Segment Information (Tables)

12 Months Ended

Dec. 31, 2024

Segment Reporting [Abstract]

Schedule of segment information

Reportable segment information, including intercompany transactions, is presented below:

	Year ended December 31,
	2024		2023		2022
Revenue from external customers:
Hospital division	$	449,063,683	$	218,070,397	$	198,508,245
Population health management division	30,884,950		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 services	77,788,622		19,454,561		19,869,230
Medical supplies	15,285,481		14,151,140		12,118,893
Other hospital division expenses	29,511,951		28,407,079		30,195,780
Hospital division expenses	236,744,354		165,793,470		171,505,466
Population health management division expenses	27,971,030		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 division	1,533,261		1,647,417		1,162,864
Real estate division	658,391		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 division	1,380,659		(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 taxes	1,613,226		(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

Schedule of assets

	December 31,
	2024		2023
Assets:
Hospital division	$	607,589,989	$	278,635,841
Population health management division	28,338,173		83,647,378
Real estate division	19,392,231		35,962,278
Total Assets	$	655,320,393	$	398,245,497