0001014739-21-000011 | 10-K | XBRL Viewer

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COVER PAGE - USD ($)	12 Months Ended
COVER PAGE - USD ($)	Dec. 31, 2020	Mar. 08, 2021	Jun. 30, 2020
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2020
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-11993
Entity Registrant Name	OPTION CARE HEALTH, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	05-0489664
Entity Address, Address Line One	3000 Lakeside Dr.
Entity Address, Address Line Two	Suite 300N
Entity Address, City or Town	Bannockburn
Entity Address, State or Province	IL
Entity Address, Postal Zip Code	60015
City Area Code	312
Local Phone Number	940-2443
Title of 12(b) Security	Common Stock, $0.0001 par value per share
Trading Symbol	OPCH
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Entity Shell Company	false
Entity Public Float			$ 473,322,477
Entity Common Stock, Shares Outstanding		179,814,189
Documents Incorporated by Reference	Portions of the registrant’s definitive proxy statement for its 2021 Annual Meeting of Stockholders to be filed with the Securities and Exchange Commission (the “SEC”) within 120 days after the close of the registrant’s fiscal year are incorporated by reference into Part III of this Annual Report on Form 10-K.
Entity Central Index Key	0001014739
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	FY
Amendment Flag	false

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
CURRENT ASSETS:
Cash and cash equivalents	$ 99,265	$ 67,056
Accounts receivable, net	328,340	324,416
Inventories	158,601	115,876
Prepaid expenses and other current assets	70,806	51,306
Total current assets	657,012	558,654
NONCURRENT ASSETS:
Property and equipment, net	121,149	133,198
Operating lease right-of-use asset	68,795	63,502
Intangible assets, net	351,052	385,910
Goodwill	1,428,610	1,425,542
Other noncurrent assets	20,821	22,741
Total noncurrent assets	1,990,427	2,030,893
TOTAL ASSETS	2,647,439	2,589,547
CURRENT LIABILITIES:
Accounts payable	282,913	221,060
Accrued compensation and employee benefits	58,899	45,765
Accrued expenses and other current liabilities	64,075	33,538
Current portion of operating lease liability	18,886	20,391
Current portion of long-term debt	9,250	9,250
Total current liabilities	434,023	330,004
NONCURRENT LIABILITIES:
Long-term debt, net of discount, deferred financing costs and current portion	1,115,103	1,277,246
Operating lease liability, net of current portion	70,776	58,242
Deferred income taxes	3,339	2,143
Other noncurrent liabilities	8,474	15,085
Total noncurrent liabilities	1,197,692	1,352,716
Total liabilities	1,631,715	1,682,720
STOCKHOLDERS’ EQUITY:
Preferred stock; $0.0001 par value; 12,500,000 shares authorized, no shares outstanding as of December 31, 2020 and 2019, respectively.	0	0
Common stock; $0.0001 par value: 250,000,000 shares authorized, 180,178,308 shares issued and 179,794,586 shares outstanding as of December 31, 2020; 176,975,628 shares issued and 176,591,907 shares outstanding as of December 31, 2019.	18	18
Treasury stock; 383,722 shares outstanding, at cost, as of December 31, 2020 and 2019, respectively.	(2,403)	(2,403)
Paid-in capital	1,129,312	1,008,362
Accumulated deficit	(100,031)	(91,955)
Accumulated other comprehensive loss	(11,172)	(7,195)
Total stockholders’ equity	1,015,724	906,827
TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY	$ 2,647,439	$ 2,589,547

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 31, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Preferred stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Preferred stock, shares authorized (in shares)	12,500,000	12,500,000
Preferred stock, shares, outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common stock, shares authorized (in shares)	250,000,000	250,000,000
Common stock, shares, issued (in shares)	180,178,308	176,975,628
Common stock, shares, outstanding (in shares)	179,794,586	176,591,907
Treasury stock, at cost (in shares)	383,722	383,722

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Statement [Abstract]
NET REVENUE	$ 3,032,610	$ 2,310,417	$ 1,939,791
COST OF REVENUE	2,350,346	1,797,418	1,517,576
GROSS PROFIT	682,264	512,999	422,215
OPERATING COSTS AND EXPENSES:
Selling, general and administrative expenses	500,199	459,628	345,884
Depreciation and amortization expense	71,310	53,690	38,062
Total operating expenses	571,509	513,318	383,946
OPERATING INCOME (LOSS)	110,755	(319)	38,269
OTHER INCOME (EXPENSE):
Interest expense, net	(107,770)	(73,724)	(45,824)
Equity in earnings of joint ventures	3,313	2,840	1,020
Other, net	(11,541)	(6,991)	(2,233)
Total other expense	(115,998)	(77,875)	(47,037)
LOSS BEFORE INCOME TAXES	(5,243)	(78,194)	(8,768)
INCOME TAX EXPENSE (BENEFIT)	2,833	(2,274)	(2,653)
NET LOSS	(8,076)	(75,920)	(6,115)
OTHER COMPREHENSIVE (LOSS) INCOME, NET OF TAX:
Change in unrealized (losses) gains on cash flow hedges, net of income taxes of $0, $259 and $234, respectively	(3,977)	(8,039)	774
OTHER COMPREHENSIVE (LOSS) INCOME	(3,977)	(8,039)	774
NET COMPREHENSIVE LOSS	$ (12,053)	$ (83,959)	$ (5,341)
LOSS PER COMMON SHARE
Net loss per share, basic and diluted (in dollars per share)	$ (0.04)	$ (0.49)	$ (0.04)
Weighted average common shares outstanding, basic and diluted (in shares)	180,971	156,280	142,614

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Statement [Abstract]
Income taxes on unrealized gains (losses) on cash flow hedges	$ 0	$ 259	$ 234

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
CASH FLOWS FROM OPERATING ACTIVITIES:
Net loss	$ (8,076)	$ (75,920)	$ (6,115)
Adjustments to reconcile net loss to net cash provided by operations:
Depreciation and amortization expense	77,896	57,869	41,055
Non-cash operating lease costs	18,814	19,719	0
Deferred income taxes - net	1,196	(4,607)	(3,595)
Loss on sale of assets	742	3,269	1,123
Business casualty loss	0	(626)	3,549
Loss on extinguishment of debt	11,545	5,469	72
Amortization of deferred financing costs	5,517	4,544	3,107
Loss on interest rate swaps upon discontinuing hedge accounting	3,746	0	0
Paid-in-kind interest capitalized as principal	7,525	12,256	0
Equity in earnings of joint ventures	(3,313)	(2,840)	(1,020)
Stock-based incentive compensation expense	2,920	4,170	2,139
Interest on management notes receivable	0	(62)	(78)
Capital distribution from equity method investments	3,250	500	2,000
Change in contingent consideration liability	(1,500)	(300)	0
Changes in operating assets and liabilities:
Accounts receivable, net	(3,924)	82,285	(21,012)
Inventories	(42,725)	(12,853)	2,965
Prepaid expenses and other current assets	(19,500)	(2,940)	(4,715)
Accounts payable	59,215	(30,856)	10,965
Accrued compensation and employee benefits	13,134	2,671	(5,586)
Accrued expenses and other current liabilities	22,809	(317)	(1,740)
Operating lease liabilities	(18,089)	(17,253)	0
Other noncurrent assets and liabilities	(3,790)	(4,711)	1,314
Net cash provided by operating activities	127,392	39,467	24,428
CASH FLOWS FROM INVESTING ACTIVITIES:
Acquisition of property and equipment	(26,875)	(28,292)	(26,276)
Proceeds from sale of assets	0	10	0
Insurance proceeds from business casualty loss	0	626	0
Business acquisitions, net of cash acquired	0	(700,170)	(10,727)
Other investing cash flows	541	0	0
Net cash used in investing activities	(26,334)	(727,826)	(37,003)
CASH FLOWS FROM FINANCING ACTIVITIES:
Redemptions to related parties	0	(2,000)	0
Sale of management notes receivable	0	1,310	0
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(904)	(2,501)	0
Net proceeds from issuance of common stock	118,934	0	0
Proceeds from debt	0	981,050	1,000
Repayments of debt principal	(9,250)	(2,075)	(5,150)
Retirement of debt obligations	(174,000)	(226,738)	0
Deferred financing costs	(149)	(30,022)	0
Debt prepayment fees	(3,480)	0	0
Net cash (used in) provided by financing activities	(68,849)	719,024	(4,150)
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS	32,209	30,665	(16,725)
Cash and cash equivalents - beginning of the period	67,056	36,391	53,116
CASH AND CASH EQUIVALENTS - END OF PERIOD	99,265	67,056	36,391
Supplemental disclosure of cash flow information:
Cash paid for interest	97,640	50,808	47,173
Cash paid for income taxes	2,884	2,405	$ 1,600
Cash paid for operating leases	$ 26,809	$ 18,992

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY - USD ($) $ in Thousands	Total	Preferred Stock	Common Stock	Treasury Stock	Paid-in Capital	Management Notes Receivable	Accumulated Deficit	Accumulated Other Comprehensive Income (Loss)
Equity, beginning balance at Dec. 31, 2017	$ 606,105	$ 0	$ 14	$ 0	$ 617,057	$ (1,116)	$ (9,920)	$ 70
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stockholders' contributions	0				425	(425)
Interest on management notes receivable	(78)					(78)
Stock-based incentive compensation	2,139				2,139		0
Net loss	(6,115)						(6,115)
Other comprehensive income (loss)	774							774
Equity, ending balance at Dec. 31, 2018	602,825	0	14	0	619,621	(1,619)	(16,035)	844
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Purchase of BioScrip, Inc.	387,044		4		387,040
Interest on management notes receivable	(62)					(62)
Repayment of management notes receivable	1,310					1,310
Stockholders' redemptions	(2,000)				(2,371)	371
Stock-based incentive compensation	4,170				4,170
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(2,501)			(2,403)	(98)
Net loss	(75,920)						(75,920)
Other comprehensive income (loss)	(8,039)							(8,039)
Equity, ending balance at Dec. 31, 2019	906,827	0	18	(2,403)	1,008,362	0	(91,955)	(7,195)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based incentive compensation	2,920				2,920
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(904)				(904)
Net proceeds from the issuance of common stock	118,934		1		118,933
Cancellation of common stock	0		(1)		1
Net loss	(8,076)						(8,076)
Other comprehensive income (loss)	(3,977)							(3,977)
Equity, ending balance at Dec. 31, 2020	$ 1,015,724	$ 0	$ 18	$ (2,403)	$ 1,129,312	$ 0	$ (100,031)	$ (11,172)

NATURE OF OPERATIONS AND PRESENTATION OF FINANCIAL STATEMENTS	12 Months Ended
	Dec. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of Operations and Presentation of Financial Statements	NATURE OF OPERATIONS AND PRESENTATION OF FINANCIAL STATEMENTS Corporate Organization and Business — HC Group Holdings II, Inc. (“HC II”) was incorporated under the laws of the State of Delaware on January 7, 2015, with its sole shareholder being HC Group Holdings I, LLC. (“HC I”). On April 7, 2015, HC I and HC II collectively acquired Walgreens Infusion Services, Inc. and its subsidiaries from Walgreen Co., and the business was rebranded as Option Care (“Option Care”). On March 14, 2019, HC I and HC II entered into a definitive agreement (the “Merger Agreement”) to merge with and into a wholly-owned subsidiary of BioScrip, Inc. (“BioScrip”), a national provider of infusion and home care management solutions, along with certain other subsidiaries of BioScrip and HC II. The merger contemplated by the Merger Agreement (the “Merger”) was completed on August 6, 2019 (the “Merger Date”). The Merger was accounted for as a reverse merger under the acquisition method of accounting for business combinations with Option Care being considered the accounting acquirer and BioScrip being considered the legal acquirer. Under the terms of the Merger Agreement, shares of HC II common stock issued and outstanding immediately prior to the Merger Date were converted into 135,565,392 shares of BioScrip common stock, par value $0.0001 (the “BioScrip common stock”). BioScrip also issued an additional 7,048,357 shares to HC I in respect of certain outstanding unvested contingent restricted stock units of BioScrip, which were set aside to prevent dilution related to potential additional vesting on certain share-based instruments. See Note 16, Stockholders’ Equity, for additional discussion of these shares set aside. In conjunction with the Merger, holders of BioScrip preferred shares and certain warrants received 864,603 additional shares of BioScrip common stock and preferred shares were repurchased for $125.8 million of cash. In addition, all legacy BioScrip debt was settled for $575.0 million. As a result of the Merger, BioScrip’s stockholders held approximately 19.2% of the combined company, and HC I held approximately 80.8% of the combined company. Following the close of the transaction, BioScrip was rebranded as Option Care Health, Inc. (“Option Care Health”, or the “Company”). The combined company’s stock was listed on the Nasdaq Global Select Market as of December 31, 2020. See Note 3, Business Acquisitions, for further discussion of the Merger. Option Care Health, and its wholly-owned subsidiaries, provides infusion therapy and other ancillary health care services through a national network of 99 full service pharmacies and 46 stand-alone ambulatory infusion sites. The Company contracts with managed care organizations, third-party payers, hospitals, physicians, and other referral sources to provide pharmaceuticals and complex compounded solutions to patients for intravenous delivery in the patients’ homes or other nonhospital settings. The Company operates in one segment, infusion services. Basis of Presentation — The accompanying consolidated financial statements have been prepared in conformity with generally accepted accounting principles (“GAAP”) in the United States. These principals require management to make certain estimates and assumptions in determining assets, liabilities, revenue, expenses, and related disclosures. Actual amounts could differ materially from those estimates. Principles of Consolidation — The Company’s consolidated financial statements include the accounts of Option Care Health, Inc. and its subsidiaries. The BioScrip results have been included in the consolidated financial results since the Merger Date. All intercompany transactions and balances are eliminated in consolidation. The Company has investments in companies that are 50% owned and are accounted for as equity-method investments. The Company’s share of earnings from equity-method investments is included in the line entitled “Equity in earnings of joint ventures” in the consolidated statements of comprehensive income (loss). See “Equity-Method Investments” within Note 2, Summary of Significant Accounting Policies, for further discussion of the Company’s equity-method investments.

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	12 Months Ended
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	Dec. 31, 2020
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Cash and Cash Equivalents — The Company considers all highly liquid investments with original maturities of three months or less to be cash equivalents. Accounts Receivable — The Company’s accounts receivable is reported at the net realizable value amount that reflects the consideration the Company expects to receive in exchange for providing services, which is inclusive of adjustments for price concessions. The majority of accounts receivable are due from private insurance carriers and governmental health care programs, such as Medicare and Medicaid. Price concessions may result from patient hardships, patient uncollectible accounts sent to collection agencies, lack of recovery due to not receiving prior authorization, differing interpretations of covered therapies in payer contracts, different pricing methodologies, or various other reasons. In accordance with Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers (“ASC 606”), an allowance for doubtful accounts is established only as a result of an adverse change in the Company’s payers’ ability to pay outstanding billings. The allowance for doubtful accounts balance is $0 as of December 31, 2020 and 2019, respectively. Included in accounts receivable are earned but unbilled gross receivables of $79.0 million and $68.7 million as of December 31, 2020 and 2019, respectively. Delays ranging from one day up to several weeks between the date of service and billing can occur due to delays in obtaining certain required payer-specific documentation from internal and external sources. See Revenue Recognition for a further discussion of the Company’s revenue recognition policy. Inventory — Inventory, which consists primarily of pharmaceuticals, is stated at the lower of first‑in, first‑out cost or net realizable value basis, which the Company believes is reflective of the physical flow of inventories. During the year ended December 31, 2018, one Company location was destroyed by a hurricane, resulting in a loss of $2.9 million of inventory. This business casualty loss was recorded as a component of operating costs and expenses within the consolidated statements of comprehensive income (loss). The Company received insurance proceeds of $0.8 million during the year ended December 31, 2018, and recorded a receivable of $1.0 million. Both of these amounts were recorded as a partial offset to the business casualty loss in the consolidated statements of comprehensive income (loss). The $0.8 million of insurance proceeds were reflected as a component of cash flows from operating activities in the consolidated statements of cash flows. During the year ended December 31, 2019, $3.0 million in proceeds were received related to recovery of inventory and business interruption and was included as a component of cash flows from operating activities in the consolidated statements of cash flows. These proceeds resulted in a gain on business casualty loss of $2.0 million recorded as a component of selling, general and administrative expense in the consolidated statement of comprehensive income (loss). Prepaid expenses and other current assets — Included in prepaid expenses and other current assets are rebates receivable from pharmaceutical and medical supply manufacturers of $35.2 million and $13.9 million for the years ended December 31, 2020 and 2019, respectively. There were no other items included in prepaid expenses and other current assets that comprised 5% or more of the balance. Leases — The Company has lease agreements for facilities, warehouses, office space and property and equipment. Effective as of January 1, 2019, at the inception of a contract, the Company determines if the contract is a lease or contains an embedded lease arrangement. Operating leases are included in the operating lease right-of-use asset (“ROU asset”) and operating lease liabilities in the consolidated financial statements. ROU assets, which represent the Company’s right to use the leased assets, and operating lease liabilities, which represent the present value of unpaid lease payments, are both recognized by the Company at the lease commencement date. The Company utilizes its estimated incremental borrowing rate at the lease commencement date to determine the present value of unpaid lease obligations. The rates are estimated primarily using a methodology dependent on the Company’s financial condition, creditworthiness, and availability of certain observable data. In particular, the Company considers its actual cost of borrowing for collateralized loans and its credit rating, along with the corporate bond yield curve in estimating its incremental borrowing rates. ROU assets are recorded as the amount of operating lease liability, adjusted for prepayments, accrued lease payments, initial direct costs, lease incentives, and impairment of the ROU asset. Tenant improvement allowances used to fund leasehold improvements are recognized when earned and reduce the related ROU asset. Tenant improvement allowances are recognized through the ROU asset as a reduction of expense over the term of the lease. Leases may contain rent escalations, however the Company recognizes the lease expense on a straight-line basis over the expected lease term. The Company reviews the terms of any lease renewal options to determine if it is reasonably certain that the renewal options will be exercised. The Company has determined that the expected lease term is typically the minimum non-cancelable period of the lease. The Company has lease agreements that contain both lease and non-lease components which the Company has elected to account for as a single lease component for all asset classes. Leases with an initial term of 12 months or less are not recorded on the consolidated balance sheet and are expensed on a straight-line basis over the term of the lease. The Company’s lease agreements do not contain any material residual value guarantees or material restrictive covenants. See Note 8, Leases, for further discussion of leases. Goodwill, Intangible Assets, and Property and Equipment — Goodwill represents the excess of the purchase price over the fair value of assets acquired and liabilities assumed. The Company accounts for goodwill under ASC Topic 350, Intangibles-Goodwill and Other. The Company tests goodwill for impairment annually, or more frequently whenever events or circumstances indicate impairment may exist. Goodwill is stated at cost less accumulated impairment losses. The Company completes its goodwill impairment test annually in the fourth quarter. See Note 10, Goodwill and Other Intangible Assets, for further discussion of the Company’s goodwill and other intangible assets. Intangible assets arising from the Company’s acquisitions are amortized on a straight‑line basis over the estimated useful life of each asset. Referral sources have a useful life of 15-20 years. Trademarks/names have a useful life ranging from two to fifteen years. The useful lives for other amortizable intangible assets range from approximately two to nine years. The Company does not have any indefinite‑lived intangible assets. Property and equipment is recorded at cost, net of accumulated depreciation. Depreciation on owned property and equipment is provided for on a straight‑line basis over the estimated useful lives of owned assets. Leasehold improvements are amortized over the estimated useful life of the property or over the term of the lease, whichever is shorter. Estimated useful lives are seven years for infusion pumps and three years to thirteen years for equipment. Major repairs, which extend the useful life of an asset, are capitalized in the property and equipment accounts. Routine maintenance and repairs are expensed as incurred. Computer software is included in property and equipment and consists of purchased software and internally-developed software. The Company capitalizes application-stage development costs for significant internally-developed software projects. Once the software is ready for its intended use, these costs are amortized on a straight‑line basis over the software’s estimated useful life, generally five years. Costs recognized in the preliminary project phase and the post-implementation phase, as well as maintenance and training costs, are expensed as incurred. The Company tests long‑lived assets for impairment whenever events or circumstances indicate that a certain asset or asset group may be impaired. Once identified, the amount of the impairment is computed by comparing the carrying value of the respective asset or asset group to its fair value, which is based on the discounted estimated future cash flows. Equity-Method Investments — The Company’s investments in certain unconsolidated entities are accounted for under the equity method. The balance of these investments is included in other noncurrent assets in the accompanying consolidated balance sheets. As of December 31, 2020 and 2019, the balance of the investments was $17.0 million and $17.0 million, respectively. The investments are increased to reflect the Company’s capital contributions and equity in earnings of the investees. The investments are decreased to reflect the Company’s equity in losses of the investees and for distributions received that are not in excess of the carrying amount of the investments. The Company’s proportionate share of earnings or losses of the investees is recorded in equity in earnings of joint ventures in the accompanying consolidated statements of comprehensive income (loss). The Company’s proportionate share of earnings was $3.3 million, $2.8 million and $1.0 million for the years ended December 31, 2020, 2019 and 2018, respectively. Distributions from the investees are treated as cash inflows from operating activities in the consolidated statements of cash flows. During the years ended December 31, 2020, 2019 and 2018, the Company received distributions from the investees of $3.3 million, $0.5 million and $2.0 million, respectively. See Footnote 17, Related-Party Transactions, for discussion of related-party transactions with these investees. Hedging Instruments — The Company uses derivative financial instruments to limit its exposure to increases in the interest rate of its variable rate debt instruments. The derivative financial instruments are recognized on the consolidated balance sheets at fair value. See Note 12, Derivative Instruments, for additional information. At inception of the hedge, the Company designated the derivative instruments as a hedge of the cash flows related to the interest on the variable rate debt. For all instruments designated as hedges, the Company documents the hedging relationships and its risk management objective of the hedging relationship. For all hedging instruments, the terms of the hedge perfectly offset the hedged expected cash flows. Revenue Recognition — Net revenue is reported at the net realizable value amount that reflects the consideration the Company expects to receive in exchange for providing services. Revenues are from government payers, commercial payers, and patients for goods and services provided and are based on a gross price based on payer contracts, fee schedules, or other arrangements less any implicit price concessions. Due to the nature of the health care industry and the reimbursement environment in which the Company operates, certain estimates are required to record revenue and accounts receivable at their net realizable values at the time goods or services are provided. Inherent in these estimates is the risk that they will have to be revised or updated as additional information becomes available. The Company assesses the expected consideration to be received at the time of patient acceptance based on the verification of the patient’s insurance coverage, historical information with the patient, similar patients, or the payer. Performance obligations are determined based on the nature of the services provided by the Company. The majority of the Company’s performance obligations are to provide infusion services to deliver medicine, nutrients, or fluids directly into the body. The Company provides a variety of infusion-related therapies to patients, which frequently include multiple deliverables of pharmaceutical drugs and related nursing services. After applying the criteria from ASC 606, the Company concluded that multiple performance obligations exist in its contracts with its customers. Revenue is allocated to each performance obligation based on relative standalone price, determined based on reimbursement rates established in the third-party payer contracts. Pharmaceutical drug revenue is recognized at the time the pharmaceutical drug is delivered to the patient, and nursing revenue is recognized on the date of service. The Company's outstanding performance obligations relate to contracts with a duration of less than one year. Therefore, the Company has elected to apply the practical expedient provided by ASC 606 and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. Any unsatisfied or partially unsatisfied performance obligations at the end of a reporting period are generally completed prior to the patient being discharged. See Note 4, Revenue for a further discussion of revenue. Cost of Revenue — Cost of revenue consists of the actual cost of pharmaceuticals and other medical supplies dispensed to patients, as well as all other costs directly related to the production of revenue. These costs include warehousing costs, purchasing costs, freight costs, cash discounts, wages and related costs for pharmacists and nurses, along with depreciation expense relating to revenue-generating assets, such as infusion pumps. The Company receives prompt payment discounts from some of its pharmaceutical and medical supplies vendors. These prompt payment discounts are recorded as a reduction of inventory and are accounted for as a reduction of cost of goods sold when the related inventory is sold. The Company also receives rebates from pharmaceutical and medical supply manufacturers. Rebates are generally volume-based incentives and are recorded as a reduction of inventory and are accounted for as a reduction of cost of goods sold when the related inventory is sold. Selling, General and Administrative Expenses — Selling, general and administrative expenses mainly consist of salaries for administrative employees that directly and indirectly support the operations, occupancy costs, marketing expenditures, insurance, and professional fees. Stock Based Incentive Compensation - The Company accounts for stock-based incentive compensation expense in accordance with ASC Topic 718, Compensation-Stock Compensation (“ASC 718”). Stock-based incentive compensation expense is based on the grant date fair value. The Company estimates the fair value of stock option awards using a Black-Scholes option pricing model and the fair value of restricted stock unit awards using the closing price of the Company’s common stock on the grant date. For awards with a service-based vesting condition, the Company recognizes expense on a straight-line basis over the service period of the award. For awards with performance-based vesting conditions, the Company will recognize expense when it is probable that the performance-based conditions will be met. When the Company determines that it is probable that the performance-based conditions will be met, a cumulative catch-up of expense will be recorded as if the award had been vesting on a straight-line basis from the award date. The award will continue to be expensed on a straight-line basis through the remainder of the vesting period and will be updated if the Company determines that there has been a change in the probability of achieving the performance-based conditions. The Company records the impact of forfeited awards in the period in which the forfeiture occurs. Prior to the Merger, HCI issued incentive units to certain employees of Option Care, who remained employees of the Company following the Merger. In accordance with ASC 718, the Company recognizes compensation expense on a straight-line basis over the shorter of the vesting period of the award or the employee’s expected eligibility date. HC I also issued equity incentive units to certain members of the Option Care Board of Directors, who remained members of the Board of Directors following the Merger. See Note 15, Stock-Based Incentive Compensation, for a further discussion of equity incentive plans. Business Acquisitions - The Company accounts for business acquisitions in accordance with ASC Topic 805, Business Combinations, with assets and liabilities being recorded at their acquisition date fair value and goodwill being calculated as the purchase price in excess of the net identifiable assets. See Note 3, Business Acquisitions, for further discussion of the Company’s business acquisitions. Income Taxes — The Company accounts for income taxes using the asset and liability method. Deferred tax assets and liabilities are reported for book-tax basis differences and are measured based on currently enacted tax laws using rates expected to apply to taxable income in the years in which the differences are expected to reverse. The effect of a change in tax rate on deferred taxes is recognized in income tax expense in the period that includes the enactment date of the change. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. Valuation allowances are established when necessary to reduce deferred tax assets to the amounts more likely than not to be realized. The Company recognizes income tax positions that are more likely than not to be sustained on their technical merits. The Company measures recognized income tax positions at the maximum benefit that is more likely than not, based on cumulative probability, realizable upon final settlement of the position. Interest and penalties related to unrecognized tax benefits are reported in income tax expense. Concentrations of Business Risk — The Company generates revenue from managed care contracts and other agreements with commercial third-party payers. Revenue related to the Company’s largest payer was approximately 15%, 16% and 17% for the years ended December 31, 2020, 2019 and 2018, respectively. In December 2019, the Company renewed and expanded its multi-year contract with this payer. The contract renewal was effective in February 2020 for a two-year term and auto-renews at the end of that term. There were no other managed care contracts that represent greater than 10% of revenue for the years presented. For the years ended December 31, 2020, 2019 and 2018, approximately 15%, 12% and 12%, respectively, of the Company’s revenue was reimbursable through direct government healthcare programs such as Medicare and Medicaid. As of December 31, 2020 and 2019, approximately 15% and 12%, respectively, of the Company’s accounts receivable was related to these programs. Governmental programs pay for services based on fee schedules and rates that are determined by the related governmental agency. Laws and regulations pertaining to government programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility that recorded estimates will change in the near term. The Company does not require its patients nor other payers to carry collateral for any amounts owed for goods or services provided. Other than as discussed above, concentrations of credit risk relating to trade accounts receivable is limited due to the Company’s diversity of patients and payers. Further, the Company generally does not provide charity care. For the years ended December 31, 2020 and 2019, approximately 70% and 70%, respectively, of the Company’s pharmaceutical and medical supply purchases were from three vendors. For the year ended December 31, 2018, approximately 66% of the Company’s pharmaceutical and medical supply purchases were from two vendors. Although there are a limited number of suppliers, the Company believes that other vendors could provide similar products on comparable terms. However, a change in suppliers could cause delays in service delivery and possible losses in revenue, which could adversely affect the Company’s financial condition or operating results. Although there is uncertainty regarding the COVID-19 pandemic, as of December 31, 2020 the Company has been able to maintain adequate levels of supplies and pharmaceuticals to support its operations. Fair Value Measurements — The fair value measurement accounting standard, ASC Topic 820, Fair Value Measurement (“ASC 820”), provides a framework for measuring fair value and defines fair value as the price that would be received to sell an asset or paid to transfer a liability. Fair value is a market-based measurement that should be determined using assumptions that market participants would use in pricing an asset or liability. The standard establishes a valuation hierarchy for inputs used in measuring fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs by requiring that the most observable inputs be used when available. Observable inputs are inputs market participants would use in valuing the asset or liability developed based on independent market data sources. Unobservable inputs are inputs that reflect the Company’s assumptions about the factors market participants would use in valuing the asset or liability developed based upon the best information available. The valuation hierarchy is composed of three categories. The categorization within the valuation hierarchy is based on the lowest level of input that is significant to the fair value measurement. The categories within the valuation hierarchy are described as follows: •Level 1 - Inputs to the fair value measurement are quoted prices in active markets for identical assets or liabilities. •Level 2 - Inputs to the fair value measurement include quoted prices in active markets for similar assets or liabilities, quoted prices for identical or similar assets or liabilities in markets that are not active, and inputs other than quoted prices that are observable for the asset or liability, either directly or indirectly. •Level 3 - Inputs to the fair value measurement are unobservable inputs or valuation techniques. While the Company believes its valuation methods are appropriate and consistent with other market participants, the use of different methodologies or assumptions to determine the fair value of certain financial instruments could result in a different fair value measurement at the reporting date. Recently-Adopted Accounting Pronouncements — In June 2016, the FASB issued ASU 2016-13, Financial Instruments — Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, which requires measurement and recognition of expected credit losses for financial assets held. The amendments in ASU 2016-13 eliminate the probable threshold for initial recognition of a credit loss in current GAAP and reflect an entity’s current estimate of all expected credit losses. ASU 2016-13 is effective for interim and annual reporting periods beginning after December 15, 2019 and is to be applied using a modified retrospective transition method. The Company adopted the standard as of January 1, 2020. The adoption of this standard did not have a material impact on the Company’s consolidated financial statements.

BUSINESS ACQUISITIONS

12 Months Ended

Dec. 31, 2020

Business Combinations [Abstract]

Business Acquisitions

BUSINESS ACQUISITIONS

Merger with BioScrip, Inc. — As discussed in Note 1, Nature of Operations and Presentation of Financial Statements, Option Care merged with BioScrip on August 6, 2019. BioScrip was a national provider of infusion and home care management solutions. The Merger of Option Care and BioScrip into Option Care Health created an expanded national platform and the opportunity to drive economies of scale through procurement savings, facility rationalization and other operating cost savings.

The fair value of purchase consideration transferred on the closing date includes the value of the number of shares of the combined company owned by BioScrip shareholders at closing of the Merger, the value of common shares issued to certain warrant and preferred shareholders in conjunction with the Merger, the fair value of stock-based instruments that were vested or earned as of the Merger, and cash payments made in conjunction with the Merger. The fair value per share of BioScrip’s common stock was $2.67 per share. This is the closing price of the BioScrip common stock on August 6, 2019.

Under the acquisition method of accounting, the calculation of total consideration exchanged is as follows (in thousands):


	Amount
Number of BioScrip common shares outstanding at time of the Merger (1)	129,181
Common shares issued to warrant and preferred stockholders at time of the Merger (1)	3,458
Total shares of BioScrip common stock outstanding at time of the Merger (1)	132,639
BioScrip share price as of August 6, 2019	$	2.67
Fair value of common shares	$	354,146
Fair value of share-based instruments	$	32,898
Cash paid in conjunction with the Merger included in purchase consideration	$	714,957
Fair value of total consideration transferred	$	1,102,001
Less: cash acquired	$	14,787
Fair value of total consideration acquired, net of cash acquired	$	1,087,214

(1) These shares were not adjusted for the one share for four share reverse stock split, which occurred on February 3, 2020.

Cash paid in conjunction with the Merger includes payments made for settlement of $575.0 million in legacy BioScrip debt, $125.8 million in existing BioScrip preferred shares, and $14.1 million in legacy BioScrip success-based fees owed to third-party advisors. HC II financed these payments primarily through cash on hand and debt financing, which is discussed in Note 11, Indebtedness.

The Company’s allocation of consideration exchanged to the net tangible and intangible assets acquired and liabilities assumed, net of cash acquired, in the Merger is as follows (in thousands):


	Amount
Accounts receivable, net (1)	$	96,532
Inventories (2)	19,683
Property and equipment, net (3)	48,732
Intangible assets, net (4)	193,245
Deferred tax assets, net of deferred tax liabilities (5)	26,731
Operating lease right-of-use asset (6)	22,378
Operating lease liability (6)	(28,897)
Accounts payable (7)	(66,668)
Other assumed liabilities, net of other acquired assets (7)	(20,663)
Total acquired identifiable assets and liabilities	291,073
Goodwill (8)	796,141
Total consideration transferred	$	1,087,214

(1)Management has valued accounts receivables based on the estimated future collectability of the receivables portfolio.

(2)Inventories are stated at fair value as of the Merger Date.

(3)The fair value of the property and equipment was determined based upon the best and highest use of the property with final values determined based upon an analysis of the cost, sales comparison, and income capitalization approaches for each property appraised.

(4)The allocation of consideration exchanged to intangible assets acquired is as follows (in thousands):


	Fair Value		Weighted Average Estimated Life (in years)
Trademarks/Names	$	12,536	2
Patient referral sources	180,329		20
Licenses	380		1.5
Total intangible assets, net	$	193,245	18.8

The Company valued trademarks/names utilizing the relief of royalty method and patient referral sources utilizing the multi-period excess earnings method, a form of the income approach.

(5)Net deferred tax assets represented the expected future tax consequences of temporary differences between the fair values of the assets acquired and liabilities assumed and their tax bases. See Note 6, Income Taxes, for additional discussion of the Company’s combined income tax position subsequent to the Merger.

(6)The fair value of the operating lease liability and corresponding right-of-use asset (current and long-term) was based on current market rates available to the Company.

(7)Accounts payable as well as certain other current and non-current assets and liabilities are stated at fair value as of the Merger Date.

(8)The Merger resulted in $796.1 million of goodwill, which is attributable to cost synergies resulting from procurement and operational efficiencies and elimination of duplicative administrative costs. The goodwill created in the Merger is not expected to be deductible for tax purposes.

Assuming BioScrip had been acquired as of January 1, 2018, and the results of BioScrip had been included in operations beginning on January 1, 2018, the following tables provide estimated unaudited pro forma results of operations for the years ended December 31, 2019 and 2018 (in thousands). The estimated pro forma net income adjusts for the effect of fair value adjustments related to the Merger, transaction costs and other non-recurring costs directly attributable to the Merger and the impact of the additional debt to finance the Merger.


	Year Ended December 31,
	2019		2018
Net revenue	$	2,755,361	$	2,648,694
Net loss	(49,566)		(70,932)

Estimated unaudited pro forma information is not necessarily indicative of the results that actually would have occurred had the Merger been completed on the date indicated or the future operating results.

For the periods subsequent to the Merger Date that are included in the results of operations for the year ended December 31, 2019, BioScrip had net revenue of $308.9 million and a net loss of $30.1 million.

Acquisition-related costs were expensed as incurred, with the exception of BioScrip success-based fees that are included in consideration transferred. The Company recorded transaction costs that are expensed in selling, general and administrative expenses during the year ended December 31, 2019 of approximately $25.8 million. Transaction expenses consisted of professional fees for advisory, consulting and underwriting services as well as other incremental costs directly related to the acquisition.

Baptist Health Asset Acquisition — In August 2018, pursuant to the Purchase and Sale Agreement dated August 8, 2018, Option Care completed the acquisition of certain assets of Baptist Health in Little Rock, Arkansas for a purchase price of $1.0 million.

Home I.V. Specialists, Inc. Acquisition — In September 2018, pursuant to the Stock Purchase Agreement dated September 18, 2018, Option Care completed the acquisition of 100% of the outstanding shares of Home I.V. Specialists, Inc. (“Home I.V.”) for a purchase price of $11.6 million, net of cash acquired. The total consideration was comprised of cash paid of $9.8 million and a contingent payment of $1.8 million payable one year after the acquisition date. During the year ended December 31, 2019, the Company reduced the contingent liability by $0.3 million. During the year ended December 31, 2020, the Company determined that the contingent payment was not payable and reduced the remaining contingent liability by $1.5 million.

REVENUE

12 Months Ended

Dec. 31, 2020

Revenue from Contract with Customer [Abstract]

Revenue

REVENUE

The following table sets forth the net revenue earned by category of payer for the years ended December 31, 2020, 2019 and 2018 (in thousands):


	Year Ended December 31,
	2020		2019		2018
Commercial payers	$	2,542,985	$	2,001,105	$	1,699,450
Government payers	450,067		285,128		217,876
Patients	39,558		24,184		22,465
Net revenue	$	3,032,610	$	2,310,417	$	1,939,791

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-URI http://asc.fasb.org/topic&trid=49130388

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 10
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130551-203045

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130556-203045

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 9
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130550-203045

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (e)
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (d)
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 15
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130558-203045

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045

+ Details

EMPLOYEE BENEFIT PLANS	12 Months Ended
EMPLOYEE BENEFIT PLANS	Dec. 31, 2020
Retirement Benefits [Abstract]
Employee Benefit Plans	EMPLOYEE BENEFIT PLANSThe Company maintains a 401(k) plan and matches 100% of employee contributions, up to 4% of employee compensation. The Company recorded expense for the defined contribution plan of $9.7 million, $6.4 million and $6.3 million for the years ended December 31, 2020, 2019 and 2018, respectively. In the years ended December 31, 2020, 2019 and 2018, Company contributions of $8.9 million, $6.6 million and $6.3 million, respectively, were paid.

INCOME TAXES

12 Months Ended

Dec. 31, 2020

Income Tax Disclosure [Abstract]

Income Taxes

INCOME TAXES

The income tax expense (benefit) consists of the following for the years ended December 31, 2020, 2019 and 2018 (in thousands):


	2020		2019		2018
US federal income tax expense (benefit):
Current	$	(69)	$	—	$	—
Deferred	996		(3,072)		(2,688)
	927		(3,072)		(2,688)
State income tax expense (benefit):
Current	1,707		2,074		1,176
Deferred	199		(1,276)		(1,141)
	1,906		798		35
Total income tax expense (benefit)	$	2,833	$	(2,274)	$	(2,653)

The difference between the statutory federal income tax rate and the effective tax rate is as follows for the years ended December 31, 2020, 2019 and 2018:


	2020		2019		2018
US federal statutory tax rate	21.0	%	21.0	%	21.0	%
State and local income taxes net of federal tax benefit	(29.5)		(0.5)		2.4
Valuation allowance	(29.9)		(13.4)		0.0
Stock-based compensation	6.7		0.0		0.0
Non-deductible compensation	(16.3)		(0.7)		0.0
Changes in uncertain tax positions	0.0		0.0		14.7
Non-deductible expenses	(8.2)		(2.8)		(7.5)
Other, net	2.2		(0.7)		(0.3)
Effective income tax rate	(54.0)	%	2.9	%	30.3	%

The components of deferred income tax assets and liabilities using the 21% U.S. Federal statutory tax rate were as follows as of December 31, 2020 and 2019 (in thousands):


	2020		2019
Deferred tax assets:
Price concessions	$	6,907	$	12,302
Compensation and benefits	4,058		3,672
Interest limitation carryforward	39,094		38,623
Operating lease liability	22,644		19,462
Net operating losses	155,922		147,749
Other	8,682		5,506
Deferred tax assets before valuation allowance	237,307		227,314
Valuation allowance	(112,085)		(109,531)
Deferred tax assets net of valuation allowance	125,222		117,783

Deferred tax liabilities:
Accelerated depreciation	(12,593)		(10,376)
Operating lease right-of-use asset	(17,186)		(15,442)
Intangible assets	(67,127)		(71,204)
Goodwill	(28,976)		(20,250)
Other	(2,679)		(2,654)
Deferred tax liabilities	(128,561)		(119,926)
Net deferred tax liabilities	$	(3,339)	$	(2,143)

As a result of the Merger, the Company recorded a full valuation allowance against all of its net U.S. federal and state deferred tax assets except for certain state net operating losses (“NOL”) which were estimated to be $0.4 million as of December 31, 2020. The initial recognition of this valuation allowance by the Company was reflected in the opening balance sheet of BioScrip and, to that extent, did not impact the Company’s tax expense (benefit) for the years ended December 31, 2020 and 2019. The valuation allowance for deferred tax assets as of December 31, 2020 was $112.1 million.

In assessing the realizability of deferred tax assets, the Company considers whether it is more likely than not that some or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets depends on the generation of future taxable income during the periods in which those temporary differences are deductible. The Company considers the scheduled reversal of deferred tax liabilities (including the effect in available carryback and carryforward periods), projected taxable income, and tax-planning strategies in making this assessment. On a quarterly basis, the Company evaluates the positive and negative evidence in determining if the valuation allowance is fairly stated.

The Company is subject to taxation in the United States and various states. As a result of the Merger, BioScrip carried over $458.9 million of federal net operating losses, $479.6 million of state net operating losses, and $85.0 million of interest limitation carryforwards. At December 31, 2020, the Company had $577.9 million of gross federal NOL carryforwards of which $438.1 million are available to offset future taxable income in the United States. These NOL’s will begin to expire in 2026 if not utilized. The remaining gross federal NOL’s of $139.8 million at December 31, 2020 are expected to expire unutilized due to limitations under Internal Revenue Code Section 382. At December 31, 2019, the Company had $548.0 million of gross federal NOL’s. At December 31, 2020 and 2019, the Company had $154.8 million and $145.6 million of interest limitation carryforwards. At December 31, 2020 and 2019, the Company also had $600.1 million and $578.5 million of cumulative gross state NOL carryforwards available to offset future taxable income in various states. These state NOL’s will begin to expire starting in 2021 if not utilized.

At December 31, 2020 and 2019, the unrecognized tax benefits for uncertain tax positions was $0.

The following table presents the valuation allowance for deferred tax assets for the years ended December 31, 2020, 2019 and 2018 (in thousands):


			Additions
Description	Balance at Beginning of Period		Charged (Benefit) to Costs and Expenses		Charged to Other Accounts		Balance at End Period

2018: Valuation allowance for deferred tax assets	$	1,263	$	110	$	—	$	1,373

2019: Valuation allowance for deferred tax assets	$	1,373	$	15,395	$	92,763	$	109,531

2020: Valuation allowance for deferred tax assets	$	109,531	$	1,549	$	1,005	$	112,085

Currently, the Company is not subject to any U.S. Federal income tax audits. The Company is subject to various state tax audits, and believes that the outcome of these audits will not have a material impact on the Company.

The Company recorded no income tax expense or benefit for the year ended December 31, 2020 associated with the tax provisions of the Coronavirus Aid, Relief and Economic Security Act (“CARES Act”). However, certain adjustments were made to the Company’s components of deferred tax assets and liabilities to reflect the tax provisions of the CARES Act. These adjustments were the result of the CARES Act’s tax provisions associated with interest expense limitations and bonus depreciation on leasehold improvements. These adjustments to the Company’s components of deferred tax assets and liabilities were offset by one another or the Company’s valuation allowance.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References + Details

(LOSS) EARNINGS PER SHARE

12 Months Ended

Dec. 31, 2020

Earnings Per Share [Abstract]

(Loss) Earnings Per Share

(LOSS) EARNINGS PER SHARE

The Company presents basic and diluted (loss) earnings per share for its common stock. Basic (loss) earnings per share is calculated by dividing the net (loss) income of the Company by the weighted average number of shares of common stock outstanding during the period. Diluted (loss) earnings per share is determined by adjusting the profit or loss and the weighted average number of shares of common stock outstanding for the effects of all dilutive potential common shares.

As a result of the Merger, all historical per share data and number of shares and equity awards were retroactively adjusted. The (loss) earnings is used as the basis of determining whether the inclusion of common stock equivalents would be anti-dilutive. Accordingly, the computation of diluted shares for the years ended December 31, 2020 and 2019 excludes the effect of shares that would be issued in connection with warrants, stock options and restricted stock awards, as their inclusion would be anti-dilutive to the loss per share. As of December 31, 2020 there were 2,285,784 warrants, 412,831 stock options and 549,650 restricted stock awards outstanding that were excluded from the calculation as they would be anti-dilutive. As of December 31, 2019 there were 2,328,120 warrants, 644,975 stock options and 231,562 restricted stock awards outstanding that were excluded from the calculation as they were anti-dilutive. There were no dilutive potential common shares for the years ended December 31, 2018.

The following table presents the Company’s basic and diluted (loss) earnings per share and shares outstanding (in thousands, except per share data):


	Year Ended December 31,
	2020		2019		2018
Numerator:
Net loss	$	(8,076)	$	(75,920)	$	(6,115)
Denominator:
Weighted average number of common shares outstanding	180,971		156,280		142,614
Loss per Common Share:
Loss per common share, basic and diluted	$	(0.04)	$	(0.49)	$	(0.04)

LEASES

12 Months Ended

Dec. 31, 2020

Leases [Abstract]

Leases

LEASES

On January 1, 2018, the Company adopted ASC 842, Leases, using an optional transition method that permitted application of the standards as of the effective date without requiring the standard to be applied to the comparative periods presented in the consolidated financial statements. The Company elected the transition package of three practical expedients, which allowed the Company not to reassess prior conclusions about lease identification, lease classification and initial, direct costs. The Company did not elect the practical expedient to use hindsight and accordingly, the initial lease term did not differ under the new standards versus prior accounting practice.

During the years ended December 31, 2020 and 2019, the Company incurred operating lease expenses of $30.8 million and $25.8 million including short-term lease expenses, which were included as a component of selling, general and administrative expenses in the consolidated statements of comprehensive income (loss). As of December 31, 2020, the weighted-average remaining lease term was 6.7 years and the weighted-average discount rate was 5.18%.

Operating leases mature as follows (in thousands):


Year Ending December 31	Minimum Payments
2021	$	23,770
2022	19,216
2023	15,804
2024	11,684
2025	9,369
2026 and beyond	30,168
Total lease payments	110,011
Less: Interest	(20,349)
Present value of lease liabilities	$	89,662

During the year ended December 31, 2020, the Company commenced new leases, extensions and amendments, resulting in non-cash investing and financing activities in the consolidated statements of cash flows of $29.1 million related to the increases in the operating lease right-of-use asset and operating lease liabilities, respectively. During the year ended December 31, 2019, the Company did not enter into any significant new operating or financing leases. As of December 31, 2020, the Company did not have any significant operating or financing leases that had not yet commenced.

During the year ended December 31, 2018, the Company incurred rent expense of $17.3 million, under ASC Topic 840, Leases, which was included as a component of selling, general and administrative expenses in the consolidated statements of comprehensive income (loss).

Leases

LEASES

Operating leases mature as follows (in thousands):


Year Ending December 31	Minimum Payments
2021	$	23,770
2022	19,216
2023	15,804
2024	11,684
2025	9,369
2026 and beyond	30,168
Total lease payments	110,011
Less: Interest	(20,349)
Present value of lease liabilities	$	89,662

PROPERTY AND EQUIPMENT

12 Months Ended

Dec. 31, 2020

Property, Plant and Equipment [Abstract]

Property and Equipment

PROPERTY AND EQUIPMENT

Property and equipment was as follows as of December 31, 2020 and 2019 (in thousands):


	December 31, 2020		December 31, 2019
Infusion pumps	$	31,678	$	30,416
Equipment, furniture and other	47,886		51,454
Leasehold improvements	87,483		80,916
Computer software, purchased and internally developed	27,799		34,884
Assets under development	10,793		14,150
	205,639		211,820
Less: accumulated depreciation	84,490		78,622
Property and equipment, net	$	121,149	$	133,198

Depreciation expense is recorded within cost of revenue and operating expenses within the consolidated statements of comprehensive income (loss), depending on the nature of the underlying fixed assets. The depreciation expense included in cost of revenue relates to revenue-generating assets, such as infusion pumps. The depreciation expense included in operating expenses is related to infrastructure items, such as furniture, computer and office equipment, and leasehold improvements. The following table presents the amount of depreciation expense recorded in cost of revenue and operating expenses for the years ended December 31, 2020, 2019 and 2018 (in thousands):


	Year ended December 31,
	2020		2019		2018
Depreciation expense in cost of revenue	$	6,586	$	4,179	$	2,993
Depreciation expense in operating expenses	36,180		27,629		18,490
Total depreciation expense	$	42,766	$	31,808	$	21,483

During the year ended December 31, 2018, one company location was destroyed by a hurricane, resulting in a loss of $0.6 million of property and equipment. A business casualty loss was recorded as a component of operating costs and expenses within the consolidated statements of comprehensive income (loss). During the year ended December 31, 2019, $0.6 million in proceeds were received related to recovery of property and equipment. These proceeds resulted in a gain on business casualty loss of $0.6 million recorded as a component of selling, general, and administrative expenses in the consolidated statements of comprehensive income (loss) during the year ended December 31, 2019. These proceeds were reflected as a component of cash flows from investing activities in the consolidated statement of cash flows.

GOODWILL AND OTHER INTANGIBLE ASSETS

12 Months Ended

Dec. 31, 2020

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Other Intangible Assets

GOODWILL AND OTHER INTANGIBLE ASSETS

Goodwill is not amortized, but is evaluated for impairment annually in the fourth quarter of the fiscal year, or more frequently if an event occurs or circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying value.

Circumstances that could trigger an interim impairment test include: a significant adverse change in the business climate or legal factors; an adverse action or assessment by a regulator; unanticipated competition; the loss of key personnel; a change in reporting units; the likelihood that a reporting unit or significant portion of a reporting unit will be sold or otherwise disposed of; and the results of testing for recoverability of a significant asset group within a reporting unit.

A qualitative impairment analysis was performed in the fourth quarter of 2020 and 2019 to assess whether it is more likely than not that the fair value of the Company’s reporting unit is less than its carrying value. The Company assessed relevant events and circumstances including macroeconomic conditions, industry and market considerations, overall financial performance, entity-specific events, and changes in the Company’s stock price. The Company determined that there was no goodwill impairment in 2020 or 2019.

A quantitative impairment analysis was performed in the fourth quarter of 2018, and the Company estimated the fair value of its reporting unit using an income approach. The income approach requires management to estimate a number of factors for its reporting unit, including projected future operating results, economic projections, anticipated future cash flows, and discount rates. The fair value determined using the income approach was then compared to marketplace fair value data from within a comparable industry grouping for reasonableness. The Company determined that there was no goodwill impairment in 2018.

The determination of fair value and the allocation of that value to individual assets and liabilities within the reporting unit requires the Company to make significant estimates and assumptions. These estimates and assumptions primarily include, but are not limited to, the selection of appropriate peer group companies; control premiums appropriate for acquisitions in the industries in which the Company competes; the discount rate; terminal growth rates; and forecasts of revenue, operating income, depreciation and amortization, and capital expenditures. Actual financial results could differ from those estimates due to the inherent uncertainty involved in making such estimates. Changes in assumptions concerning future financial results or other underlying assumptions could have a significant impact on either the fair value of the reporting unit, the amount of the goodwill impairment charge, or both.

Changes in the carrying amount of goodwill consist of the following activity for the years ended December 31, 2020, 2019 and 2018 (in thousands):


Balance at December 31, 2017	$	627,392
Acquisitions	5,077
Balance at December 31, 2018	$	632,469
Acquisitions	793,073
Balance at December 31, 2019	$	1,425,542
Purchase accounting adjustments	3,068
Balance at December 31, 2020	$	1,428,610

The carrying amount and accumulated amortization of intangible assets consists of the following as of December 31, 2020 and 2019 (in thousands):


	December 31, 2020		December 31, 2019
Gross intangible assets:
Referral sources	$	438,121	$	438,121
Trademarks/names	44,536		44,536
Other amortizable intangible assets	402		402
Total gross intangible assets	483,059		483,059

Accumulated amortization:
Referral sources	(110,498)		(84,295)
Trademarks/names	(21,146)		(12,748)
Other amortizable intangible assets	(363)		(106)
Total accumulated amortization	(132,007)		(97,149)
Total intangible assets, net	$	351,052	$	385,910

Amortization expense for intangible assets was $35.1 million, $26.1 million and $19.6 million for the years ended December 31, 2020, 2019 and 2018, respectively.

Expected future amortization expense for intangible assets recorded at December 31, 2020, is as follows (in thousands):


2021	$	32,015
2022	28,338
2023	28,338
2024	28,338
2025	28,338
2026 and beyond	205,685
Total	$	351,052

INDEBTEDNESS

12 Months Ended

Dec. 31, 2020

Debt Disclosure [Abstract]

Indebtedness

INDEBTEDNESS

Long-term debt consisted of the following as of December 31, 2020 (in thousands):


	Principal Amount		Discount		Debt Issuance Costs		Net Balance
ABL Facility	$	—	$	—	$	—	$	—
First Lien Term Loan	915,750		(7,253)		(19,710)		888,787
Second Lien Notes	245,781		(6,102)		(4,113)		235,566
	$	1,161,531	$	(13,355)	$	(23,823)	1,124,353
Less: current portion							(9,250)
Total long-term debt							$	1,115,103

Long-term debt consisted of the following as of December 31, 2019 (in thousands):


	Principal Amount		Discount		Debt Issuance Costs		Net Balance
ABL Facility	$	—	$	—	$	—	$	—
First Lien Term Loan	925,000		(8,399)		(22,825)		893,776
Second Lien Notes	412,256		(11,672)		(7,864)		392,720
	$	1,337,256	$	(20,071)	$	(30,689)	1,286,496
Less: current portion							(9,250)
Total long-term debt							$	1,277,246

Retired Debt Obligations — Prior to the Merger, the Company had two credit arrangements that provided for up to $645.0 million in senior secured credit facilities through an $80.0 million revolving credit facility (the “Previous Revolving Credit Facility”), a $415.0 million first lien term loan (the “Previous First Lien Term Loan”), and a $150.0 million second lien term loan (the “Previous Second Lien Term Loan”, and together with the Previous First Lien Term Loan, the “Previous Term Loans”, and the Previous Term Loans, together with the Previous Revolving Credit Facility, the “Previous Credit Facilities”). The principal balance on the Previous First Lien Term Loan was repayable in quarterly installments of $1.0 million.

On August 6, 2019, the Company repaid the outstanding balance of Previous Term Loans and retired the outstanding Previous Credit Facilities by entering into two new credit arrangements and a notes indenture, described below under “New Debt Obligations”. The weighted average interest rate paid on the Previous First Lien Term Loan was 6.20% for the year ended December 31, 2019, prior to the retirement of the debt obligations. The weighted average interest paid on the Previous Second Lien Term Loan was 11.36% for the year ended December 31, 2019, prior to the retirement of the debt obligations.

New Debt Obligations — In conjunction with the Merger, the Company entered into an asset-based-lending revolving credit facility administered by Bank of America, N.A. The Company also issued senior secured second lien PIK toggle floating rate notes due 2027 (the “Second Lien Notes”) under an indenture with Ankura Trust Company, LLC. The two new credit agreements and the indenture were entered into on August 6, 2019 and initially provided for up to $1,475.0 million in senior secured credit facilities through a $150.0 million asset-based-lending revolving credit facility (the “ABL Facility”), a $925.0 million first lien term loan (the “First Lien Term Loan”, and together with the ABL Facility, the “Loan Facilities”), and a $400.0 million issuance of Second Lien Notes.

The ABL Facility initially provided for borrowings up to $150.0 million, which matures on August 6, 2024. During the year ended December 31, 2020, the Company increased the borrowing capacity of its ABL Facility from $150.0 million to $175.0 million. The ABL Facility bears interest at a per annum rate initially provided that is determined by the Company’s periodic selection of rate type, either the Base Rate or the Eurocurrency Rate. Interest on the ABL Facility is charged on Base Rate loans at the greater of Base Rate, as defined, or 0.25% plus 1.25% to 1.75%, depending on the historical excess availability as a percentage of the Line Cap, as defined in the ABL Facility credit agreement. Interest on the ABL Facility is charged on Eurocurrency Rate Loans at the Eurocurrency Rate, as defined, plus 2.25% to 2.75%, depending on the historical excess availability as a percentage of the Line Cap, as defined in the ABL Facility credit agreement. The ABL Facility contains commitment fees payable on the unused portion ranging from 0.25% to 0.375%, depending on various factors including the Company’s leverage ratio, type of loan and rate type, and letter of credit fees of 2.50%. Borrowings under the ABL Facility are secured by a first priority security interest in the Company’s and each of its subsidiaries’ inventory, accounts receivable, cash, deposit accounts and certain assets and property related thereto (the “ABL Priority Collateral”), in each case subject to certain exceptions, and a third priority security interest in the Term Loan Priority Collateral, as defined below. The Company had no outstanding borrowings under the ABL Facility at December 31, 2020 and 2019. The Company had $9.6 million of undrawn letters of credit issued and outstanding, resulting in net borrowing availability under the ABL of $165.4 million as of December 31, 2020.

The principal balance of the First Lien Term Loan is repayable in quarterly installments which commenced in March 2020 of $2.3 million plus interest, with a final payment of all remaining outstanding principal due on August 6, 2026. Interest on the First Lien Term Loan is payable monthly on Base Rate loans at Base Rate, as defined, plus 3.25% to 3.50%, depending on the Company’s leverage ratio. Interest is charged on Eurocurrency Rate loans at the Eurocurrency Rate, as defined, plus 4.25% to 4.50%, depending on the Company’s leverage ratio. The interest rate on the First Lien Term Loan was 4.40% and 6.20% as of December 31, 2020 and 2019, respectively. The weighted average interest rate incurred was 5.09% for the year ended December 31, 2020. The weighted average interest rate incurred was 6.47% for the period August 6, 2019 through December 31, 2019. Amounts borrowed under the First Lien Term Loan are secured by a first priority security interest in each of the Company’s subsidiaries’ capital stock (subject to certain exceptions) and substantially all of the Company’s property and assets (other than the ABL Priority Collateral), (the “Term Loan Priority Collateral”), in each case subject to certain exceptions, and a second priority security interest in the ABL Priority Collateral.

The Second Lien Notes mature on August 6, 2027. Interest on the Second Lien Notes is payable quarterly and is at London Interbank Offered Rate (“LIBOR”), plus 8.75%. The Company elected to pay-in-kind (“PIK”) the first quarterly interest payment, due in November 2019, which resulted in the Company capitalizing $12.3 million in interest to the principal balance on the interest payment date. The Company also elected to PIK the quarterly interest payment due in August 2020, which resulted in the Company capitalizing $7.5 million in interest expense to the principal balance of the Second Lien Notes on the interest payment date. In connection with the PIK elections, the Company was charged an additional 1.00% in interest expense on those quarterly interest payments. The interest rate on the Second Lien Notes was 8.98% and 10.66% as of December 31, 2020 and 2019. The weighted average interest incurred was 9.39% for the year ended December 31, 2020. The weighted average interest incurred was 11.45% for the period August 6, 2019 through December 31, 2019.

During the year ended December 31, 2020, the Company completed a public offering of stock for proceeds of $118.9 million. Those proceeds, along with additional cash on hand, were used to prepay $174.0 million of the Second Lien Notes, which is reflected as a cash outflow from financing activities in the Company’s consolidated statements of cash flows. The Company recognized a loss on extinguishment of debt of $11.5 million, of which $3.5 million related to the prepayment penalty and $8.0 million related to deferred financing fees which were written off upon extinguishment. The $3.5 million prepayment penalty was reflected as a cash outflow from financing activities in the Company’s consolidated statements of cash flows. The loss on extinguishment was recorded as a component of other, net in the Company’s consolidated statements of comprehensive income (loss). See Note 16, Stockholders’ Equity, for further discussion of the public offering.

During the year ended December 31, 2019, the Company assessed whether the repayment of the Previous Term Loans and subsequent issuance of the First Lien Term Loan and the Second Lien Notes resulted in an insubstantial modification or an extinguishment of the existing debt for each loan in the syndication by grouping lenders as follows: (i) Lenders participating in both the Previous Credit Facilities and the new Loan Facilities and Second Lien Notes; (ii) previous lenders that exited; and (iii) new lenders. The Company determined that $226.7 million of the Previous First Lien Term Loan was extinguished and none of the Previous Second Lien Term Loan was extinguished, which is disclosed as an outflow from financing activities in the consolidated statements of cash flows. The Company determined that $752.4 million of new debt was issued related to the First Lien Term Loan and $250.0 million of new debt was issued related to the Second Lien Notes, which is disclosed as an inflow from financing activities in the consolidated statements of cash flows. In connection with the issuance of the First Lien Term Loan, the Second Lien Notes, and the ABL Facility, the Company incurred $52.6 million in debt issuance costs and third-party fees, of which $48.1 million was capitalized, $1.3 million was expensed as a component of other expense and $3.2 million was expensed as a loss on extinguishment as a component of other expense. Further, $21.3 million of the total fees incurred of $52.6 million was netted against the $981.1 million of proceeds from debt as a component of the cash flows from financing activities, $30.0 million was presented as deferred financing costs as a component of cash flows from financing activities, and the remaining $1.3 million was included in cash flows from operating activities.

During the year ended December 31, 2019, the Company recognized a loss on extinguishment of debt of $5.5 million, of which $3.2 million related to debt issue costs incurred with the issuance of the Loan Facilities and Second Lien Notes, as discussed above, and $2.3 million related to deferred financing fees on the Previous Credit Facilities, which were written off upon extinguishment. All remaining deferred financing fees related to the Previous Credit Facilities of $7.6 million were attributed to modified loans, which are capitalized and will be amortized over the remaining term of the Loan Facilities and Second Lien Notes.

Long-term debt matures as follows (in thousands):


Year Ending December 31,	Minimum Payments
2021	$	9,250
2022	9,250
2023	9,250
2024	9,250
2025	9,250
2026 and beyond	1,115,281
Total	$	1,161,531

In January 2021, the Company entered into an amendment on the First Lien Term Loan, which resulted in an additional $250.0 million of incremental First Lien Term Loan indebtedness being issued, which was used to prepay the remaining $245.8 million outstanding balance of the Second Lien Notes. See Note 19, Subsequent Events, for further discussion.

During the year ended December 31, 2020, the Company engaged in hedging activities to limit its exposure to changes in interest rates. See Note 12, Derivative Instruments, for further discussion.

The following table presents the estimated fair values of the Company’s debt obligations as of December 31, 2020 (in thousands):


Financial Instrument	Carrying Value as of December 31, 2020		Markets for Identical Item (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
First Lien Note Facility	$	888,787	$	—	$	913,461	$	—
Second Lien Note Facility	235,566		—		—		266,438
Total debt instruments	$	1,124,353	$	—	$	913,461	$	266,438

The following table sets forth the changes in Level 3 measurements for the year ended December 31, 2020 (in thousands):


	Level 3 Measurements
Second Lien Notes fair value as of January 1, 2020	$	411,119
Principal prepayment	(174,000)
Interest rate PIK	7,525
Change in fair value	21,794
Second Lien Notes fair value as of December 31, 2020	$	266,438

See Note 13, Fair Value Measurements, for further discussion.

DERIVATIVE INSTRUMENTS

12 Months Ended

Dec. 31, 2020

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Derivative Instruments

DERIVATIVE INSTRUMENTS

The Company utilizes derivative financial instruments for hedging and non-trading purposes to limit the Company’s exposure to its variable interest rate risk. Use of derivative financial instruments in hedging strategies subjects the Company to certain risks, such as market and credit risks. Market risk represents the possibility that the value of the derivative financial instrument will change. Credit risk related to a derivative financial instrument represents the possibility that the counterparty will not fulfill the terms of the contract. The notional, or contractual, amount of the Company’s derivative financial instruments is used to measure interest to be paid or received and does not represent the Company’s exposure due to credit risk. Credit risk is monitored through established approval procedures, including reviewing credit ratings when appropriate.

During 2017, Option Care entered into interest rate caps that reduce the risk of increased interest payments due to rising interest rates. The hedges offset the risk of rising interest rates through 2020 on the first $250.0 million of the Previous First Lien Term Loan. The interest rate caps perfectly offset the terms of the interest rates associated with the variable interest rate Previous First Lien Term Loan. Option Care entered into the interest rate caps as a cash flow hedge for a notional amount of $1.9 million. In April 2019, Option Care terminated its interest rate caps and received cash proceeds of $1.7 million, net of early termination fees. In conjunction with the termination of the interest rate caps, Option Care discontinued the hedge accounting associated with the interest rate caps.

In August 2019, the Company entered into interest rate swap agreements that reduce the variability in the interest rates on the newly-issued debt obligations. The first interest rate swap for $925.0 million notional was effective in August 2019 with $911.1 million designated as a cash flow hedge against the underlying interest rate on the First Lien Term Loan interest payments indexed to one-month LIBOR through August 2021. In accordance with ASU 2017-12, Targeted Improvements to Accounting for Hedges, the Company has determined that the $911.1 million designated cash flow hedge is perfectly effective. The remaining $13.9 million notional amount of the first interest rate swap is not designated as a hedging instrument. The second interest rate swap for $400.0 million notional was effective in November 2019 and was designated as a cash flow hedge against the underlying interest rate on the Second Lien Notes interest payment indexed to three-month LIBOR through November 2020.

In May 2020, the Company elected to PIK the Second Lien Notes’ quarterly interest payment due in August 2020. Upon making the PIK election, the Company determined that the hedged interest payment would no longer occur, resulting in an ineffective hedge, so the Company discontinued hedge accounting on its $400.0 million notional interest rate swap. As a result, the Company reclassified accumulated comprehensive loss of $3.7 million to interest expense, net in the consolidated statements of comprehensive income (loss). The gains and losses associated with the $400.0 million notional swap were recognized in net income (loss) through interest expense until the swap expired in November 2020. See Note 11, Indebtedness, for further discussion of the PIK.

The following table summarizes the amount and location of the Company’s derivative instruments in the consolidated balance sheets (in thousands):


	Fair value - Derivatives in liability position
Derivative	Balance Sheet Caption	December 31, 2020		December 31, 2019
Interest rate swaps designated as cash flow hedges	Accrued expenses and other current liabilities	$	11,172	$	1,275
Interest rate swaps not designated as hedges	Accrued expenses and other current liabilities	170		—
Interest rate swaps designated as cash flow hedges	Other noncurrent liabilities	—		5,920
Interest rate swaps not designated as hedges	Other noncurrent liabilities	—		90
Total derivatives		$	11,342	$	7,285

The gain and loss associated with the changes in the fair value of the effective portion of the hedging instrument are recorded into other comprehensive (loss) income. The gain and loss associated with the changes in the fair value of the $400.0 million notional swap and the $13.9 million notional amount not designated as a hedging instrument are recognized in net income (loss) through interest expense. The following table presents the pre-tax gains (losses) from derivative instruments recognized in other comprehensive (loss) income in the Company’s consolidated statements of comprehensive income (loss) (in thousands):


	Years Ended December 31,
Derivative	2020		2019		2018
Interest rate caps designated as cash flow hedges	$	—	$	(1,103)	$	1,008
Interest rate swaps designated as cash flow hedges	(7,723)		(7,195)		—
Interest rate swaps that discontinued hedge accounting	3,746		—		—
Total	$	(3,977)	$	(8,298)	$	1,008

The following table presents the amount and location of pre-tax income (loss) recognized in the Company’s consolidated statement of comprehensive income (loss) related to the Company’s derivative instruments (in thousands):


		Year Ended December 31,
Derivative	Income Statement Caption	2020		2019		2018
Interest rate caps designated as cash flow hedges	Interest expense	$	—	$	(125)	$	300
Interest rate swaps designated as cash flow hedges	Interest expense	(12,799)		(115)		—
Interest rate swaps not designated as hedges	Interest expense	(34)		(92)		—
Interest rate swaps that discontinued hedge accounting	Interest expense	(3,746)		—		—
Total		$	(16,579)	$	(332)	$	300

The Company expects to reclassify $11.2 million of total interest rate costs from accumulated other comprehensive loss against interest expense during the next 12 months.

FAIR VALUE MEASURMENTS	12 Months Ended
FAIR VALUE MEASURMENTS	Dec. 31, 2020
Fair Value Disclosures [Abstract]
Fair Value Measurements	FAIR VALUE MEASUREMENTS Fair value measurements are determined by maximizing the use of observable inputs and minimizing the use of unobservable inputs. The hierarchy places the highest priority on unadjusted quoted market prices in active markets for identical assets or liabilities (Level 1 measurements) and gives the lowest priority to unobservable inputs (Level 3 measurements). The three levels of inputs within the fair value hierarchy are defined in Note 2, Summary of Significant Accounting Policies. While the Company believes its valuation methods are appropriate and consistent with other market participants, the use of different methodologies or assumptions to determine the fair value of certain financial instruments could result in a different fair value measurement at the reporting date. First Lien Term Loan: The fair value of the First Lien Term Loan is derived from a broker quote on the loans in the syndication (Level 2 inputs). See Note 11, Indebtedness, for further discussion of the carrying amount and fair value of the First Lien Term Loan. Second Lien Notes: The fair value of the Second Lien Notes is derived from a cash flow model that discounted the cash flows based on market interest rates (Level 3 inputs). See Note 11, Indebtedness, for further discussion of the carrying amount and fair value of the Second Lien Notes. Interest rate swaps: The fair values of interest rate swaps are derived from the interest rates prevalent in the market and future expectations of those interest rates (Level 2 inputs). The Company determines the fair value of the investments based on quoted prices from third-party brokers. See Note 12, Derivative Instruments, for further discussion of the fair value of the interest rate swaps. Interest rate caps: The fair values of interest rate caps are derived from the interest rates prevalent in the market and future expectations of those interest rates (Level 2 inputs). The Company determines the fair value of the investments based on quoted prices from third-party brokers. In April 2019, Option Care terminated its interest rate caps. See Note 12, Derivative Instruments, for further discussion of the fair value of the interest rate caps. There were no other assets or liabilities measured at fair value at December 31, 2020 or 2019.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

COMMITMENTS AND CONTINGENCIES	12 Months Ended
COMMITMENTS AND CONTINGENCIES	Dec. 31, 2020
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	COMMITMENTS AND CONTINGENCIESThe Company is involved in legal proceedings and is subject to investigations, inspections, audits, inquiries, and similar actions by governmental authorities, arising in the normal course of the Company’s business. Some of these suits may purport or may be determined to be class actions and/or involve parties seeking large and/or indeterminate amounts, including punitive or exemplary damages, and may remain unresolved for several years. From time to time, the Company may also be involved in legal proceedings as a plaintiff involving antitrust, tax, contract, intellectual property, and other matters. Gain contingencies, if any, are recognized when they are realized. The results of legal proceedings are often uncertain and difficult to predict, and the costs incurred in litigation can be substantial, regardless of the outcome. The Company believes that its defenses and assertions in pending legal proceedings have merit and does not believe that any of these pending matters, after consideration of applicable reserves and rights to indemnification, will have a material adverse effect on the Company’s consolidated balance sheets. However, substantial unanticipated verdicts, fines, and rulings may occur. As a result, the Company may from time to time incur judgments, enter into settlements, or revise expectations regarding the outcome of certain matters, and such developments could have a material adverse effect on its results of operations in the period in which the amounts are accrued and/or its cash flows in the period in which the amounts are paid.

STOCK-BASED INCENTIVE COMPENSATION

12 Months Ended

Dec. 31, 2020

Share-based Payment Arrangement [Abstract]

Stock-Based Incentive Compensation

STOCK-BASED INCENTIVE COMPENSATION

Equity Incentive Plans — Under the Company’s 2018 Equity Incentive Plan (the “2018 Plan”), approved at the annual meeting by the BioScrip stockholders on May 3, 2018, the Company may issue, among other things, incentive stock options, non-qualified stock options, stock appreciation rights, restricted stock units, stock grants, and performance units to key employees and directors. The 2018 plan is administered by the Company’s Compensation Committee, a standing committee of the Board of Directors. A total of 4,101,735 shares of common stock were initially authorized for issuance under the 2018 Plan.

Stock Options — Options granted under the 2018 Plan typically vest over a three- or four-year period and, in certain instances, may fully vest upon a change in control of the Company. The options also typically have an exercise price that may not be less than 100% of its fair market value on the date of grant and are exercisable seven to ten years after the date of grant, subject to earlier termination in certain circumstances.

Compensation expense from stock options is recognized on a straight-line basis over the requisite service period. During the years ended December 31, 2020 and 2019, the Company recognized compensation expense related to stock options of $0.4 million and $0.4 million. The Company did not recognize any compensation expense related to stock options prior to the Merger.

The weighted average grant-date fair value of options granted during the year ended December 31, 2020 was $5.94. The Company did not grant any options during the years ended December 31, 2019 or 2018. The fair value of stock options granted was estimated on the date of grant using a Black-Scholes pricing model. The assumptions used to compute the fair value of options for the year ended December 31, 2020 are as follows:


Expected volatility	45.7	%
Risk-free interest rate	0.53	%
Expected life of options	6.3 years
Dividend rate	—

A summary of stock option activity for the year ended December 31, 2020 is as follows:


	Options	Weighted Average Exercise Price		Aggregate Intrinsic Value (thousands)		Weighted Average Remaining Contractual Life
Balance at December 31, 2019	644,975	$	15.36	$	2,754
Granted	204,928	$	13.34	$	471
Exercised	(266,065)	$	7.63	$	2,548
Forfeited and expired	(171,007)	$	26.36	$	88
Balance at December 31, 2020	412,831	$	14.77	$	1,320	6.7 years
Exercisable at December 31, 2020	197,735	$	16.51	$	789	4.2 years

During the year ended December 31, 2020, shares were surrendered to satisfy tax withholding obligations on the exercise of stock options with a cost basis of $2.7 million. During the year ended December 31, 2019, shares were surrendered to satisfy tax withholding obligations on the exercise of stock options with a cost basis of $0.4 million, which are all held as treasury stock as of December 31, 2020. During the year ended December 31, 2020, $0.4 million of cash was received from stock option exercises under share-based payment arrangements. No cash was received from stock option exercises under share-based payment arrangements for the years ended December 31, 2019 or 2018.

The maximum term of stock options under these plans is ten years. Options outstanding as of December 31, 2020 expire on various dates ranging from January 2021 through March 2030. The following table outlines the outstanding and exercisable stock options as of December 31, 2020:


	Options Outstanding				Options Exercisable
Range of Option Exercise Price	Outstanding Options	Weighted Average Exercise Price		Weighted Average Remaining Contractual Life	Options Exercisable	Weighted Average Exercise Price
$0.00 - $8.24	9,901	$	6.52	6.1 years	9,901	$	6.52
$8.24 - $16.52	345,180	$	12.08	7.5 years	130,084	$	10.27
$16.52 - $24.76	25,500	$	22.61	2.7 years	25,500	$	22.61
$24.76 - $33.00	15,000	$	30.41	2.3 years	15,000	$	30.41
$33.00 - $41.28	—	$	—	0.0 years	—	$	—
$41.28 - $49.52	12,500	$	44.16	1.3 years	12,500	$	44.16
$49.52 - $57.76	3,500	$	56.24	2.0 years	3,500	$	56.24
$57.76 - $66.00	—	$	—	0.0 years	—	$	—
$66.00 - $74.28	1,250	$	66.52	2.6 years	1,250	$	66.52
All options	412,831				197,735

As of December 31, 2020, there was $1.0 million of unrecognized compensation expense related to unvested option grants that is expected to be recognized over a weighted-average period of 1.8 years.

Restricted Stock — Restricted stock grants subject solely to an employee’s continued service with the Company generally will become fully vested within one to four years from the grant date and, in certain instances, may fully vest upon a change in control of the Company. Restricted stock grants subject solely to a Director’s continued service with the Company generally will become fully vested within one year from the date of grant.

Compensation expense from restricted stock is recognized on a straight-line basis over the requisite service period. During the years ended December 31, 2020 and 2019, the Company recognized compensation expense related to restricted stock awards of $2.3 million and $1.9 million, respectively. The Company did not recognize any compensation expense related to restricted stock awards prior to the Merger.

A summary of restricted stock award activity for the year ended December 31, 2020 is as follows:


	Restricted Stock	Weighted Average Grant Date Fair Value
Balance at December 31, 2019	231,562	$	10.68
Granted	490,557	$	13.32
Vested and issued	(120,782)	$	12.15
Forfeited and expired	(51,687)	$	12.92
Balance at December 31, 2020	549,650	$	13.26

During the year ended December 31, 2020, shares were surrendered to satisfy tax withholding obligations on the vesting of restricted stock awards with a cost basis of $0.3 million. During the year ended December 31, 2019, shares were surrendered to satisfy tax withholding obligations on the vesting of restricted stock awards with a cost basis of $2.1 million, of which $2.0 million is held as treasury stock as of December 31, 2019.

As of December 31, 2020, there was $6.0 million in unrecognized compensation expense related to unvested restricted stock awards that is expected to be recognized over a weighted average period of 1.7 years. The total fair value of restricted stock awards vested during the years ended December 31, 2020, 2019 and 2018 was $1.5 million, $1.9 million and $0, respectively.

HC I Incentive Units — Beginning in October 2015, HC I implemented an equity incentive plan for certain officers and employees of the Company. Incentive units are equity-based awards subject to time and performance vesting restrictions. The compensation expense related to this plan has been reflected in the Company’s financial statements.

In accordance with ASC Topic 718, Compensation-Stock Compensation, compensation expense is recognized on a straight-line basis over the vesting period of the award or the employee’s retirement eligible date, if earlier. During the years ended December 31, 2020, 2019 and 2018, the Company recognized compensation expense related to the HC I incentive units of $0.2 million, $1.9 million and $2.1 million, respectively.

No awards were issued during the year ended December 31, 2020. The fair value of each award was determined using a Monte-Carlo simulation with the following weighted average assumptions:


Risk-free interest rate (1)	2.25	%
Average time to liquidity (years) (2)	2.1 years
Volatility (3)	47.00	%
Discount for lack of marketability (4)	30.00	%
Weighted-average grant-date fair value per share	$1.13

(1) Represents the US Treasury security rate for the expected time to liquidity event.
(2) Represents the period of time expected prior to liquidity event.
(3) Based on historical volatility of comparable public companies.
(4) Represents a discount taken to reflect the private nature of the investment.

STOCKHOLDERS' EQUITY	12 Months Ended
STOCKHOLDERS' EQUITY	Dec. 31, 2020
Equity [Abstract]
Stockholders' Equity	STOCKHOLDERS’ EQUITY On January 3, 2020, the Company’s board of directors and HC I, the stockholder of a majority of the Company’s common stock, approved a reverse stock split of the Company’s issued and outstanding common stock on a one share for four share basis and appropriately amended the Company’s Third Amended and Restated Certificate of Incorporation to reflect the change. On February 3, 2020, the reverse stock split became effective. In connection with the reverse stock split, the Company changed its ticker symbol from “BIOS” to “OPCH” and transferred the Company’s common stock from the Nasdaq Capital Market to the Nasdaq Global Select Market. The par value of the Company’s common stock remained unchanged as a result of the reverse stock split, resulting in a decrease to the aggregate par value of common stock and corresponding increase to paid-in capital in the Company’s consolidated financial statements, which was retrospectively applied to all periods presented in the financial statements. All common shares, warrants and stock awards presented in the consolidated financial statements have been retrospectively adjusted for the reverse stock split. During the year ended December 31, 2020, the Company completed a public offering of 20,700,000 shares of the Company’s common stock at a price of $12.50 per share, consisting of 10,000,000 shares of common stock issued and sold by the Company and 10,700,000 shares of common stock sold by HC I. The Company received net proceeds from the offering of $118.9 million, after deducting underwriting discounts and commissions and estimated offering expenses payable by the Company. Also, during the year ended December 31, 2020, HC I completed an additional secondary offering of 10,600,000 shares of common stock. Following the offerings, HC I holds approximately 63.6% of the common stock of the Company. The Company used the proceeds from the offering, along with additional cash on hand, to repay $174.0 million on the principal balance of its Second Lien Notes outstanding. See Note 11, Indebtedness, for further discussion of the repayment of the Second Lien Notes. 2017 Warrants — Prior to the Merger, BioScrip issued warrants to certain debt holders pursuant to a Warrant Purchase Agreement dated as of June 29, 2017. In conjunction with the Merger, the 2017 Warrants were amended to entitle the purchasers of the warrants to purchase 2.1 million shares of common stock. The 2017 Warrants have a 10-year term and an exercise price of $8.00 per share and may be exercised by payment of the exercise price in cash or surrender of shares of common stock into which the 2017 Warrants are being converted in an aggregate amount sufficient to pay the exercise price. The 2017 Warrants are classified as equity instruments, and the fair value of these warrants of $14.1 million was recorded in paid-in capital as of the Merger Date. During the years ended December 31, 2020 and 2019, warrant holders exercised warrants to purchase 0.0 million and 0.7 million shares of common stock. No proceeds were received from these exercises as the warrant holders elected to surrender shares to pay the exercise price. At December 31, 2020 and 2019, the remaining warrant holders are entitled to purchase 1.4 million shares of common stock, respectively. 2015 Warrants — Prior to the Merger, BioScrip issued warrants pursuant to a Common Stock Warrant Agreement dated as of March 9, 2015 which entitle the holders to purchase 0.9 million shares of common stock. The 2015 Warrants have a 10-year term and have exercise prices in a range of $20.68 per share to $25.80 per share. The 2015 Warrants were assumed by the Company in conjunction with the Merger and are classified as equity instruments, and the fair value of these warrants of $4.6 million was recorded in paid in capital as of the Merger Date. Home Solutions Restricted Stock — In conjunction with BioScrip’s 2016 acquisition of Home Solutions, Inc., 1.8 million restricted shares of common stock were issued, of which 0.8 million of these units vest upon the closing price of the Company’s common stock averaging at or above $16.00 per share over 20 consecutive trading days prior to December 31, 2019 and 1.0 million of these units vest upon the closing price of the Company’s common stock averaging at or above $20.00 per share over 20 consecutive trading days prior to December 31, 2019. The restricted stock expired on December 31, 2019. As discussed in Note 1, Nature of Operations and Presentation of Financial Statements, 7,048,357 common shares issued to HC I in conjunction with the Merger were set aside to prevent dilution related to the vesting of the Home Solutions restricted stock. During the year ended December 31, 2020, this matter was resolved with no common shares being issued to Home Solutions, Inc., and the 7,048,357 shares, at $0.0001 par value, set aside were cancelled as unvested and removed from the Company’s common shares issued and outstanding. Treasury Stock — During the year ended December 31, 2019, 290,117 shares were surrendered to satisfy tax withholding obligations on the exercise of stock options and the vesting of restricted stock awards with a cost basis of $2.5 million, of which $2.4 million remains held in treasury as of December 31, 2020 and 2019. At December 31, 2020 and 2019, the Company held 383,722 shares of treasury stock. Preferred Stock — In conjunction with the Merger, all legacy BioScrip preferred stock was settled, and no preferred stock is outstanding as of December 31, 2020 or 2019.

RELATED-PARTY TRANSACTIONS	12 Months Ended
RELATED-PARTY TRANSACTIONS	Dec. 31, 2020
Related Party Transactions [Abstract]
Related-Party Transactions	RELATED-PARTY TRANSACTIONS Management Services — In conjunction with the Option Care acquisition from Walgreen Co. in 2015, the Company entered into two separate Management Services Agreements with Madison Dearborn Partners VI-B, L.P. and Walgreen Co. Each Management Services Agreement required the Company to pay $0.3 million to each party quarterly beginning July 1, 2015 for on-going management, consulting and financial services provided to the Company. Following the close of the Merger, both Management Services Agreements were terminated. The Company did not incur any management services expense during the year ended December 31, 2020. In 2019, prior to the Merger, the Company incurred $1.5 million of management services expense, which has been reflected as a component of selling, general and administrative expense in the consolidated statements of comprehensive income (loss) for the year ended December 31, 2019. During the year ended December 31, 2018, management services expense of $2.0 million was recorded as a component of selling, general, and administrative expense in the consolidated statements of comprehensive income (loss). Management Equity Ownership Plan — In October 2015, HC I implemented an equity ownership and incentive plan for certain officers and employees of Option Care. The officers were able to purchase membership units in HC I and could fund a portion of the purchase with a loan from Option Care. These loans were treated as a shareholder contribution in Option Care. For the years ended December 31, 2020, 2019 and 2018, $0, $0 and $0.4 million, respectively, were credited to paid-in capital related to HC I membership units purchased with a loan from Option Care. There were no shareholder redemptions during the year ended December 31, 2020. During the year ended December 31, 2019, shareholder redemptions totaled $2.4 million, comprised of a cash distribution to HC I of $2.0 million and notes redeemed of $0.4 million. There were no shareholder redemptions during the year ended December 31, 2018. During the year ended December 31, 2019, prior to the Merger, Option Care sold its notes receivable from management, along with all accrued interest expense, to a third-party bank. Option Care received cash proceeds of $1.3 million, which represented payment of $1.1 million in outstanding notes receivable from management and payment of $0.2 million in accrued interest expense. There were no notes receivable from management outstanding as of December 31, 2020 and 2019. As of December 31, 2018, notes receivable from management and associated interest receivable of $1.6 million are recorded in management notes receivable as a reduction to equity in the Company’s consolidated statements of stockholders’ equity. Transactions with Equity-Method Investees — The Company provides management services to its joint ventures such as accounting, invoicing and collections in addition to day-to-day managerial support of the operations of the businesses. The Company recorded management fee income of $2.9 million, $2.5 million and $2.2 million for the years ended December 31, 2020, 2019 and 2018, respectively. Management fees are recorded in net revenues in the accompanying consolidated statements of comprehensive income (loss). The Company had amounts due from its joint ventures of $2.4 million as of December 31, 2020. The Company had amounts due to its joint ventures of $4.3 million as of December 31, 2019. These receivables were included in prepaid expenses and other current assets in the accompanying balance sheets and these payables were included in accrued expenses and other current liabilities in the accompanying balance sheets. These balances primarily relate to cash collections received by the Company on behalf of the joint ventures, offset by certain pharmaceutical inventories purchased by the Company on behalf of the joint ventures.

SELECTED QUARTERLY FINANCIAL DATA (UNAUDITED)

12 Months Ended

Dec. 31, 2020

Quarterly Financial Information Disclosure [Abstract]

Selected Quarterly Financial Data (Unaudited)

SELECTED QUARTERLY FINANCIAL DATA (UNAUDITED)

A summary of unaudited quarterly financial information for the years ended December 31, 2020 and 2019 is as follows (in thousands except per share amounts).


	First Quarter		Second Quarter		Third Quarter		Fourth Quarter
Year ended December 31, 2020
Net revenue	$	705,440	$	740,848	$	781,609	$	804,713
Gross profit	158,029		166,320		174,153		183,762
Operating income	8,648		23,208		34,556		44,343
Net (loss) income	$	(19,910)	$	(7,668)	$	1,663	$	17,839

(Loss) earnings per share, basic	$	(0.11)	$	(0.04)	$	0.01	$	0.10
(Loss) earnings per share, diluted	$	(0.11)	$	(0.04)	$	0.01	$	0.10

	First Quarter		Second Quarter		Third Quarter		Fourth Quarter
Year ended December 31, 2019
Net revenue	$	476,492	$	497,266	$	615,880	$	720,779
Gross profit	98,194		101,390		137,773		175,642
Operating income (loss)	5,438		(8,005)		(11,725)		13,973
Net loss	$	(3,712)	$	(13,603)	$	(42,794)	$	(15,811)

Loss per share, basic	$	(0.03)	$	(0.10)	$	(0.26)	$	(0.09)
Loss per share, diluted	$	(0.03)	$	(0.1)	$	(0.26)	$	(0.09)

The net loss in the third quarter of 2019 included transaction expenses, integration costs and loss on extinguishment of debt incurred in conjunction with the Merger.

SUBSEQUENT EVENTS	12 Months Ended
SUBSEQUENT EVENTS	Dec. 31, 2020
Subsequent Events [Abstract]
Subsequent Events	SUBSEQUENT EVENTS The Company has evaluated whether any subsequent events occurred since December 31, 2020 and noted the following subsequent event: In January 2021, the Company entered into an amendment on the First Lien Term Loan (the “First Lien Credit Agreement Amendment”). The First Lien Credit Agreement Amendment resulted in an additional $250.0 million of incremental First Lien Term Loan indebtedness being issued and reduced the interest rate on all outstanding First Lien Term Loan indebtedness from LIBOR plus 4.25% to LIBOR plus 3.75%. The proceeds of the $250.0 million incremental First Lien Term Loan indebtedness were used to prepay the remaining $245.8 million outstanding balance of the Second Lien Notes. In connection with the First Lien Credit Agreement Amendment and prepayment of the Second Lien Notes the Company incurred debt prepayment penalties of $4.9 million, third party fees of $1.3 million and original issue discount of $1.0 million. Following the First Lien Credit Agreement Amendment, the First Lien Term Loan is repayable in quarterly installments of $2.9 million plus interest, with a final payment of all remaining outstanding principal due on August 6, 2026. In February 2021, HC I completed a secondary offering of 17,250,000 shares of the Company’s common stock. Following the offering, HC I holds approximately 54% of the Company’s common stock.

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	12 Months Ended
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	Dec. 31, 2020
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation — The accompanying consolidated financial statements have been prepared in conformity with generally accepted accounting principles (“GAAP”) in the United States.
Principles of Consolidation	Principles of Consolidation — The Company’s consolidated financial statements include the accounts of Option Care Health, Inc. and its subsidiaries. The BioScrip results have been included in the consolidated financial results since the Merger Date. All intercompany transactions and balances are eliminated in consolidation.
Cash and Cash Equivalents	Cash and Cash Equivalents — The Company considers all highly liquid investments with original maturities of three months or less to be cash equivalents.
Accounts Receivable	Accounts Receivable — The Company’s accounts receivable is reported at the net realizable value amount that reflects the consideration the Company expects to receive in exchange for providing services, which is inclusive of adjustments for price concessions. The majority of accounts receivable are due from private insurance carriers and governmental health care programs, such as Medicare and Medicaid.Price concessions may result from patient hardships, patient uncollectible accounts sent to collection agencies, lack of recovery due to not receiving prior authorization, differing interpretations of covered therapies in payer contracts, different pricing methodologies, or various other reasons. In accordance with Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers (“ASC 606”), an allowance for doubtful accounts is established only as a result of an adverse change in the Company’s payers’ ability to pay outstanding billings.
Inventory	Inventory — Inventory, which consists primarily of pharmaceuticals, is stated at the lower of first‑in, first‑out cost or net realizable value basis, which the Company believes is reflective of the physical flow of inventories.
Leases	Leases — The Company has lease agreements for facilities, warehouses, office space and property and equipment. Effective as of January 1, 2019, at the inception of a contract, the Company determines if the contract is a lease or contains an embedded lease arrangement. Operating leases are included in the operating lease right-of-use asset (“ROU asset”) and operating lease liabilities in the consolidated financial statements. ROU assets, which represent the Company’s right to use the leased assets, and operating lease liabilities, which represent the present value of unpaid lease payments, are both recognized by the Company at the lease commencement date. The Company utilizes its estimated incremental borrowing rate at the lease commencement date to determine the present value of unpaid lease obligations. The rates are estimated primarily using a methodology dependent on the Company’s financial condition, creditworthiness, and availability of certain observable data. In particular, the Company considers its actual cost of borrowing for collateralized loans and its credit rating, along with the corporate bond yield curve in estimating its incremental borrowing rates. ROU assets are recorded as the amount of operating lease liability, adjusted for prepayments, accrued lease payments, initial direct costs, lease incentives, and impairment of the ROU asset. Tenant improvement allowances used to fund leasehold improvements are recognized when earned and reduce the related ROU asset. Tenant improvement allowances are recognized through the ROU asset as a reduction of expense over the term of the lease. Leases may contain rent escalations, however the Company recognizes the lease expense on a straight-line basis over the expected lease term. The Company reviews the terms of any lease renewal options to determine if it is reasonably certain that the renewal options will be exercised. The Company has determined that the expected lease term is typically the minimum non-cancelable period of the lease. The Company has lease agreements that contain both lease and non-lease components which the Company has elected to account for as a single lease component for all asset classes. Leases with an initial term of 12 months or less are not recorded on the consolidated balance sheet and are expensed on a straight-line basis over the term of the lease. The Company’s lease agreements do not contain any material residual value guarantees or material restrictive covenants.
Goodwill and Intangible Assets	Goodwill, Intangible Assets, and Property and Equipment — Goodwill represents the excess of the purchase price over the fair value of assets acquired and liabilities assumed. The Company accounts for goodwill under ASC Topic 350, Intangibles-Goodwill and Other. The Company tests goodwill for impairment annually, or more frequently whenever events or circumstances indicate impairment may exist. Goodwill is stated at cost less accumulated impairment losses. The Company completes its goodwill impairment test annually in the fourth quarter. See Note 10, Goodwill and Other Intangible Assets, for further discussion of the Company’s goodwill and other intangible assets.Intangible assets arising from the Company’s acquisitions are amortized on a straight‑line basis over the estimated useful life of each asset. Referral sources have a useful life of 15-20 years. Trademarks/names have a useful life ranging from two to fifteen years. The useful lives for other amortizable intangible assets range from approximately two to nine years.
Property and Equipment	Property and equipment is recorded at cost, net of accumulated depreciation. Depreciation on owned property and equipment is provided for on a straight‑line basis over the estimated useful lives of owned assets. Leasehold improvements are amortized over the estimated useful life of the property or over the term of the lease, whichever is shorter. Estimated useful lives are seven years for infusion pumps and three years to thirteen years for equipment. Major repairs, which extend the useful life of an asset, are capitalized in the property and equipment accounts. Routine maintenance and repairs are expensed as incurred. Computer software is included in property and equipment and consists of purchased software and internally-developed software. The Company capitalizes application-stage development costs for significant internally-developed software projects. Once the software is ready for its intended use, these costs are amortized on a straight‑line basis over the software’s estimated useful life, generally five years. Costs recognized in the preliminary project phase and the post-implementation phase, as well as maintenance and training costs, are expensed as incurred. The Company tests long‑lived assets for impairment whenever events or circumstances indicate that a certain asset or asset group may be impaired. Once identified, the amount of the impairment is computed by comparing the carrying value of the respective asset or asset group to its fair value, which is based on the discounted estimated future cash flows.
Equity Method Investments	Equity-Method Investments — The Company’s investments in certain unconsolidated entities are accounted for under the equity method. The balance of these investments is included in other noncurrent assets in the accompanying consolidated balance sheets. As of December 31, 2020 and 2019, the balance of the investments was $17.0 million and $17.0 million, respectively. The investments are increased to reflect the Company’s capital contributions and equity in earnings of the investees. The investments are decreased to reflect the Company’s equity in losses of the investees and for distributions received that are not in excess of the carrying amount of the investments. The Company’s proportionate share of earnings or losses of the investees is recorded in equity in earnings of joint ventures in the accompanying consolidated statements of comprehensive income (loss). The Company’s proportionate share of earnings was $3.3 million, $2.8 million and $1.0 million for the years ended December 31, 2020, 2019 and 2018, respectively. Distributions from the investees are treated as cash inflows from operating activities in the consolidated statements of cash flows. During the years ended December 31, 2020, 2019 and 2018, the Company received distributions from the investees of $3.3 million, $0.5 million and $2.0 million, respectively. See Footnote 17, Related-Party Transactions, for discussion of related-party transactions with these investees.
Hedging Instruments	Hedging Instruments — The Company uses derivative financial instruments to limit its exposure to increases in the interest rate of its variable rate debt instruments. The derivative financial instruments are recognized on the consolidated balance sheets at fair value. See Note 12, Derivative Instruments, for additional information.At inception of the hedge, the Company designated the derivative instruments as a hedge of the cash flows related to the interest on the variable rate debt. For all instruments designated as hedges, the Company documents the hedging relationships and its risk management objective of the hedging relationship. For all hedging instruments, the terms of the hedge perfectly offset the hedged expected cash flows.
Revenue	Revenue Recognition — Net revenue is reported at the net realizable value amount that reflects the consideration the Company expects to receive in exchange for providing services. Revenues are from government payers, commercial payers, and patients for goods and services provided and are based on a gross price based on payer contracts, fee schedules, or other arrangements less any implicit price concessions. Due to the nature of the health care industry and the reimbursement environment in which the Company operates, certain estimates are required to record revenue and accounts receivable at their net realizable values at the time goods or services are provided. Inherent in these estimates is the risk that they will have to be revised or updated as additional information becomes available. The Company assesses the expected consideration to be received at the time of patient acceptance based on the verification of the patient’s insurance coverage, historical information with the patient, similar patients, or the payer. Performance obligations are determined based on the nature of the services provided by the Company. The majority of the Company’s performance obligations are to provide infusion services to deliver medicine, nutrients, or fluids directly into the body. The Company provides a variety of infusion-related therapies to patients, which frequently include multiple deliverables of pharmaceutical drugs and related nursing services. After applying the criteria from ASC 606, the Company concluded that multiple performance obligations exist in its contracts with its customers. Revenue is allocated to each performance obligation based on relative standalone price, determined based on reimbursement rates established in the third-party payer contracts. Pharmaceutical drug revenue is recognized at the time the pharmaceutical drug is delivered to the patient, and nursing revenue is recognized on the date of service. The Company's outstanding performance obligations relate to contracts with a duration of less than one year. Therefore, the Company has elected to apply the practical expedient provided by ASC 606 and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. Any unsatisfied or partially unsatisfied performance obligations at the end of a reporting period are generally completed prior to the patient being discharged.
Cost of Revenue	Cost of Revenue — Cost of revenue consists of the actual cost of pharmaceuticals and other medical supplies dispensed to patients, as well as all other costs directly related to the production of revenue. These costs include warehousing costs, purchasing costs, freight costs, cash discounts, wages and related costs for pharmacists and nurses, along with depreciation expense relating to revenue-generating assets, such as infusion pumps. The Company receives prompt payment discounts from some of its pharmaceutical and medical supplies vendors. These prompt payment discounts are recorded as a reduction of inventory and are accounted for as a reduction of cost of goods sold when the related inventory is sold. The Company also receives rebates from pharmaceutical and medical supply manufacturers. Rebates are generally volume-based incentives and are recorded as a reduction of inventory and are accounted for as a reduction of cost of goods sold when the related inventory is sold.
Selling, General and Administrative Expenses	Selling, General and Administrative Expenses — Selling, general and administrative expenses mainly consist of salaries for administrative employees that directly and indirectly support the operations, occupancy costs, marketing expenditures, insurance, and professional fees.
Stock Based Incentive Compensation	Stock Based Incentive Compensation - The Company accounts for stock-based incentive compensation expense in accordance with ASC Topic 718, Compensation-Stock Compensation (“ASC 718”). Stock-based incentive compensation expense is based on the grant date fair value. The Company estimates the fair value of stock option awards using a Black-Scholes option pricing model and the fair value of restricted stock unit awards using the closing price of the Company’s common stock on the grant date. For awards with a service-based vesting condition, the Company recognizes expense on a straight-line basis over the service period of the award. For awards with performance-based vesting conditions, the Company will recognize expense when it is probable that the performance-based conditions will be met. When the Company determines that it is probable that the performance-based conditions will be met, a cumulative catch-up of expense will be recorded as if the award had been vesting on a straight-line basis from the award date. The award will continue to be expensed on a straight-line basis through the remainder of the vesting period and will be updated if the Company determines that there has been a change in the probability of achieving the performance-based conditions. The Company records the impact of forfeited awards in the period in which the forfeiture occurs. Prior to the Merger, HCI issued incentive units to certain employees of Option Care, who remained employees of the Company following the Merger. In accordance with ASC 718, the Company recognizes compensation expense on a straight-line basis over the shorter of the vesting period of the award or the employee’s expected eligibility date. HC I also issued equity incentive units to certain members of the Option Care Board of Directors, who remained members of the Board of Directors following the Merger.
Business Acquisitions	Business Acquisitions - The Company accounts for business acquisitions in accordance with ASC Topic 805, Business Combinations, with assets and liabilities being recorded at their acquisition date fair value and goodwill being calculated as the purchase price in excess of the net identifiable assets
Income Taxes	Income Taxes — The Company accounts for income taxes using the asset and liability method. Deferred tax assets and liabilities are reported for book-tax basis differences and are measured based on currently enacted tax laws using rates expected to apply to taxable income in the years in which the differences are expected to reverse. The effect of a change in tax rate on deferred taxes is recognized in income tax expense in the period that includes the enactment date of the change. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. Valuation allowances are established when necessary to reduce deferred tax assets to the amounts more likely than not to be realized. The Company recognizes income tax positions that are more likely than not to be sustained on their technical merits. The Company measures recognized income tax positions at the maximum benefit that is more likely than not, based on cumulative probability, realizable upon final settlement of the position. Interest and penalties related to unrecognized tax benefits are reported in income tax expense.
Concentrations of Business Risk	Concentrations of Business Risk — The Company generates revenue from managed care contracts and other agreements with commercial third-party payers. Revenue related to the Company’s largest payer was approximately 15%, 16% and 17% for the years ended December 31, 2020, 2019 and 2018, respectively. In December 2019, the Company renewed and expanded its multi-year contract with this payer. The contract renewal was effective in February 2020 for a two-year term and auto-renews at the end of that term. There were no other managed care contracts that represent greater than 10% of revenue for the years presented. For the years ended December 31, 2020, 2019 and 2018, approximately 15%, 12% and 12%, respectively, of the Company’s revenue was reimbursable through direct government healthcare programs such as Medicare and Medicaid. As of December 31, 2020 and 2019, approximately 15% and 12%, respectively, of the Company’s accounts receivable was related to these programs. Governmental programs pay for services based on fee schedules and rates that are determined by the related governmental agency. Laws and regulations pertaining to government programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility that recorded estimates will change in the near term. The Company does not require its patients nor other payers to carry collateral for any amounts owed for goods or services provided. Other than as discussed above, concentrations of credit risk relating to trade accounts receivable is limited due to the Company’s diversity of patients and payers. Further, the Company generally does not provide charity care. For the years ended December 31, 2020 and 2019, approximately 70% and 70%, respectively, of the Company’s pharmaceutical and medical supply purchases were from three vendors. For the year ended December 31, 2018, approximately 66% of the Company’s pharmaceutical and medical supply purchases were from two vendors. Although there are a limited number of suppliers, the Company believes that other vendors could provide similar products on comparable terms. However, a change in suppliers could cause delays in service delivery and possible losses in revenue, which could adversely affect the Company’s financial condition or operating results. Although there is uncertainty regarding the COVID-19 pandemic, as of December 31, 2020 the Company has been able to maintain adequate levels of supplies and pharmaceuticals to support its operations.
Fair Value Measurements	Fair Value Measurements — The fair value measurement accounting standard, ASC Topic 820, Fair Value Measurement (“ASC 820”), provides a framework for measuring fair value and defines fair value as the price that would be received to sell an asset or paid to transfer a liability. Fair value is a market-based measurement that should be determined using assumptions that market participants would use in pricing an asset or liability. The standard establishes a valuation hierarchy for inputs used in measuring fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs by requiring that the most observable inputs be used when available. Observable inputs are inputs market participants would use in valuing the asset or liability developed based on independent market data sources. Unobservable inputs are inputs that reflect the Company’s assumptions about the factors market participants would use in valuing the asset or liability developed based upon the best information available. The valuation hierarchy is composed of three categories. The categorization within the valuation hierarchy is based on the lowest level of input that is significant to the fair value measurement. The categories within the valuation hierarchy are described as follows: •Level 1 - Inputs to the fair value measurement are quoted prices in active markets for identical assets or liabilities. •Level 2 - Inputs to the fair value measurement include quoted prices in active markets for similar assets or liabilities, quoted prices for identical or similar assets or liabilities in markets that are not active, and inputs other than quoted prices that are observable for the asset or liability, either directly or indirectly. •Level 3 - Inputs to the fair value measurement are unobservable inputs or valuation techniques. While the Company believes its valuation methods are appropriate and consistent with other market participants, the use of different methodologies or assumptions to determine the fair value of certain financial instruments could result in a different fair value measurement at the reporting date. FAIR VALUE MEASUREMENTS Fair value measurements are determined by maximizing the use of observable inputs and minimizing the use of unobservable inputs. The hierarchy places the highest priority on unadjusted quoted market prices in active markets for identical assets or liabilities (Level 1 measurements) and gives the lowest priority to unobservable inputs (Level 3 measurements). The three levels of inputs within the fair value hierarchy are defined in Note 2, Summary of Significant Accounting Policies. While the Company believes its valuation methods are appropriate and consistent with other market participants, the use of different methodologies or assumptions to determine the fair value of certain financial instruments could result in a different fair value measurement at the reporting date. First Lien Term Loan: The fair value of the First Lien Term Loan is derived from a broker quote on the loans in the syndication (Level 2 inputs). See Note 11, Indebtedness, for further discussion of the carrying amount and fair value of the First Lien Term Loan. Second Lien Notes: The fair value of the Second Lien Notes is derived from a cash flow model that discounted the cash flows based on market interest rates (Level 3 inputs). See Note 11, Indebtedness, for further discussion of the carrying amount and fair value of the Second Lien Notes. Interest rate swaps: The fair values of interest rate swaps are derived from the interest rates prevalent in the market and future expectations of those interest rates (Level 2 inputs). The Company determines the fair value of the investments based on quoted prices from third-party brokers. See Note 12, Derivative Instruments, for further discussion of the fair value of the interest rate swaps. Interest rate caps: The fair values of interest rate caps are derived from the interest rates prevalent in the market and future expectations of those interest rates (Level 2 inputs). The Company determines the fair value of the investments based on quoted prices from third-party brokers.
Recent Accounting Pronouncements	Recently-Adopted Accounting Pronouncements — In June 2016, the FASB issued ASU 2016-13, Financial Instruments — Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, which requires measurement and recognition of expected credit losses for financial assets held. The amendments in ASU 2016-13 eliminate the probable threshold for initial recognition of a credit loss in current GAAP and reflect an entity’s current estimate of all expected credit losses. ASU 2016-13 is effective for interim and annual reporting periods beginning after December 15, 2019 and is to be applied using a modified retrospective transition method. The Company adopted the standard as of January 1, 2020. The adoption of this standard did not have a material impact on the Company’s consolidated financial statements.

BUSINESS ACQUISITIONS (Tables)

12 Months Ended

Dec. 31, 2020

Business Combinations [Abstract]

Schedule of Consideration Exchanged

Under the acquisition method of accounting, the calculation of total consideration exchanged is as follows (in thousands):


	Amount
Number of BioScrip common shares outstanding at time of the Merger (1)	129,181
Common shares issued to warrant and preferred stockholders at time of the Merger (1)	3,458
Total shares of BioScrip common stock outstanding at time of the Merger (1)	132,639
BioScrip share price as of August 6, 2019	$	2.67
Fair value of common shares	$	354,146
Fair value of share-based instruments	$	32,898
Cash paid in conjunction with the Merger included in purchase consideration	$	714,957
Fair value of total consideration transferred	$	1,102,001
Less: cash acquired	$	14,787
Fair value of total consideration acquired, net of cash acquired	$	1,087,214

(1) These shares were not adjusted for the one share for four share reverse stock split, which occurred on February 3, 2020.

Schedule of Acquired Identifiable Assets and Assumed Liabilities

The Company’s allocation of consideration exchanged to the net tangible and intangible assets acquired and liabilities assumed, net of cash acquired, in the Merger is as follows (in thousands):


	Amount
Accounts receivable, net (1)	$	96,532
Inventories (2)	19,683
Property and equipment, net (3)	48,732
Intangible assets, net (4)	193,245
Deferred tax assets, net of deferred tax liabilities (5)	26,731
Operating lease right-of-use asset (6)	22,378
Operating lease liability (6)	(28,897)
Accounts payable (7)	(66,668)
Other assumed liabilities, net of other acquired assets (7)	(20,663)
Total acquired identifiable assets and liabilities	291,073
Goodwill (8)	796,141
Total consideration transferred	$	1,087,214

(1)Management has valued accounts receivables based on the estimated future collectability of the receivables portfolio.

(2)Inventories are stated at fair value as of the Merger Date.

(4)The allocation of consideration exchanged to intangible assets acquired is as follows (in thousands):


	Fair Value		Weighted Average Estimated Life (in years)
Trademarks/Names	$	12,536	2
Patient referral sources	180,329		20
Licenses	380		1.5
Total intangible assets, net	$	193,245	18.8

The Company valued trademarks/names utilizing the relief of royalty method and patient referral sources utilizing the multi-period excess earnings method, a form of the income approach.

(6)The fair value of the operating lease liability and corresponding right-of-use asset (current and long-term) was based on current market rates available to the Company.

(7)Accounts payable as well as certain other current and non-current assets and liabilities are stated at fair value as of the Merger Date.

Schedule of Allocation of Consideration to Intangible Assets Acquired

The allocation of consideration exchanged to intangible assets acquired is as follows (in thousands):


	Fair Value		Weighted Average Estimated Life (in years)
Trademarks/Names	$	12,536	2
Patient referral sources	180,329		20
Licenses	380		1.5
Total intangible assets, net	$	193,245	18.8

The Company valued trademarks/names utilizing the relief of royalty method and patient referral sources utilizing the multi-period excess earnings method, a form of the income approach.

(6)The fair value of the operating lease liability and corresponding right-of-use asset (current and long-term) was based on current market rates available to the Company.

(7)Accounts payable as well as certain other current and non-current assets and liabilities are stated at fair value as of the Merger Date.

Schedule of Pro Forma Financial Information


	Year Ended December 31,
	2019		2018
Net revenue	$	2,755,361	$	2,648,694
Net loss	(49,566)		(70,932)

REVENUE (Tables)

12 Months Ended

Dec. 31, 2020

Revenue from Contract with Customer [Abstract]

Schedule of Net Revenue Earned by Category of Payer

The following table sets forth the net revenue earned by category of payer for the years ended December 31, 2020, 2019 and 2018 (in thousands):


	Year Ended December 31,
	2020		2019		2018
Commercial payers	$	2,542,985	$	2,001,105	$	1,699,450
Government payers	450,067		285,128		217,876
Patients	39,558		24,184		22,465
Net revenue	$	3,032,610	$	2,310,417	$	1,939,791

INCOME TAXES Income Taxes (Tables)

12 Months Ended

Dec. 31, 2020

Income Tax Disclosure [Abstract]

Schedule of Income Tax Expense (Benefit)

The income tax expense (benefit) consists of the following for the years ended December 31, 2020, 2019 and 2018 (in thousands):


	2020		2019		2018
US federal income tax expense (benefit):
Current	$	(69)	$	—	$	—
Deferred	996		(3,072)		(2,688)
	927		(3,072)		(2,688)
State income tax expense (benefit):
Current	1,707		2,074		1,176
Deferred	199		(1,276)		(1,141)
	1,906		798		35
Total income tax expense (benefit)	$	2,833	$	(2,274)	$	(2,653)

Schedule of Effective Income Tax Rate Reconciliation

The difference between the statutory federal income tax rate and the effective tax rate is as follows for the years ended December 31, 2020, 2019 and 2018:


	2020		2019		2018
US federal statutory tax rate	21.0	%	21.0	%	21.0	%
State and local income taxes net of federal tax benefit	(29.5)		(0.5)		2.4
Valuation allowance	(29.9)		(13.4)		0.0
Stock-based compensation	6.7		0.0		0.0
Non-deductible compensation	(16.3)		(0.7)		0.0
Changes in uncertain tax positions	0.0		0.0		14.7
Non-deductible expenses	(8.2)		(2.8)		(7.5)
Other, net	2.2		(0.7)		(0.3)
Effective income tax rate	(54.0)	%	2.9	%	30.3	%

Schedule of Deferred Tax Assets and Liabilities

The components of deferred income tax assets and liabilities using the 21% U.S. Federal statutory tax rate were as follows as of December 31, 2020 and 2019 (in thousands):


	2020		2019
Deferred tax assets:
Price concessions	$	6,907	$	12,302
Compensation and benefits	4,058		3,672
Interest limitation carryforward	39,094		38,623
Operating lease liability	22,644		19,462
Net operating losses	155,922		147,749
Other	8,682		5,506
Deferred tax assets before valuation allowance	237,307		227,314
Valuation allowance	(112,085)		(109,531)
Deferred tax assets net of valuation allowance	125,222		117,783

Deferred tax liabilities:
Accelerated depreciation	(12,593)		(10,376)
Operating lease right-of-use asset	(17,186)		(15,442)
Intangible assets	(67,127)		(71,204)
Goodwill	(28,976)		(20,250)
Other	(2,679)		(2,654)
Deferred tax liabilities	(128,561)		(119,926)
Net deferred tax liabilities	$	(3,339)	$	(2,143)

Summary of Valuation Allowance

The following table presents the valuation allowance for deferred tax assets for the years ended December 31, 2020, 2019 and 2018 (in thousands):


			Additions
Description	Balance at Beginning of Period		Charged (Benefit) to Costs and Expenses		Charged to Other Accounts		Balance at End Period

2018: Valuation allowance for deferred tax assets	$	1,263	$	110	$	—	$	1,373

2019: Valuation allowance for deferred tax assets	$	1,373	$	15,395	$	92,763	$	109,531

2020: Valuation allowance for deferred tax assets	$	109,531	$	1,549	$	1,005	$	112,085

(LOSS) EARNINGS PER SHARE (Tables)

12 Months Ended

Dec. 31, 2020

Earnings Per Share [Abstract]

Schedule of Basic and Diluted Loss Per Share

The following table presents the Company’s basic and diluted (loss) earnings per share and shares outstanding (in thousands, except per share data):


	Year Ended December 31,
	2020		2019		2018
Numerator:
Net loss	$	(8,076)	$	(75,920)	$	(6,115)
Denominator:
Weighted average number of common shares outstanding	180,971		156,280		142,614
Loss per Common Share:
Loss per common share, basic and diluted	$	(0.04)	$	(0.49)	$	(0.04)

LEASES (Tables)

12 Months Ended

Dec. 31, 2020

Leases [Abstract]

Maturities of Lease Liabilities, Operating

Operating leases mature as follows (in thousands):


Year Ending December 31	Minimum Payments
2021	$	23,770
2022	19,216
2023	15,804
2024	11,684
2025	9,369
2026 and beyond	30,168
Total lease payments	110,011
Less: Interest	(20,349)
Present value of lease liabilities	$	89,662

Maturities of Lease Liabilities, Financing

Operating leases mature as follows (in thousands):


Year Ending December 31	Minimum Payments
2021	$	23,770
2022	19,216
2023	15,804
2024	11,684
2025	9,369
2026 and beyond	30,168
Total lease payments	110,011
Less: Interest	(20,349)
Present value of lease liabilities	$	89,662

PROPERTY AND EQUIPMENT (Tables)

12 Months Ended

Dec. 31, 2020

Property, Plant and Equipment [Abstract]

Schedule of Property and Equipment

Property and equipment was as follows as of December 31, 2020 and 2019 (in thousands):


	December 31, 2020		December 31, 2019
Infusion pumps	$	31,678	$	30,416
Equipment, furniture and other	47,886		51,454
Leasehold improvements	87,483		80,916
Computer software, purchased and internally developed	27,799		34,884
Assets under development	10,793		14,150
	205,639		211,820
Less: accumulated depreciation	84,490		78,622
Property and equipment, net	$	121,149	$	133,198

The following table presents the amount of depreciation expense recorded in cost of revenue and operating expenses for the years ended December 31, 2020, 2019 and 2018 (in thousands):


	Year ended December 31,
	2020		2019		2018
Depreciation expense in cost of revenue	$	6,586	$	4,179	$	2,993
Depreciation expense in operating expenses	36,180		27,629		18,490
Total depreciation expense	$	42,766	$	31,808	$	21,483

GOODWILL AND OTHER INTANGIBLE ASSETS (Tables)

12 Months Ended

Dec. 31, 2020

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of the Carrying Amount of Goodwill

Changes in the carrying amount of goodwill consist of the following activity for the years ended December 31, 2020, 2019 and 2018 (in thousands):


Balance at December 31, 2017	$	627,392
Acquisitions	5,077
Balance at December 31, 2018	$	632,469
Acquisitions	793,073
Balance at December 31, 2019	$	1,425,542
Purchase accounting adjustments	3,068
Balance at December 31, 2020	$	1,428,610

Schedule of Carrying Amount and Accumulated Amortization of Intangible Assets

The carrying amount and accumulated amortization of intangible assets consists of the following as of December 31, 2020 and 2019 (in thousands):


	December 31, 2020		December 31, 2019
Gross intangible assets:
Referral sources	$	438,121	$	438,121
Trademarks/names	44,536		44,536
Other amortizable intangible assets	402		402
Total gross intangible assets	483,059		483,059

Accumulated amortization:
Referral sources	(110,498)		(84,295)
Trademarks/names	(21,146)		(12,748)
Other amortizable intangible assets	(363)		(106)
Total accumulated amortization	(132,007)		(97,149)
Total intangible assets, net	$	351,052	$	385,910

Schedule of Future Amortization Expense for Intangible Assets

Expected future amortization expense for intangible assets recorded at December 31, 2020, is as follows (in thousands):


2021	$	32,015
2022	28,338
2023	28,338
2024	28,338
2025	28,338
2026 and beyond	205,685
Total	$	351,052

INDEBTEDNESS (Tables)

12 Months Ended

Dec. 31, 2020

Debt Disclosure [Abstract]

Summary of Debt

Long-term debt consisted of the following as of December 31, 2020 (in thousands):


	Principal Amount		Discount		Debt Issuance Costs		Net Balance
ABL Facility	$	—	$	—	$	—	$	—
First Lien Term Loan	915,750		(7,253)		(19,710)		888,787
Second Lien Notes	245,781		(6,102)		(4,113)		235,566
	$	1,161,531	$	(13,355)	$	(23,823)	1,124,353
Less: current portion							(9,250)
Total long-term debt							$	1,115,103

Long-term debt consisted of the following as of December 31, 2019 (in thousands):


	Principal Amount		Discount		Debt Issuance Costs		Net Balance
ABL Facility	$	—	$	—	$	—	$	—
First Lien Term Loan	925,000		(8,399)		(22,825)		893,776
Second Lien Notes	412,256		(11,672)		(7,864)		392,720
	$	1,337,256	$	(20,071)	$	(30,689)	1,286,496
Less: current portion							(9,250)
Total long-term debt							$	1,277,246

Schedule of Long-term Debt Maturities

Long-term debt matures as follows (in thousands):


Year Ending December 31,	Minimum Payments
2021	$	9,250
2022	9,250
2023	9,250
2024	9,250
2025	9,250
2026 and beyond	1,115,281
Total	$	1,161,531

Schedule of Estimated Fair Values of Debt Obligations

The following table presents the estimated fair values of the Company’s debt obligations as of December 31, 2020 (in thousands):


Financial Instrument	Carrying Value as of December 31, 2020		Markets for Identical Item (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
First Lien Note Facility	$	888,787	$	—	$	913,461	$	—
Second Lien Note Facility	235,566		—		—		266,438
Total debt instruments	$	1,124,353	$	—	$	913,461	$	266,438

The following table sets forth the changes in Level 3 measurements for the year ended December 31, 2020 (in thousands):


	Level 3 Measurements
Second Lien Notes fair value as of January 1, 2020	$	411,119
Principal prepayment	(174,000)
Interest rate PIK	7,525
Change in fair value	21,794
Second Lien Notes fair value as of December 31, 2020	$	266,438

DERIVATIVE INSTRUMENTS (Tables)

12 Months Ended

Dec. 31, 2020

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Summary of Amount and Location of Derivatives in the Balance Sheet

The following table summarizes the amount and location of the Company’s derivative instruments in the consolidated balance sheets (in thousands):


	Fair value - Derivatives in liability position
Derivative	Balance Sheet Caption	December 31, 2020		December 31, 2019
Interest rate swaps designated as cash flow hedges	Accrued expenses and other current liabilities	$	11,172	$	1,275
Interest rate swaps not designated as hedges	Accrued expenses and other current liabilities	170		—
Interest rate swaps designated as cash flow hedges	Other noncurrent liabilities	—		5,920
Interest rate swaps not designated as hedges	Other noncurrent liabilities	—		90
Total derivatives		$	11,342	$	7,285

Schedule of Pre-tax Income (Loss) Recognized in the Statements of Comprehensive Income (Loss)

The following table presents the pre-tax gains (losses) from derivative instruments recognized in other comprehensive (loss) income in the Company’s consolidated statements of comprehensive income (loss) (in thousands):


	Years Ended December 31,
Derivative	2020		2019		2018
Interest rate caps designated as cash flow hedges	$	—	$	(1,103)	$	1,008
Interest rate swaps designated as cash flow hedges	(7,723)		(7,195)		—
Interest rate swaps that discontinued hedge accounting	3,746		—		—
Total	$	(3,977)	$	(8,298)	$	1,008


		Year Ended December 31,
Derivative	Income Statement Caption	2020		2019		2018
Interest rate caps designated as cash flow hedges	Interest expense	$	—	$	(125)	$	300
Interest rate swaps designated as cash flow hedges	Interest expense	(12,799)		(115)		—
Interest rate swaps not designated as hedges	Interest expense	(34)		(92)		—
Interest rate swaps that discontinued hedge accounting	Interest expense	(3,746)		—		—
Total		$	(16,579)	$	(332)	$	300

STOCK-BASED INCENTIVE COMPENSATION Stock-Based Incentive Compensation (Tables)

12 Months Ended

Dec. 31, 2020

Share-based Payment Arrangement [Abstract]

Schedule of Fair Value of Awards

The assumptions used to compute the fair value of options for the year ended December 31, 2020 are as follows:


Expected volatility	45.7	%
Risk-free interest rate	0.53	%
Expected life of options	6.3 years
Dividend rate	—

The fair value of each award was determined using a Monte-Carlo simulation with the following weighted average assumptions:


Risk-free interest rate (1)	2.25	%
Average time to liquidity (years) (2)	2.1 years
Volatility (3)	47.00	%
Discount for lack of marketability (4)	30.00	%
Weighted-average grant-date fair value per share	$1.13

(1) Represents the US Treasury security rate for the expected time to liquidity event.
(2) Represents the period of time expected prior to liquidity event.
(3) Based on historical volatility of comparable public companies.
(4) Represents a discount taken to reflect the private nature of the investment.

Summary of Stock Option Activity

A summary of stock option activity for the year ended December 31, 2020 is as follows:


	Options	Weighted Average Exercise Price		Aggregate Intrinsic Value (thousands)		Weighted Average Remaining Contractual Life
Balance at December 31, 2019	644,975	$	15.36	$	2,754
Granted	204,928	$	13.34	$	471
Exercised	(266,065)	$	7.63	$	2,548
Forfeited and expired	(171,007)	$	26.36	$	88
Balance at December 31, 2020	412,831	$	14.77	$	1,320	6.7 years
Exercisable at December 31, 2020	197,735	$	16.51	$	789	4.2 years

Summary of Outstanding Options by Exercise Price Range

The following table outlines the outstanding and exercisable stock options as of December 31, 2020:


	Options Outstanding				Options Exercisable
Range of Option Exercise Price	Outstanding Options	Weighted Average Exercise Price		Weighted Average Remaining Contractual Life	Options Exercisable	Weighted Average Exercise Price
$0.00 - $8.24	9,901	$	6.52	6.1 years	9,901	$	6.52
$8.24 - $16.52	345,180	$	12.08	7.5 years	130,084	$	10.27
$16.52 - $24.76	25,500	$	22.61	2.7 years	25,500	$	22.61
$24.76 - $33.00	15,000	$	30.41	2.3 years	15,000	$	30.41
$33.00 - $41.28	—	$	—	0.0 years	—	$	—
$41.28 - $49.52	12,500	$	44.16	1.3 years	12,500	$	44.16
$49.52 - $57.76	3,500	$	56.24	2.0 years	3,500	$	56.24
$57.76 - $66.00	—	$	—	0.0 years	—	$	—
$66.00 - $74.28	1,250	$	66.52	2.6 years	1,250	$	66.52
All options	412,831				197,735

Summary of Restricted Stock Award Activity

A summary of restricted stock award activity for the year ended December 31, 2020 is as follows:


	Restricted Stock	Weighted Average Grant Date Fair Value
Balance at December 31, 2019	231,562	$	10.68
Granted	490,557	$	13.32
Vested and issued	(120,782)	$	12.15
Forfeited and expired	(51,687)	$	12.92
Balance at December 31, 2020	549,650	$	13.26

SELECTED QUARTERLY FINANCIAL DATA (UNAUDITED) (Tables)

12 Months Ended

Dec. 31, 2020

Quarterly Financial Information Disclosure [Abstract]

Schedule of Quarterly Financial Information

A summary of unaudited quarterly financial information for the years ended December 31, 2020 and 2019 is as follows (in thousands except per share amounts).


	First Quarter		Second Quarter		Third Quarter		Fourth Quarter
Year ended December 31, 2020
Net revenue	$	705,440	$	740,848	$	781,609	$	804,713
Gross profit	158,029		166,320		174,153		183,762
Operating income	8,648		23,208		34,556		44,343
Net (loss) income	$	(19,910)	$	(7,668)	$	1,663	$	17,839

(Loss) earnings per share, basic	$	(0.11)	$	(0.04)	$	0.01	$	0.10
(Loss) earnings per share, diluted	$	(0.11)	$	(0.04)	$	0.01	$	0.10

	First Quarter		Second Quarter		Third Quarter		Fourth Quarter
Year ended December 31, 2019
Net revenue	$	476,492	$	497,266	$	615,880	$	720,779
Gross profit	98,194		101,390		137,773		175,642
Operating income (loss)	5,438		(8,005)		(11,725)		13,973
Net loss	$	(3,712)	$	(13,603)	$	(42,794)	$	(15,811)

Loss per share, basic	$	(0.03)	$	(0.10)	$	(0.26)	$	(0.09)
Loss per share, diluted	$	(0.03)	$	(0.1)	$	(0.26)	$	(0.09)

NATURE OF OPERATIONS AND PRESENTATION OF FINANCIAL STATEMENTS (Details) $ / shares in Units, $ in Thousands		12 Months Ended
	Aug. 06, 2019 USD ($) $ / shares shares	Dec. 31, 2020 USD ($) location site $ / shares shares	Dec. 31, 2019 USD ($) $ / shares
Business Acquisition [Line Items]
Common stock, par value (in dollars per share) \| $ / shares		$ 0.0001	$ 0.0001
Principal amount of debt \| $		$ 1,124,353	$ 1,286,496
Number of service locations \| location		99
Number of infusion sites \| site		46
OptionCare Enterprises, Inc.
Business Acquisition [Line Items]
Shares converted in merger (in shares) \| shares	135,565,392
Common stock, par value (in dollars per share) \| $ / shares	$ 0.0001
Additional shares issued (in shares) \| shares	7,048,357	7,048,357
Ownership retained by shareholders after merger	19.20%
Preferred Stock and Certain Warrants \| OptionCare Enterprises, Inc.
Business Acquisition [Line Items]
Shares repurchased \| $	$ 125,800
Preferred Stock and Certain Warrants \| Common Stock \| OptionCare Enterprises, Inc.
Business Acquisition [Line Items]
Additional shares issued (in shares) \| shares	864,603
HC Group Holdings I, LLC \| OptionCare Enterprises, Inc.
Business Acquisition [Line Items]
Percentage of the combined company held	80.80%
Senior Notes \| First Lien Term Loan
Business Acquisition [Line Items]
Principal amount of debt \| $	$ 575,000
Legacy Health Systems
Business Acquisition [Line Items]
Ownership interest		50.00%

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details) - USD ($)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Concentration Risk [Line Items]
Allowance for doubtful accounts	$ 0	$ 0
Unbilled receivables	79,000,000.0	68,700,000
Gain on business casualty loss	0	626,000	$ (3,549,000)
Rebate receivable	35,200,000	13,900,000
Investments in equity-method investees	17,000,000.0	17,000,000.0
Proportionate share of earnings in equity-method investees	3,313,000	2,840,000	1,020,000
Capital distribution from equity method investments	$ 3,250,000	$ 500,000	$ 2,000,000
Renewal term length	2 years
Revenue from Contract with Customer Benchmark \| Company's Largest Payer
Concentration Risk [Line Items]
Concentration risk	15.00%	16.00%	17.00%
Revenue from Contract with Customer Benchmark \| Governmental Programs
Concentration Risk [Line Items]
Concentration risk	15.00%	12.00%	12.00%
Accounts Receivable \| Governmental Programs
Concentration Risk [Line Items]
Concentration risk	15.00%	12.00%
Cost of Goods and Service, Product and Service Benchmark \| Medical Supply Vendors
Concentration Risk [Line Items]
Concentration risk	70.00%	70.00%	66.00%
Hurricane
Concentration Risk [Line Items]
Inventory write-down			$ 2,900,000
Insurance proceeds			800,000
Insurance receivable			$ 1,000,000.0
Infusion pumps
Concentration Risk [Line Items]
Intangible asset useful life (in years)	7 years
Computer Software
Concentration Risk [Line Items]
Intangible asset useful life (in years)	5 years
Minimum \| Referral sources
Concentration Risk [Line Items]
Intangible asset useful life (in years)	15 years
Minimum \| Trademarks/Names
Concentration Risk [Line Items]
Intangible asset useful life (in years)	2 years
Minimum \| Other amortizable intangible assets
Concentration Risk [Line Items]
Intangible asset useful life (in years)	2 years
Minimum \| Equipment
Concentration Risk [Line Items]
Intangible asset useful life (in years)	3 years
Maximum \| Referral sources
Concentration Risk [Line Items]
Intangible asset useful life (in years)	20 years
Maximum \| Trademarks/Names
Concentration Risk [Line Items]
Intangible asset useful life (in years)	15 years
Maximum \| Other amortizable intangible assets
Concentration Risk [Line Items]
Intangible asset useful life (in years)	9 years
Maximum \| Equipment
Concentration Risk [Line Items]
Intangible asset useful life (in years)	13 years
Inventories \| Hurricane
Concentration Risk [Line Items]
Insurance proceeds		$ 3,000,000.0
Gain on business casualty loss		$ 2,000,000.0

BUSINESS ACQUISITIONS - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands				12 Months Ended
	Aug. 06, 2019	Sep. 18, 2018	Aug. 08, 2018	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Goodwill				$ 1,428,610	$ 1,425,542	$ 632,469	$ 627,392
Purchase price, net of cash acquired				0	700,170	$ 10,727
BioScrip
Business Acquisition [Line Items]
Share price (in dollars per share)	$ 2.67
Payment of shares in acquisition	$ 125,800
Success-based fees	14,100
Goodwill	796,141
Net sales since acquisition					308,900
Net loss since acquisition					30,100
Payments of transaction costs					25,800
Purchase price	1,102,001
Purchase price, net of cash acquired	1,087,214
Cash paid	714,957
Baptist Health In Little Rock, Arkansas
Business Acquisition [Line Items]
Purchase price			$ 1,000
Home I.V. Specialists, Inc.
Business Acquisition [Line Items]
Payment in settlement of debt		$ 1,800
Percentage of outstanding shares purchased		100.00%
Purchase price, net of cash acquired		$ 11,600
Cash paid		$ 9,800
Reduction of liabilities incurred				$ 1,500	$ 300
First Lien Term Loan \| BioScrip \| Senior Notes
Business Acquisition [Line Items]
Payment in settlement of debt	$ 575,000

BUSINESS ACQUISITIONS - Consideration Exchanged (Details) $ / shares in Units, $ in Thousands			12 Months Ended
	Feb. 03, 2020	Aug. 06, 2019 USD ($) $ / shares shares	Dec. 31, 2020 USD ($) shares	Dec. 31, 2019 USD ($) shares	Dec. 31, 2018 USD ($)	Aug. 05, 2019 shares
Business Acquisition [Line Items]
Number of BioScrip common shares outstanding at time of the merger (in shares) \| shares			179,794,586	176,591,907
Fair value of total consideration acquired, net of cash acquired			$ 0	$ 700,170	$ 10,727
Stock conversion ratio	0.25
BioScrip
Business Acquisition [Line Items]
Number of BioScrip common shares outstanding at time of the merger (in shares) \| shares		132,639,000				129,181,000
Common shares issued to warrant and preferred stockholders at time of the merger (in shares) \| shares		3,458,000
BioScrip share price as of August 6, 2019 (in dollars per share) \| $ / shares		$ 2.67
Fair value of common shares		$ 354,146
Fair value of share-based instruments		32,898
Cash paid in conjunction with the Merger included in purchase consideration		714,957
Fair value of total consideration transferred		1,102,001
Less: cash acquired		14,787
Fair value of total consideration acquired, net of cash acquired		$ 1,087,214

BUSINESS ACQUISITIONS - Acquired Identifiable Assets and Assumed Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019	Aug. 06, 2019	Dec. 31, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Goodwill	$ 1,428,610	$ 1,425,542		$ 632,469	$ 627,392
BioScrip
Business Acquisition [Line Items]
Accounts receivable, net			$ 96,532
Inventories			19,683
Property and equipment, net			48,732
Intangible assets, net			193,245
Deferred tax assets, net of deferred tax liabilities			26,731
Operating lease right-of-use asset			22,378
Operating lease liability			(28,897)
Accounts payable			(66,668)
Other assumed liabilities, net of other acquired assets			(20,663)
Total acquired identifiable assets and liabilities			291,073
Goodwill			796,141
Total consideration transferred			$ 1,087,214

BUSINESS ACQUISITIONS - Consideration Allocated to Intangible Assets (Details) - BioScrip $ in Thousands	Aug. 06, 2019 USD ($)
Business Acquisition [Line Items]
Total intangible assets, net	$ 193,245
Weighted Average Estimated Life (in years)	18 years 9 months 18 days
Trademarks/Names
Business Acquisition [Line Items]
Total intangible assets, net	$ 12,536
Weighted Average Estimated Life (in years)	2 years
Patient referral sources
Business Acquisition [Line Items]
Total intangible assets, net	$ 180,329
Weighted Average Estimated Life (in years)	20 years
Licenses
Business Acquisition [Line Items]
Total intangible assets, net	$ 380
Weighted Average Estimated Life (in years)	1 year 6 months

BUSINESS ACQUISITIONS - Pro Forma Financial Information (Details) - BioScrip - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Business Acquisition [Line Items]
Net revenue	$ 2,755,361	$ 2,648,694
Net loss	$ (49,566)	$ (70,932)

REVENUE - Net Revenue Earned by Category of Payer (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Disaggregation of Revenue [Line Items]
Net revenue	$ 804,713	$ 781,609	$ 740,848	$ 705,440	$ 720,779	$ 615,880	$ 497,266	$ 476,492	$ 3,032,610	$ 2,310,417	$ 1,939,791
Commercial payers
Disaggregation of Revenue [Line Items]
Net revenue									2,542,985	2,001,105	1,699,450
Government payers
Disaggregation of Revenue [Line Items]
Net revenue									450,067	285,128	217,876
Patients
Disaggregation of Revenue [Line Items]
Net revenue									$ 39,558	$ 24,184	$ 22,465

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 30
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8906-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 40
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9031-108599

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 41
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9038-108599

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8933-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8933-108599

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 4
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130543-203045

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8736-108599

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8736-108599

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 42
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9054-108599

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130545-203045

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 924
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 11.L)
-URI http://asc.fasb.org/extlink&oid=6472922&loc=d3e499488-122856

+ Details

EMPLOYEE BENEFIT PLANS (Details) - USD ($) $ in Millions	12 Months Ended
EMPLOYEE BENEFIT PLANS (Details) - USD ($) $ in Millions	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Retirement Benefits [Abstract]
Employer matching contribution percent	100.00%
Employer matching contribution percent of employees' gross pay	4.00%
Defined contribution plan expense	$ 9.7	$ 6.4	$ 6.3
Company contributions	$ 8.9	$ 6.6	$ 6.3

INCOME TAXES - Income Tax Benefit (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
US federal income tax expense (benefit):
Current	$ (69)	$ 0	$ 0
Deferred	996	(3,072)	(2,688)
Federal income tax expense (benefit)	927	(3,072)	(2,688)
State and Local Income Tax Expense (Benefit), Continuing Operations [Abstract]
Current	1,707	2,074	1,176
Deferred	199	(1,276)	(1,141)
State income tax expense (benefit)	1,906	798	35
Total income tax expense (benefit)	$ 2,833	$ (2,274)	$ (2,653)

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References + Details

INCOME TAXES - Income Tax Reconciliation (Details)	12 Months Ended
INCOME TAXES - Income Tax Reconciliation (Details)	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
US federal statutory tax rate	21.00%	21.00%	21.00%
State and local income taxes net of federal tax benefit	(29.50%)	(0.50%)	2.40%
Valuation allowance	(29.90%)	(13.40%)	0.00%
Stock-based compensation	6.70%	0.00%	0.00%
Non-deductible compensation	(16.30%)	(0.70%)	0.00%
Changes in uncertain tax positions	0.00%	0.00%	14.70%
Non-deductible expenses	(8.20%)	(2.80%)	(7.50%)
Other, net	2.20%	(0.70%)	(0.30%)
Effective income tax rate	(54.00%)	2.90%	30.30%

INCOME TAXES - Deferred Income Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Deferred tax assets:
Price concessions	$ 6,907	$ 12,302
Compensation and benefits	4,058	3,672
Interest limitation carryforward	39,094	38,623
Operating lease liability	22,644	19,462
Net operating losses	155,922	147,749
Other	8,682	5,506
Deferred tax assets before valuation allowance	237,307	227,314
Valuation allowance	(112,085)	(109,531)	$ (1,373)	$ (1,263)
Deferred tax assets net of valuation allowance	125,222	117,783
Deferred tax liabilities:
Accelerated depreciation	(12,593)	(10,376)
Operating lease right-of-use asset	(17,186)	(15,442)
Intangible assets	(67,127)	(71,204)
Goodwill	(28,976)	(20,250)
Other	(2,679)	(2,654)
Deferred tax liabilities	(128,561)	(119,926)
Net deferred tax liabilities	$ (3,339)	$ (2,143)

INCOME TAXES - Narrative (Details) - USD ($)	12 Months Ended
INCOME TAXES - Narrative (Details) - USD ($)	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Tax Examination [Line Items]
Valuation allowance	$ 112,085,000	$ 109,531,000	$ 1,373,000	$ 1,263,000
Interest limitation carryforward	39,094,000	38,623,000
Net operating losses	155,922,000	147,749,000
Unrecognized tax benefits	0	0
Income tax expense (benefit) related to CARES Act	0
Federal
Income Tax Examination [Line Items]
Net operating losses		548,000,000.0
Operating loss carryforwards subject to expiration	139,800,000
Merger Operating Loss Carryforward
Income Tax Examination [Line Items]
Interest limitation carryforward	85,000,000.0
Net operating losses	400,000
Merger Operating Loss Carryforward \| Federal
Income Tax Examination [Line Items]
Operating loss carryforwards	458,900,000
Net operating losses	577,900,000
Merger Operating Loss Carryforward \| State
Income Tax Examination [Line Items]
Operating loss carryforwards	479,600,000
Federal Net Operating Loss Carryfowards Available To Offset Future Taxable Income \| Federal
Income Tax Examination [Line Items]
Net operating losses	438,100,000
Federal Net Operating Loss Carryfowards Available To Offset Future Taxable Income \| State
Income Tax Examination [Line Items]
Net operating losses	600,100,000	578,500,000
Interest Limitation Carryforwards
Income Tax Examination [Line Items]
Interest limitation carryforward	$ 154,800,000	$ 145,600,000

INCOME TAXES - Valuation Allowance for Deferred Tax Assets (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Change in Deferred Tax Asset Valuation Allowance
Balance at Beginning of Period	$ 109,531	$ 1,373	$ 1,263
Balance at End Period	112,085	109,531	1,373
Charged (Benefit) to Costs and Expenses
Change in Deferred Tax Asset Valuation Allowance
Deferred tax asset, additions	1,549	15,395	110
Charged to Other Accounts
Change in Deferred Tax Asset Valuation Allowance
Deferred tax asset, additions	$ 1,005	$ 92,763	$ 0

(LOSS) EARNINGS PER SHARE (Details) - USD ($)	3 Months Ended								12 Months Ended
(LOSS) EARNINGS PER SHARE (Details) - USD ($)	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Dilutive potential common shares											$ 0
Numerator:
Net (loss) income	$ 17,839,000	$ 1,663,000	$ (7,668,000)	$ (19,910,000)	$ (15,811,000)	$ (42,794,000)	$ (13,603,000)	$ (3,712,000)	$ (8,076,000)	$ (75,920,000)	$ (6,115,000)
Denominator:
Weighted average number of common shares outstanding (in shares)									180,971,000	156,280,000	142,614,000
Loss per Common Share:
Loss per common share, basic and diluted (in dollars per share)									$ (0.04)	$ (0.49)	$ (0.04)
Warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation (in shares)									2,285,784	2,328,120
Stock Option
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation (in shares)									412,831	644,975
Restricted Stock Award
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation (in shares)									549,650	231,562

LEASES - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Leases [Abstract]
Operating lease cost	$ 30.8	$ 25.8
Weighted-average remaining lease term, operating leases	6 years 8 months 12 days
Weighted-average discount rate, operating leases	5.18%
Right of use asset obtained in exchange for operating lease liabilities	$ 29.1
Incurred rent expense			$ 17.3

LEASES - Maturities of Lease Liabilities (Details) $ in Thousands	Dec. 31, 2020 USD ($)
Leases [Abstract]
2021	$ 23,770
2022	19,216
2023	15,804
2024	11,684
2025	9,369
2026 and beyond	30,168
Total lease payments	110,011
Less: Interest	(20,349)
Present value of lease liabilities	$ 89,662

PROPERTY AND EQUIPMENT (Details) - USD ($) $ in Thousands	12 Months Ended
PROPERTY AND EQUIPMENT (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 205,639	$ 211,820
Less: accumulated depreciation	84,490	78,622
Property and equipment, net	121,149	133,198
Depreciation expense	42,766	31,808	$ 21,483
Gain on business casualty loss	0	626	(3,549)
Hurricane
Property, Plant and Equipment [Line Items]
Loss on disposition of property and equipment			600
Insurance proceeds			800
Property and Equipment \| Hurricane
Property, Plant and Equipment [Line Items]
Insurance proceeds		600
Gain on business casualty loss		600
Depreciation expense in cost of revenue
Property, Plant and Equipment [Line Items]
Depreciation expense	6,586	4,179	2,993
Depreciation expense in operating expenses
Property, Plant and Equipment [Line Items]
Depreciation expense	36,180	27,629	$ 18,490
Infusion pumps
Property, Plant and Equipment [Line Items]
Property and equipment, gross	31,678	30,416
Equipment, furniture and other
Property, Plant and Equipment [Line Items]
Property and equipment, gross	47,886	51,454
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	87,483	80,916
Computer software, purchased and internally developed
Property, Plant and Equipment [Line Items]
Property and equipment, gross	27,799	34,884
Assets under development
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 10,793	$ 14,150

GOODWILL AND OTHER INTANGIBLE ASSETS - Narrative (Details) - USD ($)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill impairment	$ 0	$ 0	$ 0
Amortization expense for intangible assets	$ 35,100,000	$ 26,100,000	$ 19,600,000

GOODWILL AND OTHER INTANGIBLE ASSETS - Carrying Amount of Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Goodwill [Roll Forward]
Goodwill - net book value, begging of period	$ 1,425,542	$ 632,469	$ 627,392
Acquisitions	3,068	793,073	5,077
Goodwill - net book value, end of period	$ 1,428,610	$ 1,425,542	$ 632,469

GOODWILL AND OTHER INTANGIBLE ASSETS - Carrying Amount and Accumulated Amortization of Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	$ 483,059	$ 483,059
Total accumulated amortization	(132,007)	(97,149)
Total intangible assets, net	351,052	385,910
Referral sources
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	438,121	438,121
Total accumulated amortization	(110,498)	(84,295)
Trademarks/names
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	44,536	44,536
Total accumulated amortization	(21,146)	(12,748)
Other amortizable intangible assets
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	402	402
Total accumulated amortization	$ (363)	$ (106)

GOODWILL AND OTHER INTANGIBLE ASSETS - Future Amortization Expense of Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
2021	$ 32,015
2022	28,338
2023	28,338
2024	28,338
2025	28,338
2026 and beyond	205,685
Total intangible assets, net	$ 351,052	$ 385,910

INDEBTEDNESS - Summary of Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Principal Amount	$ 1,161,531	$ 1,337,256
Discount	(13,355)	(20,071)
Debt Issuance Costs	(23,823)	(30,689)
Total	1,124,353	1,286,496
Less: current portion	(9,250)	(9,250)
Total long-term debt	1,115,103	1,277,246
Senior Notes \| First Lien Term Loan
Debt Instrument [Line Items]
Principal Amount	915,750	925,000
Discount	(7,253)	(8,399)
Debt Issuance Costs	(19,710)	(22,825)
Total	888,787	893,776
Senior Notes \| Second Lien Notes
Debt Instrument [Line Items]
Principal Amount	245,781	412,256
Discount	(6,102)	(11,672)
Debt Issuance Costs	(4,113)	(7,864)
Total	235,566	392,720
Senior Notes \| Revolving Credit Facility
Debt Instrument [Line Items]
Principal Amount	0	0
Discount	0	0
Debt Issuance Costs	0	0
Total	$ 0	$ 0

INDEBTEDNESS - Additional Information (Details) - USD ($)	1 Months Ended		5 Months Ended	12 Months Ended
	Jan. 31, 2021	Nov. 30, 2019	Dec. 31, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Aug. 06, 2019
Debt Instrument [Line Items]
Principal amount of debt			$ 1,286,496,000	$ 1,124,353,000	$ 1,286,496,000
Paid-in-kind interest capitalized as principal				7,525,000	12,256,000	$ 0
Payments to extinguish debt				9,250,000	2,075,000	5,150,000
Loss on extinguishment of debt				11,545,000	5,469,000	72,000
Proceeds from issuance of debt				0	981,050,000	1,000,000
Debt issuance costs			30,689,000	23,823,000	30,689,000
Fees incurred netted against proceeds				149,000	30,022,000	$ 0
Common Stock \| Public Offering
Debt Instrument [Line Items]
Proceeds from sale of equity				118,900,000
Senior Notes
Debt Instrument [Line Items]
Loss on extinguishment of debt					5,500,000
Credit Arrangements Administered By Bank Of America, N.A. \| Senior Notes
Debt Instrument [Line Items]
Face amount of debt instruments				645,000,000.0
Loss on extinguishment of debt					(2,300,000)
Credit Agreements, Entered Into 2019
Debt Instrument [Line Items]
Loss on extinguishment of debt				11,500,000
Prepayment penalty				3,500,000
Deferred commitment fee				8,000,000.0
Credit Agreements, Entered Into 2019 \| Senior Notes
Debt Instrument [Line Items]
Face amount of debt instruments							$ 1,475,000,000.0
Proceeds from issuance of debt					981,100,000
Debt issuance costs and third party fees			52,600,000		52,600,000
Debt issuance costs			48,100,000		48,100,000
Issuance costs expensed			1,300,000		1,300,000
Fees incurred netted against proceeds					21,300,000
Deferred financing costs					30,000,000.0
Deferred financing costs, investing activities					1,300,000
Credit Agreements, Entered Into 2019 \| Notes Payable
Debt Instrument [Line Items]
Payments to extinguish debt				174,000,000.0
Credit Arrangements, Entered Into 2015, Modified Loans \| Senior Notes
Debt Instrument [Line Items]
Debt issuance costs			7,600,000		7,600,000
Revolving Credit Facility \| Senior Notes
Debt Instrument [Line Items]
Principal amount of debt			0	0	0
Debt issuance costs			0	0	0
Revolving Credit Facility \| Credit Agreements, Entered Into 2019 \| Senior Notes
Debt Instrument [Line Items]
Face amount of debt instruments				$ 175,000,000.0			150,000,000.0
Base rate				0.25%
Commitment fee percentage				2.50%
Principal amount of debt			$ 0	$ 0	$ 0
Net borrowing availability				$ 165,400,000
Revolving Credit Facility \| Minimum \| Credit Agreements, Entered Into 2019 \| Senior Notes
Debt Instrument [Line Items]
Commitment fee, unused portion				0.25%
Revolving Credit Facility \| Minimum \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate				1.25%
Revolving Credit Facility \| Minimum \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Eurocurrency Rate
Debt Instrument [Line Items]
Basis spread on variable rate				2.25%
Revolving Credit Facility \| Maximum \| Credit Agreements, Entered Into 2019 \| Senior Notes
Debt Instrument [Line Items]
Commitment fee, unused portion				0.375%
Revolving Credit Facility \| Maximum \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate				1.75%
Revolving Credit Facility \| Maximum \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Eurocurrency Rate
Debt Instrument [Line Items]
Basis spread on variable rate				2.75%
Letters of Credit \| Credit Agreements, Entered Into 2019 \| Senior Notes
Debt Instrument [Line Items]
Undrawn letters of credit issued and outstanding				$ 9,600,000
First Lien Term Loan \| Senior Notes
Debt Instrument [Line Items]
Principal amount of debt							575,000,000.0
First Lien Term Loan \| Credit Arrangements Administered By Bank Of America, N.A. \| Senior Notes
Debt Instrument [Line Items]
Face amount of debt instruments				415,000,000.0
Quarterly installment payments				1,000,000.0
Weighted average interest rate			6.20%		6.20%
First Lien Term Loan \| Credit Agreements, Entered Into 2019 \| Senior Notes
Debt Instrument [Line Items]
Face amount of debt instruments							925,000,000.0
Quarterly installment payments				$ 2,300,000
Weighted average interest rate paid on term loans during period			6.47%	5.09%
Basis spread on variable rate				4.25%
Effective rate on term loans at end of period			6.20%	4.40%	6.20%
Payments to extinguish debt					$ 226,700,000
Proceeds from issuance of debt					$ 752,400,000
First Lien Term Loan \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Subsequent Event
Debt Instrument [Line Items]
Face amount of debt instruments	$ 250,000,000.0
Quarterly installment payments	$ 2,900,000
Basis spread on variable rate	3.75%
First Lien Term Loan \| Minimum \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate				3.25%
First Lien Term Loan \| Minimum \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Eurocurrency Rate
Debt Instrument [Line Items]
Basis spread on variable rate				4.25%
First Lien Term Loan \| Maximum \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate				3.50%
First Lien Term Loan \| Maximum \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Eurocurrency Rate
Debt Instrument [Line Items]
Basis spread on variable rate				4.50%
Second Lien Term Loan \| Credit Arrangements Administered By Bank Of America, N.A. \| Senior Notes
Debt Instrument [Line Items]
Face amount of debt instruments							150,000,000.0
Weighted average interest rate paid on term loans during period					11.36%
Second Lien Term Loan \| Credit Agreements, Entered Into 2019 \| Senior Notes
Debt Instrument [Line Items]
Face amount of debt instruments							$ 400,000,000.0
Weighted average interest rate paid on term loans during period			11.45%	9.39%
Effective rate on term loans at end of period			10.66%	8.98%	10.66%
Interest capitalized to debt principal		$ 12,300,000
Paid-in-kind interest capitalized as principal				$ 7,500,000
Additional interest expense charge				1.00%
Payments to extinguish debt					$ 0
Loss on extinguishment of debt					3,200,000
Proceeds from issuance of debt					$ 250,000,000.0
Second Lien Term Loan \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Subsequent Event
Debt Instrument [Line Items]
Prepayment penalty	$ 4,900,000
Second Lien Term Loan \| Credit Agreements, Entered Into 2019 \| Senior Notes \| LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate				8.75%
Second Lien Term Loan \| Credit Agreements, Entered Into 2019 \| Notes Payable \| Subsequent Event
Debt Instrument [Line Items]
Payments to extinguish debt	$ 245,800,000
Bank Of America, N.A. \| Revolving Credit Facility \| Credit Arrangements Administered By Bank Of America, N.A. \| Senior Notes
Debt Instrument [Line Items]
Face amount of debt instruments				$ 80,000,000.0

INDEBTEDNESS - Long-term Debt Maturities (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Debt Disclosure [Abstract]
2021	$ 9,250
2022	9,250
2023	9,250
2024	9,250
2025	9,250
2026 and beyond	1,115,281
Total	$ 1,161,531	$ 1,337,256

INDEBTEDNESS - Estimated Fair Values of Debt Obligations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Principal prepayment	$ (9,250)	$ (2,075)	$ (5,150)
Interest rate PIK	7,525	12,256	$ 0
Senior Notes
Debt Instrument [Line Items]
Total debt instruments	1,124,353
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of January 1, 2020
Second Lien Notes fair value as of December 31, 2020	1,124,353
Senior Notes \| First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	888,787
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of January 1, 2020
Second Lien Notes fair value as of December 31, 2020	888,787
Senior Notes \| Second Lien Notes
Debt Instrument [Line Items]
Total debt instruments	235,566
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of January 1, 2020
Second Lien Notes fair value as of December 31, 2020	235,566
Senior Notes \| Markets for Identical Item (Level 1)
Debt Instrument [Line Items]
Total debt instruments	0
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of January 1, 2020
Second Lien Notes fair value as of December 31, 2020	0
Senior Notes \| Markets for Identical Item (Level 1) \| First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	0
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of January 1, 2020
Second Lien Notes fair value as of December 31, 2020	0
Senior Notes \| Markets for Identical Item (Level 1) \| Second Lien Notes
Debt Instrument [Line Items]
Total debt instruments	0
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of January 1, 2020
Second Lien Notes fair value as of December 31, 2020	0
Senior Notes \| Significant Other Observable Inputs (Level 2)
Debt Instrument [Line Items]
Total debt instruments	913,461
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of January 1, 2020
Second Lien Notes fair value as of December 31, 2020	913,461
Senior Notes \| Significant Other Observable Inputs (Level 2) \| First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	913,461
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of January 1, 2020
Second Lien Notes fair value as of December 31, 2020	913,461
Senior Notes \| Significant Other Observable Inputs (Level 2) \| Second Lien Notes
Debt Instrument [Line Items]
Total debt instruments	0
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of January 1, 2020
Second Lien Notes fair value as of December 31, 2020	0
Senior Notes \| Significant Unobservable Inputs (Level 3)
Debt Instrument [Line Items]
Total debt instruments	411,119	411,119
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of January 1, 2020	411,119
Principal prepayment	(174,000)
Second Lien Notes fair value as of December 31, 2020	266,438	$ 411,119
Senior Notes \| Significant Unobservable Inputs (Level 3) \| First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	0
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of January 1, 2020
Second Lien Notes fair value as of December 31, 2020	0
Senior Notes \| Significant Unobservable Inputs (Level 3) \| Second Lien Notes
Debt Instrument [Line Items]
Total debt instruments	266,438
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of January 1, 2020
Interest rate PIK	7,525
Change in fair value	21,794
Second Lien Notes fair value as of December 31, 2020	$ 266,438

DERIVATIVE INSTRUMENTS - Additional Information (Details) - USD ($) $ in Thousands	1 Months Ended		12 Months Ended
	May 31, 2020	Apr. 30, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Nov. 06, 2019	Aug. 31, 2019	Dec. 31, 2017
Derivative [Line Items]
Total interest rate costs expected to reclassify during next 12 months			$ 11,200
Interest Rate Cap \| Interest expense
Derivative [Line Items]
Accumulated comprehensive loss reclassified			0	$ 125	$ (300)
Interest Rate Swap
Derivative [Line Items]
Notional amount of derivative							$ 925,000
Interest Rate Swap \| Interest expense
Derivative [Line Items]
Accumulated comprehensive loss reclassified	$ 3,700		$ 12,799	$ 115	$ 0
Designated as Hedging Instrument \| Senior Notes \| First Lien Term Loan \| Credit Agreements, Entered Into 2019 \| Interest Rate Cap
Derivative [Line Items]
Notional amount of derivative								$ 250,000
Designated as Hedging Instrument \| Senior Notes \| Second Lien Term Loan \| Credit Agreements, Entered Into 2019 \| Interest Rate Swap
Derivative [Line Items]
Notional amount of derivative						$ 400,000
Not Designated as Hedging Instrument \| Interest Rate Swap
Derivative [Line Items]
Notional amount of derivative							13,900
Cash Flow Hedging \| Designated as Hedging Instrument \| Interest Rate Cap
Derivative [Line Items]
Notional amount of derivative								$ 1,900
Proceeds from early termination of hedge		$ 1,700
Cash Flow Hedging \| Designated as Hedging Instrument \| Interest Rate Swap
Derivative [Line Items]
Notional amount of derivative							$ 911,100

DERIVATIVE INSTRUMENTS - Balance Sheet Location of Derivatives (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Fair value - Derivatives in liability position
Total derivatives	$ 11,342	$ 7,285
Designated as Hedging Instrument \| Accrued expenses and other current liabilities \| Interest Rate Swap
Fair value - Derivatives in liability position
Interest rate swaps	11,172	1,275
Designated as Hedging Instrument \| Other noncurrent liabilities \| Interest Rate Swap
Fair value - Derivatives in liability position
Interest rate swaps	0	5,920
Not Designated as Hedging Instrument \| Accrued expenses and other current liabilities \| Interest Rate Swap
Fair value - Derivatives in liability position
Interest rate swaps	170	0
Not Designated as Hedging Instrument \| Other noncurrent liabilities \| Interest Rate Swap
Fair value - Derivatives in liability position
Interest rate swaps	$ 0	$ 90

DERIVATIVE INSTRUMENTS - Pre-tax Gain (Loss) on Derivative Instruments (Details) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	May 31, 2020	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Derivative [Line Items]
Pre-tax gains (losses) on interest rate derivatives recognized		$ (3,977)	$ (8,298)	$ 1,008
Total gain (loss) on derivatives		(16,579)	(332)	300
Interest Rate Cap
Derivative [Line Items]
Pre-tax gains (losses) on interest rate derivatives recognized		0	(1,103)	1,008
Interest Rate Swap
Derivative [Line Items]
Pre-tax gains (losses) on interest rate derivatives recognized		(7,723)	(7,195)	0
Interest rate swaps that discontinued hedge accounting		3,746	0	0
Interest expense \| Interest Rate Cap
Derivative [Line Items]
Gain (loss) location of derivative instruments		0	(125)	300
Interest expense \| Interest Rate Swap
Derivative [Line Items]
Gain (loss) location of derivative instruments	$ (3,700)	(12,799)	(115)	0
Gain (loss) location of derivative instruments not designated		(34)	(92)	0
Gain (loss) location of discontinued derivative instruments		$ (3,746)	$ 0	$ 0

STOCK-BASED INCENTIVE COMPENSATION (Details) - USD ($)	12 Months Ended
STOCK-BASED INCENTIVE COMPENSATION (Details) - USD ($)	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	May 03, 2018
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Weighted-average grant-date fair value per share (in dollars per share)	$ 1.13
Proceeds from stock option exercises	$ 400,000	$ 0	$ 0
Stock Option
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based compensation expense	$ 400,000	$ 400,000
Weighted-average grant-date fair value per share (in dollars per share)	$ 5.94
Options granted in period (in shares)	204,928	0	0
Value of shares surrendered to satisfy tax withholding obligations	$ 2,700,000	$ 400,000
Unrecognized compensation expense	$ 1,000,000.0
Weighted average period of recognition	1 year 9 months 18 days
Restricted Stock
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based compensation expense	$ 2,300,000	1,900,000
Value of shares surrendered to satisfy tax withholding obligations	300,000	2,100,000
Unrecognized compensation expense	$ 6,000,000.0
Weighted average period of recognition	1 year 8 months 12 days
Value of shares vested in period	$ 1,500,000	1,900,000	$ 0
HC I Incentive Units
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based compensation expense	$ 200,000	1,900,000	$ 2,100,000
The 2018 Plan
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Number of shares authorized (in shares)				4,101,735
Treasury Stock \| Restricted Stock
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Value of shares surrendered to satisfy tax withholding obligations		$ 2,000,000.0
Minimum
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercisable range of years	7 years
Minimum \| Stock Option
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Vesting period	3 years
Minimum \| Restricted Stock
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Vesting period	1 year
Maximum
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercisable range of years	10 years
Maximum \| Stock Option
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Vesting period	4 years
Maximum \| Restricted Stock
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Vesting period	4 years
Director \| Restricted Stock
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Vesting period	1 year

STOCK-BASED INCENTIVE COMPENSATION - Assumptions Used to Compute Fair Value of Stock Options (Details)	12 Months Ended
	Dec. 31, 2020
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Risk-free interest rate	2.25%
Stock Option
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Expected volatility	45.70%
Risk-free interest rate	0.53%
Expected life of options	6 years 3 months 18 days
Dividend rate	0.00%

STOCK-BASED INCENTIVE COMPENSATION - Summary of Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Aggregate Intrinsic Value
Weighted Average Remaining Contractual Life at December 31, 2020	2 years 1 month 6 days
Stock Option
Options
Balance at December 31, 2019 (in shares)	644,975
Granted (in shares)	204,928	0	0
Exercised (in shares)	(266,065)
Forfeited and expired (in shares)	(171,007)
Balance at December 31, 2020 (in shares)	412,831	644,975
Exercisable at December 31, 2020 (in shares)	197,735
Weighted Average Exercise Price
Balance at December 31, 2019 (in dollars per share)	$ 15.36
Granted (in dollars per share)	13.34
Exercised (in dollars per share)	7.63
Forfeited and expired (in dollars per share)	26.36
Balance at December 31, 2020 (in dollars per share)	14.77	$ 15.36
Exercisable at December 31, 2020 (in dollars per share)	$ 16.51
Aggregate Intrinsic Value
Balance at December 31, 2019	$ 2,754
Granted	471
Exercised	2,548
Forfeited and expired	88
Balance at December 31, 2020	1,320	$ 2,754
Exercisable at December 31, 2020	$ 789
Weighted Average Remaining Contractual Life at December 31, 2020	6 years 8 months 12 days
Weighted Average Remaining Contractual Life Exercisable at December 31, 2020	4 years 2 months 12 days

STOCK-BASED INCENTIVE COMPENSATION - Summary of Outstanding and Exercisable Stock Options (Details)	12 Months Ended
	Dec. 31, 2020 $ / shares shares
Options Outstanding
Options Outstanding (in shares) \| shares	412,831
Options Exercisable
Options Exercisable (in shares) \| shares	197,735
0
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Lower range limit (in dollars per share)	$ 0.00
Upper range limit (in dollars per share)	$ 8.24
Options Outstanding
Options Outstanding (in shares) \| shares	9,901
Weighted Average Exercise Price (in dollars per share)	$ 6.52
Weighted Average Remaining Contractual Life	6 years 1 month 6 days
Options Exercisable
Options Exercisable (in shares) \| shares	9,901
Weighted Average Exercise Price (in dollars per share)	$ 6.52
8.24
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Lower range limit (in dollars per share)	8.24
Upper range limit (in dollars per share)	$ 16.52
Options Outstanding
Options Outstanding (in shares) \| shares	345,180
Weighted Average Exercise Price (in dollars per share)	$ 12.08
Weighted Average Remaining Contractual Life	7 years 6 months
Options Exercisable
Options Exercisable (in shares) \| shares	130,084
Weighted Average Exercise Price (in dollars per share)	$ 10.27
16.52
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Lower range limit (in dollars per share)	16.52
Upper range limit (in dollars per share)	$ 24.76
Options Outstanding
Options Outstanding (in shares) \| shares	25,500
Weighted Average Exercise Price (in dollars per share)	$ 22.61
Weighted Average Remaining Contractual Life	2 years 8 months 12 days
Options Exercisable
Options Exercisable (in shares) \| shares	25,500
Weighted Average Exercise Price (in dollars per share)	$ 22.61
24.76
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Lower range limit (in dollars per share)	24.76
Upper range limit (in dollars per share)	$ 33.00
Options Outstanding
Options Outstanding (in shares) \| shares	15,000
Weighted Average Exercise Price (in dollars per share)	$ 30.41
Weighted Average Remaining Contractual Life	2 years 3 months 18 days
Options Exercisable
Options Exercisable (in shares) \| shares	15,000
Weighted Average Exercise Price (in dollars per share)	$ 30.41
33
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Lower range limit (in dollars per share)	33.00
Upper range limit (in dollars per share)	$ 41.28
Options Outstanding
Options Outstanding (in shares) \| shares	0
Weighted Average Exercise Price (in dollars per share)	$ 0
Weighted Average Remaining Contractual Life	0 years
Options Exercisable
Options Exercisable (in shares) \| shares	0
Weighted Average Exercise Price (in dollars per share)	$ 0
41.28
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Lower range limit (in dollars per share)	41.28
Upper range limit (in dollars per share)	$ 49.52
Options Outstanding
Options Outstanding (in shares) \| shares	12,500
Weighted Average Exercise Price (in dollars per share)	$ 44.16
Weighted Average Remaining Contractual Life	1 year 3 months 18 days
Options Exercisable
Options Exercisable (in shares) \| shares	12,500
Weighted Average Exercise Price (in dollars per share)	$ 44.16
49.52
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Lower range limit (in dollars per share)	49.52
Upper range limit (in dollars per share)	$ 57.76
Options Outstanding
Options Outstanding (in shares) \| shares	3,500
Weighted Average Exercise Price (in dollars per share)	$ 56.24
Weighted Average Remaining Contractual Life	2 years
Options Exercisable
Options Exercisable (in shares) \| shares	3,500
Weighted Average Exercise Price (in dollars per share)	$ 56.24
57.76
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Lower range limit (in dollars per share)	57.76
Upper range limit (in dollars per share)	$ 66.00
Options Outstanding
Options Outstanding (in shares) \| shares	0
Weighted Average Exercise Price (in dollars per share)	$ 0
Weighted Average Remaining Contractual Life	0 years
Options Exercisable
Options Exercisable (in shares) \| shares	0
Weighted Average Exercise Price (in dollars per share)	$ 0
66
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Lower range limit (in dollars per share)	66.00
Upper range limit (in dollars per share)	$ 74.28
Options Outstanding
Options Outstanding (in shares) \| shares	1,250
Weighted Average Exercise Price (in dollars per share)	$ 66.52
Weighted Average Remaining Contractual Life	2 years 7 months 6 days
Options Exercisable
Options Exercisable (in shares) \| shares	1,250
Weighted Average Exercise Price (in dollars per share)	$ 66.52

STOCK-BASED INCENTIVE COMPENSATION - Summary of Restricted Stock Award Activity (Details) - Restricted Stock	12 Months Ended
	Dec. 31, 2020 $ / shares shares
Restricted Stock
Balance at December 31, 2019 (in shares) \| shares	231,562
Granted (in shares) \| shares	490,557
Vested and issued (in shares) \| shares	(120,782)
Forfeited and expired (in shares) \| shares	(51,687)
Balance at December 31, 2020 (in shares) \| shares	549,650
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value [Abstract]
Balance at December 31, 2019 (in dollars per share) \| $ / shares	$ 10.68
Shares granted (in dollars per share) \| $ / shares	13.32
Vested and issued (in dollars per share) \| $ / shares	12.15
Forfeited and expired (in dollars per share) \| $ / shares	12.92
Balance at December 31, 2020 (in dollars per share) \| $ / shares	$ 13.26

STOCK-BASED INCENTIVE COMPENSATION - Fair Value of Awards (Details)	12 Months Ended
	Dec. 31, 2020 $ / shares
Share-based Payment Arrangement [Abstract]
Risk-free interest rate	2.25%
Average time to liquidity (in years)	2 years 1 month 6 days
Volatility	47.00%
Discount for lack of marketability	30.00%
Weighted-average grant-date fair value per share (in dollars per share)	$ 1.13

STOCKHOLDERS' EQUITY (Details) $ / shares in Units, $ in Thousands			12 Months Ended
	Feb. 03, 2020	Aug. 06, 2019 USD ($) $ / shares shares	Dec. 31, 2020 USD ($) $ / shares shares	Dec. 31, 2019 USD ($) day $ / shares shares	Dec. 31, 2018 USD ($)	Dec. 31, 2016 shares	Aug. 05, 2019 shares	Jun. 29, 2017 $ / shares	Mar. 09, 2015 $ / shares
Class of Warrant or Right [Line Items]
Stock conversion ratio	0.25
Payments to extinguish debt \| $			$ 9,250	$ 2,075	$ 5,150
Common stock, par value (in dollars per share) \| $ / shares			$ 0.0001	$ 0.0001
Shares surrendered to satisfy tax withholding (in shares)				290,117
Treasury stock held (in shares)			383,722	383,722
Preferred stock outstanding (in shares)			0	0
Credit Agreements, Entered Into 2019 \| Notes Payable
Class of Warrant or Right [Line Items]
Payments to extinguish debt \| $			$ 174,000
HC Group Holdings I, LLC
Class of Warrant or Right [Line Items]
Percentage of outstanding common stock			0.636
Common Stock \| Public Offering
Class of Warrant or Right [Line Items]
Additional shares issued (in shares)			20,700,000
Shares issued, price per share (in dollars per share) \| $ / shares			$ 12.50
Proceeds from sale of equity \| $			$ 118,900
Common Stock \| Public Offering \| Option Care Health, Inc
Class of Warrant or Right [Line Items]
Additional shares issued (in shares)			10,000,000
Common Stock \| Public Offering \| HC Group Holdings I, LLC
Class of Warrant or Right [Line Items]
Additional shares issued (in shares)			10,700,000
Common Stock \| Secondary Offering
Class of Warrant or Right [Line Items]
Additional shares issued (in shares)			10,600,000
Common Stock \| 2017 Warrants
Class of Warrant or Right [Line Items]
Number of shares purchasable through warrants (in shares)		2,100,000
Term of warrants								10 years
Exercise price of warrants (in dollars per share) \| $ / shares								$ 8.00
Fair value of warrants \| $		$ 14,100
Shares purchased from exercise of warrants (in shares)			0.0	700,000
Class of warrant or right, outstanding (in shares)			1,400,000	1,400,000
Common Stock \| 2015 Warrants
Class of Warrant or Right [Line Items]
Number of shares purchasable through warrants (in shares)							900,000
Term of warrants									10 years
Fair value of warrants \| $		$ 4,600
Minimum \| Common Stock \| 2015 Warrants
Class of Warrant or Right [Line Items]
Exercise price of warrants (in dollars per share) \| $ / shares									$ 20.68
Maximum \| Common Stock \| 2015 Warrants
Class of Warrant or Right [Line Items]
Exercise price of warrants (in dollars per share) \| $ / shares									$ 25.80
OptionCare Enterprises, Inc.
Class of Warrant or Right [Line Items]
Additional shares issued (in shares)		7,048,357	7,048,357
Common stock, par value (in dollars per share) \| $ / shares		$ 0.0001
Restricted Stock Units (RSUs) \| Home Solutions
Class of Warrant or Right [Line Items]
Shares issued pursuant to acquisition (in shares)						1,800,000
Restricted Stock And Stock Options
Class of Warrant or Right [Line Items]
Value of shares surrendered to satisfy tax withholding obligations \| $				$ 2,500
Restricted Stock And Stock Options \| Treasury Stock
Class of Warrant or Right [Line Items]
Value of shares surrendered to satisfy tax withholding obligations \| $			$ 2,400	$ 2,400
Tranche One \| Restricted Stock Units (RSUs) \| Home Solutions
Class of Warrant or Right [Line Items]
Shares issued pursuant to acquisition (in shares)				800,000
Stock price threshold (in dollars per share) \| $ / shares				$ 16.00
Consecutive trading days threshold \| day				20
Tranche Two \| Restricted Stock Units (RSUs) \| Home Solutions
Class of Warrant or Right [Line Items]
Shares issued pursuant to acquisition (in shares)				1,000,000.0
Stock price threshold (in dollars per share) \| $ / shares				$ 20.00
Consecutive trading days threshold \| day				20

RELATED-PARTY TRANSACTIONS (Details) - USD ($)	12 Months Ended
RELATED-PARTY TRANSACTIONS (Details) - USD ($)	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Related Party Transaction [Line Items]
Selling, general and administrative expenses	$ 500,199,000	$ 459,628,000	$ 345,884,000
Sale Of Notes Receivable
Related Party Transaction [Line Items]
Sale of management notes receivable		1,300,000
Madison Dearborn Partners VI-B, L.P. \| Option Care Acquisition
Related Party Transaction [Line Items]
Due to joint ventures	300,000
Management
Related Party Transaction [Line Items]
Selling, general and administrative expenses		1,500,000	2,000,000.0
Notes receivable	0	0	1,600,000
Management \| Sale Of Notes Receivable
Related Party Transaction [Line Items]
Sale of management notes receivable		1,100,000
Accrued interest expense		200,000
HC Group Holdings I, LLC \| Loans Funded For Membership Unit Purchase
Related Party Transaction [Line Items]
Amount credited to paid-in capital for membership units sold and funded	0	0	400,000
Shareholder redemptions	0	2,400,000	0
Cash distributions		2,000,000.0
Notes redeemed		400,000
Joint Venture
Related Party Transaction [Line Items]
Due to joint ventures		4,300,000
Management fee income	2,900,000	$ 2,500,000	$ 2,200,000
Due from joint ventures	$ 2,400,000

SELECTED QUARTERLY FINANCIAL DATA (UNAUDITED) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Quarterly Financial Information Disclosure [Abstract]
Net revenue	$ 804,713	$ 781,609	$ 740,848	$ 705,440	$ 720,779	$ 615,880	$ 497,266	$ 476,492	$ 3,032,610	$ 2,310,417	$ 1,939,791
Gross profit	183,762	174,153	166,320	158,029	175,642	137,773	101,390	98,194	682,264	512,999	422,215
Operating income	44,343	34,556	23,208	8,648	13,973	(11,725)	(8,005)	5,438	110,755	(319)	38,269
Net (loss) income	$ 17,839	$ 1,663	$ (7,668)	$ (19,910)	$ (15,811)	$ (42,794)	$ (13,603)	$ (3,712)	$ (8,076)	$ (75,920)	$ (6,115)
(Loss) earnings per share, basic (in dollars per share)	$ 0.10	$ 0.01	$ (0.04)	$ (0.11)	$ (0.09)	$ (0.26)	$ (0.10)	$ (0.03)
(Loss) earnings per share, diluted (in dollars per share)	$ 0.10	$ 0.01	$ (0.04)	$ (0.11)	$ (0.09)	$ (0.26)	$ (0.1)	$ (0.03)

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

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-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8933-108599

Reference 23: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 8
-URI http://asc.fasb.org/extlink&oid=109234566&loc=d3e22658-107794

SUBSEQUENT EVENTS (Details)	1 Months Ended		12 Months Ended
SUBSEQUENT EVENTS (Details)	Feb. 28, 2021 shares	Jan. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)	Dec. 31, 2019 USD ($)	Dec. 31, 2018 USD ($)	Aug. 06, 2019 USD ($)
Subsequent Event [Line Items]
Payments to extinguish debt			$ 9,250,000	$ 2,075,000	$ 5,150,000
Original issue discount			$ 13,355,000	20,071,000
HC Group Holdings I, LLC
Subsequent Event [Line Items]
Percentage of outstanding common stock			0.636
Credit Agreements, Entered Into 2019
Subsequent Event [Line Items]
Prepayment penalty			$ 3,500,000
Credit Agreements, Entered Into 2019 \| Senior Notes
Subsequent Event [Line Items]
Face amount of debt instruments						$ 1,475,000,000.0
Credit Agreements, Entered Into 2019 \| Notes Payable
Subsequent Event [Line Items]
Payments to extinguish debt			$ 174,000,000.0
Credit Agreements, Entered Into 2019 \| First Lien Term Loan \| Senior Notes
Subsequent Event [Line Items]
Face amount of debt instruments						925,000,000.0
Basis spread on variable rate			4.25%
Payments to extinguish debt				226,700,000
Quarterly installment payments			$ 2,300,000
Credit Agreements, Entered Into 2019 \| Second Lien Term Loan \| Senior Notes
Subsequent Event [Line Items]
Face amount of debt instruments						$ 400,000,000.0
Payments to extinguish debt				$ 0
Subsequent Event \| HC Group Holdings I, LLC
Subsequent Event [Line Items]
Percentage of outstanding common stock	0.54
Subsequent Event \| Common Stock \| Secondary Offering
Subsequent Event [Line Items]
Number of shares issued in transaction (in shares) \| shares	17,250,000
Subsequent Event \| Credit Agreements, Entered Into 2019 \| First Lien Term Loan \| Senior Notes
Subsequent Event [Line Items]
Face amount of debt instruments		$ 250,000,000.0
Basis spread on variable rate		3.75%
Quarterly installment payments		$ 2,900,000
Subsequent Event \| Credit Agreements, Entered Into 2019 \| Second Lien Term Loan \| Senior Notes
Subsequent Event [Line Items]
Prepayment penalty		4,900,000
Third party fees		1,300,000
Original issue discount		1,000,000.0
Subsequent Event \| Credit Agreements, Entered Into 2019 \| Second Lien Term Loan \| Notes Payable
Subsequent Event [Line Items]
Payments to extinguish debt		$ 245,800,000