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Schedule of Accrued Expenses (Details) - USD ($)
Sep. 30, 2023
Dec. 31, 2022
Payables and Accruals [Abstract]    
Accrued payroll and related liabilities $ 8,525,232 $ 8,533,710
HHS Provider Relief Funds 266,527 552,099
Accrued interest 6,720,113 5,736,096
Accrued legal expenses and settlements 498,000 534,550
Medicare cost report settlement reserves 861,046 2,101,837
Other accrued expenses 2,589,245 2,105,516
Accrued expenses $ 19,460,163 $ 19,563,808