REVENUE AND ACCOUNTS RECEIVABLEPatient and resident service revenue is derived from services rendered, under short-term contracts, to patients for skilled nursing, rehabilitation therapy, and assisted living services. Patient and resident service revenue is reported at the amount that reflects the consideration to which the Company expects to be entitled in exchange for providing patient services. These amounts are due from patients, governmental programs, and other third-party payors, and include variable consideration for retroactive revenue adjustments due to settlement of audits, reviews, and investigations.
Disaggregation of Revenue
The Company disaggregates revenue from contracts with its patients by payors. The Company determines that disaggregating revenue into these categories achieves the disclosure objectives to depict how the nature, amount, timing, and uncertainty of revenue and cash flows are affected by economic factors. The composition of patient and resident service revenue by primary payors for the years ended December 31, 2025, 2024, and 2023 are as follows:
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| 2025 | | % of Revenue | | 2024 | | % of Revenue | | 2023 | | % of Revenue |
| Medicare | $ | 1,783,686 | | | 33.7 | % | | $ | 1,381,236 | | | 33.8 | % | | $ | 1,200,801 | | | 38.6 | % |
| Medicaid | 2,139,613 | | | 40.5 | % | | 1,651,401 | | | 40.4 | % | | 1,168,455 | | | 37.6 | % |
| Managed care | 989,072 | | | 18.7 | % | | 813,865 | | | 19.9 | % | | 586,850 | | | 18.9 | % |
| Private and other | 375,514 | | | 7.1 | % | | 240,153 | | | 5.9 | % | | 154,008 | | | 4.9 | % |
Total patient and resident service revenue | $ | 5,287,885 | | | 100.0 | % | | $ | 4,086,655 | | | 100.0 | % | | $ | 3,110,114 | | | 100.0 | % |
Refund Liability
The balance of the refund liability was $181,129 and $145,795 as of December 31, 2025 and 2024, respectively, and is presented within current liabilities on the Company's combined/consolidated balance sheets.
Additional Funding and CARES Act
Through the CARES Act of 2020, the Company received $14,962 in funding from the U.S. Department of Health and Human Services (HHS) through the Provider Relief Fund (PRF) during the year ended December 31, 2022. These funds were provided to healthcare providers who diagnosed, tested, or cared for individuals with cases of COVID-19 and had
health-care-related expenses and lost revenues attributable to COVID-19. The Company recorded these funds as deferred revenue upon receipt and revenue was recognized only to the extent that health-care-related expenses or lost revenues had been incurred and were not reimbursed from other funding sources. The Company recognized an immaterial amount of revenue within additional funding on its combined/consolidated statements of income for the ended December 31, 2023 for funds received prior to 2023. The Company did not receive any funds related to this program during the years ended December 31, 2025, 2024 or 2023.
The CARES Act also provided for refundable payroll tax credits known as the Employee Retention Tax Credit (ERTC), which allowed qualified employers to receive a credit of 70% of the employee qualified wages and related payroll costs paid after December 31, 2020 through September 30, 2021, up to a maximum credit of $7 per employee, per quarter, for a maximum of $21 per employee in 2021. Due to uncertainty related to meeting the necessary qualifications, the Company recorded a reserve against the entire amount claimed. In the years ended December 31, 2025 and 2024, the Company recognized $14,946 and $14,599, respectively, of the ERTC as an offset to labor in cost of services, as the statute of limitations surrounding the uncertainty of the qualifications, for certain of the funds received, expired. As of December 31, 2025 and 2024, the Company has recorded $9,674 and $21,917, respectively, in other liabilities to reflect the cash already received related to these credits which may need to be returned and potential penalties.