Long-Term Debt - Schedule of Long-Term Debt (Details) - USD ($)
$ in Thousands |
|
|
|
3 Months Ended |
6 Months Ended |
9 Months Ended |
12 Months Ended |
Nov. 24, 2025 |
Jul. 17, 2025 |
May 23, 2025 |
Dec. 31, 2025 |
Sep. 30, 2025 |
Jun. 30, 2025 |
Sep. 30, 2025 |
Dec. 31, 2025 |
Dec. 31, 2024 |
Dec. 31, 2023 |
| Long-term debt disclosure |
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|
|
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|
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|
| Long-term debt, weighted average interest rate, at point in time |
|
|
|
5.51%
|
|
|
|
5.51%
|
5.68%
|
|
| Financing lease obligations |
|
|
|
$ 185,120
|
|
|
|
$ 185,120
|
|
|
| Long-term debt totals: |
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|
|
|
|
|
|
|
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| Total debt principal outstanding |
|
|
|
10,344,583
|
|
|
|
10,344,583
|
$ 9,511,106
|
|
| Discount, premium and deferred financing costs |
|
|
|
(71,394)
|
|
|
|
(71,394)
|
(64,336)
|
|
| Carrying amount of long-term debt, net of unamortized discounts, premiums and deferred financing costs |
|
|
|
10,273,189
|
|
|
|
10,273,189
|
9,446,770
|
|
| Less current portion |
|
|
|
(109,201)
|
|
|
|
(109,201)
|
(270,867)
|
|
| Total long-term debt |
|
|
|
10,163,988
|
|
|
|
10,163,988
|
9,175,903
|
|
| Debt Instrument, footnotes to the table |
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|
|
|
|
|
|
|
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| Debt extinguishment and modification costs |
|
|
|
9,028
|
$ 5,150
|
|
|
14,178
|
19,813
|
$ 7,962
|
| Senior Notes 4.625% due 2030 |
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| Senior Notes: |
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| Senior Notes |
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|
|
2,750,000
|
|
|
|
$ 2,750,000
|
2,750,000
|
|
| Long-term debt disclosure |
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|
|
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|
|
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|
| Debt Instrument, Maturity Date |
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|
|
|
|
|
|
Jun. 01, 2030
|
|
|
| Debt, interest rate at a point in time. |
|
|
|
|
|
|
|
4.625%
|
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|
| Debt Instrument, Fair Value Disclosure |
|
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|
2,667,500
|
|
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|
$ 2,667,500
|
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|
| Senior Notes 3.75% due 2031 |
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| Senior Notes: |
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|
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| Senior Notes |
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|
1,500,000
|
|
|
|
$ 1,500,000
|
1,500,000
|
|
| Long-term debt disclosure |
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| Debt Instrument, Maturity Date |
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|
|
|
|
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|
Feb. 15, 2031
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| Debt, interest rate at a point in time. |
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|
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|
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|
3.75%
|
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|
| Debt Instrument, Fair Value Disclosure |
|
|
|
1,383,750
|
|
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|
$ 1,383,750
|
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|
| Senior Notes 6.875% due 2032 |
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| Senior Notes: |
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|
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| Senior Notes |
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|
1,000,000
|
|
|
|
$ 1,000,000
|
1,000,000
|
|
| Long-term debt disclosure |
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| Debt Instrument, Maturity Date |
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|
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|
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|
Sep. 01, 2032
|
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| Debt, interest rate at a point in time. |
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|
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|
|
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|
6.875%
|
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|
| Debt Instrument, Fair Value Disclosure |
|
|
|
$ 1,036,250
|
|
|
|
$ 1,036,250
|
|
|
| Acquisition obligations and other notes payable |
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| Long-term debt disclosure |
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| Long-term debt, weighted average interest rate, at point in time |
|
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|
4.89%
|
|
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|
4.89%
|
|
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| Acquisition obligations and other notes payable |
|
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|
$ 40,904
|
|
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|
$ 40,904
|
56,483
|
|
| Acquisition obligations and other notes payable, fair value |
|
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|
40,904
|
|
|
|
$ 40,904
|
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|
| Debt instrument, maturity date, description |
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|
2026-2038
|
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| Financing lease obligations |
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| Long-term debt disclosure |
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| Financing lease obligations |
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|
$ 185,120
|
|
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|
$ 185,120
|
$ 216,401
|
|
| Finance lease, weighted average discount rate, percent |
|
|
|
4.44%
|
|
|
|
4.44%
|
4.58%
|
4.58%
|
| Debt instrument, maturity date, description |
|
|
|
|
|
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|
2026-2039
|
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| Change Healthcare Temporary Funding Assistance |
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| Long-term debt disclosure |
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|
|
|
|
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| Debt, interest rate at a point in time. |
|
|
|
|
|
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0.00%
|
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|
| Debt Instrument, footnotes to the table |
|
|
|
|
|
|
|
|
|
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| CHC Temporary Funding Assistance |
|
|
|
$ 0
|
|
|
|
$ 0
|
$ 92,777
|
|
| CHC Temporary Funding Assistance, Fair Value |
|
|
|
0
|
|
|
|
0
|
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| Senior Notes 6.75% due 2033 |
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| Senior Notes: |
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| Senior Notes |
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|
$ 1,000,000
|
1,000,000
|
|
|
|
$ 1,000,000
|
0
|
|
| Long-term debt disclosure |
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| Debt Instrument, Maturity Date |
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|
Jul. 15, 2033
|
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|
Jul. 15, 2033
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| Debt, interest rate at a point in time. |
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|
6.75%
|
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|
6.75%
|
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| Debt Instrument, Fair Value Disclosure |
|
|
|
1,035,000
|
|
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|
$ 1,035,000
|
|
|
| Debt Instrument, footnotes to the table |
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| Debt Instrument, Payment Terms |
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|
The 6.75% Senior Notes pay interest on January 15 and July 15 of each year beginning January 15, 2026 and mature on July 15, 2033
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| Debt Instrument, Date of First Required Payment |
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|
Jan. 15, 2026
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| Debt Instrument, Redemption, Description |
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|
The Company may redeem up to 40% of the aggregate principal amount of the 6.75% Senior Notes at any time prior to July 15, 2028 at 106.75% of the aggregate principal amount from the proceeds of one or more equity offerings, plus accrued and unpaid interest.
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| Debt Instrument, Fee Amount |
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|
$ 12,147
|
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|
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| Debt Instrument, Redemption Price, if change of control |
|
|
101.00%
|
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| Debt Instrument, Redemption Price, Percentage Any time Prior to July 15, 2028 |
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|
106.75%
|
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| Term Loan B-1 | SOFR | SOFR Loans |
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| Debt Instrument, footnotes to the table |
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| Debt Instrument, Basis Spread on Variable Rate |
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|
2.00%
|
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| Term Loan A-2 and Revolver | SOFR | SOFR Loans |
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|
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| Debt Instrument, footnotes to the table |
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|
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| Debt Instrument, Basis Spread on Variable Rate |
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|
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|
1.50%
|
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| Term Loan A-2 and Revolver | Adjusted Rate | Base Rate Loans |
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| Debt Instrument, footnotes to the table |
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| Debt Instrument, Basis Spread on Variable Rate |
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0.50%
|
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| Revolving line of credit |
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| Senior Secured Credit Facilities: |
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| Secured Debt |
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|
0
|
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|
$ 0
|
0
|
|
| Long-term debt disclosure |
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|
|
|
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|
|
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| Debt Instrument, Maturity Date |
|
|
|
|
|
|
|
Nov. 24, 2030
|
|
|
| Line of Credit Facility, Fair Value of Amount Outstanding |
|
|
|
0
|
|
|
|
$ 0
|
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|
| Debt Instrument, footnotes to the table |
|
|
|
|
|
|
|
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| Maximum borrowing capacity on revolving credit facilities |
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|
1,500,000
|
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|
$ 1,500,000
|
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|
| Revolving line of credit | SOFR |
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| Debt Instrument, footnotes to the table |
|
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|
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| Debt Instrument, Description of Variable Rate Basis |
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|
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|
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|
SOFR + 1.50%
|
|
|
| Term Loan A-1 and Revolver |
|
|
|
|
|
|
|
|
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|
| Debt Instrument, footnotes to the table |
|
|
|
|
|
|
|
|
|
|
| Constructive Financing Cash Outflows And Financing Cash Inflows |
|
|
|
773,722
|
|
|
|
|
|
|
| Term Loan A-1 and Revolver | SOFR | SOFR Loans |
|
|
|
|
|
|
|
|
|
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| Debt Instrument, footnotes to the table |
|
|
|
|
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|
|
|
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| Debt Instrument, Basis Spread on Variable Rate |
|
|
|
|
|
|
1.75%
|
|
|
|
| Term Loan A-1 and Revolver | Adjusted Rate |
|
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|
|
|
|
|
|
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|
| Debt Instrument, footnotes to the table |
|
|
|
|
|
|
|
|
|
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| Debt Instrument, Basis Spread on Variable Rate |
|
|
|
|
|
|
0.10%
|
|
|
|
| Term Loan A-1 |
|
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|
|
|
|
|
|
|
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| Senior Secured Credit Facilities: |
|
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|
|
|
|
|
|
|
|
| Secured Debt |
|
|
|
0
|
|
|
|
$ 0
|
2,259,295
|
|
| Long-term debt disclosure |
|
|
|
|
|
|
|
|
|
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| Debt Instrument, Maturity Date |
|
|
|
|
|
|
|
Apr. 28, 2028
|
|
|
| Debt Instrument, Fair Value Disclosure |
|
|
|
0
|
|
|
|
$ 0
|
|
|
| Debt Instrument, footnotes to the table |
|
|
|
|
|
|
|
|
|
|
| Constructive Financing Cash Outflow |
|
|
|
|
250,000
|
|
|
|
|
|
| Repayments of Debt |
$ 1,949,840
|
|
|
|
250,000
|
|
|
|
|
|
| Debt Instrument, Periodic Payment, Principal |
|
|
|
|
|
|
|
59,455
|
|
|
| Term Loan B-1 |
|
|
|
|
|
|
|
|
|
|
| Senior Secured Credit Facilities: |
|
|
|
|
|
|
|
|
|
|
| Secured Debt |
|
|
|
0
|
|
|
|
$ 0
|
1,636,150
|
|
| Long-term debt disclosure |
|
|
|
|
|
|
|
|
|
|
| Debt Instrument, Maturity Date |
|
|
|
|
|
|
|
May 09, 2031
|
|
|
| Debt Instrument, Fair Value Disclosure |
|
|
|
0
|
|
|
|
$ 0
|
|
|
| Debt Instrument, footnotes to the table |
|
|
|
|
|
|
|
|
|
|
| Debt Instrument, Periodic Payment, Principal |
|
|
|
|
|
|
|
8,201
|
|
|
| Senior Notes |
|
|
|
|
|
|
|
|
|
|
| Debt Instrument, footnotes to the table |
|
|
|
|
|
|
|
|
|
|
| Deferred Financing Costs |
|
|
|
42,653
|
|
|
|
42,653
|
37,612
|
|
| Debt Instrument, Unamortized Premium |
|
|
|
$ 8,349
|
|
|
|
$ 8,349
|
10,239
|
|
| Senior Secured Credit Facilities |
|
|
|
|
|
|
|
|
|
|
| Long-term debt disclosure |
|
|
|
|
|
|
|
|
|
|
| Long-term debt, weighted average interest rate, at point in time |
|
|
|
6.00%
|
|
|
|
6.00%
|
|
|
| Debt Instrument, footnotes to the table |
|
|
|
|
|
|
|
|
|
|
| Debt Instrument, Unamortized Discount |
|
|
|
$ 5,242
|
|
|
|
$ 5,242
|
8,084
|
|
| Deferred Financing Costs |
|
|
|
31,848
|
|
|
|
31,848
|
28,879
|
|
| Term Loan B-2 |
|
|
|
|
|
|
|
|
|
|
| Senior Secured Credit Facilities: |
|
|
|
|
|
|
|
|
|
|
| Secured Debt |
|
$ 1,877,949
|
|
1,868,559
|
|
|
|
$ 1,868,559
|
0
|
|
| Long-term debt disclosure |
|
|
|
|
|
|
|
|
|
|
| Debt Instrument, Maturity Date |
|
May 09, 2031
|
|
|
|
|
|
May 09, 2031
|
|
|
| Debt Instrument, Fair Value Disclosure |
|
|
|
1,877,902
|
|
|
|
$ 1,877,902
|
|
|
| Debt Instrument, footnotes to the table |
|
|
|
|
|
|
|
|
|
|
| Debt Instrument, Payment Terms |
|
The Term Loan B-2 requires quarterly principal payments that began on September 30, 2025 of 0.25% of the aggregate principal amount of the Term Loan B-2 outstanding on the Seventh Amendment Effective Date, with the balance due on May 9, 2031.
|
|
|
|
|
|
|
|
|
| Debt Instrument, Maturity Date Range, Start |
|
Sep. 30, 2025
|
|
|
|
|
|
|
|
|
| Constructive Financing Cash Outflow |
|
|
|
|
57,090
|
|
|
|
|
|
| Constructive Financing Cash Inflow |
|
|
|
|
306,246
|
|
|
|
|
|
| Debt Instrument, Effective Date |
|
Jul. 17, 2025
|
|
|
|
|
|
|
|
|
| Debt Instrument, Date of First Required Payment |
|
Sep. 30, 2025
|
|
|
|
|
|
|
|
|
| Debt Instrument, Maturity Date Range, End |
|
May 09, 2031
|
|
|
|
|
|
|
|
|
| Other Significant Noncash Financing Activity |
|
|
|
|
314,790
|
|
|
|
|
|
| Debt Instrument, Periodic Payment Terms, Balloon Payment to be Paid |
|
|
|
1,769,967
|
|
|
|
1,769,967
|
|
|
| Debt Instrument, Frequency of Periodic Payment |
|
quarterly
|
|
|
|
|
|
|
|
|
| Debt Instrument, Increase (Decrease), Net |
|
|
|
|
$ 250,000
|
|
|
|
|
|
| Debt Instrument, Quarterly Payment, % of Beginning Balance Outstanding |
|
0.25%
|
|
|
|
|
|
|
|
|
| Debt Instrument, Periodic Payment, Principal |
|
|
|
|
|
|
|
$ 9,390
|
|
|
| Term Loan B-2 | SOFR |
|
|
|
|
|
|
|
|
|
|
| Debt Instrument, footnotes to the table |
|
|
|
|
|
|
|
|
|
|
| Debt Instrument, Description of Variable Rate Basis |
|
|
|
|
|
|
|
SOFR + 1.75%
|
|
|
| Term Loan B-2 | Adjusted Rate | Base Rate Loans |
|
|
|
|
|
|
|
|
|
|
| Debt Instrument, footnotes to the table |
|
|
|
|
|
|
|
|
|
|
| Debt Instrument, Basis Spread on Variable Rate |
|
|
|
|
|
|
|
0.75%
|
|
|
| Term Loan A-2 |
|
|
|
|
|
|
|
|
|
|
| Senior Secured Credit Facilities: |
|
|
|
|
|
|
|
|
|
|
| Secured Debt |
|
|
|
2,000,000
|
|
|
|
$ 2,000,000
|
$ 0
|
|
| Long-term debt disclosure |
|
|
|
|
|
|
|
|
|
|
| Debt Instrument, Maturity Date |
|
|
|
|
|
|
|
Nov. 24, 2030
|
|
|
| Debt Instrument, Fair Value Disclosure |
|
|
|
1,995,000
|
|
|
|
$ 1,995,000
|
|
|
| Debt Instrument, footnotes to the table |
|
|
|
|
|
|
|
|
|
|
| Debt Instrument, Payment Terms |
The Term Loan A-2 requires amortizing quarterly principal payments that begin on March 31, 2026 of $12,500 per quarter through December 31, 2027, and $25,000 per quarter from March 31, 2028 through September 30, 2030, with the balance due on November 24, 2030.
|
|
|
|
|
|
|
|
|
|
| Secured Debt Outstanding Principal Balance Subject To SOFR |
|
|
|
368,559
|
|
|
|
368,559
|
|
|
| Debt Instrument, Maturity Date Range, End |
Nov. 24, 2030
|
|
|
|
|
|
|
|
|
|
| Other Significant Noncash Financing Activity |
|
|
|
967,528
|
|
|
|
|
|
|
| Debt Instrument, Periodic Payment Terms, Balloon Payment to be Paid |
|
|
|
$ 1,625,000
|
|
|
|
$ 1,625,000
|
|
|
| Debt Instrument, Frequency of Periodic Payment |
quarterly
|
|
|
|
|
|
|
|
|
|
| Debt Instrument, Quarterly Payment Through December 31, 2027 |
$ 12,500
|
|
|
|
|
|
|
|
|
|
| Debt Instrument, Quarterly Payment From March 31, 2028 Through September 30,2030 |
$ 25,000
|
|
|
|
|
|
|
|
|
|
| Term Loan A-2 | SOFR |
|
|
|
|
|
|
|
|
|
|
| Debt Instrument, footnotes to the table |
|
|
|
|
|
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| Debt Instrument, Description of Variable Rate Basis |
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|
SOFR + 1.50%
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| Term Loan A-2 | Revolving line of credit |
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| Debt Instrument, footnotes to the table |
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| Debt Instrument Becomes Due Before Maturity Date When Unpaid Amount Triggers Change In Due Date |
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|
Mar. 02, 2030
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| Term Loan A-2 and Revolver |
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| Debt Instrument, footnotes to the table |
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| Debt Instrument, Maturity Date Range, Start |
Mar. 31, 2026
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| Debt Instrument, Effective Date |
Nov. 24, 2025
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| Debt Instrument, Date of First Required Payment |
Mar. 31, 2026
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| Proceeds from Issuance of Debt |
$ 2,000,000
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| Term Loan A-2 and Revolver | SOFR | Minimum |
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| Debt Instrument, footnotes to the table |
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| Debt Instrument, Basis Spread on Variable Rate |
0.00%
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| Term Loan A-2 and Revolver | SOFR | Maximum |
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| Debt Instrument, footnotes to the table |
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| Debt Instrument, Basis Spread on Variable Rate |
1.75%
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| Term Loan B-2, Term Loan A-2 and Revolver | Minimum |
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| Debt Instrument, footnotes to the table |
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| Debt Instrument, Variable Rate |
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|
0.00%
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| Term Loan B-2, Term Loan A-2 and Revolver | Fed Funds Effective Rate Overnight Index Swap Rate | Maximum | Base Rate Loans |
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| Debt Instrument, footnotes to the table |
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| Debt Instrument, Basis Spread on Variable Rate |
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|
0.50%
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| Term Loan B-2, Term Loan A-2 and Revolver | 1-Month SOFR | Maximum | Base Rate Loans |
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| Debt Instrument, footnotes to the table |
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| Debt Instrument, Basis Spread on Variable Rate |
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|
1.00%
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| Term Loan B-2, Term Loan A-2 and Revolver | Prime Rate | Maximum | Base Rate Loans |
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| Debt Instrument, footnotes to the table |
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| Debt Instrument, Description of Variable Rate Basis |
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|
prime commercial lending rate
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