Credit Facility, Bank Loans, and Lines of Credit - Lines of Credit (Details)		1 Months Ended	12 Months Ended
	Jan. 25, 2022 USD ($)	May 31, 2021 USD ($)	Dec. 31, 2023 USD ($) loan	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Dec. 14, 2023 USD ($)	Apr. 30, 2021 USD ($)	Sep. 10, 2019 USD ($)
Line of Credit Facility [Line Items]
Number of real estate loans | loan			3
Interest expense			$ 16,102,000	$ 7,920,000	$ 5,394,000
APC | Standby Letters of Credit
Line of Credit Facility [Line Items]
Maximum loan availability			$ 3,900,000
Term of facility			1 year
120 Hellman LLC
Line of Credit Facility [Line Items]
Long-term debt			$ 16,000,000			$ 15,600,000
Face amount of debt	$ 16,300,000
120 Hellman LLC | Prime Rate
Line of Credit Facility [Line Items]
Basis spread on variable rate (as a percent)	2.00%
Real Estate Loan One | APC
Line of Credit Facility [Line Items]
Long-term debt				$ 5,900,000
Real Estate Loan One | APC | Prime Rate
Line of Credit Facility [Line Items]
Basis spread on variable rate (as a percent)				0.50%
Real Estate Loan Two | APC
Line of Credit Facility [Line Items]
Long-term debt				$ 600,000
Real Estate Loan Two | APC | Prime Rate
Line of Credit Facility [Line Items]
Basis spread on variable rate (as a percent)				0.50%
Real Estate Loan Three | APC
Line of Credit Facility [Line Items]
Long-term debt				$ 600,000
Real Estate Loan Three | APC | Prime Rate
Line of Credit Facility [Line Items]
Basis spread on variable rate (as a percent)				0.30%
Construction Loan * | Tag-8 Medical Investment Group, LLC — related party
Line of Credit Facility [Line Items]
Face amount of debt			$ 4,200,000			$ 8,500,000	$ 10,700,000
Subordinated Loan Agreement | Subordinated Debt
Line of Credit Facility [Line Items]
Face amount of debt		$ 2,000,000
Subordinated Loan Agreement | Prime Rate | Subordinated Debt
Line of Credit Facility [Line Items]
Basis spread on variable rate (as a percent)		1.00%
Credit Agreement
Line of Credit Facility [Line Items]
Interest rate during period			6.19%	3.22%	2.06%
Interest expense			$ 1,100,000	$ 900,000	$ 1,200,000
APC Business Loan Agreement | APC | Line of Credit | Preferred Bank
Line of Credit Facility [Line Items]
Maximum loan availability								$ 4,100,000
APC Business Loan Agreement | APC | Standby Letters of Credit | Truist Bank
Line of Credit Facility [Line Items]
Maximum loan availability								$ 36,500,000
Amended Credit Agreement | Truist Bank | Standby Letters of Credit
Line of Credit Facility [Line Items]
Term of facility			1 year