Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Deferred tax assets
Implicit discounts and adjustments	$ 10,970	$ 11,685
Compensation and benefit-related accruals	21,017	17,217
Professional malpractice liability insurance	6,872	7,838
Federal and state net operating loss and state tax credit carryforwards	3,602	3,288
Interest limitation carryforward	2,153	0
Stock awards	142	151
Operating lease liabilities	123,301	106,329
Research and experimental expenditures	9,048	7,929
Other	3,206	2,707
Deferred tax assets	180,311	157,144
Valuation allowance	(2,618)	(2,933)
Deferred tax assets, net of valuation allowance	177,693	154,211
Deferred tax liabilities
Depreciation and amortization	(80,947)	(76,776)
Operating lease right-of-use assets	(113,491)	(98,055)
Other	(4,223)	(2,744)
Deferred tax liabilities	(198,661)	(177,575)
Deferred tax liabilities, net of deferred tax assets	$ (20,968)	$ (23,364)