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REVENUE AND ACCOUNTS RECEIVABLE
 9 Months Ended
Sep. 30, 2025
Revenue from Contract with Customer [Abstract]  
REVENUE AND ACCOUNTS RECEIVABLE REVENUE AND ACCOUNTS RECEIVABLE
The Company's service revenue is derived primarily from providing healthcare services to its patients. Revenue is recognized when services are provided to patients at the amount that reflects the consideration that the Company expects to be entitled from patients and third-party payors, including Medicaid, Medicare and insurers (private and Medicare replacement plans), in exchange for providing patient care.
Disaggregation of Revenue
The Company disaggregates revenue from contracts with its patients by payors. The Company has determined that disaggregating revenue into these categories achieves the disclosure objectives to depict how the nature, amount, timing and uncertainty of revenue and cash flows are affected by economic factors.
Revenue by Payor

The Company’s revenue is derived primarily from providing healthcare services to patients and is recognized on the date services are provided at amounts billable to individual patients, adjusted for estimates for variable consideration. For patients under reimbursement arrangements with third-party payors, including Medicaid, Medicare and private insurers, revenue is recorded based on contractually agreed-upon amounts or rates, adjusted for estimates for variable consideration, on a per patient, daily basis or as services are performed.

Revenue from the Medicare and Medicaid programs accounted for 69.5% and 69.6% of all service revenue for the three and nine months ended September 30, 2025, respectively, and 70.2% and 71.0% of all service revenue for the three and nine months ended September 30, 2024, respectively. Settlements with Medicare and Medicaid payors for retroactive adjustments due to audits and reviews are considered variable consideration and are included in the determination of the estimated transaction price. These settlements are estimated based on the terms of the payment agreement with the payor, correspondence from the payor and the Company’s historical settlement activity. Consistent with healthcare industry practices, any changes to these revenue estimates are recorded in the period the change or adjustment becomes known based on the final settlement. The Company recorded adjustments to revenue which were not material to the Company's revenue for the three and nine months ended September 30, 2025 and 2024.
Service revenue for the three and nine months ended September 30, 2025 and 2024 is summarized in the following tables:
 Three Months Ended September 30,
20252024
Revenue% of RevenueRevenue% of Revenue
Medicaid(1)
$515,157 39.9 %$425,642 39.6 %
Medicare303,281 23.5 263,594 24.5 
Medicaid — skilled78,450 6.1 65,907 6.1 
Total Medicaid and Medicare$896,888 69.5 %$755,143 70.2 %
Managed care237,978 18.5 202,528 18.8 
Private and other(2)
154,913 12.0 118,421 11.0 
SERVICE REVENUE$1,289,779 100.0 %$1,076,092 100.0 %
(1) Medicaid payor includes revenue for senior living operations.
(2) Private and other includes revenue for skilled services (private, Veteran Affairs and hospice payors), senior living and ancillary operations.
 Nine Months Ended September 30,
20252024
Revenue% of RevenueRevenue% of Revenue
Medicaid(1)
$1,454,845 39.6 %$1,227,565 39.5 %
Medicare882,149 24.0 788,046 25.3 
Medicaid — skilled223,208 6.0 192,185 6.2 
Total Medicaid and Medicare$2,560,202 69.6 %$2,207,796 71.0 %
Managed care694,690 18.9 581,654 18.7 
Private and other(2)
423,341 11.5 321,701 10.3 
SERVICE REVENUE$3,678,233 100.0 %$3,111,151 100.0 %
(1) Medicaid payor includes revenue for senior living operations.
(2) Private and other includes revenue for skilled services (private, Veteran Affairs and hospice payors), senior living and ancillary operations.
In addition to the service revenue above, the Company's rental revenue derived from triple-net lease arrangements with third parties was $6,626 and $18,982, respectively, for the three and nine months ended September 30, 2025 and $5,684 and $17,082, respectively, for the three and nine months ended September 30, 2024.
Balance Sheet Impact
Included in the Company’s condensed consolidated balance sheets are contract balances, comprised of billed accounts receivable and unbilled receivables, which are the result of the timing of revenue recognition, billings and cash collections, as well as contract liabilities, which primarily represent payments the Company receives in advance of services provided. The Company had no material contract liabilities or contract assets as of September 30, 2025 and December 31, 2024, or activity during the three and nine months ended September 30, 2025 and 2024.

Accounts receivable consist primarily of amounts due from Medicare and Medicaid programs, other government programs, managed care health plans and private payor sources, net of estimates for variable consideration and doubtful accounts. Accounts receivable as of September 30, 2025 and December 31, 2024, is summarized in the following table:
September 30, 2025December 31, 2024
Medicaid$266,048 $228,872 
Managed care162,905 139,711 
Medicare97,949 77,056 
Private and other payors93,790 132,693 
 $620,692 $578,332 
Less: allowance for doubtful accounts(7,948)(8,435)
ACCOUNTS RECEIVABLE, NET$612,744 $569,897