Income Taxes (Tables)

12 Months Ended

Dec. 31, 2017

Income Tax Disclosure [Abstract]

Income tax provision (benefit)

Provision for (benefit from) income taxes consisted of the following for the years ended December 31: 

 

	2017		2016
Current
Federal	$	19,219,251	$	9,161,855
State		5,336,885		2,664,336
		24,556,136		11,826,191
Deferred
Federal		(18,718,113)		(2,199,180)
State		(1,951,238)		(810,599)
		(20,669,351)		(3,009,779)
Total provision for income taxes	$	3,886,785	$	8,816,412

Deferred tax assets (liabilities)

	2017		2016
Deferred tax assets (liabilities)
State taxes	$	1,001,754	$	888,867
Stock options		1,784,524		1,685,965
Accrued payroll and related cost		185,130		208,576
Accrued hospital pool deficit		282,913		-
Net operating loss carryforward		7,069,776		-
Property and equipment		(1,286,452)		(2,009,313)
Acquired intangible assets		(28,626,943)		(44,036,361)
Other		(1,941,368)		(3,669,941)
Net deferred tax liabilities before valuation allowance		(21,530,666)		(46,932,207)
Valuation allowance		(3,385,932)		-
Net deferred tax liabilities	$	(24,916,598)	$	(46,932,207)

Provision for income taxes

The provision for income taxes differs from the amount computed by applying the federal income tax rate as follows for the years ended December 31:

	2017			2016
Tax provision at U.S. Federal statutory rates		35.0	%		35.0	%
State income taxes net of federal benefit		4.4			6.0
Non-deductible permanent items		(9.7)			6.5
Non-taxable entities		(1.9)			(3.2)
Stock-based compensation		0.9			0.0
Other		1.4			2.5
Change in valuation allowance		(2.9)			0.0
Change in rate		(19.4)			0.0
Effective income tax rate		7.8	%		46.8	%