0001014739-23-000042 | 10-Q | XBRL Viewer

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LEASES - Maturities of Lease Liabilities (Details) $ in Thousands	Sep. 30, 2023 USD ($)
Minimum Payments
2023	$ 9,410
2024	23,564
2025	21,350
2026	18,490
2027	15,315
Thereafter	44,262
Total lease payments	132,391
Less: interest	(28,500)
Present value of lease liabilities	$ 103,891

INDEBTEDNESS - Additional Information (Details) - Senior Notes - USD ($) $ in Millions		3 Months Ended		9 Months Ended
	Jan. 13, 2023	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Asset-based-lending (“ABL”) Facility
Debt Instrument [Line Items]
Credit facility, increase in borrowing capacity	$ 50.0
Credit facility, borrowing availability	$ 225.0
First Lien Term Loan \| Credit Agreements Amendment
Debt Instrument [Line Items]
Effective rate on term loans at end of period		8.20%		8.20%		6.82%
Weighted average interest rate paid on term loans during period		8.11%	4.94%	7.71%	3.90%
Second Lien Term Loan \| Credit Agreements Amendment
Debt Instrument [Line Items]
Effective rate on term loans at end of period		4.375%		4.375%		4.375%
Weighted average interest rate paid on term loans during period		4.375%	4.375%	4.375%	4.375%

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Sep. 30, 2022
Pay vs Performance Disclosure
Net income	$ 56,302	$ 114,403	$ 39,208	$ 38,823	$ 33,929	$ 30,275	$ 209,913	$ 103,027

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

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+ Details

STOCKHOLDERS' EQUITY (Details) - USD ($) $ / shares in Units, $ in Millions		3 Months Ended		9 Months Ended
	Mar. 03, 2023	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Feb. 20, 2023	Dec. 31, 2022
Class of Warrant or Right [Line Items]
Treasury stock, shares, acquired (in shares)	2,475,166	2,913,520		5,388,686
Treasury stock acquired, average cost per share (in dollars per share)		$ 34.32		$ 32.48
Shares repurchased	$ 75.0	$ 100.0		$ 175.0
Stock repurchase program, authorized amount		$ 75.0		$ 75.0
Common Stock
Class of Warrant or Right [Line Items]
Number of shares authorized to be repurchased (in shares)						250,000,000
Common Stock \| 2017 Warrants
Class of Warrant or Right [Line Items]
Number of warrants exercisable (in shares)			0
Number of warrants exercised (in shares)		188,350		188,350	1,130,089
Class of warrant or right, outstanding (in shares)		51,838		51,838			240,188
Common Stock \| 2015 Warrants
Class of Warrant or Right [Line Items]
Number of warrants exercised (in shares)		0	31,968	0	900,272
Class of warrant or right, outstanding (in shares)		13,892		13,892			15,231

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Statement [Abstract]
Change in unrealized gain (loss) on cash flow hedges, net of income tax (expense) benefit	$ 8	$ (1,398)	$ 57	$ (5,917)

GOODWILL AND OTHER INTANGIBLE ASSETS - Carrying Amount and Accumulated Amortization of Intangible Assets (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	$ 554,527		$ 554,527		$ 549,066
Total accumulated amortization	(210,533)		(210,533)		(184,951)
Total intangible assets, net	343,994		343,994		364,115
Amortization expense for intangible assets	8,600	$ 8,400	25,600	$ 24,600
Referral sources
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	514,388		514,388		509,646
Total accumulated amortization	(191,262)		(191,262)		(167,902)
Trademarks/names
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	39,136		39,136		38,508
Total accumulated amortization	(18,973)		(18,973)		(16,901)
Other amortizable intangible assets
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	1,003		1,003		912
Total accumulated amortization	$ (298)		$ (298)		$ (148)

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Concentration Risk [Line Items]
Rebate receivable	$ 51,000		$ 51,000		$ 53,400
Investments in equity-method investees	19,500		19,500		$ 19,400
Proportionate share of earnings in equity-method investees	$ 1,300	$ 1,500	4,107	$ 4,065
Distributions received from the investees		$ 1,500	$ 4,000	$ 2,500
Revenue from Contract with Customer Benchmark \| Company's Largest Payer \| Largest Payer
Concentration Risk [Line Items]
Concentration risk	14.00%	14.00%	14.00%	15.00%
Revenue from Contract with Customer Benchmark \| Governmental Healthcare Programs \| Government Healthcare Programs
Concentration Risk [Line Items]
Concentration risk	11.00%	12.00%	12.00%	12.00%
Accounts Receivable, Benchmark \| Governmental Healthcare Programs \| 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	73.00%	74.00%	73.00%	73.00%

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 209,913	$ 103,027
Adjustments to reconcile net income to net cash provided by operations:
Depreciation and amortization expense	46,423	49,723
Non-cash operating lease costs	14,610	14,451
Deferred income taxes - net	11,767	37,631
Amortization of deferred financing costs	3,312	3,206
Equity in earnings of joint ventures	(4,107)	(4,065)
Stock-based incentive compensation expense	22,908	12,581
Capital distribution from equity method investments	4,000	2,500
Other adjustments	1,769	695
Changes in operating assets and liabilities:
Accounts receivable, net	(5,075)	(23,153)
Inventories	(28,362)	(52,749)
Prepaid expenses and other current assets	3,197	(10,335)
Accounts payable	50,726	129,859
Accrued compensation and employee benefits	4,197	(26,711)
Accrued expenses and other current liabilities	9,829	19,495
Operating lease liabilities	(13,019)	(15,372)
Other noncurrent assets and liabilities	(11,762)	(16,691)
Net cash provided by operating activities	320,326	224,092
CASH FLOWS FROM INVESTING ACTIVITIES:
Acquisition of property and equipment	(21,981)	(17,111)
Business acquisitions, net of cash acquired	(12,855)	(87,315)
Other investing activities	(5,889)	0
Net cash used in investing activities	(40,725)	(104,426)
CASH FLOWS FROM FINANCING ACTIVITIES:
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(1,940)	(37)
Proceeds from warrant exercises	0	20,916
Repayments of debt principal	(4,500)	(4,500)
Purchase of company stock	(175,108)	0
Other financing activities	(5,750)	0
Net cash (used in) provided by financing activities	(187,298)	16,379
NET INCREASE IN CASH AND CASH EQUIVALENTS	92,303	136,045
Cash and cash equivalents - beginning of the period	294,186	119,423
CASH AND CASH EQUIVALENTS - END OF PERIOD	386,489	255,468
Supplemental disclosure of cash flow information:
Cash paid for interest	46,377	29,578
Cash paid for income taxes	53,699	6,690
Cash paid for operating leases	$ 20,272	$ 18,964

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Statement [Abstract]
NET REVENUE	$ 1,093,014	$ 1,020,918	$ 3,177,934	$ 2,917,522
COST OF REVENUE	838,748	802,917	2,443,834	2,281,685
GROSS PROFIT	254,266	218,001	734,100	635,837
OPERATING COSTS AND EXPENSES:
Selling, general and administrative expenses	158,214	142,015	459,644	417,771
Depreciation and amortization expense	15,005	15,268	44,417	46,027
Total operating expenses	173,219	157,283	504,061	463,798
OPERATING INCOME	81,047	60,718	230,039	172,039
OTHER INCOME (EXPENSE):
Interest expense, net	(11,786)	(13,997)	(38,816)	(39,008)
Equity in earnings of joint ventures	1,273	1,472	4,107	4,065
Other, net	(449)	3,888	84,487	3,891
Total other (expense) income	(10,962)	(8,637)	49,778	(31,052)
INCOME BEFORE INCOME TAXES	70,085	52,081	279,817	140,987
INCOME TAX EXPENSE	13,783	13,258	69,904	37,960
NET INCOME	56,302	38,823	209,913	103,027
OTHER COMPREHENSIVE INCOME (LOSS), NET OF TAX:
Change in unrealized gain (loss) on cash flow hedges, net of income tax benefit (expense) of $8, $(1,398), $57 and $(5,917), respectively	53	9,255	(99)	24,962
OTHER COMPREHENSIVE INCOME (LOSS)	53	9,255	(99)	24,962
NET COMPREHENSIVE INCOME	$ 56,355	$ 48,078	$ 209,814	$ 127,989
EARNINGS PER COMMON SHARE:
Earnings per share, basic (in dollars per share)	$ 0.31	$ 0.21	$ 1.17	$ 0.57
Earnings per share, diluted (in dollars per share)	$ 0.31	$ 0.21	$ 1.16	$ 0.57
Weighted average common shares outstanding, basic (in shares)	178,826	181,884	179,956	180,829
Weighted average common shares outstanding, diluted (in shares)	180,528	183,022	181,286	181,760

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY - USD ($) $ in Thousands	Total	Preferred Stock	Common Stock	Treasury Stock	Paid-in Capital	Retained Earnings	Accumulated Other Comprehensive Income (Loss)
Equity, beginning balance at Dec. 31, 2021	$ 1,175,886	$ 0	$ 18	$ (2,403)	$ 1,138,855	$ 39,867	$ (451)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options, vesting of restricted stock, and related tax withholdings	355				355
Stock-based incentive compensation	4,178				4,178
Net income	30,275					30,275
Other comprehensive income (loss)	11,070						11,070
Equity, ending balance at Mar. 31, 2022	1,221,764	0	18	(2,403)	1,143,388	70,142	10,619
Equity, beginning balance at Dec. 31, 2021	1,175,886	0	18	(2,403)	1,138,855	39,867	(451)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	103,027
Other comprehensive income (loss)	24,962
Equity, ending balance at Sep. 30, 2022	1,337,335	0	18	(2,403)	1,172,315	142,894	24,511
Equity, beginning balance at Mar. 31, 2022	1,221,764	0	18	(2,403)	1,143,388	70,142	10,619
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options, vesting of restricted stock, and related tax withholdings	168				168
Exercise of warrants	20,098				20,098
Stock-based incentive compensation	4,398				4,398
Net income	33,929					33,929
Other comprehensive income (loss)	4,637						4,637
Equity, ending balance at Jun. 30, 2022	1,284,994	0	18	(2,403)	1,168,052	104,071	15,256
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(560)				(560)
Exercise of warrants	818				818
Stock-based incentive compensation	4,005				4,005
Net income	38,823					38,823
Other comprehensive income (loss)	9,255						9,255
Equity, ending balance at Sep. 30, 2022	1,337,335	0	18	(2,403)	1,172,315	142,894	24,511
Equity, beginning balance at Dec. 31, 2022	1,386,103	0	18	(2,403)	1,176,906	190,423	21,159
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(1,902)				(1,902)
Stock-based incentive compensation	5,988				5,988
Purchase of company stock	(75,735)			(75,735)
Net income	39,208					39,208
Other comprehensive income (loss)	(3,443)						(3,443)
Equity, ending balance at Mar. 31, 2023	1,350,219	0	18	(78,138)	1,180,992	229,631	17,716
Equity, beginning balance at Dec. 31, 2022	1,386,103	0	18	(2,403)	1,176,906	190,423	21,159
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	209,913
Other comprehensive income (loss)	(99)
Equity, ending balance at Sep. 30, 2023	1,440,083	0	18	(179,205)	1,197,874	400,336	21,060
Equity, beginning balance at Mar. 31, 2023	1,350,219	0	18	(78,138)	1,180,992	229,631	17,716
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(247)				(247)
Stock-based incentive compensation	7,685				7,685
Purchase of company stock, and related tax effects	32			32
Net income	114,403					114,403
Other comprehensive income (loss)	3,291						3,291
Equity, ending balance at Jun. 30, 2023	1,475,383	0	18	(78,106)	1,188,430	344,034	21,007
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options, vesting of restricted stock, and related tax withholdings	209				209
Stock-based incentive compensation	9,235				9,235
Purchase of company stock, and related tax effects	(101,099)			(101,099)
Net income	56,302					56,302
Other comprehensive income (loss)	53						53
Equity, ending balance at Sep. 30, 2023	$ 1,440,083	$ 0	$ 18	$ (179,205)	$ 1,197,874	$ 400,336	$ 21,060

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

- Definition

Equity impact of the value of stock that has been repurchased during the period and has not been retired and is not held in treasury. Some state laws may mandate the circumstances under which an entity may acquire its own stock and prescribe the accounting treatment therefore. This element is used when state law does not recognize treasury stock.

+ References + Details

- Definition

Amount of equity (deficit) attributable to parent. Excludes temporary equity and equity attributable to noncontrolling interest.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
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+ Details

GOODWILL AND OTHER INTANGIBLE ASSETS

9 Months Ended

Sep. 30, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

GOODWILL AND OTHER INTANGIBLE ASSETS

Changes in the carrying amount of goodwill consist of the following activity for the three and nine months ended September 30, 2023 (in thousands):


Balance at December 31, 2022	$	1,533,424
Purchase accounting adjustments	145
Balance at March 31, 2023	$	1,533,569
Acquisitions	6,998
Balance at June 30, 2023	$	1,540,567
Purchase accounting adjustments	(321)
Balance at September 30, 2023	$	1,540,246

The carrying amount and accumulated amortization of intangible assets consist of the following as of September 30, 2023 and December 31, 2022 (in thousands):


	September 30, 2023		December 31, 2022
Gross intangible assets:
Referral sources	$	514,388	$	509,646
Trademarks/names	39,136		38,508
Other amortizable intangible assets	1,003		912
Total gross intangible assets	554,527		549,066

Accumulated amortization:
Referral sources	(191,262)		(167,902)
Trademarks/names	(18,973)		(16,901)
Other amortizable intangible assets	(298)		(148)
Total accumulated amortization	(210,533)		(184,951)
Total intangible assets, net	$	343,994	$	364,115

Amortization expense for intangible assets was $8.6 million and $25.6 million for the three and nine months ended September 30, 2023, respectively. Amortization expense for intangible assets was $8.4 million and $24.6 million for the three and nine months ended September 30, 2022, respectively.

GOODWILL AND OTHER INTANGIBLE ASSETS - Carrying Amount of Goodwill (Details) - USD ($) $ in Thousands	3 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023
Goodwill [Roll Forward]
Goodwill - net book value, begging of period	$ 1,540,567	$ 1,533,569	$ 1,533,424
Purchase accounting adjustments	(321)		145
Acquisitions		6,998
Goodwill - net book value, end of period	$ 1,540,246	$ 1,540,567	$ 1,533,569

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References + Details

INCOME TAXES	9 Months Ended
INCOME TAXES	Sep. 30, 2023
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXES During the three months ended September 30, 2023, the Company recorded tax expense of $13.8 million. During the nine months ended September 30, 2023, the Company recorded tax expense of $69.9 million, which includes $22.1 million of tax expense related to the Termination Fee payment received on behalf of Amedisys, under the terms of the Mutual Termination Agreement, net of merger-related expenses. The tax expense for the three and nine months ended September 30, 2023 represents an effective tax rate of 19.7% and 25.0%, respectively. The variance in the Company’s effective tax rate of 19.7% and 25.0% for the three and nine months ended September 30, 2023, respectively, compared to the federal statutory rate of 21%, is primarily attributable to the difference between federal and state tax rates, various non-deductible expenses, and a change in state valuation allowance. During the three months ended September 30, 2023, the Company released $5.8 million of state valuation allowance. During the three and nine months ended September 30, 2022, the Company recorded tax expense of $13.3 million and $38.0 million, respectively, which represents an effective tax rate of 25.5% and 26.9%, respectively. The variance in the Company’s effective tax rate of 25.5% and 26.9% for the three and nine months ended September 30, 2022, compared to the federal statutory rate of 21%, is primarily attributable to current and deferred state taxes as well as various non-deductible expenses. The Company maintains a valuation allowance of $7.2 million against certain state net operating losses. 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. In making this assessment, 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. On a quarterly basis, the Company evaluates all positive and negative evidence in determining if the valuation allowance is fairly stated. The Company’s tax expense for the three and nine months ended September 30, 2023 of $13.8 million and $69.9 million, respectively, consists of quarterly federal and state tax liabilities as well as recognized deferred federal and state tax expense. The Company’s tax expense for the three and nine months ended September 30, 2022 of $13.3 million and $38.0 million, respectively, consists of quarterly tax liabilities attributable to specific state taxing authorities as well as recognized deferred federal and state tax expense. The Company has accumulated federal net operating loss carryovers that are subject to one or more Section 382 limitations. This may limit the Company’s ability to utilize its federal net operating losses

- 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

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-Topic 946
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-Name Accounting Standards Codification
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+ Details

LEASES (Tables)

9 Months Ended

Sep. 30, 2023

Leases [Abstract]

Schedule of Maturities of Lease Liabilities, Operating

Operating leases mature as follows (in thousands):


Fiscal Year Ended December 31,	Minimum Payments
2023	$	9,410
2024	23,564
2025	21,350
2026	18,490
2027	15,315
Thereafter	44,262
Total lease payments	132,391
Less: interest	(28,500)
Present value of lease liabilities	$	103,891

LEASES - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Leases [Abstract]
Operating lease cost	$ 7.8	$ 7.8	$ 22.3	$ 22.7
Weighted-average remaining lease term, operating leases	6 years 10 months 24 days		6 years 10 months 24 days
Weighted-average discount rate, operating leases	6.04%		6.04%
Increase in operating lease right-of-use asset and lease liabilities			$ 26.1	$ 13.6

Cover Page - shares	9 Months Ended
Cover Page - shares	Sep. 30, 2023	Oct. 23, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2023
Document Transition Report	false
Entity File Number	001-11993
Entity Registrant Name	OPTION CARE HEALTH, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	05-0489664
Entity Address, Address Line One	3000 Lakeside Dr.
Entity Address, Address Line Two	Suite 300N,
Entity Address, City or Town	Bannockburn,
Entity Address, State or Province	IL
Entity Address, Postal Zip Code	60015
City Area Code	312
Local Phone Number	940-2443
Title of 12(b) Security	Common Stock, $0.0001 par value per share
Trading Symbol	OPCH
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		177,130,539
Entity Central Index Key	0001014739
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q3
Amendment Flag	false

INDEBTEDNESS - Long Term Debt Maturities (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Debt Disclosure [Abstract]
2023	$ 1,500
2024	6,000
2025	6,000
2026	6,000
2027	6,000
Thereafter	1,064,000
Total	$ 1,089,500	$ 1,094,000

INDEBTEDNESS - Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Principal Amount	$ 1,089,500	$ 1,094,000
Discount	(7,313)	(8,307)
Debt Issuance Costs	(19,171)	(21,489)
Net Balance	1,063,016	1,064,204
Less: current portion	(6,000)	(6,000)
Total long-term debt	1,057,016	1,058,204
Senior Notes \| First Lien Term Loan
Debt Instrument [Line Items]
Principal Amount	589,500	594,000
Discount	(7,313)	(8,307)
Debt Issuance Costs	(10,149)	(11,529)
Net Balance	572,038	574,164
Senior Notes \| Senior Notes
Debt Instrument [Line Items]
Principal Amount	500,000	500,000
Discount	0	0
Debt Issuance Costs	(9,022)	(9,960)
Net Balance	490,978	490,040
Senior Notes \| Asset-based-lending (“ABL”) Facility
Debt Instrument [Line Items]
Principal Amount	0	0
Discount	0	0
Debt Issuance Costs	0	0
Net Balance	$ 0	$ 0

GOODWILL AND OTHER INTANGIBLE ASSETS (Tables)

9 Months Ended

Sep. 30, 2023

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 three and nine months ended September 30, 2023 (in thousands):


Balance at December 31, 2022	$	1,533,424
Purchase accounting adjustments	145
Balance at March 31, 2023	$	1,533,569
Acquisitions	6,998
Balance at June 30, 2023	$	1,540,567
Purchase accounting adjustments	(321)
Balance at September 30, 2023	$	1,540,246

Schedule of Carrying Amount and Accumulated Amortization of Intangible Assets

The carrying amount and accumulated amortization of intangible assets consist of the following as of September 30, 2023 and December 31, 2022 (in thousands):


	September 30, 2023		December 31, 2022
Gross intangible assets:
Referral sources	$	514,388	$	509,646
Trademarks/names	39,136		38,508
Other amortizable intangible assets	1,003		912
Total gross intangible assets	554,527		549,066

Accumulated amortization:
Referral sources	(191,262)		(167,902)
Trademarks/names	(18,973)		(16,901)
Other amortizable intangible assets	(298)		(148)
Total accumulated amortization	(210,533)		(184,951)
Total intangible assets, net	$	343,994	$	364,115

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
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+ Details

INCOME TAXES (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
INCOME TAXES (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Tax Disclosure [Abstract]
Income tax (benefit) expense	$ 13,783	$ 13,258	$ 69,904	$ 37,960
Termination fee, tax expense			$ 22,100
Effective tax rate	19.70%	25.50%	25.00%	26.90%
State valuation allowance, released	$ 5,800
Valuation allowance	$ 7,200		$ 7,200

- Definition

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

+ References + Details

BUSINESS COMBINATIONS - Preliminary Estimate of the Allocation Consideration Transferred (Details) - USD ($) $ in Thousands	1 Months Ended	9 Months Ended
	Aug. 31, 2022	Sep. 30, 2023	Sep. 30, 2022	Jun. 30, 2023	Mar. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Goodwill		$ 1,540,246		$ 1,540,567	$ 1,533,569	$ 1,533,424
Purchase price, net of cash acquired		$ 12,855	$ 87,315
Rochester Home Infusion, Inc
Business Acquisition [Line Items]
Accounts receivable	$ 686
Intangible assets	5,449
Other assets	394
Accounts payable and other liabilities	(434)
Fair value identifiable assets and liabilities	6,095
Goodwill	21,323
Cash acquired	201
Purchase price	27,619
Purchase price, net of cash acquired	$ 27,418

STOCKHOLDERS' EQUITY	9 Months Ended
STOCKHOLDERS' EQUITY	Sep. 30, 2023
Equity [Abstract]
STOCKHOLDERS’ EQUITY	STOCKHOLDERS’ EQUITY 2017 Warrants — During the three and nine months ended September 30, 2023, warrant holders elected to exercise 188,350 warrants to purchase shares of common stock. During the three months ended September 30, 2022, warrant holders did not elect to exercise any warrants to purchase shares of common stock. During the nine months ended September 30, 2022, warrant holders elected to exercise 1,130,089 warrants to purchase shares of common stock. As of September 30, 2023 and December 31, 2022, the remaining warrant holders are entitled to purchase 51,838 and 240,188 shares of common stock, respectively. 2015 Warrants — During the three and nine months ended September 30, 2023, warrant holders exercised an immaterial number of warrants to purchase shares of common stock. During the three and nine months ended September 30, 2022, warrant holders elected to exercise 31,968 and 900,272 warrants to purchase shares of common stock, respectively. As of September 30, 2023 and December 31, 2022, the remaining warrant holders are entitled to purchase 13,892 and 15,231 shares of common stock, respectively. Share Repurchase Program — On February 20, 2023, the Company’s Board of Directors approved a share repurchase program of up to an aggregate $250.0 million of common stock of the Company. Under the share repurchase program, repurchases may occur in any number of methods depending on timing, market conditions, regulatory requirements, and other corporate considerations. The share repurchase program has no specified expiration date. During the three and nine months ended September 30, 2023, the Company purchased 2,913,520 and 5,388,686 shares of common stock for an average share price of $34.32 and $32.48, totaling $100.0 million and $175.0 million, respectively. All repurchased shares became treasury stock. As of September 30, 2023, the Company is authorized to repurchase up to a remaining $75.0 million of common stock of the Company.

- Definition

The entire disclosure for equity.

+ References

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+ Details

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Sep. 30, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

NATURE OF OPERATIONS AND PRESENTATION OF FINANCIAL STATEMENTS	9 Months Ended
	Sep. 30, 2023
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, Inc. (“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”) (the “Merger”), a national provider of infusion and home care management solutions, which was completed on August 6, 2019 (the “Merger Date”). Following the close of the transaction, BioScrip was rebranded as Option Care Health. The combined Company’s stock is listed on the Nasdaq Global Select Market as of September 30, 2023. During the nine months ended September 30, 2023, HC I completed sales of 23,771,926 shares of common stock. In addition, the Company repurchased 2,475,166 shares from HC I on March 3, 2023 under the Company’s share repurchase program. See Note 15, Stockholders’ Equity, for further discussion of the Company’s share repurchase program. As of September 30, 2023, HC I no longer holds shares of the Company’s common stock. Option Care Health, and its wholly-owned subsidiaries, provides infusion therapy and other ancillary health care services through a national network of 93 full service pharmacies and 81 stand-alone ambulatory infusion suites. 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 unaudited condensed consolidated financial statements have been prepared in conformity with generally accepted accounting principles (“GAAP”) in the United States and contain all adjustments, including normal recurring adjustments, necessary to present fairly the Company’s financial position, results of operations and cash flows for interim financial reporting. The results of operations for the interim periods presented are not necessarily indicative of the results of operations for the entire year. These unaudited condensed consolidated financial statements do not include all of the information and notes to the financial statements required by GAAP for complete financial statements and should be read in conjunction with the 2022 audited consolidated financial statements, including the notes thereto, as presented in our Form 10-K. Principles of Consolidation — The Company’s unaudited condensed consolidated financial statements include the accounts of Option Care Health, Inc. and its subsidiaries. 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 unaudited condensed consolidated statements of comprehensive income. See Equity-Method Investments within Note 2, Summary of Significant Accounting Policies, for further discussion of the Company’s equity-method investments.

INDEBTEDNESS - Estimated Fair Values of Debt Obligations (Details) $ in Thousands	Sep. 30, 2023 USD ($)
Debt Instrument [Line Items]
Total debt instruments	$ 1,063,016
Markets for Identical Item (Level 1)
Debt Instrument [Line Items]
Total debt instruments	0
Significant Other Observable Inputs (Level 2)
Debt Instrument [Line Items]
Total debt instruments	1,021,740
Significant Unobservable Inputs (Level 3)
Debt Instrument [Line Items]
Total debt instruments	0
Senior Notes
Debt Instrument [Line Items]
Total debt instruments	490,979
Senior Notes \| First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	572,037
Senior Notes \| Markets for Identical Item (Level 1)
Debt Instrument [Line Items]
Total debt instruments	0
Senior Notes \| Markets for Identical Item (Level 1) \| First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	0
Senior Notes \| Significant Other Observable Inputs (Level 2)
Debt Instrument [Line Items]
Total debt instruments	430,000
Senior Notes \| Significant Other Observable Inputs (Level 2) \| First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	591,740
Senior Notes \| Significant Unobservable Inputs (Level 3)
Debt Instrument [Line Items]
Total debt instruments	0
Senior Notes \| Significant Unobservable Inputs (Level 3) \| First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	$ 0

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

INDEBTEDNESS (Tables)

9 Months Ended

Sep. 30, 2023

Debt Disclosure [Abstract]

Schedule of Debt

Long-term debt consisted of the following as of September 30, 2023 (in thousands):


	Principal Amount		Discount		Debt Issuance Costs		Net Balance
Asset-based-lending (“ABL”) Facility	$	—	$	—	$	—	$	—
First Lien Term Loan	589,500		(7,313)		(10,149)		572,038
Senior Notes	500,000		—		(9,022)		490,978
	$	1,089,500	$	(7,313)	$	(19,171)	1,063,016
Less: current portion							(6,000)
Total long-term debt							$	1,057,016

Long-term debt consisted of the following as of December 31, 2022 (in thousands):


	Principal Amount		Discount		Debt Issuance Costs		Net Balance
ABL Facility	$	—	$	—	$	—	$	—
First Lien Term Loan	594,000		(8,307)		(11,529)		574,164
Senior Notes	500,000		—		(9,960)		490,040
	$	1,094,000	$	(8,307)	$	(21,489)	1,064,204
Less: current portion							(6,000)
Total long-term debt							$	1,058,204

Schedule of Long-term Debt Maturities

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


Fiscal Year Ended December 31,	Minimum Payments
2023	$	1,500
2024	6,000
2025	6,000
2026	6,000
2027	6,000
Thereafter	1,064,000
Total	$	1,089,500

Schedule of Estimated Fair Values of Debt Obligations

The following table presents the estimated fair values of the Company’s debt obligations as of September 30, 2023 (in thousands):


Financial Instrument	Carrying Value as of September 30, 2023		Markets for Identical Item (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
First Lien Term Loan	$	572,037	$	—	$	591,740	$	—
Senior Notes	490,979		—		430,000		—
Total debt instruments	$	1,063,016	$	—	$	1,021,740	$	—

REVENUE - Net Revenue Earned by Category of Payer (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Disaggregation of Revenue [Line Items]
Net revenue	$ 1,093,014	$ 1,020,918	$ 3,177,934	$ 2,917,522
Commercial payers
Disaggregation of Revenue [Line Items]
Net revenue	957,601	888,162	2,765,513	2,526,354
Government payers
Disaggregation of Revenue [Line Items]
Net revenue	124,122	122,793	370,648	357,383
Patients
Disaggregation of Revenue [Line Items]
Net revenue	$ 11,291	$ 9,963	$ 41,773	$ 33,785

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

- 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.

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-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 41
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-41

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 4
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-4

+ Details

PROPERTY AND EQUIPMENT (Tables)

9 Months Ended

Sep. 30, 2023

Property, Plant and Equipment [Abstract]

Schedule of Property and Equipment

Property and equipment was as follows as of September 30, 2023 and December 31, 2022 (in thousands):


	September 30, 2023		December 31, 2022
Infusion pumps	$	37,027	$	34,942
Equipment, furniture and other	35,955		31,929
Leasehold improvements	101,283		99,085
Computer software, purchased and internally developed	47,878		34,922
Assets under development	26,915		29,411
	249,058		230,289
Less: accumulated depreciation	(141,098)		(121,968)
Property and equipment, net	$	107,960	$	108,321

The following table presents the amount of depreciation expense recorded in cost of revenue and operating expenses for the three and nine months ended September 30, 2023 and 2022 (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Depreciation expense in cost of revenue	$	616	$	1,205	$	2,006	$	3,696
Depreciation expense in operating expenses	6,365		6,778		18,665		21,337
Total depreciation expense	$	6,981	$	7,983	$	20,671	$	25,033

DERIVATIVE INSTRUMENTS - Additional Information (Details) - Interest rate cap designated as cash flow hedge - First Lien Term Loan - Designated as Hedging Instrument - Senior Notes	1 Months Ended
	Oct. 31, 2021 USD ($)
Derivative [Line Items]
Notional amount of derivative	$ 300,000,000
Derivative, term of contract	5 years

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	9 Months Ended
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	Sep. 30, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation — The accompanying unaudited condensed consolidated financial statements have been prepared in conformity with generally accepted accounting principles (“GAAP”) in the United States and contain all adjustments, including normal recurring adjustments, necessary to present fairly the Company’s financial position, results of operations and cash flows for interim financial reporting. The results of operations for the interim periods presented are not necessarily indicative of the results of operations for the entire year. These unaudited condensed consolidated financial statements do not include all of the information and notes to the financial statements required by GAAP for complete financial statements and should be read in conjunction with the 2022 audited consolidated financial statements, including the notes thereto, as presented in our Form 10-K.
Principles of Consolidation	Principles of Consolidation — The Company’s unaudited condensed consolidated financial statements include the accounts of Option Care Health, Inc. and its subsidiaries. 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. As of September 30, 2023, cash equivalents consisted of money market funds.
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 condensed consolidated balance sheets. As of September 30, 2023 and December 31, 2022, the balance of the investments was $19.5 million and $19.4 million, respectively. The balance of these investments is increased to reflect the Company’s capital contributions and equity in earnings of the investees. The balance of these investments is 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 unaudited condensed consolidated statements of comprehensive income. The Company’s proportionate share of earnings was $1.3 million and $4.1 million for the three and nine months ended September 30, 2023, respectively. The Company’s proportionate share of earnings was $1.5 million and $4.1 million for the three and nine months ended September 30, 2022, respectively. Distributions from the investees are treated as cash inflows from operating activities in the unaudited condensed consolidated statements of cash flows. During the three and nine months ended September 30, 2023, the Company received distributions from the investees of $1.5 million and $4.0 million, respectively. During the three and nine months ended September 30, 2022, the Company received distributions from the investees of $1.5 million and $2.5 million, respectively. See Note 16, Related-Party Transactions, for discussion of related-party transactions with these investees.
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 14% for the three and nine months ended September 30, 2023. Revenue related to the Company’s largest payer was approximately 14% and 15% for the three and nine months ended September 30, 2022, respectively. There were no other managed care contracts that represent greater than 10% of revenue for the periods presented. For the three and nine months ended September 30, 2023, approximately 11% and 12%, respectively, of the Company’s revenue was reimbursable through direct government healthcare programs, such as Medicare and Medicaid. For the three and nine months ended September 30, 2022, approximately 12% of the Company’s revenue was reimbursable through direct government healthcare programs, such as Medicare and Medicaid. As of September 30, 2023 and December 31, 2022, 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 or other payers to carry collateral for any amounts owed for goods or services provided. Other than as discussed above, concentration 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; however, Option Care Health offers a financial assistance program for patients that meet certain defined hardship criteria. For the three and nine months ended September 30, 2023, approximately 73% of the Company’s pharmaceutical and medical supply purchases were from four vendors. For the three and nine months ended September 30, 2022, approximately 74% and 73%, respectively, of the Company’s pharmaceutical and medical supply purchases were from four 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.
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 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. First Lien Term Loan: The fair value of the First Lien Term Loan is derived from a broker quote on the loans in the syndication (Level 2 inputs). See Note 10, Indebtedness, for further discussion of the carrying amount and fair value of the First Lien Term Loan. Senior Notes: The fair value of the Senior Notes is derived from a broker quote (Level 2 inputs). See Note 10, Indebtedness, for further discussion of the carrying amount and fair value of the Senior Notes. Interest Rate Cap: The fair value of the interest rate cap is 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 11, Derivative Instruments, for further discussion of the fair value of the interest rate cap. Money Market Funds: The fair value of the money market funds is derived from the closing price reported by the fund sponsor and classified as cash and cash equivalents on the Company’s condensed consolidated balance sheets (Level 1 inputs).

FAIR VALUE MEASURMENTS	9 Months Ended
FAIR VALUE MEASURMENTS	Sep. 30, 2023
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 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. First Lien Term Loan: The fair value of the First Lien Term Loan is derived from a broker quote on the loans in the syndication (Level 2 inputs). See Note 10, Indebtedness, for further discussion of the carrying amount and fair value of the First Lien Term Loan. Senior Notes: The fair value of the Senior Notes is derived from a broker quote (Level 2 inputs). See Note 10, Indebtedness, for further discussion of the carrying amount and fair value of the Senior Notes. Interest Rate Cap: The fair value of the interest rate cap is 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 11, Derivative Instruments, for further discussion of the fair value of the interest rate cap. Money Market Funds: The fair value of the money market funds is derived from the closing price reported by the fund sponsor and classified as cash and cash equivalents on the Company’s condensed consolidated balance sheets (Level 1 inputs). There were no other material assets or liabilities measured at fair value at September 30, 2023 and December 31, 2022.

- 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	9 Months Ended
COMMITMENTS AND CONTINGENCIES	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	COMMITMENTS AND CONTINGENCIES The 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 condensed 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.

DERIVATIVE INSTRUMENTS - Pre-tax Gain (Loss) on Derivative Instruments (Details) - Interest rate cap designated as cash flow hedge - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Derivative [Line Items]
Interest rate cap designated as cash flow hedge	$ 45	$ 10,653	$ (156)	$ 30,879
Interest expense, net
Derivative [Line Items]
Interest rate cap designated as cash flow hedge	$ 2,931	$ (1,775)	$ 8,002	$ (591)

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	9 Months Ended
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	Sep. 30, 2023
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. As of September 30, 2023, cash equivalents consisted of money market funds. Prepaid Expenses and Other Current Assets — Included in prepaid expenses and other current assets are rebates receivable from pharmaceutical and medical supply manufacturers of $51.0 million and $53.4 million as of September 30, 2023 and December 31, 2022, respectively. 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 condensed consolidated balance sheets. As of September 30, 2023 and December 31, 2022, the balance of the investments was $19.5 million and $19.4 million, respectively. The balance of these investments is increased to reflect the Company’s capital contributions and equity in earnings of the investees. The balance of these investments is 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 unaudited condensed consolidated statements of comprehensive income. The Company’s proportionate share of earnings was $1.3 million and $4.1 million for the three and nine months ended September 30, 2023, respectively. The Company’s proportionate share of earnings was $1.5 million and $4.1 million for the three and nine months ended September 30, 2022, respectively. Distributions from the investees are treated as cash inflows from operating activities in the unaudited condensed consolidated statements of cash flows. During the three and nine months ended September 30, 2023, the Company received distributions from the investees of $1.5 million and $4.0 million, respectively. During the three and nine months ended September 30, 2022, the Company received distributions from the investees of $1.5 million and $2.5 million, respectively. See Note 16, Related-Party Transactions, for discussion of related-party transactions with these investees. 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 14% for the three and nine months ended September 30, 2023. Revenue related to the Company’s largest payer was approximately 14% and 15% for the three and nine months ended September 30, 2022, respectively. There were no other managed care contracts that represent greater than 10% of revenue for the periods presented. For the three and nine months ended September 30, 2023, approximately 11% and 12%, respectively, of the Company’s revenue was reimbursable through direct government healthcare programs, such as Medicare and Medicaid. For the three and nine months ended September 30, 2022, approximately 12% of the Company’s revenue was reimbursable through direct government healthcare programs, such as Medicare and Medicaid. As of September 30, 2023 and December 31, 2022, 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 or other payers to carry collateral for any amounts owed for goods or services provided. Other than as discussed above, concentration 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; however, Option Care Health offers a financial assistance program for patients that meet certain defined hardship criteria. For the three and nine months ended September 30, 2023, approximately 73% of the Company’s pharmaceutical and medical supply purchases were from four vendors. For the three and nine months ended September 30, 2022, approximately 74% and 73%, respectively, of the Company’s pharmaceutical and medical supply purchases were from four 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.

PROPERTY AND EQUIPMENT

9 Months Ended

Sep. 30, 2023

Property, Plant and Equipment [Abstract]

PROPERTY AND EQUIPMENT

Property and equipment was as follows as of September 30, 2023 and December 31, 2022 (in thousands):


	September 30, 2023		December 31, 2022
Infusion pumps	$	37,027	$	34,942
Equipment, furniture and other	35,955		31,929
Leasehold improvements	101,283		99,085
Computer software, purchased and internally developed	47,878		34,922
Assets under development	26,915		29,411
	249,058		230,289
Less: accumulated depreciation	(141,098)		(121,968)
Property and equipment, net	$	107,960	$	108,321

Depreciation expense is recorded within cost of revenue and operating expenses within the unaudited condensed consolidated statements of comprehensive income, 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 three and nine months ended September 30, 2023 and 2022 (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Depreciation expense in cost of revenue	$	616	$	1,205	$	2,006	$	3,696
Depreciation expense in operating expenses	6,365		6,778		18,665		21,337
Total depreciation expense	$	6,981	$	7,983	$	20,671	$	25,033

DERIVATIVE INSTRUMENTS

9 Months Ended

Sep. 30, 2023

Derivative Instruments and Hedging Activities Disclosure [Abstract]

DERIVATIVE INSTRUMENTS

The Company uses derivative financial instruments for hedging and non-trading purposes to limit the Company’s exposure to increases in interest rates related to its variable interest rate debt. Use of derivative financial instruments in hedging programs 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. In a hedging relationship, the change in the value of the derivative financial instrument is offset to a great extent by the change in the value of the underlying hedged item. 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 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’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. As a result of the First Lien Credit Agreement Amendment, the Company elected an optional expedient allowed under ASC Topic 848 such that we will continue the hedging relationship for the interest rate cap hedge.

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


	Fair Value - Derivatives in Asset Position
Derivative	Balance Sheet Caption	September 30, 2023		December 31, 2022
Interest rate cap designated as cash flow hedge	Prepaid expenses and other current assets	$	5,927	$	10,926
Interest rate cap designated as cash flow hedge	Other noncurrent assets	22,185		17,342
Total derivative assets		$	28,112	$	28,268

The gain (loss) associated with the change in the fair value of the effective portion of the hedging instrument is recorded in other comprehensive income (loss). The following table presents the pre-tax gain (loss) from derivative instruments recognized in other comprehensive income (loss) in the Company’s unaudited condensed consolidated statements of comprehensive income (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
Derivative	2023		2022		2023		2022
Interest rate cap designated as cash flow hedge	$	45	$	10,653	$	(156)	$	30,879

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


		Three Months Ended September 30,				Nine Months Ended September 30,
Derivative	Income Statement Caption	2023		2022		2023		2022
Interest rate cap designated as cash flow hedge	Interest expense, net	$	2,931	$	(1,775)	$	8,002	$	(591)

REVENUE (Tables)

9 Months Ended

Sep. 30, 2023

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 three and nine months ended September 30, 2023 and 2022 (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Commercial payers	$	957,601	$	888,162	$	2,765,513	$	2,526,354
Government payers	124,122		122,793		370,648		357,383
Patients	11,291		9,963		41,773		33,785
Net revenue	$	1,093,014	$	1,020,918	$	3,177,934	$	2,917,522

DERIVATIVE INSTRUMENTS - Balance Sheet Location of Derivatives (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Derivative [Line Items]
Total derivative assets	$ 28,112	$ 28,268
Designated as Hedging Instrument \| Prepaid expenses and other current assets \| Interest rate cap designated as cash flow hedge
Derivative [Line Items]
Total derivative assets	5,927	10,926
Designated as Hedging Instrument \| Other noncurrent assets \| Interest rate cap designated as cash flow hedge
Derivative [Line Items]
Total derivative assets	$ 22,185	$ 17,342

- Definition

Fair value, after the effects of master netting arrangements, of a financial asset or other contract with one or more underlyings, notional amount or payment provision or both, and the contract can be net settled by means outside the contract or delivery of an asset. Includes assets not subject to a master netting arrangement and not elected to be offset.

+ References

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Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 320
-Name Accounting Standards Codification
-Section S99
-Paragraph 5
-Subparagraph (SX 210.12-13(Column A)(Footnote 3))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480032/946-320-S99-5

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 320
-Name Accounting Standards Codification
-Section S99
-Paragraph 5C
-Subparagraph (SX 210.12-13C(Column H))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480032/946-320-S99-5C

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 320
-Name Accounting Standards Codification
-Section S99
-Paragraph 5A
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-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480032/946-320-S99-5A

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
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Reference 20: http://www.xbrl.org/2003/role/disclosureRef
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Reference 21: http://www.xbrl.org/2003/role/disclosureRef
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Reference 22: http://www.xbrl.org/2003/role/exampleRef
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Reference 23: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
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Reference 24: http://www.xbrl.org/2003/role/disclosureRef
-Topic 825
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482907/825-10-50-10

+ Details

EARNINGS PER SHARE

9 Months Ended

Sep. 30, 2023

Earnings Per Share [Abstract]

EARNINGS PER SHARE

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

The earnings are used as the basis of determining whether the inclusion of common stock equivalents would be anti-dilutive. The computation of diluted shares for the three and nine months ended September 30, 2023 and 2022 includes the effect of shares that would be issued in connection with warrants, stock options, restricted stock awards and performance stock unit awards, as these common stock equivalents are dilutive to the earnings per share recorded in those periods.

The following table presents the Company’s common stock equivalents that were excluded from the calculation of earnings per share as they would be anti-dilutive:


	Three Months Ended September 30,		Nine Months Ended September 30,
	2023	2022	2023	2022
Stock option awards	984,567	520,944	1,180,376	794,887
Restricted stock awards	16,564	13,561	569,831	476,329
Performance stock unit awards	—	—	288,680	—

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


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Numerator:
Net income (1)	$	56,302	$	38,823	$	209,913	$	103,027
Denominator:
Weighted average number of common shares outstanding	178,826		181,884		179,956		180,829
Earnings per common share:
Earnings per common share, basic	$	0.31	$	0.21	$	1.17	$	0.57

(1) Net income for the nine months ended September 30, 2023 includes $62.8 million related to the termination payment received on behalf of Amedisys, under the terms of the Mutual Termination Agreement, net of merger-related expenses and taxes. See Note 3, Business Combinations, for further discussion.

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


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Numerator:
Net income (1)	$	56,302	$	38,823	$	209,913	$	103,027
Denominator:
Weighted average number of common shares outstanding	178,826		181,884		179,956		180,829
Effect of dilutive securities	1,702		1,138		1,330		931
Weighted average number of common shares outstanding, diluted	180,528		183,022		181,286		181,760
Earnings per common share:
Earnings per common share, diluted	$	0.31	$	0.21	$	1.16	$	0.57

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
CURRENT ASSETS:
Cash and cash equivalents	$ 386,489	$ 294,186
Accounts receivable, net	382,957	377,542
Inventories	251,366	224,281
Prepaid expenses and other current assets	95,473	98,330
Total current assets	1,116,285	994,339
NONCURRENT ASSETS:
Property and equipment, net	107,960	108,321
Operating lease right-of-use asset	83,732	72,424
Intangible assets, net	20,868	22,371
Referral sources, net	323,126	341,744
Goodwill	1,540,246	1,533,424
Other noncurrent assets	51,399	40,313
Total noncurrent assets	2,127,331	2,118,597
TOTAL ASSETS	3,243,616	3,112,936
CURRENT LIABILITIES:
Accounts payable	429,536	378,763
Accrued compensation and employee benefits	81,159	76,906
Accrued expenses and other current liabilities	88,921	84,302
Current portion of operating lease liability	18,468	19,380
Current portion of long-term debt	6,000	6,000
Total current liabilities	624,084	565,351
NONCURRENT LIABILITIES:
Long-term debt, net of discount, deferred financing costs and current portion	1,057,016	1,058,204
Operating lease liability, net of current portion	85,423	71,441
Deferred income taxes	33,921	22,154
Other noncurrent liabilities	3,089	9,683
Total noncurrent liabilities	1,179,449	1,161,482
Total liabilities	1,803,533	1,726,833
STOCKHOLDERS’ EQUITY:
Preferred stock; $0.0001 par value; 12,500,000 shares authorized, no shares outstanding as of September 30, 2023 and December 31, 2022	0	0
Common stock; $0.0001 par value: 250,000,000 shares authorized, 182,901,785 shares issued and 177,129,378 shares outstanding as of September 30, 2023; 182,341,420 shares issued and 181,957,698 shares outstanding as of December 31, 2022	18	18
Treasury stock; 5,772,407 and 383,722 shares outstanding, at cost, as of September 30, 2023 and December 31, 2022, respectively	(179,205)	(2,403)
Paid-in capital	1,197,874	1,176,906
Retained earnings	400,336	190,423
Accumulated other comprehensive income	21,060	21,159
Total stockholders’ equity	1,440,083	1,386,103
TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY	$ 3,243,616	$ 3,112,936

RELATED-PARTY TRANSACTIONS	9 Months Ended
RELATED-PARTY TRANSACTIONS	Sep. 30, 2023
Related Party Transactions [Abstract]
RELATED-PARTY TRANSACTIONS	RELATED-PARTY TRANSACTIONS 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 $1.3 million and $3.9 million for the three and nine months ended September 30, 2023, respectively. The Company recorded management fee income of $1.1 million and $2.9 million for the three and nine months ended September 30, 2022, respectively. Management fees are recorded in net revenues in the accompanying unaudited condensed consolidated statements of comprehensive income. During the three and nine months ended September 30, 2023, the Company received distributions from the investees of $1.5 million and $4.0 million, respectively. During the three and nine months ended September 30, 2022, the Company received distributions from the investees of $1.5 million and $2.5 million, respectively. The Company had an amounts due from its joint ventures of $0.2 million and due to its joint ventures of $0.6 million as of September 30, 2023. Receivables were included in prepaid expenses and other current assets in the accompanying condensed consolidated balance sheets. Payables were included in accrued expenses and other current liabilities in the accompanying condensed consolidated balance sheets. The Company also had amounts due to its joint ventures of $1.5 million as of December 31, 2022. These payables were included in accrued expenses and other current liabilities in the accompanying condensed consolidated balance sheets. These balances primarily relate to cash collections received by the Company on behalf of the joint ventures, offset by certain pharmaceutical inventories and other expenses paid for by the Company on behalf of the joint ventures. Share Repurchase Agreement — On February 28, 2023, we entered into a Share Repurchase Agreement (the “Share Repurchase Agreement”) with HC I, pursuant to which we agreed to repurchase, subject to the terms and conditions contained therein, up to $75.0 million of our common stock then held by HC I at the same purchase price per share as the underwriter in a concurrent underwritten public offering of our common stock held by HC I. On March 3, 2023, the transactions contemplated by the Share Repurchase Agreement closed, and we repurchased directly from HC I 2,475,166 shares of our common stock.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-5

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-6

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(g)(3))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483575/946-220-S99-1

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(c))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483575/946-220-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(e))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483575/946-220-S99-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//850/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-6

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

+ Details

NATURE OF OPERATIONS AND PRESENTATION OF FINANCIAL STATEMENTS (Details)		3 Months Ended	9 Months Ended
	Mar. 03, 2023 shares	Sep. 30, 2023 pharmacy suite shares	Sep. 30, 2023 pharmacy suite segment shares
Business Acquisition [Line Items]
Treasury stock, shares, acquired (in shares)	2,475,166	2,913,520	5,388,686
Number of service locations \| pharmacy		93	93
Number of infusion sites \| suite		81	81
Number of operating segments \| segment			1
Common Stock
Business Acquisition [Line Items]
Number of shares issued in transaction (in shares)			23,771,926
Legacy Health Systems
Business Acquisition [Line Items]
Ownership interest		50.00%	50.00%

BUSINESS COMBINATIONS - Additional Information (Details) - USD ($) $ in Thousands	1 Months Ended		9 Months Ended
	May 31, 2023	Aug. 31, 2022	Sep. 30, 2023	Jun. 30, 2023	Jun. 26, 2023	May 03, 2023	Mar. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Business combination, acquisition-related expenses			$ 21,100
Goodwill			1,540,246	$ 1,540,567			$ 1,533,569	$ 1,533,424
Amedisys
Business Acquisition [Line Items]
Business combination, contingent consideration, asset, termination fee			$ 62,800		$ 106,000
Amedisys \| Combined company, following merger
Business Acquisition [Line Items]
Company's stockholders, ownership percentage following merger						64.50%
Revitalized, LLC
Business Acquisition [Line Items]
Percentage of the combined company held	100.00%
Purchase price, net of cash acquired	$ 12,500
Goodwill	6,700
Non-cash working capital adjustment	400
Intangible assets	$ 5,500
Rochester Home Infusion, Inc
Business Acquisition [Line Items]
Percentage of the combined company held		100.00%
Purchase price, net of cash acquired		$ 27,400
Goodwill		$ 21,323

EARNINGS PER SHARE - Antidilutive Securities Excluded from Computation of Earnings Per Share (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Stock option awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded (in shares)	984,567	520,944	1,180,376	794,887
Restricted stock awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded (in shares)	16,564	13,561	569,831	476,329
Performance stock unit awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded (in shares)	0	0	288,680	0

BUSINESS COMBINATIONS

9 Months Ended

Sep. 30, 2023

Business Combination and Asset Acquisition [Abstract]

BUSINESS COMBINATIONS

Amedisys, Inc. — On May 3, 2023, the Company entered into a definitive merger agreement (the “Merger Agreement”) with Amedisys, Inc. (“Amedisys”), a leading provider of healthcare in home health and hospice settings. Under the terms of the merger agreement, the Company would issue new shares of its common stock to Amedisys’s stockholders, which would result in the Company’s stockholders holding approximately 64.5% of the combined company.

On June 26, 2023, the Company entered into an agreement to terminate the Merger Agreement (the “Mutual Termination Agreement”). Under the terms of the Mutual Termination Agreement, the Company received a payment of $106.0 million in cash on behalf of Amedisys (“Termination Fee”). The Termination Fee is included in Other, net in the unaudited condensed consolidated statements of comprehensive income and in Net cash provided by operating activities in the unaudited condensed consolidated statements of cash flows.

During the nine months ended September 30, 2023, the Company incurred $21.1 million in merger-related expenses, which are included in Other, net in the unaudited condensed consolidated statements of comprehensive income and in Net cash provided by operating activities in the unaudited condensed consolidated statements of cash flows.

Revitalized, LLC — In May 2023, pursuant to the equity purchase agreement dated May 1, 2023, the Company completed the acquisition of 100% of the membership interests in Revitalized, LLC (“Revitalized”) for a purchase price, net of cash acquired, of $12.5 million, inclusive of a $0.4 million non-cash receivable adjustment, which primarily consisted of $6.7 million of goodwill and $5.5 million of intangible assets.

Rochester Home Infusion, Inc. — In August 2022, pursuant to the stock purchase agreement dated June 10, 2022, the Company completed the acquisition of 100% of the equity interests in Rochester Home Infusion, Inc. (“RHI”) for a purchase price, net of cash acquired, of $27.4 million.

The allocation of the purchase price of RHI 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 final allocation of the consideration transferred to acquired identifiable assets and assumed liabilities, net of cash acquired (in thousands):


	Amount
Accounts receivable	$	686
Intangible assets	5,449
Other assets	394
Accounts payable and other liabilities	(434)
Fair value identifiable assets and liabilities	6,095
Goodwill (1)	21,323
Cash acquired	201
Purchase price	27,619
Less: cash acquired	(201)
Purchase price, net of cash acquired	$	27,418

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

LEASES

9 Months Ended

Sep. 30, 2023

Leases [Abstract]

LEASES

During the three and nine months ended September 30, 2023, the Company incurred operating lease expenses of $7.8 million and $22.3 million, respectively, including short-term lease expenses, which were included as a component of selling, general and administrative expenses in the unaudited condensed consolidated statements of comprehensive income. During the three and nine months ended September 30, 2022, the Company incurred operating lease expenses of $7.8 million and $22.7 million, respectively, including short-term lease expenses, which were included as a component of selling, general and administrative expenses in the unaudited condensed consolidated statements of comprehensive income. As of September 30, 2023, the weighted-average remaining lease term was 6.9 years and the weighted-average discount rate was 6.04%.

Operating leases mature as follows (in thousands):


Fiscal Year Ended December 31,	Minimum Payments
2023	$	9,410
2024	23,564
2025	21,350
2026	18,490
2027	15,315
Thereafter	44,262
Total lease payments	132,391
Less: interest	(28,500)
Present value of lease liabilities	$	103,891

During the nine months ended September 30, 2023, the Company commenced new leases, extensions and amendments, resulting in non-cash operating activities in the unaudited condensed consolidated statements of cash flow of $26.1 million related to increases in the operating lease right-of-use assets and operating lease liabilities. During the nine months ended September 30, 2022, the Company commenced new leases, extensions and amendments, resulting in non-cash operating activities in the unaudited condensed consolidated statements of cash flow of $13.6 million related to increases in the operating lease right-of-use assets and operating lease liabilities. As of September 30, 2023, the Company did not have any significant operating or financing leases that had not yet commenced.

LEASES

Operating leases mature as follows (in thousands):


Fiscal Year Ended December 31,	Minimum Payments
2023	$	9,410
2024	23,564
2025	21,350
2026	18,490
2027	15,315
Thereafter	44,262
Total lease payments	132,391
Less: interest	(28,500)
Present value of lease liabilities	$	103,891

DERIVATIVE INSTRUMENTS (Tables)

9 Months Ended

Sep. 30, 2023

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Schedule 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 condensed consolidated balance sheets (in thousands):


	Fair Value - Derivatives in Asset Position
Derivative	Balance Sheet Caption	September 30, 2023		December 31, 2022
Interest rate cap designated as cash flow hedge	Prepaid expenses and other current assets	$	5,927	$	10,926
Interest rate cap designated as cash flow hedge	Other noncurrent assets	22,185		17,342
Total derivative assets		$	28,112	$	28,268

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

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


	Three Months Ended September 30,				Nine Months Ended September 30,
Derivative	2023		2022		2023		2022
Interest rate cap designated as cash flow hedge	$	45	$	10,653	$	(156)	$	30,879


		Three Months Ended September 30,				Nine Months Ended September 30,
Derivative	Income Statement Caption	2023		2022		2023		2022
Interest rate cap designated as cash flow hedge	Interest expense, net	$	2,931	$	(1,775)	$	8,002	$	(591)

EARNINGS PER SHARE (Tables)

9 Months Ended

Sep. 30, 2023

Earnings Per Share [Abstract]

Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share

The following table presents the Company’s common stock equivalents that were excluded from the calculation of earnings per share as they would be anti-dilutive:


	Three Months Ended September 30,		Nine Months Ended September 30,
	2023	2022	2023	2022
Stock option awards	984,567	520,944	1,180,376	794,887
Restricted stock awards	16,564	13,561	569,831	476,329
Performance stock unit awards	—	—	288,680	—

Schedule of Basic and Diluted Earnings Per Share

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


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Numerator:
Net income (1)	$	56,302	$	38,823	$	209,913	$	103,027
Denominator:
Weighted average number of common shares outstanding	178,826		181,884		179,956		180,829
Earnings per common share:
Earnings per common share, basic	$	0.31	$	0.21	$	1.17	$	0.57

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


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Numerator:
Net income (1)	$	56,302	$	38,823	$	209,913	$	103,027
Denominator:
Weighted average number of common shares outstanding	178,826		181,884		179,956		180,829
Effect of dilutive securities	1,702		1,138		1,330		931
Weighted average number of common shares outstanding, diluted	180,528		183,022		181,286		181,760
Earnings per common share:
Earnings per common share, diluted	$	0.31	$	0.21	$	1.16	$	0.57

BUSINESS COMBINATIONS (Tables)

9 Months Ended

Sep. 30, 2023

Business Combination and Asset Acquisition [Abstract]

Schedule of Acquired Identifiable Assets and Assumed Liabilities

The following is a final allocation of the consideration transferred to acquired identifiable assets and assumed liabilities, net of cash acquired (in thousands):


	Amount
Accounts receivable	$	686
Intangible assets	5,449
Other assets	394
Accounts payable and other liabilities	(434)
Fair value identifiable assets and liabilities	6,095
Goodwill (1)	21,323
Cash acquired	201
Purchase price	27,619
Less: cash acquired	(201)
Purchase price, net of cash acquired	$	27,418

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

REVENUE

9 Months Ended

Sep. 30, 2023

Revenue from Contract with Customer [Abstract]

REVENUE

The following table sets forth the net revenue earned by category of payer for the three and nine months ended September 30, 2023 and 2022 (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Commercial payers	$	957,601	$	888,162	$	2,765,513	$	2,526,354
Government payers	124,122		122,793		370,648		357,383
Patients	11,291		9,963		41,773		33,785
Net revenue	$	1,093,014	$	1,020,918	$	3,177,934	$	2,917,522

- 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
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
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+ Details

EARNINGS PER SHARE - Schedule of Basic and Diluted Earnings (Loss) (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Sep. 30, 2022	Jun. 26, 2023
Numerator:
Net income	$ 56,302	$ 114,403	$ 39,208	$ 38,823	$ 33,929	$ 30,275	$ 209,913	$ 103,027
Denominator:
Weighted average number of common shares outstanding (in shares)	178,826			181,884			179,956	180,829
Effect of dilutive securities (in shares)	1,702			1,138			1,330	931
Weighted average number of common shares outstanding, diluted (in shares)	180,528			183,022			181,286	181,760
Earnings per common share, basic
Earnings per common share, basic (in dollars per share)	$ 0.31			$ 0.21			$ 1.17	$ 0.57
Earnings per common share, diluted
Earnings per common share, diluted (in dollars per share)	$ 0.31			$ 0.21			$ 1.16	$ 0.57
Amedisys
Earnings per common share, diluted
Business combination, contingent consideration, asset, termination fee	$ 62,800						$ 62,800		$ 106,000

STOCK-BASED INCENTIVE COMPENSATION (Details) - 2018 Plan - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	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
HC I Incentive Units
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based compensation expense	$ 9.2	$ 4.0	$ 22.9	$ 12.6

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

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+ Details

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Sep. 30, 2023	Dec. 31, 2022
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)	182,901,785	182,341,420
Common stock, shares, outstanding (in shares)	177,129,378	181,957,698
Treasury stock, at cost (in shares)	5,772,407	383,722

PROPERTY AND EQUIPMENT (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
PROPERTY AND EQUIPMENT (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 249,058		$ 249,058		$ 230,289
Less: accumulated depreciation	(141,098)		(141,098)		(121,968)
Property and equipment, net	107,960		107,960		108,321
Total depreciation expense	6,981	$ 7,983	20,671	$ 25,033
Depreciation expense in cost of revenue
Property, Plant and Equipment [Line Items]
Total depreciation expense	616	1,205	2,006	3,696
Depreciation expense in operating expenses
Property, Plant and Equipment [Line Items]
Total depreciation expense	6,365	$ 6,778	18,665	$ 21,337
Infusion pumps
Property, Plant and Equipment [Line Items]
Property and equipment, gross	37,027		37,027		34,942
Equipment, furniture and other
Property, Plant and Equipment [Line Items]
Property and equipment, gross	35,955		35,955		31,929
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	101,283		101,283		99,085
Computer software, purchased and internally developed
Property, Plant and Equipment [Line Items]
Property and equipment, gross	47,878		47,878		34,922
Assets under development
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 26,915		$ 26,915		$ 29,411

RELATED-PARTY TRANSACTIONS (Details) - USD ($) $ in Thousands		3 Months Ended		9 Months Ended
	Mar. 03, 2023	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Related Party Transaction [Line Items]
Management fee income		$ 1,093,014	$ 1,020,918	$ 3,177,934	$ 2,917,522
Distributions received from the investees			1,500	4,000	2,500
Shares repurchased	$ 75,000	$ 100,000		$ 175,000
Treasury stock, shares, acquired (in shares)	2,475,166	2,913,520		5,388,686
Joint Venture
Related Party Transaction [Line Items]
Management fee income		$ 1,300	1,100	$ 3,900	2,900
Distributions received from the investees		1,500	$ 1,500	4,000	$ 2,500
Due from joint ventures		200		200
Due to joint ventures		$ 600		$ 600		$ 1,500

- Definition

+ References

+ Details

STOCK-BASED INCENTIVE COMPENSATION	9 Months Ended
STOCK-BASED INCENTIVE COMPENSATION	Sep. 30, 2023
Share-Based Payment Arrangement [Abstract]
STOCK-BASED INCENTIVE COMPENSATION	STOCK-BASED INCENTIVE COMPENSATIONEquity 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 and amended and restated on May 19, 2021, 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, resulting in a total of 9,101,734 shares of common stock authorized for issuance. The 2018 Plan is administered by the Company’s Compensation Committee, a standing committee of the Company’s Board of Directors. The Company had stock options, restricted stock units and performance stock units outstanding related to the 2018 Plan as of September 30, 2023 and 2022. During the three and nine months ended September 30, 2023, total stock-based incentive compensation expense recognized by the Company related to the 2018 Plan was $9.2 million and $22.9 million, respectively. During the three and nine months ended September 30, 2022, total stock-based incentive compensation expense recognized by the Company related to the 2018 Plan was $4.0 million and $12.6 million, respectively.

INDEBTEDNESS

9 Months Ended

Sep. 30, 2023

Debt Disclosure [Abstract]

INDEBTEDNESS

Long-term debt consisted of the following as of September 30, 2023 (in thousands):


	Principal Amount		Discount		Debt Issuance Costs		Net Balance
Asset-based-lending (“ABL”) Facility	$	—	$	—	$	—	$	—
First Lien Term Loan	589,500		(7,313)		(10,149)		572,038
Senior Notes	500,000		—		(9,022)		490,978
	$	1,089,500	$	(7,313)	$	(19,171)	1,063,016
Less: current portion							(6,000)
Total long-term debt							$	1,057,016

Long-term debt consisted of the following as of December 31, 2022 (in thousands):


	Principal Amount		Discount		Debt Issuance Costs		Net Balance
ABL Facility	$	—	$	—	$	—	$	—
First Lien Term Loan	594,000		(8,307)		(11,529)		574,164
Senior Notes	500,000		—		(9,960)		490,040
	$	1,094,000	$	(8,307)	$	(21,489)	1,064,204
Less: current portion							(6,000)
Total long-term debt							$	1,058,204

Effective June 30, 2023, the Company entered into an agreement, dated as of June 8, 2023, to amend the First Lien Term Loan (the “First Lien Credit Agreement Amendment”) solely to replace London Interbank Offered Rate (“LIBOR”) and related definitions and provisions with Secured Overnight Financing Rate (“SOFR”) as the new reference rate. The Company elected an optional expedient allowed under ASC Topic 848 such that we will account for the modification as a continuation of the existing contract.

The interest rate on the First Lien Term Loan was 8.20% and 6.82% as of September 30, 2023 and December 31, 2022, respectively. The weighted average interest rate incurred on the First Lien Term Loan was 8.11% and 7.71% for the three and nine months ended September 30, 2023, respectively. The weighted average interest rate incurred on the First Lien Term Loan was 4.94% and 3.90% for the three and nine months ended September 30, 2022, respectively. The interest rate on the Senior Notes was 4.375% as of September 30, 2023 and December 31, 2022. The weighted average interest rate incurred on the Senior Notes was 4.375% for the three and nine months ended September 30, 2023, respectively. The weighted average interest rate incurred on the Senior Notes was 4.375% for the three and nine months ended September 30, 2022, respectively.

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


Fiscal Year Ended December 31,	Minimum Payments
2023	$	1,500
2024	6,000
2025	6,000
2026	6,000
2027	6,000
Thereafter	1,064,000
Total	$	1,089,500

During the three and nine months ended September 30, 2023 and 2022, the Company engaged in hedging activities to limit its exposure to changes in interest rates. See Note 11, Derivative Instruments, for further discussion.

The following table presents the estimated fair values of the Company’s debt obligations as of September 30, 2023 (in thousands):


Financial Instrument	Carrying Value as of September 30, 2023		Markets for Identical Item (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
First Lien Term Loan	$	572,037	$	—	$	591,740	$	—
Senior Notes	490,979		—		430,000		—
Total debt instruments	$	1,063,016	$	—	$	1,021,740	$	—

See Note 12, Fair Value Measurements, for further discussion.

Effective January 13, 2023, the Company entered into an agreement to amend the ABL Facility, to among other things, increase the amount of borrowing availability by $50.0 million to $225.0 million total borrowing availability and to replace LIBOR with SOFR as the new reference rate.

- 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://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Section 50
-Paragraph 1B
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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-Paragraph 1I
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

+ Details