increase Decrease In Accrued Liabilities IncreaseDecreaseInAccruedLiabilities	-73159000	usd
CY2022	us-gaap	Increase Decrease In Accrued Liabilities IncreaseDecreaseInAccruedLiabilities	12839000	usd
CY2023	us-gaap	Increase Decrease In Accrued Liabilities IncreaseDecreaseInAccruedLiabilities	84095000	usd
CY2021	sem	Increase Decrease In Government Advances Cares Act IncreaseDecreaseInGovernmentAdvancesCARESAct	-241185000	usd
CY2022	sem	Increase Decrease In Government Advances Cares Act IncreaseDecreaseInGovernmentAdvancesCARESAct	-83790000	usd
CY2023	sem	Increase Decrease In Government Advances Cares Act IncreaseDecreaseInGovernmentAdvancesCARESAct	0	usd
CY2021	sem	Increase Decrease In Unearned Government Assistance Cares Act IncreaseDecreaseInUnearnedGovernmentAssistanceCARESAct	-82514000	usd
CY2022	sem	Increase Decrease In Unearned Government Assistance Cares Act IncreaseDecreaseInUnearnedGovernmentAssistanceCARESAct	13000	usd
CY2023	sem	Increase Decrease In Unearned Government Assistance Cares Act IncreaseDecreaseInUnearnedGovernmentAssistanceCARESAct	0	usd
CY2021	us-gaap	Net Cash Provided By Used In Operating Activities NetCashProvidedByUsedInOperatingActivities	401228000	usd
CY2022	us-gaap	Net Cash Provided By Used In Operating Activities NetCashProvidedByUsedInOperatingActivities	284825000	usd
CY2023	us-gaap	Net Cash Provided By Used In Operating Activities NetCashProvidedByUsedInOperatingActivities	582058000	usd
CY2021	us-gaap	Payments To Acquire Businesses Net Of Cash Acquired PaymentsToAcquireBusinessesNetOfCashAcquired	81911000	usd
CY2022	us-gaap	Payments To Acquire Businesses Net Of Cash Acquired PaymentsToAcquireBusinessesNetOfCashAcquired	26987000	usd
CY2023	us-gaap	Payments To Acquire Businesses Net Of Cash Acquired PaymentsToAcquireBusinessesNetOfCashAcquired	29567000	usd
CY2021	us-gaap	Payments To Acquire Productive Assets PaymentsToAcquireProductiveAssets	180537000	usd
CY2022	us-gaap	Payments To Acquire Productive Assets PaymentsToAcquireProductiveAssets	190372000	usd
CY2023	us-gaap	Payments To Acquire Productive Assets PaymentsToAcquireProductiveAssets	229200000	usd
CY2021	us-gaap	Payments To Acquire Equity Method Investments PaymentsToAcquireEquityMethodInvestments	20967000	usd
CY2022	us-gaap	Payments To Acquire Equity Method Investments PaymentsToAcquireEquityMethodInvestments	17323000	usd
CY2023	us-gaap	Payments To Acquire Equity Method Investments PaymentsToAcquireEquityMethodInvestments	9873000	usd
CY2021	us-gaap	Proceeds From Sales Of Business Affiliate And Productive Assets ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets	26821000	usd
CY2022	us-gaap	Proceeds From Sales Of Business Affiliate And Productive Assets ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets	8343000	usd
CY2023	us-gaap	Proceeds From Sales Of Business Affiliate And Productive Assets ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets	163000	usd
CY2021	us-gaap	Net Cash Provided By Used In Investing Activities NetCashProvidedByUsedInInvestingActivities	-256594000	usd
CY2022	us-gaap	Net Cash Provided By Used In Investing Activities NetCashProvidedByUsedInInvestingActivities	-226339000	usd
CY2023	us-gaap	Net Cash Provided By Used In Investing Activities NetCashProvidedByUsedInInvestingActivities	-268477000	usd
CY2021	us-gaap	Proceeds From Lines Of Credit ProceedsFromLinesOfCredit	160000000	usd
CY2022	us-gaap	Proceeds From Lines Of Credit ProceedsFromLinesOfCredit	1120000000	usd
CY2023	us-gaap	Proceeds From Lines Of Credit ProceedsFromLinesOfCredit	905000000	usd
CY2021	us-gaap	Repayments Of Long Term Lines Of Credit RepaymentsOfLongTermLinesOfCredit	0	usd
CY2022	us-gaap	Repayments Of Long Term Lines Of Credit RepaymentsOfLongTermLinesOfCredit	835000000	usd
CY2021	us-gaap	Proceeds From Issuance Of Secured Debt ProceedsFromIssuanceOfSecuredDebt	0	usd
CY2022	us-gaap	Proceeds From Issuance Of Secured Debt ProceedsFromIssuanceOfSecuredDebt	0	usd
CY2023	us-gaap	Proceeds From Issuance Of Secured Debt ProceedsFromIssuanceOfSecuredDebt	2092232000	usd
CY2021	us-gaap	Repayments Of Secured Debt RepaymentsOfSecuredDebt	0	usd
CY2022	us-gaap	Repayments Of Secured Debt RepaymentsOfSecuredDebt	0	usd
CY2023	us-gaap	Repayments Of Secured Debt RepaymentsOfSecuredDebt	2113952000	usd
CY2021	us-gaap	Proceeds From Other Debt ProceedsFromOtherDebt	33013000	usd
CY2022	us-gaap	Proceeds From Other Debt ProceedsFromOtherDebt	25666000	usd
CY2023	us-gaap	Proceeds From Other Debt ProceedsFromOtherDebt	31399000	usd
CY2021	us-gaap	Repayments Of Debt And Capital Lease Obligations RepaymentsOfDebtAndCapitalLeaseObligations	39668000	usd
CY2022	us-gaap	Repayments Of Debt And Capital Lease Obligations RepaymentsOfDebtAndCapitalLeaseObligations	35594000	usd
CY2023	us-gaap	Repayments Of Debt And Capital Lease Obligations RepaymentsOfDebtAndCapitalLeaseObligations	46946000	usd
CY2021	us-gaap	Payments Of Dividends Common Stock PaymentsOfDividendsCommonStock	50600000	usd
CY2022	us-gaap	Payments Of Dividends Common Stock PaymentsOfDividendsCommonStock	64589000	usd
CY2023	us-gaap	Payments Of Dividends Common Stock PaymentsOfDividendsCommonStock	63904000	usd
CY2021	us-gaap	Payments For Repurchase Of Equity PaymentsForRepurchaseOfEquity	79476000	usd
CY2022	us-gaap	Payments For Repurchase Of Equity PaymentsForRepurchaseOfEquity	195528000	usd
CY2023	us-gaap	Payments For Repurchase Of Equity PaymentsForRepurchaseOfEquity	12759000	usd
CY2021	us-gaap	Increase Decrease In Book Overdrafts IncreaseDecreaseInBookOverdrafts	42353000	usd
CY2022	us-gaap	Increase Decrease In Book Overdrafts IncreaseDecreaseInBookOverdrafts	-10392000	usd
CY2023	us-gaap	Increase Decrease In Book Overdrafts IncreaseDecreaseInBookOverdrafts	-1687000	usd
CY2021	us-gaap	Proceeds From Minority Shareholders ProceedsFromMinorityShareholders	20732000	usd
CY2022	us-gaap	Proceeds From Minority Shareholders ProceedsFromMinorityShareholders	9530000	usd
CY2023	us-gaap	Proceeds From Minority Shareholders ProceedsFromMinorityShareholders	22935000	usd
CY2021	us-gaap	Payments Of Dividends Minority Interest PaymentsOfDividendsMinorityInterest	73081000	usd
CY2022	us-gaap	Payments Of Dividends Minority Interest PaymentsOfDividendsMinorityInterest	43107000	usd
CY2023	us-gaap	Payments Of Dividends Minority Interest PaymentsOfDividendsMinorityInterest	63531000	usd
CY2021	us-gaap	Payments For Repurchase Of Redeemable Noncontrolling Interest PaymentsForRepurchaseOfRedeemableNoncontrollingInterest	660658000	usd
CY2022	us-gaap	Payments For Repurchase Of Redeemable Noncontrolling Interest PaymentsForRepurchaseOfRedeemableNoncontrollingInterest	5876000	usd
CY2023	us-gaap	Payments For Repurchase Of Redeemable Noncontrolling Interest PaymentsForRepurchaseOfRedeemableNoncontrollingInterest	6268000	usd
CY2021	us-gaap	Net Cash Provided By Used In Financing Activities NetCashProvidedByUsedInFinancingActivities	-647385000	usd
CY2022	us-gaap	Net Cash Provided By Used In Financing Activities NetCashProvidedByUsedInFinancingActivities	-34890000	usd
CY2023	us-gaap	Net Cash Provided By Used In Financing Activities NetCashProvidedByUsedInFinancingActivities	-327481000	usd
CY2021	us-gaap	Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents Period Increase Decrease Including Exchange Rate Effect CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect	-502751000	usd
CY2022	us-gaap	Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents Period Increase Decrease Including Exchange Rate Effect CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect	23596000	usd
CY2023	us-gaap	Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents Period Increase Decrease Including Exchange Rate Effect CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect	-13900000	usd
CY2020Q4	us-gaap	Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents	577061000	usd
CY2021Q4	us-gaap	Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents	74310000	usd
CY2022Q4	us-gaap	Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents	97906000	usd
CY2021Q4	us-gaap	Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents	74310000	usd
CY2022Q4	us-gaap	Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents	97906000	usd
CY2023Q4	us-gaap	Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents	84006000	usd
CY2022	us-gaap	Derivative Cash Received On Hedge DerivativeCashReceivedOnHedge	19584000	usd
CY2023	us-gaap	Derivative Cash Received On Hedge DerivativeCashReceivedOnHedge	82818000	usd
CY2021	us-gaap	Interest Paid Net InterestPaidNet	132203000	usd
CY2022	us-gaap	Interest Paid Net InterestPaidNet	183453000	usd
CY2023	us-gaap	Interest Paid Net InterestPaidNet	272261000	usd
CY2021	us-gaap	Income Taxes Paid Net IncomeTaxesPaidNet	181184000	usd
CY2022	us-gaap	Income Taxes Paid Net IncomeTaxesPaidNet	32290000	usd
CY2023	us-gaap	Income Taxes Paid Net IncomeTaxesPaidNet	88510000	usd
CY2021	us-gaap	Capital Expenditures Incurred But Not Yet Paid CapitalExpendituresIncurredButNotYetPaid	23441000	usd
CY2022	us-gaap	Capital Expenditures Incurred But Not Yet Paid CapitalExpendituresIncurredButNotYetPaid	51529000	usd
CY2023	us-gaap	Capital Expenditures Incurred But Not Yet Paid CapitalExpendituresIncurredButNotYetPaid	18403000	usd
CY2023Q4	us-gaap	Number Of States In Which Entity Operates NumberOfStatesInWhichEntityOperates	46	state
CY2023	us-gaap	Number Of Reportable Segments NumberOfReportableSegments	4	business_segment
CY2023	us-gaap	Use Of Estimates UseOfEstimates	<div style="margin-bottom:9pt;margin-top:9pt;text-align:justify"><span style="color:#000000;font-family:'Times New Roman',sans-serif;font-size:10pt;font-style:italic;font-weight:700;line-height:120%">Use of Estimates</span></div><div style="margin-bottom:9pt;margin-top:9pt;text-align:justify;text-indent:22.5pt"><span style="color:#000000;font-family:'Times New Roman',sans-serif;font-size:10pt;font-weight:400;line-height:120%">The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues, and expenses. Estimates and assumptions are used for, but not limited to: revenue recognition, allowances for expected credit losses, estimated useful lives of assets, the fair value of goodwill and intangible assets, the fair value of derivatives, amounts payable for self-insured losses, and the computation of income taxes. Future events and their effects cannot be predicted with certainty; accordingly, the Company’s accounting estimates require the exercise of judgment. The accounting estimates used in the preparation of the financial statements will change as new events occur, as more experience is acquired, as additional information is obtained, and as the Company’s operating environment changes. The Company’s management evaluates and updates assumptions and estimates on an ongoing basis. Actual results could differ from those estimates.</span></div>
CY2020Q4	us-gaap	Redeemable Noncontrolling Interest Equity Carrying Amount RedeemableNoncontrollingInterestEquityCarryingAmount	398171000	usd
CY2021Q4	us-gaap	Redeemable Noncontrolling Interest Equity Carrying Amount RedeemableNoncontrollingInterestEquityCarryingAmount	39033000	usd
CY2022Q4	us-gaap	Redeemable Noncontrolling Interest Equity Carrying Amount RedeemableNoncontrollingInterestEquityCarryingAmount	34043000	usd
CY2021	us-gaap	Net Income Loss Attributable To Redeemable Noncontrolling Interest NetIncomeLossAttributableToRedeemableNoncontrollingInterest	50153000	usd
CY2022	us-gaap	Net Income Loss Attributable To Redeemable Noncontrolling Interest NetIncomeLossAttributableToRedeemableNoncontrollingInterest	7572000	usd
CY2023	us-gaap	Net Income Loss Attributable To Redeemable Noncontrolling Interest NetIncomeLossAttributableToRedeemableNoncontrollingInterest	8087000	usd
CY2021	sem	Noncontrolling Interest Distributionsto Redeemable Noncontrolling Interests NoncontrollingInterestDistributionstoRedeemableNoncontrollingInterests	911000	usd
CY2022	sem	Noncontrolling Interest Distributionsto Redeemable Noncontrolling Interests NoncontrollingInterestDistributionstoRedeemableNoncontrollingInterests	5443000	usd
CY2023	sem	Noncontrolling Interest Distributionsto Redeemable Noncontrolling Interests NoncontrollingInterestDistributionstoRedeemableNoncontrollingInterests	8217000	usd
CY2021	us-gaap	Minority Interest Change In Redemption Value MinorityInterestChangeInRedemptionValue	-250083000	usd
CY2022	us-gaap	Minority Interest Change In Redemption Value MinorityInterestChangeInRedemptionValue	3385000	usd
CY2023	us-gaap	Minority Interest Change In Redemption Value MinorityInterestChangeInRedemptionValue	1527000	usd
CY2021	us-gaap	Minority Interest Decrease From Redemptions MinorityInterestDecreaseFromRedemptions	660658000	usd
CY2022	us-gaap	Minority Interest Decrease From Redemptions MinorityInterestDecreaseFromRedemptions	5876000	usd
CY2023	us-gaap	Minority Interest Decrease From Redemptions MinorityInterestDecreaseFromRedemptions	6268000	usd
CY2021	us-gaap	Temporary Equity Other Changes TemporaryEquityOtherChanges	2195000	usd
CY2022	us-gaap	Temporary Equity Other Changes TemporaryEquityOtherChanges	2142000	usd
CY2023	us-gaap	Temporary Equity Other Changes TemporaryEquityOtherChanges	179000	usd
CY2021Q4	us-gaap	Redeemable Noncontrolling Interest Equity Carrying Amount RedeemableNoncontrollingInterestEquityCarryingAmount	39033000	usd
CY2022Q4	us-gaap	Redeemable Noncontrolling Interest Equity Carrying Amount RedeemableNoncontrollingInterestEquityCarryingAmount	34043000	usd
CY2023Q4	us-gaap	Redeemable Noncontrolling Interest Equity Carrying Amount RedeemableNoncontrollingInterestEquityCarryingAmount	26297000	usd
CY2021	sem	Operating Lease Cost Unrelated Parties OperatingLeaseCostUnrelatedParties	283595000	usd
CY2021	sem	Operating Lease Cost Related Parties OperatingLeaseCostRelatedParties	7186000	usd
CY2021	us-gaap	Operating Lease Cost OperatingLeaseCost	290781000	usd
CY2022	sem	Operating Lease Cost Unrelated Parties OperatingLeaseCostUnrelatedParties	299077000	usd
CY2022	sem	Operating Lease Cost Related Parties OperatingLeaseCostRelatedParties	7245000	usd
CY2022	us-gaap	Operating Lease Cost OperatingLeaseCost	306322000	usd
CY2023	sem	Operating Lease Cost Unrelated Parties OperatingLeaseCostUnrelatedParties	310000000	usd
CY2023	sem	Operating Lease Cost Related Parties OperatingLeaseCostRelatedParties	7335000	usd
CY2023	us-gaap	Operating Lease Cost OperatingLeaseCost	317335000	usd
CY2021	sem	Finance Lease Right Of Use Asset Amortization Unrelated Parties FinanceLeaseRightOfUseAssetAmortizationUnrelatedParties	647000	usd
CY2021	sem	Finance Lease Right Of Use Asset Amortization Related Parties FinanceLeaseRightOfUseAssetAmortizationRelatedParties	0	usd
CY2021	us-gaap	Finance Lease Right Of Use Asset Amortization FinanceLeaseRightOfUseAssetAmortization	647000	usd
CY2022	sem	Finance Lease Right Of Use Asset Amortization Unrelated Parties FinanceLeaseRightOfUseAssetAmortizationUnrelatedParties	1488000	usd
CY2022	sem	Finance Lease Right Of Use Asset Amortization Related Parties FinanceLeaseRightOfUseAssetAmortizationRelatedParties	0	usd
CY2022	us-gaap	Finance Lease Right Of Use Asset Amortization FinanceLeaseRightOfUseAssetAmortization	1488000	usd
CY2023	sem	Finance Lease Right Of Use Asset Amortization Unrelated Parties FinanceLeaseRightOfUseAssetAmortizationUnrelatedParties	1572000	usd
CY2023	sem	Finance Lease Right Of Use Asset Amortization Related Parties FinanceLeaseRightOfUseAssetAmortizationRelatedParties	0	usd
CY2023	us-gaap	Finance Lease Right Of Use Asset Amortization FinanceLeaseRightOfUseAssetAmortization	1572000	usd
CY2021	sem	Finance Lease Interest Expense Unrelated Parties FinanceLeaseInterestExpenseUnrelatedParties	1142000	usd
CY2021	sem	Finance Lease Interest Expense Related Parties FinanceLeaseInterestExpenseRelatedParties	0	usd
CY2021	us-gaap	Finance Lease Interest Expense FinanceLeaseInterestExpense	1142000	usd
CY2022	sem	Finance Lease Interest Expense Unrelated Parties FinanceLeaseInterestExpenseUnrelatedParties	1335000	usd
CY2022	sem	Finance Lease Interest Expense Related Parties FinanceLeaseInterestExpenseRelatedParties	0	usd
CY2022	us-gaap	Finance Lease Interest Expense FinanceLeaseInterestExpense	1335000	usd
CY2021	sem	Short Term Lease Cost Unrelated Parties ShortTermLeaseCostUnrelatedParties	269000	usd
CY2021	sem	Short Term Lease Cost Related Parties ShortTermLeaseCostRelatedParties	0	usd
CY2021	us-gaap	Short Term Lease Cost ShortTermLeaseCost	269000	usd
CY2022	sem	Short Term Lease Cost Unrelated Parties ShortTermLeaseCostUnrelatedParties	74000	usd
CY2022	sem	Short Term Lease Cost Related Parties ShortTermLeaseCostRelatedParties	0	usd
CY2022	us-gaap	Short Term Lease Cost ShortTermLeaseCost	74000	usd
CY2023	sem	Short Term Lease Cost Unrelated Parties ShortTermLeaseCostUnrelatedParties	0	usd
CY2023	sem	Short Term Lease Cost Related Parties ShortTermLeaseCostRelatedParties	0	usd
CY2023	us-gaap	Short Term Lease Cost ShortTermLeaseCost	0	usd
CY2021	sem	Variable Lease Cost Unrelated Parties VariableLeaseCostUnrelatedParties	52666000	usd
CY2021	sem	Variable Lease Cost Related Parties VariableLeaseCostRelatedParties	426000	usd
CY2021	us-gaap	Variable Lease Cost VariableLeaseCost	53092000	usd
CY2022	sem	Variable Lease Cost Unrelated Parties VariableLeaseCostUnrelatedParties	57335000	usd
CY2022	sem	Variable Lease Cost Related Parties VariableLeaseCostRelatedParties	462000	usd
CY2022	us-gaap	Variable Lease Cost VariableLeaseCost	57797000	usd
CY2023	sem	Variable Lease Cost Unrelated Parties VariableLeaseCostUnrelatedParties	64920000	usd
CY2023	sem	Variable Lease Cost Related Parties VariableLeaseCostRelatedParties	84000	usd
CY2023	us-gaap	Variable Lease Cost VariableLeaseCost	65004000	usd
CY2021	sem	Sublease Income Unrelated Parties SubleaseIncomeUnrelatedParties	8955000	usd
CY2021	sem	Sublease Income Related Parties SubleaseIncomeRelatedParties	0	usd
CY2021	us-gaap	Sublease Income SubleaseIncome	8955000	usd
CY2022	sem	Sublease Income Unrelated Parties SubleaseIncomeUnrelatedParties	7803000	usd
CY2022	sem	Sublease Income Related Parties SubleaseIncomeRelatedParties	0	usd
CY2022	us-gaap	Sublease Income SubleaseIncome	7803000	usd
CY2023	sem	Sublease Income Unrelated Parties SubleaseIncomeUnrelatedParties	6725000	usd
CY2023	sem	Sublease Income Related Parties SubleaseIncomeRelatedParties	0	usd
CY2023	us-gaap	Sublease Income SubleaseIncome	6725000	usd
CY2021	sem	Lease Cost Unrelated Parties LeaseCostUnrelatedParties	329364000	usd
CY2021	sem	Lease Cost Related Parties LeaseCostRelatedParties	7612000	usd
CY2021	us-gaap	Lease Cost LeaseCost	336976000	usd
CY2022	sem	Lease Cost Unrelated Parties LeaseCostUnrelatedParties	351506000	usd
CY2022	sem	Lease Cost Related Parties LeaseCostRelatedParties	7707000	usd
CY2022	us-gaap	Lease Cost LeaseCost	359213000	usd
CY2023	sem	Lease Cost Unrelated Parties LeaseCostUnrelatedParties	371172000	usd
CY2023	sem	Lease Cost Related Parties LeaseCostRelatedParties	7419000	usd
CY2023	us-gaap	Lease Cost LeaseCost	378591000	usd
CY2021	us-gaap	Operating Lease Payments OperatingLeasePayments	294576000	usd
CY2022	us-gaap	Operating Lease Payments OperatingLeasePayments	308085000	usd
CY2023	us-gaap	Operating Lease Payments OperatingLeasePayments	317256000	usd
CY2021	us-gaap	Finance Lease Interest Payment On Liability FinanceLeaseInterestPaymentOnLiability	1142000	usd
CY2022	us-gaap	Finance Lease Interest Payment On Liability FinanceLeaseInterestPaymentOnLiability	1335000	usd
CY2023	us-gaap	Finance Lease Interest Payment On Liability FinanceLeaseInterestPaymentOnLiability	1239000	usd
CY2021	us-gaap	Finance Lease Principal Payments FinanceLeasePrincipalPayments	616000	usd
CY2022	us-gaap	Finance Lease Principal Payments FinanceLeasePrincipalPayments	1472000	usd
CY2023	us-gaap	Finance Lease Principal Payments FinanceLeasePrincipalPayments	1617000	usd
CY2021	us-gaap	Right Of Use Asset Obtained In Exchange For Operating Lease Liability RightOfUseAssetObtainedInExchangeForOperatingLeaseLiability	284657000	usd
CY2022	us-gaap	Right Of Use Asset Obtained In Exchange For Operating Lease Liability RightOfUseAssetObtainedInExchangeForOperatingLeaseLiability	340845000	usd
CY2023	us-gaap	Right Of Use Asset Obtained In Exchange For Operating Lease Liability RightOfUseAssetObtainedInExchangeForOperatingLeaseLiability	270153000	usd
CY2021	us-gaap	Right Of Use Asset Obtained In Exchange For Finance Lease Liability RightOfUseAssetObtainedInExchangeForFinanceLeaseLiability	4545000	usd
CY2022	us-gaap	Right Of Use Asset Obtained In Exchange For Finance Lease Liability RightOfUseAssetObtainedInExchangeForFinanceLeaseLiability	495000	usd
CY2023	us-gaap	Right Of Use Asset Obtained In Exchange For Finance Lease Liability RightOfUseAssetObtainedInExchangeForFinanceLeaseLiability	0	usd
CY2022Q4	sem	Operating Lease Right Of Use Asset Unrelated Parties OperatingLeaseRightOfUseAssetUnrelatedParties	1136014000	usd
CY2022Q4	sem	Operating Lease Right Of Use Asset Related Parties OperatingLeaseRightOfUseAssetRelatedParties	33726000	usd
CY2022Q4	us-gaap	Operating Lease Right Of Use Asset OperatingLeaseRightOfUseAsset	1169740000	usd
CY2023Q4	sem	Operating Lease Right Of Use Asset Unrelated Parties OperatingLeaseRightOfUseAssetUnrelatedParties	1159025000	usd
CY2023Q4	sem	Operating Lease Right Of Use Asset Related Parties OperatingLeaseRightOfUseAssetRelatedParties	29591000	usd
CY2023Q4	us-gaap	Operating Lease Right Of Use Asset OperatingLeaseRightOfUseAsset	1188616000	usd
CY2022Q4	sem	Operating Lease Liability Current Unrelated Parties OperatingLeaseLiabilityCurrentUnrelatedParties	231595000	usd
CY2022Q4	sem	Operating Lease Liability Current Related Parties OperatingLeaseLiabilityCurrentRelatedParties	5189000	usd
CY2022Q4	us-gaap	Operating Lease Liability Current OperatingLeaseLiabilityCurrent	236784000	usd
CY2023Q4	sem	Operating Lease Liability Current Unrelated Parties OperatingLeaseLiabilityCurrentUnrelatedParties	239807000	usd
CY2023Q4	sem	Operating Lease Liability Current Related Parties OperatingLeaseLiabilityCurrentRelatedParties	5593000	usd
CY2023Q4	us-gaap	Operating Lease Liability Current OperatingLeaseLiabilityCurrent	245400000	usd
CY2022Q4	sem	Operating Lease Liability Noncurrent Unrelated Parties OperatingLeaseLiabilityNoncurrentUnrelatedParties	977645000	usd
CY2022Q4	sem	Operating Lease Liability Noncurrent Related Parties OperatingLeaseLiabilityNoncurrentRelatedParties	30749000	usd
CY2022Q4	us-gaap	Operating Lease Liability Noncurrent OperatingLeaseLiabilityNoncurrent	1008394000	usd
CY2023Q4	sem	Operating Lease Liability Noncurrent Unrelated Parties OperatingLeaseLiabilityNoncurrentUnrelatedParties	1000583000	usd
CY2023Q4	sem	Operating Lease Liability Noncurrent Related Parties OperatingLeaseLiabilityNoncurrentRelatedParties	25284000	usd
CY2023Q4	us-gaap	Operating Lease Liability Noncurrent OperatingLeaseLiabilityNoncurrent	1025867000	usd
CY2022Q4	sem	Operating Lease Liability Unrelated Parties OperatingLeaseLiabilityUnrelatedParties	1209240000	usd
CY2022Q4	sem	Operating Lease Liability Related Parties OperatingLeaseLiabilityRelatedParties	35938000	usd
CY2022Q4	us-gaap	Operating Lease Liability OperatingLeaseLiability	1245178000	usd
CY2023Q4	sem	Operating Lease Liability Unrelated Parties OperatingLeaseLiabilityUnrelatedParties	1240390000	usd
CY2023Q4	sem	Operating Lease Liability Related Parties OperatingLeaseLiabilityRelatedParties	30877000	usd
CY2023Q4	us-gaap	Operating Lease Liability OperatingLeaseLiability	1271267000	usd
CY2022Q4	sem	Finance Lease Right Of Use Asset After Accumulated Amortization Unrelated Parties FinanceLeaseRightOfUseAssetAfterAccumulatedAmortizationUnrelatedParties	7563000	usd
CY2022Q4	sem	Finance Lease Right Of Use Asset After Accumulated Amortization Related Parties FinanceLeaseRightOfUseAssetAfterAccumulatedAmortizationRelatedParties	0	usd
CY2022Q4	us-gaap	Finance Lease Right Of Use Asset FinanceLeaseRightOfUseAsset	7563000	usd
CY2023Q4	sem	Finance Lease Right Of Use Asset After Accumulated Amortization Unrelated Parties FinanceLeaseRightOfUseAssetAfterAccumulatedAmortizationUnrelatedParties	6035000	usd
CY2023Q4	sem	Finance Lease Right Of Use Asset After Accumulated Amortization Related Parties FinanceLeaseRightOfUseAssetAfterAccumulatedAmortizationRelatedParties	0	usd
CY2023Q4	us-gaap	Finance Lease Right Of Use Asset FinanceLeaseRightOfUseAsset	6035000	usd
CY2022Q4	sem	Finance Lease Liability Current Unrelated Parties FinanceLeaseLiabilityCurrentUnrelatedParties	1628000	usd
CY2022Q4	sem	Finance Lease Liability Current Related Parties FinanceLeaseLiabilityCurrentRelatedParties	0	usd
CY2022Q4	us-gaap	Finance Lease Liability Current FinanceLeaseLiabilityCurrent	1628000	usd
CY2023Q4	sem	Finance Lease Liability Current Unrelated Parties FinanceLeaseLiabilityCurrentUnrelatedParties	1385000	usd
CY2023Q4	sem	Finance Lease Liability Current Related Parties FinanceLeaseLiabilityCurrentRelatedParties	0	usd
CY2023Q4	us-gaap	Finance Lease Liability Current FinanceLeaseLiabilityCurrent	1385000	usd
CY2022Q4	sem	Finance Lease Liability Noncurrent Unrelated Parties FinanceLeaseLiabilityNoncurrentUnrelatedParties	15478000	usd
CY2022Q4	sem	Finance Lease Liability Noncurrent Related Parties FinanceLeaseLiabilityNoncurrentRelatedParties	0	usd
CY2022Q4	us-gaap	Finance Lease Liability Noncurrent FinanceLeaseLiabilityNoncurrent	15478000	usd
CY2023Q4	sem	Finance Lease Liability Noncurrent Unrelated Parties FinanceLeaseLiabilityNoncurrentUnrelatedParties	14103000	usd
CY2023Q4	sem	Finance Lease Liability Noncurrent Related Parties FinanceLeaseLiabilityNoncurrentRelatedParties	0	usd
CY2023Q4	us-gaap	Finance Lease Liability Noncurrent FinanceLeaseLiabilityNoncurrent	14103000	usd
CY2022Q4	sem	Finance Lease Liability Unrelated Parties FinanceLeaseLiabilityUnrelatedParties	17106000	usd
CY2022Q4	sem	Finance Lease Liability Related Parties FinanceLeaseLiabilityRelatedParties	0	usd
CY2022Q4	us-gaap	Finance Lease Liability FinanceLeaseLiability	17106000	usd
CY2023Q4	sem	Finance Lease Liability Unrelated Parties FinanceLeaseLiabilityUnrelatedParties	15488000	usd
CY2023Q4	sem	Finance Lease Liability Related Parties FinanceLeaseLiabilityRelatedParties	0	usd
CY2023Q4	us-gaap	Finance Lease Liability FinanceLeaseLiability	15488000	usd
CY2022Q4	us-gaap	Operating Lease Weighted Average Remaining Lease Term1 OperatingLeaseWeightedAverageRemainingLeaseTerm1	P7Y9M18D
CY2023Q4	us-gaap	Operating Lease Weighted Average Remaining Lease Term1 OperatingLeaseWeightedAverageRemainingLeaseTerm1	P7Y8M12D
CY2022Q4	us-gaap	Finance Lease Weighted Average Remaining Lease Term1 FinanceLeaseWeightedAverageRemainingLeaseTerm1	P24Y9M18D
CY2023Q4	us-gaap	Finance Lease Weighted Average Remaining Lease Term1 FinanceLeaseWeightedAverageRemainingLeaseTerm1	P25Y10M24D
CY2022Q4	us-gaap	Operating Lease Weighted Average Discount Rate Percent OperatingLeaseWeightedAverageDiscountRatePercent	0.058
CY2023Q4	us-gaap	Operating Lease Weighted Average Discount Rate Percent OperatingLeaseWeightedAverageDiscountRatePercent	0.061
CY2022Q4	us-gaap	Finance Lease Weighted Average Discount Rate Percent FinanceLeaseWeightedAverageDiscountRatePercent	0.074
CY2023Q4	us-gaap	Finance Lease Weighted Average Discount Rate Percent FinanceLeaseWeightedAverageDiscountRatePercent	0.074
CY2023Q4	us-gaap	Lessee Operating Lease Liability Payments Due Next Twelve Months LesseeOperatingLeaseLiabilityPaymentsDueNextTwelveMonths	313222000	usd
CY2023Q4	us-gaap	Finance Lease Liability Payments Due Next Twelve Months FinanceLeaseLiabilityPaymentsDueNextTwelveMonths	2499000	usd
CY2023Q4	us-gaap	Lessee Operating Lease Liability Payments Due Year Two LesseeOperatingLeaseLiabilityPaymentsDueYearTwo	270654000	usd
CY2023Q4	us-gaap	Finance Lease Liability Payments Due Year Two FinanceLeaseLiabilityPaymentsDueYearTwo	2227000	usd
CY2023Q4	us-gaap	Lessee Operating Lease Liability Payments Due Year Three LesseeOperatingLeaseLiabilityPaymentsDueYearThree	235529000	usd
CY2023Q4	us-gaap	Finance Lease Liability Payments Due Year Three FinanceLeaseLiabilityPaymentsDueYearThree	2157000	usd
CY2023Q4	us-gaap	Lessee Operating Lease Liability Payments Due Year Four LesseeOperatingLeaseLiabilityPaymentsDueYearFour	187853000	usd
CY2023Q4	us-gaap	Finance Lease Liability Payments Due Year Four FinanceLeaseLiabilityPaymentsDueYearFour	1641000	usd
CY2023Q4	us-gaap	Lessee Operating Lease Liability Payments Due Year Five LesseeOperatingLeaseLiabilityPaymentsDueYearFive	138320000	usd
CY2023Q4	us-gaap	Finance Lease Liability Payments Due Year Five FinanceLeaseLiabilityPaymentsDueYearFive	1272000	usd
CY2023Q4	us-gaap	Lessee Operating Lease Liability Payments Due After Year Five LesseeOperatingLeaseLiabilityPaymentsDueAfterYearFive	524516000	usd
CY2023Q4	us-gaap	Finance Lease Liability Payments Due After Year Five FinanceLeaseLiabilityPaymentsDueAfterYearFive	25387000	usd
CY2023Q4	us-gaap	Lessee Operating Lease Liability Payments Due LesseeOperatingLeaseLiabilityPaymentsDue	1670094000	usd
CY2023Q4	us-gaap	Finance Lease Liability Payments Due FinanceLeaseLiabilityPaymentsDue	35183000	usd
CY2023Q4	us-gaap	Lessee Operating Lease Liability Undiscounted Excess Amount LesseeOperatingLeaseLiabilityUndiscountedExcessAmount	398827000	usd
CY2023Q4	us-gaap	Finance Lease Liability Undiscounted Excess Amount FinanceLeaseLiabilityUndiscountedExcessAmount	19695000	usd
CY2023Q4	us-gaap	Operating Lease Liability OperatingLeaseLiability	1271267000	usd
CY2023Q4	us-gaap	Finance Lease Liability FinanceLeaseLiability	15488000	usd
CY2022Q4	us-gaap	Property Plant And Equipment Gross PropertyPlantAndEquipmentGross	2281360000	usd
CY2023Q4	us-gaap	Property Plant And Equipment Gross PropertyPlantAndEquipmentGross	2448699000	usd
CY2022Q4	us-gaap	Accumulated Depreciation Depletion And Amortization Property Plant And Equipment AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment	1279920000	usd
CY2023Q4	us-gaap	Accumulated Depreciation Depletion And Amortization Property Plant And Equipment AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment	1425138000	usd
CY2022Q4	us-gaap	Property Plant And Equipment Net PropertyPlantAndEquipmentNet	1001440000	usd
CY2023Q4	us-gaap	Property Plant And Equipment Net PropertyPlantAndEquipmentNet	1023561000	usd
CY2021	us-gaap	Depreciation Depreciation	173200000	usd
CY2022	us-gaap	Depreciation Depreciation	174800000	usd
CY2023	us-gaap	Depreciation Depreciation	177100000	usd
CY2021Q4	us-gaap	Goodwill Goodwill	3448912000	usd
CY2022	us-gaap	Goodwill Acquired During Period GoodwillAcquiredDuringPeriod	22037000	usd
CY2022	us-gaap	Goodwill Purchase Accounting Adjustments GoodwillPurchaseAccountingAdjustments	13251000	usd
CY2022Q4	us-gaap	Goodwill Goodwill	3484200000	usd
CY2023	us-gaap	Goodwill Acquired During Period GoodwillAcquiredDuringPeriod	28970000	usd
CY2023Q4	us-gaap	Goodwill Goodwill	3513170000	usd
CY2022Q4	us-gaap	Intangible Assets Gross Excluding Goodwill IntangibleAssetsGrossExcludingGoodwill	543369000	usd
CY2022Q4	us-gaap	Finite Lived Intangible Assets Accumulated Amortization FiniteLivedIntangibleAssetsAccumulatedAmortization	191707000	usd
CY2022Q4	us-gaap	Intangible Assets Net Excluding Goodwill IntangibleAssetsNetExcludingGoodwill	351662000	usd
CY2023Q4	us-gaap	Intangible Assets Gross Excluding Goodwill IntangibleAssetsGrossExcludingGoodwill	555550000	usd
CY2023Q4	us-gaap	Finite Lived Intangible Assets Accumulated Amortization FiniteLivedIntangibleAssetsAccumulatedAmortization	225634000	usd
CY2023Q4	us-gaap	Intangible Assets Net Excluding Goodwill IntangibleAssetsNetExcludingGoodwill	329916000	usd
CY2021	us-gaap	Amortization Of Intangible Assets AmortizationOfIntangibleAssets	29500000	usd
CY2022	us-gaap	Amortization Of Intangible Assets AmortizationOfIntangibleAssets	31000000	usd
CY2023	us-gaap	Amortization Of Intangible Assets AmortizationOfIntangibleAssets	31700000	usd
CY2023Q4	us-gaap	Finite Lived Intangible Assets Amortization Expense Next Twelve Months FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths	23249000	usd
CY2023Q4	us-gaap	Finite Lived Intangible Assets Amortization Expense Year Two FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo	16535000	usd
CY2023Q4	us-gaap	Finite Lived Intangible Assets Amortization Expense Year Three FiniteLivedIntangibleAssetsAmortizationExpenseYearThree	15385000	usd
CY2023Q4	us-gaap	Finite Lived Intangible Assets Amortization Expense Year Four FiniteLivedIntangibleAssetsAmortizationExpenseYearFour	14441000	usd
CY2023Q4	us-gaap	Finite Lived Intangible Assets Amortization Expense Year Five FiniteLivedIntangibleAssetsAmortizationExpenseYearFive	13337000	usd
CY2023Q4	sem	Loss Contingency Accrual Insurance Programs Discount Rate LossContingencyAccrualInsuranceProgramsDiscountRate	0.03
CY2022Q4	sem	Loss Contingency Accrual Insurance Programs Discount Rate LossContingencyAccrualInsuranceProgramsDiscountRate	0.03
CY2022Q4	sem	Loss Contingency Insurance Programs Accrual Discounted LossContingencyInsuranceProgramsAccrualDiscounted	192300000	usd
CY2022Q4	sem	Loss Contingency Insurance Programs Accrual Discounted LossContingencyInsuranceProgramsAccrualDiscounted	192300000	usd
CY2023Q4	sem	Loss Contingency Insurance Programs Accrual Discounted LossContingencyInsuranceProgramsAccrualDiscounted	179100000	usd
CY2022Q4	sem	Loss Contingency Insurance Programs Accrual Undiscounted LossContingencyInsuranceProgramsAccrualUndiscounted	197200000	usd
CY2023Q4	sem	Loss Contingency Insurance Programs Accrual Undiscounted LossContingencyInsuranceProgramsAccrualUndiscounted	183700000	usd
CY2022Q4	us-gaap	Loss Contingency Receivable LossContingencyReceivable	13100000	usd
CY2023Q4	us-gaap	Loss Contingency Receivable LossContingencyReceivable	11600000	usd
CY2023Q4	sem	Long Term Debt Gross And Finance Lease Obligation LongTermDebtGrossAndFinanceLeaseObligation	3665740000	usd
CY2023Q4	us-gaap	Debt Instrument Unamortized Discount Premium Net DebtInstrumentUnamortizedDiscountPremiumNet	-3493000	usd
CY2023Q4	us-gaap	Deferred Finance Costs Net DeferredFinanceCostsNet	11229000	usd
CY2023Q4	sem	Long Term Debt And Finance Lease Obligation LongTermDebtAndFinanceLeaseObligation	3658004000	usd
CY2023Q4	us-gaap	Debt Instrument Fair Value DebtInstrumentFairValue	3667340000	usd
CY2023Q4	sem	Long Term Debt And Finance Lease Obligation Maturities Repayments Of Principal In Next Twelve Months LongTermDebtAndFinanceLeaseObligationMaturitiesRepaymentsOfPrincipalInNextTwelveMonths	70329000	usd
CY2023Q4	sem	Long Term Debt And Finance Lease Obligation Maturities Repayments Of Principal In Year Two LongTermDebtAndFinanceLeaseObligationMaturitiesRepaymentsOfPrincipalInYearTwo	23624000	usd
CY2023Q4	sem	Long Term Debt And Finance Lease Obligation Maturities Repayments Of Principal In Year Three LongTermDebtAndFinanceLeaseObligationMaturitiesRepaymentsOfPrincipalInYearThree	1248491000	usd
CY2023Q4	sem	Long Term Debt And Finance Lease Obligation Maturities Repayments Of Principal In Year Four LongTermDebtAndFinanceLeaseObligationMaturitiesRepaymentsOfPrincipalInYearFour	2311337000	usd
CY2023Q4	sem	Long Term Debt And Finance Lease Obligation Maturities Repayments Of Principal In Year Five LongTermDebtAndFinanceLeaseObligationMaturitiesRepaymentsOfPrincipalInYearFive	1620000	usd
CY2023Q4	sem	Long Term Debt And Finance Lease Obligation Maturities Repayments Of Principal After Year Five LongTermDebtAndFinanceLeaseObligationMaturitiesRepaymentsOfPrincipalAfterYearFive	10339000	usd
CY2023Q4	sem	Long Term Debt Gross And Finance Lease Obligation LongTermDebtGrossAndFinanceLeaseObligation	3665740000	usd
CY2022Q4	sem	Long Term Debt Gross And Finance Lease Obligation LongTermDebtGrossAndFinanceLeaseObligation	3878237000	usd
CY2022Q4	us-gaap	Debt Instrument Unamortized Discount Premium Net DebtInstrumentUnamortizedDiscountPremiumNet	-17179000	usd
CY2022Q4	us-gaap	Deferred Finance Costs Net DeferredFinanceCostsNet	15854000	usd
CY2022Q4	sem	Long Term Debt And Finance Lease Obligation LongTermDebtAndFinanceLeaseObligation	3879562000	usd
CY2022Q4	us-gaap	Debt Instrument Fair Value DebtInstrumentFairValue	3767795000	usd
CY2021	us-gaap	Revenue From Contract With Customer Excluding Assessed Tax RevenueFromContractWithCustomerExcludingAssessedTax	6204515000	usd
CY2021	sem	Adjusted Ebitda AdjustedEbitda	947359000	usd
CY2021Q4	us-gaap	Assets Assets	7360171000	usd
CY2021	us-gaap	Payments To Acquire Productive Assets PaymentsToAcquireProductiveAssets	180537000	usd
CY2022	us-gaap	Revenue From Contract With Customer Excluding Assessed Tax RevenueFromContractWithCustomerExcludingAssessedTax	6333538000	usd
CY2022	sem	Adjusted Ebitda AdjustedEbitda	646863000	usd
CY2022Q4	us-gaap	Assets Assets	7665293000	usd
CY2022	us-gaap	Payments To Acquire Productive Assets PaymentsToAcquireProductiveAssets	190372000	usd
CY2023	us-gaap	Revenue From Contract With Customer Excluding Assessed Tax RevenueFromContractWithCustomerExcludingAssessedTax	6664058000	usd
CY2023	sem	Adjusted Ebitda AdjustedEbitda	807425000	usd
CY2023Q4	us-gaap	Assets Assets	7689631000	usd
CY2023	us-gaap	Payments To Acquire Productive Assets PaymentsToAcquireProductiveAssets	229200000	usd
CY2021	us-gaap	Operating Income Loss OperatingIncomeLoss	713774000	usd
CY2021	us-gaap	Income Loss From Equity Method Investments IncomeLossFromEquityMethodInvestments	44428000	usd
CY2021	us-gaap	Disposal Group Not Discontinued Operation Gain Loss On Disposal DisposalGroupNotDiscontinuedOperationGainLossOnDisposal	2155000	usd
CY2021	us-gaap	Litigation Settlement Interest LitigationSettlementInterest	-5350000	usd
CY2021	us-gaap	Interest Expense InterestExpense	135985000	usd
CY2021	us-gaap	Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest	629722000	usd
CY2022	us-gaap	Operating Income Loss OperatingIncomeLoss	403283000	usd
CY2022	us-gaap	Income Loss From Equity Method Investments IncomeLossFromEquityMethodInvestments	26407000	usd
CY2022	us-gaap	Interest Expense InterestExpense	169111000	usd
CY2022	us-gaap	Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest	260579000	usd
CY2023	us-gaap	Operating Income Loss OperatingIncomeLoss	554874000	usd
CY2023	us-gaap	Gains Losses On Extinguishment Of Debt GainsLossesOnExtinguishmentOfDebt	-14692000	usd
CY2023	us-gaap	Income Loss From Equity Method Investments IncomeLossFromEquityMethodInvestments	40813000	usd
CY2023	us-gaap	Interest Expense InterestExpense	198639000	usd
CY2023	us-gaap	Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest	382356000	usd
CY2022	us-gaap	Revenue From Contract With Customer Excluding Assessed Tax RevenueFromContractWithCustomerExcludingAssessedTax	6333538000	usd
CY2023	us-gaap	Revenue From Contract With Customer Excluding Assessed Tax RevenueFromContractWithCustomerExcludingAssessedTax	6664058000	usd
CY2023Q4	us-gaap	Share Based Compensation Arrangement By Share Based Payment Award Number Of Shares Authorized ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAuthorized	7612000	shares
CY2023Q4	us-gaap	Share Based Compensation Arrangement By Share Based Payment Award Number Of Shares Available For Grant ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant	1477956	shares
CY2021	us-gaap	Allocated Share Based Compensation Expense AllocatedShareBasedCompensationExpense	30940000	usd
CY2022	us-gaap	Allocated Share Based Compensation Expense AllocatedShareBasedCompensationExpense	37755000	usd
CY2023	us-gaap	Allocated Share Based Compensation Expense AllocatedShareBasedCompensationExpense	43809000	usd
CY2023Q4	sem	Employee Service Share Based Compensation Nonvested Awards Total Compensation Cost Not Yet Recognized Recognizedin Year1 EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedRecognizedinYear1	40830000	usd
CY2023Q4	sem	Employee Service Share Based Compensation Nonvested Awards Total Compensation Cost Not Yet Recognized Recognizedin Year2 EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedRecognizedinYear2	25019000	usd
CY2023Q4	sem	Employee Service Share Based Compensation Nonvested Awards Total Compensation Cost Not Yet Recognized Recognizedin Year3 EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedRecognizedinYear3	10884000	usd
CY2023Q4	sem	Employee Service Share Based Compensation Nonvested Awards Total Compensation Cost Not Yet Recognized Recognizedin Year4 EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedRecognizedinYear4	1418000	usd
CY2021	us-gaap	Current Federal Tax Expense Benefit CurrentFederalTaxExpenseBenefit	99254000	usd
CY2022	us-gaap	Current Federal Tax Expense Benefit CurrentFederalTaxExpenseBenefit	42000000	usd
CY2023	us-gaap	Current Federal Tax Expense Benefit CurrentFederalTaxExpenseBenefit	76878000	usd
CY2021	us-gaap	Current State And Local Tax Expense Benefit CurrentStateAndLocalTaxExpenseBenefit	25464000	usd
CY2022	us-gaap	Current State And Local Tax Expense Benefit CurrentStateAndLocalTaxExpenseBenefit	13032000	usd
CY2023	us-gaap	Current State And Local Tax Expense Benefit CurrentStateAndLocalTaxExpenseBenefit	21866000	usd
CY2021	us-gaap	Current Income Tax Expense Benefit CurrentIncomeTaxExpenseBenefit	124718000	usd
CY2022	us-gaap	Current Income Tax Expense Benefit CurrentIncomeTaxExpenseBenefit	55032000	usd
CY2023	us-gaap	Current Income Tax Expense Benefit CurrentIncomeTaxExpenseBenefit	98744000	usd
CY2021	us-gaap	Deferred Income Tax Expense Benefit DeferredIncomeTaxExpenseBenefit	5055000	usd
CY2022	us-gaap	Deferred Income Tax Expense Benefit DeferredIncomeTaxExpenseBenefit	7521000	usd
CY2023	us-gaap	Deferred Income Tax Expense Benefit DeferredIncomeTaxExpenseBenefit	-16119000	usd
CY2021	us-gaap	Income Tax Expense Benefit IncomeTaxExpenseBenefit	129773000	usd
CY2022	us-gaap	Income Tax Expense Benefit IncomeTaxExpenseBenefit	62553000	usd
CY2023	us-gaap	Income Tax Expense Benefit IncomeTaxExpenseBenefit	82625000	usd
CY2021	us-gaap	Effective Income Tax Rate Reconciliation At Federal Statutory Income Tax Rate EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate	0.210
CY2022	us-gaap	Effective Income Tax Rate Reconciliation At Federal Statutory Income Tax Rate EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate	0.210
CY2023	us-gaap	Effective Income Tax Rate Reconciliation At Federal Statutory Income Tax Rate EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate	0.210
CY2021	us-gaap	Effective Income Tax Rate Reconciliation State And Local Income Taxes EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes	0.042
CY2022	us-gaap	Effective Income Tax Rate Reconciliation State And Local Income Taxes EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes	0.050
CY2023	us-gaap	Effective Income Tax Rate Reconciliation State And Local Income Taxes EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes	0.049
CY2021	us-gaap	Effective Income Tax Rate Reconciliation Nondeductible Expense EffectiveIncomeTaxRateReconciliationNondeductibleExpense	0.005
CY2022	us-gaap	Effective Income Tax Rate Reconciliation Nondeductible Expense EffectiveIncomeTaxRateReconciliationNondeductibleExpense	0.007
CY2023	us-gaap	Effective Income Tax Rate Reconciliation Nondeductible Expense EffectiveIncomeTaxRateReconciliationNondeductibleExpense	0.007
CY2021	sem	Effective Income Tax Rate Reconciliation Changein Enacted Tax Rate State Percent EffectiveIncomeTaxRateReconciliationChangeinEnactedTaxRateStatePercent	-0.012
CY2022	sem	Effective Income Tax Rate Reconciliation Changein Enacted Tax Rate State Percent EffectiveIncomeTaxRateReconciliationChangeinEnactedTaxRateStatePercent	0.006
CY2023	sem	Effective Income Tax Rate Reconciliation Changein Enacted Tax Rate State Percent EffectiveIncomeTaxRateReconciliationChangeinEnactedTaxRateStatePercent	-0.010
CY2021	us-gaap	Effective Income Tax Rate Reconciliation Change In Deferred Tax Assets Valuation Allowance EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance	0.002
CY2022	us-gaap	Effective Income Tax Rate Reconciliation Change In Deferred Tax Assets Valuation Allowance EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance	0.017
CY2023	us-gaap	Effective Income Tax Rate Reconciliation Change In Deferred Tax Assets Valuation Allowance EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance	-0.007
CY2021	sem	Effective Income Tax Rate Reconciliation Nondeductible Expense Officer Compensation Percent EffectiveIncomeTaxRateReconciliationNondeductibleExpenseOfficerCompensationPercent	0.009
CY2022	sem	Effective Income Tax Rate Reconciliation Nondeductible Expense Officer Compensation Percent EffectiveIncomeTaxRateReconciliationNondeductibleExpenseOfficerCompensationPercent	0.020
CY2023	sem	Effective Income Tax Rate Reconciliation Nondeductible Expense Officer Compensation Percent EffectiveIncomeTaxRateReconciliationNondeductibleExpenseOfficerCompensationPercent	0.020
CY2021	us-gaap	Effective Income Tax Rate Reconciliation Tax Credits EffectiveIncomeTaxRateReconciliationTaxCredits	0.004
CY2022	us-gaap	Effective Income Tax Rate Reconciliation Tax Credits EffectiveIncomeTaxRateReconciliationTaxCredits	0.016
CY2023	us-gaap	Effective Income Tax Rate Reconciliation Tax Credits EffectiveIncomeTaxRateReconciliationTaxCredits	0.011
CY2021	us-gaap	Effective Income Tax Rate Reconciliation Share Based Compensation Excess Tax Benefit Percent EffectiveIncomeTaxRateReconciliationShareBasedCompensationExcessTaxBenefitPercent	-0.017
CY2022	us-gaap	Effective Income Tax Rate Reconciliation Share Based Compensation Excess Tax Benefit Percent EffectiveIncomeTaxRateReconciliationShareBasedCompensationExcessTaxBenefitPercent	-0.008
CY2023	us-gaap	Effective Income Tax Rate Reconciliation Share Based Compensation Excess Tax Benefit Percent EffectiveIncomeTaxRateReconciliationShareBasedCompensationExcessTaxBenefitPercent	-0.007
CY2021	us-gaap	Effective Income Tax Rate Reconciliation Minority Interest Income Expense EffectiveIncomeTaxRateReconciliationMinorityInterestIncomeExpense	0.019
CY2022	us-gaap	Effective Income Tax Rate Reconciliation Minority Interest Income Expense EffectiveIncomeTaxRateReconciliationMinorityInterestIncomeExpense	0.042
CY2023	us-gaap	Effective Income Tax Rate Reconciliation Minority Interest Income Expense EffectiveIncomeTaxRateReconciliationMinorityInterestIncomeExpense	0.037
CY2021	us-gaap	Effective Income Tax Rate Reconciliation Other Adjustments EffectiveIncomeTaxRateReconciliationOtherAdjustments	-0.010
CY2022	us-gaap	Effective Income Tax Rate Reconciliation Other Adjustments EffectiveIncomeTaxRateReconciliationOtherAdjustments	-0.004
CY2023	us-gaap	Effective Income Tax Rate Reconciliation Other Adjustments EffectiveIncomeTaxRateReconciliationOtherAdjustments	0.002
CY2021	us-gaap	Effective Income Tax Rate Continuing Operations EffectiveIncomeTaxRateContinuingOperations	0.206
CY2022	us-gaap	Effective Income Tax Rate Continuing Operations EffectiveIncomeTaxRateContinuingOperations	0.240
CY2023	us-gaap	Effective Income Tax Rate Continuing Operations EffectiveIncomeTaxRateContinuingOperations	0.216
CY2022Q4	us-gaap	Deferred Tax Assets Tax Deferred Expense Reserves And Accruals Allowance For Doubtful Accounts DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts	13345000	usd
CY2023Q4	us-gaap	Deferred Tax Assets Tax Deferred Expense Reserves And Accruals Allowance For Doubtful Accounts DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts	15794000	usd
CY2022Q4	us-gaap	Deferred Tax Assets Tax Deferred Expense Compensation And Benefits DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefits	57669000	usd
CY2023Q4	us-gaap	Deferred Tax Assets Tax Deferred Expense Compensation And Benefits DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefits	58176000	usd
CY2022Q4	us-gaap	Deferred Tax Assets Tax Deferred Expense Reserves And Accruals Self Insurance DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsSelfInsurance	21885000	usd
CY2023Q4	us-gaap	Deferred Tax Assets Tax Deferred Expense Reserves And Accruals Self Insurance DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsSelfInsurance	21447000	usd
CY2022Q4	us-gaap	Deferred Tax Assets Operating Loss Carryforwards DeferredTaxAssetsOperatingLossCarryforwards	32940000	usd
CY2023Q4	us-gaap	Deferred Tax Assets Operating Loss Carryforwards DeferredTaxAssetsOperatingLossCarryforwards	28766000	usd
CY2022Q4	us-gaap	Deferred Tax Asset Interest Carryforward DeferredTaxAssetInterestCarryforward	13554000	usd
CY2023Q4	us-gaap	Deferred Tax Asset Interest Carryforward DeferredTaxAssetInterestCarryforward	17683000	usd
CY2022Q4	us-gaap	Deferred Tax Assets Tax Deferred Expense Compensation And Benefits Share Based Compensation Cost DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost	5608000	usd
CY2023Q4	us-gaap	Deferred Tax Assets Tax Deferred Expense Compensation And Benefits Share Based Compensation Cost DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost	7150000	usd
CY2022Q4	us-gaap	Deferred Tax Assets Equity Method Investments DeferredTaxAssetsEquityMethodInvestments	5073000	usd
CY2023Q4	us-gaap	Deferred Tax Assets Equity Method Investments DeferredTaxAssetsEquityMethodInvestments	4724000	usd
CY2022Q4	sem	Deferred Tax Assets Operating Lease Liability DeferredTaxAssetsOperatingLeaseLiability	251058000	usd
CY2023Q4	sem	Deferred Tax Assets Operating Lease Liability DeferredTaxAssetsOperatingLeaseLiability	254972000	usd
CY2022Q4	sem	Deferred Tax Assets In Process Research And Development Expenditures DeferredTaxAssetsInProcessResearchAndDevelopmentExpenditures	9022000	usd
CY2023Q4	sem	Deferred Tax Assets In Process Research And Development Expenditures DeferredTaxAssetsInProcessResearchAndDevelopmentExpenditures	21049000	usd
CY2022Q4	us-gaap	Deferred Tax Assets Other DeferredTaxAssetsOther	2380000	usd
CY2023Q4	us-gaap	Deferred Tax Assets Other DeferredTaxAssetsOther	2995000	usd
CY2022Q4	us-gaap	Deferred Tax Assets Gross DeferredTaxAssetsGross	412534000	usd
CY2023Q4	us-gaap	Deferred Tax Assets Gross DeferredTaxAssetsGross	432756000	usd
CY2022Q4	us-gaap	Deferred Tax Assets Valuation Allowance DeferredTaxAssetsValuationAllowance	20444000	usd
CY2023Q4	us-gaap	Deferred Tax Assets Valuation Allowance DeferredTaxAssetsValuationAllowance	17427000	usd
CY2022Q4	us-gaap	Deferred Tax Assets Net DeferredTaxAssetsNet	392090000	usd
CY2023Q4	us-gaap	Deferred Tax Assets Net DeferredTaxAssetsNet	415329000	usd
CY2022Q4	us-gaap	Deferred Tax Liabilities Investment In Noncontrolled Affiliates DeferredTaxLiabilitiesInvestmentInNoncontrolledAffiliates	16370000	usd
CY2023Q4	us-gaap	Deferred Tax Liabilities Investment In Noncontrolled Affiliates DeferredTaxLiabilitiesInvestmentInNoncontrolledAffiliates	16788000	usd
CY2022Q4	us-gaap	Deferred Tax Liabilities Property Plant And Equipment DeferredTaxLiabilitiesPropertyPlantAndEquipment	260237000	usd
CY2023Q4	us-gaap	Deferred Tax Liabilities Property Plant And Equipment DeferredTaxLiabilitiesPropertyPlantAndEquipment	264715000	usd
CY2022Q4	us-gaap	Deferred Tax Liabilities Deferred Expense Deferred Financing Costs DeferredTaxLiabilitiesDeferredExpenseDeferredFinancingCosts	2425000	usd
CY2023Q4	us-gaap	Deferred Tax Liabilities Deferred Expense Deferred Financing Costs DeferredTaxLiabilitiesDeferredExpenseDeferredFinancingCosts	1483000	usd
CY2022Q4	us-gaap	Deferred Tax Liabilities Leasing Arrangements DeferredTaxLiabilitiesLeasingArrangements	233188000	usd
CY2023Q4	us-gaap	Deferred Tax Liabilities Leasing Arrangements DeferredTaxLiabilitiesLeasingArrangements	236243000	usd
CY2022Q4	us-gaap	Deferred Tax Liabilities Derivatives DeferredTaxLiabilitiesDerivatives	28739000	usd
CY2023Q4	us-gaap	Deferred Tax Liabilities Derivatives DeferredTaxLiabilitiesDerivatives	14151000	usd
CY2022Q4	us-gaap	Deferred Tax Liabilities Other DeferredTaxLiabilitiesOther	3936000	usd
CY2023Q4	us-gaap	Deferred Tax Liabilities Other DeferredTaxLiabilitiesOther	4167000	usd
CY2022Q4	us-gaap	Deferred Income Tax Liabilities DeferredIncomeTaxLiabilities	544895000	usd
CY2023Q4	us-gaap	Deferred Income Tax Liabilities DeferredIncomeTaxLiabilities	537547000	usd
CY2022Q4	us-gaap	Deferred Tax Liabilities DeferredTaxLiabilities	152805000	usd
CY2023Q4	us-gaap	Deferred Tax Liabilities DeferredTaxLiabilities	122218000	usd
CY2022Q4	us-gaap	Deferred Income Tax Assets Net DeferredIncomeTaxAssetsNet	16988000	usd
CY2023Q4	us-gaap	Deferred Income Tax Assets Net DeferredIncomeTaxAssetsNet	21088000	usd
CY2022Q4	us-gaap	Deferred Income Tax Liabilities Net DeferredIncomeTaxLiabilitiesNet	169793000	usd
CY2023Q4	us-gaap	Deferred Income Tax Liabilities Net DeferredIncomeTaxLiabilitiesNet	143306000	usd
CY2022Q4	us-gaap	Deferred Tax Liabilities DeferredTaxLiabilities	152805000	usd
CY2023Q4	us-gaap	Deferred Tax Liabilities DeferredTaxLiabilities	122218000	usd
CY2022	us-gaap	Valuation Allowance Deferred Tax Asset Change In Amount ValuationAllowanceDeferredTaxAssetChangeInAmount	2700000	usd
CY2023	us-gaap	Valuation Allowance Deferred Tax Asset Change In Amount ValuationAllowanceDeferredTaxAssetChangeInAmount	-3000000	usd
CY2022Q4	us-gaap	Deferred Tax Liabilities DeferredTaxLiabilities	152800000	usd
CY2023Q4	us-gaap	Deferred Tax Liabilities DeferredTaxLiabilities	122200000	usd
CY2023	sem	Deferred Tax Asset Periodof Reviewfor Entitieswith Cumulative Losses DeferredTaxAssetPeriodofReviewforEntitieswithCumulativeLosses	P3Y
CY2023	us-gaap	Dividends And Interest Paid DividendsAndInterestPaid	0	usd
CY2022	us-gaap	Dividends And Interest Paid DividendsAndInterestPaid	0	usd
CY2021	us-gaap	Dividends And Interest Paid DividendsAndInterestPaid	0	usd
CY2021	us-gaap	Profit Loss ProfitLoss	499949000	usd
CY2022	us-gaap	Profit Loss ProfitLoss	198026000	usd
CY2023	us-gaap	Profit Loss ProfitLoss	299731000	usd
CY2021	us-gaap	Net Income Loss Attributable To Noncontrolling Interest NetIncomeLossAttributableToNoncontrollingInterest	97724000	usd
CY2022	us-gaap	Net Income Loss Attributable To Noncontrolling Interest NetIncomeLossAttributableToNoncontrollingInterest	39032000	usd
CY2023	us-gaap	Net Income Loss Attributable To Noncontrolling Interest NetIncomeLossAttributableToNoncontrollingInterest	56240000	usd
CY2021	us-gaap	Net Income Loss NetIncomeLoss	402225000	usd
CY2022	us-gaap	Net Income Loss NetIncomeLoss	158994000	usd
CY2023	us-gaap	Net Income Loss NetIncomeLoss	243491000	usd
CY2021	us-gaap	Participating Securities Distributed And Undistributed Earnings Loss Diluted ParticipatingSecuritiesDistributedAndUndistributedEarningsLossDiluted	13435000	usd
CY2021	us-gaap	Participating Securities Distributed And Undistributed Earnings Loss Basic ParticipatingSecuritiesDistributedAndUndistributedEarningsLossBasic	13435000	usd
CY2022	us-gaap	Participating Securities Distributed And Undistributed Earnings Loss Basic ParticipatingSecuritiesDistributedAndUndistributedEarningsLossBasic	5609000	usd
CY2022	us-gaap	Participating Securities Distributed And Undistributed Earnings Loss Diluted ParticipatingSecuritiesDistributedAndUndistributedEarningsLossDiluted	5609000	usd
CY2023	us-gaap	Participating Securities Distributed And Undistributed Earnings Loss Basic ParticipatingSecuritiesDistributedAndUndistributedEarningsLossBasic	8773000	usd
CY2023	us-gaap	Participating Securities Distributed And Undistributed Earnings Loss Diluted ParticipatingSecuritiesDistributedAndUndistributedEarningsLossDiluted	8773000	usd
CY2021	us-gaap	Net Income Loss Available To Common Stockholders Diluted NetIncomeLossAvailableToCommonStockholdersDiluted	388790000	usd
CY2021	us-gaap	Net Income Loss Available To Common Stockholders Basic NetIncomeLossAvailableToCommonStockholdersBasic	388790000	usd
CY2022	us-gaap	Net Income Loss Available To Common Stockholders Diluted NetIncomeLossAvailableToCommonStockholdersDiluted	153385000	usd
CY2022	us-gaap	Net Income Loss Available To Common Stockholders Basic NetIncomeLossAvailableToCommonStockholdersBasic	153385000	usd
CY2023	us-gaap	Net Income Loss Available To Common Stockholders Basic NetIncomeLossAvailableToCommonStockholdersBasic	234718000	usd
CY2023	us-gaap	Net Income Loss Available To Common Stockholders Diluted NetIncomeLossAvailableToCommonStockholdersDiluted	234718000	usd
CY2021	us-gaap	Net Income Loss Available To Common Stockholders Diluted NetIncomeLossAvailableToCommonStockholdersDiluted	388790000	usd
CY2021	us-gaap	Net Income Loss Available To Common Stockholders Basic NetIncomeLossAvailableToCommonStockholdersBasic	388790000	usd
CY2021	us-gaap	Weighted Average Number Of Diluted Shares Outstanding WeightedAverageNumberOfDilutedSharesOutstanding	130249000	shares
CY2021	us-gaap	Weighted Average Number Of Shares Outstanding Basic WeightedAverageNumberOfSharesOutstandingBasic	130249000	shares
CY2021	us-gaap	Earnings Per Share Basic EarningsPerShareBasic	2.98
CY2021	us-gaap	Earnings Per Share Diluted EarningsPerShareDiluted	2.98
CY2021	us-gaap	Participating Securities Distributed And Undistributed Earnings Loss Diluted ParticipatingSecuritiesDistributedAndUndistributedEarningsLossDiluted	13435000	usd
CY2021	us-gaap	Participating Securities Distributed And Undistributed Earnings Loss Basic ParticipatingSecuritiesDistributedAndUndistributedEarningsLossBasic	13435000	usd
CY2021	us-gaap	Incremental Common Shares Attributable To Participating Nonvested Shares With Non Forfeitable Dividend Rights IncrementalCommonSharesAttributableToParticipatingNonvestedSharesWithNonForfeitableDividendRights	4501000	shares
CY2021	us-gaap	Earnings Per Share Basic EarningsPerShareBasic	2.98
CY2021	us-gaap	Earnings Per Share Diluted EarningsPerShareDiluted	2.98
CY2021	us-gaap	Net Income Loss NetIncomeLoss	402225000	usd
CY2022	us-gaap	Net Income Loss Available To Common Stockholders Diluted NetIncomeLossAvailableToCommonStockholdersDiluted	153385000	usd
CY2022	us-gaap	Net Income Loss Available To Common Stockholders Basic NetIncomeLossAvailableToCommonStockholdersBasic	153385000	usd
CY2022	us-gaap	Weighted Average Number Of Diluted Shares Outstanding WeightedAverageNumberOfDilutedSharesOutstanding	124628000	shares
CY2022	us-gaap	Weighted Average Number Of Shares Outstanding Basic WeightedAverageNumberOfSharesOutstandingBasic	124628000	shares
CY2022	us-gaap	Earnings Per Share Basic EarningsPerShareBasic	1.23
CY2022	us-gaap	Earnings Per Share Diluted EarningsPerShareDiluted	1.23
CY2022	us-gaap	Participating Securities Distributed And Undistributed Earnings Loss Basic ParticipatingSecuritiesDistributedAndUndistributedEarningsLossBasic	5609000	usd
CY2022	us-gaap	Participating Securities Distributed And Undistributed Earnings Loss Diluted ParticipatingSecuritiesDistributedAndUndistributedEarningsLossDiluted	5609000	usd
CY2022	us-gaap	Incremental Common Shares Attributable To Participating Nonvested Shares With Non Forfeitable Dividend Rights IncrementalCommonSharesAttributableToParticipatingNonvestedSharesWithNonForfeitableDividendRights	4557000	shares
CY2022	us-gaap	Earnings Per Share Basic EarningsPerShareBasic	1.23
CY2022	us-gaap	Earnings Per Share Diluted EarningsPerShareDiluted	1.23
CY2022	us-gaap	Net Income Loss NetIncomeLoss	158994000	usd
CY2023	us-gaap	Net Income Loss Available To Common Stockholders Basic NetIncomeLossAvailableToCommonStockholdersBasic	234718000	usd
CY2023	us-gaap	Net Income Loss Available To Common Stockholders Diluted NetIncomeLossAvailableToCommonStockholdersDiluted	234718000	usd
CY2023	us-gaap	Weighted Average Number Of Shares Outstanding Basic WeightedAverageNumberOfSharesOutstandingBasic	123105000	shares
CY2023	us-gaap	Weighted Average Number Of Diluted Shares Outstanding WeightedAverageNumberOfDilutedSharesOutstanding	123105000	shares
CY2023	us-gaap	Earnings Per Share Basic EarningsPerShareBasic	1.91
CY2023	us-gaap	Earnings Per Share Diluted EarningsPerShareDiluted	1.91
CY2023	us-gaap	Participating Securities Distributed And Undistributed Earnings Loss Basic ParticipatingSecuritiesDistributedAndUndistributedEarningsLossBasic	8773000	usd
CY2023	us-gaap	Participating Securities Distributed And Undistributed Earnings Loss Diluted ParticipatingSecuritiesDistributedAndUndistributedEarningsLossDiluted	8773000	usd
CY2023	us-gaap	Incremental Common Shares Attributable To Participating Nonvested Shares With Non Forfeitable Dividend Rights IncrementalCommonSharesAttributableToParticipatingNonvestedSharesWithNonForfeitableDividendRights	4601000	shares
CY2023	us-gaap	Earnings Per Share Diluted EarningsPerShareDiluted	1.91
CY2023	us-gaap	Earnings Per Share Basic EarningsPerShareBasic	1.91
CY2023	us-gaap	Net Income Loss NetIncomeLoss	243491000	usd
	sem	Proceeds From Government Assistance Cares Act ProceedsFromGovernmentAssistanceCARESAct	239700000	usd
CY2020	sem	Government Assistance Recognized In Earnings Cares Act GovernmentAssistanceRecognizedInEarningsCARESAct	90000000	usd
CY2021	sem	Government Assistance Recognized In Earnings Cares Act GovernmentAssistanceRecognizedInEarningsCARESAct	123800000	usd
CY2022	sem	Government Assistance Recognized In Earnings Cares Act GovernmentAssistanceRecognizedInEarningsCARESAct	23800000	usd
CY2023Q4	sem	Unearned Government Assistance Cares Act UnearnedGovernmentAssistanceCARESAct	100000	usd
CY2020	sem	Proceeds From Government Advances Cares Act ProceedsFromGovernmentAdvancesCARESAct	325000000	usd
CY2021	sem	Government Advances Recouped Cares Act GovernmentAdvancesRecoupedCARESAct	241200000	usd
CY2022	sem	Government Advances Recouped Cares Act GovernmentAdvancesRecoupedCARESAct	83800000	usd
CY2020Q4	sem	Social Security Tax Employer Deferral Cares Act SocialSecurityTaxEmployerDeferralCARESAct	106200000	usd
CY2021	sem	Payment Of Payroll Taxes Deferred Care Act PaymentOfPayrollTaxesDeferredCAREAct	53200000	usd
CY2022	sem	Payment Of Payroll Taxes Deferred Care Act PaymentOfPayrollTaxesDeferredCAREAct	53000000	usd

Files In Submission

Name	View Source	Status
0001628280-24-006385-index-headers.html	Edgar Link	pending
0001628280-24-006385-index.html	Edgar Link	pending
0001628280-24-006385.txt	Edgar Link	pending
0001628280-24-006385-xbrl.zip	Edgar Link	pending
Financial_Report.xlsx	Edgar Link	pending
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report.css	Edgar Link	pending
sem-1231202310kex1072.htm	Edgar Link	pending
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sem-20231231_def.xml	Edgar Link	unprocessable
sem-20231231_lab.xml	Edgar Link	unprocessable
sem-20231231_pre.xml	Edgar Link	unprocessable
sem-20231231_htm.xml	Edgar Link	completed
sem-20231231_cal.xml	Edgar Link	unprocessable

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$SEM
SELECT MEDICAL HOLDINGS CORP Stock $sem

2024 Q1 Form 10-K Financial Statement

#000162828024006385 Filed on February 22, 2024

Income Statement

Balance Sheet

Cashflow Statement

Facts In Submission

Files In Submission

$SEM SELECT MEDICAL HOLDINGS CORP Stock $sem

2024 Q1 Form 10-K Financial Statement

#000162828024006385 Filed on February 22, 2024

Income Statement

Balance Sheet

Cashflow Statement

Facts In Submission

Files In Submission

$SEM
SELECT MEDICAL HOLDINGS CORP Stock $sem