0001014739-22-000009 | 10-K | XBRL Viewer

Print Document View Excel Document

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
CURRENT ASSETS:
Cash and cash equivalents	$ 119,423	$ 99,265
Accounts receivable, net	338,242	328,340
Inventories	183,095	158,601
Prepaid expenses and other current assets	69,496	70,806
Total current assets	710,256	657,012
NONCURRENT ASSETS:
Property and equipment, net	111,535	121,149
Operating lease right-of-use asset	74,777	68,795
Intangible assets, net	21,433	23,429
Referral sources	344,587	327,623
Goodwill	1,477,564	1,428,610
Deferred income taxes	27,033	0
Other noncurrent assets	23,733	20,821
Total noncurrent assets	2,080,662	1,990,427
TOTAL ASSETS	2,790,918	2,647,439
CURRENT LIABILITIES:
Accounts payable	279,246	282,913
Accrued compensation and employee benefits	83,503	58,899
Accrued expenses and other current liabilities	71,857	64,075
Current portion of operating lease liability	19,089	18,886
Current portion of long-term debt	6,000	9,250
Total current liabilities	459,695	434,023
NONCURRENT LIABILITIES:
Long-term debt, net of discount, deferred financing costs and current portion	1,059,900	1,115,103
Operating lease liability, net of current portion	74,492	70,776
Deferred income taxes	0	3,339
Other noncurrent liabilities	20,945	8,474
Total noncurrent liabilities	1,155,337	1,197,692
Total liabilities	1,615,032	1,631,715
STOCKHOLDERS’ EQUITY:
Preferred stock; $0.0001 par value; 12,500,000 shares authorized, no shares outstanding as of December 31, 2021 and 2020, respectively.	0	0
Common stock; $0.0001 par value: 250,000,000 shares authorized, 180,309,637 shares issued and 179,925,915 shares outstanding as of December 31, 2021; 180,178,308 shares issued and 179,794,586 shares outstanding as of December 31, 2020.	18	18
Treasury stock; 383,722 shares outstanding, at cost, as of December 31, 2021 and 2020, respectively.	(2,403)	(2,403)
Paid-in capital	1,138,855	1,129,312
Retained earnings (Accumulated deficit)	39,867	(100,031)
Accumulated other comprehensive loss	(451)	(11,172)
Total stockholders’ equity	1,175,886	1,015,724
TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY	$ 2,790,918	$ 2,647,439

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 31, 2021	Dec. 31, 2020
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)	180,309,637	180,178,308
Common stock, shares, outstanding (in shares)	179,925,915	179,794,586
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, 2021	Dec. 31, 2020	Dec. 31, 2019
Income Statement [Abstract]
NET REVENUE	$ 3,438,640	$ 3,032,610	$ 2,310,417
COST OF REVENUE	2,659,034	2,350,346	1,797,418
GROSS PROFIT	779,606	682,264	512,999
OPERATING COSTS AND EXPENSES:
Selling, general and administrative expenses	525,707	500,199	459,628
Depreciation and amortization expense	63,058	71,310	53,690
Total operating expenses	588,765	571,509	513,318
OPERATING INCOME (LOSS)	190,841	110,755	(319)
OTHER INCOME (EXPENSE):
Interest expense, net	(67,003)	(107,770)	(73,724)
Equity in earnings of joint ventures	6,030	3,313	2,840
Other, net	(13,374)	(11,541)	(6,991)
Total other expense	(74,347)	(115,998)	(77,875)
INCOME (LOSS) BEFORE INCOME TAXES	116,494	(5,243)	(78,194)
INCOME TAX (BENEFIT) EXPENSE	(23,404)	2,833	(2,274)
NET INCOME (LOSS)	139,898	(8,076)	(75,920)
OTHER COMPREHENSIVE INCOME (LOSS), NET OF TAX:
Change in unrealized gains (losses) on cash flow hedges, net of income taxes of $0, $0 and $259, respectively	10,721	(3,977)	(8,039)
OTHER COMPREHENSIVE INCOME (LOSS)	10,721	(3,977)	(8,039)
NET COMPREHENSIVE INCOME (LOSS)	$ 150,619	$ (12,053)	$ (83,959)
EARNINGS (LOSS) PER COMMON SHARE
Earnings (loss) per share, basic (in dollars per share)	$ 0.78	$ (0.04)	$ (0.49)
Earnings (loss) per share, diluted (in dollars per share)	$ 0.77	$ (0.04)	$ (0.49)
Weighted average common shares outstanding, basic (in shares)	179,855	180,971	156,280
Weighted average common shares outstanding, diluted (in shares)	181,205	180,971	156,280

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Income Statement [Abstract]
Income taxes on unrealized gains (losses) on cash flow hedges	$ 0	$ 0	$ 259

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income (loss)	$ 139,898	$ (8,076)	$ (75,920)
Adjustments to reconcile net income (loss) to net cash provided by operations:
Depreciation and amortization expense	68,804	77,896	57,869
Non-cash operating lease costs	15,168	18,814	19,719
Deferred income taxes - net	(30,372)	1,196	(4,607)
Loss on sale of assets	767	742	3,269
Loss on extinguishment of debt	13,387	11,545	5,469
Amortization of deferred financing costs	4,998	5,517	4,544
Loss on interest rate swaps upon discontinuing hedge accounting	0	3,746	0
Paid-in-kind interest capitalized as principal	0	7,525	12,256
Equity in earnings of joint ventures	(6,030)	(3,313)	(2,840)
Stock-based incentive compensation expense	9,575	2,920	4,170
Capital distribution from equity method investments	2,900	3,250	500
Change in contingent consideration liability	0	(1,500)	(300)
Other adjustments	844	0	(688)
Changes in operating assets and liabilities:
Accounts receivable, net	(4,273)	(3,924)	82,285
Inventories	(22,700)	(42,725)	(12,853)
Prepaid expenses and other current assets	1,420	(19,500)	(2,940)
Accounts payable	(10,381)	59,215	(30,856)
Accrued compensation and employee benefits	23,977	13,134	2,671
Accrued expenses and other current liabilities	18,383	22,809	(317)
Operating lease liabilities	(18,496)	(18,089)	(17,253)
Other noncurrent assets and liabilities	700	(3,790)	(4,711)
Net cash provided by operating activities	208,569	127,392	39,467
CASH FLOWS FROM INVESTING ACTIVITIES:
Acquisition of property and equipment	(25,632)	(26,875)	(28,292)
Proceeds from sale of assets	0	0	10
Insurance proceeds from business casualty loss	0	0	626
Business acquisitions, net of cash acquired	(85,909)	0	(700,170)
Other investing cash flows	0	541	0
Net cash used in investing activities	(111,541)	(26,334)	(727,826)
CASH FLOWS FROM FINANCING ACTIVITIES:
Redemptions to related parties	0	0	(2,000)
Sale of management notes receivable	0	0	1,310
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(32)	(904)	(2,501)
Net proceeds from issuance of common stock	0	118,934	0
Proceeds from debt	855,136	0	981,050
Repayments of debt principal	(8,832)	(9,250)	(2,075)
Retirement of debt obligations	(910,345)	(174,000)	(226,738)
Deferred financing costs	(10,339)	(149)	(30,022)
Debt prepayment fees	(2,458)	(3,480)	0
Net cash (used in) provided by financing activities	(76,870)	(68,849)	719,024
NET INCREASE IN CASH AND CASH EQUIVALENTS	20,158	32,209	30,665
Cash and cash equivalents - beginning of the period	99,265	67,056	36,391
CASH AND CASH EQUIVALENTS - END OF PERIOD	119,423	99,265	67,056
Supplemental disclosure of cash flow information:
Cash paid for interest	60,920	97,640	50,808
Cash paid for income taxes	5,706	2,884	2,405
Cash paid for operating leases	$ 26,174	$ 26,809	$ 18,992

CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY - USD ($) $ in Thousands	Total	Preferred Stock	Common Stock	Treasury Stock	Paid-in Capital	Management Notes Receivable	Retained Earnings (Accumulated Deficit)	Accumulated Other Comprehensive Income (Loss)
Equity, beginning 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 income (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 income (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)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based incentive compensation	9,575				9,575
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(32)				(32)
Net income (loss)	139,898						139,898
Other comprehensive income (loss)	10,721							10,721
Equity, ending balance at Dec. 31, 2021	$ 1,175,886	$ 0	$ 18	$ (2,403)	$ 1,138,855	$ 0	$ 39,867	$ (451)

NATURE OF OPERATIONS AND PRESENTATION OF FINANCIAL STATEMENTS	12 Months Ended
	Dec. 31, 2021
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, 2021. 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 97 full service pharmacies and 57 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

Dec. 31, 2021

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, 2021 and 2020, respectively.

Included in accounts receivable are earned but unbilled gross receivables of $80.1 million and $79.0 million as of December 31, 2021 and 2020, 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.

Prepaid expenses and other current assets — Included in prepaid expenses and other current assets are rebates receivable from pharmaceutical and medical supply manufacturers of $43.0 million and $35.2 million for the years ended December 31, 2021 and 2020, respectively. There were no other items included in prepaid expenses and other current assets that comprised 5% or more of total assets.

Leases — The Company has lease agreements for facilities, warehouses, office space and property and equipment. 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 fifteen to twenty 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, 2021 and 2020, the balance of the investments was $20.1 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 $6.0 million, $3.3 million and $2.8 million for the years ended December 31, 2021, 2020 and 2019, 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, 2021, 2020 and 2019, the Company received distributions from the investees of $2.9 million, $3.3 million and $0.5 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.

Immaterial Error Correction — During the three months ended June 30, 2021, the Company identified prior period misstatements related to the net revenue earned by category of payer for the periods ended September 30, 2020, December 31, 2020, March 31, 2021, and June 30, 2021. Certain individual payers were improperly classified as direct government and instead should have been classified as commercial payers. This error over-stated the Company’s government revenues and under-stated the Company’s commercial revenues in those periods. The Company assessed the materiality of these misstatements both quantitatively and qualitatively and determined the correction of these errors to be immaterial to the prior

consolidated financial statements taken as a whole. As a result, the Company has corrected the misstatements as disclosed in the following tables:


	Three Months ended September 30, 2020				Nine Months ended September 30, 2020			Three Months ended December 31, 2020				Twelve Months ended December 31, 2020
	Amount		% of Revenue		Amount	% of Revenue		Amount		% of Revenue		Amount		% of Revenue
Commercial:
As Previously Reported	$	644,385	82.4	%	1,893,105	85.0	%	$	649,880	80.8	%	$	2,542,985	83.9	%
Adjustment	34,321		4.4	%	34,321	1.5	%	40,806		5.1	%	75,127		2.5	%
As Revised	678,706		86.8	%	1,927,426	86.5	%	690,686		85.9	%	2,618,112		86.4	%

Government:
As Previously Reported	127,435		16.3	%	308,830	13.9	%	141,237		17.6	%	450,067		14.8	%
Adjustment	(34,321)		(4.4)	%	(34,321)	(1.5)	%	(40,806)		(5.1)	%	(75,127)		(2.5)	%
As Revised	93,114		11.9	%	274,509	12.4	%	100,431		12.5	%	374,940		12.3	%


	Three Months ended March 31, 2021				Three Months ended June 30, 2021				Six Months ended June 30, 2021
	Amount		% of Revenue		Amount		% of Revenue		Amount		% of Revenue
Commercial:
As Previously Reported	$	611,434	80.5	%	$	703,429	81.8	%	$	1,314,862	81.2	%
Adjustment	37,073		4.9	%	43,218		5.0	%	80,292		4.9	%
As Revised	648,507		85.4	%	746,647		86.8	%	1,395,154		86.1	%

Government:
As Previously Reported	134,914		17.8	%	145,799		16.9	%	280,714		17.3	%
Adjustment	(37,073)		(4.9)	%	(43,218)		(5.0)	%	(80,292)		(4.9)	%
As Revised	97,841		12.9	%	102,581		11.9	%	200,422		12.4	%

There was no impact to the Company’s consolidated balance sheets, consolidated statements of comprehensive income (loss) or the consolidated statements of cash flows for any of these periods.

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 16%, 15% and 16% for the years ended December 31, 2021, 2020 and 2019, respectively. The Company renewed its contract with this payer effective February 2022. There were no other managed care contracts that represent greater than 10% of revenue for the years presented.

For the years ended December 31, 2021, 2020 and 2019, approximately 12%, 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, 2021 and 2020, approximately 11% and 13%, 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 year ended December 31, 2021, approximately 74% of the Company’s pharmaceutical and medical supply purchases were from four vendors. For the years ended December 31, 2020 and 2019, approximately 70% of the Company’s pharmaceutical and medical supply purchases were from three 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, 2021 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 Issued Accounting Pronouncements — In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting. This ASU provides optional expedient and exceptions for applying generally accepted accounting principles to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criteria are met. The FASB further issued ASU 2021-01 to clarify the scope of Topic 848. The ASU can be adopted no later than December 1, 2022 with early adoption permitted. The Company does not expect adoption will have any material impact on the Company’s results of operations, cash flows or financial position.

BUSINESS ACQUISITIONS

12 Months Ended

Dec. 31, 2021

Business Combination and Asset Acquisition [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 of $1,087,214, 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 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	$	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

Assuming BioScrip had been acquired as of January 1, 2019, and the results of BioScrip had been included in operations beginning on January 1, 2019, the following tables provide estimated unaudited pro forma results of operations for the year ended December 31, 2019 (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.



	2019
Net revenue	$	2,755,361
Net loss	(49,566)

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.

BioCure Asset Acquisition — In April 2021, pursuant to the asset purchase agreement dated April 7, 2021, the Company completed the acquisition of certain assets of BioCure, LLC (“BioCure”) for a purchase price of $18.9 million.

The allocation of the purchase price of BioCure was accounted for as an asset acquisition in accordance with ASC Topic 805, Business Combinations, with the total purchase price being allocated to the assets acquired based on the relative fair value of each asset. The purchase price was allocated to the assets acquired as follows:


	Amount
Inventories	$	601
Intangible assets, net	$	18,251
Total consideration transferred	$	18,852

Intangibles assets, net consists of referral sources which were assigned a useful life of 15 years, amortized on a straight-line basis.

Infinity Infusion Nursing LLC — In October 2021, pursuant to the equity purchase agreement dated October 1, 2021, the Company completed the 100% acquisition of the equity interest in Infinity Infusion LLC (“Infinity”) for a purchase price, net of cash acquired of $59.6 million, which is comprised of a $50.0 million cash payment, two contingent $5.0 million payments (included as a non-cash change in other noncurrent assets and liabilities within the consolidated statements of cash flows), and $(.4) million of other purchase price adjustments.

The allocation of the purchase price of Infinity was accounted for as a business combination in accordance with ASC Topic 805, Business Combinations, with the total purchase price being allocated to the assets and liabilities acquired based on the relative fair value of each asset and liability. The following is a preliminary estimate of the allocation of the consideration transferred, open for accounts receivable and accounts payable, to acquired identifiable assets and assumed liabilities, net of cash acquired, as of December 31, 2021 (in thousands):


	Amount
Accounts receivable	$	2,219
Intangible assets	25,400
Accounts payable and other assumed liabilities	(539)
Fair value identifiable assets and liabilities	27,080
Goodwill (1)	32,524
Cash acquired	1,426
Purchase Price	61,030
Less: cash acquired	(1,426)
Purchase price, net of cash acquired	59,604

(1) Goodwill is attributable to cost synergies from operational efficiencies and establishing a more comprehensive clinical platform through the Company’s national infrastructure and Infinity’s nursing network.

Wasatch Infusion LLC Acquisition — In December 2021, pursuant to the executed asset purchase agreement on December 29, 2021, the Company completed the acquisition of Wasatch Infusion LLC (“Wasatch”) for a purchase price of $19.5 million, which is comprised of a $17.8 million cash payment, a contingent $2.0 million payment (included as a non-cash change in other noncurrent assets and liabilities within the consolidated statements of cash flows), and $(.3) million of other purchase price adjustments.

The allocation of the purchase price of Wasatch was accounted for as a business combination in accordance with ASC Topic 805, Business Combinations, with the total purchase price being allocated to the assets and liabilities acquired based on the relative fair value of each asset and liability. The following is a preliminary estimate of the allocation of the consideration transferred, open for accounts receivable and accounts payable, to acquired identifiable assets and assumed liabilities, as of December 31, 2021 (in thousands):


	Amount
Accounts receivable	$	3,410
Inventories	2,038
Intangible assets	4,245
Other assets	958
Accounts payable	(6,686)
Other assumed liabilities	(940)
Fair value Identifiable assets and liabilities	3,025
Goodwill (1)	16,430
Purchase Price	19,455

(1) Goodwill is attributable to cost synergies from procurement and operational efficiencies and elimination of duplicative administrative costs.

REVENUE

12 Months Ended

Dec. 31, 2021

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, 2021, 2020 and 2019 (in thousands):


	Year Ended December 31,
	2021		2020		2019
Commercial payers	$	2,971,900	$	2,618,112	$	2,001,105
Government payers	417,088		374,940		285,128
Patients	49,652		39,558		24,184
Net revenue	$	3,438,640	$	3,032,610	$	2,310,417

- 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=123351226&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=123351226&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=123351226&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=123351226&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=123351226&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=123351226&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=123351226&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=123351226&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=123351226&loc=SL49130554-203045

+ Details

EMPLOYEE BENEFIT PLANS	12 Months Ended
EMPLOYEE BENEFIT PLANS	Dec. 31, 2021
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 $11.6 million, $9.7 million and $6.4 million for the years ended December 31, 2021, 2020 and 2019, respectively. In the years ended December 31, 2021, 2020 and 2019, Company contributions of $10.9 million, $8.9 million and $6.6 million, respectively, were paid.

INCOME TAXES

12 Months Ended

Dec. 31, 2021

Income Tax Disclosure [Abstract]

Income Taxes

INCOME TAXES

The income tax expense (benefit) consists of the following for the years ended December 31, 2021, 2020 and 2019 (in thousands):


	2021		2020		2019
US federal income tax (benefit) expense:
Current	$	—	$	(69)	$	—
Deferred	(30,411)		996		(3,072)
	(30,411)		927		(3,072)
State income tax expense:
Current	6,817		1,707		2,074
Deferred	190		199		(1,276)
	7,007		1,906		798
Total income tax (benefit) expense	$	(23,404)	$	2,833	$	(2,274)

The difference between the statutory federal income tax rate and the effective tax rate is as follows for the years ended December 31, 2021, 2020 and 2019:


	2021		2020		2019
US federal statutory tax rate	21.0	%	21.0	%	21.0	%
State and local income taxes net of federal tax benefit	4.9	%	(29.5)	%	(0.5)	%
Valuation allowance	(46.2)	%	(29.9)	%	(13.4)	%
Stock-based compensation	(0.1)	%	6.7	%	0.0	%
Non-deductible compensation	0.1	%	(16.3)	%	(0.7)	%
Non-deductible expenses	0.3	%	(8.2)	%	(2.8)	%
Other, net	(0.1)	%	2.2	%	(0.7)	%
Effective income tax rate	(20.1)	%	(54.0)	%	2.9	%

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, 2021 and 2020 (in thousands):


	2021		2020
Deferred tax assets:
Price concessions	$	6,373	$	6,907
Compensation and benefits	5,889		4,058
Interest limitation carryforward	35,114		39,094
Operating lease liability	23,266		22,644
Net operating losses	97,880		155,922
Other	6,381		8,501
Deferred tax assets before valuation allowance	174,903		237,126
Valuation allowance	(13,151)		(112,085)
Deferred tax assets net of valuation allowance	161,752		125,041

Deferred tax liabilities:
Accelerated depreciation	(10,602)		(12,593)
Operating lease right-of-use asset	(18,437)		(17,186)
Intangible assets	(61,629)		(67,127)
Goodwill	(36,702)		(28,976)
Other	(7,349)		(2,498)
Deferred tax liabilities	(134,719)		(128,380)
Net deferred tax assets (liabilities)	$	27,033	$	(3,339)

As a result of the Merger, the Company had 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”). 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 company adjusted its valuation allowance to offset tax benefits that would have otherwise been recognized for the years ended December 31, 2020 and 2019. In the current year ended December 31, 2021, the company has assessed that it more likely than not will realize its deferred tax assets, with the exception of certain state NOL’s valued at $13.2 million, resulting in a reversal of the company’s valuation allowance in the current period.

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. In the current period, the company determined the positive evidence to outweigh any negative evidence, such that the realization of the deferred tax assets is more likely than not and the reversal of the Company’s valuation allowance is warranted. Compelling objective positive evidence is the Company now realizing a multi-year cumulative income position combined with actual utilization of its deferred tax assets in the current period due to the Company generating positive pre-tax book income. Other objective positive factors include the Company’s January 2021 and October 2021 debt refinancing transactions, which result in reduced interest expense for the company compared to historical trends as well as the Company’s 2021 business acquisitions, which provide for a new and objective source of future income compared to prior year earnings. With the exception of the federal NOL carryovers noted below that are expected to expire unutilized due to limitations under Internal Revenue Code (“Code”) Section 382, the Company expects to fully utilize all of its deferred tax assets prior to any expiration based on current period income trends of the company.

The Company is subject to taxation in the United States and various states. At December 31, 2021, the Company had $358.4 million of gross federal NOL carryforwards all of which are currently available to offset future taxable income in the United States and reflected as a deferred tax asset of the company. Gross federal NOL carryforwards of $223.7 million expire beginning in 2025 through 2037 and $134.7 million have an indefinite carryforward period. Excluded from this figure and not reflected as a deferred tax asset is $139.8 million of federal NOL carryovers that are expected to expire unutilized due to limitations under Code Section 382 and were written off in the current year. At December 31, 2020, the Company had $577.9 million of gross federal NOL’s, which included $139.8 million of fully reserved federal NOL carryovers that are expected to expire unutilized due to limitations under Code Section 382. At December 31, 2021 and 2020, the Company had $140.2 million and $154.8 million of interest limitation carryforwards which have an indefinite carryforward period. At December 31, 2021

and 2020, the Company also had $405.1 million and $600.1 million of cumulative gross state NOL carryforwards available to offset future taxable income in various states. These state NOL carryforwards will begin to expire beginning in 2022 through 2041, with some having an indefinite carryforward period.

At December 31, 2021 and 2020, 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, 2021, 2020 and 2019 (in thousands):


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

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

2021: Valuation allowance for deferred tax assets	$	112,085	$	(96,136)	$	(2,798)	$	13,151

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 years ended December 31, 2021 and 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 previously recognized 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

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 21
-URI http://asc.fasb.org/extlink&oid=121826272&loc=d3e32857-109319

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
-URI http://asc.fasb.org/extlink&oid=122134291&loc=d3e330215-122817

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 17
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=121826272&loc=d3e32809-109319

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 6.I.5.Q1)
-URI http://asc.fasb.org/extlink&oid=122134291&loc=d3e330036-122817

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 14
-URI http://asc.fasb.org/extlink&oid=121826272&loc=d3e32705-109319

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 270
-Section 50
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=6424409&loc=d3e44925-109338

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-URI http://asc.fasb.org/topic&trid=2144680

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 30
-Section 50
-Paragraph 2
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=6424122&loc=d3e41874-109331

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

+ Details

EARNINGS (LOSS) PER SHARE

12 Months Ended

Dec. 31, 2021

Earnings Per Share [Abstract]

Earnings (Loss) Per Share

EARNINGS (LOSS) PER SHARE

The Company presents basic and diluted earnings (loss) per share for its common stock. Basic earnings (loss) per share is calculated by dividing the net income (loss) of the Company by the weighted average number of shares of common stock outstanding during the period. Diluted earnings (loss) 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 potentially dilutive securities.

The earnings (loss) is used as the basis of determining whether the inclusion of common stock equivalents would be anti-dilutive. The computation of diluted shares for the year ended December 31, 2021 includes the effect of shares that would be issued in connection with warrants, stock options and restricted stock awards, as these common stock equivalents are dilutive to the earnings per share. 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, 2021 there were 457,753 warrants, 490,968 stock options and 316,454 restricted stock awards outstanding that were excluded from the calculation as they would be anti-dilutive. 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 were 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.

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


	Year Ended December 31,
	2021		2020		2019
Numerator:
Net income (loss) (1)	$	139,898	$	(8,076)	$	(75,920)
Denominator:
Weighted average number of common shares outstanding	179,855		180,971		156,280
Earnings (loss) per Common Share:
Earnings (loss) per common share, basic	$	0.78	$	(0.04)	$	(0.49)

(1) Net income (loss) for the year ended December 31, 2021 includes the impact of the Company’s release of its valuation allowance. See Note 6, Income Taxes, for further discussion.

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


	Year Ended December 31,
	2021		2020		2019
Numerator:
Net income (loss) (1)	$	139,898	$	(8,076)	$	(75,920)
Denominator:
Weighted average number of common shares outstanding	179,855		180,971		156,280
Effect of dilutive securities	1,350		—		—
Weighted average number of common shares outstanding, diluted	181,205		180,971		156,280
Earnings (loss) per Common Share:
Earnings (loss) per common share, diluted	$	0.77	$	(0.04)	$	(0.49)

(1) Net income (loss) for the year ended December 31, 2021 includes the impact of the Company’s release of its valuation allowance. See Note 6, Income Taxes, for further discussion.

LEASES

12 Months Ended

Dec. 31, 2021

Leases [Abstract]

Leases

LEASES

During the years ended December 31, 2021 and 2020, the Company incurred operating lease expenses of $29.8 million and $30.8 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, 2021, the weighted-average remaining lease term was 6.6 years and the weighted-average discount rate was 5.10%.

Operating leases mature as follows (in thousands):


Year Ending December 31	Minimum Payments
2022	$	23,558
2023	20,508
2024	14,930
2025	12,218
2026	9,315
2027 and beyond	28,052
Total lease payments	108,581
Less: Interest	(15,000)
Present value of lease liabilities	$	93,581

During the year ended December 31, 2021, the Company commenced new leases, extensions and amendments, resulting in non-cash investing and financing activities in the consolidated statements of cash flows of $20.7 million related to the increases in the operating lease right-of-use asset and operating lease liabilities, respectively. As of December 31, 2021, the Company did not have any significant operating or financing leases that had not yet commenced.

Leases

LEASES

Operating leases mature as follows (in thousands):


Year Ending December 31	Minimum Payments
2022	$	23,558
2023	20,508
2024	14,930
2025	12,218
2026	9,315
2027 and beyond	28,052
Total lease payments	108,581
Less: Interest	(15,000)
Present value of lease liabilities	$	93,581

PROPERTY AND EQUIPMENT

12 Months Ended

Dec. 31, 2021

Property, Plant and Equipment [Abstract]

Property and Equipment

PROPERTY AND EQUIPMENT

Property and equipment was as follows as of December 31, 2021 and 2020 (in thousands):


	December 31, 2021		December 31, 2020
Infusion pumps	$	34,547	$	31,678
Equipment, furniture and other	52,913		47,886
Leasehold improvements	92,229		87,483
Computer software, purchased and internally developed	30,744		27,799
Assets under development	19,924		10,793
	230,357		205,639
Less: accumulated depreciation	118,822		84,490
Property and equipment, net	$	111,535	$	121,149

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, 2021, 2020 and 2019 (in thousands):


	Year ended December 31,
	2021		2020		2019
Depreciation expense in cost of revenue	$	5,746	$	6,586	$	4,179
Depreciation expense in operating expenses	29,865		36,180		27,629
Total depreciation expense	$	35,611	$	42,766	$	31,808

GOODWILL AND OTHER INTANGIBLE ASSETS

12 Months Ended

Dec. 31, 2021

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 2021, 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 2021, 2020, or 2019.

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, 2021, 2020 and 2019 (in thousands):


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
Acquisitions	48,954
Balance at December 31, 2021	$	1,477,564

The carrying amount and accumulated amortization of intangible assets consists of the following as of December 31, 2021 and 2020 (in thousands):


	December 31, 2021		December 31, 2020
Gross intangible assets:
Referral sources	$	482,200	$	438,121
Trademarks/names	47,718		44,536
Other amortizable intangible assets	1,037		402
Total gross intangible assets	530,955		483,059

Accumulated amortization:
Referral sources	(137,613)		(110,498)
Trademarks/names	(26,936)		(21,146)
Other amortizable intangible assets	(386)		(363)
Total accumulated amortization	(164,935)		(132,007)
Total intangible assets, net	$	366,020	$	351,052

Amortization expense for intangible assets was $32.9 million, $35.1 million and $26.1 million for the years ended December 31, 2021, 2020 and 2019, respectively.

Expected future amortization expense for intangible assets recorded at December 31, 2021, is as follows (in thousands):


2022	$	31,628
2023	31,628
2024	31,628
2025	31,628
2026	31,628
2027 and beyond	207,880
Total	$	366,020

INDEBTEDNESS

12 Months Ended

Dec. 31, 2021

Debt Disclosure [Abstract]

Indebtedness

INDEBTEDNESS

Long-term debt consisted of the following as of December 31, 2021 (in thousands):


	Principal Amount		Discount		Debt Issuance Costs		Net Balance
ABL Facility	$	—	$	—	$	—	$	—
First Lien Term Loan	600,000		(9,605)		(13,331)		577,064
Senior Notes	500,000		—		(11,164)		488,836
	$	1,100,000	$	(9,605)	$	(24,495)	1,065,900
Less: current portion							(6,000)
Total long-term debt							$	1,059,900

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

On August 6, 2019, the Company repaid the outstanding balance of an $80.0 million revolving credit facility, a $415.0 million first lien term loan (“Previous First Lien Term Loan”) and a $150.0 million second lien term loan (“Previous Second Lien”) and retired the outstanding Previous Credit Facilities by entering into two new credit arrangements and a notes indenture. The two new credit agreements and the indenture 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 bore 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 was 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 was 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. 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 was 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% as of December 31, 2020. The weighted average interest rate incurred was 5.09% for the year ended December 31, 2020. 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 were set to mature on August 6, 2027. Interest on the Second Lien Notes was 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% as of December 31, 2020. The weighted average interest incurred was 9.39% for the year ended December 31, 2020.

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.

January 2021 Refinancing - 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. 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.

The Company assessed whether the repayment of the Second Lien Notes by issuing incremental First Lien Term Loan indebtedness 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 First Lien Term Loan and Second Lien Notes; (ii) previous lenders that exited; and (iii) new lenders. The Company determined that $161.2 million of the First Lien Term Loan was extinguished and $122.9 million of the Second Lien Term Loan was extinguished, which is disclosed as an outflow from financing activities in the consolidated statements of cash flows. The First Lien Term Loan and Second Lien Notes had insubstantial modifications for lenders that participated in both debt instruments, which resulted in a cash outflow from financing activities of $352.0 million in the consolidated statements of cash flows. The Company determined that $356.2 million of new debt was issued related to the First Lien Term Loan, which is disclosed as an inflow from financing activities in the consolidated statements of cash flows. In connection with the prepayment of the Second Lien Notes and incremental First Lien Term Loan indebtedness, the Company incurred $7.2 million in debt issuance costs and third-party fees, of which $3.7 million was capitalized, $0.9 million was expensed as a component of other expense and $2.6 million was expensed as a loss on extinguishment as a component of other expense in the consolidated statements of comprehensive income (loss). Further, $1.0 million of the total fees incurred of $7.2 million was netted against the $356.2 million of proceeds from debt as a component of the cash flows from financing activities, $2.9 million was presented as deferred financing costs as a component of cash flows from financing activities, $2.4 million was presented as debt prepayment fees as a component of cash flows from financing activities, and the remaining $0.9 million was included in cash flows from operating activities in the consolidated statements of cash flows.

The Company recognized a loss on extinguishment of debt of $12.4 million included in the line entitled “Other, net” in the consolidated statements of comprehensive income (loss), of which $2.6 million related to debt issuance costs incurred with the incremental First Lien Term Loan indebtedness and prepayment of the Second Lien Notes, as discussed above, and $9.8 million related to existing deferred financing fees that were written off upon extinguishment.

October 2021 Refinancing - In October 2021, the Company refinanced its $1,157.0 million outstanding existing First Lien Term Loan due 2026. The Company amended the existing First Lien Term Loan, to provide $600.0 million of refinanced borrowings (the “First Lien Term Loan Facility”). The refinancing changed the interest rate from LIBOR plus 3.75% to, at the Parent Borrower’s option, either (i) LIBOR (or a comparable successor rate, with a floor of 0.50% per annum) plus an applicable margin of 2.75% for Eurocurrency Rate Loans (as such term is defined in the First Lien Term Loan Agreement) and (ii) a base rate determined in accordance with in the First Lien Term Loan Agreement, plus 1.75% for Base Rate Loans (as such term is defined in the First Lien Term Loan Agreement). The First Lien Term Loan Facility is repayable in quarterly installments, beginning in March 2022, of $1.5 million plus interest and extended its maturity to October 27, 2028. The interest rate on the First Lien Term Loan was 3.25% as of December 31, 2021. The weighted average interest rate incurred was 3.79% for the year ended December 31, 2021. In conjunction with the refinancing, the Company also issued $500.0 million in aggregate principal of unsecured senior notes (“Senior Notes”). The Senior Notes bear interest at a rate of 4.375% per annum payable semi-annually in arrears on October 31 and April 30 of each year, commencing April 30, 2022. The Senior Notes mature on October 31, 2029.

The Company assessed whether the refinancing of the First Lien Term Loan Facility and issuance of the Senior 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 continuing to participate in either the First Lien Term Loan Facility and Senior Notes (ii) previous lenders that exited; and (iii) new lenders. The Company determined that $35.7 million of the First Lien Term Loan was extinguished, which is disclosed as an outflow from financing activities in the condensed consolidated statements of cash flows. The First Lien Term Loan had insubstantial modifications for lenders that continued to participate in either debt instrument, which resulted in a cash outflow from financing activities of $558.3 million in the consolidated statements of cash flows. The Company determined that $501.4 million of new debt was issued related to the First Lien Term Loan, which is disclosed as an inflow from financing activities in the consolidated statements of cash flows. In connection with the refinancing of the First Lien Term Loan and issuance of the Senior Notes, the Company incurred $10.7 million in debt issuance costs and third-party fees, of which $8.8 million was capitalized, $1.7 million was expensed as a component of other expense and $0.2 million was expensed as a loss on extinguishment as a component of other expense in the consolidated statements of comprehensive income (loss). Further, $1.5 million of the total fees incurred of $10.7 million was netted against the $501.4 million of proceeds from debt as a component of the cash flows from financing activities, $7.4 million was presented as deferred financing costs as a component of cash flows from financing activities, and the remaining $1.8 million was included in cash flows from operating activities in the consolidated statements of cash flows.

The Company recognized a loss on extinguishment of debt of $1.0 million included in the line entitled “Other, net” in the consolidated statements of comprehensive income (loss), of which $0.2 million related to debt issuance costs incurred with the First Lien Term Loan refinancing and issuance of the Senior Notes, as discussed above, and $0.8 million related to existing deferred financing fees that were written off upon extinguishment.

The Company also entered into an agreement to amend its existing ABL Facility. The ABL Facility bears interest at a rate equal to, at the Borrowers’ election, either (i) a base rate determined in accordance with the ABL Credit Agreement plus an applicable margin, which is equal to between 0.25% and 0.75% based on the historical excess availability as a percentage of the Line Cap (as such term is defined in the ABL Credit Agreement) and (ii) LIBOR (or a comparable successor rate, with a floor of 0.00% per annum) plus an applicable margin, which is equal to between 1.25% and 1.75% based on the historical excess availability as a percentage of the Line Cap. The Company had no outstanding borrowings under the ABL Facility at December 31, 2021. The Company had $7.1 million of undrawn letters of credit issued and outstanding, resulting in net borrowing availability under the ABL Facility of $167.9 million as of December 31, 2021. The ABL Facility matures on October 27, 2026.

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


Year Ending December 31,	Minimum Payments
2022	$	6,000
2023	6,000
2024	6,000
2025	6,000
2026	6,000
2027 and beyond	1,070,000
Total	$	1,100,000

During the year ended December 31, 2021, 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, 2021 (in thousands):


Financial Instrument	Carrying Value as of December 31, 2021		Markets for Identical Item (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
First Lien Note Facility	$	577,064	$	—	$	598,500	$	—
Senior Notes	488,836		—		501,250		—
Total debt instruments	$	1,065,900	$	—	$	1,099,750	$	—

The following table sets forth the changes in Level 3 measurements for the year ended December 31, 2021 (in thousands). As the Second Lien Notes were prepaid in Q1, there was no change in the fair value thereafter:


	Level 3 Measurements
Second Lien Notes fair value as of January 1, 2021	$	266,438
Principal prepayment	(245,781)

Change in fair value	(20,657)
Second Lien Notes fair value as of December 31, 2021	$	—

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

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-URI http://asc.fasb.org/topic&trid=2208564

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1B
-Subparagraph (h)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1C
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495334-112611

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1I
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495371-112611

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1I
-Subparagraph (d)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495371-112611

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(c))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1B
-Subparagraph (g)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1C
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495334-112611

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1C
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495334-112611

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1E
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495348-112611

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1B
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1I
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495371-112611

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1B
-Subparagraph (i)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

+ Details

DERIVATIVE INSTRUMENTS

12 Months Ended

Dec. 31, 2021

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.

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 following the Merger with BioScrip. 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 had 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 first interest rate swap expired in August 2021. The second interest rate swap of $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 payments 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.

In October 2021, the Company entered into an interest rate cap hedge with a notional amount of $300 million for a 5-year term beginning November 30, 2021. The hedge partially offsets risk associated with the First Lien Term Loan Facility’s variable interest rate. The interest rate cap instrument perfectly offsets the terms of the interest rates associated with the variable interest rate of the First Lien Term Loan.

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, 2021		December 31, 2020
Interest rate caps designated as cash flow hedges	Accrued expenses and other current liabilities	$	601	$	—
Interest rate swaps designated as cash flow hedges	Accrued expenses and other current liabilities	—		11,172
Interest rate swaps not designated as hedges	Accrued expenses and other current liabilities	—		170


Total derivatives		$	601	$	11,342

The gain and loss associated with the changes in the fair value of the effective portion of hedging instruments are recorded into other comprehensive (loss) income. The gain and loss associated with the changes in the fair value of the hedging instruments not designated 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	2021		2020		2019
Interest rate caps designated as cash flow hedges	$	(601)	$	—	$	(1,103)
Interest rate swaps designated as cash flow hedges	11,172		(7,723)		(7,195)
Interest rate swaps that discontinued hedge accounting	—		3,746		—
Total	$	10,571	$	(3,977)	$	(8,298)

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	2021		2020		2019
Interest rate caps designated as cash flow hedges	Interest expense	$	(239)	$	—	$	(125)
Interest rate swaps designated as cash flow hedges	Interest expense	(11,298)		(12,799)		(115)
Interest rate swaps not designated as hedges	Interest expense	(2)		(34)		(92)
Interest rate swaps that discontinued hedge accounting	Interest expense	—		(3,746)		—
Total		$	(11,539)	$	(16,579)	$	(332)

The Company expects to reclassify $2.8 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, 2021
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: Prior to the October refinancing, 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: Prior to the January refinancing, 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. New First Lien Term Loan: The fair value of the New 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 New First Lien Term Loan. Senior Notes: The fair value of the Senior Notes is derived from a broker quote (Level 2 inputs). See Note 11, Indebtedness, for further discussion of the carrying amount and fair value of the Senior 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. Both interest rate swaps have been terminated. See Note 12, Derivative Instruments, for further discussion of the fair value of the interest rate swaps. Interest rate cap: The fair values of the interest rate cap 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 caps. There were no other assets or liabilities measured at fair value at December 31, 2021 or 2020.

- 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, 2021
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, 2021

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. In May 2021, an additional 4,999,999 shares were authorized for issuance under the 2018 Plan, resulting in a total 9,101,734 shares of common stock authorized for issuance.

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, 2021 and 2020, the Company recognized compensation expense related to stock options of $1.9 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 years ended December 31, 2021 and 2020 was $17.79 and $5.94, respectively. The Company did not grant any options during the year ended December 31, 2019. 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, 2021 and 2020 are as follows:


	Years Ended December 31,
	2021		2020
Expected volatility	51.92	%	45.7	%
Risk-free interest rate	1.4	%	0.53	%
Expected life of options	6.5 years		6.3 years
Dividend rate	—		—

A summary of stock option activity for the year ended December 31, 2021 is as follows:


	Options	Weighted Average Exercise Price		Aggregate Intrinsic Value (thousands)		Weighted Average Remaining Contractual Life
Balance at December 31, 2020	412,831	$	14.77	$	1,320
Granted	853,089	$	22.14	$	5,335
Exercised	(42,405)	$	10.65	$	461
Forfeited and expired	(53,374)	$	22.13	$	478
Balance at December 31, 2021	1,170,141	$	19.96	$	10,154	8.55 years
Exercisable at December 31, 2021	150,890	$	15.84	$	2,131	3.63 years

During the year ended December 31, 2021, shares were surrendered to satisfy tax withholding obligations on the exercise of stock options with a cost basis of $0.1 million. 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, which are all held as treasury stock as of December 31, 2021. 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 year ended December 31, 2019.

The maximum term of stock options under these plans is ten years. Options outstanding as of December 31, 2021 expire on various dates ranging from March 2023 through October 2031. The following table outlines the outstanding and exercisable stock options as of December 31, 2021:


	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	5.1 years	9,901	$	6.52
$8.24 - $16.52	292,189	$	12.32	7.0 years	99,739	$	10.30
$16.52 - $24.76	521,461	$	19.90	9.0 years	21,375	$	23.56
$24.76 - $33.00	336,715	$	26.20	9.6 years	10,000	$	30.20

$41.28 - $49.52	6,250	$	44.16	1.2 years	6,250	$	44.16
$49.52 - $57.76	2,375	$	56.24	1.3 years	2,375	$	56.24

$66.00 - $74.28	1,250	$	66.52	1.6 years	1,250	$	66.52
All options	1,170,141				150,890

As of December 31, 2021, there was $13.9 million of unrecognized compensation expense related to unvested option grants that is expected to be recognized over a weighted-average period of 2.3 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, 2021 and 2020, the Company recognized compensation expense related to restricted stock awards of $4.9 million and $2.3 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, 2021 is as follows:


	Restricted Stock	Weighted Average Grant Date Fair Value
Balance at December 31, 2020	549,650	$	13.26
Granted	875,554	$	19.95
Vested and issued	(91,858)	$	13.01
Forfeited and expired	(67,120)	$	15.62
Balance at December 31, 2021	1,266,226	$	17.73

During the year ended December 31, 2021, shares were surrendered to satisfy tax withholding obligations on the vesting of restricted stock awards with a cost basis of $0.0 million. 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.

As of December 31, 2021, there was $31.2 million in unrecognized compensation expense related to unvested restricted stock awards that is expected to be recognized over a weighted average period of 2.1 years. The total fair value of restricted stock awards vested during the years ended December 31, 2021, 2020 and 2019 was $1.2 million, $1.5 million and $1.9 million, 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, 2021, 2020 and 2019, the Company recognized compensation expense related to the HC I incentive units of $0.1 million, $0.2 million and $1.9 million, respectively.There are no awards outstanding as of December 31, 2021 and no awards were issued during the year ended December 31, 2021.

STOCKHOLDERS' EQUITY	12 Months Ended
STOCKHOLDERS' EQUITY	Dec. 31, 2021
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. During the year ended December 31, 2021, HC I completed secondary offerings of 76,400,000 shares of common stock. For the year ended December 31, 2021, HCI holds approximately 20.7% of the common stock of the Company. 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, 2021 and 2020, warrant holders exercised warrants to purchase zero and 42,336 shares of common stock, respectively. No proceeds were received from these exercises as the warrant holders elected to surrender shares to pay the exercise price. At December 31, 2021 and 2020, 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, 2021 and 2020. At December 31, 2021 and 2020, 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, 2021 or 2020.

- Definition

The entire disclosure for shareholders' equity comprised of portions attributable to the parent entity and noncontrolling interest, including other comprehensive income. Includes, but is not limited to, balances of common stock, preferred stock, additional paid-in capital, other capital and retained earnings, accumulated balance for each classification of other comprehensive income and amount of comprehensive income.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 13
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123467817&loc=SL123496158-112644

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 13
-URI http://asc.fasb.org/extlink&oid=123467817&loc=SL123496158-112644

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 14
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=123467817&loc=SL123496171-112644

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 14
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123467817&loc=SL123496171-112644

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.3-04)
-URI http://asc.fasb.org/extlink&oid=120397183&loc=d3e187085-122770

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 18
-Subparagraph (d)
-URI http://asc.fasb.org/extlink&oid=123467817&loc=SL123496189-112644

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 13
-Subparagraph (g)
-URI http://asc.fasb.org/extlink&oid=123467817&loc=SL123496158-112644

Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-URI http://asc.fasb.org/topic&trid=2208762

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 18
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123467817&loc=SL123496189-112644

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 13
-Subparagraph (h)
-URI http://asc.fasb.org/extlink&oid=123467817&loc=SL123496158-112644

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 14
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123467817&loc=SL123496171-112644

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 18
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123467817&loc=SL123496189-112644

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 16
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123467817&loc=SL123496180-112644

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 13
-Subparagraph (i)
-URI http://asc.fasb.org/extlink&oid=123467817&loc=SL123496158-112644

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(e)(1))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

+ Details

RELATED-PARTY TRANSACTIONS	12 Months Ended
RELATED-PARTY TRANSACTIONS	Dec. 31, 2021
Related Party Transactions [Abstract]
Related-Party Transactions	RELATED-PARTY TRANSACTIONSManagement 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 years ended December 31, 2021 or 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. 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, 2021, 2020 and 2019, there was no activity 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, 2021 and 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. 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, 2021, 2020 or 2019. 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 $3.5 million, $2.9 million and $2.5 million for the years ended December 31, 2021, 2020 and 2019, respectively. Management fees are recorded in net revenues in the accompanying consolidated statements of comprehensive income (loss). The Company had amounts due to its joint ventures of $1.4 million as of December 31, 2021. The Company had amounts due from its joint ventures of $2.4 million as of December 31, 2020 and 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.

SUBSEQUENT EVENTS	12 Months Ended
SUBSEQUENT EVENTS	Dec. 31, 2021
Subsequent Events [Abstract]
Subsequent Events	SUBSEQUENT EVENTS The Company has evaluated whether any subsequent events occurred since December 31, 2021 and noted the following subsequent event: In February 2022, the Company entered into a definitive agreement to acquire Specialty Pharmacy Nursing Network, Inc. The Company expects to complete the acquisition in 2022. An estimate of the financial effect cannot be made as the acquisition has not yet been completed.

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	12 Months Ended
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	Dec. 31, 2021
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. 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 fifteen to twenty 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	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, 2021 and 2020, the balance of the investments was $20.1 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 $6.0 million, $3.3 million and $2.8 million for the years ended December 31, 2021, 2020 and 2019, 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, 2021, 2020 and 2019, the Company received distributions from the investees of $2.9 million, $3.3 million and $0.5 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 Recognition	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 16%, 15% and 16% for the years ended December 31, 2021, 2020 and 2019, respectively. The Company renewed its contract with this payer effective February 2022. There were no other managed care contracts that represent greater than 10% of revenue for the years presented. For the years ended December 31, 2021, 2020 and 2019, approximately 12%, 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, 2021 and 2020, approximately 11% and 13%, 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 year ended December 31, 2021, approximately 74% of the Company’s pharmaceutical and medical supply purchases were from four vendors. For the years ended December 31, 2020 and 2019, approximately 70% of the Company’s pharmaceutical and medical supply purchases were from three 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, 2021 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: Prior to the October refinancing, 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: Prior to the January refinancing, 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. New First Lien Term Loan: The fair value of the New 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 New First Lien Term Loan. Senior Notes: The fair value of the Senior Notes is derived from a broker quote (Level 2 inputs). See Note 11, Indebtedness, for further discussion of the carrying amount and fair value of the Senior 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. Both interest rate swaps have been terminated. See Note 12, Derivative Instruments, for further discussion of the fair value of the interest rate swaps. Interest rate cap: The fair values of the interest rate cap 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 caps. There were no other assets or liabilities measured at fair value at December 31, 2021 or 2020.
Recently Issued Accounting Pronouncements	Recently Issued Accounting Pronouncements — In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting. This ASU provides optional expedient and exceptions for applying generally accepted accounting principles to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criteria are met. The FASB further issued ASU 2021-01 to clarify the scope of Topic 848. The ASU can be adopted no later than December 1, 2022 with early adoption permitted. The Company does not expect adoption will have any material impact on the Company’s results of operations, cash flows or financial position.

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Tables)

12 Months Ended

Dec. 31, 2021

Accounting Policies [Abstract]

Schedule of Error Corrections and Prior Period Adjustments

As a result, the Company has corrected the misstatements as disclosed in the following tables:


	Three Months ended September 30, 2020				Nine Months ended September 30, 2020			Three Months ended December 31, 2020				Twelve Months ended December 31, 2020
	Amount		% of Revenue		Amount	% of Revenue		Amount		% of Revenue		Amount		% of Revenue
Commercial:
As Previously Reported	$	644,385	82.4	%	1,893,105	85.0	%	$	649,880	80.8	%	$	2,542,985	83.9	%
Adjustment	34,321		4.4	%	34,321	1.5	%	40,806		5.1	%	75,127		2.5	%
As Revised	678,706		86.8	%	1,927,426	86.5	%	690,686		85.9	%	2,618,112		86.4	%

Government:
As Previously Reported	127,435		16.3	%	308,830	13.9	%	141,237		17.6	%	450,067		14.8	%
Adjustment	(34,321)		(4.4)	%	(34,321)	(1.5)	%	(40,806)		(5.1)	%	(75,127)		(2.5)	%
As Revised	93,114		11.9	%	274,509	12.4	%	100,431		12.5	%	374,940		12.3	%


	Three Months ended March 31, 2021				Three Months ended June 30, 2021				Six Months ended June 30, 2021
	Amount		% of Revenue		Amount		% of Revenue		Amount		% of Revenue
Commercial:
As Previously Reported	$	611,434	80.5	%	$	703,429	81.8	%	$	1,314,862	81.2	%
Adjustment	37,073		4.9	%	43,218		5.0	%	80,292		4.9	%
As Revised	648,507		85.4	%	746,647		86.8	%	1,395,154		86.1	%

Government:
As Previously Reported	134,914		17.8	%	145,799		16.9	%	280,714		17.3	%
Adjustment	(37,073)		(4.9)	%	(43,218)		(5.0)	%	(80,292)		(4.9)	%
As Revised	97,841		12.9	%	102,581		11.9	%	200,422		12.4	%

BUSINESS ACQUISITIONS (Tables)

12 Months Ended

Dec. 31, 2021

Business Combination and Asset Acquisition [Abstract]

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	$	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

The following is a preliminary estimate of the allocation of the consideration transferred, open for accounts receivable and accounts payable, to acquired identifiable assets and assumed liabilities, net of cash acquired, as of December 31, 2021 (in thousands):


	Amount
Accounts receivable	$	2,219
Intangible assets	25,400
Accounts payable and other assumed liabilities	(539)
Fair value identifiable assets and liabilities	27,080
Goodwill (1)	32,524
Cash acquired	1,426
Purchase Price	61,030
Less: cash acquired	(1,426)
Purchase price, net of cash acquired	59,604


	Amount
Accounts receivable	$	3,410
Inventories	2,038
Intangible assets	4,245
Other assets	958
Accounts payable	(6,686)
Other assumed liabilities	(940)
Fair value Identifiable assets and liabilities	3,025
Goodwill (1)	16,430
Purchase Price	19,455

(1) Goodwill is attributable to cost synergies from procurement and operational efficiencies and elimination of duplicative administrative costs.

Schedule of Pro Forma Financial Information



	2019
Net revenue	$	2,755,361
Net loss	(49,566)

Schedule of Purchase Price Allocated to Assets Acquired

The purchase price was allocated to the assets acquired as follows:


	Amount
Inventories	$	601
Intangible assets, net	$	18,251
Total consideration transferred	$	18,852

REVENUE (Tables)

12 Months Ended

Dec. 31, 2021

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, 2021, 2020 and 2019 (in thousands):


	Year Ended December 31,
	2021		2020		2019
Commercial payers	$	2,971,900	$	2,618,112	$	2,001,105
Government payers	417,088		374,940		285,128
Patients	49,652		39,558		24,184
Net revenue	$	3,438,640	$	3,032,610	$	2,310,417

INCOME TAXES Income Taxes (Tables)

12 Months Ended

Dec. 31, 2021

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, 2021, 2020 and 2019 (in thousands):


	2021		2020		2019
US federal income tax (benefit) expense:
Current	$	—	$	(69)	$	—
Deferred	(30,411)		996		(3,072)
	(30,411)		927		(3,072)
State income tax expense:
Current	6,817		1,707		2,074
Deferred	190		199		(1,276)
	7,007		1,906		798
Total income tax (benefit) expense	$	(23,404)	$	2,833	$	(2,274)

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, 2021, 2020 and 2019:


	2021		2020		2019
US federal statutory tax rate	21.0	%	21.0	%	21.0	%
State and local income taxes net of federal tax benefit	4.9	%	(29.5)	%	(0.5)	%
Valuation allowance	(46.2)	%	(29.9)	%	(13.4)	%
Stock-based compensation	(0.1)	%	6.7	%	0.0	%
Non-deductible compensation	0.1	%	(16.3)	%	(0.7)	%
Non-deductible expenses	0.3	%	(8.2)	%	(2.8)	%
Other, net	(0.1)	%	2.2	%	(0.7)	%
Effective income tax rate	(20.1)	%	(54.0)	%	2.9	%

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, 2021 and 2020 (in thousands):


	2021		2020
Deferred tax assets:
Price concessions	$	6,373	$	6,907
Compensation and benefits	5,889		4,058
Interest limitation carryforward	35,114		39,094
Operating lease liability	23,266		22,644
Net operating losses	97,880		155,922
Other	6,381		8,501
Deferred tax assets before valuation allowance	174,903		237,126
Valuation allowance	(13,151)		(112,085)
Deferred tax assets net of valuation allowance	161,752		125,041

Deferred tax liabilities:
Accelerated depreciation	(10,602)		(12,593)
Operating lease right-of-use asset	(18,437)		(17,186)
Intangible assets	(61,629)		(67,127)
Goodwill	(36,702)		(28,976)
Other	(7,349)		(2,498)
Deferred tax liabilities	(134,719)		(128,380)
Net deferred tax assets (liabilities)	$	27,033	$	(3,339)

Summary of Valuation Allowance

The following table presents the valuation allowance for deferred tax assets for the years ended December 31, 2021, 2020 and 2019 (in thousands):


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

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

2021: Valuation allowance for deferred tax assets	$	112,085	$	(96,136)	$	(2,798)	$	13,151

EARNINGS (LOSS) PER SHARE (Tables)

12 Months Ended

Dec. 31, 2021

Earnings Per Share [Abstract]

Schedule of Basic and Diluted Earnings (Loss) Per Share

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


	Year Ended December 31,
	2021		2020		2019
Numerator:
Net income (loss) (1)	$	139,898	$	(8,076)	$	(75,920)
Denominator:
Weighted average number of common shares outstanding	179,855		180,971		156,280
Earnings (loss) per Common Share:
Earnings (loss) per common share, basic	$	0.78	$	(0.04)	$	(0.49)

(1) Net income (loss) for the year ended December 31, 2021 includes the impact of the Company’s release of its valuation allowance. See Note 6, Income Taxes, for further discussion.

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


	Year Ended December 31,
	2021		2020		2019
Numerator:
Net income (loss) (1)	$	139,898	$	(8,076)	$	(75,920)
Denominator:
Weighted average number of common shares outstanding	179,855		180,971		156,280
Effect of dilutive securities	1,350		—		—
Weighted average number of common shares outstanding, diluted	181,205		180,971		156,280
Earnings (loss) per Common Share:
Earnings (loss) per common share, diluted	$	0.77	$	(0.04)	$	(0.49)

(1) Net income (loss) for the year ended December 31, 2021 includes the impact of the Company’s release of its valuation allowance. See Note 6, Income Taxes, for further discussion.

LEASES (Tables)

12 Months Ended

Dec. 31, 2021

Leases [Abstract]

Maturities of Lease Liabilities, Operating

Operating leases mature as follows (in thousands):


Year Ending December 31	Minimum Payments
2022	$	23,558
2023	20,508
2024	14,930
2025	12,218
2026	9,315
2027 and beyond	28,052
Total lease payments	108,581
Less: Interest	(15,000)
Present value of lease liabilities	$	93,581

Maturities of Lease Liabilities, Financing

Operating leases mature as follows (in thousands):


Year Ending December 31	Minimum Payments
2022	$	23,558
2023	20,508
2024	14,930
2025	12,218
2026	9,315
2027 and beyond	28,052
Total lease payments	108,581
Less: Interest	(15,000)
Present value of lease liabilities	$	93,581

PROPERTY AND EQUIPMENT (Tables)

12 Months Ended

Dec. 31, 2021

Property, Plant and Equipment [Abstract]

Schedule of Property and Equipment

Property and equipment was as follows as of December 31, 2021 and 2020 (in thousands):


	December 31, 2021		December 31, 2020
Infusion pumps	$	34,547	$	31,678
Equipment, furniture and other	52,913		47,886
Leasehold improvements	92,229		87,483
Computer software, purchased and internally developed	30,744		27,799
Assets under development	19,924		10,793
	230,357		205,639
Less: accumulated depreciation	118,822		84,490
Property and equipment, net	$	111,535	$	121,149

The following table presents the amount of depreciation expense recorded in cost of revenue and operating expenses for the years ended December 31, 2021, 2020 and 2019 (in thousands):


	Year ended December 31,
	2021		2020		2019
Depreciation expense in cost of revenue	$	5,746	$	6,586	$	4,179
Depreciation expense in operating expenses	29,865		36,180		27,629
Total depreciation expense	$	35,611	$	42,766	$	31,808

GOODWILL AND OTHER INTANGIBLE ASSETS (Tables)

12 Months Ended

Dec. 31, 2021

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, 2021, 2020 and 2019 (in thousands):


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
Acquisitions	48,954
Balance at December 31, 2021	$	1,477,564

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, 2021 and 2020 (in thousands):


	December 31, 2021		December 31, 2020
Gross intangible assets:
Referral sources	$	482,200	$	438,121
Trademarks/names	47,718		44,536
Other amortizable intangible assets	1,037		402
Total gross intangible assets	530,955		483,059

Accumulated amortization:
Referral sources	(137,613)		(110,498)
Trademarks/names	(26,936)		(21,146)
Other amortizable intangible assets	(386)		(363)
Total accumulated amortization	(164,935)		(132,007)
Total intangible assets, net	$	366,020	$	351,052

Schedule of Future Amortization Expense for Intangible Assets

Expected future amortization expense for intangible assets recorded at December 31, 2021, is as follows (in thousands):


2022	$	31,628
2023	31,628
2024	31,628
2025	31,628
2026	31,628
2027 and beyond	207,880
Total	$	366,020

INDEBTEDNESS (Tables)

12 Months Ended

Dec. 31, 2021

Debt Disclosure [Abstract]

Summary of Debt

Long-term debt consisted of the following as of December 31, 2021 (in thousands):


	Principal Amount		Discount		Debt Issuance Costs		Net Balance
ABL Facility	$	—	$	—	$	—	$	—
First Lien Term Loan	600,000		(9,605)		(13,331)		577,064
Senior Notes	500,000		—		(11,164)		488,836
	$	1,100,000	$	(9,605)	$	(24,495)	1,065,900
Less: current portion							(6,000)
Total long-term debt							$	1,059,900

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

Schedule of Long-term Debt Maturities

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


Year Ending December 31,	Minimum Payments
2022	$	6,000
2023	6,000
2024	6,000
2025	6,000
2026	6,000
2027 and beyond	1,070,000
Total	$	1,100,000

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, 2021 (in thousands):


Financial Instrument	Carrying Value as of December 31, 2021		Markets for Identical Item (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
First Lien Note Facility	$	577,064	$	—	$	598,500	$	—
Senior Notes	488,836		—		501,250		—
Total debt instruments	$	1,065,900	$	—	$	1,099,750	$	—


	Level 3 Measurements
Second Lien Notes fair value as of January 1, 2021	$	266,438
Principal prepayment	(245,781)

Change in fair value	(20,657)
Second Lien Notes fair value as of December 31, 2021	$	—

DERIVATIVE INSTRUMENTS (Tables)

12 Months Ended

Dec. 31, 2021

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, 2021		December 31, 2020
Interest rate caps designated as cash flow hedges	Accrued expenses and other current liabilities	$	601	$	—
Interest rate swaps designated as cash flow hedges	Accrued expenses and other current liabilities	—		11,172
Interest rate swaps not designated as hedges	Accrued expenses and other current liabilities	—		170


Total derivatives		$	601	$	11,342

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	2021		2020		2019
Interest rate caps designated as cash flow hedges	$	(601)	$	—	$	(1,103)
Interest rate swaps designated as cash flow hedges	11,172		(7,723)		(7,195)
Interest rate swaps that discontinued hedge accounting	—		3,746		—
Total	$	10,571	$	(3,977)	$	(8,298)


		Year Ended December 31,
Derivative	Income Statement Caption	2021		2020		2019
Interest rate caps designated as cash flow hedges	Interest expense	$	(239)	$	—	$	(125)
Interest rate swaps designated as cash flow hedges	Interest expense	(11,298)		(12,799)		(115)
Interest rate swaps not designated as hedges	Interest expense	(2)		(34)		(92)
Interest rate swaps that discontinued hedge accounting	Interest expense	—		(3,746)		—
Total		$	(11,539)	$	(16,579)	$	(332)

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

12 Months Ended

Dec. 31, 2021

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, 2021 and 2020 are as follows:


	Years Ended December 31,
	2021		2020
Expected volatility	51.92	%	45.7	%
Risk-free interest rate	1.4	%	0.53	%
Expected life of options	6.5 years		6.3 years
Dividend rate	—		—

Summary of Stock Option Activity

A summary of stock option activity for the year ended December 31, 2021 is as follows:


	Options	Weighted Average Exercise Price		Aggregate Intrinsic Value (thousands)		Weighted Average Remaining Contractual Life
Balance at December 31, 2020	412,831	$	14.77	$	1,320
Granted	853,089	$	22.14	$	5,335
Exercised	(42,405)	$	10.65	$	461
Forfeited and expired	(53,374)	$	22.13	$	478
Balance at December 31, 2021	1,170,141	$	19.96	$	10,154	8.55 years
Exercisable at December 31, 2021	150,890	$	15.84	$	2,131	3.63 years

Summary of Outstanding Options by Exercise Price Range

The following table outlines the outstanding and exercisable stock options as of December 31, 2021:


	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	5.1 years	9,901	$	6.52
$8.24 - $16.52	292,189	$	12.32	7.0 years	99,739	$	10.30
$16.52 - $24.76	521,461	$	19.90	9.0 years	21,375	$	23.56
$24.76 - $33.00	336,715	$	26.20	9.6 years	10,000	$	30.20

$41.28 - $49.52	6,250	$	44.16	1.2 years	6,250	$	44.16
$49.52 - $57.76	2,375	$	56.24	1.3 years	2,375	$	56.24

$66.00 - $74.28	1,250	$	66.52	1.6 years	1,250	$	66.52
All options	1,170,141				150,890

Summary of Restricted Stock Award Activity

A summary of restricted stock award activity for the year ended December 31, 2021 is as follows:


	Restricted Stock	Weighted Average Grant Date Fair Value
Balance at December 31, 2020	549,650	$	13.26
Granted	875,554	$	19.95
Vested and issued	(91,858)	$	13.01
Forfeited and expired	(67,120)	$	15.62
Balance at December 31, 2021	1,266,226	$	17.73

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, 2021 USD ($) pharmacy site segment $ / shares	Dec. 31, 2020 USD ($) $ / shares shares
Business Acquisition [Line Items]
Common stock, par value (in dollars per share) \| $ / shares		$ 0.0001	$ 0.0001
Principal amount of debt		$ 1,065,900	$ 1,124,353
Number of service locations \| pharmacy		97
Number of infusion sites \| site		57
Number of operating segments \| segment		1
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
Business Acquisition [Line Items]
Principal amount of debt		$ 488,836
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 - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Concentration Risk [Line Items]
Allowance for doubtful accounts	$ 0	$ 0
Unbilled receivables	80,100,000	79,000,000
Rebate receivable	43,000,000	35,200,000
Investments in equity-method investees	20,100,000	17,000,000
Proportionate share of earnings in equity-method investees	6,030,000	3,313,000	$ 2,840,000
Capital distribution from equity method investments	$ 2,900,000	$ 3,250,000	$ 500,000
Revenue from Contract with Customer Benchmark \| Customer Concentration Risk \| Largest Payer
Concentration Risk [Line Items]
Concentration risk	16.00%	15.00%	16.00%
Revenue from Contract with Customer Benchmark \| Governmental Programs \| Government Healthcare Programs
Concentration Risk [Line Items]
Concentration risk	12.00%	12.00%	12.00%
Accounts Receivable \| Customer Concentration Risk \| Government Healthcare Programs
Concentration Risk [Line Items]
Concentration risk	11.00%	13.00%
Cost of Goods and Service, Product and Service Benchmark \| Medical Supply Vendors \| Four Vendors
Concentration Risk [Line Items]
Concentration risk	74.00%
Cost of Goods and Service, Product and Service Benchmark \| Medical Supply Vendors \| Three Vendors
Concentration Risk [Line Items]
Concentration risk		70.00%	70.00%
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 and Trade 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 and Trade 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

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Immaterial Error Correction (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended	9 Months Ended	12 Months Ended
	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2021	Sep. 30, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Concentration Risk [Line Items]
Net revenue							$ 3,438,640	$ 3,032,610	$ 2,310,417
Commercial
Concentration Risk [Line Items]
Net revenue	$ 746,647	$ 648,507	$ 690,686	$ 678,706	$ 1,395,154	$ 1,927,426	2,971,900	$ 2,618,112	2,001,105
Commercial \| Revenue Benchmark \| Customer Concentration Risk
Concentration Risk [Line Items]
Concentration risk	86.80%	85.40%	85.90%	86.80%	86.10%	86.50%		86.40%
Government
Concentration Risk [Line Items]
Net revenue	$ 102,581	$ 97,841	$ 100,431	$ 93,114	$ 200,422	$ 274,509	$ 417,088	$ 374,940	$ 285,128
Government \| Revenue Benchmark \| Customer Concentration Risk
Concentration Risk [Line Items]
Concentration risk	11.90%	12.90%	12.50%	11.90%	12.40%	12.40%		12.30%
As Previously Reported \| Commercial
Concentration Risk [Line Items]
Net revenue	$ 703,429	$ 611,434	$ 649,880	$ 644,385	$ 1,314,862	$ 1,893,105		$ 2,542,985
As Previously Reported \| Commercial \| Revenue Benchmark \| Customer Concentration Risk
Concentration Risk [Line Items]
Concentration risk	81.80%	80.50%	80.80%	82.40%	81.20%	85.00%		83.90%
As Previously Reported \| Government
Concentration Risk [Line Items]
Net revenue	$ 145,799	$ 134,914	$ 141,237	$ 127,435	$ 280,714	$ 308,830		$ 450,067
As Previously Reported \| Government \| Revenue Benchmark \| Customer Concentration Risk
Concentration Risk [Line Items]
Concentration risk	16.90%	17.80%	17.60%	16.30%	17.30%	13.90%		14.80%
Adjustment \| Commercial
Concentration Risk [Line Items]
Net revenue	$ 43,218	$ 37,073	$ 40,806	$ 34,321	$ 80,292	$ 34,321		$ 75,127
Adjustment \| Commercial \| Revenue Benchmark \| Customer Concentration Risk
Concentration Risk [Line Items]
Concentration risk	5.00%	4.90%	5.10%	4.40%	4.90%	1.50%		2.50%
Adjustment \| Government
Concentration Risk [Line Items]
Net revenue	$ (43,218)	$ (37,073)	$ (40,806)	$ (34,321)	$ (80,292)	$ (34,321)		$ (75,127)
Adjustment \| Government \| Revenue Benchmark \| Customer Concentration Risk
Concentration Risk [Line Items]
Concentration risk	(5.00%)	(4.90%)	(5.10%)	(4.40%)	(4.90%)	(1.50%)		(2.50%)

- 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=123359005&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=123359005&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=123359005&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=123359005&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=123359005&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=123351226&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=123359005&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=123359005&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=123359005&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=123351226&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

BUSINESS ACQUISITIONS - Additional Information (Details)					12 Months Ended
	Dec. 29, 2021 USD ($)	Oct. 01, 2021 USD ($)	Apr. 07, 2021 USD ($)	Aug. 06, 2019 USD ($)	Dec. 31, 2019 USD ($)	Oct. 31, 2021 payment
BioScrip
Business Acquisition [Line Items]
Purchase price				$ 1,087,214
Net sales since acquisition					$ 308,900,000
Net loss since acquisition					30,100,000
Payments of transaction costs					$ 25,800,000
BioCure
Business Acquisition [Line Items]
Business combination purchase price			$ 18,900,000
Intangible assets useful life			15 years
Infinity Infusion Nursing LLC
Business Acquisition [Line Items]
Purchase price		$ 61,030,000
Equity interest acquired		100.00%
Purchase price, net of cash acquired		$ 59,604,000
Cash paid		50,000,000
Number of contingent payments \| payment						2
Payment in settlement of debt		5,000,000
Other purchase price adjustments		$ (400,000)
Wasatch Infusion LLC
Business Acquisition [Line Items]
Purchase price	$ 19,455,000
Cash paid	17,800,000
Payment in settlement of debt	2,000,000
Other purchase price adjustments	$ (300,000)

BUSINESS ACQUISITIONS - Acquired Identifiable Assets and Assumed Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Aug. 06, 2019	Dec. 31, 2018
Business Acquisition [Line Items]
Goodwill	$ 1,477,564	$ 1,428,610	$ 1,425,542		$ 632,469
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 - Pro Forma Financial Information (Details) - BioScrip $ in Thousands	12 Months Ended
	Dec. 31, 2019 USD ($)
Business Acquisition [Line Items]
Net revenue	$ 2,755,361
Net loss	$ (49,566)

BUSINESS ACQUISITIONS - Purchase Price Allocated to Assets Acquired (Details) - BioCure $ in Thousands	Apr. 07, 2021 USD ($)
Business Acquisition [Line Items]
Inventories	$ 601
Intangible assets, net	18,251
Total consideration transferred	$ 18,852

BUSINESS ACQUISITIONS - Infinity Purchase Price Allocation (Details) - USD ($) $ in Thousands	Oct. 01, 2021	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Business Acquisition [Line Items]
Goodwill		$ 1,477,564	$ 1,428,610	$ 1,425,542	$ 632,469
Infinity Infusion Nursing LLC
Business Acquisition [Line Items]
Accounts receivable	$ 2,219
Intangible assets	25,400
Accounts payable and other assumed liabilities	(539)
Total acquired identifiable assets and liabilities	27,080
Goodwill	32,524
Cash acquired	(1,426)
Purchase price	61,030
Purchase price, net of cash acquired	$ 59,604

BUSINESS ACQUISITIONS - Wasatch Preliminary Estimate of the Allocation Consideration Transferred (Details) - USD ($) $ in Thousands	Dec. 29, 2021	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Business Acquisition [Line Items]
Goodwill		$ 1,477,564	$ 1,428,610	$ 1,425,542	$ 632,469
Wasatch Infusion LLC
Business Acquisition [Line Items]
Accounts receivable	$ 3,410
Inventories	2,038
Intangible assets	4,245
Other assets	958
Accounts payable	(6,686)
Other assumed liabilities	940
Total acquired identifiable assets and liabilities	3,025
Goodwill	16,430
Purchase Price	$ 19,455

REVENUE - Net Revenue Earned by Category of Payer (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended	9 Months Ended	12 Months Ended
	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2021	Sep. 30, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Disaggregation of Revenue [Line Items]
Net revenue							$ 3,438,640	$ 3,032,610	$ 2,310,417
Commercial payers
Disaggregation of Revenue [Line Items]
Net revenue	$ 746,647	$ 648,507	$ 690,686	$ 678,706	$ 1,395,154	$ 1,927,426	2,971,900	2,618,112	2,001,105
Government payers
Disaggregation of Revenue [Line Items]
Net revenue	$ 102,581	$ 97,841	$ 100,431	$ 93,114	$ 200,422	$ 274,509	417,088	374,940	285,128
Patients
Disaggregation of Revenue [Line Items]
Net revenue							$ 49,652	$ 39,558	$ 24,184

- Definition

+ References

+ Details

EMPLOYEE BENEFIT PLANS (Details) - USD ($) $ in Millions	12 Months Ended
EMPLOYEE BENEFIT PLANS (Details) - USD ($) $ in Millions	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Retirement Benefits [Abstract]
Employer matching contribution percent	100.00%
Employer matching contribution percent of employees' gross pay	4.00%
Defined contribution plan expense	$ 11.6	$ 9.7	$ 6.4
Company contributions	$ 10.9	$ 8.9	$ 6.6

INCOME TAXES - Income Tax Benefit (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
US federal income tax (benefit) expense:
Current	$ 0	$ (69)	$ 0
Deferred	(30,411)	996	(3,072)
Federal income tax expense (benefit)	(30,411)	927	(3,072)
State income tax expense:
Current	6,817	1,707	2,074
Deferred	190	199	(1,276)
State income tax expense	7,007	1,906	798
Total income tax (benefit) expense	$ (23,404)	$ 2,833	$ (2,274)

- 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, 2021	Dec. 31, 2020	Dec. 31, 2019
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	4.90%	(29.50%)	(0.50%)
Valuation allowance	(46.20%)	(29.90%)	(13.40%)
Stock-based compensation	(0.10%)	6.70%	0.00%
Non-deductible compensation	0.10%	(16.30%)	(0.70%)
Non-deductible expenses	0.30%	(8.20%)	(2.80%)
Other, net	(0.10%)	2.20%	(0.70%)
Effective income tax rate	(20.10%)	(54.00%)	2.90%

INCOME TAXES - Deferred Income Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Deferred tax assets:
Price concessions	$ 6,373	$ 6,907
Compensation and benefits	5,889	4,058
Interest limitation carryforward	35,114	39,094
Operating lease liability	23,266	22,644
Net operating losses	97,880	155,922
Other	6,381	8,501
Deferred tax assets before valuation allowance	174,903	237,126
Valuation allowance	(13,151)	(112,085)	$ (109,531)	$ (1,373)
Deferred tax assets net of valuation allowance	161,752	125,041
Deferred tax liabilities:
Accelerated depreciation	(10,602)	(12,593)
Operating lease right-of-use asset	(18,437)	(17,186)
Intangible assets	(61,629)	(67,127)
Goodwill	(36,702)	(28,976)
Other	(7,349)	(2,498)
Deferred tax liabilities	(134,719)	(128,380)
Net deferred tax assets	$ 27,033
Net deferred tax assets (liabilities)		$ (3,339)

INCOME TAXES - Narrative (Details) - USD ($)	12 Months Ended
INCOME TAXES - Narrative (Details) - USD ($)	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Tax Examination [Line Items]
Net operating losses	$ 97,880,000	$ 155,922,000
Valuation allowance	13,151,000	112,085,000	$ 109,531,000	$ 1,373,000
Interest limitation carryforward	35,114,000	39,094,000
Unrecognized tax benefits	0	0
Income tax expense (benefit) related to CARES Act	0	0
Federal
Income Tax Examination [Line Items]
Operating loss carryforwards	223,700,000	139,800,000
Net operating losses		577,900,000
State
Income Tax Examination [Line Items]
Operating loss carryforwards	13,200,000
Merger Operating Loss Carryforward \| Federal
Income Tax Examination [Line Items]
Net operating losses	358,400,000
Interest Limitation Carryforwards
Income Tax Examination [Line Items]
Interest limitation carryforward	140,200,000	154,800,000
Federal Net Operating Loss Carryfowards Available To Offset Future Taxable Income \| State
Income Tax Examination [Line Items]
Net operating losses	405,100,000	$ 600,100,000
Indefinite Carryforward Period \| Federal
Income Tax Examination [Line Items]
Operating loss carryforwards	134,700,000
Expected To Expire \| Federal
Income Tax Examination [Line Items]
Operating loss carryforwards	$ 139,800,000

INCOME TAXES - Valuation Allowance for Deferred Tax Assets (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Change in Deferred Tax Asset Valuation Allowance
Balance at Beginning of Period	$ 112,085	$ 109,531	$ 1,373
Balance at End Period	13,151	112,085	109,531
Charged (Benefit) to Costs and Expenses
Change in Deferred Tax Asset Valuation Allowance
Deferred tax asset, additions	(96,136)	1,549	15,395
Charged (Benefit) to Other Accounts
Change in Deferred Tax Asset Valuation Allowance
Deferred tax asset, additions	$ (2,798)	$ 1,005	$ 92,763

EARNINGS (LOSS) PER SHARE - Schedule of Basic and Diluted Earnings (Loss) (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Numerator:
Net income (loss)	$ 139,898	$ (8,076)	$ (75,920)
Denominator:
Weighted average number of common shares outstanding (in shares)	179,855,000	180,971,000	156,280,000
Effect of dilutive securities (in shares)	1,350,000	0	0
Weighted average common shares outstanding, diluted (in shares)	181,205,000	180,971,000	156,280,000
Earnings (loss) per common share:
Earnings (loss) per share, basic (in dollars per share)	$ 0.78	$ (0.04)	$ (0.49)
Earnings (loss) per share, diluted (in dollars per share)	$ 0.77	$ (0.04)	$ (0.49)
Warrant
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded (in shares)	457,753	2,285,784	2,328,120
Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded (in shares)	490,968	412,831	644,975
Restricted Stock Award
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded (in shares)	316,454	549,650	231,562

LEASES - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Leases [Abstract]
Operating lease cost	$ 29.8	$ 30.8
Weighted-average remaining lease term, operating leases	6 years 7 months 6 days
Weighted-average discount rate, operating leases	5.10%
Right of use asset obtained in exchange for operating lease liabilities	$ 20.7

LEASES - Maturities of Lease Liabilities (Details) $ in Thousands	Dec. 31, 2021 USD ($)
Leases [Abstract]
2022	$ 23,558
2023	20,508
2024	14,930
2025	12,218
2026	9,315
2027 and beyond	28,052
Total lease payments	108,581
Less: Interest	(15,000)
Present value of lease liabilities	$ 93,581

PROPERTY AND EQUIPMENT (Details) - USD ($) $ in Thousands	12 Months Ended
PROPERTY AND EQUIPMENT (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 230,357	$ 205,639
Less: accumulated depreciation	118,822	84,490
Property and equipment, net	111,535	121,149
Depreciation expense	35,611	42,766	$ 31,808
Depreciation expense in cost of revenue
Property, Plant and Equipment [Line Items]
Depreciation expense	5,746	6,586	4,179
Depreciation expense in operating expenses
Property, Plant and Equipment [Line Items]
Depreciation expense	29,865	36,180	$ 27,629
Infusion pumps
Property, Plant and Equipment [Line Items]
Property and equipment, gross	34,547	31,678
Equipment, furniture and other
Property, Plant and Equipment [Line Items]
Property and equipment, gross	52,913	47,886
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	92,229	87,483
Computer software, purchased and internally developed
Property, Plant and Equipment [Line Items]
Property and equipment, gross	30,744	27,799
Assets under development
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 19,924	$ 10,793

GOODWILL AND OTHER INTANGIBLE ASSETS - Narrative (Details) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill impairment	$ 0	$ 0	$ 0
Amortization expense for intangible assets	$ 32,900,000	$ 35,100,000	$ 26,100,000

GOODWILL AND OTHER INTANGIBLE ASSETS - Carrying Amount of Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Goodwill [Roll Forward]
Goodwill - net book value, begging of period	$ 1,428,610	$ 1,425,542	$ 632,469
Acquisitions	48,954	3,068	793,073
Goodwill - net book value, end of period	$ 1,477,564	$ 1,428,610	$ 1,425,542

GOODWILL AND OTHER INTANGIBLE ASSETS - Carrying Amount and Accumulated Amortization of Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	$ 530,955	$ 483,059
Total accumulated amortization	(164,935)	(132,007)
Total intangible assets, net	366,020	351,052
Referral sources
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	482,200	438,121
Total accumulated amortization	(137,613)	(110,498)
Trademarks/names
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	47,718	44,536
Total accumulated amortization	(26,936)	(21,146)
Other amortizable intangible assets
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	1,037	402
Total accumulated amortization	$ (386)	$ (363)

GOODWILL AND OTHER INTANGIBLE ASSETS - Future Amortization Expense of Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
2022	$ 31,628
2023	31,628
2024	31,628
2025	31,628
2026	31,628
2027 and beyond	207,880
Total intangible assets, net	$ 366,020	$ 351,052

INDEBTEDNESS - Summary of Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Oct. 31, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Principal Amount	$ 1,100,000		$ 1,161,531
Discount	(9,605)		(13,355)
Debt Issuance Costs	(24,495)		(23,823)
Total	1,065,900		1,124,353
Less: current portion	(6,000)		(9,250)
Total long-term debt	1,059,900		1,115,103
Senior Notes
Debt Instrument [Line Items]
Principal Amount	500,000
Discount	0
Debt Issuance Costs	(11,164)
Total	488,836
Senior Notes \| First Lien Term Loan
Debt Instrument [Line Items]
Principal Amount	600,000		915,750
Discount	(9,605)		(7,253)
Debt Issuance Costs	(13,331)	$ (8,800)	(19,710)
Total	577,064		888,787
Senior Notes \| Second Lien Notes
Debt Instrument [Line Items]
Principal Amount			245,781
Discount			(6,102)
Debt Issuance Costs			(4,113)
Total			235,566
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)		1 Months Ended			12 Months Ended
INDEBTEDNESS - Additional Information (Details)	Aug. 06, 2019 USD ($) arrangement	Oct. 31, 2021 USD ($)	Jan. 31, 2021 USD ($)	Nov. 30, 2019 USD ($)	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)	Dec. 31, 2019 USD ($)
Debt Instrument [Line Items]
Payments to extinguish debt					$ 8,832,000	$ 9,250,000	$ 2,075,000
Principal amount of debt					1,065,900,000	1,124,353,000
Paid-in-kind interest capitalized as principal					0	7,525,000	12,256,000
Loss on extinguishment of debt					13,387,000	11,545,000	5,469,000
Cash outflow from financing activities					76,870,000	68,849,000	(719,024,000)
Proceeds from issuance of debt					855,136,000	0	981,050,000
Debt issuance costs					24,495,000	23,823,000
Fees incurred netted against proceeds					10,339,000	149,000	$ 30,022,000
Common Stock \| Public Offering
Debt Instrument [Line Items]
Proceeds from sale of equity						118,900,000
Senior Notes
Debt Instrument [Line Items]
Principal amount of debt					488,836,000
Loss on extinguishment of debt					12,400,000
Debt issuance costs					11,164,000
Credit Agreements, Entered Into 2019
Debt Instrument [Line Items]
Loss on extinguishment of debt						11,500,000
Prepayment penalty					2,400,000	3,500,000
Deferred commitment fee						8,000,000
Credit Agreements, Entered Into 2019 \| Senior Notes
Debt Instrument [Line Items]
Number of credit arrangements \| arrangement	2
Face amount of debt instruments	$ 1,475,000,000
Loss on extinguishment of debt					9,800,000
Cash outflow from financing activities					352,000,000
Proceeds from issuance of debt					356,200,000
Debt issuance costs and third party fees					7,200,000
Debt issuance costs					3,700,000
Issuance costs expensed					900,000
Fees incurred netted against proceeds					1,000,000
Deferred financing costs					2,900,000
Payments of debt issuance costs, operating activities					900,000
Credit Agreements, Entered Into 2019 \| Notes Payable
Debt Instrument [Line Items]
Payments to extinguish debt						174,000,000
First Lien Term Loan \| Senior Notes
Debt Instrument [Line Items]
Face amount of debt instruments		$ 1,157,000,000
Principal amount of debt					577,064,000	888,787,000
Loss on extinguishment of debt					1,000,000
Cash outflow from financing activities					558,300,000
Proceeds from issuance of debt		501,400,000			501,400,000
Debt issuance costs and third party fees		10,700,000
Debt issuance costs		8,800,000			13,331,000	19,710,000
Issuance costs expensed		1,700,000
Fees incurred netted against proceeds		1,500,000
Deferred financing costs		7,400,000
Payments of debt issuance costs, operating activities		1,800,000
Write off of deferred debt issuance cost					800,000
New Senior Unsecured Notes \| Senior Notes
Debt Instrument [Line Items]
Face amount of debt instruments		$ 500,000,000
Effective rate on term loans at end of period		4.375%
Revolving Credit Facility
Debt Instrument [Line Items]
Payments to extinguish debt	80,000,000
Revolving Credit Facility \| Senior Notes
Debt Instrument [Line Items]
Principal amount of debt					0	0
Debt issuance costs					0	0
Revolving Credit Facility \| Credit Agreements, Entered Into 2019 \| Senior Notes
Debt Instrument [Line Items]
Face amount of debt instruments	150,000,000					$ 175,000,000
Base rate						0.25%
Commitment fee percentage						2.50%
Principal amount of debt					0
Undrawn letters of credit issued and outstanding					$ 7,100,000
Net borrowing availability						$ 165,400,000
Floor interest rate					0.00%
Available borrowing capacity					$ 167,900,000
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 \| Eurocurrency Rate
Debt Instrument [Line Items]
Basis spread on variable rate						2.25%
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 \| First Lien Term Loan \| Senior Notes \| LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate					1.25%
Revolving Credit Facility \| Minimum \| First Lien Term Loan \| Senior Notes \| Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate					0.25%
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 \| Eurocurrency Rate
Debt Instrument [Line Items]
Basis spread on variable rate						2.75%
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 \| First Lien Term Loan \| Senior Notes \| LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate					1.75%
Revolving Credit Facility \| Maximum \| First Lien Term Loan \| Senior Notes \| Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate					0.75%
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
Debt Instrument [Line Items]
Payments to extinguish debt	415,000,000
First Lien Term Loan \| Senior Notes
Debt Instrument [Line Items]
Principal amount of debt	575,000,000
First Lien Term Loan \| Credit Agreements, Entered Into 2019 \| Senior Notes
Debt Instrument [Line Items]
Payments to extinguish debt					$ 161,200,000
Face amount of debt instruments	925,000,000		$ 250,000,000
Basis spread on variable rate			3.75%			4.25%
Quarterly installment payments					2,900,000	$ 2,300,000
Effective rate on term loans at end of period						4.40%
Weighted average interest rate paid on term loans during period						5.09%
Loss on extinguishment of debt					2,600,000
First Lien Term Loan \| First Lien Term Loan \| Senior Notes
Debt Instrument [Line Items]
Payments to extinguish debt					$ 35,700,000
Quarterly installment payments		$ 1,500,000
Effective rate on term loans at end of period					3.25%
Weighted average interest rate paid on term loans during period					3.79%
Loss on extinguishment of debt		200,000			$ 200,000
First Lien Term Loan \| New First Lien Term Loan \| Senior Notes
Debt Instrument [Line Items]
Face amount of debt instruments		$ 600,000,000
Basis spread on variable rate		0.50%
First Lien Term Loan \| New First Lien Term Loan \| Senior Notes \| LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate		3.75%
First Lien Term Loan \| New First Lien Term Loan \| Senior Notes \| Eurocurrency Rate
Debt Instrument [Line Items]
Basis spread on variable rate		2.75%
First Lien Term Loan \| New First Lien Term Loan \| Senior Notes \| Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate		1.75%
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 \| 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 \| Maximum \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Eurocurrency Rate
Debt Instrument [Line Items]
Basis spread on variable rate						4.50%
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%
Second Lien Term Loan
Debt Instrument [Line Items]
Payments to extinguish debt	150,000,000
Second Lien Term Loan \| Credit Agreements, Entered Into 2019 \| Senior Notes
Debt Instrument [Line Items]
Payments to extinguish debt					122,900,000
Face amount of debt instruments	400,000,000
Effective rate on term loans at end of period						8.98%
Weighted average interest rate paid on term loans during period						9.39%
Interest capitalized to debt principal				$ 12,300,000
Paid-in-kind interest capitalized as principal						$ 7,500,000
Additional interest expense charge						1.00%
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
Debt Instrument [Line Items]
Payments to extinguish debt					$ 245,800,000
Second Lien Term Loan \| Credit Arrangements, Entered Into 2015 \| Senior Notes
Debt Instrument [Line Items]
Face amount of debt instruments	$ 150,000,000

INDEBTEDNESS - Long-term Debt Maturities (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Debt Disclosure [Abstract]
2022	$ 6,000
2023	6,000
2024	6,000
2025	6,000
2026	6,000
2027 and beyond	1,070,000
Total	$ 1,100,000	$ 1,161,531

INDEBTEDNESS - Estimated Fair Values of Debt Obligations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Total debt instruments	$ 1,065,900
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Principal prepayment	(8,832)	$ (9,250)	$ (2,075)
Second Lien Notes fair value as of December 31, 2021	1,065,900
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 December 31, 2021	0
Significant Other Observable Inputs (Level 2)
Debt Instrument [Line Items]
Total debt instruments	1,099,750
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of December 31, 2021	1,099,750
Significant Unobservable Inputs (Level 3)
Debt Instrument [Line Items]
Total debt instruments	0
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of December 31, 2021	0
Senior Notes
Debt Instrument [Line Items]
Total debt instruments	488,836
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of December 31, 2021	488,836
Senior Notes \| First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	577,064
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of December 31, 2021	577,064
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 December 31, 2021	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 December 31, 2021	0
Senior Notes \| Significant Other Observable Inputs (Level 2)
Debt Instrument [Line Items]
Total debt instruments	501,250
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of December 31, 2021	501,250
Senior Notes \| Significant Other Observable Inputs (Level 2) \| First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	598,500
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of December 31, 2021	598,500
Senior Notes \| Significant Unobservable Inputs (Level 3)
Debt Instrument [Line Items]
Total debt instruments	0
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of December 31, 2021	0
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 December 31, 2021	0
Senior Notes \| Significant Unobservable Inputs (Level 3) \| Second Lien Notes
Debt Instrument [Line Items]
Total debt instruments	0	266,438
Debt Instrument, Changes In Long-Term Debt [Roll Forward]
Second Lien Notes fair value as of January 1, 2021	266,438
Principal prepayment	(245,781)
Change in fair value	(20,657)
Second Lien Notes fair value as of December 31, 2021	$ 0	$ 266,438

DERIVATIVE INSTRUMENTS - Additional Information (Details) - USD ($)	1 Months Ended		12 Months Ended
	Oct. 31, 2021	May 31, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Nov. 06, 2019	Aug. 31, 2019
Derivative [Line Items]
Total interest rate costs expected to reclassify during next 12 months			$ 2,800,000
Interest Rate Cap \| Interest expense
Derivative [Line Items]
Accumulated comprehensive loss reclassified			239,000	$ 0	$ 125,000
Interest Rate Swap
Derivative [Line Items]
Notional amount of derivative							$ 925,000,000
Interest Rate Swap \| Interest expense
Derivative [Line Items]
Accumulated comprehensive loss reclassified		$ 3,700,000	$ 11,298,000	$ 12,799,000	$ 115,000
Designated as Hedging Instrument \| Senior Notes \| First Lien Term Loan \| Interest Rate Cap
Derivative [Line Items]
Notional amount of derivative	$ 300,000,000
Derivative term of contract	5 years
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						$ 400,000,000
Not Designated as Hedging Instrument \| Interest Rate Swap
Derivative [Line Items]
Notional amount of derivative							13,900,000
Cash Flow Hedging \| Designated as Hedging Instrument \| Interest Rate Swap
Derivative [Line Items]
Notional amount of derivative							$ 911,100,000

DERIVATIVE INSTRUMENTS - Balance Sheet Location of Derivatives (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Fair value - Derivatives in liability position
Total derivatives	$ 601	$ 11,342
Designated as Hedging Instrument \| Accrued expenses and other current liabilities \| Interest Rate Cap
Fair value - Derivatives in liability position
Derivative liability	601	0
Designated as Hedging Instrument \| Accrued expenses and other current liabilities \| Interest Rate Swap
Fair value - Derivatives in liability position
Derivative liability	0	11,172
Not Designated as Hedging Instrument \| Accrued expenses and other current liabilities \| Interest Rate Swap
Fair value - Derivatives in liability position
Derivative liability	$ 0	$ 170

DERIVATIVE INSTRUMENTS - Pre-tax Gain (Loss) on Derivative Instruments (Details) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	May 31, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Derivative [Line Items]
Pre-tax gains (losses) on interest rate derivatives recognized		$ 10,571	$ (3,977)	$ (8,298)
Total gain (loss) on derivatives		(11,539)	(16,579)	(332)
Interest Rate Cap
Derivative [Line Items]
Pre-tax gains (losses) on interest rate derivatives recognized		(601)	0	(1,103)
Interest Rate Swap
Derivative [Line Items]
Pre-tax gains (losses) on interest rate derivatives recognized		11,172	(7,723)	(7,195)
Interest rate swaps that discontinued hedge accounting		0	3,746	0
Interest expense \| Interest Rate Cap
Derivative [Line Items]
Gain (loss) location of derivative instruments		(239)	0	(125)
Interest expense \| Interest Rate Swap
Derivative [Line Items]
Gain (loss) location of derivative instruments	$ (3,700)	(11,298)	(12,799)	(115)
Gain (loss) location of derivative instruments not designated		(2)	(34)	(92)
Gain (loss) location of discontinued derivative instruments		$ 0	$ (3,746)	$ 0

STOCK-BASED INCENTIVE COMPENSATION - Narrative (Details) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	May 31, 2021	May 03, 2018
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Number of shares authorized (in shares)				9,101,734
Proceeds from stock option exercises	$ 400,000		$ 0
Stock Option
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based compensation expense	$ 1,900,000	$ 400,000
Weighted-average grant-date fair value per share (in dollars per share)	$ 17.79	$ 5.94
Options granted in period (in shares)	853,089		0
Value of shares surrendered to satisfy tax withholding obligations	$ 100,000,000	$ 2,700,000
Unrecognized compensation expense	$ 13,900,000
Weighted average period of recognition	2 years 3 months 18 days
Restricted Stock
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based compensation expense	$ 4,900,000	2,300,000
Value of shares surrendered to satisfy tax withholding obligations	0.0	300,000
Unrecognized compensation expense	31,200,000
Value of shares vested in period	$ 1,200,000	1,500,000	$ 1,900,000
Weighted average period of recognition	2 years 1 month 6 days
HC I Incentive Units
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based compensation expense	$ 100,000	$ 200,000	$ 1,900,000
The 2018 Plan
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Number of shares authorized (in shares)				4,999,999	4,101,735
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) - Stock Option	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Expected volatility	51.92%	45.70%
Risk-free interest rate	1.40%	0.53%
Expected life of options	6 years 6 months	6 years 3 months 18 days
Dividend rate	0.00%	0.00%

STOCK-BASED INCENTIVE COMPENSATION - Summary of Stock Option Activity (Details) - Stock Option - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2019
Options
Beginning balance (in shares)	412,831
Granted (in shares)	853,089	0
Exercised (in shares)	(42,405)
Forfeited and expired (in shares)	(53,374)
Ending balance (in shares)	1,170,141
Exercisable (in shares)	150,890
Weighted Average Exercise Price
Beginning balance (in dollars per share)	$ 14.77
Granted (in dollars per share)	22.14
Exercised (in dollars per share)	10.65
Forfeited and expired (in dollars per share)	22.13
Ending balance (in dollars per share)	19.96
Exercisable (in dollars per share)	$ 15.84
Aggregate Intrinsic Value
Balance at December 31, 2020	$ 1,320
Granted	5,335
Exercised	461
Forfeited and expired	478
Balance at December 31, 2021	10,154
Exercisable at December 31, 2021	$ 2,131
Weighted Average Remaining Contractual Life at December 31, 2020	8 years 6 months 18 days
Weighted Average Remaining Contractual Life Exercisable at December 31, 2020	3 years 7 months 17 days

STOCK-BASED INCENTIVE COMPENSATION - Summary of Outstanding and Exercisable Stock Options (Details)	12 Months Ended
	Dec. 31, 2021 $ / shares shares
Options Outstanding
Options Outstanding (in shares) \| shares	1,170,141
Options Exercisable
Options Exercisable (in shares) \| shares	150,890
$0.00 - $8.24
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	5 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 - $16.52
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	292,189
Weighted Average Exercise Price (in dollars per share)	$ 12.32
Weighted Average Remaining Contractual Life	7 years
Options Exercisable
Options Exercisable (in shares) \| shares	99,739
Weighted Average Exercise Price (in dollars per share)	$ 10.30
$16.52 - $24.76
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	521,461
Weighted Average Exercise Price (in dollars per share)	$ 19.90
Weighted Average Remaining Contractual Life	9 years
Options Exercisable
Options Exercisable (in shares) \| shares	21,375
Weighted Average Exercise Price (in dollars per share)	$ 23.56
$24.76 - $33.00
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	336,715
Weighted Average Exercise Price (in dollars per share)	$ 26.20
Weighted Average Remaining Contractual Life	9 years 7 months 6 days
Options Exercisable
Options Exercisable (in shares) \| shares	10,000
Weighted Average Exercise Price (in dollars per share)	$ 30.20
$41.28 - $49.52
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	6,250
Weighted Average Exercise Price (in dollars per share)	$ 44.16
Weighted Average Remaining Contractual Life	1 year 2 months 12 days
Options Exercisable
Options Exercisable (in shares) \| shares	6,250
Weighted Average Exercise Price (in dollars per share)	$ 44.16
$49.52 - $57.76
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	2,375
Weighted Average Exercise Price (in dollars per share)	$ 56.24
Weighted Average Remaining Contractual Life	1 year 3 months 18 days
Options Exercisable
Options Exercisable (in shares) \| shares	2,375
Weighted Average Exercise Price (in dollars per share)	$ 56.24
$66.00 - $74.28
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	1 year 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, 2021 $ / shares shares
Restricted Stock
Balance at December 31, 2019 (in shares) \| shares	549,650
Granted (in shares) \| shares	875,554
Vested and issued (in shares) \| shares	(91,858)
Forfeited and expired (in shares) \| shares	(67,120)
Balance at December 31, 2020 (in shares) \| shares	1,266,226
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	$ 13.26
Shares granted (in dollars per share) \| $ / shares	19.95
Vested and issued (in dollars per share) \| $ / shares	13.01
Forfeited and expired (in dollars per share) \| $ / shares	15.62
Balance at December 31, 2020 (in dollars per share) \| $ / shares	$ 17.73

STOCKHOLDERS' EQUITY (Details)			12 Months Ended
STOCKHOLDERS' EQUITY (Details)	Feb. 03, 2020	Aug. 06, 2019 USD ($) $ / shares shares	Dec. 31, 2021 USD ($) $ / shares shares	Dec. 31, 2020 USD ($) $ / shares shares	Dec. 31, 2019 USD ($) day $ / shares shares	Dec. 31, 2016 shares	Jun. 29, 2017 $ / shares	Mar. 09, 2015 $ / shares shares
Class of Warrant or Right [Line Items]
Stock conversion ratio	0.25
Percentage of outstanding common stock			0.207
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
Common Stock \| Secondary Offering
Class of Warrant or Right [Line Items]
Additional shares issued (in shares)			76,400,000
Common Stock \| Public Offering
Class of Warrant or Right [Line Items]
Additional shares issued (in shares)				10,700,000
Proceeds from sale of equity \| $				$ 118,900,000
Shares issued, price per share (in dollars per share) \| $ / shares				$ 12.50
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 \| $		$ 14,100,000
Shares purchased from exercise of warrants (in shares)			0	42,336
Proceeds from warrant exercises \| $			$ 0
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 \| $		$ 4,600,000
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 \| $					$ 2,500,000
Restricted Stock And Stock Options \| Treasury Stock
Class of Warrant or Right [Line Items]
Value of shares surrendered to satisfy tax withholding obligations \| $			$ 2,400,000	$ 2,400,000
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
Stock price threshold (in dollars per share) \| $ / shares					$ 20.00
Consecutive trading days threshold \| day					20

RELATED-PARTY TRANSACTIONS (Details)	12 Months Ended
RELATED-PARTY TRANSACTIONS (Details)	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)	Dec. 31, 2019 USD ($)	Dec. 31, 2015 agreement
Related Party Transaction [Line Items]
Number of agreements \| agreement				2
Selling, general and administrative expenses	$ 525,707,000	$ 500,199,000	$ 459,628,000
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
Notes receivable	0	0	0
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]
Shareholder redemptions	0	0	2,400,000
Cash distributions			2,000,000
Notes redeemed			400,000
Joint Venture
Related Party Transaction [Line Items]
Due to joint ventures	1,400,000		4,300,000
Management fee income	$ 3,500,000	2,900,000	$ 2,500,000
Due from joint ventures		$ 2,400,000