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  "notes": "Includes specific financial impact of the definition change for 2020-2022.",
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      "text": "For periods through December 31, 2022, in calculating Adjusted EBITDA, the Company had excluded the impact of “de novo losses,” which consist of those costs associated with the ramp up of new medical centers and losses incurred for the 12 months after the opening of a new facility. These costs collectively are higher than comparable expenses incurred once such a facility has been opened and is generating revenue, and would not have been incurred unless a new facility was being opened.",
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      "text": "The Company presents Adjusted EBITDA to exclude the impact on EBITDA from certain gains/losses, such as non-cash stock-based compensation expense, non-cash goodwill impairment loss, and certain other non-operating items that are not directly attributable to the Company's underlying operating performance, such as acquisition, integration and divestiture transaction costs (including corporate development payroll costs), restructuring and other charges, fair value adjustments in contingent consideration, loss on the early extinguishment of debt, changes in fair value of warrant liabilities, results and gains/losses on discontinued operations and other miscellaneous expenses.",
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      "text": "The Company plans to reduce its de novo investments in 2023 and will streamline the definition of Adjusted EBITDA beginning January 1, 2023. Therefore, de novo losses will no longer be included as an adjustment in calculating Adjusted EBITDA in future periods. Under the new definition, Adjusted EBITDA would have been $73.5 million, ($13.3) million and $64.2 million for the years ended December 31, 2022, 2021 and 2020, respectively, compared to reported Adjusted EBITDA of $152.5 million, $27.3 million and $72.8 million with de novo losses included for the years ended December 31, 2022, 2021 and 2020, respectively.",
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      "text": "The Company presents Adjusted EBITDA because the Company's management believes that some of these items may not occur in certain periods, the amounts recognized can vary significantly from period to period and the elimination of the effects of certain charges that are not directly attributable to the Company's underlying performance can facilitate an understanding of the Company's business and results of operations.",
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