v3.26.1
Condensed Consolidated Statements Of Cash Flows - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Cash flows from operating activities:    
Net income $ 58,488 $ 58,965
Adjustments to reconcile net income to net cash used in operating activities:    
Depreciation and amortization 42,986 36,201
Other non-operating (gains) losses (1,886) 217
Amortization of deferred financing costs and debt discounts 811 1,237
Deferred income taxes (429) (1,940)
Equity-based compensation 8,929 9,263
Income from non-consolidated affiliates (8,989) (1,229)
Changes in operating assets and liabilities, net of effect of acquisitions and divestitures:    
Accounts receivable 32 (30,717)
Inventories (1,245) (5,192)
Prepaid expenses and other current assets (79,130) 36,049
Accounts payable and other accrued expenses and liabilities (14,199) (46,695)
Accrued salaries and benefits (65,590) (80,946)
Net cash used in operating activities (60,222) (24,787)
Cash flows from investing activities:    
Purchases of property and equipment (28,088) (22,908)
Other 187 (214)
Net cash used in investing activities (27,901) (23,122)
Cash flows from financing activities:    
Proceeds from insurance financing arrangements 17,033 10,959
Payments of principal on insurance financing arrangements (2,848) (3,104)
Payments of principal on long-term debt (3,643) (1,387)
Distributions to noncontrolling interests (21,314) (19,239)
Other (1,014) (1,061)
Net cash used in financing activities (11,786) (13,832)
Net decrease in cash and cash equivalents (99,909) (61,741)
Cash and cash equivalents at beginning of period 709,601 556,785
Cash and cash equivalents at end of period 609,692 495,044
Supplemental Cash Flow Information:    
Non-cash purchases of property and equipment $ 936 $ 6,662