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Segment Information
 9 Months Ended
Sep. 30, 2025
Segment Reporting [Abstract]  
Segment Information
13.    Segment Information
Our business is organized into three operating segments based primarily on the type or location of occupational health services provided: (i) occupational health centers, (ii) onsite health clinics, and (iii) other businesses. All three operating segments are aggregated into a single reportable segment in our consolidated financial statements based on similar services provided, service delivery process involved, target customers, and similar economic characteristics. Across our operating segments, we offer a diverse and comprehensive array of services, which includes workers’ compensation, employer services and consumer health. Our patients are generally employed by our main customers - employers across the United States.
Occupational health services are focused on the diagnosis and treatment of work-related injuries and illnesses (workers’ compensation services) and employer services such as examinations, physicals, tests and screenings, vaccinations, and a range of consulting services designed to protect employees from workplace hazards.
The chief operating decision maker (“CODM”) is our Chief Executive Officer. The CODM uses Segment Adjusted EBITDA in the annual budgeting and forecasting process, in the review of budget-to-actual and prior year variances to make decisions about the allocation of operating and capital resources, and to establish management’s compensation.
The following table is representative of the significant categories, including significant expenses, regularly provided to the CODM when managing the Company’s single reporting segment.
Three Months Ended September 30,Nine Months Ended September 30,
2025202420252024
(in thousands)
Revenue$572,800 $489,638 $1,624,337 $1,435,151 
Expenses:(1)
Personnel expenses
325,280 277,959 914,404 811,418 
Facility expenses
52,561 45,665 152,235 134,508 
Other expenses
76,042 64,443 221,104 189,912 
Total segment expenses453,883 388,067 1,287,743 1,135,838 
Segment Adjusted EBITDA$118,917 $101,571 $336,594 $299,313 
Total assets$2,843,930 $2,481,042 $2,843,930 $2,481,042 
Purchases of property and equipment$21,209 $15,145 $62,167 $47,639 
Depreciation and amortization$19,909 $15,213 $55,526 $51,568 
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(1)    Includes transition services agreement fees of $2.7 million and $9.9 million for the three and nine months ended September 30, 2025, and shared service fees from Select and transition services agreement fees of $3.8 million and $11.5 million for the three and nine months ended September 30, 2024. See Note 11—“Relationship with Select”, for additional information.
Segment Adjusted EBITDA is calculated as earnings excluding interest, income taxes, depreciation and amortization, gain (loss) on early retirement of debt, stock compensation expense, separation transaction costs, acquisition costs, gain (loss) on sale of businesses, and equity in earnings (losses) of unconsolidated subsidiaries.
The following table reconciles Segment Adjusted EBITDA to income before income taxes for the periods indicated.
 Three Months Ended September 30,Nine Months Ended September 30,
 2025202420252024
(in thousands)
Segment Adjusted EBITDA
$118,917 $101,571 $336,594 $299,313 
Interest expense
(28,683)(21,369)(82,424)(21,275)
Interest expense on related party debt
— (2,691)— (21,980)
Loss on early retirement of debt
— — (875)— 
Equity in losses of unconsolidated subsidiaries— — — (3,676)
Stock compensation expense
(2,330)(168)(6,884)(500)
Depreciation and amortization
(19,909)(15,213)(55,526)(51,568)
Separation transaction costs(1)
(1,025)44 (2,700)(1,569)
Nova and Pivot Onsite Innovations acquisition costs
(1,181)— (7,151)— 
Income before income taxes
$65,789 $62,174 $181,034 $198,745 
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(1)    Separation transaction costs represent non-recurring incremental consulting, legal, audit-related fees, system implementation, and software disposal costs incurred in connection with the Company’s separation into a new, publicly traded company and are included within general and administrative expenses on the condensed consolidated statements of operations.