Income Taxes (Tables)

12 Months Ended

Dec. 31, 2025

Schedule of Deferred Tax Assets and Liabilities

Significant components of the Company’s net deferred tax assets (liabilities) are as follows (in thousands):


	Years Ended December 31,
	2025		2024
Deferred tax assets:
Patient accounts receivable, net	$	8,702	$	19,430
Accrued liabilities	976		5,253
Deferred compensation	20,196		17,751
Self-insurance reserves	35,137		31,252
Financing costs	10,521		16,082
Lease liability	283,704		278,369
Other	4,699		4,697
Federal tax credits	163		89
Federal net operating loss carryforward	3,150		2,369
State net operating loss carryforward	8,380		8,560
Change in value of derivatives	1,274		—
Total deferred tax assets	376,902		383,852
Deferred tax liabilities:
Prepaid expenses	(6,856)		(7,971)
Right of use assets	(283,704)		(278,369)
Depreciation and amortization	(73,371)		(61,423)
Partnership basis differences	(33,061)		(13,897)
Change in value of derivatives	—		(3,440)
Total deferred tax liabilities	(396,992)		(365,100)
Valuation allowance for deferred tax assets	(6,468)		(6,431)
Net deferred tax (liabilities) assets	$	(26,558)	$	12,321

Schedule of Income before Income Tax, Domestic and Foreign

Significant components of the provision for income taxes are as follows (in thousands):


	Years Ended December 31,
	2025		2024		2023
Current:
Federal	$	6,097	$	30,560	$	11,190
State	6,532		9,511		6,693
Total current	12,629		40,071		17,883
Deferred:
Federal	36,735		21,965		5,814
State	6,859		1,316		(1,060)
Total deferred	43,594		23,281		4,754
Total provision	$	56,223	$	63,352	$	22,637

Schedule of Effective Income Tax Rate Reconciliation

The Company’s consolidated effective tax rate from continuing operations differed from the amounts computed using the federal statutory rate as set forth below (dollar amounts in thousands):


		Years Ended December 31,
		2025				2024				2023
		Amount		Percent		Amount		Percent		Amount		Percent
Tax at federal statutory rate		$	60,135	21.0	%	$	76,243	21.0	%	$	31,839	21.0	%
State taxes, net of federal benefits (a)		12,191		4.3		9,758		2.7		4,217		2.8
Non-taxable or non-deductible items
Permanent differences		899		0.3		1,621		0.4		1,707		1.1
Executive and equity-based compensation limitations		4,676		1.6		3,545		1.0		190		0.1
Noncontrolling interests		(19,761)		(6.9)		(18,099)		(5.0)		(15,171)		(10.0)
Change in valuation allowance		—		—		—		—		—		—
Change in unrecognized tax benefit		—		—		(9,210)		(2.5)		664		0.5
Tax credits		(382)		(0.1)		(464)		(0.1)		(1,001)		(0.7)
Other, net		(1,535)		(0.5)		(42)		—		192		0.1
		$	56,223	19.7	%	$	63,352	17.5	%	$	22,637	14.9	%

(a)	State taxes in Oklahoma and Texas for 2025, Texas and New Mexico for 2024 and Texas for 2023 made up the majority (greater than 50%) of the tax effect in this category.

Schedule of Cash Flow, Supplemental Disclosures

The Company paid the following income taxes (net of refunds) during the periods presented, which are disaggregated by federal and significant state jurisdictions (in thousands):


	Years Ended December 31,
	2025		2024		2023
Federal	$	23,999	$	32,600	$	14,000
State
Texas	5,481		4,605		4,900
New Mexico	3,030		2,130		—
New Jersey	2,080		—		—
Other	1,920		2,268		533
Total	$	36,510	$	41,603	$	19,433