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Income Taxes
 12 Months Ended
Dec. 31, 2025
Income Tax Disclosure [Abstract]  
Income Taxes Income Taxes
The components of the Company’s income tax expense from continuing operations for the years ended December 31, 2023, 2024, and 2025, are as follows:
 For the Year Ended December 31,
 202320242025
 (in thousands)
Current income tax expense:   
Federal$24,766 $50,372 $21,827 
State and local14,317 25,280 5,737 
Total current income tax expense39,083 75,652 27,564 
Deferred income tax expense (benefit)(9,830)(30,870)30,652 
Total income tax expense from continuing operations$29,253 $44,782 $58,216 
Reconciliations of the statutory federal income tax rate to the effective income tax rate are as follows:
 For the Year Ended December 31,
 20232024
Federal income tax at statutory rate21.0 %21.0 %
State and local income taxes, less federal income tax benefit11.8 6.5 
Permanent differences1.8 1.7 
Deferred income taxes — state income tax rate adjustment(3.0)0.0 
Deferred income taxes - covered employee adjustment— 0.9 
Valuation allowance(1.8)1.5 
Limitation on officers’ compensation7.4 15.8 
Tax credits(2.7)(1.6)
Stock-based compensation(1.2)(5.4)
Non-controlling interest(12.2)(15.0)
Other(0.2)0.2 
Effective income tax rate20.9 %25.6 %
 For the Year Ended December 31, 2025
 (in thousands, except percentages)
Federal income tax at statutory rate$57,290 21.0 %
State and local income taxes, less federal income tax benefit (1)
8,536 3.1 
Tax credits:
R&D credits(1,145)(0.4)
Other tax credits(2,174)(0.8)
Nontaxable or nondeductible items:
Limitation on officers’ compensation3,535 1.3 
Stock-based compensation1,306 0.5 
Noncontrolling interest(14,346)(5.3)
Other5,214 1.9 
Effective income tax rate$58,216 21.3 %
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(1)    In 2025, state taxes in Michigan, New Jersey, Minnesota, and Pennsylvania made up the majority (greater than 50%) of the tax effect in this category.
The Company’s net cash paid for income taxes consisted of the following:
 For the Year Ended December 31, 2025
 (in thousands)
Federal$10,745 
Aggregated state and local jurisdictions5,731 
Disaggregated state and local jurisdictions
Florida1,284 
New Jersey1,474 
Ohio1,171 
Pennsylvania5,617 
Net cash paid for income taxes$26,022 
The Company’s deferred tax assets and liabilities are as follows:
December 31,
 20242025
 (in thousands)
Deferred tax assets  
Implicit discounts and adjustments$6,169 $4,166 
Compensation and benefit-related accruals44,651 46,459 
Professional malpractice liability insurance14,081 14,724 
Federal and state net operating loss and state tax credit carryforwards22,611 26,506 
Interest limitation carryforward47,905 46,187 
Stock awards2,314 995 
Equity investments1,235 1,442 
Operating lease liabilities174,165 192,152 
Derivatives— 1,548 
Research and experimental expenditures20,478 9,914 
Excess capital loss4,941 1,131 
Other384 399 
Deferred tax assets338,934 345,623 
Valuation allowance(15,230)(16,644)
Deferred tax assets, net of valuation allowance323,704 328,979 
Deferred tax liabilities  
Investment in unconsolidated affiliates$(20,228)$(22,502)
Investment in consolidated affiliates(3,511)(3,613)
Depreciation and amortization(190,355)(205,334)
Deferred financing costs(494)(420)
Operating lease right-of-use assets(162,171)(178,359)
Other(1,378)(1,813)
Deferred tax liabilities(378,137)(412,041)
Deferred tax liabilities, net of deferred tax assets$(54,433)$(83,062)
The Company’s deferred tax assets and liabilities are included in the consolidated balance sheet captions as follows:
December 31,
 20242025
 (in thousands)
Other assets$27,064 $29,095 
Non-current deferred tax liability(81,497)(112,157)
$(54,433)$(83,062)
As of December 31, 2024 and 2025, the Company’s valuation allowance is primarily attributable to the uncertainty regarding the realization of state net operating losses and other net deferred tax assets of loss entities.
For the year ended December 31, 2024, the Company recorded a net valuation allowance increase of $0.7 million. The changes in the Company’s valuation allowance were recognized as a result of management’s reassessment of the amount of its deferred tax assets that are more likely than not to be realized. For the year ended December 31, 2025, the Company recorded a net valuation allowance increase of $1.4 million. The changes in the Company’s valuation allowance were recognized as a result of management’s reassessment of the amount of its deferred tax assets that are more likely than not to be realized.
At December 31, 2024 and 2025, the Company’s net deferred tax liabilities of approximately $54.4 million and $83.1 million, respectively, consist of items which have been recognized for tax reporting purposes, but which will increase tax on returns to be filed in the future. The Company has performed an assessment of positive and negative evidence regarding the realization of the net deferred tax assets. This assessment included a review of legal entities with three years of cumulative losses, estimates of projected future taxable income, the effect on future taxable income resulting from the reversal of existing deferred tax liabilities in future periods, and the impact of tax planning strategies that management would and could implement in order to keep deferred tax assets from expiring unused. Although realization is not assured, based on the Company’s assessment, it has concluded that it is more likely than not that such assets, net of the determined valuation allowance, will be realized.
The total state net operating losses are approximately $607.9 million. State net operating loss carryforwards expire and are subject to valuation allowances as follows:
State Net Operating LossesGross Valuation Allowance
 (in thousands)
2026$23,592 $22,458 
202740,402 38,795 
202847,292 44,776 
202927,019 21,800 
Thereafter through 2042469,567 345,522