Segment Information - Operations (Details) - USD ($)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Segment Information
Total revenue	$ 479,948,633	$ 247,646,316	$ 219,294,306
Payroll	117,527,022	108,377,938	111,785,110
Contract services	100,757,191	42,349,982	35,913,441
Medical supplies	15,285,481	14,151,140	12,118,893
Other hospital division expenses	31,145,690	30,401,513	30,923,750
Total depreciation and amortization	18,971,972	17,591,572	13,131,374
Gross profit	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)
Interest expense, net	19,932,015	16,317,869	12,490,260
Other (income) expense	(668,930)	399,182	559,299
Income before taxes	109,825,742	(48,490,799)	(419,648,713)
Operating Segment
Segment Information
Total segment expenses	264,715,384	195,280,573	190,741,194
Gross profit	196,261,277	34,774,171	15,421,738
Consolidated operating income (loss)	130,697,800	(31,773,748)	(406,599,154)
Total capital expenditures	2,303,897	9,496,832	14,632,414
Corporate non-segment reconciling item
Segment Information
Corporate and other costs	(65,563,477)	(66,547,919)	(422,020,892)
Income before taxes	(68,716,766)	(68,984,154)	(424,623,465)
Hospital division | Operating Segment
Segment Information
Total revenue	449,063,683	218,070,397	198,508,245
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
Total segment expenses	236,744,354	165,793,470	171,505,466
Total depreciation and amortization	16,780,320	15,940,716	11,967,649
Gross profit	195,539,009	36,336,211	15,035,130
Interest expense, net	18,283,988	14,041,235	10,367,921
Other (income) expense	(332,652)	142,278	(343,564)
Income before taxes	177,587,673	22,152,698	5,010,773
Total capital expenditures	2,303,897	9,496,832	5,926,119
Population health management division | Operating Segment
Segment Information
Total revenue	30,884,950	29,575,919	20,786,061
Total segment expenses	27,971,030	29,487,103	19,235,728
Total depreciation and amortization	1,533,261	1,647,417	1,162,864
Gross profit	1,380,659	(1,558,601)	387,469
Income before taxes	1,613,226	(1,655,905)	(35,160)
Real estate division | Operating Segment
Segment Information
Total depreciation and amortization	658,391	3,439	861
Gross profit	(658,391)	(3,439)	(861)
Income before taxes	(658,391)	(3,439)	(861)
Total capital expenditures	0	0	8,706,295
Real estate division | Intersegment Eliminations
Segment Information
Total revenue	$ 2,419,772	$ (799,850)	$ 269,699