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American Renal Associates Holdings, Inc. – ‘10-Q’ for 9/30/20 – ‘EX-101.DEF’

On:  Thursday, 11/5/20, at 8:16pm ET   ·   As of:  11/6/20   ·   For:  9/30/20   ·   Accession #:  1498068-20-110   ·   File #:  1-37751

Previous ‘10-Q’:  ‘10-Q’ on 8/10/20 for 6/30/20   ·   Latest ‘10-Q’:  This Filing   ·   4 References:   

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  As Of               Filer                 Filing    For·On·As Docs:Size

11/06/20  American Renal Assocs Holdin… Inc 10-Q        9/30/20   84:10M

Quarterly Report   —   Form 10-Q
Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 10-Q        Quarterly Report                                    HTML   1.23M 
 2: EX-10.2     Material Contract                                   HTML     21K 
 3: EX-31.1     Certification -- §302 - SOA'02                      HTML     27K 
 4: EX-31.2     Certification -- §302 - SOA'02                      HTML     27K 
 5: EX-32.1     Certification -- §906 - SOA'02                      HTML     24K 
 6: EX-32.2     Certification -- §906 - SOA'02                      HTML     24K 
13: R1          Cover Page                                          HTML     77K 
14: R2          Condensed Consolidated Balance Sheets               HTML    141K 
15: R3          Condensed Consolidated Balance Sheets               HTML     36K 
                (Parenthetical)                                                  
16: R4          Condensed Consolidated Statements of Operations     HTML    110K 
17: R5          Condensed Consolidated Statements of Comprehensive  HTML     45K 
                Income (Loss)                                                    
18: R6          Condensed Consolidated Statement of Changes in      HTML    116K 
                Equity                                                           
19: R7          Condensed Consolidated Statements of Cash Flows     HTML    124K 
20: R8          Basis of Presentation, Organization and Recent      HTML     46K 
                Events                                                           
21: R9          Revenue                                             HTML     50K 
22: R10         Divestitures                                        HTML     26K 
23: R11         Assets Held for Sale and Goodwill                   HTML     60K 
24: R12         Fair Value Measurements                             HTML     87K 
25: R13         Accrued Expenses and Other Current Liabilities      HTML     39K 
26: R14         Variable Interest Entities                          HTML     30K 
27: R15         Noncontrolling Interests Subject to Put Provisions  HTML     52K 
28: R16         Debt                                                HTML     71K 
29: R17         Leases                                              HTML    212K 
30: R18         Income Taxes                                        HTML     30K 
31: R19         Stock-Based Compensation                            HTML     63K 
32: R20         (Loss) Earnings Per Share                           HTML     59K 
33: R21         Related Party Transactions                          HTML     37K 
34: R22         Commitments and Contingencies                       HTML     28K 
35: R23         Certain Legal and Other Matters                     HTML     42K 
36: R24         Changes in Ownership Interest in Consolidated       HTML     40K 
                Subsidiaries                                                     
37: R25         Subsequent Events                                   HTML     30K 
38: R26         Basis of Presentation, Organization and Recent      HTML     49K 
                Events (Policies)                                                
39: R27         Revenue (Tables)                                    HTML     40K 
40: R28         Assets Held for Sale and Goodwill (Tables)          HTML     64K 
41: R29         Fair Value Measurements (Tables)                    HTML     81K 
42: R30         Accrued Expenses and Other Current Liabilities      HTML     41K 
                (Tables)                                                         
43: R31         Noncontrolling Interests Subject to Put Provisions  HTML     48K 
                (Tables)                                                         
44: R32         Debt (Tables)                                       HTML     48K 
45: R33         Leases (Tables)                                     HTML    156K 
46: R34         Stock-Based Compensation (Tables)                   HTML     64K 
47: R35         (Loss) Earnings Per Share (Tables)                  HTML     57K 
48: R36         Changes in Ownership Interest in Consolidated       HTML     41K 
                Subsidiaries (Tables)                                            
49: R37         Basis of Presentation, Organization and Recent      HTML     73K 
                Events (Details)                                                 
50: R38         Revenue (Details)                                   HTML     46K 
51: R39         DIVESTITURES - Narrative (Details)                  HTML     34K 
52: R40         ASSETS HELD FOR SALE AND GOODWILL - Schedule of     HTML    114K 
                assets and liabilities held for sale (Details)                   
53: R41         ASSETS HELD FOR SALE AND GOODWILL - Schedule of     HTML     27K 
                changes in goodwill (Details)                                    
54: R42         FAIR VALUE MEASUREMENTS - Schedule of fair values   HTML     75K 
                (Details)                                                        
55: R43         FAIR VALUE MEASUREMENTS - Fair value rollforward    HTML     32K 
                for tax receivable agreement liability (Details)                 
56: R44         FAIR VALUE MEASUREMENTS - Narrative (Details)       HTML     30K 
57: R45         Accrued Expenses and Other Current Liabilities      HTML     48K 
                (Details)                                                        
58: R46         Variable Interest Entities (Details)                HTML     34K 
59: R47         Noncontrolling Interests Subject to Put Provisions  HTML     58K 
                (Details)                                                        
60: R48         DEBT - Schedule of long-term debt (Details)         HTML     49K 
61: R49         DEBT - Scheduled maturities of long-term debt       HTML     40K 
                (Details)                                                        
62: R50         DEBT - Narrative (Details)                          HTML    191K 
63: R51         LEASES - Narrative (Details)                        HTML     51K 
64: R52         LEASES - Lease cost (Details)                       HTML     41K 
65: R53         LEASES - Supplemental cash flow related to leases   HTML     36K 
                (Details)                                                        
66: R54         LEASES - Supplemental balance sheet related to      HTML     66K 
                leases (Details)                                                 
67: R55         LEASES - Future Minimum Lease Payments Under        HTML     95K 
                Noncancelable Leases - For Period Ending September               
                30, 2020 (Details)                                               
68: R56         LEASES - Future Minimum Lease Payments Under        HTML    100K 
                Noncancelable Leases - For Period Ending December                
                31, 2019 (Details)                                               
69: R57         Income Taxes (Details)                              HTML     31K 
70: R58         STOCK-BASED COMPENSATION - Schedule of expense      HTML     31K 
                (Details)                                                        
71: R59         STOCK-BASED COMPENSATION - Narrative (Details)      HTML     58K 
72: R60         STOCK-BASED COMPENSATION STOCK-BASED COMPENSATION   HTML     36K 
                - Assumptions used for options granted (Details)                 
73: R61         STOCK-BASED COMPENSATION - Option activity          HTML     55K 
                (Details)                                                        
74: R62         STOCK-BASED COMPENSATION - Restricted stock awards  HTML     47K 
                (Details)                                                        
75: R63         (Loss) Earnings Per Share (Details)                 HTML     61K 
76: R64         Related Party Transactions (Details)                HTML     91K 
77: R65         Commitments and Contingencies (Details)             HTML     24K 
78: R66         Certain Legal and Other Matters (Details)           HTML     57K 
79: R67         Changes in Ownership Interest in Consolidated       HTML     39K 
                Subsidiaries (Details)                                           
80: R68         Subsequent Events (Details)                         HTML     33K 
82: XML         IDEA XML File -- Filing Summary                      XML    150K 
12: XML         XBRL Instance -- ara-20200930_htm                    XML   2.48M 
81: EXCEL       IDEA Workbook of Financial Reports                  XLSX    115K 
 8: EX-101.CAL  XBRL Calculations -- ara-20200930_cal                XML    371K 
 9: EX-101.DEF  XBRL Definitions -- ara-20200930_def                 XML    707K 
10: EX-101.LAB  XBRL Labels -- ara-20200930_lab                      XML   2.18M 
11: EX-101.PRE  XBRL Presentations -- ara-20200930_pre               XML   1.20M 
 7: EX-101.SCH  XBRL Schema -- ara-20200930                          XSD    227K 
83: JSON        XBRL Instance as JSON Data -- MetaLinks              459±   695K 
84: ZIP         XBRL Zipped Folder -- 0001498068-20-000110-xbrl      Zip    426K 


‘EX-101.DEF’   —   XBRL Definitions — ara-20200930_def


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2 Subsequent Filings that Reference this Filing

  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

12/15/20  American Renal Assocs Holdin… Inc DEFM14A    12/15/20    1:3.7M                                   Broadridge Fin’l So… Inc
11/24/20  American Renal Assocs Holdin… Inc PREM14A    11/24/20    1:3.7M                                   Broadridge Fin’l So… Inc


2 Previous Filings that this Filing References

  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

10/02/20  American Renal Assocs Holdin… Inc 8-K:1,7,9  10/01/20   13:1M                                     Broadridge Fin’l So… Inc
 4/26/16  American Renal Assocs Holdin… Inc 8-K:1,3,5,8 4/20/16   11:4.2M                                   Toppan Merrill/FA
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