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Stock-based Compensation (Tables)
 9 Months Ended
Sep. 30, 2025
Share-Based Payment Arrangement [Abstract]  
Schedule of measurement of shares issued
Measurement Periods ending on or prior to September 30, 2025 (dollars in thousands):
Number of HospitalsEnd of Measurement PeriodNumber of Shares IssuableNumber of Shares Issued to DateInception-to-date Compensation ExpenseYear-to-date 2025 Compensation Expense
1February 28, 2023— — $— $— 
2February 29, 202427,03527,035458 — 
1February 28, 2025422,091422,09123,173 15,942 
2June 30, 2025602,798602,798 75,042 68,962 
1August 31, 2025307,700307,700 25,927 22,881 
71,359,624 1,359,624 $124,600 $107,785 
Measurement Periods ending after September 30, 2025 (dollars in thousands):
Number of HospitalsEnd of Measurement PeriodEstimated Number of Shares IssuableEstimated Compensation ExpenseInception-to-date Compensation ExpenseYear-to-date 2025 Compensation Expense
1March 31, 202621,100 1,550 $1,355 $1,355 
1November 30, 2026150,200 10,061 7,541 7,541 
1December 31, 202647,300 3,122 2,298 2,298 
3218,600$14,733 $11,194 $11,194 
Schedule of stock-based awards activity The following table summarizes stock-based awards activity:
Options
Outstanding		Weighted Average
Exercise Price		Weighted Average
Remaining Contractual
Life (Years)
Options outstanding at December 31, 202327,590$335.75 6.94
Options exercised—— 
Options cancelled(3,334)367.51 
Options outstanding at September 30, 202424,256$335.75 5.68
Options outstanding at December 31, 202421,965$331.34 5.45
Options exercised—— 
Options cancelled(2,200)330.72 
Options outstanding at September 30, 202519,765$331.40 4.80
Schedule of stock options outstanding
Options outstanding as of September 30, 2025 consisted of:
Expiration
Date		Number
Outstanding		Number
Exercisable		Exercise
Price
December 31, 2025500500225.00 
December 31, 2025300300241.50 
December 31, 20251,2141,214412.50 
December 31, 20256868834.00 
May 11, 20271,0011,001225.00 
June 9, 2027167167376.50 
January 27, 20301,1151,115225.00 
January 28, 20316,6676,667241.50 
September 9, 20318,2328,232412.50 
December 17, 2031501501525.00 
Total19,76519,765
Schedule of changes in restricted stock units The following table summarizes activity in restricted stock units:
Shares
(in thousands)		Weighted Average Grant-Date Fair Value Per Share
Non-vested awards, December 31, 20233$151.50 
Granted1185.40 
Forfeitures(3)92.48 
Vested(1)151.50 
Non-vested awards, September 30, 2024117$37.23 
Non-vested awards, December 31, 2024117$37.23 
Granted6141.15 
Forfeitures(7)5.40 
Vested(37)72.76 
Non-vested awards, September 30, 2025134$36.20