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Deferred tax assets (liabilities) (Detail) - USD ($) | Dec. 31, 2017 | Dec. 31, 2016
--- | --- | ---
Deferred tax assets (liabilities): |  |
State taxes | $ 1,001,754 | $ 888,867
Stock options | 1,784,524 | 1,685,965
Accrued payroll and related costs | 185,130 | 208,576
Accrued hospital pool deficit | 282,913 | 0
Net operating loss carryforward | 7,069,776 | 0
Property and equipment | (1,286,452) | (2,009,313)
Acquired intangible assets | (28,626,943) | (44,036,361)
Other | (1,941,368) | (3,669,941)
Net deferred tax liabilities before valuation allowance | (21,530,666) | (46,932,207)
Valuation Allowance | (3,385,932) | 0
Net deferred tax liabilities | $ (24,916,598) | $ (46,932,207)

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