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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Operating activities      
Net income $ 214,533 $ 296,704 $ 299,731
Adjustments to reconcile net income to net cash provided by operating activities:      
Distributions from unconsolidated subsidiaries 52,970 39,178 23,417
Depreciation and amortization 140,303 203,894 208,742
Provision for expected credit losses 2,362 4,279 1,030
Equity in earnings of unconsolidated subsidiaries (54,521) (60,228) (40,813)
Loss on extinguishment of debt 0 19,038 175
(Gain) loss on sale or disposal of assets 8 (1,063) (57)
Stock compensation expense 16,702 100,670 43,809
Amortization of debt discount, premium and issuance costs 3,136 2,963 2,647
Deferred income taxes 30,652 (32,434) (16,119)
Changes in operating assets and liabilities, net of effects of business combinations:      
Accounts receivable (45,185) (95,845) 1,156
Other current assets 413 18,072 (29,374)
Other assets (8,808) 12,933 10,031
Accounts payable (854) (16,789) (6,412)
Accrued expenses (5,244) 26,492 84,095
Net cash provided by operating activities 346,467 517,864 582,058
Investing activities      
Business combinations, net of cash acquired (9,197) (13,097) (29,567)
Purchases of property, equipment, and other assets (229,225) (222,177) (229,200)
Investment in businesses (1,455) 0 (9,873)
Proceeds from sales and exchanges of assets and sale of business 23,391 4,263 163
Net cash used in investing activities (216,486) (231,011) (268,477)
Financing activities      
Borrowings on revolving facilities 1,290,000 1,240,000 905,000
Payments on revolving facilities (1,295,000) (1,415,000) (1,070,000)
Proceeds from term loans, net of issuance costs 0 1,880,052 2,092,232
Payments on term loans (10,500) (2,092,485) (2,113,952)
Payment on senior notes, including call premium 0 (1,237,764) 0
Proceeds from senior notes, net of issuance costs 0 1,176,598 0
Borrowings of other debt 101,218 24,892 31,399
Principal payments on other debt (34,328) (65,280) (46,946)
Dividends paid to common stockholders (31,435) (64,617) (63,904)
Repurchase of common stock (100,077) (37,905) (12,759)
Decrease in overdrafts (9,052) (4,471) (1,687)
Proceeds from issuance of non-controlling interests 15,904 15,713 22,935
Distributions to and purchases of non-controlling interests (89,882) (60,001) (63,531)
Purchase of membership interests of Concentra Group Holdings Parent 0 0 (6,268)
Proceeds from Concentra initial public offering 0 511,198 0
Cash transferred to Concentra at separation 0 (182,095) 0
Net cash used in financing activities (163,152) (311,165) (327,481)
Net decrease in cash and cash equivalents (33,171) (24,312) (13,900)
Cash and cash equivalents at beginning of period 59,694 84,006 97,906
Cash and cash equivalents at end of period 26,523 59,694 84,006
Supplemental information:      
Cash paid for interest, excluding amounts received of $82,818 and $68,069 under the interest rate cap contract for the years ended December 31, 2023 and 2024, respectively. 120,624 256,229 272,261
Cash paid for taxes 26,022 133,187 88,510
Non-cash investing and financing activities:      
Liabilities for purchases of property and equipment $ 36,268 $ 21,784 $ 18,403