Income Taxes
The components of the Company's (loss) income before income taxes are as follows:
 Year Ended December 31,
 202520242023
(amounts in thousands)
United States$(85,353)$(17,435)$102,200 
Foreign1,843 1,037 694 
(Loss) income before income taxes$(83,510)$(16,398)$102,894 

 The components of the Company’s income tax expense (benefit) are as follows:
 Year Ended December 31,
 202520242023
(amounts in thousands)
Current:   
Federal$15 $(104)$19,871 
State791 (75)8,940 
Foreign466 281 148 
Total1,272 102 28,959 
Deferred:   
Federal8,144 (2,004)554 
State1,675 (105)596 
Foreign251 165 154 
Total10,070 (1,944)1,304 
Effective tax rate$11,342 $(1,842)$30,263 

Deferred income taxes reflect the Company's net tax effect of temporary differences between the carrying amount of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes.
Significant components of the Company’s deferred tax assets and liabilities are as follows:
 December 31,
 20252024
(amounts in thousands)
Deferred Tax Assets:
Accrued other and prepaid expenses$1,666 $432 
Allowance for credit losses2,378 2,379 
Intangible assets10,438 7,784 
Net operating loss carryforwards7,182 6,571 
Accrued professional liability2,309 1,907 
Accrued workers’ compensation3,057 3,215 
Share-based compensation460 918 
Operating lease liabilities332 659 
Depreciation1,093 203 
Credit carryforwards236 170 
Other1,333 1,127 
Gross deferred tax assets30,484 25,365 
Valuation allowance(29,741)(178)
743 25,187 
Deferred Tax Liabilities:
Indefinite-lived intangibles(2,120)(16,763)
Operating lease right-of-use assets(330)(320)
Tax on unrepatriated earnings(815)(565)
(3,265)(17,648)
Net deferred taxes$(2,522)$7,539 


As of December 31, 2025, the Company had approximately $31.5 million of federal net operating loss carryforwards, $52.5 million of state net operating loss carryforwards, and an immaterial amount of foreign net operating loss carryforwards. As a result of the Tax Cuts and Jobs Act of 2017 (2017 Tax Act), the federal net operating loss and certain state net operating losses generated in 2024 and 2025 carry forward indefinitely. Those net operating losses that do not carry forward indefinitely expire between 2027 and 2045.

As of December 31, 2025 and 2024, the Company had $29.7 million and $0.2 million of valuation allowances on its deferred tax assets. As of December 31, 2025, management assessed the available positive and negative evidence to estimate whether sufficient future taxable income will be generated to permit use of its existing deferred tax assets. On the basis of this evaluation, additional nonrecurring and recurring valuation allowances of $29.5 million were recorded in the fourth quarter of 2025 as income tax expense to reduce the portion of the deferred tax assets that are not more likely than not to be realized. The Company intends to maintain a valuation allowance until sufficient positive evidence exists to support its reversal. The December 31, 2025 valuation allowance applied to all domestic deferred tax assets other than certain deferred tax assets expected to be realized, and an immaterial amount of international net operating losses. The December 31, 2024 valuation allowance applied to the uncertainty of the realization of certain state net operating losses, and an immaterial amount of international net operating losses.
Income Taxes Paid

Cash income taxes paid during the years ended December 31, 2025, 2024, and 2023 were disaggregated by jurisdiction as follows:

 Year Ended December 31,
 202520242023
(amounts in thousands)
Federal$(4,500)$596 $14,984 
State(1,586)1,551 6,837 
Foreign399 280 165 
Total$(5,687)$2,427 $21,986 

Income taxes paid (net of refunds) exceeded five percent of total income taxes paid (net of refunds) in the following jurisdictions:

 Year Ended December 31,
 202520242023
(amounts in thousands)
State:   
California*$270 *
Illinois***
Florida**$1,258 
New York$(375)$411 *
New York City$(447)**
Oregon*$123 *
Texas*$234 *
Foreign:
India$399 $281 *
________________

(*) Jurisdiction below the five percent threshold for the period presented.
The reconciliation of income tax computed at the U.S. federal statutory rate to income tax (benefit) expense is as follows:

Year Ended December 31,
202520242023
AmountPercentAmountPercentAmountPercent
(amounts in thousands)
U.S. federal statutory tax rate$(17,537)20.97 %$(3,444)21.00 %$21,608 21.00 %
State and local income taxes, net of federal income tax effect (a)
1,501 (1.79)%(653)3.98 %6,834 6.64 %
Foreign tax effects329 (0.39)%228 (1.39)%155 0.15 %
Effect of cross-border tax laws497 (0.59)%— — %— — %
Tax credits(66)0.08 %(38)0.23 %(895)(0.87)%
Changes in valuation allowances23,660 (28.29)%— — %— — %
Nontaxable or nondeductible items
   Meals and incidentals534 (0.64)%832 (5.07)%473 0.46 %
   Officers' compensation1,002 (1.21)%313 (1.91)%(275)(0.27)%
   Other69 (0.08)%88 (0.54)%100 0.10 %
Changes in unrecognized tax benefits1,332 (1.59)%867 (5.28)%2,771 2.69 %
Other adjustments21 (0.03)%(35)0.21 %(508)(0.49)%
Effective tax rate$11,342 (13.56)%$(1,842)11.23 %$30,263 29.41 %
________________

(a) In 2023, state and local income taxes in California, Florida, Illinois, Maine, and New York comprise the majority of the domestic state and local income taxes, net of federal effect category. In 2024, state and local income taxes in California, Florida, New York, and Pennsylvania comprise the majority of the domestic state and local income taxes, net of federal effect category. In 2025, state and local income taxes in California, Florida, Illinois, New York, Tennessee, and Virginia comprise the majority of the domestic state and local income taxes, net of federal effect category.
 
A reconciliation of the beginning and ending amounts of unrecognized tax benefits is as follows: 
Year Ended December 31,
 202520242023
(amounts in thousands)
Balance at January 1 $10,862 $10,377 $7,581 
Additions based on tax positions related to the current year1,187 1,336 2,737 
Additions (reductions) based on tax positions related to prior years15 (851)59 
Balance at December 31$12,064 $10,862 $10,377 

There were no short-term unrecognized tax benefits as of December 31, 2025 and 2024. Long-term unrecognized tax benefits are included in non-current uncertain tax positions in the consolidated balance sheets and were $10.4 million and $10.1 million as of December 31, 2025 and 2024, respectively. As of December 31, 2025 and 2024, the Company had unrecognized tax benefits, which would affect the effective tax rate if recognized, of $12.0 million and $10.7 million, respectively.
 
The Company recognizes interest and penalties related to unrecognized tax benefits in the provision for income taxes. During the years ended December 31, 2025, 2024, and 2023, interest and penalties were immaterial. Tax years 2012 through 2025 remain open to examination by certain taxing jurisdictions to which the Company is subject to tax.
An unrecognized tax benefit should be presented in the financial statements as a reduction to a deferred tax asset for a net operating loss carryforward if such carryforward would offset the disallowance of the tax position. As a result of the Company’s generation of a net operating loss, the Company reclassified $2.4 million of unrecognized tax benefits from long-term liabilities to deferred tax assets in the year ended December 31, 2025. As a result of the Company’s utilization of its federal net operating loss carryforward and a material amount of state net operating loss carryforwards, the Company reclassified $1.3 million of unrecognized tax benefits from deferred tax assets to long-term liabilities in the year ended December 31, 2024.

Historical Timeline

Fiscal YearFiled
2025Mar 9, 2026Showing above
2024Mar 5, 2025
2023Feb 23, 2024
2022Feb 23, 2023
2020Feb 25, 2021
2019Mar 5, 2020
2018Mar 1, 2019
2016Mar 3, 2017

About Income Taxes Disclosures

The income tax disclosure reveals how much a company actually pays in taxes versus what the statutory rate would predict. Analysts focus on the effective tax rate (ETR) reconciliation, which breaks down every item driving the gap between the 21% federal rate and the company's reported ETR — including R&D credits, foreign rate differentials, and state taxes. Deferred tax assets (DTAs) and their valuation allowances signal management's confidence in future profitability: a rising allowance suggests the company doubts it can use accumulated tax benefits. Uncertain tax benefit (UTB) reserves quantify exposure to IRS challenges on aggressive positions.

Key signals to watch: sudden ETR drops without clear operational reasons, large increases in valuation allowances, growing UTB balances, and significant unremitted foreign earnings. Post-TCJA, pay attention to GILTI and BEAT provisions that affect multinational tax structures. Compare the cash taxes paid (from the cash flow statement) against the income tax provision to gauge earnings quality.