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Derivative Instruments
 9 Months Ended
Sep. 30, 2025
Derivative Instruments [Abstract]  
Derivative Instruments
10. Derivative Instruments
The Company is exposed to certain market risks in the ordinary course of business due to adverse changes in interest rates. The exposure to interest rate risk primarily results from the Company’s variable-rate borrowing. The Company may elect to use derivative financial instruments to manage risks from fluctuations in interest rates. The Company does not purchase or hold derivatives for trading or speculative purposes. Fluctuations in interest rates can be volatile and the Company’s risk management activities do not eliminate these risks.

Interest Rate Swap

In May 2022, the Company entered into an interest rate swap agreement, effective on June 30, 2022, with Bank of America, N.A, which had a $150 million notional value, and a maturity date of June 30, 2027. Beginning in July 2022, the Company receives 1-month SOFR, and pays a fixed rate of interest of 2.815% on 1-month SOFR. The total interest rate in any period also includes an applicable margin based on the Company’s consolidated leverage ratio. In connection with the swap, no cash was exchanged between the Company and the counterparty.

The Company designated its interest rate swap as a cash flow hedge and structured it to be highly effective. Consequently, unrealized gains and losses related to the fair value of the interest rate swap are recorded to accumulated other comprehensive income (loss), net of tax.

The impact of the Company’s derivative instruments on the accompanying Consolidated Statements of Comprehensive Income is presented in the table below.

 
  
Three Months Ended
    
Nine Months Ended
  
 
  
September 30, 2025
    
September 30, 2024
    
September 30, 2025
    
September 30, 2024
  
   
(In thousands)
  
Net income
  $ 17,642     $ 9,777     $ 48,830     $ 33,106  
Other comprehensive (loss) gain:
                               
Unrealized (loss) gain on cash flow hedge
    
(360
)
    
(3,687
)
    
(2,489
)
    
(1,937
)
Tax effect at statutory rate (federal and state)
    
92
      
942
      
636
      
495
  
Comprehensive income
    
17,374
      
7,032
      
46,977
      
31,664
  

                               
Comprehensive income attributable to non-controlling interest
     (4,504 )     (3,149 )     (13,400 )     (10,926 )
Comprehensive income attributable to USPH shareholders
   $ 12,870     $ 3,883     $ 33,577     $ 20,738  

The valuations of the Company’s interest rate derivatives are measured as the present value of all expected future cash flows based on SOFR-based yield curves. The present value calculation uses discount rates that have been adjusted to reflect the credit quality of the Company and its counterparty which is a Level 2 fair value measurement.

The carrying and fair value of the Company’s interest rate derivatives (included in other current assets and other assets) were as follows.

   
September 30, 2025
    
December 31, 2024
  

 
(In thousands)
  
Other current assets
  
$
1,008
    
$
1,752
  
Other assets
    
261
      
2,006
  
   
$
1,269
    
$
3,758