Unaudited Condensed Consolidated Statements of Operations - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Statement [Abstract]
Service revenue, net	$ 684,451	$ 662,306
Grant income	0	1,464
Operating expenses:
Service expense	583,566	550,266
General and administrative expense	77,177	79,713
Depreciation and amortization	27,103	25,693
Total operating expenses	687,846	655,672
Operating income (loss)	(3,395)	8,098
Interest expense, net	18,686	15,958
Loss before income taxes and equity method investment	(22,081)	(7,860)
Income tax benefit	543	1,873
Equity in net income (loss) of investee, net of tax	(762)	2,025
Net loss	$ (22,300)	$ (3,962)
Loss per common share:
Basic (in dollars per share)	$ (1.57)	$ (0.28)
Diluted (in dollars per share)	$ (1.57)	$ (0.28)
Weighted-average number of common shares outstanding:
Basic (in shares)	14,202,000	14,163,511
Diluted (in shares)	14,202,000	14,163,511