v3.26.3
BUSINESS SEGMENTS - Schedule of Segment Financial Information (Details) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Sep. 30, 2026
Sep. 30, 2025
Segment Reporting [Line Items]        
Service revenue $ 1,476,835 $ 1,289,779 $ 4,291,635 $ 3,678,233
Rental revenue 7,167 6,626 22,044 18,982
TOTAL REVENUE 1,484,002 1,296,405 4,313,679 3,697,215
Depreciation and amortization 32,646 26,633 92,853 76,606
Interest expense 2,286 1,971 6,151 6,033
All other not included in segment income (58,751) (56,148) (173,022) (148,854)
Income before provision for income taxes 140,198 106,600 402,444 325,538
Cost of services 1,166,802 1,044,659 3,396,865 2,944,288
Rent—cost of services 66,970 61,528 198,888 175,799
General and administrative expense 79,595 67,367 239,727 199,029
Operating segments        
Segment Reporting [Line Items]        
Service revenue 1,421,971 1,239,096 4,132,718 3,536,226
Rental revenue 47,704 32,610 127,939 92,479
TOTAL REVENUE 1,469,675 1,271,706 4,260,657 3,628,705
Segment income 198,949 162,748 575,466 474,392
Operating segments | Skilled Services        
Segment Reporting [Line Items]        
Service revenue 1,421,971 1,239,096 4,132,718 3,536,226
Rental revenue 0 0 0 0
TOTAL REVENUE 1,421,971 1,239,096 4,132,718 3,536,226
Other segment items 1,221,494 1,071,815 3,547,848 3,048,047
Depreciation and amortization 15,279 14,155 46,034 41,118
Interest expense 0 0 0 0
Segment income 185,198 153,126 538,836 447,061
Cost of services 1,121,332 989,959 3,263,165 2,814,637
Rent—cost of services 100,162 81,856 284,683 233,410
Operating segments | Standard Bearer        
Segment Reporting [Line Items]        
Service revenue 0 0 0 0
Rental revenue 47,704 32,610 127,939 92,479
TOTAL REVENUE 47,704 32,610 127,939 92,479
Other segment items 3,688 2,959 10,431 8,331
Depreciation and amortization 13,565 9,709 37,024 27,450
Interest expense 16,700 10,320 43,854 29,367
Segment income 13,751 9,622 36,630 27,331
Cost of services 323 596 1,448 1,666
Rent—cost of services 362 265 973 792
General and administrative expense 3,003 2,098 8,010 5,873
Other        
Segment Reporting [Line Items]        
Service revenue 63,654 57,377 183,768 160,978
Rental revenue 3,273 3,201 9,683 9,358
TOTAL REVENUE 66,927 60,578 193,451 170,336
Intercompany Elimination        
Segment Reporting [Line Items]        
Service revenue (8,790) (6,694) (24,851) (18,971)
Rental revenue (43,810) (29,185) (115,578) (82,855)
TOTAL REVENUE (52,600) (35,879) (140,429) (101,826)
Other segment items (52,600) (35,879) (140,429) (101,826)
Interest expense $ (14,949) $ (9,090) $ (38,865) $ (25,153)