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Pay vs Performance Disclosure - USD ($)

12 Months Ended

Dec. 31, 2025

Dec. 31, 2024

Dec. 31, 2023

Dec. 31, 2022

Dec. 31, 2021

Pay vs Performance Disclosure

Pay vs Performance Disclosure, Table

Pay-Versus-Performance

This disclosure has been prepared in accordance with the SEC’s pay-versus-performance rules in Item 402(v) of Regulation S-K under the Exchange Act and does not necessarily reflect the value of compensation actually realized by the NEOs or how the Compensation Committee evaluates compensation decisions. For a discussion of how the Compensation Committee seeks to align pay with performance when making compensation decisions, please review the “Compensation Discussion and Analysis” section above.

The following table shows the information for the past five fiscal years of (i) the “Summary Compensation Table” (“SCT”) total compensation for our principal executive officer (“PEO”) and, on an average basis, our non-PEO NEOs; (ii) the “compensation actually paid” to our PEO and, on an average basis, our non-PEO NEOs (in each case, as determined in accordance with SEC rules); (iii) our total stockholder return; (iv) our peer group total stockholder return; (v) our net income; and (vi) our Adjusted EBITDA.

Pay-Versus-Performance Table


	Year			SCT Total for PEO ($)⁽¹⁾⁽²⁾			Compensation Actually Paid to PEO ($)^(1)(2)(3)			Average SCT Total for Non-PEO NEOs ($)⁽¹⁾⁽²⁾			Average Compensation Actually Paid to Non-PEO NEOs ($)^(1)(2)(3)			Value of Initial Fixed $100 Investment Based On:						Net Income ($M)			Adjusted EBITDA ($M)⁽⁶⁾
	Year			SCT Total for PEO ($)⁽¹⁾⁽²⁾			Compensation Actually Paid to PEO ($)^(1)(2)(3)			Average SCT Total for Non-PEO NEOs ($)⁽¹⁾⁽²⁾						Company Total Shareholder Return ($)⁽⁴⁾			Peer Group ($)⁽⁴⁾⁽⁵⁾			Net Income ($M)			Adjusted EBITDA ($M)⁽⁶⁾
	2025			9,266,330			21,639,897			2,633,015			4,913,749			203.71			109.97			207.6			471.3
	2024			8,222,800			(1,867,673)			2,794,597			831,097			148.34			92.81			211.8			443.8
	2023			16,613,200			22,231,884			3,647,608			4,661,216			215.41			91.50			267.1			425.2
	2022			6,754,639			10,072,293			1,943,041			286,518			192.39			87.48			150.6			342.9
	2021			8,418,659			13,139,273			3,292,294			4,992,770			181.84			109.45			139.9			289.8

(1)	The PEO and other NEOs for the applicable years were as follows:

•	2025: Mr. Rademacher (PEO); Ms. Sethna, Mr. Whitworth, Mr. Smyser, Mr. Grashoff, Mr. Shapiro (other NEOs)

•	2024: Mr. Rademacher (PEO); Mr. Shapiro, Mr. Whitworth, Mr. Smyser, Mr. Grashoff (other NEOs)

•	2023: Mr. Rademacher (PEO); Mr. Shapiro, Mr. Whitworth, Mr. Smyser, Mr. Bavaro, Richard Denness (other NEOs)

•	2022: Mr. Rademacher (PEO); Mr. Shapiro, Harriet Booker, Mr. Denness, Mr. Smyser (other NEOs)

•	2021: Mr. Rademacher (PEO); Mr. Shapiro, Ms. Booker, Mr. Denness, Clifford Berman (other NEOs)

(2)	A reconciliation of Total Compensation from the Summary Compensation Table to Compensation Actually Paid to our PEO and other NEOs is shown below:


				2025
				PEO			Average Non-PEO NEOs
	Total Compensation from “2025 Summary Compensation Table”			$9,266,330			$2,633,015
	Adjustments for Equity Awards
	Adjustment for grant date values in the Summary Compensation Table			($6,500,050)			($1,755,038)
	Year-end fair value of unvested awards granted in the current year			$10,527,372			$2,662,967
	Year-over-year difference of year-end fair values for unvested awards granted in prior years			$5,768,515			$1,052,017
	Fair values at vest date for awards granted and vested in current year			$0			$0
	Difference in fair values between prior year-end fair values and vest date fair values for awards granted in prior years			$2,577,729			$320,788
	Forfeitures during current year equal to prior year-end fair value			$0			$0
	Dividends or dividend equivalents not otherwise included in the total compensation			$0			$0
	Total Adjustments for Equity Awards			$12,373,567			$2,280,733
	Compensation Actually Paid (as calculated)			$21,639,897			$4,913,749

(3)	These numbers differ from those reported in 2025 as subsequent to that filing, an administrative error was discovered. The numbers in this filing represent a more accurate calculation of CAP for these individuals.

(4)	Total shareholder return as calculated based on a fixed investment of one hundred dollars measured from the market close on December 31, 2020 (the last trading day of 2020) through and including the end of the fiscal year for each year reported in the table.

(5)	Our peer group for the total shareholder return calculation is the S&P Health Care Services Select Industry Index, which is the industry index used to show our performance in the 2025 Form 10-K.

(6)

Our company-selected measure, which is the measure we believe represents the most important financial performance measure not otherwise presented in the table above that we use to link compensation actually paid to our named executive officers for our company’s performance is Adjusted EBITDA. For these purposes, we define Adjusted EBITDA, which is a non-GAAP figure, as net income before net interest expense, income tax expense, depreciation and amortization, stock-based compensation expense, and restructuring, integration and other expenses.

Company Selected Measure Name

Adjusted EBITDA

Named Executive Officers, Footnote

(1)	The PEO and other NEOs for the applicable years were as follows:

•	2025: Mr. Rademacher (PEO); Ms. Sethna, Mr. Whitworth, Mr. Smyser, Mr. Grashoff, Mr. Shapiro (other NEOs)

•	2024: Mr. Rademacher (PEO); Mr. Shapiro, Mr. Whitworth, Mr. Smyser, Mr. Grashoff (other NEOs)

•	2023: Mr. Rademacher (PEO); Mr. Shapiro, Mr. Whitworth, Mr. Smyser, Mr. Bavaro, Richard Denness (other NEOs)

•	2022: Mr. Rademacher (PEO); Mr. Shapiro, Harriet Booker, Mr. Denness, Mr. Smyser (other NEOs)

•	2021: Mr. Rademacher (PEO); Mr. Shapiro, Ms. Booker, Mr. Denness, Clifford Berman (other NEOs)

Peer Group Issuers, Footnote

(5)	Our peer group for the total shareholder return calculation is the S&P Health Care Services Select Industry Index, which is the industry index used to show our performance in the 2025 Form 10-K.

PEO Total Compensation Amount

$ 9,266,330

$ 8,222,800

$ 16,613,200

$ 6,754,639

$ 8,418,659

PEO Actually Paid Compensation Amount

$ 21,639,897

(1,867,673)

22,231,884

10,072,293

13,139,273

Adjustment To PEO Compensation, Footnote

(2)	A reconciliation of Total Compensation from the Summary Compensation Table to Compensation Actually Paid to our PEO and other NEOs is shown below:


				2025
				PEO			Average Non-PEO NEOs
	Total Compensation from “2025 Summary Compensation Table”			$9,266,330			$2,633,015
	Adjustments for Equity Awards
	Adjustment for grant date values in the Summary Compensation Table			($6,500,050)			($1,755,038)
	Year-end fair value of unvested awards granted in the current year			$10,527,372			$2,662,967
	Year-over-year difference of year-end fair values for unvested awards granted in prior years			$5,768,515			$1,052,017
	Fair values at vest date for awards granted and vested in current year			$0			$0
	Difference in fair values between prior year-end fair values and vest date fair values for awards granted in prior years			$2,577,729			$320,788
	Forfeitures during current year equal to prior year-end fair value			$0			$0
	Dividends or dividend equivalents not otherwise included in the total compensation			$0			$0
	Total Adjustments for Equity Awards			$12,373,567			$2,280,733
	Compensation Actually Paid (as calculated)			$21,639,897			$4,913,749

Non-PEO NEO Average Total Compensation Amount

$ 2,633,015

2,794,597

3,647,608

1,943,041

3,292,294

Non-PEO NEO Average Compensation Actually Paid Amount

$ 4,913,749

831,097

4,661,216

286,518

4,992,770

Adjustment to Non-PEO NEO Compensation Footnote

(2)	A reconciliation of Total Compensation from the Summary Compensation Table to Compensation Actually Paid to our PEO and other NEOs is shown below:


				2025
				PEO			Average Non-PEO NEOs
	Total Compensation from “2025 Summary Compensation Table”			$9,266,330			$2,633,015
	Adjustments for Equity Awards
	Adjustment for grant date values in the Summary Compensation Table			($6,500,050)			($1,755,038)
	Year-end fair value of unvested awards granted in the current year			$10,527,372			$2,662,967
	Year-over-year difference of year-end fair values for unvested awards granted in prior years			$5,768,515			$1,052,017
	Fair values at vest date for awards granted and vested in current year			$0			$0
	Difference in fair values between prior year-end fair values and vest date fair values for awards granted in prior years			$2,577,729			$320,788
	Forfeitures during current year equal to prior year-end fair value			$0			$0
	Dividends or dividend equivalents not otherwise included in the total compensation			$0			$0
	Total Adjustments for Equity Awards			$12,373,567			$2,280,733
	Compensation Actually Paid (as calculated)			$21,639,897			$4,913,749

Compensation Actually Paid vs. Total Shareholder Return

Compensation Actually Paid vs. Net Income

Compensation Actually Paid vs. Company Selected Measure

Total Shareholder Return Vs Peer Group

Tabular List, Table

2025 Performance Measures

In accordance with SEC rules, the following table lists the financial performance measures that, in our assessment, represent the most important financial performance measures used to link “compensation actually paid” to our NEOs to company performance for 2025, as further described in “Compensation Discussion and Analysis” above.

Adjusted EBITDA

Adjusted EBITDA Growth

Cash Flow from Operations Growth

Incentive EBITDA

Revenue

Revenue Growth

Stock Price

Total Shareholder Return Amount

$ 203.71

148.34

215.41

192.39

181.84

Peer Group Total Shareholder Return Amount

109.97

92.81

91.5

87.48

109.45

Net Income (Loss)

$ 207,600,000

$ 211,800,000

$ 267,100,000

$ 150,600,000

$ 139,900,000

Company Selected Measure Amount

471,300,000

443,800,000

425,200,000

342,900,000

289,800,000

Mr. Rademacher

Mr. Rademacher

Mr. Rademacher

Mr. Rademacher

Mr. Rademacher

Pay vs Performance Disclosure

Adjusted EBITDA

Non-GAAP Measure Description

(6)

Our company-selected measure, which is the measure we believe represents the most important financial performance measure not otherwise presented in the table above that we use to link compensation actually paid to our named executive officers for our company’s performance is Adjusted EBITDA. For these purposes, we define Adjusted EBITDA, which is a non-GAAP figure, as net income before net interest expense, income tax expense, depreciation and amortization, stock-based compensation expense, and restructuring, integration and other expenses.

Pay vs Performance Disclosure

Adjusted EBITDA Growth

Pay vs Performance Disclosure

Cash Flow from Operations Growth

Pay vs Performance Disclosure

Incentive EBITDA

Pay vs Performance Disclosure

Revenue

Pay vs Performance Disclosure

Revenue Growth

Pay vs Performance Disclosure

Stock Price

PEO | Equity Awards Adjustments

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

$ 12,373,567

PEO | Aggregate Grant Date Fair Value of Equity Award Amounts Reported in Summary Compensation Table

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

(6,500,050)

PEO | Year-end Fair Value of Equity Awards Granted in Covered Year that are Outstanding and Unvested

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

10,527,372

PEO | Year-over-Year Change in Fair Value of Equity Awards Granted in Prior Years That are Outstanding and Unvested

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

5,768,515

PEO | Vesting Date Fair Value of Equity Awards Granted and Vested in Covered Year

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

0

PEO | Change in Fair Value as of Vesting Date of Prior Year Equity Awards Vested in Covered Year

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

2,577,729

PEO | Prior Year End Fair Value of Equity Awards Granted in Any Prior Year that Fail to Meet Applicable Vesting Conditions During Covered Year

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

0

PEO | Dividends or Other Earnings Paid on Equity Awards not Otherwise Reflected in Total Compensation for Covered Year

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

0

Non-PEO NEO | Equity Awards Adjustments

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

2,280,733

Non-PEO NEO | Aggregate Grant Date Fair Value of Equity Award Amounts Reported in Summary Compensation Table

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

(1,755,038)

Non-PEO NEO | Year-end Fair Value of Equity Awards Granted in Covered Year that are Outstanding and Unvested

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

2,662,967

Non-PEO NEO | Year-over-Year Change in Fair Value of Equity Awards Granted in Prior Years That are Outstanding and Unvested

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

1,052,017

Non-PEO NEO | Vesting Date Fair Value of Equity Awards Granted and Vested in Covered Year

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

0

Non-PEO NEO | Change in Fair Value as of Vesting Date of Prior Year Equity Awards Vested in Covered Year

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

320,788

Non-PEO NEO | Prior Year End Fair Value of Equity Awards Granted in Any Prior Year that Fail to Meet Applicable Vesting Conditions During Covered Year

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

0

Non-PEO NEO | Dividends or Other Earnings Paid on Equity Awards not Otherwise Reflected in Total Compensation for Covered Year

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

$ 0