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Income Taxes (Tables)

12 Months Ended

Dec. 31, 2024

Income Tax Disclosure [Abstract]

Schedule of Income Tax Expense (Benefit)

Income tax expense (benefit) is comprised of the following (in millions):

						Year Ended December 31,
						2024						2023						2022
Current:
Federal						$	—					$	—					$	—
State						3.1						1.4						1.5
Deferred:
Federal						114.6						(1.5)						17.5
State						16.9						(0.2)						4.3
Total income tax expense (benefit)						$	134.6					$	(0.3)					$	23.3

Schedule of Effective Income Tax Rate Reconciliation

A reconciliation of the provision for income taxes as reported in the consolidated statements of operations and the amount of income tax expense (benefit) computed by multiplying consolidated income (loss) in each year by the U.S. federal statutory rate of 21% follows (in millions):

						Year Ended December 31,
						2024						2023						2022
Tax expense at U.S. federal statutory rate						$	30.8					$	28.4					$	23.2
State income tax, net of U.S. federal tax benefit						19.9						0.9						6.0
Change in federal valuation allowance						115.4						21.5						29.1
Net income attributable to non-controlling interests						(41.5)						(30.9)						(30.2)
Stock option compensation						5.5						0.1						(2.5)
Differences related to divested facilities						(3.3)						(18.9)						(1.4)
Tax return reconciling differences						8.0						(1.0)						(1.0)
Change in effective tax rate						—						—						(0.5)
Tax receivable agreement liability						—						—						0.4
Other						(0.2)						(0.4)						0.2
Total income tax expense (benefit)						$	134.6					$	(0.3)					$	23.3

Schedule of Deferred Tax Assets and Liabilities

The components of temporary differences and the approximate tax effects that give rise to the Company’s net deferred tax balance are as follows (in millions):

						December 31,
						2024						2023
Deferred tax assets:
Medical malpractice liability						$	3.8					$	3.6
Accrued vacation and incentive compensation						0.2						3.0
Net operating loss carryforwards						142.9						143.6
Allowance for bad debts						1.1						1.2
Capital loss carryforwards						3.3						1.8
Deferred financing costs						—						3.3
Section 163(j) interest						191.6						162.3
Interest rate derivative liability						2.5						4.7
Right of use liability						46.2						47.2
Software development costs						2.1						1.7
Other deferred assets						9.9						9.6
Total gross deferred tax assets						403.6						382.0
Less: Valuation allowance						(284.7)						(150.1)
Total deferred tax assets						118.9						231.9
Deferred tax liabilities:
Depreciation on property and equipment						(1.3)						(3.0)
Basis differences of partnerships and joint ventures						(106.7)						(84.2)
Right of use asset						(36.8)						(35.6)
Deferred financing costs						(5.3)						—
Amortization of intangible assets						(3.1)						(3.0)
Interest rate derivative asset						(2.9)						(15.1)
Other deferred liabilities						(2.0)						(1.5)
Total deferred tax liabilities						(158.1)						(142.4)
Net deferred tax (liabilities) assets						$	(39.2)					$	89.5

Schedule of Unrecognized Tax Benefits Roll Forward

A reconciliation of the beginning and ending liability for gross unrecognized tax benefits for the years ended December 31, 2024 and 2023 is as follows (in millions):

						December 31,
						2024						2023
Unrecognized tax benefits at beginning of year						$	—					$	0.1
Additions for tax provisions of the current year						—						—
Additions for acquired positions						—						—
Additions for tax positions of prior years						—						—
Reductions for tax positions of prior years						—						(0.1)
Reductions for statute of limitations expirations						—						—
Unrecognized tax benefits at end of year						$	—					$	—

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Tabular disclosure of the components of income tax expense attributable to continuing operations for each year presented including, but not limited to: current tax expense (benefit), deferred tax expense (benefit), investment tax credits, government grants, the benefits of operating loss carryforwards, tax expense that results from allocating certain tax benefits either directly to contributed capital or to reduce goodwill or other noncurrent intangible assets of an acquired entity, adjustments of a deferred tax liability or asset for enacted changes in tax laws or rates or a change in the tax status of the entity, and adjustments of the beginning-of-the-year balances of a valuation allowance because of a change in circumstances that causes a change in judgment about the realizability of the related deferred tax asset in future years.

+ References

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-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
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Tabular disclosure of the components of net deferred tax asset or liability recognized in an entity's statement of financial position, including the following: the total of all deferred tax liabilities, the total of all deferred tax assets, the total valuation allowance recognized for deferred tax assets.

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Tabular disclosure of the reconciliation using percentage or dollar amounts of the reported amount of income tax expense attributable to continuing operations for the year to the amount of income tax expense that would result from applying domestic federal statutory tax rates to pretax income from continuing operations.

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Reference 1: http://www.xbrl.org/2003/role/exampleRef
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Tabular disclosure of the change in unrecognized tax benefits.

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