Long-Term Debt
As of December 31, 2025, the Company’s long-term debt and notes payable are as follows:
| | | | | | | | | | | | | | | | | | | | | | | | | | |
| | Principal Outstanding | | Unamortized Premium (Discount) | | Unamortized Issuance Costs | | Carrying Value | | | |
| (in thousands) |
6.875% senior notes | $ | 650,000 | | | $ | — | | | $ | (10,356) | | | $ | 639,644 | | | | |
Credit facilities: | | | | | | | | | | |
Revolving Credit Facility | — | | | — | | | — | | | — | | | | |
Term Loan | 942,875 | | | (839) | | | (10,789) | | | 931,247 | | | | |
Other debt(1) | 3,505 | | | — | | | — | | | 3,505 | | | | |
| Total debt | $ | 1,596,380 | | | $ | (839) | | | $ | (21,145) | | | $ | 1,574,396 | | | | |
As of December 31, 2025, principal maturities of the Company’s long-term debt and notes payable are as follows:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | 2026 | | 2027 | | 2028 | | 2029 | | 2030 | | Thereafter | | Total |
| | | | | | | (in thousands) | | | | | | |
6.875% senior notes | $ | — | | | $ | — | | | $ | — | | | $ | — | | | $ | — | | | $ | 650,000 | | | $ | 650,000 | |
| Credit facilities: | | | | | | | | | | | | | |
Revolving Credit Facility | — | | | — | | | — | | | — | | | — | | | — | | | — | |
Term Loan | 9,500 | | | 9,500 | | | 9,500 | | | 9,500 | | | 9,500 | | | 895,375 | | | 942,875 | |
Other debt(1) | 1,238 | | | 505 | | | 524 | | | 172 | | | 162 | | | 904 | | | 3,505 | |
| Total debt | $ | 10,738 | | | $ | 10,005 | | | $ | 10,024 | | | $ | 9,672 | | | $ | 9,662 | | | $ | 1,546,279 | | | $ | 1,596,380 | |
As of December 31, 2024, the Company’s long-term debt and notes payable are as follows:
| | | | | | | | | | | | | | | | | | | | | | | |
| | Principal Outstanding | | Unamortized Premium (Discount) | | Unamortized Issuance Costs | | Carrying Value |
| (in thousands) |
6.875% senior notes | $ | 650,000 | | | $ | — | | | $ | (11,925) | | | $ | 638,075 | |
| Credit facilities: | | | | | | | |
Revolving Credit Facility | — | | | — | | | — | | | — | |
Term Loan | 847,875 | | | (995) | | | (11,468) | | | 835,412 | |
| | | | | | | |
Other debt(1) | 5,523 | | | — | | | — | | | 5,523 | |
| Total debt | $ | 1,503,398 | | | $ | (995) | | | $ | (23,393) | | | $ | 1,479,010 | |
____________________________________________(1) Other debt is primarily comprised of insurance financing arrangements, promissory notes executed in connection with business combinations, and finance leases.
Credit Facilities
On July 26, 2024, CHSI entered into a senior secured credit agreement (the “Credit Agreement”) that provides for an $850.0 million term loan (the “Term Loan”), and a $400.0 million revolving credit facility, including a $75.0 million sublimit for the issuance of standby letters of credit (the “Revolving Credit Facility” and, together with the Term Loan, the “Credit Facilities”). In March 2025, the Company completed an amendment to the Credit Agreement to increase our Revolving Credit Facility by $50.0 million from $400.0 million to $450.0 million. The interest rate for the Revolving Credit Facility has been reduced from the Term Secured Overnight Financing Rate (“Term SOFR”) plus 2.50% to Term SOFR plus 2.00%, subject to a leverage-based pricing grid including a 25-basis point step down at a net leverage ratio of ≤3.50x. In addition, the amendment to the Credit Agreement also added new debt through an incremental term loan of $102.1 million, which provides an updated Term Loan of $950.0 million. The Term Loan interest rate has been reduced from Term SOFR plus 2.25% down to Term SOFR plus 2.00%, subject to a leverage-based pricing grid including a 25-basis point step down at a net leverage ratio of ≤3.25x.
Borrowings under the Credit Facilities are guaranteed by the Company and substantially all of the Company’s current domestic subsidiaries and will be guaranteed by CHSI’s future domestic subsidiaries and collateralized by substantially all of the Company’s existing and future property and assets and by a pledge of the Company’s capital stock, the capital stock of CHSI’s domestic subsidiaries, and up to 65% of the capital stock of CHSI’s foreign subsidiaries held directly by CHSI or a domestic subsidiary.
Borrowings under the Credit Agreement bear interest at a rate equal to: (i) in the case of the Term Loan, Term SOFR plus a percentage ranging from 1.75% to 2.00%, or Alternate Base Rate plus a percentage ranging from 0.75% to 1.00%, in each case based on CHSI’s leverage ratio; and (ii) in the case of the Revolving Credit Facility, Term SOFR plus a percentage ranging from 1.75% to 2.25%, or Alternate Base Rate plus a percentage ranging from 0.75% to 1.25%, in each case based on CHSI’s leverage ratio, as defined in the Credit Agreement. As of December 31, 2025, the Term Loan borrowings had an interest rate of 5.72%.
The updated Term Loan amortizes in equal quarterly installments in amounts equal to 0.25% of the aggregate original principal amount of the Term Loan commencing on June 30, 2025. The balance of the Term Loan will be payable on July 26, 2031. Similarly, the Revolving Credit Facility will be payable on July 26, 2029.
The Credit Facilities require CHSI to maintain a leverage ratio (as defined in the Credit Agreement), which is tested quarterly and currently must not be greater than 6.5 to 1.0. As of December 31, 2025, CHSI’s leverage ratio was 3.4x. Failure to comply with this covenant would result in an event of default under the Revolving Credit Facility and, absent a waiver or an amendment from the revolving lenders, preclude CHSI from making further borrowings under the Revolving Credit Facility and permit the revolving lenders to accelerate all outstanding borrowings under the Revolving Credit Facility. Upon termination of the commitments for the Revolving Credit Facility and acceleration of all outstanding borrowings thereunder, failure to comply with the covenant also would constitute an event of default with respect to the Term Loan.
The Credit Facilities also contain a number of other affirmative and restrictive covenants, including limitations on mergers, consolidations and dissolutions; sales of assets; investments and acquisitions; indebtedness; liens; affiliate transactions; and dividends and restricted payments. The Credit Facilities contain events of default for non-payment of principal and interest when due, cross-default and cross-acceleration provisions and an event of default that would be triggered by a change of control. As of December 31, 2025, the Company was in compliance with all debt covenants.
At December 31, 2025, the Company had $428.0 million of availability under its Revolving Credit Facility after giving effect to $22.0 million of outstanding letters of credit. The Company did not have any outstanding borrowings under its Revolving Credit Facility.
Prepayment of borrowings
CHSI will be required to prepay borrowings under the Credit Facilities with (i) 100% of the net cash proceeds received from non-ordinary course asset sales or other dispositions, or as a result of a casualty or condemnation, subject to reinvestment provisions and other customary carveouts and, to the extent required, the payment of certain indebtedness secured by liens subject to a first lien intercreditor agreement if CHSI’s total net leverage ratio is greater than 4.50 to 1.00 and 50% of such net cash proceeds if our total net leverage ratio is less than or equal to 4.50 to 1.00 and greater than 4.00 to 1.00, (ii) 100% of the net cash proceeds received from the issuance of debt obligations other than certain permitted debt obligations, and (iii) 50% of excess cash flow (as defined in the Credit Agreement) if CHSI’s leverage ratio is greater than 4.50 to 1.00 and 25% of excess cash flow if CHSI’s leverage ratio is less than or equal to 4.50 to 1.00 and greater than 4.00 to 1.00, in each case, reduced by the aggregate amount of term loans, revolving loans and certain other debt optionally prepaid (and, in the case of revolving loans, accompanied by a reduction in the related commitment) during the applicable fiscal year. CHSI will not be required to prepay borrowings with excess cash flow or the net cash proceeds of asset sales if CHSI’s leverage ratio is less than or equal to 4.00 to 1.00.
6.875% Senior Notes
On July 11, 2024, the Company completed a private offering by its wholly owned subsidiary, Concentra Escrow Issuer Corporation (the “Escrow Issuer”), of $650.0 million aggregate principal amount of 6.875% senior notes due July 15, 2032 (the “Senior Notes”). On July 26, 2024, Escrow Issuer merged with and into CHSI, with CHSI continuing as the surviving entity, and CHSI assumed all of the Escrow Issuer’s obligations under the Senior Notes. The Senior Notes are unconditionally guaranteed, jointly and severally, on a senior unsecured basis by the Company and certain of its wholly owned subsidiaries. Interest on the Senior Notes accrues at a rate of 6.875% per annum and is payable semi-annually in cash in arrears on January 15 and July 15 of each year, commencing on January 15, 2025.
At December 31, 2025, the Company had $650.0 million of the Senior Notes outstanding (excluding unamortized premium and debt issuance costs of $10.4 million).
Long-term revolving promissory note with related party
A portion of the net proceeds of the IPO, further discussed in Note 1—“Organization”, was used to repay the long-term revolving promissory note with Select.