Income Taxes (Tables)

12 Months Ended

Dec. 31, 2022

Income Tax Disclosure [Abstract]

Schedule of Components of Loss Before Income Taxes

The components of the Company's income (loss) before income taxes are as follows:

	Year Ended December 31,
	2022		2021		2020
	(amounts in thousands)
United States	$	255,661	$	132,809	$	(12,998)
Foreign	664		399		668
Income (loss) before income taxes	$	256,325	$	133,208	$	(12,330)

Schedule of Components of Income Tax Expense (Benefit)

The components of the Company’s income tax expense (benefit) are as follows:

	Year Ended December 31,
	2022		2021		2020
	(amounts in thousands)
Current:
Federal	$	48,664	$	5,165	$	25
State	13,919		5,638		600
Foreign	219		330		119
Total	62,802		11,133		744
Deferred:
Federal	383		892		(138)
State	4,623		(10,648)		(818)
Foreign	56		(171)		24
Total	5,062		(9,927)		(932)
Income tax expense (benefit)	$	67,864	$	1,206	$	(188)

Schedule of Significant Components of Deferred Tax Assets and Liabilities

Significant components of the Company’s deferred tax assets and liabilities are as follows:

	December 31,
	2022		2021
	(amounts in thousands)
Deferred Tax Assets:
Accrued other and prepaid expenses	$	96	$	237
Allowance for doubtful accounts	3,471		1,644
Intangible assets	7,518		9,273
Net operating loss carryforwards	1,389		4,112
Accrued professional liability claims	1,118		1,335
Accrued workers’ compensation claims	3,631		3,097
Share-based compensation	992		840
Operating lease liabilities	2,228		3,790
Credit carryforwards	1		41
Other	630		505
Gross deferred tax assets	21,074		24,874
Valuation allowance	(2)		(20)
	21,072		24,854
Deferred Tax Liabilities:
Depreciation	(1,411)		(1,515)
Indefinite-lived intangibles	(11,829)		(9,993)
Operating lease right-of-use assets	(740)		(1,821)
Tax on unrepatriated earnings	(247)		(190)
	(14,227)		(13,519)
Net deferred taxes	$	6,845	$	11,335

Schedule of Reconciliation of Income Tax Computed At U. S. Federal Statutory Rate to Income Tax (Benefit) Expense

The reconciliation of income tax computed at the U.S. federal statutory rate to income tax expense (benefit) is as follows:

	Year Ended December 31,
	2022		2021		2020
	(amounts in thousands)
Tax at U.S. statutory rate	$	53,828	$	27,974	$	(2,589)
State taxes, net of federal benefit	15,423		8,573		135
Noncontrolling interest	—		(5)		(172)
Non-deductible items(a)	179		550		544
Foreign tax expense	136		76		1
Valuation allowances	1		(37,450)		117
Uncertain tax positions	(1,694)		1,891		1,110
Officers' compensation	404		344		621
Return to provision	(169)		44		87
Other	(244)		(791)		(42)
Income tax expense (benefit)	$	67,864	$	1,206	$	(188)

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(a) Includes non-deductible meals and incidentals and other miscellaneous non-deductible items.

Schedule of Reconciliation of Beginning and Ending Amounts of Unrecognized Tax Benefits

A reconciliation of the beginning and ending amounts of unrecognized tax benefits is as follows: 

	Year Ended December 31,
	2022		2021		2020
	(amounts in thousands)
Balance at January 1	$	9,179	$	6,891	$	5,792
Additions based on tax positions related to the current year	349		1,873		974
(Reductions) additions based on tax positions related to prior years	(1,947)		—		125
Reductions as a result of a lapse of applicable statute of limitations	—		(47)		—
Other	—		462		—
Balance at December 31	$	7,581	$	9,179	$	6,891