0001014739-24-000009 | 10-K | XBRL Viewer

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STOCKHOLDERS' EQUITY (Details) $ / shares in Units, $ in Thousands				12 Months Ended
	Mar. 03, 2023 shares	Feb. 28, 2023 USD ($)	Feb. 03, 2020	Dec. 31, 2023 USD ($) $ / shares shares	Dec. 31, 2022 USD ($) shares	Dec. 31, 2021 USD ($)	Dec. 06, 2023 shares	Aug. 06, 2019 USD ($) shares	Jun. 29, 2017 $ / shares	Mar. 09, 2015 $ / shares shares
Class of Warrant or Right [Line Items]
Stock conversion ratio			0.25
Proceeds from warrant exercises \| $				$ 0	$ 20,916	$ 0
Treasury stock, shares, acquired (in shares)	2,475,166			7,946,301
Treasury stock acquired, average cost per share (in dollars per share) \| $ / shares				$ 31.46
Shares repurchased \| $		$ 75,000		$ 250,000
Remaining authorized repurchase amount \| $				$ 250,000
Treasury stock, shares (in shares)				8,330,022	383,722
Preferred stock outstanding (in shares)				0	0
Common Stock \| Minimum
Class of Warrant or Right [Line Items]
Number of shares authorized to be repurchased (in shares)							250,000,000
Common Stock \| Maximum
Class of Warrant or Right [Line Items]
Number of shares authorized to be repurchased (in shares)							500,000,000
2017 Warrants \| Common Stock
Class of Warrant or Right [Line Items]
Number of shares to be purchased (in shares)								2,100,000
Term of warrants									10 years
Exercise price of warrants (in dollars per share) \| $ / shares									$ 8.00
Fair value of warrants \| $								$ 14,100
Shares purchased from exercise of warrants (in shares)				188,350	1,130,089
Proceeds from warrant exercises \| $				$ 0
Class of warrant or right, outstanding (in shares)				51,838	240,188
2015 Warrants \| Common Stock
Class of Warrant or Right [Line Items]
Number of shares to be purchased (in shares)										900,000
Term of warrants										10 years
Fair value of warrants \| $								$ 4,600
Shares purchased from exercise of warrants (in shares)				0	900,272
Proceeds from warrant exercises \| $				$ 0	$ 20,900
Class of warrant or right, outstanding (in shares)				13,888	15,231
2015 Warrants \| Common Stock \| Minimum
Class of Warrant or Right [Line Items]
Exercise price of warrants (in dollars per share) \| $ / shares										$ 20.68
2015 Warrants \| Common Stock \| Maximum
Class of Warrant or Right [Line Items]
Exercise price of warrants (in dollars per share) \| $ / shares										$ 25.80
Common Stock \| Secondary Offering
Class of Warrant or Right [Line Items]
Additional shares issued (in shares)				23,771,926	11,000,000

LEASES - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Operating lease cost	$ 30.6	$ 29.1	$ 29.8
Weighted-average remaining lease term, operating leases	6 years 9 months 18 days
Weighted-average discount rate, operating leases	6.16%
Right of use asset obtained in exchange for operating lease liabilities	$ 30.5

BUSINESS ACQUISITIONS AND DIVESTITURES

12 Months Ended

Dec. 31, 2023

Business Combination and Asset Acquisition [Abstract]

BUSINESS ACQUISITIONS AND DIVESTITURES

Amedisys, Inc. — On May 3, 2023, the Company entered into a definitive merger agreement with Amedisys. 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 Amedisys Merger Agreement. Under the terms of the Mutual Termination Agreement, the Company received a payment of $106.0 million in cash on behalf of Amedisys. The Termination Fee is included in Other, net in the consolidated statements of comprehensive income and in Net cash provided by operating activities in the consolidated statements of cash flows.

During the year ended December 31, 2023, the Company incurred $21.1 million in merger-related expenses, which are included in Other, net in the consolidated statements of comprehensive income and in Net cash provided by operating activities in the 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 for a purchase price, net of cash acquired, of $12.5 million, which primarily consisted of $6.7 million of goodwill and $5.5 million of intangible assets.

Respiratory Therapy Asset Sale — The Company closed the transaction in December 2022, for a sale price of $18.4 million comprised of $14.7 million in proceeds received at the time of closing and $3.7 million recorded as a current asset was paid in the year ended December 31, 2023. Pursuant to the final transaction terms, $8.8 million of assets were sold, along with $0.7 million of liabilities that were previously classified as held for sale at the lower of their carrying amount or fair values less cost to sell. As a result of the transaction, a $10.3 million pre-tax gain on sale was recorded within Other, net in the Company’s consolidated statements of comprehensive income within the year ended December 31, 2022.

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.

Specialty Pharmacy Nursing Network, Inc. — In April 2022, pursuant to the equity purchase agreement dated February 7, 2022, the Company completed the acquisition of 100% of the equity interests in Specialty Pharmacy Nursing Network, Inc. (“SPNN”) for a purchase price, net of cash acquired, of $59.9 million.

The allocation of the purchase price of SPNN 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. As of December 31, 2022, the Company finalized the purchase price allocation of the acquisition. Certain adjustments were made to preliminary valuation amounts related to accrued compensation. 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	$	2,303
Intangible assets	25,580
Other assets	600
Accrued compensation	(1,115)
Accounts payable and other liabilities	(1,168)
Fair value identifiable assets and liabilities	26,200
Goodwill (1)	33,746
Cash acquired	661
Purchase price	60,607
Less: cash acquired	(661)
Purchase price, net of cash acquired	$	59,946

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

Wasatch Infusion LLC Acquisition — In December 2021, pursuant to the executed asset purchase agreement on December 29, 2021, the Company completed the acquisition of Wasatch Infusion LLC for a purchase price of $19.5 million, which primarily consisted of $17.4 million of goodwill, $4.2 million of intangible assets, $2.7 million of accounts receivable, $2.0 million in inventories, and $(6.7) million of accounts payable.

Infinity Infusion Nursing LLC — In October 2021, pursuant to the equity purchase agreement dated October 1, 2021, the Company completed the 100% acquisition of the equity interest in Infinity Infusion LLC (“Infinity”) for a purchase price, net of cash acquired of $59.6 million, which is comprised of a $50.0 million cash payment, two contingent $5.0 million payments (included as a non-cash change in other noncurrent assets and liabilities within the consolidated statements of cash flows), and $(0.4) million of other purchase price adjustments.

The allocation of the purchase price of Infinity was accounted for as a business combination in accordance with ASC Topic 805, Business Combinations, with the total purchase price being allocated to the assets and liabilities acquired based on the relative fair value of each asset and liability. The Company has finalized the purchase price allocation of the acquisition and no purchase accounting adjustments were made. The following is an allocation of acquired identifiable assets and assumed liabilities, net of cash acquired, (in thousands):


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

BioCure Asset Acquisition — In April 2021, pursuant to the asset purchase agreement dated April 7, 2021, the Company completed the acquisition of certain assets of BioCure, LLC for a purchase price of $18.9 million, which is comprised of $18.3 million of intangible assets, net and $0.6 million of inventories.

INCOME TAXES - Deferred Income Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Deferred tax assets:
Price concessions	$ 5,365	$ 6,169
Compensation and benefits	7,609	5,517
Interest limitation carryforward	13,802	29,453
Operating lease liability	26,378	22,765
Net operating losses	56,980	62,027
Other	7,556	6,576
Deferred tax assets before valuation allowance	117,690	132,507
Valuation allowance	(6,371)	(13,056)	$ (13,151)	$ (112,085)
Deferred tax assets net of valuation allowance	111,319	119,451
Deferred tax liabilities:
Accelerated depreciation	(8,882)	(7,026)
Operating lease right-of-use asset	(21,504)	(18,076)
Intangible assets	(52,502)	(57,673)
Goodwill	(52,188)	(44,949)
Other	(11,163)	(13,881)
Deferred tax liabilities	(146,239)	(141,605)
Net deferred tax liabilities	$ (34,920)	$ (22,154)

EARNINGS PER SHARE - Antidilutive Securities Excluded from Computation of Earnings Per Share (Details) - shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded (in shares)	0	0	457,753
Stock option awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded (in shares)	1,214,560	629,690	490,968
Restricted stock awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded (in shares)	340,331	205,652	316,454
Performance stock unit awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded (in shares)	0	0	0

STOCK-BASED INCENTIVE COMPENSATION - Summary of Stock Option Activity (Details) - Stock Option $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) $ / shares shares
Options
Beginning balance (in shares) \| shares	1,021,370
Granted (in shares) \| shares	872,264
Exercised (in shares) \| shares	(60,106)
Forfeited and expired (in shares) \| shares	(87,256)
Ending balance (in shares) \| shares	1,746,272
Exercisable (in shares) \| shares	283,571
Weighted Average Exercise Price
Beginning balance (in dollars per share) \| $ / shares	$ 21.63
Granted (in dollars per share) \| $ / shares	28.87
Exercised (in dollars per share) \| $ / shares	18.56
Forfeited and expired (in dollars per share) \| $ / shares	28.13
Ending balance (in dollars per share) \| $ / shares	25.08
Exercisable (in dollars per share) \| $ / shares	$ 17.07
Aggregate Intrinsic Value
Balance at December 31, 2022 \| $	$ 8,816
Granted \| $	4,208
Exercised \| $	827
Forfeited and expired \| $	561
Balance at December 31, 2023 \| $	15,028
Exercisable at December 31, 2023 \| $	$ 4,713
Weighted Average Remaining Contractual Life	8 years 2 months 8 days
Weighted Average Remaining Contractual Life Exercisable	6 years 4 months 9 days

STOCKHOLDERS' EQUITY	12 Months Ended
STOCKHOLDERS' EQUITY	Dec. 31, 2023
Equity [Abstract]
STOCKHOLDERS' EQUITY	STOCKHOLDERS’ EQUITY During the years ended December 31, 2023 and 2022, HC I completed secondary offerings of 23,771,926 and 11,000,000 shares of common stock, respectively. As of December 31, 2023, HC I no longer holds shares of the Company’s common stock. 2017 Warrants — Prior to the Merger, BioScrip issued warrants to certain debt holders pursuant to a Warrant Purchase Agreement dated as of June 29, 2017. In conjunction with the Merger, the 2017 Warrants were amended to entitle the purchasers of the warrants to purchase 2.1 million shares of common stock. The 2017 Warrants have a 10-year term and an exercise price of $8.00 per share and may be exercised by payment of the exercise price in cash or surrender of shares of common stock into which the 2017 Warrants are being converted in an aggregate amount sufficient to pay the exercise price. The 2017 Warrants are classified as equity instruments, and the fair value of these warrants of $14.1 million was recorded in paid-in capital as of the Merger Date. During the years ended December 31, 2023 and 2022, warrant holders exercised warrants to purchase 188,350 and 1,130,089 shares of common stock, respectively. No proceeds were received from these exercises as the warrant holders elected to surrender shares to pay the exercise price. At December 31, 2023 and 2022, the remaining warrant holders are entitled to purchase 51,838 and 240,188 shares of common stock, respectively. 2015 Warrants — Prior to the Merger, BioScrip issued warrants pursuant to a Common Stock Warrant Agreement dated as of March 9, 2015 which entitle the holders to purchase 0.9 million shares of common stock. The 2015 Warrants have a 10-year term and have exercise prices in a range of $20.68 per share to $25.80 per share. The 2015 Warrants were assumed by the Company in conjunction with the Merger and are classified as equity instruments, and the fair value of these warrants of $4.6 million was recorded in paid in capital as of the Merger Date. During the year ended December 31, 2023, warrant holders exercised an immaterial number of warrants to purchase shares of common stock. During the year ended December 31, 2022, warrant holders exercised warrants to purchase 900,272 shares of common stock. During the year ended December 31, 2023, no cash proceeds were received from warrant exercises. During the year ended December 31, 2022, $20.9 million of cash was received as proceeds from warrant exercises. At December 31, 2023 and 2022, the remaining warrant holders are entitled to purchase 13,888 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. On December 6, 2023, the Company’s Board of Directors approved an increase to its share repurchase program authorization from $250.0 million to $500 million. 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 year ended December 31, 2023, the Company purchased 7,946,301 shares of common stock for an average share price of $31.46, totaling $250.0 million. All repurchased shares became treasury stock. As of December 31, 2023, the Company is authorized to repurchase up to a remaining $250.0 million of common stock of the Company. Treasury Stock — As of December 31, 2023 and 2022, the Company held 8,330,022 and 383,722 shares of treasury stock, respectively. Preferred Stock — The Company had no preferred stock outstanding as of December 31, 2023 or 2022.

- Definition

The entire disclosure for equity.

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+ Details

INDEBTEDNESS - Schedule of Illustrates the Aforementioned Interest Rate Terms (Details) - Second Lien Credit Agreement	12 Months Ended
	Dec. 31, 2023
Greater than or equal to 3.00x \| Applicable Rate for Term SOFR Loans
Debt Instrument [Line Items]
Basis spread on variable rate	2.25%
Greater than or equal to 3.00x \| Applicable Rate for Base Rate Loans
Debt Instrument [Line Items]
Basis spread on variable rate	1.25%
Less than 3.00x, but greater than or equal to 2.25x \| Applicable Rate for Term SOFR Loans
Debt Instrument [Line Items]
Basis spread on variable rate	2.00%
Less than 3.00x, but greater than or equal to 2.25x \| Applicable Rate for Base Rate Loans
Debt Instrument [Line Items]
Basis spread on variable rate	1.00%
Less than 2.25x, but greater than or equal to 1.50x \| Applicable Rate for Term SOFR Loans
Debt Instrument [Line Items]
Basis spread on variable rate	1.75%
Less than 2.25x, but greater than or equal to 1.50x \| Applicable Rate for Base Rate Loans
Debt Instrument [Line Items]
Basis spread on variable rate	0.75%
Less than 1.50x, but greater than or equal to 1.00x \| Applicable Rate for Term SOFR Loans
Debt Instrument [Line Items]
Basis spread on variable rate	1.50%
Less than 1.50x, but greater than or equal to 1.00x \| Applicable Rate for Base Rate Loans
Debt Instrument [Line Items]
Basis spread on variable rate	0.50%
Less than 1.00x \| Applicable Rate for Term SOFR Loans
Debt Instrument [Line Items]
Basis spread on variable rate	1.25%
Less than 1.00x \| Applicable Rate for Base Rate Loans
Debt Instrument [Line Items]
Basis spread on variable rate	0.25%

STOCK-BASED INCENTIVE COMPENSATION - Assumptions Used to Compute Fair Value of Stock Options (Details) - Stock Option	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Expected volatility	51.43%	51.19%	51.92%
Risk-free interest rate	4.16%	3.91%	1.40%
Expected life of options	6 years 2 months 12 days	6 years 2 months 12 days	6 years 6 months
Dividend rate	0.00%	0.00%	0.00%

- 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

PROPERTY AND EQUIPMENT (Details) - USD ($) $ in Thousands	12 Months Ended
PROPERTY AND EQUIPMENT (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 244,501	$ 230,289
Less: accumulated depreciation	(123,871)	(121,968)
Property and equipment, net	120,630	108,321
Depreciation expense	27,819	32,243	$ 35,611
Depreciation expense in cost of revenue
Property, Plant and Equipment [Line Items]
Depreciation expense	2,999	4,869	5,746
Depreciation expense in operating expenses
Property, Plant and Equipment [Line Items]
Depreciation expense	24,820	27,374	$ 29,865
Infusion pumps
Property, Plant and Equipment [Line Items]
Property and equipment, gross	36,943	34,942
Equipment, furniture and other
Property, Plant and Equipment [Line Items]
Property and equipment, gross	23,593	31,929
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	99,725	99,085
Computer software, purchased and internally developed
Property, Plant and Equipment [Line Items]
Property and equipment, gross	50,572	34,922
Assets under development
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 33,668	$ 29,411

Audit Information	12 Months Ended
Audit Information	Dec. 31, 2023
Audit Information [Abstract]
Auditor Name	KPMG LLP
Auditor Location	Chicago, Illinois
Auditor Firm ID	185

INDEBTEDNESS - Long-term Debt Maturities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Debt Disclosure [Abstract]
2024	$ 6,000
2025	6,000
2026	6,000
2027	6,000
2028	564,000
2029 and beyond	500,000
Total	$ 1,088,000	$ 1,094,000

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Concentration Risk [Line Items]
Allowance for doubtful accounts	$ 0	$ 0
Unbilled receivables	89,100,000	101,500,000
Rebate receivable	52,000,000	53,400,000
Investments in equity-method investees	20,900,000	19,400,000
Proportionate share of earnings in equity-method investees	5,530,000	5,125,000	$ 6,030,000
Capital distribution from equity method investments	$ 4,000,000	$ 5,875,000	$ 2,900,000
Revenue from Contract with Customer Benchmark \| Customer Concentration Risk \| Largest Payer
Concentration Risk [Line Items]
Concentration risk	14.00%	14.00%	16.00%
Revenue from Contract with Customer Benchmark \| Governmental Programs \| Government Healthcare Programs
Concentration Risk [Line Items]
Concentration risk	12.00%	12.00%	12.00%
Accounts Receivable Benchmark \| Governmental Programs \| Government Healthcare Programs
Concentration Risk [Line Items]
Concentration risk	12.00%	13.00%
Cost of Goods and Service, Product and Service Benchmark \| Medical Supply Vendors \| Four Vendors
Concentration Risk [Line Items]
Concentration risk	72.00%	73.00%	74.00%
Infusion pumps
Concentration Risk [Line Items]
Intangible asset useful life (in years)	7 years
Computer Software
Concentration Risk [Line Items]
Intangible asset useful life (in years)	5 years
Minimum \| Referral sources
Concentration Risk [Line Items]
Intangible asset useful life (in years)	15 years
Minimum \| Trademarks and Trade Names
Concentration Risk [Line Items]
Intangible asset useful life (in years)	2 years
Minimum \| Other amortizable intangible assets
Concentration Risk [Line Items]
Intangible asset useful life (in years)	2 years
Minimum \| Equipment
Concentration Risk [Line Items]
Intangible asset useful life (in years)	3 years
Maximum \| Referral sources
Concentration Risk [Line Items]
Intangible asset useful life (in years)	20 years
Maximum \| Trademarks and Trade Names
Concentration Risk [Line Items]
Intangible asset useful life (in years)	15 years
Maximum \| Other amortizable intangible assets
Concentration Risk [Line Items]
Intangible asset useful life (in years)	9 years
Maximum \| Equipment
Concentration Risk [Line Items]
Intangible asset useful life (in years)	13 years

GOODWILL AND OTHER INTANGIBLE ASSETS - Carrying Amount of Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Goodwill [Roll Forward]
Goodwill - net book value, beginning of period	$ 1,533,424	$ 1,477,564	$ 1,428,610
Purchase accounting adjustments	(176)	1,317
Acquisitions	6,998	54,543	48,954
Goodwill - net book value, end of period	$ 1,540,246	$ 1,533,424	$ 1,477,564

- 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

INDEBTEDNESS (Tables)

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Schedule of Debt

Long-term debt consisted of the following as of December 31, 2023 (in thousands):


	Principal Amount		Discount		Debt Issuance Costs		Net Balance
Revolver Facility	$	—	$	—	$	—	$	—
First Lien Term Loan	588,000		(6,974)		(9,678)		571,348
Senior Notes	500,000		—		(8,698)		491,302
	$	1,088,000	$	(6,974)	$	(18,376)	1,062,650
Less: current portion							(6,000)
Total long-term debt							$	1,056,650

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 Illustrates the Aforementioned Interest Rate Terms

The table below illustrates the aforementioned interest rate terms:


Pricing Level	Total Net Leverage Ratio	Applicable Rate for Term SOFR Loans	Applicable Rate for Base Rate Loans
I	Greater than or equal to 3.00x	2.25%	1.25%
II	Less than 3.00x, but greater than or equal to 2.25x	2.00%	1.00%
III	Less than 2.25x, but greater than or equal to 1.50x	1.75%	0.75%
IV	Less than 1.50x, but greater than or equal to 1.00x	1.50%	0.50%
V	Less than 1.00x	1.25%	0.25%

Schedule of Long-term Debt Maturities

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


Fiscal Year Ended December 31,	Minimum Payments
2024	$	6,000
2025	6,000
2026	6,000
2027	6,000
2028	564,000
2029 and beyond	500,000
Total	$	1,088,000

Schedule of Estimated Fair Values of Debt Obligations

The following table presents the estimated fair values of the Company’s debt obligations as of December 31, 2023 (in thousands):


Financial Instrument	Carrying Value as of December 31, 2023		Markets for Identical Item (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
First Lien Term Loan	$	571,348	$	—	$	590,234	$	—
Senior Notes	491,302		—		448,750		—
Total debt instruments	$	1,062,650	$	—	$	1,038,984	$	—

INCOME TAXES - Valuation Allowance for Deferred Tax Assets (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Change in Deferred Tax Asset Valuation Allowance
Balance at Beginning of Period	$ 13,056	$ 13,151	$ 112,085
Balance at End of Period	6,371	13,056	13,151
Charged (Benefit) to Costs and Expenses
Change in Deferred Tax Asset Valuation Allowance
Additions	(6,685)	(95)	(96,136)
Charged (Benefit) to Other Accounts
Change in Deferred Tax Asset Valuation Allowance
Additions	$ 0	$ 0	$ (2,798)

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 267,090	$ 150,556	$ 139,898
Adjustments to reconcile net income to net cash provided by operations:
Depreciation and amortization expense	62,200	65,434	68,804
Non-cash operating lease costs	18,533	19,713	15,168
Deferred income taxes - net	12,766	49,187	(30,372)
(Gain)/loss on sale of assets	0	(9,403)	767
Loss on extinguishment of debt	0	0	13,387
Amortization of deferred financing costs	4,446	4,304	4,998
Equity in earnings of joint ventures	(5,530)	(5,125)	(6,030)
Stock-based incentive compensation expense	30,479	16,783	9,575
Capital distribution from equity method investments	4,000	5,875	2,900
Other adjustments	(1,244)	0	844
Changes in operating assets and liabilities:
Accounts receivable, net	224	(36,889)	(4,273)
Inventories	(51,000)	(41,010)	(22,700)
Prepaid expenses and other current assets	(6,290)	(16,798)	1,420
Accounts payable	47,703	98,885	(10,381)
Accrued compensation and employee benefits	15,546	(7,770)	23,977
Accrued expenses and other current liabilities	(1,727)	10,535	18,383
Operating lease liabilities	(17,529)	(21,395)	(18,496)
Other noncurrent assets and liabilities	(8,372)	(15,335)	700
Net cash provided by operating activities	371,295	267,547	208,569
CASH FLOWS FROM INVESTING ACTIVITIES:
Acquisition of property and equipment	(41,866)	(35,358)	(25,632)
Proceeds from sale of assets	3,743	14,670	0
Business acquisitions, net of cash acquired	(12,494)	(87,364)	(85,909)
Other investing activities	(5,889)	0	0
Net cash used in investing activities	(56,506)	(108,052)	(111,541)
CASH FLOWS FROM FINANCING ACTIVITIES:
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(3,115)	352	(32)
Purchase of company stock	(250,261)	0	0
Proceeds from warrant exercises	0	20,916	0
Proceeds from issuance of debt	0	0	855,136
Repayments of debt principal	(6,000)	(6,000)	(8,832)
Retirement of debt obligations	0	0	(910,345)
Deferred financing costs	0	0	(10,339)
Debt prepayment fees	0	0	(2,458)
Other financing activities	(5,750)	0	0
Net cash (used in) provided by financing activities	(265,126)	15,268	(76,870)
NET INCREASE IN CASH AND CASH EQUIVALENTS	49,663	174,763	20,158
Cash and cash equivalents - beginning of the period	294,186	119,423	99,265
CASH AND CASH EQUIVALENTS - END OF PERIOD	343,849	294,186	119,423
Supplemental disclosure of cash flows information:
Cash paid for interest	69,804	50,372	60,920
Cash paid for income taxes	75,241	13,438	5,706
Cash paid for operating leases	$ 27,391	$ 25,311	$ 26,174

INCOME TAXES - Income Tax Reconciliation (Details)	12 Months Ended
INCOME TAXES - Income Tax Reconciliation (Details)	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
U.S. federal statutory tax rate	21.00%	21.00%	21.00%
State and local income taxes net of federal tax benefit	4.80%	5.00%	4.90%
Non-deductible expenses	0.10%	0.20%	0.30%
Valuation allowance	(1.50%)	0.00%	(46.20%)
Non-deductible and stock-based compensation	0.70%	0.40%	0.00%
Other, net	0.40%	0.20%	(0.10%)
Effective income tax rate	25.50%	26.80%	(20.10%)

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Pay vs Performance Disclosure
Net (loss) income	$ 267,090	$ 150,556	$ 139,898

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY - USD ($) $ in Thousands	Total	Preferred Stock	Common Stock	Treasury Stock	Paid-in Capital	Retained Earnings (Accumulated Deficit)	Accumulated Other Comprehensive Income (Loss)
Equity, beginning balance at Dec. 31, 2020	$ 1,015,724	$ 0	$ 18	$ (2,403)	$ 1,129,312	$ (100,031)	$ (11,172)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based incentive compensation	9,575				9,575
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(32)				(32)
Net income	139,898					139,898
Other comprehensive income	10,721						10,721
Equity, ending 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]
Stock-based incentive compensation	16,783				16,783
Exercise of stock options, vesting of restricted stock, and related tax withholdings	352				352
Exercise of warrants	20,916				20,916
Net income	150,556					150,556
Other comprehensive income	21,610						21,610
Equity, ending 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]
Stock-based incentive compensation	30,479				30,479
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(3,115)				(3,115)
Purchase of company stock, and related tax effects	(252,704)				(252,704)
Net income	267,090					267,090
Other comprehensive income	(6,181)						(6,181)
Equity, ending balance at Dec. 31, 2023	$ 1,421,672	$ 0	$ 18	$ (255,107)	$ 1,204,270	$ 457,513	$ 14,978

- 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.

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+ Details

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 31, 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)	182,905,559	182,341,420
Common stock, shares, outstanding (in shares)	174,575,537	181,957,698
Treasury stock, shares (in shares)	8,330,022	383,722

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	12 Months Ended
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	Dec. 31, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation — The accompanying consolidated financial statements have been prepared in conformity with generally accepted accounting principles (“GAAP”) in the United States. GAAP
Principles of Consolidation	Principles of Consolidation — The Company’s 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 December 31, 2023, cash equivalents consisted of money market funds.
Accounts Receivable	Accounts Receivable — The Company’s accounts receivable are reported at the net realizable value amount that reflects the consideration the Company expects to receive in exchange for providing services, which is inclusive of adjustments for price concessions. The majority of accounts receivable are due from private insurance carriers and governmental healthcare programs, such as Medicare and Medicaid. Price concessions may result from patient hardships, patient uncollectible accounts sent to collection agencies, lack of recovery due to not receiving prior authorization, differing interpretations of covered therapies in payer contracts, different pricing methodologies, or various other reasons. In accordance with Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers (“ASC 606”), an allowance for doubtful accounts is established only as a result of an adverse change in the Company’s payers’ ability to pay outstanding billings.
Inventories	Inventories — Inventories, which consists primarily of pharmaceuticals, is stated at the lower of first‑in, first‑out cost or net realizable value basis, which the Company believes is reflective of the physical flow of inventories.
Leases	Leases — The Company has lease agreements for facilities, warehouses, office space and property and equipment. At the inception of a contract, the Company determines if the contract is a lease or contains an embedded lease arrangement. Operating leases are included in the operating lease right-of-use asset (“ROU asset”) and operating lease liabilities in the consolidated financial statements. ROU assets, which represent the Company’s right to use the leased assets, and operating lease liabilities, which represent the present value of unpaid lease payments, are both recognized by the Company at the lease commencement date. The Company utilizes its estimated incremental borrowing rate at the lease commencement date to determine the present value of unpaid lease obligations. The rates are estimated primarily using a methodology dependent on the Company’s financial condition, creditworthiness, and availability of certain observable data. In particular, the Company considers its actual cost of borrowing for collateralized loans and its credit rating, along with the corporate bond yield curve in estimating its incremental borrowing rates. ROU assets are recorded as the amount of operating lease liability, adjusted for prepayments, accrued lease payments, initial direct costs, lease incentives, and impairment of the ROU asset. Tenant improvement allowances used to fund leasehold improvements are recognized when earned and reduce the related ROU asset. Tenant improvement allowances are recognized through the ROU asset as a reduction of expense over the term of the lease. Leases may contain rent escalations, however the Company recognizes the lease expense on a straight-line basis over the expected lease term. The Company reviews the terms of any lease renewal options to determine if it is reasonably certain that the renewal options will be exercised. The Company has determined that the expected lease term is typically the minimum non-cancelable period of the lease. The Company has lease agreements that contain both lease and non-lease components which the Company has elected to account for as a single lease component for all asset classes. Leases with an initial term of 12 months or less are not recorded on the consolidated balance sheet and are expensed on a straight-line basis over the term of the lease. The Company’s lease agreements do not contain any material residual value guarantees or material restrictive covenants.
Goodwill, Intangible Assets, Property and Equipment, and Referral Sources	Goodwill, Intangible Assets, Property and Equipment, and Referral Sources — Goodwill represents the excess of the purchase price over the fair value of assets acquired and liabilities assumed. The Company accounts for goodwill under ASC Topic 350, Intangibles-Goodwill and Other. The Company tests goodwill for impairment annually, or more frequently whenever events or circumstances indicate impairment may exist. Goodwill is stated at cost less accumulated impairment losses. The Company completes its goodwill impairment test annually in the fourth quarter on a qualitative basis. See Note 10, Goodwill and Other Intangible Assets, for further discussion of the Company’s goodwill and other intangible assets. Intangible assets arising from the Company’s acquisitions are amortized on a straight‑line basis over the estimated useful life of each asset. Referral sources have a useful life of fifteen to twenty years. Trademarks/names have a useful life ranging from two to fifteen years. The useful lives for other amortizable intangible assets range from approximately two to nine years. The Company does not have any indefinite‑lived intangible assets.
Property and Equipment	Property and equipment is recorded at cost, net of accumulated depreciation. Depreciation on owned property and equipment is provided for on a straight‑line basis over the estimated useful lives of owned assets. Leasehold improvements are amortized over the estimated useful life of the property or over the term of the lease, whichever is shorter. Estimated useful lives are seven years for infusion pumps and three to thirteen years for equipment. Major repairs, which extend the useful life of an asset, are capitalized in the property and equipment accounts. Routine maintenance and repairs are expensed as incurred. Computer software is included in property and equipment and consists of purchased software and internally-developed software. The Company capitalizes application-stage development costs for significant internally-developed software projects. Once the software is ready for its intended use, these costs are amortized on a straight‑line basis over the software’s estimated useful life, generally five years. Costs recognized in the preliminary project phase and the post-implementation phase, as well as maintenance and training costs, are expensed as incurred. The Company assesses long‑lived assets for impairment whenever events or circumstances indicate that a certain asset or asset group may be impaired. If circumstances require a long-lived asset or asset group be tested for possible impairment, the Company first compares undiscounted cash flows expected to be generated by that asset or asset group to its carrying amount. If the carrying amount of the long-lived asset or asset group is not recoverable on an undiscounted cash flows basis, an impairment is recognized to the extent that the carrying amount exceeds its fair value.
Equity Method Investments	Equity-Method Investments — The Company’s investments in certain unconsolidated entities are accounted for under the equity method. The balance of these investments is included in other noncurrent assets in the accompanying consolidated balance sheets. As of December 31, 2023 and 2022, the balance of the investments was $20.9 million and $19.4 million, respectively. The investments are increased to reflect the Company’s capital contributions and equity in earnings of the investees. The investments are decreased to reflect the Company’s equity in losses of the investees and for distributions received that are not in excess of the carrying amount of the investments. The Company’s proportionate share of earnings or losses of the investees is recorded in equity in earnings of joint ventures in the accompanying consolidated statements of comprehensive income. The Company’s proportionate share of earnings was $5.5 million, $5.1 million and $6.0 million for the years ended December 31, 2023, 2022 and 2021, respectively. Distributions from the investees are treated as cash inflows from operating activities in the consolidated statements of cash flows. During the years ended December 31, 2023, 2022 and 2021, the Company received distributions from the investees of $4.0 million, $5.9 million and $2.9 million, respectively. See Note 17, Related-Party Transactions, for discussion of related-party transactions with these investees.
Hedging Instruments	Hedging Instruments — The Company uses derivative financial instruments to limit its exposure to increases in the interest rate of its variable rate debt instruments. The derivative financial instruments are recognized on the consolidated balance sheets at fair value. See Note 12, Derivative Instruments, for additional information. At inception of the hedge, the Company designated the derivative instruments as a hedge of the cash flows related to the interest on the variable rate debt. For all instruments designated as hedges, the Company documents the hedging relationships and its risk management objective of the hedging relationship. For all hedging instruments, the terms of the hedge perfectly offset the hedged expected cash flows.
Revenue Recognition	Revenue Recognition — Net revenue is reported at the net realizable value amount that reflects the consideration the Company expects to receive in exchange for providing goods and services. Revenues are from government payers, commercial payers, and patients for goods and services provided and are based on a gross price based on payer contracts, fee schedules, or other arrangements less any implicit price concessions. Due to the nature of the healthcare industry and the reimbursement environment in which the Company operates, certain estimates are required to record revenue and accounts receivable at their net realizable values at the time goods or services are provided. Inherent in these estimates is the risk that they will have to be revised or updated as additional information becomes available. The Company assesses the expected consideration to be received at the time of patient acceptance, based on the verification of the patient’s insurance coverage, historical information with the patient, similar patients, or the payer. Performance obligations are determined based on the nature of the services provided by the Company. The majority of the Company’s performance obligations are to provide infusion services to deliver medicine, nutrients, or fluids directly into the body. The Company provides a variety of infusion-related therapies to patients, which frequently include multiple deliverables of pharmaceutical drugs and related nursing services. After applying the criteria from ASC 606, the Company concluded that multiple performance obligations exist in its contracts with its customers. Revenue is allocated to each performance obligation based on relative standalone price, determined based on reimbursement rates established in the third-party payer contracts. Pharmaceutical drug revenue is recognized at the time the pharmaceutical drug is delivered to the patient, and nursing revenue is recognized on the date of service. The Company's outstanding performance obligations relate to contracts with a duration of less than one year. Therefore, the Company has elected to apply the practical expedient provided by ASC 606 and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. Any unsatisfied or partially unsatisfied performance obligations at the end of a reporting period are generally completed prior to the patient being discharged.
Cost of Revenue	Cost of Revenue — Cost of revenue consists of the actual cost of pharmaceuticals and other medical supplies dispensed to patients, as well as all other costs directly related to the production of revenue. These costs include warehousing costs, purchasing costs, freight costs, cash discounts, wages and related costs for pharmacists and nurses, along with depreciation expense relating to revenue-generating assets, such as infusion pumps. The Company also receives rebates from pharmaceutical and medical supply manufacturers. Rebates are generally volume-based incentives and are recorded as a reduction of inventory and are accounted for as a reduction of cost of goods sold when the related inventory is sold.
Selling, General and Administrative Expenses	Selling, General and Administrative Expenses — Selling, general and administrative expenses mainly consist of salaries for administrative employees that directly and indirectly support the operations, occupancy costs, marketing expenditures, insurance, and professional fees.
Stock Based Incentive Compensation	Stock Based Incentive Compensation — The Company accounts for stock-based incentive compensation expense in accordance with ASC Topic 718, Compensation-Stock Compensation (“ASC 718”). Stock-based incentive compensation expense is based on the grant date fair value. The Company estimates the fair value of stock option awards using a Black-Scholes option pricing model and the fair value of restricted stock unit awards using the closing price of the Company’s common stock on the grant date. For awards with a service-based vesting condition, the Company recognizes expense on a straight-line basis over the service period of the award. For awards with performance-based vesting conditions, the Company will recognize expense when it is probable that the performance-based conditions will be met. When the Company determines that it is probable that the performance-based conditions will be met, a cumulative catch-up of expense will be recorded as if the award had been vesting on a straight-line basis from the award date. The award will continue to be expensed on a straight-line basis through the remainder of the vesting period and will be updated if the Company determines that there has been a change in the probability of achieving the performance-based conditions. The Company records the impact of forfeited awards in the period in which the forfeiture occurs.
Business Acquisitions	Business Acquisitions — The Company accounts for business acquisitions in accordance with ASC Topic 805, Business Combinations, with assets and liabilities being recorded at their acquisition date fair value and goodwill being calculated as the purchase price in excess of the net identifiable assets.
Income Taxes	Income Taxes — The Company accounts for income taxes using the asset and liability method. Deferred tax assets and liabilities are reported for book-tax basis differences and are measured based on currently enacted tax laws using rates expected to apply to taxable income in the years in which the differences are expected to reverse. The effect of a change in tax rate on deferred taxes is recognized in income tax expense in the period that includes the enactment date of the change. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. Valuation allowances are established when necessary to reduce deferred tax assets to the amounts more likely than not to be realized. The Company recognizes income tax positions that are more likely than not to be sustained on their technical merits. The Company measures recognized income tax positions at the maximum benefit that is more likely than not, based on cumulative probability, realizable upon final settlement of the position. Interest and penalties related to unrecognized tax benefits are reported in income tax expense (benefit).
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%, 14% and 16% for the years ended December 31, 2023, 2022 and 2021, respectively. There were no other managed care contracts that represent greater than 10% of revenue for the years presented. For the years ended December 31, 2023, 2022 and 2021, approximately 12%, 12% and 12%, respectively, of the Company’s revenue was reimbursable through direct government healthcare programs such as Medicare and Medicaid. As of December 31, 2023 and 2022, approximately 12% and 13%, respectively, of the Company’s accounts receivable was related to these programs. Governmental programs pay for services based on fee schedules and rates that are determined by the related governmental agency. Laws and regulations pertaining to government programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility that recorded estimates will change in the near term. The Company does not require its patients nor other payers to carry collateral for any amounts owed for goods or services provided. Other than as discussed above, concentrations of credit risk relating to trade accounts receivable is limited due to the Company’s diversity of patients and payers. Further, the Company generally does not provide charity care; however, Option Care Health offers a financial assistance program for patients that meet certain defined hardship criteria. For the years ended December 31, 2023, 2022, and 2021, approximately 72%, 73% and 74%, 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 — The fair value measurement accounting standard, ASC Topic 820, Fair Value Measurement (“ASC 820”), provides a framework for measuring fair value and defines fair value as the price that would be received to sell an asset or paid to transfer a liability. Fair value is a market-based measurement that should be determined using assumptions that market participants would use in pricing an asset or liability. The standard establishes a valuation hierarchy for inputs used in measuring fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs by requiring that the most observable inputs be used when available. Observable inputs are inputs market participants would use in valuing the asset or liability developed based on independent market data sources. Unobservable inputs are inputs that reflect the Company’s assumptions about the factors market participants would use in valuing the asset or liability developed based upon the best information available. The valuation hierarchy is composed of three categories. The categorization within the valuation hierarchy is based on the lowest level of input that is significant to the fair value measurement. The categories within the valuation hierarchy are described as follows: •Level 1 - Inputs to the fair value measurement are quoted prices in active markets for identical assets or liabilities. •Level 2 - Inputs to the fair value measurement include quoted prices in active markets for similar assets or liabilities, quoted prices for identical or similar assets or liabilities in markets that are not active, and inputs other than quoted prices that are observable for the asset or liability, either directly or indirectly. •Level 3 - Inputs to the fair value measurement are unobservable inputs or valuation techniques. While the Company believes its valuation methods are appropriate and consistent with other market participants, the use of different methodologies or assumptions to determine the fair value of certain financial instruments could result in a different fair value measurement at the reporting date. FAIR VALUE MEASUREMENTS Fair value measurements are determined by maximizing the use of observable inputs and minimizing the use of unobservable inputs. The hierarchy places the highest priority on unadjusted quoted market prices in active markets for identical assets or liabilities (Level 1 measurements) and gives the lowest priority to unobservable inputs (Level 3 measurements). The three levels of inputs within the fair value hierarchy are defined in Note 2, Summary of Significant Accounting Policies. While the Company believes its valuation methods are appropriate and consistent with other market participants, the use of different methodologies or assumptions to determine the fair value of certain financial instruments could result in a different fair value measurement at the reporting date. First Lien Term Loan: The fair value of the First Lien Term Loan is derived from a broker quote on the loans in the syndication (Level 2 inputs). See Note 11, Indebtedness, for further discussion of the carrying amount and fair value of the First Lien Term Loan. Senior Notes: The fair value of the Senior Notes is derived from a broker quote (Level 2 inputs). See Note 11, Indebtedness, for further discussion of the carrying amount and fair value of the Senior Notes. Interest Rate 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 12, 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 consolidated balance sheets (Level 1 inputs). There were no other assets or liabilities measured at fair value at December 31, 2023 or 2022.
Recently Issued Accounting Pronouncements	Recently Issued Accounting Pronouncements — In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. This ASU addresses investor requests for more transparency about income tax information through improvements to income tax disclosures primarily related to the rate reconciliation and income taxes paid information. The ASU improves the transparency of income tax disclosures by requiring consistent categories and greater disaggregation of information in the rate reconciliation and income taxes paid disaggregated by jurisdiction. The ASU allows investors to better assess, in their capital allocation decisions, how an entity’s worldwide operations and related tax risks and tax planning and operational opportunities affect its income tax rate and prospects for future cash flows. This ASU also improves the effectiveness and comparability of disclosures by adding disclosures of pretax income (loss) and income tax expense (benefit) to be consistent with U.S. Securities and Exchange Commission (“SEC”) Regulation S-X and removing disclosures that no longer are considered cost beneficial or relevant. The Company is required to adopt this ASU for annual periods beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the impact of this ASU on its results of operations, cash flows, financial position, and disclosures. In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures. This ASU improves the disclosures about a public entity’s reportable segments and addresses requests from investors for additional, more detailed information about a reportable segment’s expenses. The ASU improves financial reporting by requiring disclosure of incremental segment information on an annual and interim basis for all public entities, including those public entities that have a single reportable segment, to enable investors to develop more decision-useful financial analyses. The Company is required to adopt this ASU for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. Once adopted the Company will apply the ASU retrospectively to all prior periods presented in the financial statements. The Company is currently evaluating the impact of this ASU on its results of operations, cash flows, financial position, and disclosures. In October 2023, the FASB issued ASU 2023-06, Disclosure Improvements: Codification Amendments in Response to the SEC’s Disclosure Update and Simplification Initiative. This ASU is the result of the Board’s decision to incorporate into the Codification 14 disclosures referred by the SEC. The ASU represents changes to clarify or improve disclosure and presentation requirements of a variety of Topics. Many of the amendments allow users to more easily compare entities subject to the SEC’s existing disclosures with those entities that were not previously subject to the SEC’s requirements. Also, the amendments align the requirements in the Codification with the SEC’s regulations. The effective date for each amendment will be the date on which the SEC’s removal of that related disclosure from Regulation S-X or Regulation S-K becomes effective, with early adoption permitted. If by June 30, 2027, the SEC has not removed the applicable requirement from Regulation S-X or Regulation S-K, the pending content of the related amendment will be removed from the Codification and will not become effective. The Company is currently evaluating the impact of this ASU on its results of operations, cash flows, financial position, and disclosures.

NATURE OF OPERATIONS AND PRESENTATION OF FINANCIAL STATEMENTS	12 Months Ended
	Dec. 31, 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 — The Company’s stock is listed on the Nasdaq Global Select Market as of December 31, 2023. During the year ended December 31, 2023, HC Group Holdings I, LLC. (“HC I”) completed sales of 23,771,926 shares of its Option Care 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 16, Stockholders’ Equity, for further discussion of the Company’s share repurchase program. As of December 31, 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 healthcare services through a national network of 93 full service pharmacies and 84 stand-alone ambulatory infusion sites. The Company contracts with managed care organizations, third-party payers, hospitals, physicians, and other referral sources to provide pharmaceuticals and complex compounded solutions to patients for intravenous delivery in the patients’ homes or other nonhospital settings. The Company operates in one segment, infusion services. Basis of Presentation — The accompanying consolidated financial statements have been prepared in conformity with generally accepted accounting principles (“GAAP”) in the United States. GAAP requires management to make certain estimates and assumptions in determining assets, liabilities, revenue, expenses, and related disclosures. Actual amounts could differ materially from those estimates. Principles of Consolidation — The Company’s consolidated financial statements include the accounts of Option Care Health, Inc. and its subsidiaries. All intercompany transactions and balances are eliminated in consolidation. The Company has investments in companies that are 50% owned and are accounted for as equity-method investments. The Company’s share of earnings from equity-method investments is included in the line entitled “Equity in earnings of joint ventures” in the consolidated statements of comprehensive income. 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	Dec. 31, 2023 USD ($)
Debt Instrument [Line Items]
Total debt instruments	$ 1,062,650
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	1,038,984
Significant Unobservable Inputs (Level 3)
Debt Instrument [Line Items]
Total debt instruments	0
Senior Notes
Debt Instrument [Line Items]
Total debt instruments	491,302
Senior Notes \| First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	571,348
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	448,750
Senior Notes \| Significant Other Observable Inputs (Level 2) \| First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	590,234
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.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 835
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
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Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
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-Paragraph 1
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (SX 210.12-04(a))
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-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-3

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/exampleRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

EARNINGS PER SHARE

12 Months Ended

Dec. 31, 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 years ended December 31, 2023, 2022 and 2021 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.

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:


	Year Ended December 31,
	2023	2022	2021
Warrants	—	—	457,753
Stock option awards	1,214,560	629,690	490,968
Restricted stock awards	340,331	205,652	316,454
Performance stock unit awards	—	—	—

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


	Year Ended December 31,
	2023		2022		2021
Numerator:
Net income (1) (2) (3)	$	267,090	$	150,556	$	139,898
Denominator:
Weighted average number of common shares outstanding	178,973		181,105		179,855
Earnings per Common Share:
Earnings per common share, basic	$	1.49	$	0.83	$	0.78

(1) Net income for the year ended December 31, 2023 includes $63.1 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 Acquisitions and Divestitures, for further discussion. In addition, net income includes approximately $5.3 million of other non-operating income.

(2) Net income for the year ended December 31, 2022 includes the impact of the Company’s Respiratory Therapy Asset Sale. See Note 3, Business Acquisitions and Divestitures, for further discussion.

(3) Net income for the year ended December 31, 2021 includes the impact of the Company’s release of its valuation allowance.

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


	Year Ended December 31,
	2023		2022		2021
Numerator:
Net income (1) (2) (3)	$	267,090	$	150,556	$	139,898
Denominator:
Weighted average number of common shares outstanding	178,973		181,105		179,855
Effect of dilutive securities	1,402		970		1,350
Weighted average number of common shares outstanding, diluted	180,375		182,075		181,205
Earnings per Common Share:
Earnings per common share, diluted	$	1.48	$	0.83	$	0.77

(2) Net income for the year ended December 31, 2022 includes the impact of the Company’s Respiratory Therapy Asset Sale. See Note 3, Business Acquisitions and Divestitures, for further discussion.

(3) Net income for the year ended December 31, 2021 includes the impact of the Company’s release of its valuation allowance.

BUSINESS ACQUISITIONS AND DIVESTITURES (Tables)

12 Months Ended

Dec. 31, 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.

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	$	2,303
Intangible assets	25,580
Other assets	600
Accrued compensation	(1,115)
Accounts payable and other liabilities	(1,168)
Fair value identifiable assets and liabilities	26,200
Goodwill (1)	33,746
Cash acquired	661
Purchase price	60,607
Less: cash acquired	(661)
Purchase price, net of cash acquired	$	59,946

The following is an allocation of acquired identifiable assets and assumed liabilities, net of cash acquired, (in thousands):


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

GOODWILL AND OTHER INTANGIBLE ASSETS (Tables)

12 Months Ended

Dec. 31, 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 years ended December 31, 2023, 2022 and 2021 (in thousands):


Balance at December 31, 2020	$	1,428,610
Acquisitions	48,954
Balance at December 31, 2021	$	1,477,564
Acquisitions	54,543
Purchase accounting adjustments	1,317
Balance at December 31, 2022	$	1,533,424
Acquisitions	6,998
Purchase accounting adjustments	(176)
Balance at December 31, 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 December 31, 2023 and 2022 (in thousands):


	December 31, 2023		December 31, 2022
Gross intangible assets:
Referral sources	$	514,388	$	509,646
Trademarks/names	39,136		38,508
Other amortizable intangible assets	995		912
Total gross intangible assets	554,519		549,066

Accumulated amortization:
Referral sources	(199,084)		(167,902)
Trademarks/names	(19,698)		(16,901)
Other amortizable intangible assets	(341)		(148)
Total accumulated amortization	(219,123)		(184,951)
Total intangible assets, net	$	335,396	$	364,115

Schedule of Future Amortization Expense for Intangible Assets

Expected future amortization expense for intangible assets recorded at December 31, 2023, is as follows (in thousands):


	Amount
2024	$	34,386
2025	34,176
2026	34,071
2027	33,931
2028	33,881
2029 and beyond	164,951
Total	$	335,396

- 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
-Paragraph 24
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-URI https://asc.fasb.org//1943274/2147482548/350-20-55-24

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
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-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 10: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 11: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1A
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1A

Reference 12: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-2

+ Details

GOODWILL AND OTHER INTANGIBLE ASSETS

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

GOODWILL AND OTHER INTANGIBLE ASSETS

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

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

A qualitative impairment analysis was performed in the fourth quarter of 2023, 2022 and 2021, to assess whether it is more likely than not that the fair value of the Company’s reporting unit is less than its carrying value. The Company assessed relevant events and circumstances including macroeconomic conditions, industry and market considerations, overall financial performance, entity-specific events, and changes in the Company’s stock price. The Company determined that there was no goodwill impairment in 2023, 2022 or 2021.

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

Changes in the carrying amount of goodwill consist of the following activity for the years ended December 31, 2023, 2022 and 2021 (in thousands):


Balance at December 31, 2020	$	1,428,610
Acquisitions	48,954
Balance at December 31, 2021	$	1,477,564
Acquisitions	54,543
Purchase accounting adjustments	1,317
Balance at December 31, 2022	$	1,533,424
Acquisitions	6,998
Purchase accounting adjustments	(176)
Balance at December 31, 2023	$	1,540,246

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


	December 31, 2023		December 31, 2022
Gross intangible assets:
Referral sources	$	514,388	$	509,646
Trademarks/names	39,136		38,508
Other amortizable intangible assets	995		912
Total gross intangible assets	554,519		549,066

Accumulated amortization:
Referral sources	(199,084)		(167,902)
Trademarks/names	(19,698)		(16,901)
Other amortizable intangible assets	(341)		(148)
Total accumulated amortization	(219,123)		(184,951)
Total intangible assets, net	$	335,396	$	364,115

Amortization expense for intangible assets was $34.2 million, $32.9 million and $32.9 million for the years ended December 31, 2023, 2022 and 2021, respectively.

Expected future amortization expense for intangible assets recorded at December 31, 2023, is as follows (in thousands):


	Amount
2024	$	34,386
2025	34,176
2026	34,071
2027	33,931
2028	33,881
2029 and beyond	164,951
Total	$	335,396

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Dec. 31, 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

DERIVATIVE INSTRUMENTS - Pre-tax Gain (Loss) on Derivative Instruments (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Derivative [Line Items]
Pre-tax gains (losses) on interest rate derivatives recognized	$ (8,339)	$ 28,869	$ 10,571
Total gain (loss) on derivatives	$ 10,974	$ 1,090	$ (11,539)
Derivative, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Interest Expense	Interest Expense	Interest Expense
Interest rate cap designated as cash flows hedge
Derivative [Line Items]
Pre-tax gains (losses) on interest rate derivatives recognized	$ (8,339)	$ 28,869	$ (601)
Interest Rate Swap
Derivative [Line Items]
Pre-tax gains (losses) on interest rate derivatives recognized	0	0	11,172
Interest expense \| Interest rate cap designated as cash flows hedge
Derivative [Line Items]
Gain (loss) location of derivative instruments	10,974	1,090	(239)
Interest expense \| Interest Rate Swap
Derivative [Line Items]
Gain (loss) location of derivative instruments	0	0	(11,298)
Gain (loss) location of derivative instruments not designated	$ 0	$ 0	$ (2)

STOCK-BASED INCENTIVE COMPENSATION

12 Months Ended

Dec. 31, 2023

Share-Based Payment Arrangement [Abstract]

STOCK-BASED INCENTIVE COMPENSATION

Equity Incentive Plans — Under the Company’s 2018 Equity Incentive Plan (the “2018 Plan”), approved at the annual meeting by the BioScrip stockholders on May 3, 2018, the Company may issue, among other things, incentive stock options, non-qualified stock options, stock appreciation rights, restricted stock units, stock grants, and performance units to key employees and directors. The 2018 plan is administered by the Company’s Compensation Committee, a standing committee of the Board of Directors. A total of 4,101,735 shares of common stock were initially authorized for issuance under the 2018 Plan. In May 2021, an additional 4,999,999 shares were authorized for issuance under the 2018 Plan, resulting in a total 9,101,734 shares of common stock authorized for issuance.

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

Compensation expense from stock options is recognized on a straight-line basis over the requisite service period. During the years ended December 31, 2023, 2022 and 2021, the Company recognized compensation expense related to stock options of $6.5 million, $2.5 million and $1.9 million, respectively.

The weighted average grant-date fair value of options granted during the years ended December 31, 2023, 2022 and 2021 was $15.72, $12.51 and $17.79, respectively. The fair value of stock options granted was estimated on the date of grant using a Black-Scholes pricing model. The assumptions used to compute the fair value of options for the years ended December 31, 2023, 2022 and 2021 are as follows:


	Year Ended December 31,
	2023		2022		2021
Expected volatility	51.43	%	51.19	%	51.92	%
Risk-free interest rate	4.16	%	3.91	%	1.40	%
Expected life of options	6.2 years		6.2 years		6.5 years
Dividend rate	—		—		—

A summary of stock option activity for the year ended December 31, 2023 is as follows:


	Options	Weighted Average Exercise Price		Aggregate Intrinsic Value (thousands)		Weighted Average Remaining Contractual Life
Balance at December 31, 2022	1,021,370	$	21.63	$	8,816
Granted	872,264	$	28.87	$	4,208
Exercised	(60,106)	$	18.56	$	827
Forfeited and expired	(87,256)	$	28.13	$	561
Balance at December 31, 2023	1,746,272	$	25.08	$	15,028	8.19 years
Exercisable at December 31, 2023	283,571	$	17.07	$	4,713	6.36 years

During the years ended December 31, 2023, 2022 and 2021, shares were surrendered to satisfy tax withholding obligations on the exercise of stock options with a cost basis of $0.3 million, $0.7 million and $0.1 million, respectively. No cash was received from stock option exercises under share-based payment arrangements for the years ended December 31, 2023, 2022 and 2021.

The maximum term of stock options under these plans is ten years. Options outstanding as of December 31, 2023 expire on various dates ranging from May 2024 through July 2033. The following table outlines the outstanding and exercisable stock options as of December 31, 2023:


	Options Outstanding				Options Exercisable
Range of Option Exercise Price	Outstanding Options	Weighted Average Exercise Price		Weighted Average Remaining Contractual Life	Options Exercisable	Weighted Average Exercise Price
$0.00 - $8.24	9,901	$	6.52	3.1 years	9,901	$	6.52
$8.24 - $16.52	132,752	$	12.44	5.4 years	108,767	$	12.24
$16.52 - $24.76	460,969	$	21.41	7.6 years	159,439	$	20.59
$24.76 - $33.00	1,142,650	$	28.19	8.8 years	5,464	$	29.51





All options	1,746,272				283,571

As of December 31, 2023, there was $13.0 million of unrecognized compensation expense related to unvested option grants that is expected to be recognized over a weighted-average period of 1.2 years.

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

Compensation expense from restricted stock is recognized on a straight-line basis over the requisite service period. During the years ended December 31, 2023, 2022 and 2021, the Company recognized compensation expense related to restricted stock awards of $16.6 million, $10.2 million and $4.9 million, respectively.

The grant-date fair value of restricted stock is valued as the closing price of the Company’s common stock on the date of the grant.

A summary of restricted stock award activity for the year ended December 31, 2023 is as follows:


	Restricted Stock	Weighted Average Grant Date Fair Value
Balance at December 31, 2022	1,668,847	$	22.45
Granted	945,589	$	29.02
Vested and issued	(504,597)	$	19.54
Forfeited and expired	(226,723)	$	24.86
Balance at December 31, 2023	1,883,116	$	26.28

During the years ended December 31, 2023 and 2022, shares were surrendered to satisfy tax withholding obligations on the vesting of restricted stock awards with a cost basis of $4.4 million and $1.4 million, respectively. During the year ended December 31, 2021, shares were surrendered to satisfy tax withholding obligations on the vesting of restricted stock awards with an immaterial cost basis.

As of December 31, 2023, there was $31.4 million in unrecognized compensation expense related to unvested restricted stock awards that is expected to be recognized over a weighted average period of 1.2 years. The total fair value of restricted stock awards vested during the years ended December 31, 2023, 2022 and 2021 was $9.9 million, $3.7 million and $1.2 million, respectively.

Performance Stock Units — Performance-based stock units are generally earned based on the attainment of specified goals achieved over a designated performance period. During the years ended December 31, 2023, 2022 and 2021, the Company’s Compensation Committee approved awards of performance-based stock units to certain senior executives of the Company with grant dates in 2023, 2022 and 2021, respectively. The performance-based stock units approved during 2023 (“2023 PSU”), 2022 (“2022 PSU”) and 2021 (“2021 PSU”) each offer a three-year-cliff vesting schedule. Each award reflects a target number of shares (“Target Shares”) that may be issued to the award recipient. The 2023 PSU, 2022 PSU and 2021 PSU awards may be earned upon the completion of the two-year-average performance periods ending December 31, 2024, 2023 and 2022, respectively.

Whether units are earned at the end of the performance period will be determined based on the achievement of certain performance objectives over the performance period. The performance objectives include achieving a target growth for adjusted EBITDA and revenue combined in addition to a target growth for cash flows from operations over the performance period. Depending on the results achieved during the performance period, the actual number of shares that a grant recipient receives at the end of the period may range from 0% to 200% of the Target Shares granted. Each period begins with 100% of the Target Shares and true-up or true-down adjustments are considered every quarter-end based on the forecasted performance period results.

The fair value of the Target Shares and performance stock unit awards are based on the fair value of the underlying shares as of market close on the grant date. Compensation expense for performance unit stock awards is recognized on a straight-line basis over the requisite service period. During the year ended December 31, 2023, the Company recognized compensation expense related to the 2023 PSU, 2022 PSU and 2021 PSU awards of $2.2 million, $2.9 million and $2.4 million, respectively. During the year ended December 31, 2022, the Company recognized compensation expense related to the 2022 PSU and 2021 PSU awards of $2.4 million and $1.7 million, respectively. During the year ended December 31, 2021, the Company recognized compensation expense related to the 2021 PSU awards of $2.7 million. As of December 31, 2023, there were $5.5 million, $3.3 million and $0.3 million in unrecognized compensation expense related to unvested 2023 PSU, 2022 PSU and 2021 PSU awards, respectively, that are expected to be recognized over the period of 2.2 years, 1.2 years and 0.2 years, respectively.

LEASES

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

LEASES

During the years ended December 31, 2023, 2022 and 2021, the Company incurred operating lease expenses of $30.6 million, $29.1 million, and $29.8 million, respectively, including short-term lease expenses, which were included as a component of selling, general and administrative expenses in the consolidated statements of comprehensive income. As of December 31, 2023, the weighted-average remaining lease term was 6.8 years, and the weighted-average discount rate was 6.16%.

Operating leases mature as follows (in thousands):


Fiscal Year Ended December 31,	Minimum Payments
2024	$	24,610
2025	22,447
2026	19,567
2027	16,281
2028	10,980
2029 and beyond	34,528
Total lease payments	128,413
Less: interest	(24,651)
Present value of lease liabilities	$	103,762

During the year ended December 31, 2023, the Company commenced new leases, extensions and amendments, resulting in non-cash operating activities in the consolidated statements of cash flows of $30.5 million related to the increases in the operating lease ROU asset and operating lease liabilities. As of December 31, 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
2024	$	24,610
2025	22,447
2026	19,567
2027	16,281
2028	10,980
2029 and beyond	34,528
Total lease payments	128,413
Less: interest	(24,651)
Present value of lease liabilities	$	103,762

BUSINESS ACQUISITIONS AND DIVESTITURES - Additional Information (Details) $ in Thousands				1 Months Ended				12 Months Ended
	Dec. 29, 2021 USD ($)	Oct. 01, 2021 USD ($) payment	Apr. 07, 2021 USD ($)	May 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Aug. 31, 2022 USD ($)	Apr. 30, 2022 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Jun. 26, 2023 USD ($)	May 03, 2023	Dec. 31, 2020 USD ($)
Business Acquisition [Line Items]
Business combination, acquisition-related expenses								$ 21,100
Goodwill					$ 1,533,424			1,540,246	$ 1,533,424	$ 1,477,564			$ 1,428,610
Sale price					18,400				18,400
Proceeds from sale of assets					14,700			3,743	14,670	$ 0
Consideration receivable					3,700				3,700
Assets held for sale					8,800				8,800
Liabilities held for sale					700				$ 700
Gain on sale					$ 10,300
Disposal Group, Not Discontinued Operation, Gain (Loss) on Disposal, Statement of Income or Comprehensive Income [Extensible Enumeration]					Other, net
BioCure
Business Acquisition [Line Items]
Business combination purchase price			$ 18,900
Intangible assets, net			18,300
Asset acquisition, inventory			$ 600
Amedisys, Inc.
Business Acquisition [Line Items]
Termination fee								$ 63,100			$ 106,000
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
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
Purchase price						27,619
Intangible assets						5,449
Accounts receivable						$ 686
Specialty Pharmacy Nursing Network, Inc.
Business Acquisition [Line Items]
Percentage of the combined company held							100.00%
Purchase price, net of cash acquired							$ 59,900
Goodwill							33,746
Purchase price							60,607
Intangible assets							25,580
Accounts receivable							$ 2,303
Wasatch Infusion LLC
Business Acquisition [Line Items]
Goodwill	$ 17,400
Purchase price	19,500
Intangible assets	4,200
Accounts receivable	2,700
Inventory	2,000
Accounts payable and other assumed liabilities	$ (6,700)
Infinity Infusion Nursing LLC
Business Acquisition [Line Items]
Percentage of the combined company held		100.00%
Purchase price, net of cash acquired		$ 59,604
Goodwill		32,524
Purchase price		61,030
Intangible assets		25,400
Accounts receivable		2,219
Accounts payable and other assumed liabilities		(539)
Cash paid		$ 50,000
Number of contingent payments \| payment		2
Payment in settlement of debt		$ 5,000
Other purchase price adjustments		$ (400)
Option Care, Combined Company \| Amedisys, Inc.
Business Acquisition [Line Items]
Company's stockholders, ownership percentage following merger												64.50%

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Statement [Abstract]
Income taxes on unrealized gains (losses) on cash flow hedges	$ 2,158	$ (7,259)	$ 0

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Statement [Abstract]
NET REVENUE	$ 4,302,324	$ 3,944,735	$ 3,438,640
COST OF REVENUE	3,321,101	3,077,817	2,659,034
GROSS PROFIT	981,223	866,918	779,606
OPERATING COSTS AND EXPENSES:
Selling, general and administrative expenses	607,427	566,122	525,707
Depreciation and amortization expense	59,201	60,565	63,058
Total operating expenses	666,628	626,687	588,765
OPERATING INCOME	314,595	240,231	190,841
OTHER INCOME (EXPENSE):
Interest expense, net	(51,248)	(53,806)	(67,003)
Equity in earnings of joint ventures	5,530	5,125	6,030
Other, net	89,865	14,218	(13,374)
Total other income (expense)	44,147	(34,463)	(74,347)
INCOME BEFORE INCOME TAXES	358,742	205,768	116,494
INCOME TAX EXPENSE (BENEFIT)	91,652	55,212	(23,404)
NET INCOME	267,090	150,556	139,898
OTHER COMPREHENSIVE (LOSS) INCOME, NET OF TAX:
Change in unrealized (losses) gains on cash flow hedges, net of income tax benefit (expense) of $2,158, $(7,259) and $0, respectively	(6,181)	21,610	10,721
OTHER COMPREHENSIVE (LOSS) INCOME	(6,181)	21,610	10,721
NET COMPREHENSIVE INCOME	$ 260,909	$ 172,166	$ 150,619
EARNINGS PER COMMON SHARE:
Earnings per share, basic (in dollars per share)	$ 1.49	$ 0.83	$ 0.78
Earnings per share, diluted (in dollars per share)	$ 1.48	$ 0.83	$ 0.77
Weighted average common shares outstanding, basic (in shares)	178,973	181,105	179,855
Weighted average common shares outstanding, diluted (in shares)	180,375	182,075	181,205

LEASES - Maturities of Lease Liabilities (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Leases [Abstract]
2024	$ 24,610
2025	22,447
2026	19,567
2027	16,281
2028	10,980
2029 and beyond	34,528
Total lease payments	128,413
Less: interest	(24,651)
Present value of lease liabilities	$ 103,762

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
CURRENT ASSETS:
Cash and cash equivalents	$ 343,849	$ 294,186
Accounts receivable, net	377,658	377,542
Inventories	274,004	224,281
Prepaid expenses and other current assets	98,744	98,330
Total current assets	1,094,255	994,339
NONCURRENT ASSETS:
Property and equipment, net	120,630	108,321
Operating lease right-of-use asset	84,159	72,424
Intangible assets, net	20,092	22,371
Referral sources, net	315,304	341,744
Goodwill	1,540,246	1,533,424
Other noncurrent assets	42,349	40,313
Total noncurrent assets	2,122,780	2,118,597
TOTAL ASSETS	3,217,035	3,112,936
CURRENT LIABILITIES:
Accounts payable	426,513	378,763
Accrued compensation and employee benefits	92,508	76,906
Accrued expenses and other current liabilities	75,010	84,302
Current portion of operating lease liability	18,278	19,380
Current portion of long-term debt	6,000	6,000
Total current liabilities	618,309	565,351
NONCURRENT LIABILITIES:
Long-term debt, net of discount, deferred financing costs and current portion	1,056,650	1,058,204
Operating lease liability, net of current portion	85,484	71,441
Deferred income taxes	34,920	22,154
Other noncurrent liabilities	0	9,683
Total noncurrent liabilities	1,177,054	1,161,482
Total liabilities	1,795,363	1,726,833
STOCKHOLDERS’ EQUITY:
Preferred stock; $0.0001 par value; 12,500,000 shares authorized, no shares outstanding as of December 31, 2023 and 2022, respectively.	0	0
Common stock; $0.0001 par value: 250,000,000 shares authorized, 182,905,559 shares issued and 174,575,537 shares outstanding as of December 31, 2023; 182,341,420 shares issued and 181,957,698 shares outstanding as of December 31, 2022.	18	18
Treasury stock; 8,330,022 and 383,722 shares outstanding, at cost, as of December 31, 2023 and 2022, respectively.	(255,107)	(2,403)
Paid-in capital	1,204,270	1,176,906
Retained earnings	457,513	190,423
Accumulated other comprehensive income	14,978	21,159
Total stockholders’ equity	1,421,672	1,386,103
TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY	$ 3,217,035	$ 3,112,936

EMPLOYEE BENEFIT PLANS	12 Months Ended
EMPLOYEE BENEFIT PLANS	Dec. 31, 2023
Retirement Benefits [Abstract]
EMPLOYEE BENEFIT PLANS	EMPLOYEE BENEFIT PLANSThe Company maintains a 401(k) plan and matches 100% of employee contributions, up to 4% of employee compensation. The Company recorded expense for the defined contribution plan of $13.1 million, $12.2 million and $11.6 million for the years ended December 31, 2023, 2022 and 2021, respectively. In the years ended December 31, 2023, 2022 and 2021, Company contributions of $12.4 million, $11.8 million and $10.9 million, respectively, were paid.

FAIR VALUE MEASURMENTS	12 Months Ended
FAIR VALUE MEASURMENTS	Dec. 31, 2023
Fair Value Disclosures [Abstract]
FAIR VALUE MEASURMENTS	FAIR VALUE MEASUREMENTS Fair value measurements are determined by maximizing the use of observable inputs and minimizing the use of unobservable inputs. The hierarchy places the highest priority on unadjusted quoted market prices in active markets for identical assets or liabilities (Level 1 measurements) and gives the lowest priority to unobservable inputs (Level 3 measurements). The three levels of inputs within the fair value hierarchy are defined in Note 2, Summary of Significant Accounting Policies. While the Company believes its valuation methods are appropriate and consistent with other market participants, the use of different methodologies or assumptions to determine the fair value of certain financial instruments could result in a different fair value measurement at the reporting date. First Lien Term Loan: The fair value of the First Lien Term Loan is derived from a broker quote on the loans in the syndication (Level 2 inputs). See Note 11, Indebtedness, for further discussion of the carrying amount and fair value of the First Lien Term Loan. Senior Notes: The fair value of the Senior Notes is derived from a broker quote (Level 2 inputs). See Note 11, Indebtedness, for further discussion of the carrying amount and fair value of the Senior Notes. Interest Rate 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 12, 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 consolidated balance sheets (Level 1 inputs). There were no other assets or liabilities measured at fair value at December 31, 2023 or 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

DERIVATIVE INSTRUMENTS - Balance Sheet Location of Derivatives (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Derivative
Total derivative assets	$ 19,929	$ 28,268
Derivative Asset, Statement of Financial Position [Extensible Enumeration]	Other noncurrent assets, Prepaid expenses and other current assets	Other noncurrent assets, Prepaid expenses and other current assets
Designated as Hedging Instrument \| Prepaid expenses and other current assets \| Interest rate cap designated as cash flows hedge
Derivative
Total derivative assets	$ 9,746	$ 10,926
Designated as Hedging Instrument \| Other noncurrent assets \| Interest rate cap designated as cash flows hedge
Derivative
Total derivative assets	$ 10,183	$ 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.

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+ Details

COVER PAGE - USD ($)	12 Months Ended
COVER PAGE - USD ($)	Dec. 31, 2023	Feb. 19, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2023
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-11993
Entity Registrant Name	OPTION CARE HEALTH, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	05-0489664
Entity Address, Address Line One	3000 Lakeside Dr.
Entity Address, Address Line Two	Suite 300N
Entity Address, City or Town	Bannockburn
Entity Address, State or Province	IL
Entity Address, Postal Zip Code	60015
City Area Code	312
Local Phone Number	940-2443
Title of 12(b) Security	Common Stock, $0.0001 par value per share
Trading Symbol	OPCH
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
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
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction Flag	false
Entity Shell Company	false
Entity Public Float			$ 5,843,997,419
Entity Common Stock, Shares Outstanding		173,498,090
Documents Incorporated by Reference	Portions of the registrant’s definitive proxy statement for its 2024 Annual Meeting of Stockholders to be filed with the Securities and Exchange Commission (the “SEC”) within 120 days after the close of the registrant’s fiscal year are incorporated by reference into Part III of this Annual Report on Form 10-K.
Entity Central Index Key	0001014739
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Amendment Flag	false

INDEBTEDNESS - Additional Information (Details) - USD ($)	1 Months Ended	12 Months Ended
	Oct. 31, 2021	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 07, 2023	Jan. 13, 2023
Debt Instrument [Line Items]
Payments to extinguish debt		$ 6,000,000	$ 6,000,000	$ 8,832,000
Cash outflow from financing activities		265,126,000	(15,268,000)	76,870,000
Proceeds from issuance of debt		0	0	855,136,000
Debt issuance costs		18,376,000	21,489,000
Loss on extinguishment of debt		0	0	13,387,000
Fees incurred netted against proceeds		$ 0	$ 0	10,339,000
Senior Notes
Debt Instrument [Line Items]
Loss on extinguishment of debt				12,400,000
Credit Agreements, Entered Into 2019
Debt Instrument [Line Items]
Prepayment penalty				2,400,000
Credit Agreements, Entered Into 2019 \| Senior Notes
Debt Instrument [Line Items]
Cash outflow from financing activities				352,000,000
Proceeds from issuance of debt				356,200,000
Debt issuance costs and third party fees				7,200,000
Debt issuance costs				3,700,000
Issuance costs expensed				900,000
Loss on extinguishment of debt				9,800,000
Fees incurred netted against proceeds				1,000,000
Deferred financing costs				2,900,000
Payments of debt issuance costs, operating activities				900,000
Credit Agreements, Entered Into 2019 \| Senior Notes \| First Lien Term Loan
Debt Instrument [Line Items]
Payments to extinguish debt				161,200,000
Loss on extinguishment of debt				2,600,000
Credit Agreements, Entered Into 2019 \| Senior Notes \| Second Lien Term Loan
Debt Instrument [Line Items]
Debt instrument, face amount				150,000,000
Effective rate on term loans at end of period		4.375%	4.375%
Weighted average interest rate paid on term loans during period		4.375%	4.375%
Payments to extinguish debt				122,900,000
Credit Agreements, Entered Into 2019 \| Senior Notes \| Secured Overnight Financing Rate \| First Lien Term Loan
Debt Instrument [Line Items]
Basis spread on variable rate	2.75%
Debt instrument, interest rate, floor	0.50%
Credit Agreements, Entered Into 2019 \| First Lien Term Loan \| First Lien Term Loan
Debt Instrument [Line Items]
Weighted average interest rate paid on term loans during period		7.83%
New First Lien Term Loan \| Senior Notes \| First Lien Term Loan
Debt Instrument [Line Items]
Debt instrument, face amount	$ 600,000,000
New First Lien Term Loan \| Senior Notes \| Base Rate \| First Lien Term Loan
Debt Instrument [Line Items]
Basis spread on variable rate	1.75%
First Lien Term Loan \| Senior Notes
Debt Instrument [Line Items]
Cash outflow from financing activities				558,300,000
Proceeds from issuance of debt	$ 501,400,000			501,400,000
Debt issuance costs and third party fees	10,700,000
Debt issuance costs	8,800,000	$ 9,678,000	$ 11,529,000
Issuance costs expensed	1,700,000
Loss on extinguishment of debt				1,000,000
Fees incurred netted against proceeds	1,500,000
Deferred financing costs	7,400,000
Payments of debt issuance costs, operating activities	1,800,000
Write off of deferred debt issuance cost				800,000
First Lien Term Loan \| Senior Notes \| First Lien Term Loan
Debt Instrument [Line Items]
Effective rate on term loans at end of period		8.21%	6.82%
Weighted average interest rate paid on term loans during period			4.52%
Payments to extinguish debt				35,700,000
Loss on extinguishment of debt	200,000			$ 200,000
New Senior Unsecured Notes \| Senior Notes
Debt Instrument [Line Items]
Debt instrument, face amount	$ 500,000,000
Effective rate on term loans at end of period		4.375%
ABL Facility \| Senior Notes
Debt Instrument [Line Items]
Debt issuance costs		$ 0	$ 0
ABL Facility \| Second Lien Credit Agreement \| Senior Notes
Debt Instrument [Line Items]
Debt instrument, face amount					$ 400,000,000
Available borrowing capacity		$ 394,700,000
ABL Facility \| Second Lien Credit Agreement \| Senior Notes \| Secured Overnight Financing Rate
Debt Instrument [Line Items]
Basis spread on variable rate		1.75%
ABL Facility \| Second Lien Credit Agreement \| Senior Notes \| Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate		0.75%
ABL Facility \| Credit Agreements, Entered Into 2019 \| Senior Notes
Debt Instrument [Line Items]
Debt instrument, face amount			175,000,000			$ 225,000,000
Undrawn letters of credit issued and outstanding		$ 5,300,000	6,700,000
Available borrowing capacity			$ 168,300,000
Increase in borrowing capacity						$ 50,000,000
Commitment fee percentage		2.50%	2.50%
ABL Facility \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Minimum
Debt Instrument [Line Items]
Commitment fee, unused portion		0.25%	0.25%
ABL Facility \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Maximum
Debt Instrument [Line Items]
Commitment fee, unused portion		0.375%	0.375%
ABL Facility \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Secured Overnight Financing Rate \| Minimum
Debt Instrument [Line Items]
Basis spread on variable rate		1.25%	1.25%
ABL Facility \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Secured Overnight Financing Rate \| Maximum
Debt Instrument [Line Items]
Basis spread on variable rate		1.75%	1.75%
ABL Facility \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Base Rate \| Minimum
Debt Instrument [Line Items]
Basis spread on variable rate		0.25%	0.25%
ABL Facility \| Credit Agreements, Entered Into 2019 \| Senior Notes \| Base Rate \| Maximum
Debt Instrument [Line Items]
Basis spread on variable rate		0.75%	0.75%

STOCK-BASED INCENTIVE COMPENSATION - Narrative (Details) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	May 31, 2021	May 03, 2018
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Number of shares authorized (in shares)				9,101,734
Exercise of stock options, vesting of restricted stock, and related tax withholdings	$ 0	$ 0	$ 0
Initial percentage of target shares granted	100.00%
Stock Option
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based compensation expense	$ 6,500,000	$ 2,500,000	$ 1,900,000
Weighted-average grant-date fair value per share (in dollars per share)	$ 15.72	$ 12.51	$ 17.79
Value of shares surrendered to satisfy tax withholding obligations	$ 300,000	$ 700,000	$ 100,000
Unrecognized compensation expense	$ 13,000,000
Weighted average period of recognition	1 year 2 months 12 days
Restricted Stock
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based compensation expense	$ 16,600,000	10,200,000	4,900,000
Value of shares surrendered to satisfy tax withholding obligations	4,400,000	1,400,000	0
Unrecognized compensation expense	$ 31,400,000
Weighted average period of recognition	1 year 2 months 12 days
Value of shares vested in period	$ 9,900,000	3,700,000	1,200,000
Performance Stock Units
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Vesting period	3 years
Average performance period	2 years
2023 Performance Stock Units
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based compensation expense	$ 2,200,000
Unrecognized compensation expense	$ 5,500,000
Weighted average period of recognition	2 years 2 months 12 days
2022 Performance Stock Units
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based compensation expense	$ 2,900,000	2,400,000
Unrecognized compensation expense	$ 3,300,000
Weighted average period of recognition	1 year 2 months 12 days
2021 Performance Stock Units
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based compensation expense	$ 2,400,000	$ 1,700,000	$ 2,700,000
Unrecognized compensation expense	$ 300,000
Weighted average period of recognition	2 months 12 days
The 2018 Plan
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Number of shares authorized (in shares)				4,999,999	4,101,735
Minimum
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercisable range of years	7 years
Percentage of target shares granted	0.00%
Minimum \| Stock Option
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Vesting period	3 years
Minimum \| Restricted Stock
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Vesting period	1 year
Maximum
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercisable range of years	10 years
Percentage of target shares granted	200.00%
Maximum \| Stock Option
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Vesting period	4 years
Maximum \| Restricted Stock
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Vesting period	4 years
Director \| Restricted Stock
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Vesting period	3 years

REVENUE - Net Revenue Earned by Category of Payer (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Disaggregation of Revenue [Line Items]
Net revenue	$ 4,302,324	$ 3,944,735	$ 3,438,640
Commercial payers
Disaggregation of Revenue [Line Items]
Net revenue	3,747,568	3,421,888	2,971,900
Government payers
Disaggregation of Revenue [Line Items]
Net revenue	500,891	477,818	417,088
Patients
Disaggregation of Revenue [Line Items]
Net revenue	$ 53,865	$ 45,029	$ 49,652

- 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//1943274/2147479806/606-10-50-4

+ Details

REVENUE (Tables)

12 Months Ended

Dec. 31, 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 years ended December 31, 2023, 2022 and 2021 (in thousands):


	Year Ended December 31,
	2023		2022		2021
Commercial payers	$	3,747,568	$	3,421,888	$	2,971,900
Government payers	500,891		477,818		417,088
Patients	53,865		45,029		49,652
Net revenue	$	4,302,324	$	3,944,735	$	3,438,640

NATURE OF OPERATIONS AND PRESENTATION OF FINANCIAL STATEMENTS (Details)		12 Months Ended
	Mar. 03, 2023 shares	Dec. 31, 2023 pharmacy suite segment shares
Business Acquisition [Line Items]
Treasury stock, shares, acquired (in shares)	2,475,166	7,946,301
Number of service locations \| pharmacy		93
Number of infusion sites \| suite		84
Number of operating segments \| segment		1
Common Stock \| Secondary Offering
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%

INCOME TAXES - Income Tax Benefit (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
U.S. federal income tax expense (benefit):
Current	$ 56,474	$ 4,103	$ 0
Deferred	18,739	38,810	(30,411)
Federal income tax expense (benefit)	75,213	42,913	(30,411)
State income tax expense:
Current	20,253	9,182	6,817
Deferred	(3,814)	3,117	190
State income tax expense	16,439	12,299	7,007
Total income tax expense (benefit)	$ 91,652	$ 55,212	$ (23,404)

- Definition

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

+ References + Details

PROPERTY AND EQUIPMENT (Tables)

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Schedule of Property and Equipment

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


	December 31, 2023		December 31, 2022
Infusion pumps	$	36,943	$	34,942
Equipment, furniture and other	23,593		31,929
Leasehold improvements	99,725		99,085
Computer software, purchased and internally developed	50,572		34,922
Assets under development	33,668		29,411
	244,501		230,289
Less: accumulated depreciation	(123,871)		(121,968)
Property and equipment, net	$	120,630	$	108,321

The following table presents the amount of depreciation expense recorded in cost of revenue and operating expenses for the years ended December 31, 2023, 2022 and 2021 (in thousands):


	Year ended December 31,
	2023		2022		2021
Depreciation expense in cost of revenue	$	2,999	$	4,869	$	5,746
Depreciation expense in operating expenses	24,820		27,374		29,865
Total depreciation expense	$	27,819	$	32,243	$	35,611

INCOME TAXES - Narrative (Details) - USD ($)	1 Months Ended	12 Months Ended
INCOME TAXES - Narrative (Details) - USD ($)	Sep. 30, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Examination [Line Items]
Income tax expense (benefit)		$ 91,652,000	$ 55,212,000	$ (23,404,000)
Effective income tax rate		25.50%	26.80%	(20.10%)
Termination fee income		$ 21,800,000
Valuation allowance		6,371,000	$ 13,056,000	$ 13,151,000	$ 112,085,000
Net operating losses		56,980,000	62,027,000
Interest limitation carryforward		13,802,000	29,453,000
Unrecognized tax benefits		0	0
Interest Limitation Carryforwards
Income Tax Examination [Line Items]
Interest limitation carryforward		13,800,000	29,400,000
State
Income Tax Examination [Line Items]
Valuation allowance released	$ 5,800,000
Valuation allowance		6,400,000
State \| Federal Net Operating Loss Carryfowards Available To Offset Future Taxable Income
Income Tax Examination [Line Items]
Net operating losses		17,700,000	19,500,000
Federal
Income Tax Examination [Line Items]
Operating loss carryforwards		28,400,000
Net operating losses			$ 42,300,000
Federal \| Merger Operating Loss Carryforward
Income Tax Examination [Line Items]
Net operating losses		39,300,000
Federal \| Indefinite Carryforward Period
Income Tax Examination [Line Items]
Operating loss carryforwards		$ 10,900,000

GOODWILL AND OTHER INTANGIBLE ASSETS - Future Amortization Expense of Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
2024	$ 34,386
2025	34,176
2026	34,071
2027	33,931
2028	33,881
2029 and beyond	164,951
Total intangible assets, net	$ 335,396	$ 364,115

PROPERTY AND EQUIPMENT

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

PROPERTY AND EQUIPMENT

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


	December 31, 2023		December 31, 2022
Infusion pumps	$	36,943	$	34,942
Equipment, furniture and other	23,593		31,929
Leasehold improvements	99,725		99,085
Computer software, purchased and internally developed	50,572		34,922
Assets under development	33,668		29,411
	244,501		230,289
Less: accumulated depreciation	(123,871)		(121,968)
Property and equipment, net	$	120,630	$	108,321

Depreciation expense is recorded within cost of revenue and operating expenses within the 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 years ended December 31, 2023, 2022 and 2021 (in thousands):


	Year ended December 31,
	2023		2022		2021
Depreciation expense in cost of revenue	$	2,999	$	4,869	$	5,746
Depreciation expense in operating expenses	24,820		27,374		29,865
Total depreciation expense	$	27,819	$	32,243	$	35,611

INCOME TAXES - Income Taxes (Tables)

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Schedule of Income Tax Expense (Benefit)

The income tax expense (benefit) consists of the following for the years ended December 31, 2023, 2022 and 2021 (in thousands):


	Year Ended December 31,
	2023		2022		2021
U.S. federal income tax expense (benefit):
Current	$	56,474	$	4,103	$	—
Deferred	18,739		38,810		(30,411)
	75,213		42,913		(30,411)
State income tax expense:
Current	20,253		9,182		6,817
Deferred	(3,814)		3,117		190
	16,439		12,299		7,007
Total income tax expense (benefit)	$	91,652	$	55,212	$	(23,404)

Schedule of Effective Income Tax Rate Reconciliation

The difference between the statutory federal income tax rate and the effective tax rate is as follows for the years ended December 31, 2023, 2022 and 2021:


	Year Ended December 31,
	2023		2022		2021
U.S. federal statutory tax rate	21.0	%	21.0	%	21.0	%
State and local income taxes net of federal tax benefit	4.8	%	5.0	%	4.9	%
Non-deductible expenses	0.1	%	0.2	%	0.3	%
Valuation allowance	(1.5)	%	0.0	%	(46.2)	%
Non-deductible and stock-based compensation	0.7	%	0.4	%	0.0	%
Other, net	0.4	%	0.2	%	(0.1)	%
Effective income tax rate	25.5	%	26.8	%	(20.1)	%

Schedule of Deferred Tax Assets and Liabilities

The components of deferred income tax assets and liabilities were as follows as of December 31, 2023 and 2022 (in thousands):


	December 31, 2023		December 31, 2022
Deferred tax assets:
Price concessions	$	5,365	$	6,169
Compensation and benefits	7,609		5,517
Interest limitation carryforward	13,802		29,453
Operating lease liability	26,378		22,765
Net operating losses	56,980		62,027
Other	7,556		6,576
Deferred tax assets before valuation allowance	117,690		132,507
Valuation allowance	(6,371)		(13,056)
Deferred tax assets net of valuation allowance	111,319		119,451

Deferred tax liabilities:
Accelerated depreciation	(8,882)		(7,026)
Operating lease right-of-use asset	(21,504)		(18,076)
Intangible assets	(52,502)		(57,673)
Goodwill	(52,188)		(44,949)
Other	(11,163)		(13,881)
Deferred tax liabilities	(146,239)		(141,605)
Net deferred tax liabilities	$	(34,920)	$	(22,154)

Summary of Valuation Allowance

The following table presents the valuation allowance for deferred tax assets for the years ended December 31, 2023, 2022 and 2021 (in thousands):


			Additions
Description	Balance at Beginning of Period		Charged (Benefit) to Costs and Expenses		Charged (Benefit) to Other Accounts		Balance at End of Period
2021: Valuation allowance for deferred tax assets	$	112,085	$	(96,136)	$	(2,798)	$	13,151
2022: Valuation allowance for deferred tax assets	$	13,151	$	(95)	$	—	$	13,056
2023: Valuation allowance for deferred tax assets	$	13,056	$	(6,685)	$	—	$	6,371

GOODWILL AND OTHER INTANGIBLE ASSETS - Narrative (Details) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill impairment	$ 0	$ 0	$ 0
Amortization expense for intangible assets	$ 34,200,000	$ 32,900,000	$ 32,900,000

INCOME TAXES

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

INCOME TAXES

The income tax expense (benefit) consists of the following for the years ended December 31, 2023, 2022 and 2021 (in thousands):


	Year Ended December 31,
	2023		2022		2021
U.S. federal income tax expense (benefit):
Current	$	56,474	$	4,103	$	—
Deferred	18,739		38,810		(30,411)
	75,213		42,913		(30,411)
State income tax expense:
Current	20,253		9,182		6,817
Deferred	(3,814)		3,117		190
	16,439		12,299		7,007
Total income tax expense (benefit)	$	91,652	$	55,212	$	(23,404)

The difference between the statutory federal income tax rate and the effective tax rate is as follows for the years ended December 31, 2023, 2022 and 2021:


	Year Ended December 31,
	2023		2022		2021
U.S. federal statutory tax rate	21.0	%	21.0	%	21.0	%
State and local income taxes net of federal tax benefit	4.8	%	5.0	%	4.9	%
Non-deductible expenses	0.1	%	0.2	%	0.3	%
Valuation allowance	(1.5)	%	0.0	%	(46.2)	%
Non-deductible and stock-based compensation	0.7	%	0.4	%	0.0	%
Other, net	0.4	%	0.2	%	(0.1)	%
Effective income tax rate	25.5	%	26.8	%	(20.1)	%

The Company recorded income tax expense of $91.7 million and $55.2 million, which represents an effective tax rate of 25.5% and 26.8% for the years ended December 31, 2023 and 2022, respectively. The income tax expense for the year ended December 31, 2023 includes $21.8 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. In September 2023, the Company released $5.8 million of state valuation allowance. The variance in the Company’s effective tax rate of 25.5% and 26.8% for the years ended December 31, 2023 and 2022, respectively, is primarily attributable to the difference in state taxes, various non-deductible expenses, and a change in state valuation allowance. The variance in the Company’s effective tax rate of 25.5% for the year ended December 31, 2023 compared to the federal statutory rate of 21% is also primarily attributable to state taxes, various non-deductible expenses, and a change in state valuation allowance. The variance in the Company’s effective tax rate of 26.8% and negative 20.1% for the years ended December 31, 2022 and 2021, respectively, is primarily attributable to the release of the Company’s federal valuation allowance for the year ended December 31, 2021.

The components of deferred income tax assets and liabilities were as follows as of December 31, 2023 and 2022 (in thousands):


	December 31, 2023		December 31, 2022
Deferred tax assets:
Price concessions	$	5,365	$	6,169
Compensation and benefits	7,609		5,517
Interest limitation carryforward	13,802		29,453
Operating lease liability	26,378		22,765
Net operating losses	56,980		62,027
Other	7,556		6,576
Deferred tax assets before valuation allowance	117,690		132,507
Valuation allowance	(6,371)		(13,056)
Deferred tax assets net of valuation allowance	111,319		119,451

Deferred tax liabilities:
Accelerated depreciation	(8,882)		(7,026)
Operating lease right-of-use asset	(21,504)		(18,076)
Intangible assets	(52,502)		(57,673)
Goodwill	(52,188)		(44,949)
Other	(11,163)		(13,881)
Deferred tax liabilities	(146,239)		(141,605)
Net deferred tax liabilities	$	(34,920)	$	(22,154)

Deferred tax assets are generally required to be reduced by a valuation allowance if it is more likely than not that some portion or all of the deferred tax assets will not be realized. For the year ended December 31, 2023, the Company maintains a valuation allowance of $6.4 million against certain state net operating losses (“NOL”). In assessing the realizability of deferred tax assets, the Company considers whether it is more likely than not that some or all the deferred tax assets will not be realized. The ultimate realization of deferred tax assets depends on the generation of future taxable income during the periods in which those temporary differences are deductible. The Company considers the scheduled reversal of deferred tax liabilities, including the effect in available carryback and carryforward periods, projected taxable income and tax-planning strategies, in making this assessment. On a quarterly basis, the Company evaluates all positive and negative evidence in determining if the valuation allowance is fairly stated.

The Company is subject to taxation in the United States and various states. At December 31, 2023, the Company had $39.3 million of tax-effected federal NOL carryforwards all of which are currently available to offset future taxable income in the United States and reflected as a deferred tax asset of the company. Tax-effected federal NOL carryforwards of $28.4 million expire beginning in 2028 through 2036, and $10.9 million of tax-effected federal NOLs have an indefinite carryforward period. At December 31, 2022, the Company had $42.3 million of tax-effected federal NOLs. At December 31, 2023 and 2022, the Company had $13.8 million and $29.4 million tax-effected amounts of interest limitation carryforwards which have an indefinite carryforward period. At December 31, 2023 and 2022, the Company also had $17.7 million and $19.5 million tax-effected amounts of cumulative state NOL carryforwards available to offset future taxable income in various states. These state NOL carryforwards will begin to expire beginning in 2024 through 2042, with some having an indefinite carryforward period.

At December 31, 2023 and 2022, there were no unrecognized tax benefits for uncertain tax positions.

The following table presents the valuation allowance for deferred tax assets for the years ended December 31, 2023, 2022 and 2021 (in thousands):


			Additions
Description	Balance at Beginning of Period		Charged (Benefit) to Costs and Expenses		Charged (Benefit) to Other Accounts		Balance at End of Period
2021: Valuation allowance for deferred tax assets	$	112,085	$	(96,136)	$	(2,798)	$	13,151
2022: Valuation allowance for deferred tax assets	$	13,151	$	(95)	$	—	$	13,056
2023: Valuation allowance for deferred tax assets	$	13,056	$	(6,685)	$	—	$	6,371

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

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
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-Subparagraph (SX 210.4-08(h)(2))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
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-Publisher FASB
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
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-Paragraph 21
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
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-Topic 740
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 30
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-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482603/740-30-50-2

+ Details

STOCK-BASED INCENTIVE COMPENSATION - Summary of Restricted Stock Award Activity (Details) - Restricted Stock	12 Months Ended
	Dec. 31, 2023 $ / shares shares
Restricted Stock
Beginning balance (in shares) \| shares	1,668,847
Granted (in shares) \| shares	945,589
Vested and issued (in shares) \| shares	(504,597)
Forfeited and expired (in shares) \| shares	(226,723)
Ending balance (in shares) \| shares	1,883,116
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value [Abstract]
Beginning balance (in dollars per share) \| $ / shares	$ 22.45
Shares granted (in dollars per share) \| $ / shares	29.02
Vested and issued (in dollars per share) \| $ / shares	19.54
Forfeited and expired (in dollars per share) \| $ / shares	24.86
Ending balance (in dollars per share) \| $ / shares	$ 26.28

RELATED-PARTY TRANSACTIONS	12 Months Ended
RELATED-PARTY TRANSACTIONS	Dec. 31, 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 $5.3 million, $4.1 million and $3.5 million for the years ended December 31, 2023, 2022 and 2021, respectively. Management fees are recorded in net revenues in the accompanying consolidated statements of comprehensive income. The Company had amounts due to its joint ventures of $0.5 million and due from its joint ventures of $0.1 million as of December 31, 2023. The Company had amounts due to its joint ventures of $1.5 million as of December 31, 2022. These receivables were included in prepaid expenses and other current assets in the accompanying balance sheets and these payables were included in accrued expenses and other current liabilities in the accompanying balance sheets. These balances primarily relate to cash collections received by the Company on behalf of the joint ventures, offset by certain pharmaceutical inventories purchased by the Company on behalf of the joint ventures. 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
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

+ Details

GOODWILL AND OTHER INTANGIBLE ASSETS - Carrying Amount and Accumulated Amortization of Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	$ 554,519	$ 549,066
Total accumulated amortization	(219,123)	(184,951)
Total intangible assets, net	335,396	364,115
Referral sources
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	514,388	509,646
Total accumulated amortization	(199,084)	(167,902)
Trademarks/names
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	39,136	38,508
Total accumulated amortization	(19,698)	(16,901)
Other amortizable intangible assets
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	995	912
Total accumulated amortization	$ (341)	$ (148)

DERIVATIVE INSTRUMENTS (Tables)

12 Months Ended

Dec. 31, 2023

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Summary of Amount and Location of Derivatives in the Balance Sheet

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


	Fair Value - Derivatives in Asset Position
Derivative	Balance Sheet Caption	December 31, 2023		December 31, 2022
Interest rate cap designated as cash flows hedge	Prepaid expenses and other current assets	$	9,746	$	10,926
Interest rate cap designated as cash flows hedge	Other noncurrent assets	10,183		17,342
Total derivative assets		$	19,929	$	28,268

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

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


	Year Ended December 31,
Derivative	2023		2022		2021
Interest rate cap designated as cash flows hedge	$	(8,339)	$	28,869	$	(601)
Interest rate swap designated as cash flows hedge	—		—		11,172
Total	$	(8,339)	$	28,869	$	10,571

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


		Year Ended December 31,
Derivative	Income Statement Caption	2023		2022		2021
Interest rate cap designated as cash flows hedge	Interest expense	$	10,974	$	1,090	$	(239)
Interest rate swap designated as cash flows hedge	Interest expense	—		—		(11,298)
Interest rate swap not designated as hedge	Interest expense	—		—		(2)
Total		$	10,974	$	1,090	$	(11,539)

EMPLOYEE BENEFIT PLANS (Details) - USD ($) $ in Millions	12 Months Ended
EMPLOYEE BENEFIT PLANS (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Retirement Benefits [Abstract]
Employer matching contribution percent	100.00%
Employer matching contribution percent of employees' gross pay	4.00%
Defined contribution plan expense	$ 13.1	$ 12.2	$ 11.6
Company contributions	$ 12.4	$ 11.8	$ 10.9

STOCK-BASED INCENTIVE COMPENSATION (Tables)

12 Months Ended

Dec. 31, 2023

Share-Based Payment Arrangement [Abstract]

Schedule of Fair Value of Awards

The assumptions used to compute the fair value of options for the years ended December 31, 2023, 2022 and 2021 are as follows:


	Year Ended December 31,
	2023		2022		2021
Expected volatility	51.43	%	51.19	%	51.92	%
Risk-free interest rate	4.16	%	3.91	%	1.40	%
Expected life of options	6.2 years		6.2 years		6.5 years
Dividend rate	—		—		—

Summary of Stock Option Activity

A summary of stock option activity for the year ended December 31, 2023 is as follows:


	Options	Weighted Average Exercise Price		Aggregate Intrinsic Value (thousands)		Weighted Average Remaining Contractual Life
Balance at December 31, 2022	1,021,370	$	21.63	$	8,816
Granted	872,264	$	28.87	$	4,208
Exercised	(60,106)	$	18.56	$	827
Forfeited and expired	(87,256)	$	28.13	$	561
Balance at December 31, 2023	1,746,272	$	25.08	$	15,028	8.19 years
Exercisable at December 31, 2023	283,571	$	17.07	$	4,713	6.36 years

Summary of Outstanding Options by Exercise Price Range

The following table outlines the outstanding and exercisable stock options as of December 31, 2023:


	Options Outstanding				Options Exercisable
Range of Option Exercise Price	Outstanding Options	Weighted Average Exercise Price		Weighted Average Remaining Contractual Life	Options Exercisable	Weighted Average Exercise Price
$0.00 - $8.24	9,901	$	6.52	3.1 years	9,901	$	6.52
$8.24 - $16.52	132,752	$	12.44	5.4 years	108,767	$	12.24
$16.52 - $24.76	460,969	$	21.41	7.6 years	159,439	$	20.59
$24.76 - $33.00	1,142,650	$	28.19	8.8 years	5,464	$	29.51





All options	1,746,272				283,571

Summary of Restricted Stock Award Activity

A summary of restricted stock award activity for the year ended December 31, 2023 is as follows:


	Restricted Stock	Weighted Average Grant Date Fair Value
Balance at December 31, 2022	1,668,847	$	22.45
Granted	945,589	$	29.02
Vested and issued	(504,597)	$	19.54
Forfeited and expired	(226,723)	$	24.86
Balance at December 31, 2023	1,883,116	$	26.28

RELATED-PARTY TRANSACTIONS (Details) - USD ($) $ in Thousands			12 Months Ended
	Mar. 03, 2023	Feb. 28, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Related Party Transaction [Line Items]
NET REVENUE			$ 4,302,324	$ 3,944,735	$ 3,438,640
Shares repurchased		$ 75,000	$ 250,000
Treasury stock, shares, acquired (in shares)	2,475,166		7,946,301
Joint Venture
Related Party Transaction [Line Items]
Due to joint ventures			$ 500	1,500
Due from joint ventures			100
Joint Venture \| Management Fee Income
Related Party Transaction [Line Items]
NET REVENUE			$ 5,300	$ 4,100	$ 3,500

- Definition

+ References

+ Details

DERIVATIVE INSTRUMENTS - Additional Information (Details) - USD ($) $ in Millions	1 Months Ended
	Oct. 31, 2021	Dec. 31, 2023	Aug. 31, 2019
Derivative [Line Items]
Total interest rate costs expected to reclassify during next 12 months		$ 2.8
Interest Rate Swap
Derivative [Line Items]
Notional amount of derivative			$ 925.0
Interest Rate Swap \| Not Designated as Hedging Instrument
Derivative [Line Items]
Notional amount of derivative			13.9
Interest Rate Swap \| Cash Flow Hedging \| Designated as Hedging Instrument
Derivative [Line Items]
Notional amount of derivative			$ 911.1
Interest rate cap designated as cash flows hedge \| Designated as Hedging Instrument \| First Lien Term Loan \| Senior Notes
Derivative [Line Items]
Notional amount of derivative	$ 300.0
Derivative term of contract	5 years

REVENUE

12 Months Ended

Dec. 31, 2023

Revenue from Contract with Customer [Abstract]

REVENUE

The following table sets forth the net revenue earned by category of payer for the years ended December 31, 2023, 2022 and 2021 (in thousands):


	Year Ended December 31,
	2023		2022		2021
Commercial payers	$	3,747,568	$	3,421,888	$	2,971,900
Government payers	500,891		477,818		417,088
Patients	53,865		45,029		49,652
Net revenue	$	4,302,324	$	3,944,735	$	3,438,640

- 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
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-9

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-10

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 15
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-15

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-13

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Topic 606
-Publisher FASB
-URI https://asc.fasb.org//606/tableOfContent

+ Details

DERIVATIVE INSTRUMENTS

12 Months Ended

Dec. 31, 2023

Derivative Instruments and Hedging Activities Disclosure [Abstract]

DERIVATIVE INSTRUMENTS

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

In August 2019, the Company entered into an interest rate swap agreement that reduced the variability in the interest rates on the newly-issued debt obligations following the Merger with BioScrip. The interest rate swap for $925.0 million notional was effective in August 2019 with $911.1 million designated as a cash flows hedge against the underlying interest rate on the First Lien Term Loan interest payments indexed to one-month LIBOR through August 2021. In accordance with ASU 2017-12, Targeted Improvements to Accounting for Hedges, the Company had determined that the $911.1 million designated cash flows hedge is perfectly effective. The remaining $13.9 million notional amount of the interest rate swap is not designated as a hedging instrument. The interest rate swap expired in August 2021.

In October 2021, the Company entered into an interest rate cap hedge with a notional amount of $300.0 million for a five-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.

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


	Fair Value - Derivatives in Asset Position
Derivative	Balance Sheet Caption	December 31, 2023		December 31, 2022
Interest rate cap designated as cash flows hedge	Prepaid expenses and other current assets	$	9,746	$	10,926
Interest rate cap designated as cash flows hedge	Other noncurrent assets	10,183		17,342
Total derivative assets		$	19,929	$	28,268

The gain and loss associated with the changes in the fair value of the effective portion of hedging instruments are recorded into other comprehensive (loss) income. The gain and loss associated with the changes in the fair value of the hedging instruments not designated are recognized in net income through interest expense. The following table presents the pre-tax (loss) gain from derivative instruments recognized in other comprehensive (loss) income in the Company’s consolidated statements of comprehensive income (in thousands):


	Year Ended December 31,
Derivative	2023		2022		2021
Interest rate cap designated as cash flows hedge	$	(8,339)	$	28,869	$	(601)
Interest rate swap designated as cash flows hedge	—		—		11,172
Total	$	(8,339)	$	28,869	$	10,571


		Year Ended December 31,
Derivative	Income Statement Caption	2023		2022		2021
Interest rate cap designated as cash flows hedge	Interest expense	$	10,974	$	1,090	$	(239)
Interest rate swap designated as cash flows hedge	Interest expense	—		—		(11,298)
Interest rate swap not designated as hedge	Interest expense	—		—		(2)
Total		$	10,974	$	1,090	$	(11,539)

The Company expects to reclassify $2.8 million of total interest rate costs from accumulated other comprehensive income (loss) against interest expense during the next 12 months.

COMMITMENTS AND CONTINGENCIES	12 Months Ended
COMMITMENTS AND CONTINGENCIES	Dec. 31, 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 does not believe that any of these pending matters, after consideration of applicable reserves and rights to indemnification, will have a material adverse effect on the Company’s consolidated balance sheets. However, substantial unanticipated verdicts, fines, and rulings may occur. As a result, the Company may from time to time incur judgments, enter into settlements, or revise expectations regarding the outcome of certain matters, and such developments could have a material adverse effect on its results of operations in the period in which the amounts are accrued and/or its cash flows in the period in which the amounts are paid.

STOCK-BASED INCENTIVE COMPENSATION - Summary of Outstanding and Exercisable Stock Options (Details)	12 Months Ended
	Dec. 31, 2023 $ / shares shares
Options Outstanding
Options Outstanding (in shares) \| shares	1,746,272
Options Exercisable
Options Exercisable (in shares) \| shares	283,571
$0.00 - $8.24
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Lower range limit (in dollars per share)	$ 0.00
Upper range limit (in dollars per share)	$ 8.24
Options Outstanding
Options Outstanding (in shares) \| shares	9,901
Weighted Average Exercise Price (in dollars per share)	$ 6.52
Weighted Average Remaining Contractual Life	3 years 1 month 6 days
Options Exercisable
Options Exercisable (in shares) \| shares	9,901
Weighted Average Exercise Price (in dollars per share)	$ 6.52
$8.24 - $16.52
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Lower range limit (in dollars per share)	8.24
Upper range limit (in dollars per share)	$ 16.52
Options Outstanding
Options Outstanding (in shares) \| shares	132,752
Weighted Average Exercise Price (in dollars per share)	$ 12.44
Weighted Average Remaining Contractual Life	5 years 4 months 24 days
Options Exercisable
Options Exercisable (in shares) \| shares	108,767
Weighted Average Exercise Price (in dollars per share)	$ 12.24
$16.52 - $24.76
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Lower range limit (in dollars per share)	16.52
Upper range limit (in dollars per share)	$ 24.76
Options Outstanding
Options Outstanding (in shares) \| shares	460,969
Weighted Average Exercise Price (in dollars per share)	$ 21.41
Weighted Average Remaining Contractual Life	7 years 7 months 6 days
Options Exercisable
Options Exercisable (in shares) \| shares	159,439
Weighted Average Exercise Price (in dollars per share)	$ 20.59
$24.76 - $33.00
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Lower range limit (in dollars per share)	24.76
Upper range limit (in dollars per share)	$ 33.00
Options Outstanding
Options Outstanding (in shares) \| shares	1,142,650
Weighted Average Exercise Price (in dollars per share)	$ 28.19
Weighted Average Remaining Contractual Life	8 years 9 months 18 days
Options Exercisable
Options Exercisable (in shares) \| shares	5,464
Weighted Average Exercise Price (in dollars per share)	$ 29.51

BUSINESS ACQUISITIONS AND DIVESTITURES - Acquired Identifiable Assets and Assumed Liabilities (Details) - USD ($) $ in Thousands		1 Months Ended		12 Months Ended
	Oct. 01, 2021	Aug. 31, 2022	Apr. 30, 2022	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Business Acquisition [Line Items]
Goodwill				$ 1,540,246	$ 1,533,424	$ 1,477,564	$ 1,428,610
Purchase price, net of cash acquired				$ 12,494	$ 87,364	$ 85,909
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
Cash acquired		(201)
Purchase price, net of cash acquired		27,418
Purchase price, net of cash acquired		$ 27,400
Specialty Pharmacy Nursing Network, Inc.
Business Acquisition [Line Items]
Accounts receivable			$ 2,303
Intangible assets			25,580
Other assets			600
Accrued compensation			(1,115)
Accounts payable and other liabilities			(1,168)
Fair value identifiable assets and liabilities			26,200
Goodwill			33,746
Cash acquired			661
Purchase price			60,607
Cash acquired			(661)
Purchase price, net of cash acquired			59,946
Purchase price, net of cash acquired			$ 59,900
Infinity Infusion Nursing LLC
Business Acquisition [Line Items]
Accounts receivable	$ 2,219
Intangible assets	25,400
Accounts payable and other assumed liabilities	(539)
Fair value identifiable assets and liabilities	27,080
Goodwill	32,524
Cash acquired	1,426
Purchase price	61,030
Cash acquired	(1,426)
Purchase price, net of cash acquired	$ 59,604

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	12 Months Ended
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	Dec. 31, 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 December 31, 2023, cash equivalents consisted of money market funds. Accounts Receivable — The Company’s accounts receivable are reported at the net realizable value amount that reflects the consideration the Company expects to receive in exchange for providing services, which is inclusive of adjustments for price concessions. The majority of accounts receivable are due from private insurance carriers and governmental healthcare programs, such as Medicare and Medicaid. Price concessions may result from patient hardships, patient uncollectible accounts sent to collection agencies, lack of recovery due to not receiving prior authorization, differing interpretations of covered therapies in payer contracts, different pricing methodologies, or various other reasons. In accordance with Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers (“ASC 606”), an allowance for doubtful accounts is established only as a result of an adverse change in the Company’s payers’ ability to pay outstanding billings. The Company had no allowance for doubtful accounts as of December 31, 2023 and 2022. Included in accounts receivable are earned but unbilled gross receivables of $89.1 million and $101.5 million as of December 31, 2023 and 2022, respectively. Delays ranging from one day up to several weeks between the date of service and billing can occur due to delays in obtaining certain required payer-specific documentation from internal and external sources. See Revenue Recognition for a further discussion of the Company’s revenue recognition policy. Inventories — Inventories, which consists primarily of pharmaceuticals, is stated at the lower of first‑in, first‑out cost or net realizable value basis, which the Company believes is reflective of the physical flow of inventories. Prepaid Expenses and Other Current Assets — Included in prepaid expenses and other current assets are rebates receivable from pharmaceutical and medical supply manufacturers of $52.0 million and $53.4 million for the years ended December 31, 2023 and 2022, respectively. Leases — The Company has lease agreements for facilities, warehouses, office space and property and equipment. At the inception of a contract, the Company determines if the contract is a lease or contains an embedded lease arrangement. Operating leases are included in the operating lease right-of-use asset (“ROU asset”) and operating lease liabilities in the consolidated financial statements. ROU assets, which represent the Company’s right to use the leased assets, and operating lease liabilities, which represent the present value of unpaid lease payments, are both recognized by the Company at the lease commencement date. The Company utilizes its estimated incremental borrowing rate at the lease commencement date to determine the present value of unpaid lease obligations. The rates are estimated primarily using a methodology dependent on the Company’s financial condition, creditworthiness, and availability of certain observable data. In particular, the Company considers its actual cost of borrowing for collateralized loans and its credit rating, along with the corporate bond yield curve in estimating its incremental borrowing rates. ROU assets are recorded as the amount of operating lease liability, adjusted for prepayments, accrued lease payments, initial direct costs, lease incentives, and impairment of the ROU asset. Tenant improvement allowances used to fund leasehold improvements are recognized when earned and reduce the related ROU asset. Tenant improvement allowances are recognized through the ROU asset as a reduction of expense over the term of the lease. Leases may contain rent escalations, however the Company recognizes the lease expense on a straight-line basis over the expected lease term. The Company reviews the terms of any lease renewal options to determine if it is reasonably certain that the renewal options will be exercised. The Company has determined that the expected lease term is typically the minimum non-cancelable period of the lease. The Company has lease agreements that contain both lease and non-lease components which the Company has elected to account for as a single lease component for all asset classes. Leases with an initial term of 12 months or less are not recorded on the consolidated balance sheet and are expensed on a straight-line basis over the term of the lease. The Company’s lease agreements do not contain any material residual value guarantees or material restrictive covenants. See Note 8, Leases, for further discussion of leases. Goodwill, Intangible Assets, Property and Equipment, and Referral Sources — Goodwill represents the excess of the purchase price over the fair value of assets acquired and liabilities assumed. The Company accounts for goodwill under ASC Topic 350, Intangibles-Goodwill and Other. The Company tests goodwill for impairment annually, or more frequently whenever events or circumstances indicate impairment may exist. Goodwill is stated at cost less accumulated impairment losses. The Company completes its goodwill impairment test annually in the fourth quarter on a qualitative basis. See Note 10, Goodwill and Other Intangible Assets, for further discussion of the Company’s goodwill and other intangible assets. Intangible assets arising from the Company’s acquisitions are amortized on a straight‑line basis over the estimated useful life of each asset. Referral sources have a useful life of fifteen to twenty years. Trademarks/names have a useful life ranging from two to fifteen years. The useful lives for other amortizable intangible assets range from approximately two to nine years. The Company does not have any indefinite‑lived intangible assets. Property and equipment is recorded at cost, net of accumulated depreciation. Depreciation on owned property and equipment is provided for on a straight‑line basis over the estimated useful lives of owned assets. Leasehold improvements are amortized over the estimated useful life of the property or over the term of the lease, whichever is shorter. Estimated useful lives are seven years for infusion pumps and three to thirteen years for equipment. Major repairs, which extend the useful life of an asset, are capitalized in the property and equipment accounts. Routine maintenance and repairs are expensed as incurred. Computer software is included in property and equipment and consists of purchased software and internally-developed software. The Company capitalizes application-stage development costs for significant internally-developed software projects. Once the software is ready for its intended use, these costs are amortized on a straight‑line basis over the software’s estimated useful life, generally five years. Costs recognized in the preliminary project phase and the post-implementation phase, as well as maintenance and training costs, are expensed as incurred. The Company assesses long‑lived assets for impairment whenever events or circumstances indicate that a certain asset or asset group may be impaired. If circumstances require a long-lived asset or asset group be tested for possible impairment, the Company first compares undiscounted cash flows expected to be generated by that asset or asset group to its carrying amount. If the carrying amount of the long-lived asset or asset group is not recoverable on an undiscounted cash flows basis, an impairment is recognized to the extent that the carrying amount exceeds its fair value. Equity-Method Investments — The Company’s investments in certain unconsolidated entities are accounted for under the equity method. The balance of these investments is included in other noncurrent assets in the accompanying consolidated balance sheets. As of December 31, 2023 and 2022, the balance of the investments was $20.9 million and $19.4 million, respectively. The investments are increased to reflect the Company’s capital contributions and equity in earnings of the investees. The investments are decreased to reflect the Company’s equity in losses of the investees and for distributions received that are not in excess of the carrying amount of the investments. The Company’s proportionate share of earnings or losses of the investees is recorded in equity in earnings of joint ventures in the accompanying consolidated statements of comprehensive income. The Company’s proportionate share of earnings was $5.5 million, $5.1 million and $6.0 million for the years ended December 31, 2023, 2022 and 2021, respectively. Distributions from the investees are treated as cash inflows from operating activities in the consolidated statements of cash flows. During the years ended December 31, 2023, 2022 and 2021, the Company received distributions from the investees of $4.0 million, $5.9 million and $2.9 million, respectively. See Note 17, Related-Party Transactions, for discussion of related-party transactions with these investees. Hedging Instruments — The Company uses derivative financial instruments to limit its exposure to increases in the interest rate of its variable rate debt instruments. The derivative financial instruments are recognized on the consolidated balance sheets at fair value. See Note 12, Derivative Instruments, for additional information. At inception of the hedge, the Company designated the derivative instruments as a hedge of the cash flows related to the interest on the variable rate debt. For all instruments designated as hedges, the Company documents the hedging relationships and its risk management objective of the hedging relationship. For all hedging instruments, the terms of the hedge perfectly offset the hedged expected cash flows. Revenue Recognition — Net revenue is reported at the net realizable value amount that reflects the consideration the Company expects to receive in exchange for providing goods and services. Revenues are from government payers, commercial payers, and patients for goods and services provided and are based on a gross price based on payer contracts, fee schedules, or other arrangements less any implicit price concessions. Due to the nature of the healthcare industry and the reimbursement environment in which the Company operates, certain estimates are required to record revenue and accounts receivable at their net realizable values at the time goods or services are provided. Inherent in these estimates is the risk that they will have to be revised or updated as additional information becomes available. The Company assesses the expected consideration to be received at the time of patient acceptance, based on the verification of the patient’s insurance coverage, historical information with the patient, similar patients, or the payer. Performance obligations are determined based on the nature of the services provided by the Company. The majority of the Company’s performance obligations are to provide infusion services to deliver medicine, nutrients, or fluids directly into the body. The Company provides a variety of infusion-related therapies to patients, which frequently include multiple deliverables of pharmaceutical drugs and related nursing services. After applying the criteria from ASC 606, the Company concluded that multiple performance obligations exist in its contracts with its customers. Revenue is allocated to each performance obligation based on relative standalone price, determined based on reimbursement rates established in the third-party payer contracts. Pharmaceutical drug revenue is recognized at the time the pharmaceutical drug is delivered to the patient, and nursing revenue is recognized on the date of service. The Company's outstanding performance obligations relate to contracts with a duration of less than one year. Therefore, the Company has elected to apply the practical expedient provided by ASC 606 and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. Any unsatisfied or partially unsatisfied performance obligations at the end of a reporting period are generally completed prior to the patient being discharged. See Note 4, Revenue for a further discussion of revenue. Cost of Revenue — Cost of revenue consists of the actual cost of pharmaceuticals and other medical supplies dispensed to patients, as well as all other costs directly related to the production of revenue. These costs include warehousing costs, purchasing costs, freight costs, cash discounts, wages and related costs for pharmacists and nurses, along with depreciation expense relating to revenue-generating assets, such as infusion pumps. The Company also receives rebates from pharmaceutical and medical supply manufacturers. Rebates are generally volume-based incentives and are recorded as a reduction of inventory and are accounted for as a reduction of cost of goods sold when the related inventory is sold. Selling, General and Administrative Expenses — Selling, general and administrative expenses mainly consist of salaries for administrative employees that directly and indirectly support the operations, occupancy costs, marketing expenditures, insurance, and professional fees. Stock Based Incentive Compensation — The Company accounts for stock-based incentive compensation expense in accordance with ASC Topic 718, Compensation-Stock Compensation (“ASC 718”). Stock-based incentive compensation expense is based on the grant date fair value. The Company estimates the fair value of stock option awards using a Black-Scholes option pricing model and the fair value of restricted stock unit awards using the closing price of the Company’s common stock on the grant date. For awards with a service-based vesting condition, the Company recognizes expense on a straight-line basis over the service period of the award. For awards with performance-based vesting conditions, the Company will recognize expense when it is probable that the performance-based conditions will be met. When the Company determines that it is probable that the performance-based conditions will be met, a cumulative catch-up of expense will be recorded as if the award had been vesting on a straight-line basis from the award date. The award will continue to be expensed on a straight-line basis through the remainder of the vesting period and will be updated if the Company determines that there has been a change in the probability of achieving the performance-based conditions. The Company records the impact of forfeited awards in the period in which the forfeiture occurs. Business Acquisitions — The Company accounts for business acquisitions in accordance with ASC Topic 805, Business Combinations, with assets and liabilities being recorded at their acquisition date fair value and goodwill being calculated as the purchase price in excess of the net identifiable assets. See Note 3, Business Acquisitions and Divestitures, for further discussion of the Company’s business acquisitions. Income Taxes — The Company accounts for income taxes using the asset and liability method. Deferred tax assets and liabilities are reported for book-tax basis differences and are measured based on currently enacted tax laws using rates expected to apply to taxable income in the years in which the differences are expected to reverse. The effect of a change in tax rate on deferred taxes is recognized in income tax expense in the period that includes the enactment date of the change. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. Valuation allowances are established when necessary to reduce deferred tax assets to the amounts more likely than not to be realized. The Company recognizes income tax positions that are more likely than not to be sustained on their technical merits. The Company measures recognized income tax positions at the maximum benefit that is more likely than not, based on cumulative probability, realizable upon final settlement of the position. Interest and penalties related to unrecognized tax benefits are reported in income tax expense (benefit). 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%, 14% and 16% for the years ended December 31, 2023, 2022 and 2021, respectively. There were no other managed care contracts that represent greater than 10% of revenue for the years presented. For the years ended December 31, 2023, 2022 and 2021, approximately 12%, 12% and 12%, respectively, of the Company’s revenue was reimbursable through direct government healthcare programs such as Medicare and Medicaid. As of December 31, 2023 and 2022, approximately 12% and 13%, respectively, of the Company’s accounts receivable was related to these programs. Governmental programs pay for services based on fee schedules and rates that are determined by the related governmental agency. Laws and regulations pertaining to government programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility that recorded estimates will change in the near term. The Company does not require its patients nor other payers to carry collateral for any amounts owed for goods or services provided. Other than as discussed above, concentrations of credit risk relating to trade accounts receivable is limited due to the Company’s diversity of patients and payers. Further, the Company generally does not provide charity care; however, Option Care Health offers a financial assistance program for patients that meet certain defined hardship criteria. For the years ended December 31, 2023, 2022, and 2021, approximately 72%, 73% and 74%, 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 — The fair value measurement accounting standard, ASC Topic 820, Fair Value Measurement (“ASC 820”), provides a framework for measuring fair value and defines fair value as the price that would be received to sell an asset or paid to transfer a liability. Fair value is a market-based measurement that should be determined using assumptions that market participants would use in pricing an asset or liability. The standard establishes a valuation hierarchy for inputs used in measuring fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs by requiring that the most observable inputs be used when available. Observable inputs are inputs market participants would use in valuing the asset or liability developed based on independent market data sources. Unobservable inputs are inputs that reflect the Company’s assumptions about the factors market participants would use in valuing the asset or liability developed based upon the best information available. The valuation hierarchy is composed of three categories. The categorization within the valuation hierarchy is based on the lowest level of input that is significant to the fair value measurement. The categories within the valuation hierarchy are described as follows: •Level 1 - Inputs to the fair value measurement are quoted prices in active markets for identical assets or liabilities. •Level 2 - Inputs to the fair value measurement include quoted prices in active markets for similar assets or liabilities, quoted prices for identical or similar assets or liabilities in markets that are not active, and inputs other than quoted prices that are observable for the asset or liability, either directly or indirectly. •Level 3 - Inputs to the fair value measurement are unobservable inputs or valuation techniques. While the Company believes its valuation methods are appropriate and consistent with other market participants, the use of different methodologies or assumptions to determine the fair value of certain financial instruments could result in a different fair value measurement at the reporting date. Recently Issued Accounting Pronouncements — In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. This ASU addresses investor requests for more transparency about income tax information through improvements to income tax disclosures primarily related to the rate reconciliation and income taxes paid information. The ASU improves the transparency of income tax disclosures by requiring consistent categories and greater disaggregation of information in the rate reconciliation and income taxes paid disaggregated by jurisdiction. The ASU allows investors to better assess, in their capital allocation decisions, how an entity’s worldwide operations and related tax risks and tax planning and operational opportunities affect its income tax rate and prospects for future cash flows. This ASU also improves the effectiveness and comparability of disclosures by adding disclosures of pretax income (loss) and income tax expense (benefit) to be consistent with U.S. Securities and Exchange Commission (“SEC”) Regulation S-X and removing disclosures that no longer are considered cost beneficial or relevant. The Company is required to adopt this ASU for annual periods beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the impact of this ASU on its results of operations, cash flows, financial position, and disclosures. In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures. This ASU improves the disclosures about a public entity’s reportable segments and addresses requests from investors for additional, more detailed information about a reportable segment’s expenses. The ASU improves financial reporting by requiring disclosure of incremental segment information on an annual and interim basis for all public entities, including those public entities that have a single reportable segment, to enable investors to develop more decision-useful financial analyses. The Company is required to adopt this ASU for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. Once adopted the Company will apply the ASU retrospectively to all prior periods presented in the financial statements. The Company is currently evaluating the impact of this ASU on its results of operations, cash flows, financial position, and disclosures. In October 2023, the FASB issued ASU 2023-06, Disclosure Improvements: Codification Amendments in Response to the SEC’s Disclosure Update and Simplification Initiative. This ASU is the result of the Board’s decision to incorporate into the Codification 14 disclosures referred by the SEC. The ASU represents changes to clarify or improve disclosure and presentation requirements of a variety of Topics. Many of the amendments allow users to more easily compare entities subject to the SEC’s existing disclosures with those entities that were not previously subject to the SEC’s requirements. Also, the amendments align the requirements in the Codification with the SEC’s regulations. The effective date for each amendment will be the date on which the SEC’s removal of that related disclosure from Regulation S-X or Regulation S-K becomes effective, with early adoption permitted. If by June 30, 2027, the SEC has not removed the applicable requirement from Regulation S-X or Regulation S-K, the pending content of the related amendment will be removed from the Codification and will not become effective. The Company is currently evaluating the impact of this ASU on its results of operations, cash flows, financial position, and disclosures.

EARNINGS PER SHARE - Schedule of Basic and Diluted Earnings (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Jun. 26, 2023
Earnings Per Share, Diluted, by Common Class, Including Two Class Method [Line Items]
Net (loss) income	$ 267,090	$ 150,556	$ 139,898
Weighted average common shares outstanding, basic (in shares)	178,973	181,105	179,855
Earnings per share, basic (in dollars per share)	$ 1.49	$ 0.83	$ 0.78
Effect of dilutive securities (in shares)	1,402	970	1,350
Weighted average common shares outstanding, diluted (in shares)	180,375	182,075	181,205
Earnings per share, diluted (in dollars per share)	$ 1.48	$ 0.83	$ 0.77
Other nonoperating income	$ 5,300
Amedisys, Inc.
Earnings Per Share, Diluted, by Common Class, Including Two Class Method [Line Items]
Termination fee	$ 63,100			$ 106,000

LEASES (Tables)

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Maturities of Lease Liabilities, Operating

Operating leases mature as follows (in thousands):


Fiscal Year Ended December 31,	Minimum Payments
2024	$	24,610
2025	22,447
2026	19,567
2027	16,281
2028	10,980
2029 and beyond	34,528
Total lease payments	128,413
Less: interest	(24,651)
Present value of lease liabilities	$	103,762

INDEBTEDNESS - Summary of Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Oct. 31, 2021
Debt Instrument [Line Items]
Principal Amount	$ 1,088,000	$ 1,094,000
Discount	(6,974)	(8,307)
Debt Issuance Costs	(18,376)	(21,489)
Net Balance	1,062,650	1,064,204
Less: current portion	(6,000)	(6,000)
Total long-term debt	1,056,650	1,058,204
Senior Notes \| First Lien Term Loan
Debt Instrument [Line Items]
Principal Amount	588,000	594,000
Discount	(6,974)	(8,307)
Debt Issuance Costs	(9,678)	(11,529)	$ (8,800)
Net Balance	571,348	574,164
Senior Notes \| Senior Notes
Debt Instrument [Line Items]
Principal Amount	500,000	500,000
Discount	0	0
Debt Issuance Costs	(8,698)	(9,960)
Net Balance	491,302	490,040
Senior Notes \| ABL Facility
Debt Instrument [Line Items]
Principal Amount	0	0
Discount	0	0
Debt Issuance Costs	0	0
Net Balance	$ 0	$ 0

INDEBTEDNESS

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

INDEBTEDNESS

Long-term debt consisted of the following as of December 31, 2023 (in thousands):


	Principal Amount		Discount		Debt Issuance Costs		Net Balance
Revolver Facility	$	—	$	—	$	—	$	—
First Lien Term Loan	588,000		(6,974)		(9,678)		571,348
Senior Notes	500,000		—		(8,698)		491,302
	$	1,088,000	$	(6,974)	$	(18,376)	1,062,650
Less: current portion							(6,000)
Total long-term debt							$	1,056,650

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

On December 7, 2023, the Company entered into the second amendment (the “Amendment”) to the amended and restated First Lien Credit Agreement dated as of October 27, 2021. The Amendment, among other things, provides for revolving credit commitments by the applicable Revolving Credit Lenders in an aggregate amount of $400.0 million (the “Revolver Facility”) pursuant to which such lenders have agreed to make Revolving Credit Loans to the Company. As of December 31, 2023, the Company had $5.3 million of undrawn letters of credit issued and outstanding, resulting in net borrowing availability under the Revolver Facility of $394.7 million. The Revolver Facility matures on the date that is the earlier of (i) December 7, 2028 and (ii) the date that is 91 days prior to the stated maturity date applicable to any Term B Loans. Borrowings under the Revolver Facility bear interest at a rate equal to, at the option of the Company, either (i) the Term Secured Overnight Financing Rate (“SOFR”) applicable thereto plus the Applicable Rate or (ii) the then applicable Base Rate plus the Applicable Rate, which Applicable Rate shall be, subject to certain caveats thereto, as follows (i) until delivery of financial statements and related Compliance Certificate for the first full fiscal quarter ending after the effective date of the Amendment, (A) for Term SOFR Loans, 1.75%, (B) for Base Rate Loans, 0.75% and (ii) thereafter, the following percentages per annum, based upon the Total Net Leverage Ratio as set forth in the most recent Compliance Certificate received by the Administrative Agent pursuant to the terms of the Credit Agreement. The table below illustrates the aforementioned interest rate terms:


Pricing Level	Total Net Leverage Ratio	Applicable Rate for Term SOFR Loans	Applicable Rate for Base Rate Loans
I	Greater than or equal to 3.00x	2.25%	1.25%
II	Less than 3.00x, but greater than or equal to 2.25x	2.00%	1.00%
III	Less than 2.25x, but greater than or equal to 1.50x	1.75%	0.75%
IV	Less than 1.50x, but greater than or equal to 1.00x	1.50%	0.50%
V	Less than 1.00x	1.25%	0.25%

Concurrently with the creation of the Revolver Facility, the Company terminated the ABL Credit Agreement. Prior to the transition to the Revolver Facility, the ABL Facility had been in effect from August 6, 2019 to December 7, 2023. As of December 31, 2022, the Company’s ABL Facility provided for borrowings up to $175.0 million and had a maturity date of October 27, 2026. Effective January 13, 2023, the Company entered into an agreement to amend the ABL Facility and increase the amount of borrowing availability by $50.0 million to $225.0 million total borrowing availability. As a result of the amended agreement, SOFR was established as the new reference rate, replacing LIBOR. Prior to the termination of the ABL Facility in December 2023, the ABL Facility bore interest at a rate equal to, at the Company’s election, either (i) a base rate determined in accordance with the ABL Credit Agreement plus an applicable margin, which is equal to between 0.25% and 0.75% based on the historical excess availability as a percentage of the Line Cap (as such term is defined in the ABL Credit Agreement); and (ii) SOFR plus an applicable margin, which is equal to between 1.25% and 1.75% based on the historical excess availability as a percentage of the Line Cap. The ABL Facility contained commitment fees payable on the unused portion ranging from 0.25% to 0.375%, depending on various factors including the Company’s leverage ratio, type of loan and rate type, and letter of credit fees of 2.50%. Borrowings under the ABL Facility were secured by a first priority security interest in the Company’s and each of its subsidiaries’ inventory, accounts receivable, cash, deposit accounts and certain assets and property related thereto (the “ABL Priority Collateral”), in each case subject to certain exceptions, and a third priority security interest in each of the Company’s subsidiaries’ capital stock (subject to certain exceptions) and substantially all of the Company’s property and assets (other than the ABL Priority Collateral). The Company had $6.7 million of undrawn letters of credit issued and outstanding, resulting in net borrowing availability under the ABL Facility of $168.3 million, as of December 31, 2022.

Effective June 30, 2023, the Company entered into an agreement, dated as of June 8, 2023, to amend the First Lien Term Loan to replace LIBOR and related definitions and provisions with SOFR as the new reference rate. The Company entered into the First Lien Term Loan Agreement (the “First Lien Credit Agreement Amendment”), which commenced in October 2021 (the “October 2021 Refinancing”) to provide $600.0 million of refinanced borrowings. The First Lien Term Loan (the “First Lien Term Loan Facility”) is charged an interest rate equal to, at the Company’s option, either (i) SOFR (with a floor of 0.50% per annum) plus an applicable margin of 2.75% for Term SOFR Loans (as such term is defined in the First Lien Credit Agreement Amendment); and (ii) a base rate determined in accordance with the First Lien Credit Agreement Amendment, plus 1.75% for Base Rate Loans (as such term is defined in the First Lien Credit Agreement Amendment). The First Lien Term Loan Facility is repayable in quarterly installments, which began in March 2022, and matures on October 27, 2028. The interest rate on the First Lien Term Loan was 8.21% and 6.82% as of December 31, 2023 and 2022, respectively. The weighted average interest rate incurred on the First Lien Term Loan was 7.83% and 4.52% for the years ended December 31, 2023 and 2022, respectively.

In conjunction with the October 2021 Refinancing, the Company also issued $500.0 million in aggregate principal of unsecured senior notes (“Senior Notes”). The Senior Notes bear interest at a rate of 4.375% per annum payable semi-annually in arrears on October 31 and April 30 of each year, commencing on April 30, 2022. The Senior Notes mature on October 31, 2029. The interest rate on the Senior Notes was 4.375% as of both December 31, 2023 and 2022. The weighted average interest rate incurred on the Senior Notes was 4.375% for both years ended December 31, 2023 and 2022.

The Company assessed whether the October 2021 Refinancing resulted in an insubstantial modification or an extinguishment of the existing debt for each loan in the syndication by grouping lenders as follows: (i) Lenders continuing to participate in either the First Lien Term Loan Facility and Senior Notes; (ii) previous lenders that exited; and (iii) new lenders. The Company determined that $35.7 million of the First Lien Term Loan was extinguished, which was disclosed as an outflow from financing activities in the condensed consolidated statements of cash flows. The First Lien Term Loan had insubstantial modifications for lenders that continued to participate in either debt instrument, which resulted in a cash outflow from financing activities of $558.3 million in the consolidated statements of cash flows. The Company determined that $501.4 million of new debt was issued related to the First Lien Term Loan, which is disclosed as an inflow from financing activities in the consolidated statements of cash flows. In connection with the refinancing of the First Lien Term Loan and issuance of the Senior Notes, the Company incurred $10.7 million in debt issuance costs and third-party fees, of which $8.8 million was capitalized, $1.7 million was expensed as a component of other expense and $0.2 million was expensed as a loss on extinguishment as a component of other expense in the consolidated statements of comprehensive income. Further, $1.5 million of the total fees incurred of $10.7 million was netted against the $501.4 million of proceeds from debt as a component of the cash flows from financing activities, $7.4 million was presented as deferred financing costs as a component of cash flows from financing activities, and the remaining $1.8 million was included in cash flows from operating activities in the consolidated statements of cash flows.

The Company recognized a loss on extinguishment of debt of $1.0 million included in the line entitled “Other, net” in the consolidated statements of comprehensive income, of which $0.2 million related to debt issuance costs incurred with the First Lien Term Loan refinancing and issuance of the Senior Notes, as discussed above, and $0.8 million related to existing deferred financing fees that were written off upon extinguishment within the consolidated statements of comprehensive income and cash flows during the year ended December 31, 2021.

Prior to the October 2021 Refinancing, the Company entered into an amendment on the First Lien Term Loan in January 2021 (the “January 2021 Refinancing”) which resulted in additional First Lien Term Loan indebtedness. The proceeds of the First Lien Term Loan indebtedness were used to prepay the remaining balance of the previous senior secured second lien pay-in-kind toggle floating rate notes due 2027 (“Second Lien Notes”). The Company assessed whether the repayment of the Second Lien Notes by issuing incremental First Lien Term Loan indebtedness resulted in an insubstantial modification or an extinguishment of the existing debt for each loan in the syndication by grouping lenders as follows: (i) Lenders participating in both the First Lien Term Loan and Second Lien Notes; (ii) previous lenders that exited; and (iii) new lenders. The Company determined that $161.2 million of the First Lien Term Loan was extinguished and $122.9 million of the $150.0 million second lien term loan (“Second Lien Term Loan”) was extinguished, which is disclosed as an outflow from financing activities in the consolidated statements of cash flows. The First Lien Term Loan and Second Lien Notes had insubstantial modifications for lenders that participated in both debt instruments, which resulted in a cash outflow from financing activities of $352.0 million in the consolidated statements of cash flows. The Company determined that $356.2 million of new debt was issued related to the First Lien Term Loan, which is disclosed as an inflow from financing activities in the consolidated statements of cash flows. In connection with the prepayment of the Second Lien Notes and incremental First Lien Term Loan indebtedness, the Company incurred $7.2 million in debt issuance costs and third-party fees, of which $3.7 million was capitalized, $0.9 million was expensed as a component of other expense and $2.6 million was expensed as a loss on extinguishment as a component of other expense in the consolidated statements of comprehensive income. Further, $1.0 million of the total fees incurred of $7.2 million was netted against the $356.2 million of proceeds from debt as a component of the cash flows from financing activities, $2.9 million was presented as deferred financing costs as a component of cash flows from financing activities, $2.4 million was presented as debt prepayment fees as a component of cash flows from financing activities, and the remaining $0.9 million was included in cash flows from operating activities in the consolidated statements of cash flows.

The Company recognized a loss on extinguishment of debt of $12.4 million included in the line entitled “Other, net” in the consolidated statements of comprehensive income, of which $2.6 million related to debt issuance costs incurred with the incremental First Lien Term Loan indebtedness and prepayment of the Second Lien Notes, as discussed above, and $9.8 million related to existing deferred financing fees that were written off upon extinguishment within the consolidated statements of comprehensive income and cash flows during the year ended December 31, 2021.

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


Fiscal Year Ended December 31,	Minimum Payments
2024	$	6,000
2025	6,000
2026	6,000
2027	6,000
2028	564,000
2029 and beyond	500,000
Total	$	1,088,000

During the year ended December 31, 2023, the Company engaged in hedging activities to limit its exposure to changes in interest rates. See Note 12, Derivative Instruments, for further discussion.

The following table presents the estimated fair values of the Company’s debt obligations as of December 31, 2023 (in thousands):


Financial Instrument	Carrying Value as of December 31, 2023		Markets for Identical Item (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
First Lien Term Loan	$	571,348	$	—	$	590,234	$	—
Senior Notes	491,302		—		448,750		—
Total debt instruments	$	1,062,650	$	—	$	1,038,984	$	—

The Company had no fair value measurements that utilized Level 3 inputs of the fair value hierarchy for the year ended December 31, 2023. See Note 13, Fair Value Measurements, for further discussion.

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(c))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 470
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//470/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (i)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1E
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1E

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

+ Details

EARNINGS PER SHARE (Tables)

12 Months Ended

Dec. 31, 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:


	Year Ended December 31,
	2023	2022	2021
Warrants	—	—	457,753
Stock option awards	1,214,560	629,690	490,968
Restricted stock awards	340,331	205,652	316,454
Performance stock unit awards	—	—	—

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):


	Year Ended December 31,
	2023		2022		2021
Numerator:
Net income (1) (2) (3)	$	267,090	$	150,556	$	139,898
Denominator:
Weighted average number of common shares outstanding	178,973		181,105		179,855
Earnings per Common Share:
Earnings per common share, basic	$	1.49	$	0.83	$	0.78

(2) Net income for the year ended December 31, 2022 includes the impact of the Company’s Respiratory Therapy Asset Sale. See Note 3, Business Acquisitions and Divestitures, for further discussion.

(3) Net income for the year ended December 31, 2021 includes the impact of the Company’s release of its valuation allowance.

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


	Year Ended December 31,
	2023		2022		2021
Numerator:
Net income (1) (2) (3)	$	267,090	$	150,556	$	139,898
Denominator:
Weighted average number of common shares outstanding	178,973		181,105		179,855
Effect of dilutive securities	1,402		970		1,350
Weighted average number of common shares outstanding, diluted	180,375		182,075		181,205
Earnings per Common Share:
Earnings per common share, diluted	$	1.48	$	0.83	$	0.77

(2) Net income for the year ended December 31, 2022 includes the impact of the Company’s Respiratory Therapy Asset Sale. See Note 3, Business Acquisitions and Divestitures, for further discussion.

(3) Net income for the year ended December 31, 2021 includes the impact of the Company’s release of its valuation allowance.