Related Party Transactions

3 Months Ended

Mar. 31, 2026

Related Party Transactions [Abstract]

Related Party Transactions

Related Party Transactions

The Company enters into transactions with entities owned or controlled by related parties, including its CEO, as well as with noncontrolling interest owners of consolidated entities. These related party transactions primarily include physician services arrangements, facility leases, construction-related obligations, and distributable cash arrangements. The Company believes the terms of these transactions are generally comparable to those that would be obtained in arm's-length transactions.

Summary quantitative information related to related party balances and transactions is presented below (in millions):

Balances with related parties in the condensed consolidated balance sheets:

		March 31,		December 31,
Balance sheet caption	Related party description	2026		2025
Accounts receivable - related party	Amounts due from noncontrolling interest owners of consolidated ER entities	$	6.3	$	6.0
Accounts payable - related party	Reimbursement of expenses incurred on behalf of the Company	$	1.6	$	1.1
Accounts payable - related party	Outstanding obligations of contributions for facilities under construction	$	2.3	$	2.0

Transactions with related parties in the condensed consolidated statements of operations and cash flows:

		Three Months Ended March 31,
Type of transaction	Related party description	2026		2025
Lease payments - related party facilities (cash basis)	Cash payments under facility leases with real estate entities owned by related parties, including the CEO, and the corporate headquarters lease	$	5.8	$	6.1
Distributable cash paid to CEO	CEO’s pro‑rata share (approximately 38%) of aggregate distributable cash flow from two specified locations, after debt and tax obligations	$	—	$	1.2

Additional qualitative information:

•Physician LLCs: The physicians who work in the Company’s hospitals are employed by separate limited liability companies (“Physician LLCs”). The Company has no direct ownership interest in these entities; they are owned and, in some instances, controlled by related parties, including the CEO. The Physician LLCs are consolidated as variable interest entities because they do not have significant equity at risk and the Company has historically provided support in the event of cash shortages and is the primary beneficiary of their services.

•Real estate entities: Most hospital division facilities are leased from real estate entities owned by related parties. These leases are typically triple‑net, with the hospital division responsible for operating costs, repairs, and taxes. The Company

consolidates certain real estate entities as variable interest entities when they do not have sufficient equity at risk and the Company’s hospital entities are guarantors or co‑borrowers under their mortgage loans. Real Estate VIEs with third‑party mortgage loans collateralized by land and buildings remain consolidated as of March 31, 2026; the Company has no direct ownership interest in two of these entities, which are owned and, in some cases, controlled by related parties including the CEO.

•Distributable cash arrangement with CEO: In connection with the closing of the Merger Agreement, the CEO, as an original owner, is entitled, for the first two years following closing and solely with respect to the two locations that repaid a specified short‑term loan, to receive his pro‑rata share (approximately 38%) of aggregate distributable cash flow, as determined by the Company after satisfaction of debt and tax obligations. Total distributable cash paid under this arrangement is presented in the table above.