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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
________________________________________________ 
FORM 10-Q
________________________________________________ 
 
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended SeptemberJune 30, 20212022
OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from                     to                     
Commission file number 1-9810

Owens & Minor, Inc.
(Exact name of Registrant as specified in its charter)

Virginia54-1701843
(State or other jurisdiction of
incorporation or organization)
(I.R.S. Employer
Identification No.)
9120 Lockwood BoulevardMechanicsvilleVirginia23116
(Address of principal executive offices)(Zip Code)
Post Office Box 27626,
Richmond, Virginia
23261-7626
(Mailing address of principal executive offices)(Zip Code)
Registrant’s telephone number, including area code (804) 723-7000
    Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, $2 par value per shareOMINew York Stock Exchange

Indicate by check mark whether the Registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the Registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes      No  
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).    Yes       No  
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “larger accelerated filer”, “accelerated filer”, “smaller reporting company” and "emerging growth company" in Rule 12b-2 of the Exchange Act.
Large accelerated filerAccelerated filer
Non-accelerated filer
  (Do not check if a smaller reporting company)
Smaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes  ☐   No  
The number of shares of Owens & Minor, Inc.’s common stock outstanding as of October 31, 2021,July 28, 2022 was 75,455,76076,247,585 shares.



Table of Contents
Owens & Minor, Inc. and Subsidiaries
Index
 
Page
Item 1.
Item 2.
Item 3.
Item 4.
Item 1.
Item 1A.
Item 2.
Item 6.
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Table of Contents
Part I. Financial Information
Item 1. Financial Statements
Owens & Minor, Inc. and Subsidiaries
Consolidated Statements of Operations
(unaudited)
     
 Three Months Ended
 September 30,
Nine Months Ended
September 30,
(in thousands, except per share data)2021202020212020
Net revenue$2,502,175 $2,187,928 $7,318,169 $6,118,340 
Cost of goods sold2,173,336 1,843,589 6,146,511 5,236,035 
Gross margin328,839 344,339 1,171,658 882,305 
Distribution, selling and administrative expenses262,457 262,538 849,255 758,320 
Acquisition-related and exit and realignment charges6,380 6,382 20,967 18,500 
Other operating income, net(2,873)(134)(5,016)(3,020)
Operating income62,875 75,553 306,452 108,505 
Interest expense, net11,572 20,975 36,784 65,923 
Loss on extinguishment of debt 308 40,433 2,580 
Other expense (income), net799 785 2,397 (1,193)
Income from continuing operations before income taxes50,504 53,485 226,838 41,195 
Income tax provision6,375 7,404 47,224 3,863 
Income from continuing operations, net of tax44,129 46,081 179,614 37,332 
Loss from discontinued operations, net of tax —  (58,203)
Net income (loss)$44,129 $46,081 $179,614 $(20,871)
Basic income (loss) per common share:
Income from continuing operations$0.60 $0.76 $2.47 $0.61 
Loss from discontinued operations— —  (0.95)
Net income (loss)$0.60 $0.76 $2.47 $(0.34)
Diluted income (loss) per common share:
Income from continuing operations$0.58 $0.76 $2.38 $0.61 
Loss from discontinued operations— —  (0.95)
Net income (loss)$0.58 $0.76 $2.38 $(0.34)
 Three Months Ended
 June 30,
Six Months Ended
 June 30,
(in thousands, except per share data)2022202120222021
Net revenue$2,500,015 $2,489,460 $4,906,967 $4,815,994 
Cost of goods sold1,967,510 2,089,392 4,001,014 3,973,175 
Gross margin532,505 400,068 905,953 842,819 
Distribution, selling and administrative expenses452,813 294,096 732,553 586,796 
Acquisition-related and exit and realignment charges7,602 8,624 41,150 14,587 
Other operating (income) expense, net(2,995)464 (3,894)(2,141)
Operating income75,085 96,884 136,144 243,577 
Interest expense, net35,839 11,540 47,858 25,212 
Loss on extinguishment of debt —  40,433 
Other expense, net783 1,028 1,565 1,598 
Income before income taxes38,463 84,316 86,721 176,334 
Income tax provision9,859 18,420 18,837 40,848 
Net income$28,604 $65,896 $67,884 $135,486 
Net income per common share:
Basic$0.38 $0.90 $0.92 $1.87 
Diluted$0.37 $0.87 $0.89 $1.80 
See accompanying notes to consolidated financial statements.
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Owens & Minor, Inc. and Subsidiaries
Consolidated Statements of Comprehensive Income (Loss)
(unaudited)
 
Three Months Ended
 September 30,
Nine Months Ended September 30,Three Months Ended
June 30,
Six Months Ended
June 30,
(in thousands)(in thousands)2021202020212020(in thousands)2022202120222021
Net income (loss)$44,129 $46,081 $179,614 $(20,871)
Net incomeNet income$28,604 $65,896 $67,884 $135,486 
Other comprehensive income (loss), net of tax:Other comprehensive income (loss), net of tax:Other comprehensive income (loss), net of tax:
Currency translation adjustmentsCurrency translation adjustments(12,014)5,173 (26,724)7,003 Currency translation adjustments(18,831)(2,448)(19,618)(14,710)
Change in unrecognized net periodic pension costsChange in unrecognized net periodic pension costs395 167 552 932 Change in unrecognized net periodic pension costs297 36 486 157 
Change in gains and losses on derivative instrumentsChange in gains and losses on derivative instruments 1,681 20,044 (9,792)Change in gains and losses on derivative instruments2,764 — 2,764 20,044 
Total other comprehensive income (loss), net of taxTotal other comprehensive income (loss), net of tax(11,619)7,021 (6,128)(1,857)Total other comprehensive income (loss), net of tax(15,770)(2,412)(16,368)5,491 
Comprehensive income (loss)$32,510 $53,102 $173,486 $(22,728)
Comprehensive incomeComprehensive income$12,834 $63,484 $51,516 $140,977 
    
See accompanying notes to consolidated financial statements.
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Owens & Minor, Inc. and Subsidiaries
Consolidated Balance Sheets
(unaudited)
 
September 30,December 31,June 30,December 31,
(in thousands, except per share data)(in thousands, except per share data)20212020(in thousands, except per share data)20222021
AssetsAssetsAssets
Current assetsCurrent assetsCurrent assets
Cash and cash equivalentsCash and cash equivalents$39,759 $83,058 Cash and cash equivalents$56,406 $55,712 
Accounts receivable, net of allowances of $19,273 and $19,087759,744 700,792 
Accounts receivable, net of allowances of $14,922 and $18,003Accounts receivable, net of allowances of $14,922 and $18,003743,853 681,564 
Merchandise inventoriesMerchandise inventories1,514,387 1,233,751 Merchandise inventories1,525,331 1,495,972 
Other current assetsOther current assets84,335 118,264 Other current assets108,612 88,564 
Total current assetsTotal current assets2,398,225 2,135,865 Total current assets2,434,202 2,321,812 
Property and equipment, net of accumulated depreciation of $320,389 and $284,126308,463 315,662 
Property and equipment, net of accumulated depreciation of $373,954 and $334,500Property and equipment, net of accumulated depreciation of $373,954 and $334,500595,888 317,235 
Operating lease assetsOperating lease assets184,554 144,755 Operating lease assets278,291 194,006 
GoodwillGoodwill386,693 394,086 Goodwill1,656,308 390,185 
Intangible assets, netIntangible assets, net209,789 243,351 Intangible assets, net462,444 209,745 
Other assets, netOther assets, net96,395 101,920 Other assets, net128,145 103,568 
Total assetsTotal assets$3,584,119 $3,335,639 Total assets$5,555,278 $3,536,551 
Liabilities and equityLiabilities and equityLiabilities and equity
Current liabilitiesCurrent liabilitiesCurrent liabilities
Accounts payableAccounts payable$1,118,753 $1,000,186 Accounts payable$1,137,337 $1,001,959 
Accrued payroll and related liabilitiesAccrued payroll and related liabilities100,171 109,447 Accrued payroll and related liabilities97,829 115,858 
Other current liabilitiesOther current liabilities206,094 236,094 Other current liabilities334,198 226,204 
Total current liabilitiesTotal current liabilities1,425,018 1,345,727 Total current liabilities1,569,364 1,344,021 
Long-term debt, excluding current portionLong-term debt, excluding current portion959,485 986,018 Long-term debt, excluding current portion2,565,613 947,540 
Operating lease liabilities, excluding current portionOperating lease liabilities, excluding current portion154,009 119,932 Operating lease liabilities, excluding current portion220,504 162,241 
Deferred income taxesDeferred income taxes37,093 50,641 Deferred income taxes107,181 35,310 
Other liabilitiesOther liabilities121,509 121,267 Other liabilities133,957 108,938 
Total liabilitiesTotal liabilities2,697,114 2,623,585 Total liabilities4,596,619 2,598,050 
Commitments and contingenciesCommitments and contingencies00Commitments and contingencies00
EquityEquityEquity
Common stock, par value $2 per share; authorized - 200,000 shares; issued and outstanding - 75,429 shares and 73,472 shares150,858 146,944 
Common stock, par value $2 per share; authorized - 200,000 shares; issued and outstanding - 76,171 shares and 75,433 sharesCommon stock, par value $2 per share; authorized - 200,000 shares; issued and outstanding - 76,171 shares and 75,433 shares152,343 150,865 
Paid-in capitalPaid-in capital434,952 436,597 Paid-in capital407,773 440,608 
Retained earningsRetained earnings345,832 167,022 Retained earnings455,502 387,619 
Accumulated other comprehensive lossAccumulated other comprehensive loss(44,637)(38,509)Accumulated other comprehensive loss(56,959)(40,591)
Total equityTotal equity887,005 712,054 Total equity958,659 938,501 
Total liabilities and equityTotal liabilities and equity$3,584,119 $3,335,639 Total liabilities and equity$5,555,278 $3,536,551 






See accompanying notes to consolidated financial statements.
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Owens & Minor, Inc. and Subsidiaries
Consolidated Statements of Cash Flows
(unaudited)
Nine Months Ended September 30,
(in thousands)20212020
Operating activities:
Net income (loss)$179,614 $(20,871)
Adjustments to reconcile net income (loss) to cash provided by operating activities:
Depreciation and amortization68,142 69,494 
Share-based compensation expense19,078 15,275 
Loss on divestiture 65,472 
Loss on extinguishment of debt40,433 2,580 
Provision for losses on accounts receivable19,270 9,583 
Deferred income tax (benefit) expense(18,286)25,017 
Changes in operating lease right-of-use assets and lease liabilities1,190 (1,328)
Changes in operating assets and liabilities:
Accounts receivable(84,381)(20,173)
Merchandise inventories(284,188)52,605 
Accounts payable120,821 136,156 
Net change in other assets and liabilities(8,341)(69,117)
Other, net20,484 3,503 
Cash provided by operating activities73,836 268,196 
Investing activities:
Proceeds from divestiture 133,000 
Additions to property and equipment(26,446)(21,678)
Additions to computer software(6,179)(4,702)
Proceeds from sale of property and equipment41 178 
Proceeds from cash surrender value of life insurance policies 6,032 
Cash (used for) provided by investing activities(32,584)112,830 
Financing activities:
Proceeds from issuance of debt574,900 150,000 
Repayments under revolving credit facility, net(90,900)(107,900)
Repayments of debt(553,140)(270,399)
Financing costs paid(13,912)(10,367)
Cash dividends paid(548)(467)
Payment for termination of interest rate swaps(15,434)— 
Other, net(18,188)(5,822)
Cash used for financing activities(117,222)(244,955)
Effect of exchange rate changes on cash and cash equivalents(2,454)6,721 
Net (decrease) increase in cash, cash equivalents and restricted cash(78,424)142,792 
Cash, cash equivalents and restricted cash at beginning of period134,506 84,687 
Cash, cash equivalents and restricted cash at end of period$56,082 $227,479 
Supplemental disclosure of cash flow information:
Income taxes paid (received), net of refunds$83,606 $(1,892)
Interest paid$32,035 $61,271 

Six Months Ended June 30,
(in thousands)20222021
Operating activities:
Net income$67,884 $135,486 
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization97,286 45,501 
Share-based compensation expense11,210 13,040 
Loss on extinguishment of debt 40,433 
Provision for losses on accounts receivable4,512 15,777 
Deferred income tax expense (benefit)1,601 (11,293)
Changes in operating lease right-of-use assets and lease liabilities606 826 
Loss on sale and dispositions of property and equipment226  
Changes in operating assets and liabilities:
Accounts receivable16,275 (57,256)
Merchandise inventories(24,438)(298,294)
Accounts payable12,349 127,473 
Net change in other assets and liabilities(23,945)(3,363)
Other, net5,958 4,076 
Cash provided by operating activities169,524 12,406 
Investing activities:
Acquisition, net of cash acquired(1,684,607)— 
Additions to property and equipment(62,236)(14,630)
Additions to computer software(3,463)(4,051)
Proceeds from sale of property and equipment5,846 22 
Other, net(839) 
Cash used for investing activities(1,745,299)(18,659)
Financing activities:
Proceeds from issuance of debt1,691,000 500,000 
Borrowings under revolving credit facility, net and accounts receivable securitization program30,000 5,000 
Repayments of debt(1,500)(523,140)
Borrowings under amended accounts receivable securitization program347,800 — 
Repayments under amended accounts receivable securitization program(402,800)— 
Financing costs paid(41,479)(12,868)
Cash dividends paid (364)
Payment for termination of interest rate swaps (15,434)
Other, net(42,388)(17,982)
Cash provided by (used for) financing activities1,580,633 (64,788)
Effect of exchange rate changes on cash, cash equivalents and restricted cash(3,864)(1,718)
Net increase (decrease) in cash, cash equivalents and restricted cash994 (72,759)
Cash, cash equivalents and restricted cash at beginning of period72,035 134,506 
Cash, cash equivalents and restricted cash at end of period$73,029 $61,747 
Supplemental disclosure of cash flow information:
Income taxes paid, net of refunds$25,782 $68,030 
Interest paid$32,417 $17,768 
Noncash investing activity:
Unpaid purchases of property and equipment at end of period$56,429 $— 
See accompanying notes to consolidated financial statements.
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Owens & Minor, Inc. and Subsidiaries
Consolidated Statements of Changes in Equity
(unaudited)
 
(in thousands, except per share data)(in thousands, except per share data)Common
Shares
Outstanding
Common 
Stock
($2 par value )
Paid-In
Capital
Retained
Earnings
Accumulated
Other
Comprehensive Loss
Total
Equity
(in thousands, except per share data)Common
Shares
Outstanding
Common 
Stock
($2 par value )
Paid-In
Capital
Retained
Earnings
Accumulated
Other
Comprehensive Loss
Total
Equity
Balance, December 31, 2021Balance, December 31, 202175,433 $150,865 $440,608 $387,619 $(40,591)$938,501 
Net incomeNet income39,279 39,279 
Other comprehensive lossOther comprehensive loss(598)(598)
Share-based compensation expense, exercises and otherShare-based compensation expense, exercises and other653 1,307 (30,867)(29,560)
Balance, March 31, 2022Balance, March 31, 202276,086 152,172 409,741 426,898 (41,189)947,622 
Net incomeNet income28,604 28,604 
Other comprehensive lossOther comprehensive loss(15,770)(15,770)
Share-based compensation expense, exercises and otherShare-based compensation expense, exercises and other85 171 (1,968)(1,797)
Balance, June 30, 2022Balance, June 30, 202276,171 $152,343 $407,773 $455,502 $(56,959)$958,659 
Balance, December 31, 2020Balance, December 31, 202073,472 $146,944 $436,597 $167,022 $(38,509)$712,054 Balance, December 31, 202073,472 $146,944 $436,597 $167,022 $(38,509)$712,054 
Net incomeNet income69,589 69,589 Net income69,589 69,589 
Other comprehensive incomeOther comprehensive income7,903 7,903 Other comprehensive income7,903 7,903 
Dividends declared ($0.0025 per share)Dividends declared ($0.0025 per share)(434)(434)Dividends declared ($0.0025 per share)(434)(434)
Share-based compensation expense, exercises and otherShare-based compensation expense, exercises and other1,628 3,256 (6,107)(2,851)Share-based compensation expense, exercises and other1,628 3,256 (6,107)(2,851)
Balance, March 31, 2021Balance, March 31, 202175,100 150,200 430,490 236,177 (30,606)786,261 Balance, March 31, 202175,100 150,200 430,490 236,177 (30,606)786,261 
Net incomeNet income65,896 65,896 Net income65,896 65,896 
Other comprehensive lossOther comprehensive loss(2,412)(2,412)Other comprehensive loss(2,412)(2,412)
Dividends declared ($0.0025 per share)Dividends declared ($0.0025 per share)(187)(187)Dividends declared ($0.0025 per share)(187)(187)
Share-based compensation expense, exercises and otherShare-based compensation expense, exercises and other295 591 (2,130)(1,539)Share-based compensation expense, exercises and other295 591 (2,130)(1,539)
Balance, June 30, 2021Balance, June 30, 202175,395150,791 428,360 301,886 (33,018)848,019 Balance, June 30, 202175,395 $150,791 $428,360 $301,886 $(33,018)$848,019 
Net income44,129 44,129 
Other comprehensive loss(11,619)(11,619)
Dividends declared ($0.0025 per share)(183)(183)
Share-based compensation expense, exercises and other34 67 6,592 6,659 
Balance, September 30, 202175,429$150,858 $434,952 $345,832 $(44,637)$887,005 
Balance, December 31, 201962,843 $125,686 $251,401 $137,774 $(52,707)$462,154 
Net loss(11,324)(11,324)
Other comprehensive loss(39,405)(39,405)
Dividends declared ($0.0025 per share)(127)(127)
Share-based compensation expense, exercises and other42 84 4,956 5,040 
Balance, March 31, 202062,885 125,770 256,357 126,323 (92,112)416,338 
Net loss(55,627)(55,627)
Other comprehensive income30,527 30,527 
Dividends declared ($0.0025 per share)(156)(156)
Share-based compensation expense, exercises and other852 1,704 2,376 4,080 
Balance, June 30, 202063,737 127,474 258,733 70,540 (61,585)395,162 
Net income46,081 46,081 
Other comprehensive income7,021 7,021 
Dividends declared ($0.0025 per share)(156)(156)
Share-based compensation expense, exercises and other(21)(42)3,269 3,227 
Balance, September 30, 202063,716$127,432 $262,002 $116,465 $(54,564)$451,335 
See accompanying notes to consolidated financial statements.
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Owens & Minor, Inc. and Subsidiaries
Notes to Consolidated Financial Statements
(unaudited)
(in thousands, except per share data, unless otherwise indicated)

Note 1—Summary of Significant Accounting Policies

Basis of Presentation
The accompanying unaudited consolidated financial statements include the accounts of Owens & Minor, Inc. and the subsidiaries it controls (we, us, our or our)the Company) and contain all adjustments (which are comprised only of normal recurring accruals and use of estimates) necessary to conform with U.S. generally accepted accounting principles (GAAP). All significant intercompany accounts and transactions have been eliminated. The Movianto businessrepresented a component that met accounting requirements to be classified as discontinued operations for the nine months ended September 30, 2020. In accordance with GAAP, the results of operations of the Movianto business are presented as discontinued operations through June 18, 2020 (the Divestiture Date) and, as such, have been excluded from continuing operations for the nine months ended September 30, 2020. With the exception of Note 3, the Notes to Consolidated Financial Statements reflect the continuing operations of Owens & Minor, Inc. and its subsidiaries. See Note 3 for additional information regarding discontinued operations. The results of operations for interim periods are not necessarily indicative of the results expected for the full year.
To better reflect how we go to market as well as certain changes to the leadership team, organizational structure, budgeting and financial reporting processes which drive changes to segment reporting, we have organized our business into 2 distinct segments: Products & Healthcare Services and Patient Direct. Products & Healthcare Services provides distribution, outsourced logistics and value-added services, and manufactures and sources medical surgical products through our production and kitting operations. Patient Direct expands our business along the continuum of care through delivery of disposable medical supplies sold directly to patients and home health agencies and is a leading provider of integrated home healthcare equipment and related services in the United States. Beginning with the quarter ended March 31, 2022, we now report financial results using this 2 segment structure and have recast prior year segment results on the same basis.
On March 29, 2022, we completed the acquisition of 100% of Apria, Inc. pursuant to the Agreement and Plan of Merger dated January 7, 2022, in exchange for approximately $1.7 billion, net of cash acquired. Refer to Note 3 for additional details.
Reclassifications
Certain prior year amounts have been reclassified to conform to the current year presentation.
Use of Estimates
The preparation of consolidated financial statements in conformity with GAAP requires us to make assumptions and estimates that affect reported amounts and related disclosures. Actual results may differ from these estimates.
Cash, Cash Equivalents and Restricted Cash
Cash, cash equivalents and restricted cash includes cash and marketable securities with an original maturity or maturity at acquisition of three months or less. Cash, cash equivalents and restricted cash are stated at cost. Nearly all of our cash, cash equivalents and restricted cash are held in cash depository accounts in major banks in the United States, Europe, and Asia. Cash that is held by a major bank and has restrictions on its availability to us is classified as restricted cash. Restricted cash included in Other assets, net as of SeptemberJune 30, 2022 and December 31, 2021 primarily represents cash held in an escrow account as required by the Centers for Medicare & Medicaid Services (CMS) in conjunction with the Bundled Payments for Care Improvement (BPCI) initiatives.initiatives related to wind-down costs of Fusion5.
The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the accompanying consolidated balance sheets that sum to the total of those same amounts presented in the accompanying consolidated statements of cash flows.
June 30, 2022December 31, 2021
Cash and cash equivalents$56,406 $55,712 
Restricted cash included in Other assets, net16,623 16,323 
Total cash, cash equivalents, and restricted cash$73,029 $72,035 

September 30, 2021December 31, 2020
Cash and cash equivalents$39,759 $83,058 
Restricted cash included in Other current assets 35,126 
Restricted cash included in Other assets, net16,323 16,322 
Total cash, cash equivalents, and restricted cash$56,082 $134,506 
Property and Equipment, net
Property and equipment are stated at cost less accumulated depreciation. Depreciation and amortization expense for financial reporting purposes is computed on a straight-line method over the estimated useful lives of the assets or, for capital leases and leasehold improvements, over the term of the lease, if shorter. In general, the estimated useful lives for computing depreciation and amortization are three to 15 years for machinery and equipment, five to 40 years for buildings, one to 10 years for patient equipment, and up to 15 years for leasehold and land improvements. Straight-line and accelerated methods of
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depreciation are used for income tax purposes. Normal maintenance and repairs are expensed as incurred, and renovations and betterments are capitalized. We suspend depreciation and amortization on assets that are held for sale. In addition, we record capital-related government grants earned as reductions to the cost of property and equipment; and associated unpaid liabilities and grant proceeds receivable are considered non-cash changes in such balances for purposes of preparation of our consolidated statements of cash flows. Patient equipment consists of medical equipment rented to patients on a month-to-month basis. Patient equipment depreciation is classified in our consolidated statements of operations within cost of goods sold as the equipment is rented to patients as part of our primary operations within the Patient Direct segment.
Revenue Recognition
Our revenue is primarily generated from sales contracts with customers. Under most of our distribution and product sales arrangements, our performance obligations are limited to delivery of products to a customer upon receipt of a purchase order. For these arrangements, we recognize revenue at the point in time when shipment is completed, as control passes to the customer upon product receipt.
Revenue for activity-based fees and other services is recognized over time as activities are performed. Depending on the specific contractual provisions and nature of the performance obligation, revenue from services may be recognized on a straight-line basis over the term of the service, on a proportional performance model, based on level of effort, or when final deliverables have been provided.
Our contracts sometimes allow for forms of variable consideration including rebates, discounts, performance guarantees, and implicit price concessions. In these cases, we estimate the amount of consideration to which we will be entitled in exchange for transferring the product or service to the customer. Rebates and customer discounts are estimated based on contractual terms or historical experience and we maintain an accrual for rebates or discounts that have been earned but are unpaid. When we have implicit price concessions, we determine the variable consideration under the expected value method as part of determining the sales transaction price using historical reimbursement experience, historical sales returns, and other operating trends.
In most cases, we record revenue gross, as we are the primary obligor. When we act as an agent in a sales arrangement and do not bear a significant portion of inventory risks, primarily for our outsourced logistics business, we record revenue net of product cost. Sales taxes collected from customers and remitted to governmental authorities are excluded from revenues.
Within our Patient Direct segment, revenues are recognized under fee-for-service arrangements for equipment we rent to patients and sales of equipment, supplies and other items we sell to patients. Revenue that is generated from equipment that we rent to patients is primarily recognized over the noncancelable rental period, typically one month, and commences on delivery of the equipment to the patients. Revenues are recorded at amounts estimated to be received under reimbursement arrangements with third-party payors, including private insurers, prepaid health plans, Medicare, Medicaid and patients. Rental revenue, less estimated adjustments, is recognized as earned on a straight-line basis over the noncancellable lease term. We recorded $144 million and $151 million in revenue related to equipment we rent to patients for the three and six months ended June 30, 2022. Equipment rental revenue was not material in the prior year.

Note 2—Fair Value

The carrying amounts of cash and cash equivalents, accounts receivable, and accounts payable, and accrued payroll and related liabilities reported in the consolidated balance sheets approximate fair value due to the short-term nature of these instruments. The carrying amount of restricted cash also approximates fair value due to its nature. The fair value of debt is estimated based on quoted market prices or dealer quotes for the identical liability when traded as an asset in an active market (Level 1) or, if quoted market prices or dealer quotes are not available, on the borrowing rates currently available for loans with similar terms, credit ratings, and average remaining maturities (Level 2). See Note 6 for the fair value of debt. The fair value of foreign currencyour derivative contracts is determined based on the present value of expected future cash flows considering the risks involved, including non-performance risk, and using discount rates appropriate for the respective maturities. Observable Level 2 inputs are used to determine the present value of expected future cash flows. See Note 8 for the fair value of derivatives.

Note 3—Acquisition
On March 29, 2022 (the Acquisition Date), we completed the acquisition of 100% of Apria, Inc. (Apria) pursuant to the Agreement and Plan of Merger (Apria Acquisition) dated January 7, 2022, in exchange for approximately $1.7 billion, net of $144 million of cash acquired. The purchase was funded with a combination of debt and cash on hand. At the time of the Apria Acquisition, each share of Apria’s common stock was converted into the right to receive $37.50 in cash. Apria is a leading provider of integrated home healthcare equipment and related services in the United States. This business is reported as part of the Patient Direct segment.
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Note 3—Discontinued OperationsThe following table presents the preliminary estimated fair value of the assets acquired and liabilities assumed recognized as of the Acquisition Date. The fair value and useful lives of tangible and intangible assets acquired have been estimated based on a review of publicly available data for transactions involving companies deemed comparable to the Company. The allocation of purchase price to assets and liabilities acquired is not yet complete, as valuations of tangible and intangible assets and liabilities are still in process.
Preliminary Fair Value Originally Estimated as of Acquisition Date(1)
Differences Between Prior and the Current Periods Preliminary Fair Value EstimatePreliminary Fair Value Currently Estimated as of Acquisition Date
Assets acquired:
Current assets$142,136 $(2,209)$139,927 
Goodwill1,267,079 2,808 1,269,887 
Intangible assets295,466 — 295,466 
Other non-current assets371,320 1,468 372,788 
Total assets2,076,001 2,067 2,078,068 
Liabilities assumed:
Current liabilities241,266 2,741 244,007 
Noncurrent liabilities150,128 (674)149,454 
Total liabilities391,394 2,067 393,461 
Fair value of net assets acquired, net of cash$1,684,607 $— $1,684,607 

On June 18, 2020, we completed the divestiture of our European logistics business, Movianto (the Divestiture), as well as certain support functions in our Dublin office, to Walden Group SAS (the Buyer) and EHDH (as Buyer’s guarantor) for cash consideration of $133 million. We concluded that the Movianto business met the criteria for discontinued operations through the Divestiture Date, as the intention to sell represented a strategic shift and the criteria for held-for-sale were met. Movianto was(1) As previously reported in our first quarter 2022 Form 10-Q.
Current assets acquired includes $89.3 million in fair value of receivables, which reflects the Global Solutions segment.approximate amount contractually owed. We are amortizing the preliminary fair value of acquired intangible assets, primarily customer contracts, trade names and payor and capitated relationships, over their estimated weighted average useful lives of two to 15 years.
Accordingly, the resultsGoodwill of operations from the Movianto business are reported$1.3 billion, which we assigned to our Patient Direct segment, consists largely of expected opportunities to expand into new markets and further develop a presence in the accompanying consolidated statements of operations as Loss from discontinued operations, net of tax for the three and nine months ended September 30, 2020.
The following table summarizes the financial results of our discontinued operations for the three and nine months ended September 30, 2020:

Three Months Ended September 30, 2020Nine Months Ended September 30, 2020
Net revenue$— $226,759 
Cost of goods sold— 53,923 
Gross margin— 172,836 
Distribution, selling, and administrative expenses— 157,512 
Loss on divestiture— 65,472 
Acquisition-related and exit and realignment charges— 4,825 
Other operating income, net— (388)
Operating loss— (54,585)
Interest expense, net— 3,144 
Loss from discontinued operations before income taxes— (57,729)
Income tax provision from discontinued operations— 474 
Loss from discontinued operations, net of tax$— $(58,203)

We suspended depreciation and amortization on assets that are held-for-sale, including right-of-use assets recorded in accordance with ASU No. 2016-02, for the nine months ended September 30, 2020.
No revenue or expense have been recorded in discontinued operations related to the disposal group subsequent to the Divestiture Date.
We have entered into transition services agreements with a subsidiaryhome healthcare business. None of the Buyer, pursuantgoodwill recognized is expected to which we and a subsidiary of the Buyer will provide to each other various transitional services. Certain transition service arrangement costs and reimbursements were recorded during the three and nine months ended September 30, 2021 and 2020 and were immaterialbe deductible for the periods presented. These arrangements were substantially completed as of September 30, 2021.
We had no assets and liabilities of the discontinued Movianto business reflected on the consolidated balance sheets at September 30, 2021 and December 31, 2020.income tax purposes.
The following table provides operatingpro forma results of net revenue and investing cash flow informationnet (loss) income for our discontinued operations:the three and six months ended June 30, 2022 and 2021 as if Apria was acquired on January 1, 2021. The pro forma results below are not necessarily indicative of the results that would have been if the acquisition had occurred on the dates indicated, nor are the pro forma results indicative of results which may occur in the future.

Three Months Ended June 30,Six Months Ended June 30,
2022202120222021
Net revenue$2,500,015 $2,775,739 $5,184,080 $5,377,547 
Net income (loss)$28,604 $86,472 $(61,578)$160,606 
Nine Months Ended September 30, 2020
Operating Activities:
Loss on divestiture$65,472 
Investing Activities:
Capital expenditures3,027
Pro forma net loss of $61.6 million for the six months ended June 30, 2022 includes pro forma adjustments for interest expense of $20.8 million and amortization of intangible assets of $20.3 million. The pro forma net loss also includes $39.4 million in seller transaction expenses and stock compensation expense associated with $108 million owed to the holders of Apria stock awards in connection with the Apria Acquisition. Revenue and net loss of Apria since the Acquisition Date included in the consolidated statement of operations for the six months ended June 30, 2022 were $310 million and $30.3 million, respectively.

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Note 4—Goodwill and Intangible Assets

In connection with our new segment structure, which began in the first quarter of 2022, goodwill is now reported as part of Products & Healthcare Services or Patient Direct. There was no change to our underlying reporting units as part of that segment change and therefore no reallocation of goodwill. The following table summarizes the goodwill balances by segment and the changes in the carrying amount of goodwill through SeptemberJune 30, 2021:2022:

Global SolutionsGlobal ProductsConsolidated
Carrying amount of goodwill, December 31, 2020$283,905 $110,181 $394,086 
Currency translation adjustments— (7,393)(7,393)
Carrying amount of goodwill, September 30, 2021$283,905 $102,788 $386,693 
Products & Healthcare ServicesPatient DirectConsolidated
Carrying amount of goodwill, December 31, 2021$106,280 $283,905 $390,185 
Acquisition— 1,269,887 1,269,887 
Currency translation adjustments(3,764)— (3,764)
Carrying amount of goodwill, June 30, 2022$102,516 $1,553,792 $1,656,308 

Intangible assets subject to amortization at SeptemberJune 30, 20212022 and December 31, 20202021 were as follows:

September 30, 2021December 31, 2020June 30, 2022December 31, 2021
Customer
Relationships
TradenamesOther
Intangibles
Customer
Relationships
TradenamesOther
Intangibles
Customer
Relationships
TradenamesOther
Intangibles
Customer
Relationships
TradenamesOther
Intangibles
Gross intangible assetsGross intangible assets$265,527 $90,000 $43,313 $270,505 $90,000 $43,245 Gross intangible assets$273,030 $156,936 $271,518 $275,526 $90,000 $43,189 
Accumulated amortizationAccumulated amortization(139,632)(31,152)(18,267)(121,209)(24,881)(14,309)Accumulated amortization(157,804)(39,238)(41,998)(146,168)(33,242)(19,560)
Net intangible assetsNet intangible assets$125,895 $58,848 $25,046 $149,296 $65,119 $28,936 Net intangible assets$115,226 $117,698 $229,520 $129,358 $56,758 $23,629 
Weighted average useful lifeWeighted average useful life10 years11 years8 years10 years11 years8 yearsWeighted average useful life10 years11 years5 years10 years11 years8 years

At SeptemberJune 30, 2022 and December 31, 2021, $51.1$150 million and $164 million in net intangible assets were held in the Global SolutionsProducts & Healthcare Services segment and $159$313 million and $45.7 million were held in the Global ProductsPatient Direct segment. Amortization expense for intangible assets was $10.0$30.9 million and $10.2$10.0 million for the three months ended SeptemberJune 30, 2022 and 2021 and 2020, and $30.1$41.2 million and $31.5$20.1 million for the ninesix months ended SeptemberJune 30, 20212022 and 2020.2021. At June 30, 2022, other intangibles includes preliminary estimated fair values of payor relationships, customer list and other intangible assets acquired as part of the Apria Acquisition.
Based on the current carrying value of intangible assets subject to amortization, estimated amortization expense is approximately $10$63 million for the remainder of 2021, $39 million for 2022, $39$126 million for 2023, $34$67 million for 2024, $28$42 million for 2025, and $27$41 million for 2026.2026 and $38 million for 2027.

Note 5—Exit and Realignment Costs

We periodically incur exit and realignment and other charges associated with optimizing our operations which includes the consolidation of certain distribution and outsourced logistics centers, administrative offices and warehouses, our client engagement center and IT restructuring charges. These charges also include costs associated with our strategic organizational realignment which include leadership reorganization costs, certain professional fees, and costs to streamline administrative functions and processes and divestiture related costs.
Exit and realignment charges by segment for the three and nine months ended September 30, 2021 and 2020 were as follows:

Three Months Ended
 September 30,
Nine Months Ended September 30,
2021202020212020
Global Solutions segment$5,352 $2,714 $16,166 $6,255 
Global Products segment1,028 2,877 4,801 3,364 
Total exit and realignment charges$6,380 $5,591 $20,967 $9,619 

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Exit and realignment charges by segment for the three and six months ended June 30, 2022 and 2021 were as follows:
Three Months Ended
 June 30,
Six Months Ended
June 30,
2022202120222021
Products & Healthcare Services$1,214 $7,879 $2,413 $13,842 
Patient Direct 745 483 745 
Total exit and realignment charges$1,214 $8,624 $2,896 $14,587 
The following table summarizes the activity related to exit and realignment cost accruals through SeptemberJune 30, 20212022 and 2020:

2021:
Total
Accrued exit and realignment costs, December 31, 2021$8,306 
Provision for exit and realignment activities:
Severance811 
Other871 
Cash payments(6,903)
Accrued exit and realignment costs, March 31, 20223,085
Provision for exit and realignment activities:
Severance246 
Other968 
Cash payments(3,477)
Accrued exit and realignment costs, June 30, 2022$822
Accrued exit and realignment costs, December 31, 2020$3,146 
Provision for exit and realignment activities:
Information system restructuring costs1,029 
Lease obligations347 
Other781 
Cash payments(2,915)
Accrued exit and realignment costs, March 31, 20212,388
Provision for exit and realignment activities:
Information system restructuring costs1,611 
Lease obligations(126)
Other989 
Cash payments(2,302)
Accrued exit and realignment costs, June 30, 20212,560
Provision for exit and realignment activities:
Information system restructuring costs1,506 
Lease obligations107 
Other3,142 
Cash payments(4,199)
Accrued exit and realignment costs, September 30, 2021$3,116
Accrued exit and realignment costs, December 31, 2019$8,162 
Provision for exit and realignment activities:
Severance1,391 
Information system restructuring costs183 
Lease obligations202 
Other53 
Cash payments(5,799)
Accrued exit and realignment costs, March 31, 20204,192
Provision for exit and realignment activities:
Severance809
Information system restructuring costs671
Lease obligations219
Other501
Cash payments(2,072)
Accrued exit and realignment costs, June 30, 20204,320
Provision for exit and realignment activities:
Severance1,950 
Information system restructuring costs77 
Lease obligations848 
Other2,716 
Cash payments(7,083)
Accrued exit and realignment costs, September 30, 2020$2,8282,560 
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In addition to the exit and realignment accruals in the preceding table, we also incurred $1.6$6.2 million and $11.6$10.0 million of costs that were expensed as incurred for the three and ninesix months ended SeptemberJune 30, 2021, which primarily includes $1.5$4.9 million and $9.6$8.0 million of wind-down costs related to an increase in reserves associated with certain retained assets of Fusion5 for the three and ninesix months ended SeptemberJune 30, 2021.
Acquisition-related charges within acquisition-related and exit and realignment charges presented in our consolidated statements of operations were $6.4 million and $38.3 million for the three and six months ended June 30, 2022, which consisted primarily of costs related to the Apria acquisition. There were no0 acquisition-related charges included within acquisition-related and exit and realignment charges presented in our consolidated statements of operations for the three and ninesix months ended SeptemberJune 30, 2021. Acquisition-related charges within acquisition-related and exit and realignment charges presented in our consolidated statements of operations were $0.8 million and $8.9 million for the three and nine months ended September 30, 2020, which consisted primarily of transition costs for the Halyard acquisition.
We may incurdo not expect material additional chargescosts in 20212022 for wind-down costs related to Fusion5.activities that were initiated through June 30, 2022.

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Note 6—Debt

Debt consists of the following:
September 30, 2021December 31, 2020June 30, 2022December 31, 2021
Carrying
Amount
Estimated
Fair Value
Carrying
Amount
Estimated
Fair Value
Carrying
Amount
Estimated
Fair Value
Carrying
Amount
Estimated
Fair Value
Term Loan A-2$ $ $33,865 $34,390 
Term Loan B  477,525 486,614 
Receivables Securitization ProgramReceivables Securitization Program196,683 200,000 152,929 155,100 Receivables Securitization Program$171,503 $175,000 $197,026 $200,000 
4.375% Senior Notes, due December 20244.375% Senior Notes, due December 2024245,011 261,329 244,780 253,241 4.375% Senior Notes, due December 2024245,361 241,739 245,086 263,263 
Revolver12,300 12,300 103,200 103,200 
Term Loan ATerm Loan A489,789 500,000 — — 
4.500% Senior Notes, due March 20294.500% Senior Notes, due March 2029491,430 507,075 — — 4.500% Senior Notes, due March 2029492,176 406,660 491,656 515,225 
Term Loan BTerm Loan B577,746 595,508 — — 
6.625% Senior Notes, due March 20306.625% Senior Notes, due March 2030584,432 550,782 — — 
Finance leases and otherFinance leases and other15,677 15,677 13,668 13,668 Finance leases and other15,421 15,421 15,809 15,809 
Total debtTotal debt961,101 996,381 1,025,967 1,046,213 Total debt2,576,428 2,485,110 949,577 994,297 
Less current maturitiesLess current maturities(1,616)(1,616)(39,949)(40,453)Less current maturities(10,815)(10,815)(2,037)(2,037)
Long-term debtLong-term debt$959,485 $994,765 $986,018 $1,005,760 Long-term debt$2,565,613 $2,474,295 $947,540 $992,260 

We have $246 million, excluding deferred financing costs and third party fees, of 4.375% senior notes due in 2024 (the 2024 Notes), with interest payable semi-annually. The 2024 Notes were sold at 99.6% of the principal amount with an effective yield of 4.422%. We have the option to redeem the 2024 Notes in part or in whole prior to maturity at a redemption price equal to the greater of 100% of the principal amount or the present value of the remaining scheduled payments discounted at the applicable Benchmark Treasury Rate (as defined) plus 30 basis points.
In March 2021, we issued $500 million, excluding deferred financing costs and third party fees, of 4.500% senior unsecured notes due in 2029 (the 2029 Unsecured Notes), with interest payable semi-annually (the Notes Offering). The 2029 Unsecured Notes were sold at 100% of the principal amount with an effective yield of 4.500%. We used a portion of the net proceeds from the Notes Offering to repay our Term B Loan and borrowings under our revolving credit facility. In connection with these repayments, we recorded $15.3 million in write-offs of deferred financing costs and third party fees within loss on extinguishment of debt for the nine months ended September 30, 2021. No write-offs of deferred financing costs and third party fees were recorded for the three months ended September 30, 2021. We may redeem all or part of the 2029 Unsecured Notes prior to March 31, 2024, at a price equal to 100% of the principal amount of the 2029 Unsecured Notes redeemed, plus accrued and unpaid interest, if any, to, but not including, the redemption date, plus a “make-whole” premium, as described in the Indenture dated March 10, 2021 (the Indenture). On or after March 31, 2024, we may redeem all or part of the 2029 Unsecured Notes at the applicable redemption prices described in the Indenture, plus accrued and unpaid interest, if any, to, but not including, the redemption date. We may also redeem up to 40% of the aggregate principal amount of the 2029 Unsecured Notes at any time prior to March 31, 2024, at a redemption price equal to 104.5% with an amount equal to or less than the net cash proceeds from certain equity offerings, plus accrued and unpaid interest, if any, to, but excluding, the redemption date.
On March 10, 2021,29, 2022, we terminatedcompleted the sale of $600 million in aggregate principal amount of our then existing6.625% senior notes due in 2030 (the 2030 Unsecured Notes), with interest payable semi-annually. The 2030 Unsecured Notes were sold at 100% of the principal amount with an effective yield of 6.625%.
We may redeem all or part of the 2030 Unsecured Notes, prior to April 1, 2025, at a price equal to 100% of the principal amount of the 2030 Unsecured Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date, plus a “make-whole” premium, as described in the Indenture dated March 29, 2022 (the New Indenture). From and after April 1, 2025, we may redeem all or part of the 2030 Unsecured Notes at the applicable redemption prices described in the New Indenture, plus accrued and unpaid interest, if any, to, but excluding, the redemption date. We may also redeem up to 40% of the aggregate principal amount of 2030 Unsecured Notes at any time prior to April 1, 2025, at a redemption price equal to 106.625% with an amount equal to or less than the net cash proceeds from certain equity offerings, plus accrued and unpaid interest, if any, to, but excluding, the redemption date.
The 2029 Unsecured Notes and 2030 Unsecured Notes are effectively subordinated to any of our secured indebtedness, including indebtedness under our credit agreement and all obligations thereunder were repaid. agreements.
On that same date,March 29, 2022, we entered into a newterm loan credit agreement with Bank of America, N.A.an administrative agent and collateral agent and a syndicate of financial institutions, as lenders (the Credit Agreement) withthat provides for 2 new credit facilities (i) a $300$500 million revolving credit facility.Term Loan A facility (the Term Loan A), and (ii) a $600 million Term Loan B facility (the Term Loan B). The interest rate on our revolving credit facilitythe Term Loan A is based on a spread over a benchmark rate (as describedeither the Term SOFR or the Base Rate plus an Applicable Rate which varies depending on the current Debt Ratings or Total Leverage Ratio, determined as to whichever shall result in more favorable pricing to the Borrowers (each as defined in the Credit Agreement). The Credit Agreement matures in March 2026.
At September 30, 2021 and December 31, 2020, we had borrowings of $12.3 million and $103 million and letters of credit of $9.4 million and $13.9 million outstanding under our revolving credit facilities. At September 30, 2021 and Decemberinterest rate on the Term Loan B is based on either the
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31, 2020,Term SOFR or the Base Rate plus an Applicable Rate. The Term Loan A will mature in March 2027 and the Term Loan B will mature in March 2029.
On March 29, 2022, we entered into an amendment to our revolving credit agreement, dated as of March 10, 2021 with an administrative agent and collateral agent and a syndicate of financial institutions, as lenders (Revolving Credit Agreement). The amendment (i) increased the aggregate revolving credit commitments under the Revolving Credit Agreement by $150 million, to an aggregate amount of $450 million and (ii) replaced the Eurocurrency Rate with the Adjusted Term SOFR Rate (each as defined in the Revolving Credit Agreement). The Revolving Credit Agreement matures in March 2027.
At June 30, 2022, we had $278no borrowings and letters of credit of $28.0 million under our revolving credit facility. At December 31, 2021, we had no borrowings and letters of credit of $9.4 million outstanding under our revolving credit facility. At June 30, 2022 and December 31, 2021, we had $422 million and $283$291 million available for borrowing.borrowing under our revolving credit facility. We also had letters of credit and bank guarantees, outstandingwhich were issued outside of the revolving credit facility for $2.2$2.1 million and $1.6$2.2 million as of SeptemberJune 30, 20212022 and December 31, 2020,2021, which supports certain leased facilities as well as other normal business activities in the United States and Europe. These letters of credit and guarantees were issued outside of the revolving credit facility.
WeOn March 29, 2022, we entered into a Security Agreement Supplement pursuant to which the Security and Pledge Agreement (the Security Agreement), dated March 10, 2021 pursuantwas supplemented to which we grantedgrant collateral on behalf of the holders of the 2024 Notes, and the parties secured under the Credit Agreementcredit agreements (the Secured Parties) including first priority liens and security interests in (a) all present and future shares of capital stock owned by the Credit PartiesGrantors (as defined)defined in the Credit Parties’Security Agreement) in the Grantors’ present and future subsidiaries, subject to certain customary exceptions, and (b) all present and future personal property and assets of the Credit Parties,Grantors, subject to certain exceptions.
On March 10, 2021,29, 2022, we entered into an amendment to our accounts receivable securitization program (the Receivables Securitization Program)Financing Agreement). Pursuant to the amended Receivables Securitization Program,Financing Agreement, the aggregate principal amount of the loans made by the Lenders (as defined) will not exceed $450 million outstanding at any time. The interest rate under the Receivables Securitization ProgramFinancing Agreement is based on a spread over a benchmark SOFR rate (as described in the ThirdFourth Amendment to the Receivables Financing Agreement). Under the Receivables Securitization Program,Financing Agreement, certain of our subsidiaries sell substantially all of their accounts receivable balances to our wholly owned special purpose entity, O&M Funding LLC. The Receivables Securitization ProgramFinancing Agreement matures in March 2024.2025.
The Revolving Credit Agreement, Term Loan A, Term Loan B, Receivables Securitization Program,Financing Agreement, 2024 Notes, 2029 Unsecured Notes, and 20292030 Unsecured Notes contain cross-default provisions which could result in the acceleration of payments due in the event of default of any of the related agreements. The terms of the Credit Agreementcredit agreements also require us to maintain ratios for leverage and interest coverage, including on a pro forma basis in the event of an acquisition or divestiture. We were in compliance with our debt covenants at SeptemberJune 30, 2021.2022.
As of SeptemberJune 30, 2021,2022, scheduled future principal payments of debt, excluding finance leases and other, were $446$3.0 million in 2022, $15.4 million in 2023, $274 million in 2024, $12.3$215 million in 2025, $43.5 million in 2026, and $500$403 million in 2029.2027, $6.0 million in 2028, $1.1 billion in 2029, and $600 million in 2030. Current maturities at SeptemberJune 30, 20212022 include $1.6$3.1 million in principal payments on our Term Loan A, $6.0 million in principal payments on our Term Loan B and $1.7 million in current portion of finance leases.

Note 7—Retirement Plans

We have a frozen noncontributory, unfunded retirement plan for certain retirees in the United States.States (U.S. Retirement Plan). As of June 30, 2022 and December 31, 2021, the accumulated benefit obligation of the U.S. Retirement Plan was $49.0 million and $50.2 million. Certain of our foreign subsidiaries also have defined benefit pension plans covering substantially all of their respective teammates.
The components of net periodic benefit cost for the three and ninesix months ended SeptemberJune 30, 20212022 and 20202021 were as follows:
Three Months Ended
 September 30,
Nine Months Ended
 September 30,
Three Months Ended
 June 30,
Six Months Ended
 June 30,
20212020202120202022202120222021
Service costService cost$693 $362 $2,106 $1,073 Service cost$617 $709 $1,250 $1,413 
Interest costInterest cost443 498 1,337 1,488 Interest cost519 448 1,042 894 
Recognized net actuarial lossRecognized net actuarial loss353 214 1,060 642 Recognized net actuarial loss267 354 534 707 
Net periodic benefit costNet periodic benefit cost$1,489 $1,074 $4,503 $3,203 Net periodic benefit cost$1,403 $1,511 $2,826 $3,014 

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Note 8—Derivatives

We are directly and indirectly affected by changes in foreign currency, which may adversely impact our financial performance and are referred to as “market risks.” When deemed appropriate, we use derivatives as a risk management tool to mitigate the potential impact of certain market risks. We do not enter into derivative financial instruments for trading purposes.
We enter into foreign currency contracts to manage our foreign exchange exposure related to certain balance sheet items that do not meet the requirements for hedge accounting. These derivative instruments are adjusted to fair value at the end of each period through earnings. The gain or loss recorded on these instruments is substantially offset by the remeasurement adjustment on the foreign currency denominated asset or liability.
We pay interest on our Credit Agreement which fluctuates based on changes in our benchmark interest rates. In order to mitigate the risk of increases in benchmark rates, we entered into an interest rate swap agreement whereby we agree to exchange with the counterparty, at specified intervals, the difference between fixed and variable amounts calculated by reference to the notional amount. The interest rate swaps were designated as cash flow hedges. Cash flows related to the interest rate swap agreement are included in interest expense.
We determine the fair value of our foreign currency derivatives and interest rate swaps based on observable market-based inputs or unobservable inputs that are corroborated by market data. We do not view the fair value of our derivatives in isolation, but rather in relation to the fair values or cash flows of the underlying exposure. All derivatives are carried at fair value in our consolidated balance sheets in other current assets and other current liabilities. We consider the risk of counterparty default to be minimal. We report cash flows from our hedging instruments in the same cash flow statement category as the hedged items.
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The following table summarizes the terms and fair value of our outstanding derivative financial instruments as of SeptemberJune 30, 2021:2022:
Derivative AssetsDerivative LiabilitiesDerivative AssetsDerivative Liabilities
Notional AmountMaturity DateClassificationFair ValueClassificationFair ValueNotional AmountMaturity DateClassificationFair ValueClassificationFair Value
Cash flow hedgesCash flow hedges
Interest rate swapsInterest rate swaps$400,000 March 2027Other assets$3,736 Other liabilities$— 
Economic (non-designated) hedgesEconomic (non-designated) hedgesEconomic (non-designated) hedges
Foreign currency contractsForeign currency contracts$14,400 October 2021Other current assets$92 Other current liabilities$— Foreign currency contracts$61,077 July 2022Other current assets$Other current liabilities$227 
In March 2021, we terminated the remaining $300 million in notional value of interest rate swaps concurrent with the debt financing transaction. In September 2020, we terminated $150 million in notional value of interest rate swaps. The remaining balance of the fair value adjustments of $25.1 million, which related to these terminated interest rate swaps, within Accumulated other comprehensive loss was reclassified to Loss on extinguishment of debt within our consolidated statements of operations for the ninesix months ended SeptemberJune 30, 2021.
The following table summarizes the terms and fair value of our outstanding derivative financial instruments as of December 31, 2020:2021:
Derivative AssetsDerivative LiabilitiesDerivative AssetsDerivative Liabilities
Notional AmountMaturity DateClassificationFair ValueClassificationFair ValueNotional AmountMaturity DateClassificationFair ValueClassificationFair Value
Cash flow hedges
Interest rate swaps$300,000 May 2022 and May 2025Other assets, net$— Other liabilities$17,872 
Economic (non-designated) hedgesEconomic (non-designated) hedgesEconomic (non-designated) hedges
Foreign currency contractsForeign currency contracts$30,300 January 2021Other current assets$151 Other current liabilities$— Foreign currency contracts$9,700 January 2022Other current assets$81 Other current liabilities$— 
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The following table summarizes the effect of cash flow hedge accounting on our consolidated statements of operations for the three and ninesix months ended SeptemberJune 30, 2021:2022:
Amount of Gain Recognized in Other Comprehensive Income (Loss)Location of Loss Reclassified from Accumulated Other Comprehensive Loss into IncomeTotal Amount of Expense Line Items Presented in the Consolidated Statement of Operations in Which the Effects are RecordedAmount of Loss Reclassified from Accumulated Other Comprehensive Loss into Income
Three Months Ended September 30, 2021Nine Months Ended September 30, 2021Three Months Ended September 30, 2021Nine Months Ended September 30, 2021Three Months Ended September 30, 2021Nine Months Ended September 30, 2021
Interest rate swaps$— $2,426 Loss on extinguishment of debt$— $(40,433)$— $(25,518)
The amount of ineffectiveness associated with these contracts was immaterial for the periods presented.

Amount of Gain Recognized in Other Comprehensive Income (Loss)Location of Loss Reclassified from Accumulated Other Comprehensive Loss into IncomeTotal Amount of Expense Line Items Presented in the Consolidated Statement of Operations in Which the Effects are RecordedAmount of Loss Reclassified from Accumulated Other Comprehensive Loss into Income
Three months ended June 30, 2022Six months ended June 30, 2022Three months ended June 30, 2022Six months ended June 30, 2022Three months ended June 30, 2022Six months ended June 30, 2022
Interest rate swaps$2,044 $2,044 Interest expense, net$(35,839)$(47,858)$(1,692)$(1,692)
The following table summarizes the effect of cash flow hedge accounting on our consolidated statements of operations for the three and ninesix months ended SeptemberJune 30, 2020:2021:
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Amount of Loss Recognized in Other Comprehensive Income (Loss)Location of Loss Reclassified from Accumulated Other Comprehensive Loss into IncomeTotal Amount of Expense Line Items Presented in the Consolidated Statement of Operations in Which the Effects are RecordedAmount of Loss Reclassified from Accumulated Other Comprehensive Loss into Income
Three Months Ended September 30, 2020Nine Months Ended September 30, 2020Three Months Ended September 30, 2020Nine Months Ended September 30, 2020Three Months Ended September 30, 2020Nine Months Ended September 30, 2020
Interest rate swaps$(515)$(19,913)Interest expense, net$(20,975)$(65,923)$(3,028)$(6,889)
Amount of Gain Recognized in Other Comprehensive Income (Loss)Location of Loss Reclassified from Accumulated Other Comprehensive Loss into IncomeTotal Amount of Expense Line Items Presented in the Consolidated Statement of Operations in Which the Effects are RecordedAmount of Loss Reclassified from Accumulated Other Comprehensive Loss into Income
Three months ended June 30, 2021Six months ended June 30, 2021Three months ended June 30, 2021Six months ended June 30, 2021Three months ended June 30, 2021Six months ended June 30, 2021
Interest rate swaps$— $2,426 Loss on extinguishment of debt$— $(40,433)$— $(25,518)
The amount of ineffectiveness associated with these contracts was immaterial for the periods presented.

For the three and ninesix months ended SeptemberJune 30, 20212022 we recognized losses of $0.9$1.3 million and $2.5$1.4 million associated with our economic (non-designated) foreign currency contracts. For the three and ninesix months ended SeptemberJune 30, 20202021 we recognized losses of $0.9$0.6 million and $2.3$1.6 million associated with our economic (non-designated) foreign currency contracts.
We recorded the change in fair value of derivative instruments and the remeasurement adjustment of the foreign currency denominated asset or liability in other operating income, net for our foreign exchange contracts.

Note 9—Leases

The components of lease expense were as follows:
Three Months Ended
 June 30,
Six Months Ended
 June 30,
Classification2022202120222021
Operating lease costDS&A Expenses$24,501 $14,705 $40,601 $28,791 
Finance lease cost:
Amortization of lease assetsDS&A Expenses295 182 626 421 
Interest on lease liabilitiesInterest expense, net304 294 611 601 
Total finance lease cost599 476 1,237 1,022 
Short-term lease costDS&A Expenses1,039 225 1,155 483 
Variable lease costDS&A Expenses9,299 4,343 14,028 8,660 
Total lease cost$35,438 $19,749 $57,021 $38,956 
Variable lease cost consists primarily of taxes, insurance, and common area or other maintenance costs for our leased facilities which are paid as incurred.
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Supplemental balance sheet information is as follows:
ClassificationJune 30,
2022
December 31, 2021
Assets:
Operating lease assetsOperating lease assets$278,291 $194,006 
Finance lease assetsProperty and equipment, net8,468 8,896 
Total lease assets$286,759 $202,902 
Liabilities:
Current
OperatingOther current liabilities$69,650 $41,817 
FinanceOther current liabilities1,691 2,037 
Noncurrent
OperatingOperating lease liabilities, excluding current portion220,504 162,241 
FinanceLong-term debt, excluding current portion11,429 11,314 
Total lease liabilities$303,274 $217,409 
The gross value recorded under finance leases was $17.9 million and $20.6 million with associated accumulated amortization of $9.4 million and $11.7 million as of June 30, 2022 and December 31, 2021. Operating lease assets include $77.8 million in right-of-use assets and $79.6 million of operating lease liabilities associated with Apria as of June 30, 2022.
Other information related to leases was as follows:
Six Months Ended
June 30,
20222021
Supplemental cash flow information
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating and finance leases$39,256$28,471 
Financing cash flows from finance leases$744$423 
Right-of-use assets obtained in exchange for new operating and finance lease liabilities$49,641$54,640 
Weighted average remaining lease term (years)
Operating leases4.55.2
Finance leases6.17.7
Weighted average discount rate
Operating leases6.8%8.8%
Finance leases10.8%12.4%
Maturities of lease liabilities as of June 30, 2022 were as follows:
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Operating LeasesFinance LeasesTotal
2022$45,195 $1,351 $46,546 
202388,720 2,693 91,413 
202474,905 2,641 77,546 
202554,017 2,588 56,605 
202637,149 2,506 39,655 
Thereafter54,088 4,774 58,862 
Total lease payments354,074 16,553 370,627 
Less: Interest(63,920)(3,433)(67,353)
Present value of lease liabilities$290,154 $13,120 $303,274 
As of June 30, 2022, we had an estimated net $50 million cancellable commitment, which includes a potential lease, associated with a future site of a center of excellence for medical supplies and logistics in Morgantown, West Virginia.
Note 10—Income Taxes

The effective tax rate was 12.6%25.6% and 20.8%21.7% for the three and ninesix months ended SeptemberJune 30, 2021,2022, compared to 13.8%21.8% and 9.4%23.2% in the same periods of 2020.2021. The change in these rates resulted primarily from an income tax benefit recorded in the first quarter of 2020 associated with the Coronavirus Aid, Relief, and Economic Security (CARES) Act and in the third quarter of 2021 associated with the 2017 Tax Cuts and Jobs Act, the mixture of income and losses in jurisdictions in which we operate, andoffset by the incremental income tax benefit associated with the vesting of restricted stock.stock recorded in the six months ended June 30, 2022. The liability for unrecognized tax benefits was $23.0$21.7 million at SeptemberJune 30, 20212022 and $20.8$21.4 million at December 31, 2020.2021. Included in the liability at SeptemberJune 30, 20212022 and December 31, 20202021 were $2.7 million of tax positions for which ultimate deductibility is highly certain but for which there is uncertainty about the timing of such deductibility.
On August 26, 2020, we received a Notice of Proposed Adjustment (NOPA) from the Internal Revenue ServicesService (IRS) regarding our 2015 and 2016 consolidated income tax returns. On June 30, 2021, we received a NOPA from the IRS regarding our 2017 and 2018 consolidated income tax returns. Within the NOPAs, the IRS has asserted that our taxable income for the aforementioned years should be higher based on their assessment of the appropriate amount of taxable income that we should report in the United States in connection with our sourcing of products by our foreign subsidiaries for sale in the United States by our domestic subsidiaries. Our amount of taxable income in the United States is based on our transfer pricing methodology, which has been consistently applied through the current date. We strongly disagree with the IRS position and will pursue all available administrative and judicial remedies, including those available under the U.S. - Ireland Income Tax Treaty to alleviate double taxation. We regularly assess the likelihood of adverse outcomes resulting from examinations such as this to determine the adequacy of our tax reserves. We believe that we have adequately reserved for this matter and that the final adjudication of this matter will not have a material impact on our consolidated financial position, results of operations or cash flows. However, the ultimate outcome of disputes of this nature is uncertain, and if the IRS were to prevail on its assertions, the additional tax, interest, and any potential penalties could have a material adverse impact on our financial position, results of operations or cash flows.

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Note 10—11—Net Income (Loss) per Common Share

The following summarizes the calculation of net income (loss) per common share attributable to common shareholders for the three and ninesix months ended SeptemberJune 30, 20212022 and 2020:2021:

Three Months Ended
 September 30,
Nine Months Ended
 September 30,
(in thousands, except per share data)2021202020212020
Income from continuing operations, net of tax$44,129 $46,081 $179,614 $37,332 
Loss from discontinued operations, net of tax —  (58,203)
Net income (loss)$44,129 $46,081 $179,614 $(20,871)
Weighted average shares outstanding - basic73,215 60,786 72,649 60,983
Dilutive shares2,743 137 2,754  
Weighted average shares outstanding - diluted75,958 60,923 75,403 60,983 
Basic income (loss) per common share:
Income from continuing operations$0.60 $0.76 $2.47 $0.61 
Loss from discontinued operations —  (0.95)
Net income (loss)$0.60 $0.76 $2.47 $(0.34)
Diluted income (loss) per common share:
Income from continuing operations$0.58 $0.76 $2.38 $0.61 
Loss from discontinued operations —  (0.95)
Net income (loss)$0.58 $0.76 $2.38 $(0.34)
Three Months Ended
 June 30,
Six Months Ended
 June 30,
(in thousands, except per share data)2022202120222021
Net income$28,604 $65,896 $67,884 $135,486 
Weighted average shares outstanding - basic74,710 72,81874,158 72,474
Dilutive shares1,587 2,987 2,011 2,791 
Weighted average shares outstanding - diluted76,297 75,805 76,169 75,265 
Net income per common share:
Basic$0.38 $0.90 $0.92 $1.87 
Diluted$0.37 $0.87 $0.89 $1.80 

Note 11—12—Shareholders' Equity

In May 2020, we entered into an equity distribution agreement, pursuant to which we may offer and sell, from time to time, shares of our common stock having an aggregate offering price of up to $50.0 million. We intend to use the net proceeds from the sale of our securities offered by this program for the repayment of indebtedness and/or for general corporate and working capital purposes. As of SeptemberJune 30, 2021,2022, no shares were issued and $50.0 million of common stock remained available under the at-the-market equity financing program.

Note 12—13—Accumulated Other Comprehensive Loss

The following table shows the changes in accumulated other comprehensive loss by component for the three and ninesix months ended SeptemberJune 30, 20212022 and 2020:2021: 
Retirement PlansCurrency
Translation
Adjustments
DerivativesTotal
Accumulated other comprehensive loss, March 31, 2022$(14,408)$(26,781)$— $(41,189)
Other comprehensive (loss) income before reclassifications— (18,831)2,044 (16,787)
Income tax— — (532)(532)
Other comprehensive (loss) income before reclassifications, net of tax— (18,831)1,512 (17,319)
Amounts reclassified from accumulated other comprehensive loss386 — 1,692 2,078 
Income tax(89)— (440)(529)
Amounts reclassified from accumulated other comprehensive loss, net of tax297 — 1,252 1,549 
Other comprehensive (loss) income297 (18,831)2,764 (15,770)
Accumulated other comprehensive (loss) gain, June 30, 2022$(14,111)$(45,612)$2,764 $(56,959)
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Retirement PlansCurrency
Translation
Adjustments
DerivativesTotalRetirement PlansCurrency Translation AdjustmentsDerivativesTotal
Accumulated other comprehensive loss, June 30, 2021$(18,290)$(14,728)$— $(33,018)
Accumulated other comprehensive loss, March 31, 2021Accumulated other comprehensive loss, March 31, 2021$(18,326)$(12,280)$— $(30,606)
Other comprehensive loss before reclassificationsOther comprehensive loss before reclassifications— (12,014)— (12,014)Other comprehensive loss before reclassifications— (2,448)— (2,448)
Income taxIncome tax— — — — Income tax— — — — 
Other comprehensive loss before reclassifications, net of taxOther comprehensive loss before reclassifications, net of tax— (12,014)— (12,014)Other comprehensive loss before reclassifications, net of tax— (2,448)— (2,448)
Amounts reclassified from accumulated other comprehensive lossAmounts reclassified from accumulated other comprehensive loss500 — — 500 Amounts reclassified from accumulated other comprehensive loss48 — — 48 
Income taxIncome tax(105)— — (105)Income tax(12)— — (12)
Amounts reclassified from accumulated other comprehensive loss, net of taxAmounts reclassified from accumulated other comprehensive loss, net of tax395 — — 395 Amounts reclassified from accumulated other comprehensive loss, net of tax36 — — 36 
Other comprehensive income (loss)Other comprehensive income (loss)395 (12,014)— (11,619)Other comprehensive income (loss)36 (2,448)— (2,412)
Accumulated other comprehensive loss, September 30, 2021$(17,895)$(26,742)$ $(44,637)
Accumulated other comprehensive loss, June 30, 2021Accumulated other comprehensive loss, June 30, 2021$(18,290)$(14,728)$— $(33,018)
Retirement PlansCurrency Translation AdjustmentsDerivativesTotal
Accumulated other comprehensive loss, June 30, 2020$(13,926)$(23,471)$(24,188)$(61,585)
Other comprehensive income (loss) before reclassifications— 5,173 (516)4,657 
Income tax— — 40 40 
Other comprehensive income (loss) before reclassifications, net of tax— 5,173 (476)4,697 
Amounts reclassified from accumulated other comprehensive loss214 — 3,028 3,242 
Income tax(47)— (871)(918)
Amounts reclassified from accumulated other comprehensive loss, net of tax167 — 2,157 2,324 
Other comprehensive income167 5,173 1,681 7,021 
Accumulated other comprehensive loss, September 30, 2020$(13,759)$(18,298)$(22,507)$(54,564)
Retirement PlansCurrency Translation AdjustmentsDerivativesTotal
Accumulated other comprehensive loss, December 31, 2021$(14,597)$(25,994)$— $(40,591)
Other comprehensive (loss) income before reclassifications— (19,618)2,044 (17,574)
Income tax— — (532)(532)
Other comprehensive (loss) income before reclassifications, net of tax— (19,618)1,512 (18,106)
Amounts reclassified from accumulated other comprehensive loss635 — 1,692 2,327 
Income tax(149)— (440)(589)
Amounts reclassified from accumulated other comprehensive loss, net of tax486 — 1,252 1,738 
Other comprehensive (loss) income486 (19,618)2,764 (16,368)
Accumulated other comprehensive (loss) gain, June 30, 2022$(14,111)$(45,612)$2,764 $(56,959)

Retirement PlansCurrency
Translation
Adjustments
DerivativesTotal
Accumulated other comprehensive loss, December 31, 2020$(18,447)$(18)$(20,044)$(38,509)
Other comprehensive (loss) income before reclassifications— (26,724)2,426 (24,298)
Income tax— — (611)(611)
Other comprehensive (loss) income before reclassifications, net of tax— (26,724)1,815 (24,909)
Amounts reclassified from accumulated other comprehensive loss704 — 25,518 26,222 
Income tax(152)— (7,289)(7,441)
Amounts reclassified from accumulated other comprehensive loss, net of tax552 — 18,229 18,781 
Other comprehensive income (loss)552 (26,724)20,044 (6,128)
Accumulated other comprehensive loss, September 30, 2021$(17,895)$(26,742)$ $(44,637)
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Retirement PlansCurrency Translation AdjustmentsDerivativesTotal
Accumulated other comprehensive loss, December 31, 2019$(14,691)$(25,301)$(12,715)$(52,707)
Other comprehensive loss before reclassifications— (8,577)(19,913)(28,490)
Income tax— — 5,113 5,113 
Other comprehensive loss before reclassifications, net of tax— (8,577)(14,800)(23,377)
Amounts reclassified from accumulated other comprehensive loss1,067 15,580 6,889 23,536 
Income tax(135)— (1,881)(2,016)
Amounts reclassified from accumulated other comprehensive loss, net of tax932 15,580 5,008 21,520 
Other comprehensive income (loss)932 7,003 (9,792)(1,857)
Accumulated other comprehensive loss, September 30, 2020$(13,759)$(18,298)$(22,507)$(54,564)

Retirement PlansCurrency Translation AdjustmentsDerivativesTotal
Accumulated other comprehensive loss, December 31, 2020$(18,447)$(18)$(20,044)$(38,509)
Other comprehensive (loss) income before reclassifications— (14,710)2,426 (12,284)
Income tax— — (611)(611)
Other comprehensive (loss) income before reclassifications, net of tax— (14,710)1,815 (12,895)
Amounts reclassified from accumulated other comprehensive loss204 — 25,518 25,722 
Income tax(47)— (7,289)(7,336)
Amounts reclassified from accumulated other comprehensive loss, net of tax157 — 18,229 18,386 
Other comprehensive income (loss)157 (14,710)20,044 5,491 
Accumulated other comprehensive loss, June 30, 2021$(18,290)$(14,728)$— $(33,018)
We include amounts reclassified out of accumulated other comprehensive loss related to defined benefit pension plans as a component of net periodic pension cost recorded in Other expense, (income), net.

Note 13—Segment Information
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Note 14—Segment Information
We periodically evaluate our application of accounting guidance for reportable segments and disclose information about reportable segments based on the way management organizes the enterprise for making operating decisions and assessing performance. We report our business under 2 segments: Global SolutionsProducts & Healthcare Services and Global Products.Patient Direct. The Global SolutionsProducts & Healthcare Services segment includes our United States distribution businessesbusiness (Medical Distribution and Patient Direct)Distribution), outsourced logistics and value-added services business.business, and Global Products which manufactures and sources medical surgical products through our production and kitting operations. The Patient Direct segment includes our home healthcare businesses (Byram and Apria).
We evaluate the performance of our segments based on their operating income excluding intangible amortization and acquisition-related and exit and realignment charges that, either as a result of their nature or size, would not be expected to occur as part of our normal business operations on a regular basis.
Segment assets exclude inter-segment account balances as we believe their inclusion would be misleading and not meaningful. We believe all inter-segment sales are at prices that approximate market.
The following tables present financial information by segment:
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Three Months Ended
 September 30,
Nine Months Ended
 September 30,
2021202020212020
Net revenue:
Segment net revenue
Global Solutions$2,022,919 $1,865,182 $5,850,007 $5,261,415 
Global Products679,067 473,797 2,026,385 1,235,391 
Total segment net revenue2,701,986 2,338,979 7,876,392 6,496,806 
Inter-segment revenue
Global Products(199,811)(151,051)(558,223)(378,466)
       Total inter-segment revenue(199,811)(151,051)(558,223)(378,466)
Consolidated net revenue$2,502,175 $2,187,928 $7,318,169 $6,118,340 
Operating income:
Global Solutions$20,366 $10,972 $47,729 $8,522 
Global Products51,327 89,923 310,242 160,268 
Inter-segment eliminations7,587 (8,718)(475)(10,322)
Intangible amortization(10,025)(10,242)(30,077)(31,463)
Acquisition-related and exit and realignment charges(6,380)(6,382)(20,967)(18,500)
Consolidated operating income$62,875 $75,553 $306,452 $108,505 
Depreciation and amortization:
Global Solutions$9,951 $9,572 $29,678 $31,273 
Global Products12,691 11,118 38,464 38,221 
Consolidated depreciation and amortization$22,642 $20,690 $68,142 $69,494 
Capital expenditures:
Global Solutions$5,752 $3,582 $14,776 $7,545 
Global Products8,192 10,656 17,849 15,808 
Discontinued operations —  3,027 
Consolidated capital expenditures$13,944 $14,238 $32,625 $26,380 
Three Months Ended
 June 30,
Six Months Ended
 June 30,
2022202120222021
Net revenue:
Products & Healthcare Services$1,927,388 $2,255,820 $4,061,429 $4,365,265 
Patient Direct572,627 233,640 845,538 450,729 
Consolidated net revenue$2,500,015 $2,489,460 $4,906,967 $4,815,994 
Operating income:
Products & Healthcare Services$61,243 $101,229 $150,325 $251,647 
Patient Direct52,332 14,305 68,125 26,569 
Intangible amortization(30,888)(10,026)(41,156)(20,052)
Acquisition-related and exit and realignment charges(7,602)(8,624)(41,150)(14,587)
Consolidated operating income$75,085 $96,884 $136,144 $243,577 
Depreciation and amortization:
Products & Healthcare Services$19,209 $18,847 $38,203 $38,007 
Patient Direct53,952 3,753 59,083 7,494 
Consolidated depreciation and amortization$73,161 $22,600 $97,286 $45,501 
Capital expenditures:
Products & Healthcare Services$18,418 $11,806 $29,061 $18,270 
Patient Direct36,320 252 36,638 411 
Consolidated capital expenditures$54,738 $12,058 $65,699 $18,681 


September 30, 2021December 31, 2020June 30,
2022
December 31, 2021
Total assets:Total assets:Total assets:
Global Solutions$2,135,865 $2,117,372 
Global Products1,408,495 1,135,209 
Products & Healthcare ServicesProducts & Healthcare Services$2,968,089 $3,012,303 
Patient DirectPatient Direct2,530,783 468,536 
Segment assetsSegment assets3,544,360 3,252,581 Segment assets5,498,872 3,480,839 
Cash and cash equivalentsCash and cash equivalents39,759 83,058 Cash and cash equivalents56,406 55,712 
Consolidated total assetsConsolidated total assets$3,584,119 $3,335,639 Consolidated total assets$5,555,278 $3,536,551 

The following table presents net revenue by geographic area, which were attributed based on the location from which we ship products or provide services.
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Three Months Ended September 30,Nine Months Ended September 30,
2021202020212020
Net revenue:
United States$2,380,794 $2,101,074 $6,900,222 $5,872,143 
International121,381 86,854 417,947 246,197
Consolidated net revenue$2,502,175 $2,187,928 $7,318,169 $6,118,340 
we ship products or provide services.
Three Months Ended June 30,Six Months Ended June 30,
2022202120222021
Net revenue:
United States$2,376,573 $2,336,673 $4,638,592 $4,519,428 
International123,442 152,787 268,375 296,566 
Consolidated net revenue$2,500,015 $2,489,460 $4,906,967 $4,815,994 

Note 14—15—Recent Accounting Pronouncements
In December 2019,On June 16, 2016, the FASB issued ASU No. 2019-12, Simplifying2016-13 Financial Instruments - Credit Losses, Measurement of Credit Losses on Financial Instruments, which changes the Accountingway entities measure credit losses for Income Taxes, which simplifiesmost financial assets and certain other instruments that are not measured at fair value through net earnings. This standard will be effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. Early adoption is permitted. We are still evaluating the accounting for income taxes, eliminates certain exceptions within ASC 740, Income Taxes, and clarifies certain aspectsimpact the adoption of the current guidance to promote consistency among reporting entities. Most amendments within the standard are required to be applied on a prospective basis, while certain amendments must be applied on a retrospective or modified retrospective basis. We adopted ASU No. 2019-12 effective beginning January 1, 2021. Its adoption did not2016-13 will have a material impact on our consolidated financial statements.statements and related disclosures; however, we do not expect this to have a material impact. Subsequent to the issuance of ASU No. 2016-13, the FASB issued ASU 2018-19, Codification Improvements to Topic 326, Financial Instruments - Credit Losses and ASU No. 2019-05, Financial Instruments - Credit Losses (Topic 326) Targeted Transition Relief. These ASUs do not change the core principle of the guidance in ASU No. 2016-13. Instead these amendments are intended to clarify and improve operability of certain topics included within the credit losses standard. These ASUs will have the same effective date and transition requirements as ASU No. 2016-13.
In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional expedients and exceptions for applying GAAP to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criteria are met. The amendments apply only to contracts, hedging relationships, and other transactions that reference LIBOR or another reference rate expected to be discontinued because of reference rate reform. The amendments are effective for all entities as of March 12, 2020 through December 31, 2022.Our currentmaterial debt agreements contemplateno longer reference LIBOR as a benchmark rate. The transition from LIBOR to another benchmark rate in the event that LIBOR ceases to exist. We dodid not expect the transition to have a material impact on our consolidated financial statements.
In October 2020, the FASB issued ASU No. 2020-10, Codification Improvements, to improve consistency by amending the FASB Accounting Standards Codification (the Codification) to include all disclosure guidance in the appropriate disclosure sections. This ASU also clarifies application of various provisions in the Codification by amending and adding new headings, cross referencing to other guidance, and refining or correcting terminology. The amendments in this ASU do not change GAAP and, therefore, are not expected to result in a significant change in practice. We adopted ASU No. 2020-10 effective beginning January 1, 2021. Its adoption did not have a material impact on our consolidated financial statements.
ThereIn October 2021, the FASB issued ASU No. 2021-08, Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers. ASU 2021-08 requires the company acquiring contract assets and contract liabilities obtained in a business combination to recognize and measure them in accordance with ASC 606, Revenue from Contracts with Customers. At the acquisition date, the company acquiring the business should record related revenue, as if it had originated the contract. Before the update such amounts were recognized by the acquiring company at fair value. The amendments in this ASU are effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. Early adoption is permitted, including in interim periods, for any financial statements that have not yet been no further changes inissued. We adopted ASU 2021-08 prospectively, effective beginning January 1, 2022. Its adoption did not have a material impact on our significantconsolidated financial statements.
In November 2021, the FASB issued ASU 2021-10, Government Assistance (Topic 832): Disclosures by Business Entities about Government Assistance, which requires certain annual disclosures about transactions with a government that are accounted for by applying a grant or contribution accounting policies from those contained inmodel by analogy. We adopted ASU No. 2021-10 effective beginning January 1, 2022. Its adoption did not have a material impact on our Annual Report on Form 10-K for the year ended December 31, 2020.consolidated financial statements.

Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following discussion and analysis describes results of operations and material changes in the financial condition of Owens & Minor, Inc. and its subsidiaries since December 31, 2020.2021. Trends of a material nature are discussed to the extent known and considered relevant. This discussion should be read in conjunction with the consolidated financial statements,
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related notes thereto, and management’s discussion and analysis of financial condition and results of operations included in our Annual Report on Form 10-K for the year ended December 31, 2020.2021.
Overview
Owens & Minor, Inc., along with its subsidiaries, (we, us, or our) is a leading global healthcare solutions company. To better reflect how we go to market as well as certain changes to the leadership team, organizational structure, budgeting and financial reporting processes, we have organized our business into two distinct segments: Products & Healthcare Services and Patient Direct. Products & Healthcare Services provides distribution, outsourced logistics and value-added services, and manufactures and sources medical surgical products through our production and kitting operations. Patient Direct expands our business along the continuum of care through delivery of disposable medical supplies sold directly to patients and home health agencies and is a leading provider of integrated home healthcare equipment and related services in the United States. Beginning with the quarter ended March 31, 2022, we now report financial results using this two segment structure and have recast prior year segment results on the same basis.
On June 18, 2020March 29, 2022 (the DivestitureAcquisition Date), we completed the divestitureacquisition of our European logistics business, Movianto (the Divestiture), as well as certain support functions100% of Apria, Inc. (Apria) pursuant to the Agreement and Plan of Merger (Apria Acquisition) dated January 7, 2022, in our Dublin, Ireland office, to Walden Group SAS (the Buyer) and EHDH (as Buyer’s guarantor)exchange for cash consideration of $133 million.approximately $1.7 billion. The Divestiture provides uspurchase was funded with a greater ability to focuscombination of debt and cash on and invest in our differentiated products, services and U.S. distribution businesses.
As a resulthand. At the time of the Divestiture,Apria Acquisition, each share of Apria’s common stock was converted into the resultsright to receive $37.50 in cash. Apria is a leading provider of operations from our Moviantointegrated home healthcare equipment and related services in the United States. This business areis reported as “Loss from discontinued operations, netpart of tax”the Patient Direct segment.
Net income per diluted share was $0.37 and $0.89 for the three and ninesix months ended SeptemberJune 30, 2020. See Note 3, “Discontinued Operations,” of the Notes2022 as compared to Consolidated Financial Statements for further information. Unless otherwise indicated, the following information relates to continuing operations.
Income from continuing operations per diluted share was $0.58$0.87 and $2.38$1.80 for the three and ninesix months ended SeptemberJune 30, 2021 as compared to $0.76 and $0.61 for the three and nine months ended September 30, 2020. Global Solutions2021. Products & Healthcare Services segment operating income was $20.4$61.2 million and $47.7$150 million for the three and ninesix months ended SeptemberJune 30, 2021,2022, compared to $11.0$101 million and $8.5$252 million for the three and ninesix months ended SeptemberJune 30, 2020. These increases2021. The decreases were a
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lower hospital demand, the reduction of glove cost pass through, and headwinds created by macroeconomic conditions, including accelerating inflationary pressures, supply chain issues, and rising interest rates, partially offset by operating efficiencies and productivity gains derived from the Owens & Minor business system. Patient Direct segment operating income was $52.3 million and $68.1 million for the three and six months ended June 30, 2022, compared to $14.3 million and $26.6 million for the three and six months ended June 30, 2021. The increase was primarily the result of the inclusion of Apria in the Patient Direct segment since the Acquisition Date, strong revenue growth in our Byram business, leveraging our fixed costs, and operating efficiencies. Global Products segment operatingefficiencies, partially offset by accelerating inflationary pressures. Net income per diluted share was $51.3 millionunfavorably impacted as compared to the prior year by foreign currency translation in the amount of $0.05 and $310 million$0.08 for the three and ninesix months ended SeptemberJune 30, 2021, compared to $89.9 million and $160 million for the three and nine months ended September 30, 2020. The decrease for the three months ended September 30, 2021 was primarily the result of the timing of glove cost pass-through, accelerating inflationary pressures, including commodities, transportation, and labor, partially offset by revenue growth. The increase for the nine months ended September 30, 2021 was a result of higher personal protective equipment (PPE) sales, favorable timing of cost pass-through on gloves, productivity initiatives, favorable product mix, and improved fixed cost leverage, partially offset by higher commodity prices and rising transportation costs, compared to the prior year.2022.

COVID-19 Update

We are closely monitoring the impact of the 2019 novel coronavirus (COVID-19), including the related Delta variant,its variants and sub-variants, on all aspects of our business, including how it impacts our customers, teammates, suppliers, vendors and distribution channels. We have taken actions to protect our teammates while maintaining business continuity as we respond to the needs from this global pandemic. We will continue to actively monitor the situation and may take further actions that alter our business operations as may be required by federal, state or local authorities or that we determine are in the best interests of our teammates, customers, suppliers and shareholders.
Revenue for the nine months ended September 30, 2021 of $7.3 billion continues to be impacted by COVID-19 and includes the effective response to the ongoing recovery of elective procedures, higher sales of PPE, and pass-through of elevated glove costs.Operating income for the nine months ended September 30, 2021 also benefited from improved productivity and increased manufacturing output related to PPE, favorable product mix and operating efficiencies. In 2020, we expanded our PPE production operations and have taken measures to increase and improve our production such as retooling existing equipment, installing and optimizing new production lines and ramping up our new non-woven fabric machinery. We expect that we will continue servicing our customers' needs related to the heightened demand for our PPE as a result of various factors, including the implementation of new regulations and healthcare protocols calling for increased use of PPE, healthcare professional preference for medical grade PPE, stockpile PPE demand and the creation of new channels for PPE demand in healthcare, non-healthcare and international markets.
In March 2020, under the Defense Production Act (DPA), we were awarded a contract with the U.S. Department of Health and Human Services to produce N-95 respirator masks in an effort to replenish the Strategic National Stockpile. In April 2020, also under the DPA, the U.S. Department of Defense initiated a technology investment agreement with us involving up to $30.0 million of anticipated funding of assets to expand capacity to supply N-95 respirator masks. Through September 30, 2021, substantially all of the anticipated funding had been expended and reimbursed in accordance with this arrangement.
We are unable to predict the timing of the pandemic and the full impact that COVID-19 will have on our future operating results, financial position and cash flows due to numerous variables and continued uncertainties. Travel, transportation,Transportation and business operation restrictions arising from virus containment efforts of governments around the world have continued to impact our operations in certain locations, including within Asia. Essential activity exceptions from these restrictions have allowed us to continue to operate but virus containment efforts have resulted in additional direct costs from supply chain challenges. Although we have experienced growth in sales volumes for certain of our products (such as PPE)personal protective equipment (PPE)) during the COVID-19 pandemic, as well as improved productivity and manufacturing output, there can be no assurance that such growth rates, increased sales volumes or other improvements will be maintained during or following the COVID-19 pandemic.
Results of Operations

Net revenue.Philips Respironics Recall

Three Months Ended
 September 30,
Change
(Dollars in thousands)20212020$%
Global Solutions$2,022,919 $1,865,182 $157,737 8.5 %
Global Products679,067 473,797 205,270 43.3 %
Inter-segment(199,811)(151,051)(48,760)(32.3)%
Net revenue$2,502,175 $2,187,928 $314,247 14.4 %

In June 2021, one of Apria's suppliers, Philips Respironics, announced a voluntary recall (Recall) for continuous and non-continuous ventilators (certain continuous positive airway pressure (CPAP), BiLevel positive airway pressure and ventilator devices) related to polyurethane foam used in those devices. The Food and Drug Administration (FDA) has since identified this as a Class I recall, the most serious category of recall. Because we distribute these products and provide related home respiratory services and, in part, due to the substantial number of impacted devices, we will likely devote substantial time and resources to coordinating recall-related activity and to supporting our home healthcare patients’ needs. This Recall may cause us to incur significant costs, some or all of which may not be recoverable from the product manufacturer. The Recall may
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Nine Months Ended
 September 30,
Change
(Dollars in thousands)20212020$%
Global Solutions$5,850,007 $5,261,415 $588,592 11.2 %
Global Products2,026,385 1,235,391 790,994 64.0 %
Inter-segment(558,223)(378,466)(179,757)(47.5)%
Net revenue$7,318,169 $6,118,340 $1,199,829 19.6 %
also materially negatively affect our revenues and results of operations as a result of patients not using their impacted devices, current shortages in the availability of both replacement devices for impacted patients and new devices for new patients, patient hesitancy to use respiratory devices generally or other reasons.
We are closely monitoring the impact of the Recall on our business and the uncertainty surrounding the availability and supply of CPAP and ventilators due to the Recall. There is an equipment shortage in the industry and the Recall or other supply chain disruptions may have a future material adverse effect on our financial condition or results of operations, cash flows and liquidity.

Results of Operations

Net revenue.
Three Months Ended
 June 30,
Change
(Dollars in thousands)20222021$%
Products & Healthcare Services$1,927,388 $2,255,820 $(328,432)(14.6)%
Patient Direct572,627 233,640 338,987 145.1 %
Net revenue$2,500,015 $2,489,460 $10,555 0.4 %

Six Months Ended
 June 30,
Change
(Dollars in thousands)20222021$%
Products & Healthcare Services$4,061,429 $4,365,265 $(303,836)(7.0)%
Patient Direct845,538 450,729 394,809 87.6 %
Net revenue$4,906,967 $4,815,994 $90,973 1.9 %

The changeincrease in net revenue in our Patient Direct segment for the three and ninesix months ended SeptemberJune 30, 2021 reflected our market share gains,2022 was driven by the effective response to the ongoing recoveryacquisition of elective procedures, higher sales of surgical & infection prevention (S&IP) products, pass-through of elevated glove costs, as well asApria on March 29, 2022 and continued strong performance in our Patient DirectByram business. The decrease in net revenue in our Products & Healthcare Services segment for the three and six months ended June 30, 2022 reflected lower hospital demand and the reduction of glove cost pass through. Foreign currency translation had a favorablean unfavorable impact on net revenue of $1.8$12.6 million and $23.5$21.1 million for the three and ninesix months ended SeptemberJune 30, 20212022 as compared to the prior year.

Cost of goods sold.

Three Months Ended
 September 30,
ChangeThree Months Ended
 June 30,
Change
(Dollars in thousands)(Dollars in thousands)20212020$%(Dollars in thousands)20222021$%
Cost of goods soldCost of goods sold$2,173,336 $1,843,589 $329,747 17.9 %Cost of goods sold$1,967,510 $2,089,392 $(121,882)(5.8)%

Nine Months Ended
 September 30,
ChangeSix Months Ended
 June 30,
Change
(Dollars in thousands)(Dollars in thousands)20212020$%(Dollars in thousands)20222021$%
Cost of goods soldCost of goods sold$6,146,511 $5,236,035 $910,476 17.4 %Cost of goods sold$4,001,014 $3,973,175 $27,839 0.7 %

Cost of goods sold includes the cost of the product (net of supplier incentives and cash discounts) and all costs incurred for shipments of products from manufacturers to our distribution centers for all customer arrangements where we are the primary obligor and bear risk of general and physical inventory loss. These are sometimes referred to as distribution contracts. Cost of goods sold also includes direct and certain indirect labor, depreciation of certain property and equipment, product costs, and material and overhead costs associated with our Global Products segment. There is no cost of goods sold associated with our fee-for-service arrangements.costs. Cost of goods sold compared to prior year reflects the inclusion of Apria since the Acquisition Date, changes in sales activity, including salesproduct mix, and accelerating inflationary pressures.pressures, and supply chain issues.

Gross margin.

Three Months Ended
 September 30,
Change
(Dollars in thousands)20212020$%
Gross margin$328,839 $344,339 $(15,500)(4.5)%
As a % of net revenue13.14 %15.74 %

Nine Months Ended
 September 30,
Change
(Dollars in thousands)20212020$%
Gross margin$1,171,658 $882,305 $289,353 32.8 %
As a % of net revenue16.01 %14.42 %
Gross margin decrease in the three months ended September 30, 2021 was driven by the timing of glove cost pass-through and accelerating inflationary pressures, partially offset by revenue growth. Gross margin increase in the nine months ended September 30, 2021 was driven by revenue growth, market dynamics including timing of glove price and cost changes, an overall improved sales mix and operating efficiencies, partially offset by accelerating inflationary pressures. Foreign
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Three Months Ended
 June 30,
Change
(Dollars in thousands)20222021$%
Gross margin$532,505 $400,068 $132,437 33.1 %
As a % of net revenue21.30 %16.07 %

Six Months Ended
 June 30,
Change
(Dollars in thousands)20222021$%
Gross margin$905,953 $842,819 $63,134 7.5 %
As a % of net revenue18.46 %17.50 %
Gross margin increase in the three and six months ended June 30, 2022 was driven by inclusion of Apria in the Patient Direct segment since the Acquisition Date and sales mix, partially offset by lower hospital demand, the reduction of glove cost pass through, accelerating inflationary pressures, and supply chain issues. Foreign currency translation had an unfavorable impact on gross margin of $6.2$6.9 million and $0.8$10.8 million for the three and ninesix months ended SeptemberJune 30, 20212022 as compared to the prior year.

Operating expenses.

Three Months Ended
 September 30,
ChangeThree Months Ended
 June 30,
Change
(Dollars in thousands)(Dollars in thousands)20212020$%(Dollars in thousands)20222021$%
Distribution, selling and administrative expensesDistribution, selling and administrative expenses$262,457 $262,538 $(81)— %Distribution, selling and administrative expenses$452,813 $294,096 $158,717 54.0 %
As a % of net revenueAs a % of net revenue10.49 %12.00 %As a % of net revenue18.11 %11.81 %
Acquisition-related and exit and realignment chargesAcquisition-related and exit and realignment charges$6,380 $6,382 $(2)— %Acquisition-related and exit and realignment charges$7,602 $8,624 $(1,022)(11.9)%
Other operating income, net$(2,873)$(134)$(2,739)(2,044.0)%
Other operating (income) expense, netOther operating (income) expense, net$(2,995)$464 $(3,459)(745.5)%

Nine Months Ended
 September 30,
ChangeSix Months Ended
 June 30,
Change
(Dollars in thousands)(Dollars in thousands)20212020$%(Dollars in thousands)20222021$%
Distribution, selling and administrative expensesDistribution, selling and administrative expenses$849,255 $758,320 $90,935 12.0 %Distribution, selling and administrative expenses$732,553 $586,796 $145,757 24.8 %
As a % of net revenueAs a % of net revenue11.60 %12.39 %As a % of net revenue14.93 %12.18 %
Acquisition-related and exit and realignment chargesAcquisition-related and exit and realignment charges$20,967 $18,500 $2,467 13.3 %Acquisition-related and exit and realignment charges$41,150 $14,587 $26,563 182.1 %
Other operating income, net$(5,016)$(3,020)$(1,996)(66.1)%
Other operating (income) expense, netOther operating (income) expense, net$(3,894)$(2,141)$(1,753)(81.9)%

Distribution, selling and administrative (DS&A) expenses include labor and warehousing costs associated with our distribution and outsourced logistics services and all costs associated with our fee-for-service arrangements.arrangements in our Products & Healthcare Services segment. Shipping and handling costs are primarily included in DS&A expenses and include costs to store, move, and prepare products for shipment, as well as costs to deliver products to customers.Overall DS&A expenses were affected by revenue growth, changesinclusion of Apria in incentive compensation, teammate benefits,our results since the Acquisition Date, and accelerating inflationary pressures and operational efficiencies for the three and ninesix months ended SeptemberJune 30, 2021. In addition, overall DS&A expenses were affected2022, partially offset by charitable contributions foroperating efficiencies and productivity gains derived from the nine months ended September 30, 2021.Owens & Minor business system, and changes in accrued incentive compensation. DS&A expenses also included an unfavorablea favorable impact for foreign currency translation of $0.1$1.5 million and $2.3$2.4 million for the three and ninesix months ended SeptemberJune 30, 2021.2022.
Acquisition-related and exit and realignment charges presented in our consolidated statements of operations ofwere $6.4 million and $21.0$38.3 million for the three and ninesix months ended SeptemberJune 30, 20212022 as compared to no acquisition-related charges for the three and six months ended June 30, 2021. Acquisition-related charges in 2022 consisted primarily of wind-down costs related to Fusion5, leadershipthe Apria acquisition. Exit and realignment charges were $1.2 million and $2.9 million for the three and six months ended June 30, 2022, which consisted primarily of severance and other charges associated with the reorganization costs,of our segments. Exit and realignment charges were $8.6 million and $14.6 million for the three and six months ended June 30, 2021 and consisted primarily of an increase in reserves associated with certain retained assets of Fusion5, IT restructuring charges and other costs related to the reorganization of the U.S. operations. Acquisition-related charges within acquisition-related and exit and realignment charges presented in our consolidated statements of operations were $0.8 million and $8.9 million for the three and nine months ended September 30, 2020, which consisted primarily of transition costs for the Halyard acquisition. Exit and realignment charges were $5.6 million and $9.6 million for the three and nine months ended September 30, 2020 and consisted primarily of severance from reduction in force, post divestiture costs related to the Movianto business, and other costs related to the reorganization of the U.S. commercial, operations and executive teams.
The change in other operating income, net for the three and nine months ended September 30, 2021 includes the impact of higher foreign currency transaction gains as compared to the prior year.

Interest expense, net.

Three Months Ended
 September 30,
Change
(Dollars in thousands)20212020$%
Interest expense, net$11,572 $20,975 $(9,403)(44.8)%
Effective interest rate4.17 %5.64 %
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Nine Months Ended
 September 30,
Change
(Dollars in thousands)20212020$%
Interest expense, net$36,784 $65,923 $(29,139)(44.2)%
Effective interest rate4.72 %6.35 %
The change in other operating (income) expense, net for the three and six months ended June 30, 2022 includes the impact of foreign currency transaction gains, as compared to foreign currency transaction losses for the three months ended June 30, 2021 and foreign currency gains for the six months ended June 30, 2021.

Interest expense, net.
 Three Months Ended
 June 30,
Change
(Dollars in thousands)20222021$%
Interest expense, net$35,839 $11,540 $24,299 210.6 %
Effective interest rate5.26 %4.30 %

 Six Months Ended
 June 30,
Change
(Dollars in thousands)20222021$%
Interest expense, net$47,858 $25,212 $22,646 89.8 %
Effective interest rate5.12 %4.94 %

Interest expense, net and the effective interest rate for the three and ninesix months ended SeptemberJune 30, 20212022 decreasedincreased primarily due to a reduction ofthe increase in debt and lower interest rates.associated with the Apria Acquisition on March 29, 2022. See Note 6 in Notes to Consolidated Financial Statements.

Loss on extinguishment of debt.

Three Months Ended
 September 30,
Change
(Dollars in thousands)20212020$%
Loss on extinguishment of debt$ $308 $(308)(100.0)%

Nine Months Ended
 September 30,
ChangeSix Months Ended
 June 30,
Change
(Dollars in thousands)(Dollars in thousands)20212020$%(Dollars in thousands)20222021$%
Loss on extinguishment of debtLoss on extinguishment of debt$40,433 $2,580 $37,853 1,467.2 %Loss on extinguishment of debt$ $40,433 $(40,433)(100.0)%

Loss on extinguishment of debt for the ninesix months ended SeptemberJune 30, 2021 includes the write-off of deferred financing costs and third party fees associated with the debt financing in March 2021 of $15.3 million and amounts reclassified from accumulated other comprehensive loss as a result of the termination of our interest rate swaps of $25.1 million. Loss on extinguishment of debt for the three and nine months ended September 30, 2020 primarily includes the write-off of deferred financing costs and third party fees, offset by the gain on extinguishment of debt related to the partial repurchase of our 2021 and 2024 Notes.

Other expense, (income), net.

Three Months Ended
 September 30,
ChangeThree Months Ended
 June 30,
Change
(Dollars in thousands)(Dollars in thousands)20212020$%(Dollars in thousands)20222021$%
Other expense (income), net$799 $785 $14 1.8 %
Other expense, netOther expense, net$783 $1,028 $(245)(23.8)%

Nine Months Ended
 September 30,
ChangeSix Months Ended
 June 30,
Change
(Dollars in thousands)(Dollars in thousands)20212020$%(Dollars in thousands)20222021$%
Other expense (income), net$2,397 $(1,193)$3,590 300.9 %
Other expense, netOther expense, net$1,565 $1,598 $(33)(2.1)%

Other expense, (income), net for the three and ninesix months ended SeptemberJune 30, 20212022 and 20202021 represents interest cost and net actuarial losses related to our retirement plans.Other expense (income), net for the nine months ended September 30, 2020 includes a gain from the surrender of company-owned life insurance policies.

Income taxes.
Three Months Ended
 September 30,
Change
(Dollars in thousands)20212020$%
Income tax provision$6,375 $7,404 $(1,029)(13.9)%
Effective tax rate12.6 %13.8 %

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Nine Months Ended
 September 30,
ChangeThree Months Ended
 June 30,
Change
(Dollars in thousands)(Dollars in thousands)20212020$%(Dollars in thousands)20222021$%
Income tax provisionIncome tax provision$47,224 $3,863 $43,361 1,122.5 %Income tax provision$9,859 $18,420 $(8,561)(46.5)%
Effective tax rateEffective tax rate20.8 %9.4 %Effective tax rate25.6 %21.8 %

Six Months Ended
 June 30,
Change
(Dollars in thousands)20222021$%
Income tax provision$18,837 $40,848 $(22,011)(53.9)%
Effective tax rate21.7 %23.2 %

The change in the effective tax rate for the three and ninesix months ended SeptemberJune 30, 20212022 compared to the same periods in 20202021 resulted primarily from an income tax benefit recorded in the first quarter of 2020 associated with the Coronavirus Aid, Relief, and Economic Security (CARES) Act and in the third quarter of 2021 associated with the 2017 Tax Cuts and Jobs Act, the mixture of income and losses in jurisdictions in which we operate andoffset by the incremental income tax benefit associated with the vesting of restricted stock.stock recorded in the six months ended June 30, 2022.

Financial Condition, Liquidity and Capital Resources

Financial condition. We monitor operating working capital through days sales outstanding (DSO) and merchandise inventory days. We estimate a hypothetical increase (decrease) in DSO of one day would result in a decrease (increase) in our cash balances, an increase (decrease) in borrowings against our revolving credit facility or Receivables Securitization Program,receivables securitization program, or a combination thereof of approximately $27 million.
The majority of our cash and cash equivalents are held in cash depository accounts with major banks in the United States, Europe, and Asia. Changes in our working capital can vary in the normal course of business based upon the timing of inventory purchases, collections of accounts receivable, and payments to suppliers.
September 30, 2021December 31, 2020ChangeJune 30,
2022
December 31, 2021Change
(Dollars in thousands)(Dollars in thousands)$%(Dollars in thousands)$%
Cash and cash equivalentsCash and cash equivalents$39,759 $83,058 $(43,299)(52.1)%Cash and cash equivalents$56,406 $55,712 $694 1.2 %
Accounts receivable, net of allowancesAccounts receivable, net of allowances$759,744 $700,792 $58,952 8.4 %Accounts receivable, net of allowances$743,853 $681,564 $62,289 9.1 %
Consolidated DSO (1)
Consolidated DSO (1)
27.3 26.0
Consolidated DSO (1)
26.0 24.6
Merchandise inventoriesMerchandise inventories$1,514,387 $1,233,751 $280,636 22.7 %Merchandise inventories$1,525,331 $1,495,972 $29,359 2.0 %
Inventory days (2)
Inventory days (2)
64.1 57.8
Inventory days (2)
70.5 64.7
Accounts payableAccounts payable$1,118,753 $1,000,186 $118,567 11.9 %Accounts payable$1,137,337 $1,001,959 $135,378 13.5 %
    (1) Based on period end accounts receivable and net revenue for the quarters ended SeptemberJune 30, 20212022 and December 31, 20202021.
    (2) Based on period end merchandise inventories and cost of goods sold for the quarters ended SeptemberJune 30, 20212022 and December 31, 2020

2021.
Liquidity and capital expenditures. The following table summarizes our consolidated statements of cash flows for the ninesix months ended SeptemberJune 30, 20212022 and 2020, which relates to continuing operations and discontinued operations:2021:

(Dollars in thousands)(Dollars in thousands)20212020(Dollars in thousands)20222021
Net cash provided by (used for):Net cash provided by (used for):Net cash provided by (used for):
Operating activitiesOperating activities$73,836 $268,196 Operating activities$169,524 $12,406 
Investing activitiesInvesting activities(32,584)112,830 Investing activities(1,745,299)(18,659)
Financing activitiesFinancing activities(117,222)(244,955)Financing activities1,580,633 (64,788)
Effect of exchange rate changesEffect of exchange rate changes(2,454)6,721 Effect of exchange rate changes(3,864)(1,718)
Net (decrease) increase in cash, cash equivalents and restricted cash$(78,424)$142,792 
Net increase (decrease) in cash, cash equivalents and restricted cashNet increase (decrease) in cash, cash equivalents and restricted cash$994 $(72,759)

Cash provided by operating activities in the first ninesix months of 20212022 and 20202021 reflected fluctuations incash generated by net income along with changes in working capital.
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Cash used for investing activities in the first ninesix months of 20212022 included cash paid for the acquisition of Apria of $1.7 billion and 2020capital expenditures of $65.7 million for patient equipment and our strategic and operational efficiency initiatives associated with property and equipment and capitalized software. Cash used for investing activities in the first six months of 2021 included capital expenditures of $32.6 million and $26.4$18.7 million for our strategic and operational efficiency initiatives associated with property and equipment, investments for increased manufacturing capacity in the Americas, and capitalized software. Cash provided by investing activities in the first nine months of 2020 included cash consideration received of $133 million from the sale of Movianto and proceeds of $6.0 million from the surrender of company-owned life insurance policies.
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Cash used for financing activities in the first ninesix months of 20212022 included dividend payments of $0.5 million and net repayments of $90.9 millionborrowings under our revolving credit facility, net and accounts receivable securitization program of $30.0 million compared to $0.5 million and $108net repayments of $5.0 million for the same period of 2020.2021. Gross issuances and repayments under our amended accounts receivable securitization program were $347.8 million and $402.8 million for the first six months of 2022. We also had proceeds from borrowings of $575$1.7 billion related to the 2030 Unsecured Notes, Term Loan A, and Term Loan B for the first six months of 2022, compared to $500 million related to the 2029 Unsecured Notes and Accounts Receivable Securitization Program for the first ninesix months of 2021, compared to $150 million related to the Accounts Receivable Securitization Program for the first nine months of 2020.2021. Financing activities also included repayments of $553 million for the first nine months of 2021 on our term loans, 2021 and 2024 Notes, and Accounts Receivable Securitization Program, compared to $270 million in the same period of 2020 on our term loans and 2021 and 2024 Notes. We used $83.3 million of cash to repurchase $87.9 million aggregate principal amount of the 2021 and 2024 Notes during the first nine months of 2020. We also paid $13.9$41.5 million in financing costs in the first ninesix months of 20212022, as compared to $10.4$12.9 million in financing costs for the same period of 2020. 2021. Payments for taxes related to the vesting of restricted stock awards were $44.4 million and $19.1 million for the first six months of 2022 and 2021, which are included in Other, net. Financing activities in the first six months of 2021 included repayments of $523 million on our previous Term Loan A-2 and previous Term Loan B. In addition, we paid $15.4 million to terminate the remaining $300 million in notional value of interest rate swaps during the first ninesix months of 2021. Payments for taxes related to the vesting of restricted stock awards were $19.3 million and $3.6million for the first nine months of 2021 and 2020, which are included in Other, net.

Capital resources.resources. Our sources of liquidity include cash and cash equivalents, a revolving credit facility under our Credit Agreement with Bank of America, N.A, as an administrative agent and collateral agent and a syndicate of financial institutions, as lenders (the Revolving Credit Agreement), and the Receivables Securitization Program.a receivables securitization program. The Revolving Credit Agreement provides a revolving borrowing capacity of $300$450 million. We have $1.1 billion in outstanding term loans under a term loan credit agreement (the Credit Agreement). The interest rate on our revolving credit facility is based on a spread over a benchmark rate (as described in the Revolving Credit Agreement). The Revolving Credit Agreement matures in March 2026. The interest rate on the Term Loan A facility (Term Loan A) is based on either the Term SOFR or the Base Rate plus an Applicable Rate which varies depending on the current Debt Ratings or Total Leverage Ratio, determined as to whichever shall result in more favorable pricing to the Borrowers (each as defined in the Credit Agreement). The interest rate on the Term Loan B facility (Term Loan B) is based on either the Term SOFR or the Base Rate plus an Applicable Rate. The Term Loan A will mature in March 2027 and the Term Loan B will mature in March 2029.
At SeptemberJune 30, 20212022, we had no borrowings and letters of credit of $28.0 million outstanding under our Revolving Credit Agreement. At December 31, 2020,2021, we had no borrowings of $12.3 million and $103 million, and letters of credit of $9.4 million and $13.9 million outstanding under our credit agreements.Revolving Credit Agreement. At SeptemberJune 30, 20212022 and December 31, 2020,2021, we had $278$422 million and $283$291 million, available for borrowing.borrowing under our Revolving Credit Agreement. We also had letters of credit and bank guarantees, outstandingwhich were issued outside of the Revolving Credit Facility for $2.2$2.1 million and $1.6$2.2 million as of SeptemberJune 30, 20212022 and December 31, 2020,2021, which supports certain leased facilities as well as other normal business activities in the United States and Europe. These letters of credit and guarantees were issued outside of the revolving credit facility.
WeOn March 29, 2022, we entered into a Security Agreement Supplement pursuant to which the Security and Pledge Agreement (the Security Agreement), dated March 10, 2021 pursuantwas supplemented to which we grantedgrant collateral on behalf of the holders of the 2024 Notes, and the parties secured under the Credit Agreementcredit agreements (the Secured Parties) including first priority liens and security interests in (a) all present and future shares of capital stock owned by the Credit PartiesGrantors (as defined)defined in the Credit Parties’Security Agreement) in the Grantors’ present and future subsidiaries, subject to certain customary exceptions, and (b) all present and future personal property and assets of the Credit Parties,Grantors, subject to certain exceptions.
On March 10, 2021,29, 2022, we entered into an amendment to our accounts receivable securitization program (the Receivables Securitization Program)Financing Agreement). Pursuant to the amended Receivables Securitization Program,Financing Agreement, the aggregate principal amount of the loans made by the Lenders (as defined) will not exceed$450 $450 million outstanding at any time. The interest rate under the Receivables Securitization ProgramFinancing Agreement is based on a spread over a benchmark SOFR rate (as described in the ThirdFourth Amendment to the Receivables Financing Agreement). Under the Receivables Securitization Program,Financing Agreement, certain of our subsidiaries sell substantially all of their accounts receivable balances to our wholly owned special purpose entity, O&M Funding LLC. The Receivables Securitization ProgramFinancing Agreement matures in March 2024.2025.
The Revolving Credit Agreement, Term Loan A, Term Loan B, Receivables Securitization Program,Financing Agreement, 2024 Notes, 2029 Unsecured Notes, and 20292030 Unsecured Notes contain cross-default provisions which could result in the acceleration of payments due in the event of default of any of the related agreements. The terms of the Credit Agreementcredit agreements also require us to maintain ratios for leverage and interest coverage, including on a pro forma basis in the event of an acquisition or divestiture. We were in compliance with our debt covenants at SeptemberJune 30, 2021.2022.
In May 2020, we entered into an equity distribution agreement, pursuant to which we may offer and sell, from time to time, shares of our common stock having an aggregate offering price of up to $50.0 million. We intend to use the net proceeds from the sale of our securities offered by this program for the repayment of indebtedness and/or for general corporate and
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working capital purposes. As of SeptemberJune 30, 20212022 no shares were issued and $50.0 million of common stock remained available under the at-the-market equity financing program.
We regularly evaluate market conditions, our liquidity profile and various financing alternatives to enhance our capital structure. From time to time, we may enter into transactions to repay, repurchase or redeem our outstanding indebtedness (including by means of open market purchases, privately negotiated repurchases, tender or exchange offers and/or repayments or redemptions pursuant to the debt’s terms). Our ability to consummate any such transaction will depend on prevailing market conditions, our liquidity requirements, contractual restrictions and other factors. We cannot provide any assurance as to if or when we will consummate any such transactions or the terms of any such transaction.
The third quarter dividend of $0.0025 per share was paid in September 2021. The payment of future dividends remains within the discretion of the Board of Directors and will depend upon our results of operations, financial condition, capital requirements, current and future limitations under our Credit Agreement and other factors.
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We believe available financing sources, including cash generated by operating activities and borrowings under the Revolving Credit Agreement and Receivables Securitization Program,Financing Agreement, will be sufficient to fund our working capital needs, capital expenditures, long-term strategic growth, payments under long-term debt and lease arrangements, payments of quarterly cash dividends, debt repurchases and other cash requirements. While we believe that we will have the ability to meet our financing needs in the foreseeable future, changes in economic conditions may impact (i) the ability of financial institutions to meet their contractual commitments to us, (ii) the ability of our customers and suppliers to meet their obligations to us or (iii) our cost of borrowing.
We earn a portion of our operating income in foreign jurisdictions outside the United States. Our cash and cash equivalents held by our foreign subsidiaries totaled $28.7$23.0 million and $72.0$26.9 million at SeptemberJune 30, 20212022 and December 31, 2020.2021. We continue to remain permanently reinvested in our foreign subsidiaries, with the exception of a subsidiary in Thailand. We have no specific plans to indefinitely reinvest the unremitted earnings of our foreign subsidiary located in Thailand as of SeptemberJune 30, 2021.2022. As such, we have recorded withholding tax liabilities that would be incurred upon future distribution to the U.S. There are no unrecognized deferred taxes as there is no outside basis difference unrelated to unremitted earnings for Thailand. We will continue to evaluate our foreign earnings repatriation policy in 20212022 for all our foreign subsidiaries.
Impact of Inflation
The cost to manufacture and distribute our products is influenced by the cost of raw materials, finished goods, labor, and transportation. We have recently experienced inflationary pressure and higher costs as a result of the increasing cost of raw materials, finished goods, labor, transportation, and other administrative costs associated with the normal course of business. The increase in cost of raw materials and finished goods are due in part to a shortage in the availability of certain products, the higher cost of shipping, and inflation. Additionally, it is not certain that we will be able to pass elevated costs onto customers in an effort to offset inflationary pressures. Future volatility of general price inflation and the impact of inflation on costs and availability of materials, costs for shipping and warehousing and other operational overhead could adversely affect our financial results.

Guarantor and Collateral Group Summarized Financial Information

We are providing the following information in compliance with Rule 13-01, “Financial Disclosures about Guarantors and Issuers of Guaranteed Securities” and Rule 13-02 of Regulation S-X, of with respect to our 2024 Notes. See Note 6 of the accompanying consolidated financial statements for additional information regarding the terms of the 2024 Notes.
The following tables present summarized financial information for Owens & Minor, Inc. and the guarantors of Owens & Minor, Inc.’s 2024 Notes (together, "the Guarantor Group"), on a combined basis with intercompany balances and transactions between entities in the Guarantor Group eliminated. The guarantor subsidiaries are 100% owned by Owens & Minor, Inc. Separate financial statements of the guarantor subsidiaries are not presented because the guarantees by our guarantor subsidiaries are full and unconditional, as well as joint and several.
Summarized financial information of the Guarantor Group is as follows:
Summarized Consolidated Statement of Operations - Guarantor GroupNineSix Months Ended SeptemberJune 30, 20212022
(Dollars in thousands)
Net revenue(1)
$7,197,3184,771,148 
Gross margin1,086,054839,511 
Operating income265,888
Income from continuing operations, net of tax158,735100,937 
Net income158,73548,825 
(1)Includes $297$140 million in sales to non-guarantor subsidiaries for the ninesix months ended SeptemberJune 30, 2021.2022.

Summarized Consolidated Balance Sheets - Guarantor GroupSeptember 30, 2021December 31, 2020
(Dollars in thousands)
Total current assets$1,428,986 $1,559,248 
Total assets2,950,802 2,943,125 
Current liabilities1,456,508 1,374,800 
Total liabilities2,500,939 2,465,894 
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Summarized Consolidated Balance Sheets - Guarantor GroupJune 30, 2022December 31, 2021
(Dollars in thousands)
Total current assets$1,648,833 $1,449,917 
Total assets4,915,785 2,807,581 
Current liabilities1,643,705 1,399,499 
Total liabilities4,464,205 2,422,542 

The following tables present summarized financial information for Owens & Minor, Inc. and the subsidiaries of Owens & Minor, Inc.’s 2024 Notes pledged that constitute a substantial portion of collateral (together, "the Collateral Group"), on a combined basis with intercompany balances and transactions between entities in the Collateral Group eliminated. The pledged subsidiaries are 100% owned by Owens & Minor, Inc. No trading market for the subsidiaries included in the Collateral Group exists.
Summarized financial information of the Collateral Group is as follows:
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Summarized Consolidated Balance Sheets - Collateral GroupSummarized Consolidated Balance Sheets - Collateral GroupSeptember 30, 2021December 31, 2020Summarized Consolidated Balance Sheets - Collateral GroupJune 30, 2022December 31, 2021
(Dollars in thousands)(Dollars in thousands)(Dollars in thousands)
Total current assetsTotal current assets$1,517,670 $1,651,460 Total current assets$1,718,358 $1,514,724 
Total assetsTotal assets2,703,556 2,851,226 Total assets4,839,246 2,729,455 
Current liabilitiesCurrent liabilities1,422,746 1,356,024 Current liabilities1,567,372 1,341,691 
Total liabilitiesTotal liabilities2,498,158 2,480,953 Total liabilities4,423,123 2,398,694 

The results of operations of the Collateral Group are not materially different from the corresponding amounts presented in our consolidated statements of operations.


Recent Accounting Pronouncements

For a discussion of recent accounting pronouncements, see our Annual Report on Form 10-K for the year ended December 31, 20202021 and Note 1415 in the Notes to Consolidated Financial Statements, included in this Quarterly Report on Form 10-Q for the period ended on SeptemberJune 30, 2021.2022.

Forward-looking Statements

Certain statements in this discussion constitute “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. Although we believe our expectations with respect to the forward-looking statements are based upon reasonable assumptions within the bounds of our knowledge of our business and operations, all forward-looking statements involve risks and uncertainties and, as a result, actual results could differ materially from those projected, anticipated or implied by these statements. Such forward-looking statements involve known and unknown risks, including, but not limited to:
our ability to achieve revenue and operating income goals may be affected by: COVID-19 related factors, risks and challenges, including among others, the length of time that the pandemic continues, and any worsening of the pandemic, including through any new variant strains of the underlying virus, or future pandemics, related governmental responses, the effectiveness, availability, and public acceptance of vaccines, a decrease in revenue ultimately resulting in less cash flow, longer duration in receivables collection, the need to expedite payments to important suppliers may grow, shifts in demand away from certain products we manufacture and distribute, reduced workforces which may be caused by, but not limited to, the temporary inability of the workforce to work due to illness, quarantine, or government vaccine and other mandates, temporary production and distribution center and office closures due to reduced workforces or government vaccine and other mandates, availability of raw materials, potential resulting labor negotiations or disputes, changes in the types and numbers of businesses that compete with us, including non-traditional competitors, and the aggressiveness of that competition, impacts of the pandemic or future pandemics on other third parties with whom we conduct business, the healthcare industry, and the broader business environment, and trends in elective surgeries and other healthcare spending not directly associated with COVID-19;
competitive pressures in the marketplace, including intense pricing pressure;
our ability to retain existing and attract new customers in a market characterized by consolidation among significant customer consolidationcustomers, health insurers and/or other industry participants, and intense cost-containment initiatives;
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our dependence on sales to certain customers or the loss or material reduction in purchases by key customers;
our dependence on distribution of product of certain suppliers;
our ability to successfully identify, manage or integrate acquisitions;
our ability to successfully manage our international operations, including risks associated with changes in international trade regulations, foreign currency volatility, changes in regulatory conditions, deteriorating economic conditions, adverse tax consequences, and other risks of operating in international markets;
the risk that problems may arise in successfully integrating the businesses of Apria and the Company, which may result in the combined company not operating as effectively and efficiently as expected and the risk that the combined company may be unable to achieve the anticipated synergies or cost savings, or it may take longer than expected to achieve those synergies;
the effect of our acquisition of Apria and any developments relating thereto on our relationships with customers, suppliers and other third parties, as well as our operating results and business;
uncertainties related to and our ability to adapt to changes in government regulations, including healthcare laws and regulations;
risks arising from possible violations of legal, regulatory or licensing requirements of the markets in which we operate;
uncertainties related to general economic, regulatory and business conditions;
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our ability to successfully implement our strategic initiatives;
the availability of and modifications to existing supplier funding programs and our ability to meet the terms to qualify for certain of these programs;
the effect of price volatility in the commodities markets, including fuel price fluctuations, on our operating costs and supplier product prices;
our ability to adapt to changes in product pricing and other terms of purchase by suppliers of product;
the ability of customers and suppliers to meet financial commitments due to us;
changes in manufacturer preferences between direct sales and wholesale distribution;
changing trends in customer profiles and ordering patterns and our ability to meet customer demand for additional value-added services;
our ability to manage operating expenses and improve operational efficiencies in response to changing customer profiles;
our ability to meet performance targets specified by customer contracts under contractual commitments;
availability of and our ability to access special inventory buying opportunities;
the ability of business partners and financial institutions to perform their contractual responsibilities;
our ability to continue to obtain financing, obtain financing at reasonable rates and to manage financing costs and interest rate risk, and our ability to refinance, extend or repay our substantial indebtedness;
the risk that information systems are interrupted or damaged or fail for any extended period of time, that new information systems are not successfully implemented or integrated, or that there is a data security breach in our information systems;
we depend on reimbursements by payors, which could lead to delays and uncertainties in the reimbursement process;
the home healthcare industry is highly competitive and fragmented, with limited barriers to entry which may make it susceptible to vertical integration by manufacturers, payors, providers (such as hospital systems) or disruptive new entrants;
the risk that a decline in business volume or profitability could result in an impairment of goodwill or other long-lived assets;
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our ability to timely or adequately respond to technological advances in the medical supply industry;and home healthcare industries and/or product and therapy innovations may make the services we currently provide obsolete or less competitive;
our failure to adequately insure against losses, including from substantial claims and litigation, could have an adverse impact on our operations, financial condition, or prospects;
recalls of any of our products, either voluntarily or at the direction of the Food and Drug Administration or another governmental authority, or safety risks or the discovery of serious safety issues with our products;
our capitation arrangements may prove unprofitable if actual utilization rates exceed our assumptions;
reductions in Medicare, Medicaid and commercial payor reimbursement rates could have a material adverse effect on our results of operations and financial condition;
the costs associated with and outcome of outstanding and any future litigation, including product and professional liability claims;
adverse changes in U.S. and foreign tax laws and the outcome of outstanding tax contingencies and legislative and tax proposals;
our ability to successfully implement the expense reduction and productivity and efficiency initiatives;
our ability to continue to comply with the terms and conditions of Byram Healthcare’sApria’s Corporate Integrity Agreement; and
other factors detailed from time to time in the reports we file with the SEC, including those described in “Item 1A. Risk Factors” of our Annual Report on Form 10-K for the year ended December 31, 2020,2021 and our Form 10-Q for the three months ended March 31, 2021, and our Form 10-Q for the three and six months ended June 30, 2021.2022.
We undertake no obligation to update or revise any forward-looking statements, except as required by applicable law.

Item 3. Quantitative and Qualitative Disclosures About Market Risk

We are subject to price risk for our raw materials, the most significant of which relates to the cost of polypropylene and nitrile used in the manufacturing processes of our Global Products & Healthcare Services segment. Prices of the commodities underlying these raw materials are volatile and have fluctuated significantly in recent years and in the future may contribute to fluctuations in our results of operations. The ability to hedge these commodity prices is limited.

We are exposed to risks of changes in shipping and freight costs, including container and other third party fees associated with the transportation of our products. Shipping and freight costs have fluctuated significantly in recent years and in the future may contribute to changes in our results of operations.
In the normal course of business, we are exposed to foreign currency translation and transaction risks. Our business transactions outside of the United States are denominated in the euro, Malaysian ringgit, Mexican peso, Thai baht and other currencies. We may use foreign currency forwards, swaps and options, where possible, to manage our risk related to certain foreign currency fluctuations.
We are exposed to market risk from changes in interest rates related to our borrowing under our Revolving Credit Agreement and Receivables Securitization Program. We hadFinancing Agreement. Excluding deferred financing costs and third party fees, $12.3we had $500 million in borrowings under our Term Loan A, $600 million in borrowings under our Term Loan B, no borrowings under our revolving credit facility, $197$175 million in
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borrowings under our Receivables Securitization ProgramFinancing Agreement and $9.4$28.0 million in letters of credit under the Revolving Credit Agreement at SeptemberJune 30, 2021. We2022. After considering the effects of an interest rate swap agreement entered into during April 2022, we estimate an increase in interest rates of 100 basis points would result in a potential reduction in future pre-tax earnings of approximately $2.2$8.8 million per year based on our borrowings outstanding at SeptemberJune 30, 2021.2022.
Due to the nature and pricing of our Global SolutionsProducts & Healthcare Services segment distribution services, we are exposed to potential volatility in fuel prices. Our strategies for helping to mitigate our exposure to changing domestic fuel prices have included using trucks with improved fuel efficiency. We benchmark our domestic diesel fuel purchase prices against the U.S. Weekly Retail On-Highway Diesel Prices (benchmark) as quoted by the U.S. Energy Information Administration. The benchmark averaged $3.16$4.92 and $2.58$3.06 per gallon in the first ninesix months of 20212022 and 2020.2021. Based on our fuel consumption in the first ninesix months of 2021,2022, we estimate that every 10 cents per gallon increase in the benchmark would directly reduce our Global Solutions segment operating income by approximately $0.2$0.4 million on an annualized basis.We are also indirectly exposed to increased shipping and freight costs, including container and other third party fees associated with the transportation of our products due to
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changes in fuel prices. Changes in fuel prices have contributed to significant shipping and freight costs in recent years and in the future may contribute to changes in our results of operations.

Item 4. Controls and Procedures

We carried out an evaluation, with the participation of management, including our principal executive officer and principal financial officer, of the effectiveness of our disclosure controls and procedures (pursuant to Rule 13a-15(e) under the Securities Exchange Act of 1934, as amended) as of the end of the period covered by this report. Based upon that evaluation, the principal executive officer and principal financial officer concluded that our disclosure controls and procedures were effective as of SeptemberJune 30, 2021.2022. There was no change in our internal control over financial reporting that occurred during the period of this report that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting. In connection with the Apria Acquisition, we are currently evaluating the acquired processes, information technology systems and other components of internal controls over financial reporting as part of our integration activities which may result in periodic changes. Such changes will be disclosed as required by applicable SEC guidance.
SEC guidance permits the exclusion of an evaluation of the effectiveness of a registrant's disclosure controls and procedures as they relate to the internal control over financial reporting for an acquired business during the first year following such acquisition. In the first quarter of 2022, we acquired Apria, Inc. This acquisition represented $2.0 billion of total assets and $310 million of revenues as of and for the six months ended June 30, 2022. Management's evaluation and conclusion as to the effectiveness of the design and operation of the Company's disclosure controls and procedures as of and for the period covered by this report excludes any evaluation of the internal control over financial reporting of Apria, Inc.


Part II. Other Information

Item 1. Legal Proceedings

Certain legal proceedings pending against us are described in our Annual Report on Form 10-K for the year ended December 31, 2020.2021. Through SeptemberJune 30, 2021,2022, there have been no material developments in any legal proceedings reported in such Annual Report.

Item 1A. Risk Factors

The following description ofCertain risk factors updates and supplements risk factors associated withthat we believe could affect our business previously disclosedand prospects are described in our Annual Report on Form 10-K for the year ended December 31, 2020,2021 and our Form 10-Q for the three months ended March 31, 2021, and our Form 10-Q for the three and six months ended2022. Through June 30, 2021. These2022, there have been no material changes in the risk factors are in addition to those mentioned in other parts of this report and are not all of the risks that we face. We could also be affected by risks that we currently are not aware of or that we currently do not consider material to our business.

We are subject to risks related to public health crises or future outbreaks of health crises or other adverse public health developments such as the global pandemic associated with the 2019 novel coronavirus (COVID-19).
As a global healthcare solutions company, we are impacted by public health crises such as the global pandemic associated with COVID-19. The outbreak has significantly increased uncertainty and unpredictability of global economic conditions and the demand for and supply of raw materials and finished goods required for our operations. In addition, public and private sector policies and initiatives to reduce the transmission of COVID-19, such as the imposition of travel restrictions, the adoption of remote working and vaccination mandates, have impacted or may in the future impact our operations. In these challenging and dynamic circumstances, we continue to work to protect our teammates and the public, maintain business continuity and sustain our operations, including ensuring the safety and protection of the people who work in our production and distribution centers across the world, many of whom support the manufacturing and delivery of products that are critical in response to the global pandemic. We may restrict the operations of our production and distribution centers if we deem it necessary or if recommended or mandated by governmental authorities which would have an adverse impact on us. There is a risk that revenues will decrease ultimately resulting in less cash flow, we may see longer duration in receivables collection, and the need to expedite payments to important suppliers may grow. COVID-19 has impacted and may further impact our supply chains relative to global demand for our facial protection, nitrile gloves, and protective apparel products. COVID-19 has also affected and may further affect the ability of suppliers and vendors to provide products and services to us or to do so at acceptable quality levels or prices. Some of these factors could increase the demand for our products, while others could decrease demand or make it more difficult for us to serve customers. For example, the significant reduction in elective surgical procedures, which began mid-March of 2020, resulted in a material negative impact on our revenue for 2020. Any worsening of the COVID-19 pandemic or future outbreaks could result in similar reductions in elective surgical procedures or otherwise
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reduce demand for our products, any of which could have a material negative impact on our revenues and profit for future periods.
Although we have experienced significant growth in sales volumes for certain of our products (such as PPE) during the COVID-19 pandemic, as well as improved productivity and manufacturing output, there can be no assurance that such growth rates, increased sales volumes or other improvements will be maintained during or following the COVID-19 pandemic. We may also see a declinedescribed in such growth rates and sales volumes when the impact of the pandemic subsides and the healthcare system returns to a more normalized state. In particular, demand for such products may also decline as government-sponsored COVID-19 response stimulus, relief and production initiatives, such as those under the Defense Production Act (DPA) and the Coronavirus Aid, Relief and Economic Security (CARES) Act, expire. An accelerated shift of demand away from certain of our products and services could also adversely impact our revenues and profit margins.
Furthermore, COVID-19 has impacted and may further impact the broader economies of affected countries, including negatively impacting economic growth, the proper functioning of financial and capital markets, foreign currency exchange rates, and interest rates. For example, the continued spread of COVID-19 has led to disruption and volatility in the global capital markets, which increases the cost of capital and adversely impacts access to capital. Due to the speed with which the situation is developing and the uncertainty of its duration, any future outbreaks, similar pandemics, the timing of recovery, travel restrictions, business closures or business disruptions, a recession, depression or other sustained adverse market event resulting from the spread of the COVID-19 and the effectiveness of actions taken in the United States and other countries to contain and treat the disease, we are not able at this time to predict the extent to which the COVID-19 pandemic, or any future outbreaks or similar pandemics, may have a material effect on our financial or operational results. However, the following adverse risks exist:
Actions by the United States government or other foreign government could affect our business. These actions include purchasing products that we make or sell, imposing new product standards or allowing the use of alternative products, instituting regulatory requirements to purchase only locally manufactured products, exercising control over manufacturing or distribution operations, including use of the DPA, taking trade actions including the imposition or removal of tariffs or import / export controls, subsidizing the supply of products, imposition of vaccine mandates or other actions;
Quarantine decisions by public or private entities may influence our ability to operate or our ability to ship or receive products. For example, if shipping companies cease or reduce land or sea freight channels, raw material and finished good deliveries may be slowed or stopped;
Our customers may change their payment patterns or lose their ability to pay invoices, which could have a material adverse impact on our cash flow;
Our suppliers may increase pricing or impose new purchasing requirements, such as minimum purchase quantities or pay-in-advance payment terms, which could have a material adverse impact on our cash flow;
Raw materials or finished goods that we require for our operations may not be available, or pricing for such items may increase beyond the willingness of our customers to pay;
New competitors may enter our market, including both small and large scale manufacturers;
COVID-19 illness among our workers in manufacturing or distribution operations could impact our operations or compel the closure of one or more facilities for an unknown period of time. Labor relations in our facilities related to COVID-19 could also negatively impact our operations;
We may invest in additional manufacturing capacity for which demand slows in the future, which could have a material adverse impact on our cash flow; and
Technology infrastructure failures could materially inhibit our operations that currently include a substantial portion of remote work. For example, voice or data line failures resulting from natural, manmade or cyber-attack could impair our ability to operate.
We have incurred additional costs to ensure we meet the needs of our customers, including increasing our workforce in order to produce or distribute certain essential products for our customers, providing personal protective equipment to our workforce, incremental shipping and transportation costs, incremental technology costs, and additional cleaning costs throughout our facilities. We expect to continue to incur additional costs, which may be significant as we continue to implement operational changes in response to this pandemic, any future outbreaks or similar pandemics. Further, our management is focused on mitigating COVID-19, which has required and will continue to require, a large investment of time and resources across our enterprise and will delay other value added services and strategic initiatives. Additionally, some of our teammates are currently working remotely. An extended period of remote work arrangements, and any worsening of the COVID-19 pandemic, or future outbreaks, could strain our business continuity plans, introduce operational risk, including but not limited to cybersecurity risks, and impair our ability to manage our business. If we do not respond appropriately to the pandemic, any future outbreaks or similar pandemics, or if customers do not perceive our response to be adequate for the United States or our international markets, we could suffer damage to our reputation and our brands, which could adversely affect our business.
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The impact of COVID-19 may also exacerbate other risks discussed in Item 1A. Risk Factors in our Annual Report onand First Quarter 2022 Form 10-K, any of which could have a material effect on us. This situation is changing rapidly and additional impacts may arise that we are not aware of currently.10-Q.

Item 2. Unregistered Sales of Equity Securities, Use of Proceeds and Issuer Purchases of Equity Securities

In May 2020, we entered into an equity distribution agreement, pursuant to which we may offer and sell, from time to time, shares of our common stock having an aggregate offering price of up to $50.0 million. We intend to use the net proceeds from the sale of our securities offered by this program for the repayment of indebtedness and/or for general corporate and working capital purposes. As of SeptemberJune 30, 2021,2022, no shares were issued and $50.0 million of common stock remained available under the at-the-market equity financing program.


Item 6. Exhibits

(a)Exhibits
2.1
3.1
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4.1
4.2
4.3
4.4
4.5
10.1
10.2
10.3
22.1
22.2
31.1  
31.2  
32.1  
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32.2  
101.INS  Inline XBRL Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.
101.SCH  Inline XBRL Taxonomy Extension Schema Document
101.CAL  Inline XBRL Taxonomy Extension Calculation Linkbase Document
101.DEF  Inline XBRL Taxonomy Definition Linkbase Document
101.LAB  Inline XBRL Taxonomy Extension Label Linkbase Document
101.PRE  Inline XBRL Taxonomy Extension Presentation Linkbase Document
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104Cover Page Interactive Data File (formatted as inline XBRLiXBRL and contained in Exhibit 101)

* Certain exhibits and schedules have been omitted pursuant to Item 601(b)(2) of Regulation S-K. We hereby undertake to furnish copies of such omitted materials supplementally upon request by the SEC.
** Management contract or compensatory plan or arrangement
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SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
 
 Owens & Minor, Inc.
 (Registrant)
Date:NovemberAugust 3, 20212022 /s/ Edward A. Pesicka
 Edward A. Pesicka
 President, Chief Executive Officer & Director
Date:NovemberAugust 3, 20212022 /s/ Andrew G. Long
 Andrew G. Long
 Executive Vice President & Chief Financial Officer
 
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