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Segment Information
 12 Months Ended
Dec. 31, 2024
Segment Reporting [Abstract]  
Segment Information Segment Information
We report the results of our operations as three segments in our consolidated financial statements: (i) the hospital division, (ii) the population health management division, and (iii) the real estate division.
The Company’s chief operating decision maker (“CODM”) is our Chief Executive Officer. The determination of our reporting segments was made based on our strategic priorities, which corresponds to the manner in which our CODM reviews and evaluates operating performance to make decisions about resources to be allocated. For our operating segments, the CODM uses segment operating income and segment income before tax to allocate resources (including financial and capital resources) in the annual and forecasting processes. On a monthly basis, the CODM considers month-to-month and budget-to-actual variances on a monthly basis for both measures when allocating resources to segments.
Other hospital division expenses include expenses such as facility-specific utilities, marketing and advertising, repairs and maintenance, and other tax expenses. Corporate costs primarily include expenses for support functions and salaries and benefits for corporate employees and are excluded from segment operating results.
Reportable segment information, including intercompany transactions, is presented below:
Year ended December 31,
202420232022
Revenue from external customers:
Hospital division$449,063,683 $218,070,397 $198,508,245 
Population health management division30,884,950 29,575,919 20,786,061 
Total revenue$479,948,633 $247,646,316 $219,294,306 
Revenue from inter-segment activities:
Real estate division$2,419,772 $(799,850)$269,699 
Segment expenses:
Hospital division
Payroll$114,158,300 $103,780,690 $109,321,563 
Contract services77,788,622 19,454,561 19,869,230 
Medical supplies15,285,481 14,151,140 12,118,893 
Other hospital division expenses29,511,951 28,407,079 30,195,780 
Hospital division expenses236,744,354 165,793,470 171,505,466 
Population health management division expenses27,971,030 29,487,103 19,235,728 
Total segment expenses$264,715,384 $195,280,573 $190,741,194 
Depreciation and amortization:
Hospital division$16,780,320 $15,940,716 $11,967,649 
Population health management division1,533,261 1,647,417 1,162,864 
Real estate division658,391 3,439 861 
Total depreciation and amortization$18,971,972 $17,591,572 $13,131,374 
Segment operating income (loss):
Hospital division$195,539,009 $36,336,211 $15,035,130 
Population health management division1,380,659 (1,558,601)387,469 
Real estate division(658,391)(3,439)(861)
Total segment operating income$196,261,277 $34,774,171 $15,421,738 
Consolidated operating income (loss)
Total segment operating income$196,261,277 $34,774,171 $15,421,738 
Corporate and other costs(65,563,477)(66,547,919)(422,020,892)
Consolidated operating income (loss)$130,697,800 $(31,773,748)$(406,599,154)
Segment other income (loss):
Hospital division
Interest expense, net$18,283,988 $14,041,235 $10,367,921 
Other expense (income)(332,652)142,278 (343,564)
Hospital division income before income taxes$177,587,673 $22,152,698 $5,010,773 
Population health management division income (loss) before income taxes1,613,226 (1,655,905)(35,160)
Real estate division loss before income taxes(658,391)(3,439)(861)
Non-segment loss before income taxes(68,716,766)(68,984,154)(424,623,465)
Income (loss) before income taxes$109,825,742 $(48,490,799)$(419,648,713)
Capital expenditures:
Hospital division$2,303,897 $9,496,832 $5,926,119 
Real estate division— — 8,706,295 
Total capital expenditures$2,303,897 $9,496,832 $14,632,414 
December 31,
20242023
Assets:
Hospital division$607,589,989 $278,635,841 
Population health management division28,338,173 83,647,378 
Real estate division19,392,231 35,962,278 
Total Assets$655,320,393 $398,245,497