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Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2025

The total liabilities of VIEs included in the Company’s consolidated balance sheets are shown below (in thousands):


	December 31, 2025		December 31, 2024
Current liabilities
Current installments of long-term debt	$	3,635	$	2,266
Accounts payable	102,482		89,428
Accrued salaries and benefits	36,900		37,713
Other accrued expenses and liabilities	67,419		45,250
Total current liabilities	210,436		174,657
Long-term debt, less current installments	9,734		8,192
Long-term operating lease liability	101,153		108,897
Long-term operating lease liability, related party	9,313		9,423
Self-insured liabilities	677		676
Other long-term liabilities	3,826		4,595
Total liabilities	$	335,139	$	306,440

Disaggregation of Revenue

The Company’s total revenue is presented in the following table (dollars in thousands):


	Years Ended December 31,
	2025				2024				2023
	Amount		% of Total Revenue		Amount		% of Total Revenue		Amount		% of Total Revenue
Medicare	$	2,439,774	38.6	%	$	2,334,071	39.2	%	$	2,136,695	39.5	%
Medicaid	604,767		9.6		612,889		10.3		606,770		11.2
Other managed care	2,800,359		44.3		2,599,858		43.5		2,304,718		42.6
Self-pay and other	360,062		5.6		312,673		5.2		268,239		5.0
Net patient service revenue	6,204,962		98.1		5,859,491		98.2		5,316,422		98.3
Other revenue	119,377		1.9		106,581		1.8		93,061		1.7
Total revenue	$	6,324,339	100.0	%	$	5,966,072	100.0	%	$	5,409,483	100.0	%

Revenue from External Customers by Geographic Areas

The following is an analysis by state of revenue as a percentage of the Company’s total revenue for those states in which the Company generates significant revenue:


	Years Ended December 31,
	2025		2024			2023
Oklahoma	23.6	%		24.2	%	24.2	%
New Mexico	17.0			16.0		15.5
Texas	35.7			36.0		36.2
New Jersey	10.2			9.8		10.4
Other	13.5			14.0		13.7
Total	100.0	%		100.0	%	100.0	%

Schedule of Goodwill

The following table summarizes the changes in the carrying amount of goodwill for the following periods (in thousands):


	Total
Balance at December 31, 2023	$	844,704
Goodwill acquired	7,380
Balance at December 31, 2024	852,084
Goodwill acquired	27,367
Balance at December 31, 2025	$	879,451

Schedule of Carrying Amounts and Fair Values of Debt Instruments

The carrying amounts and fair values of the Company’s senior secured term loan facility and its 5.75% Senior Notes due 2029 (the “5.75% Senior Notes”) were as follows (in thousands):


	Carrying Amount				Fair Value
	December 31, 2025		December 31, 2024		December 31, 2025		December 31, 2024
Senior secured term loan facility	$	770,499	$	773,772	$	770,499	$	779,575
5.75% Senior Notes	$	299,686	$	299,596	$	295,191	$	289,110

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 350
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-Name Accounting Standards Codification
-Section 55
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Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
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-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1

Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
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-Paragraph 1
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-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1

Reference 6: http://www.xbrl.org/2009/role/commonPracticeRef
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-Section 50
-Paragraph 1
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-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1

Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
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-Section 50
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-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1

Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
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Reference 10: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 11: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 12: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
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-Name Accounting Standards Codification
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-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482573/350-20-50-2

+ Details

- Definition

Tabular disclosure of the significant judgments and assumptions made in determining whether a variable interest (as defined) held by the entity requires the variable interest entity (VIE) (as defined) to be consolidated and (or) disclose information about its involvement with the VIE, individually or in aggregate (as applicable); the nature of restrictions, if any, on the consolidated VIE's assets and on the settlement of its liabilities reported by an entity in its statement of financial position, including the carrying amounts of such assets and liabilities; the nature of, and changes in, the risks associated with involvement in the VIE; how involvement with the VIE affects the entity's financial position, financial performance, and cash flows; the lack of recourse if creditors (or beneficial interest holders) of the consolidated VIE have no recourse to the general credit of the primary beneficiary (if applicable); the terms of arrangements, giving consideration to both explicit arrangements and implicit variable interests, if any, that could require the entity to provide financial support to the VIE, including events or circumstances that could expose the entity to a loss; the methodology used by the entity for determining whether or not it is the primary beneficiary of the variable interest entity; the significant factors considered and judgments made in determining that the power to direct the activities of a VIE that most significantly impact the VIE's economic performance are shared (as defined); the carrying amounts and classification of assets and liabilities of the VIE included in the statement of financial position; the entity's maximum exposure to loss, if any, as a result of its involvement with the VIE, including how the maximum exposure is determined and significant sources of the entity's exposure to the VIE; a comparison of the carrying amounts of the assets and liabilities and the entity's maximum exposure to loss; information about any liquidity arrangements, guarantees, and (or) other commitments by third parties that may affect the fair value or risk of the entity's variable interest in the VIE; whether or not the entity has provided financial support or other support (explicitly or implicitly) to the VIE that it was not previously contractually required to provide or whether the entity intends to provide that support, including the type and amount of the support and the primary reasons for providing the support; and supplemental information the entity determines necessary to provide.

+ References + Details