TruBridge (TBRG) 10-Q 10 May 24 2024 Q1 Quarterly report Financial data

Cover

Cover - shares	3 Months Ended
	Mar. 31, 2024	May 08, 2024
Document Information [Line Items]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2024
Document Transition Report	false
Entity File Number	000-49796
Entity Registrant Name	TRUBRIDGE, INC
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	74-3032373
Entity Address, Address Line One	54 St. Emanuel Street
Entity Address, City or Town	Mobile
Entity Address, State or Province	AL
Entity Address, Postal Zip Code	36602
City Area Code	251
Local Phone Number	639-8100
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		15,007,262
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q1
Amendment Flag	false
Entity Central Index Key	0001169445
Current Fiscal Year End Date	--12-31
Common Stock, par value $.001 per share
Document Information [Line Items]
Title of 12(b) Security	Common Stock, par value $.001 per share
Trading Symbol	TBRG
Security Exchange Name	NASDAQ
Common Stock Purchase Rights
Document Information [Line Items]
Title of 12(b) Security	Common Stock Purchase Rights
No Trading Symbol Flag	true
Security Exchange Name	NASDAQ

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 4,115	$ 3,848
Accounts receivable (net of allowance for expected credit losses of $3,773 and $3,631, respectively)	64,218	59,723
Financing receivables, current portion, net (net of allowance for expected credit losses of $304 and $319, respectively)	3,668	3,997
Inventories	980	475
Prepaid income taxes	1,151	1,628
Prepaid expenses and other current assets	17,772	15,807
Assets of held for sale disposal group	0	25,977
Total current assets	91,904	111,455
Property and equipment, net	8,750	8,974
Software development costs, net	41,237	39,139
Operating lease assets	4,672	5,192
Financing receivables, net of current portion (net of allowance for expected credit losses of $79 and $97, respectively)	959	1,226
Other assets, net of current portion	8,331	7,314
Intangible assets, net	86,086	89,213
Goodwill	172,573	171,909
Deferred tax assets	1,905	0
Total assets	416,417	434,422
Current liabilities:
Accounts payable	11,356	10,133
Current portion of long-term debt	3,074	3,141
Deferred revenue	9,079	8,677
Accrued vacation	5,429	5,410
Other accrued liabilities	18,226	19,892
Liabilities of held for sale disposal group	0	977
Total current liabilities	47,164	48,230
Long-term debt, net of current portion	181,732	195,270
Operating lease liabilities, net of current portion	2,848	3,074
Deferred tax liabilities	0	1,230
Total liabilities	231,744	247,804
Stockholders’ equity:
Common stock, $0.001 par value; 30,000 shares authorized; 15,572 and 15,121 shares issued, respectively	15	15
Additional paid-in capital	196,346	195,546
Accumulated other comprehensive gain	113	0
Retained earnings	5,616	8,132
Treasury stock, 613 shares and 572 shares, respectively	(17,417)	(17,075)
Total stockholders’ equity	184,673	186,618
Total liabilities and stockholders’ equity	$ 416,417	$ 434,422

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Accounts receivable, net of allowance for doubtful accounts	$ 3,773	$ 3,631
Financing receivable, allowance for credit loss, current	304	319
Financing receivable, allowance for credit loss, noncurrent	$ 79	$ 97
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	30,000,000	30,000,000
Common stock, shares issued (in shares)	15,572,000	15,121,000
Treasury stock (in shares)	613,000	572,000

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Revenues
Total revenues	$ 83,247	$ 86,233
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized	41,759	44,177
Product development	10,689	8,352
Sales and marketing	6,592	6,957
General and administrative	19,396	14,453
Amortization	5,869	5,500
Depreciation	400	499
Total expenses	84,705	79,938
Operating income (loss)	(1,458)	6,295
Other income (expense):
Other income	1,422	267
Interest expense	(4,072)	(2,669)
Total other income (expense)	(2,650)	(2,402)
Income (loss) before taxes	(4,108)	3,893
Provision (benefit) for income taxes	(1,592)	809
Net income (loss)	$ (2,516)	$ 3,084
Net income (loss) per common share—basic (in dollars per share)	$ (0.17)	$ 0.21
Net income (loss) per common share—diluted (in dollars per share)	$ (0.17)	$ 0.21
Weighted average shares outstanding used in per common share computations:
Basic (in shares)	14,234	14,136
Diluted (in shares)	14,234	14,136
RCM
Revenues
Total revenues	$ 53,038	$ 48,631
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized	29,597	27,183
EHR
Revenues
Total revenues	28,022	35,191
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized	11,287	16,348
Patient Engagement
Revenues
Total revenues	2,187	2,411
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized	$ 875	$ 646

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Statement of Comprehensive Income [Abstract]
Net income (loss)	$ (2,516)	$ 3,084
Other comprehensive income:
Foreign currency translation adjustment	113	0
Comprehensive income (loss)	$ (2,403)	$ 3,084

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENT OF STOCKHOLDERS’ EQUITY - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Additional Paid-in-Capital	Accumulated Other Comprehensive (Loss) Income	Retained Earnings	Treasury Stock
Beginning balance (in shares) at Dec. 31, 2022		14,913
Beginning balance at Dec. 31, 2022	$ 231,711	$ 15	$ 192,275	$ 0	$ 53,921	$ (14,500)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net (loss) income	3,084				3,084
Foreign currency translation adjustment	0
Issuance of restricted stock (in shares)		186
Stock-based compensation	1,247		1,247
Treasury stock acquired	(2,484)					(2,484)
Ending balance (in shares) at Mar. 31, 2023		15,099
Ending balance at Mar. 31, 2023	233,558	$ 15	193,522	0	57,005	(16,984)
Beginning balance (in shares) at Dec. 31, 2023		15,121
Beginning balance at Dec. 31, 2023	186,618	$ 15	195,546	0	8,132	(17,075)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net (loss) income	(2,516)				(2,516)
Foreign currency translation adjustment	113			113
Issuance of restricted stock (in shares)		451
Stock-based compensation	800		800
Treasury stock acquired	(342)					(342)
Ending balance (in shares) at Mar. 31, 2024		15,572
Ending balance at Mar. 31, 2024	$ 184,673	$ 15	$ 196,346	$ 113	$ 5,616	$ (17,417)

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Operating Activities:
Net income (loss)	$ (2,516)	$ 3,084
Adjustments to net income (loss):
Provision for credit losses	500	(352)
Deferred taxes	(2,982)	572
Stock-based compensation	800	1,247
Depreciation	400	499
Gain on sale of business	(1,250)	0
Amortization of acquisition-related intangibles	3,127	4,014
Amortization of software development costs	2,742	1,486
Amortization of deferred finance costs	107	90
Non-cash operating lease costs	675	479
Changes in operating assets and liabilities:
Accounts receivable	(4,112)	(3,099)
Financing receivables	628	619
Inventories	(505)	(398)
Prepaid expenses and other current assets	772	(3,187)
Accounts payable	1,253	5,605
Deferred revenue	1,006	47
Operating lease liabilities	(583)	(499)
Other liabilities	(2,573)	(971)
Prepaid income taxes	477	237
Net cash provided by (used in) operating activities	(2,034)	9,473
Investing Activities:
Sale of business, net of cash and cash equivalents sold	21,410	0
Investment in software development	(4,839)	(6,233)
Purchase of property and equipment	(177)	(16)
Net cash provided by (used in) investing activities	16,394	(6,249)
Financing Activities:
Payments of long-term debt principal	(875)	(875)
Proceeds from revolving line of credit	15,423	5,000
Payments of revolving line of credit	(27,729)	(5,000)
Debt issuance costs	(529)	0
Treasury stock purchases	(342)	(2,484)
Net cash provided by (used in) financing activities	(14,052)	(3,359)
Increase (decrease) in cash and cash equivalents	308	(135)
Change in cash and cash equivalents included in assets sold	(41)	0
Cash and cash equivalents at beginning of period	3,848	6,951
Cash and cash equivalents at end of period	4,115	6,816
Supplemental disclosure of cash flow information:
Cash paid for interest	6,820	898
Cash paid for income taxes	$ 1,000	$ 0

BASIS OF PRESENTATION

BASIS OF PRESENTATION	3 Months Ended
	Mar. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
BASIS OF PRESENTATION	BASIS OF PRESENTATION Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (the “SEC”) and include all adjustments that, in the opinion of management, are necessary for a fair presentation of the results of the periods presented. All such adjustments are considered of a normal recurring nature. Quarterly results of operations are not necessarily indicative of annual results. Certain footnote disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”) have been condensed or omitted. The condensed consolidated balance sheet as of December 31, 2023 was derived from the audited consolidated balance sheet at that date. These unaudited condensed consolidated financial statements should be read in conjunction with the audited financial statements of TruBridge, Inc. (“TruBridge” or the “Company”) for the year ended December 31, 2023 and the notes thereto contained in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023. During the third quarter of 2023, we changed the presentation of certain costs previously recorded within the expense captions of "Product development" and "General and administrative" to better comply with the disclosure requirements of Staff Accounting Bulletin Topic 11.B., Miscellaneous Disclosure: Depreciation and Depletion Excluded from Cost of Sales. These changes are summarized as follows: • Amortization expense associated with capitalized software development costs, previously recorded within the expense caption of "Product development," have been combined with amounts previously recorded within the expense caption "Amortization of acquisition-related intangibles" and reflected in a newly-presented expense caption of "Amortization." • Depreciation expense previously recorded within the expense caption of "General and administrative" have been reclassified within the newly-presented expense caption of "Depreciation." • The expense caption previously labelled as "Costs of sales" has been renamed "Costs of revenue (exclusive of amortization and depreciation)," with the previously reported reference to "Gross profit" removed from the current presentation. The following table provides the amounts reclassified for the three months ended March 31, 2023. Three Months Ended March 31, 2023 (in thousands) As previously reported Re-classifications As reclassified As currently reported Costs of revenue (exclusive of amortization and depreciation) RCM $ 27,183 $ — $ 27,183 $ 27,183 EHR 16,348 — 16,348 16,348 Patient engagement 646 — 646 646 Other expenses Product development 9,836 (1,484) 8,352 8,352 Sale and marketing 6,959 (2) 6,957 6,957 General and administrative 14,952 (499) 14,453 14,453 Amortization of acquisition-related intangibles 4,014 (4,014) — — Amortization — 5,500 5,500 5,500 Depreciation — 499 499 499 Principles of Consolidation The condensed consolidated financial statements of TruBridge include the accounts of the Company and its wholly-owned subsidiaries. All significant intercompany balances and transactions have been eliminated.

RECENT ACCOUNTING PRONOUNCEMENT

RECENT ACCOUNTING PRONOUNCEMENTS	3 Months Ended
	Mar. 31, 2024
Accounting Changes and Error Corrections [Abstract]
RECENT ACCOUNTING PRONOUNCEMENTS	RECENT ACCOUNTING PRONOUNCEMENTS New Accounting Standards Adopted in 2024 There were no new accounting standards required to be adopted in 2024 that would have a material impact on our consolidated financial statements. New Accounting Standards Yet to be Adopted We do not believe that any other recently issued but not yet effective accounting standards, if adopted, would have a material impact on our consolidated financial statements.

REVENUE RECOGNITION

REVENUE RECOGNITION	3 Months Ended
	Mar. 31, 2024
Revenue from Contract with Customer [Abstract]
REVENUE RECOGNITION	REVENUE RECOGNITION Revenue is recognized upon transfer of control of promised products or services to clients in an amount that reflects the consideration we expect to receive in exchange for those products and services. We enter into contracts that can include various combinations of products and services, which are generally distinct and accounted for as separate performance obligations. The Company employs the 5-step revenue recognition model under ASC 606, Revenue from Contracts with Customers , to: (1) identify the contract with the client, (2) identify the performance obligations in the contract, (3) determine the transaction price, (4) allocate the transaction price to the performance obligations in the contract, and (5) recognize revenue when (or as) the entity satisfies a performance obligation. Revenue is recognized net of shipping charges and any taxes collected from clients, which are subsequently remitted to governmental authorities. • Revenue Cycle Management Our revenue cycle management (“RCM”) business unit provides an array of business processing services (“BPS'’) consisting of accounts receivable management, private pay services, insurance services, medical coding, electronic billing, statement processing, payroll processing, and contract management. Fees are recognized over the period of the client contractual relationship as the services are performed based on the stand-alone selling price (“SSP”), net of discounts. SSP for BPS services is determined based on observable stand-alone selling prices. Fees for many of these services are invoiced, and revenue recognized accordingly, based on the volume of transactions or a percentage of client accounts receivable collections. Payment is due monthly for BPS with certain amounts varying based on utilization and/or volumes. Our RCM business unit also provides professional IT services. Revenue from professional IT services is recognized as the services are performed based on SSP, which is determined by observable stand-alone selling prices. Payment is due monthly as services are performed. Lastly, our RCM business unit also provides certain software solutions and related support under Software as a Service (“SaaS”) arrangements and time-based software licenses. Revenue from SaaS arrangements is recognized in a manner consistent with SaaS arrangements for electronic health records (“EHR”) software, as discussed below. Revenue from time-based software licenses is recognized upon delivery to the client (“point in time”) and revenue from non-license components (i.e., support) is recognized ratably over the respective contract term (“over time”). SSP for time-based licenses is determined using the residual approach, while the non-license component is based on cost plus reasonable margin. • Electronic Health Records The Company enters into contractual obligations to sell perpetual software licenses, installation, conversion, and related training services, software application support, hardware, and hardware maintenance services to acute care community hospitals and post-acute providers. • Non-recurring Revenues • Perpetual software licenses and installation, conversion, and related training services are not considered separate and distinct performance obligations due to the proprietary nature of our software and are, therefore, accounted for as a single performance obligation on a module-by-module basis. Revenue is recognized as each module's implementation is completed based on the module's SSP, net of discounts. We determine each module's SSP using the residual method. Fees for licenses and installation, conversion, and related training services are typically due in three installments: (1) at placement of order, (2) upon installation of software and commencement of training, and (3) upon satisfactory completion of monthly accounting cycle or end-of-month operation by application and as applicable for each application. Often, short-term and/or long-term financing arrangements are provided for software implementations; refer to Note 11 - Financing Receivables for further information. EHR implementations include a system warranty that terminates thirty days from the software go-live date, the date which the client begins using the system in a live environment. • Hardware revenue is recognized separately from software licenses at the point in time it is delivered to the client. The SSP of hardware is cost plus a reasonable margin and revenue is recognized on a gross basis. Payment is generally due upon delivery of the hardware to the client. Standard manufacturer warranties apply to hardware. • Recurring Revenues • Software application support and hardware maintenance services sold with software licenses and hardware are separate and distinct performance obligations. Revenue for support and maintenance services is recognized based on SSP, which is the renewal price, ratably over the life of the contract, which is generally three • Subscriptions to third-party content revenue is recognized as a separate performance obligation ratably over the subscription term based on SSP, which is cost plus a reasonable margin, and revenue is recognized on a gross basis. Payment is due monthly for subscriptions to third party content. • SaaS arrangements for EHR software and related conversion and training services are considered a single performance obligation. Revenue is recognized on a monthly basis as the SaaS service is provided to the client over the contract term. Payment is due monthly for SaaS services provided. Refer to Note 17 - Segment Reporting for further information, including revenue by client base (acute care or post-acute care) bifurcated by recurring and non-recurring revenue. • Patient Engagement The Company enters into contractual obligations to sell perpetual and term-based software licenses, implementation and customization professional services, and software application support services to a variety of healthcare organizations including hospital systems, health ministries, and government and non-profit organizations. • Non-recurring Revenues • Perpetual software licenses are sold only to one re-seller client and are considered a separate and distinct performance obligation. Revenue is recognized at the point in time perpetual licenses are delivered to the client, which occurs at the time of sale. The SSP of perpetual licenses is directly observable. Payment is generally due upon delivery of licenses. • Implementation and customization services are considered a separate and distinct performance obligation. Revenue is recognized over time based on SSP, which is generally directly observable. Payment for professional services is typically due in two installments: (1) upon signature of the agreement and (2) upon customer acceptance of the delivered services. • Recurring Revenues • Term-based software licenses are considered a separate and distinct performance obligation. Revenue is recognized based on SSP, which is directly observable, at the point in time the term-based licenses are delivered to the client or upon annual renewal. Payment is generally due upon delivery of licenses or upon annual renewal. • Software application support services sold with software licenses are separate and distinct performance obligations. The related revenues are recognized based on SSP, which is the renewal price, ratably over the life of the contract, which is generally three Refer to Note 17 - Segment Reporting for further information. Deferred Revenue Deferred revenue represents amounts invoiced to clients for which the services under contract have not been completed and revenue has not been recognized, including annual renewals of certain software subscriptions and customer deposits for implementations to be performed at a later date. Revenue is recognized ratably over the life of the software subscriptions as services are provided and at the point-in-time when implementations have been completed. The following table details deferred revenue for the three months ended March 31, 2024 and 2023, included in the condensed consolidated balance sheets: (In thousands) Three Months Ended March 31, 2024 Three Months Ended March 31, 2023 Beginning balance $ 8,677 $ 11,590 Deferred revenue recorded 4,360 6,490 Less deferred revenue recognized as revenue (3,958) (6,443) Ending balance $ 9,079 $ 11,637 The deferred revenue recorded during the three months ended March 31, 2024 and 2023 is comprised primarily of the annual renewals of certain software subscriptions billed during the first quarter of each year and deposits collected for future EHR installations. The deferred revenue recognized as revenue during the three months ended March 31, 2024 and 2023 is comprised primarily of the periodic recognition of annual renewals that were deferred until earned and deposits for future EHR installations that were earned during the period. Costs to Obtain and Fulfill a Contract with a Customer Costs to obtain a contract include the commission costs related to SaaS and RCM arrangements, which are capitalized and amortized ratably over the expected life of the customer contract. As a practical expedient, we generally recognize the incremental costs of obtaining a contract as an expense when incurred if the amortization period of the asset would have been one year or less. Costs to obtain a contract are expensed within the caption “Expenses - Sales and marketing” in the accompanying condensed consolidated statements of income. Contract fulfillment costs related to the implementation of SaaS arrangements are capitalized and amortized ratably over the expected life of the customer contract. Costs to fulfill contracts consist of the payroll costs for the implementation of SaaS arrangements, including time for training, conversions, and installation that is necessary for the software to be utilized. Contract fulfillment costs are expensed within the caption “Costs of revenue (exclusive of amortization and depreciation) - EHR” in the accompanying condensed consolidated statements of income. Costs to obtain and fulfill contracts related to SaaS and RCM arrangements are included within the “Prepaid expenses and other current assets” and "Other assets, net of current portion" line items on our condensed consolidated balance sheets as shown in the table below for the three months ended March 31, 2024 and 2023: (In thousands) Three Months Ended March 31, 2024 Three Months Ended March 31, 2023 Beginning balance $ 13,115 $ 11,557 Costs to obtain and fulfill contracts capitalized 1,703 1,824 Less costs to obtain and fulfill contracts recognized as expense (1,884) (1,264) Ending balance $ 12,934 $ 12,117 Remaining Performance Obligations Disclosures regarding remaining performance obligations are not considered material as the overwhelming majority of the Company's remaining performance obligations either (a) are related to contracts with an expected duration of one year or less, or (b) exhibit revenue recognition in the amount to which the Company has the right to invoice.

BUSINESS COMBINATIONS AND DISPO

BUSINESS COMBINATIONS AND DISPOSITIONS	3 Months Ended
	Mar. 31, 2024
Business Combination and Asset Acquisition [Abstract]
BUSINESS COMBINATIONS AND DISPOSITIONS	BUSINESS COMBINATIONS AND DISPOSITIONS Sale of American HealthTech, Inc. On January 16, 2024, we entered into a Stock Purchase Agreement (the “Purchase Agreement”), by and among the Company, American HealthTech, Inc. a Mississippi corporation (“AHT”), and Healthland Inc., a Minnesota corporation and an indirect, wholly-owned subsidiary of the Company (“Healthland” and, together with the Company, the “Seller Parties”) and PointClickCare Technologies USA Corp., a Delaware corporation (“Buyer”). The Transaction (hereinafter defined) also closed on January 16, 2024. Under the Purchase Agreement, Buyer purchased from Healthland all of the issued and outstanding capital stock of AHT (the “Transaction”), with AHT becoming a wholly-owned subsidiary of Buyer. Prior to this transaction, results for AHT were reported within our EHR operating segment. The Purchase Agreement provides for an aggregate purchase price (the “Purchase Price”) of $25 million (the “Base Cash Consideration”), subject to adjustments based on working capital, cash, indebtedness and transaction expenses of AHT. Additionally, pursuant to the Purchase Agreement, a total of approximately $3.75 million was withheld from the Base Cash Consideration at the closing and deposited by Buyer into various escrow accounts with an escrow agent, including $2.5 million as a general indemnity escrow and $1 million as a special indemnity escrow. Based upon the adjustments and the various escrow holdbacks, Buyer paid a net amount of approximately $21.41 million to Healthland at the closing. The Purchase Price was subject to a post-closing true-up. In connection with the closing of the Transaction, Buyer has provided offers of employment to certain key employees of the Company that primarily supported AHT’s business. The Purchase Agreement contains customary representations, warranties and covenants. The representations and warranties made by the Seller Parties to Buyer cover a broad range of items related to, among other things, the business and financial condition of AHT. Subject to certain exceptions and limitations, the Seller Parties have agreed to indemnify Buyer for certain breaches of representations, warranties and covenants and certain other enumerated items. Such limitations on the Seller Parties’ indemnification obligations are subject to various exceptions for certain fundamental representations, tax representations, special representations, and fraud. Subject to certain exceptions and limitations, Buyer has likewise agreed to indemnify the Seller Parties for certain breaches of representations, warranties and covenants and certain other enumerated items. As part of the divestiture, as of January 16, 2024 we entered into a transition services agreement with the buyer to assist them in the transition of certain functions, including, but not limited to, information technology, finance and accounting for the period of 18 months accordance with the terms of this agreement. Aside from these customary transition services, there will be no continuing involvement after the disposal. The Company finalized the accounting for the sale during the three months ended March 31, 2024 and has recorded a $1.25 million gain on sale, which is reflected under the caption “Other income” in the condensed consolidated statements of operations. The accompanying condensed consolidated balance sheet as of December 31, 2023 includes amounts related to this Transaction under the captions "Assets of held for sale disposal group" and "Liabilities of held for sale disposal group", the details of which are as follows as of December 31, 2023: (In thousands) Assets of held for sale disposal group Accounts receivable, net $ 3,087 Financing receivables, net 37 Prepaid expenses 34 Software costs, net 3,386 Intangibles, net 11,739 Goodwill 7,694 Total $ 25,977 Liabilities of held for sale disposal group Accounts payable $ 178 Other accrued liabilities 576 Deferred tax liability 223 Total $ 977 Acquisition of Viewgol, LLC On October 16, 2023, we acquired all of the assets and liabilities of Viewgol, LLC (“Viewgol”), a Delaware limited liability company, pursuant to a Securities Purchase Agreement dated October 16, 2023. Based in Frisco, Texas, Viewgol is a provider of ambulatory RCM analytics and complementary outsourcing services with an extensive offshore presence we intend to leverage and grow to accommodate the growing demand for RCM services by our pre-existing acute care customers. Consideration for the acquisition included cash (net of cash of the acquired entity) of $37.4 million (inclusive of seller's transaction expenses). Also included in the acquisition consideration were contingent earnout payments of (i) up to $21.5 million based on the Viewgol business achieving earnings before interest, taxes, depreciation, and amortization (“EBITDA”) of $6.0 million or more during fiscal year 2024 (the “EBITDA Earnout Amount”), and (ii) up to $10.0 million based on the number of productive agents the Viewgol business hires in India in fiscal year 2024 (the “Offshore Earnout Amount”); provided, however, that none of the Offshore Earnout Amounts may be earned if the EBITDA Earnout Amount’s minimum EBITDA threshold of $6.0 million is not achieved during fiscal 2024. During 2023, we incurred approximately $4.7 million of pre-tax acquisition expenses in our condensed consolidated statements of operations. Our acquisition of Viewgol was treated as a purchase in accordance with ASC 805, Business Combinations, which requires allocation of the purchase price to the estimated fair values of assets and liabilities acquired in the transaction. Our allocation of the purchase price was based on management's judgment after evaluating several factors, including a valuation assessment. The preliminary estimated fair values of assets acquired and liabilities assumed as of December 31, 2023, and as updated through March 31, 2024, are as follows: (In thousands) Purchase Price Allocation as of December 31, 2023 Purchase Price Allocation as of March 31, 2024 Acquired cash $ 1,449 $ 1,449 Accounts receivable 2,233 2,233 Prepaid expenses 132 132 Property and equipment 1,112 1,112 Intangible assets 17,720 17,720 Goodwill 17,263 17,927 Accounts payable and accrued liabilities (711) (711) Contingent consideration (1,044) (1,044) Net assets acquired $ 38,154 $ 38,818 In March 2024, the Company estimates an additional $664,000 for working capital adjustments will be paid which is reflected under the caption “Goodwill” in the condensed consolidated balance sheet. The intangible assets in the table above are being amortized on a straight-line basis over their estimated useful lives. The amortization is included under the caption “Amortization of acquisition-related intangibles” in our condensed consolidated statements of operations. The fair value measurements of tangible and intangible assets and liabilities (including those related to contingent consideration) were based on significant inputs not observable in the market and thus represent Level 3 measurements within the fair value measurement hierarchy (see Note 16 - Fair Value). Level 3 inputs included, among others, discount rates that we estimated would be used by a market participant in valuing these assets and liabilities, projections of revenues and cash flows, client attrition rates and market comparables. Our condensed consolidated statement of operations as of March 31, 2024 includes net sales of $4.8 million, gross profit of $2.1 million, net income of $0.8 million and adjusted EBITDA of $1.0 million (see note 17 - Segment Reporting for more information regarding, and definition of, adjusted EBITDA) attributed to the Viewgol acquistion.

PROPERTY AND EQUIPMENT

PROPERTY AND EQUIPMENT	3 Months Ended
	Mar. 31, 2024
Property, Plant and Equipment [Abstract]
PROPERTY AND EQUIPMENT	PROPERTY AND EQUIPMENT Property and equipment, net was comprised of the following at March 31, 2024 and December 31, 2023: (In thousands) March 31, December 31, 2023 Land $ 2,848 $ 2,848 Buildings and improvements 8,487 8,481 Computer equipment 10,241 10,104 Leasehold improvements 631 631 Office furniture and fixtures 618 586 Automobiles 18 18 Property and equipment, gross 22,843 22,668 Less: accumulated depreciation (14,093) (13,694) Property and equipment, net $ 8,750 $ 8,974

SOFTWARE DEVELOPMENT

SOFTWARE DEVELOPMENT	3 Months Ended
	Mar. 31, 2024
Research and Development [Abstract]
SOFTWARE DEVELOPMENT	SOFTWARE DEVELOPMENT Software development costs are accounted for in accordance with ASC 350-40, Internal-Use Software. We capitalize incurred labor costs for software development from the time the preliminary project phase is completed until the software is available for general release. Research and development costs and other computer software maintenance costs related to software development are expensed as incurred. We amortize capitalized software value on a straight-line basis over that estimated useful life of five years. If the actual useful life of the asset is determined to be shorter than our estimated useful life, we will amortize the remaining book value over the remaining actual useful life, or the asset may be deemed to be impaired and, accordingly, a write-down of the value of the asset may be recorded as a charge to earnings. Amortization begins when the related software features are placed in service. Software development costs, net was comprised of the following at March 31, 2024 and December 31, 2023: (In thousands) March 31, December 31, 2023 Software development costs $ 56,188 $ 51,349 Less: accumulated amortization (14,951) (12,210) Software development costs, net $ 41,237 $ 39,139

OTHER ACCRUED LIABILITIES

OTHER ACCRUED LIABILITIES	3 Months Ended
	Mar. 31, 2024
Payables and Accruals [Abstract]
OTHER ACCRUED LIABILITIES	OTHER ACCRUED LIABILITIES Other accrued liabilities was comprised of the following at March 31, 2024 and December 31, 2023: (In thousands) March 31, December 31, 2023 Salaries and benefits $ 9,125 $ 5,194 Severance 3,359 5,806 Commissions 714 1,185 Contingent consideration 1,044 1,044 Operating lease liabilities, current portion 1,601 1,804 Other 2,383 4,859 Other accrued liabilities $ 18,226 $ 19,892

NET INCOME (LOSS) PER SHARE

NET INCOME (LOSS) PER SHARE	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
NET INCOME (LOSS) PER SHARE	NET INCOME (LOSS) PER SHARE The Company presents basic and diluted earnings per share (“EPS”) data for its common stock. Basic EPS is calculated by dividing the net income attributable to stockholders of the Company by the weighted average number of shares of common stock outstanding during the period. Diluted EPS is determined by adjusting the net income attributable to stockholders of the Company and the weighted average number of shares of common stock outstanding during the period for the effects of all dilutive potential common shares, including awards under stock-based compensation arrangements. The Company's unvested restricted stock awards (see Note 10 - Stock-Based Compensation and Equity) are considered participating securities under ASC 260, Earnings Per Share , because they entitle holders to non-forfeitable rights to dividends until the awards vest or are forfeited. When a company has a security that qualifies as a “participating security,” the Codification requires the use of the two-class method when computing basic EPS. The two-class method is an earnings allocation formula that determines EPS for each class of common stock and participating security according to dividends declared (or accumulated) and participation rights in undistributed earnings. In determining the amount of net income to allocate to common stockholders, income is allocated to both common stock and participating securities based on their respective weighted average shares outstanding for the period, with net income attributable to common stockholders ultimately equaling net income less net income attributable to participating securities. Diluted EPS for the Company's common stock is computed using the more dilutive of the two-class method or the treasury stock method. The following is a calculation of the basic and diluted EPS for the Company's common stock, including a reconciliation between net income and net income attributable to common stockholders: Three Months Ended March 31, (In thousands, except per share data) 2024 2023 Net income (loss) $ (2,516) $ 3,084 Less: Net (income) loss attributable to participating securities 68 (63) Net income (loss) attributable to common stockholders $ (2,448) $ 3,021 Weighted average shares outstanding used in basic per common share computations 14,234 14,136 Add: Dilutive potential common shares — — Weighted average shares outstanding used in diluted per common share computations 14,234 14,136 Basic EPS $ (0.17) $ 0.21 Diluted EPS $ (0.17) $ 0.21 During 2022, 2023, and 2024, performance share awards were granted to certain executive officers and key employees of the Company that will result in the issuance of common stock if the predefined performance criteria are met. The awards provide for an aggregate target of 512,103 shares, of which none have been included in the calculation of diluted EPS for the three months ended March 31, 2024 because the related threshold award performance levels have not been achieved as of March 31, 2024. See Note 10 - Stock-Based Compensation and Equity for more information.

INCOME TAXES

INCOME TAXES	3 Months Ended
	Mar. 31, 2024
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXES The Company determines the tax provision for interim periods using an estimate of our annual effective tax rate ("ETR"), adjusted for discrete items, if any, that are taken into account in the relevant period. Each quarter we update our estimate of the annual ETR, and if our estimated tax rate changes, we make a cumulative adjustment. If a reliable estimate of the annual ETR cannot be made, the actual ETR for the year to date may be the best estimate of the annual ETR. Our effective tax rate for the three months ended March 31, 2024 increased to 38.8% from 20.8% for the three months ended March 31, 2023, with the largest contributing factor being the impact of the gain recorded on the sale of American HealthTech, Inc. Also impacting the effective tax rate is the research and development ("R&D") tax credit. This credit, which is not correlated with taxable income, resulted in an incremental benefit of 24.2% during the first quarter of 2024 over the corresponding benefit during the first quarter of 2023. In periods with taxable income, the benefit from the R&D tax credit serves to reduce income tax expense, thereby lowering the effective tax rate. However, in periods with taxable loss, the benefit from the R&D tax credit serves to increase the income tax benefit, thereby increasing the effective tax rate.

STOCK-BASED COMPENSATION AND EQ

STOCK-BASED COMPENSATION AND EQUITY	3 Months Ended
	Mar. 31, 2024
Share-Based Payment Arrangement [Abstract]
STOCK-BASED COMPENSATION AND EQUITY	STOCK-BASED COMPENSATION AND EQUITY Stock-based compensation expense is measured at the grant date based on the fair value of the award, and is recognized as an expense over the employees’ or non-employee directors’ requisite service period. The following table details total stock-based compensation expense for the three months ended March 31, 2024 and 2023, included in the condensed consolidated statements of income: Three Months Ended March 31, (In thousands) 2024 2023 Costs of revenue (exclusive of amortization and depreciation) $ 36 $ 181 Other expenses 764 1,066 Pre-tax stock-based compensation expense 800 1,247 Less: income tax effect (168) (274) Net stock-based compensation expense $ 632 $ 973 The Company's stock-based compensation awards are in the form of restricted stock and performance share awards granted pursuant to the Company's Amended and Restated 2019 Incentive Plan (the "Plan"). As of March 31, 2024, th ere was $12.4 million of unrecognized compensation expense related to unvested and unearned, as applicable, stock-based compensation arrangements granted under the Plan, which is expected to be recognized over a weighted-average period of 2.4 years . Restricted Stock The Company grants restricted stock to executive officers, certain key employees and non-employee directors under the Plan with the fair value of the awards representing the fair value of the common stock on the date the restricted stock is granted. During the vesting period, recipients of restricted stock are entitled to dividends and possess voting rights. Shares of restricted stock generally vest in equal annual installments over the applicable vesting period, which ranges from one A summary of restricted stock activity under the Plan during the three months ended March 31, 2024 and 2023 is as follows: Three Months Ended March 31, 2024 Three Months Ended March 31, 2023 Shares Weighted-Average Shares Weighted-Average Unvested restricted stock outstanding at beginning of period 343,315 $ 29.08 281,161 $ 32.24 Granted 495,003 10.03 185,487 29.23 Vested (145,180) 31.90 (133,298) 31.33 Forfeited (44,122) 31.32 — — Unvested restricted stock outstanding at end of period 649,016 $ 14.73 333,350 $ 30.93 Performance Share Awards The Company grants performance share awards to executive officers and certain key employees under the Plan, with the number of shares of common stock earned and issuable under each award determined at the end of a three-year performance period, based on the Company's achievement of performance goals predetermined by the Compensation Committee of the Board of Directors at the time of grant. These performance share awards include a modifier to the total number of shares earned based on the Company's total shareholder return (“TSR”) compared to a small-cap stock market index. If certain levels of the performance objective are met, the award results in the issuance of shares of common stock corresponding to such level. Performance share awards that result in the issuance of shares of common stock are not subject to time-based vesting at the conclusion of the three-year performance period. In the event that the Company's financial performance meets the predetermined targets for the performance objectives of the performance share awards, the Company will issue each award recipient the number of shares of common stock equal to the target award specified in the individual's underlying performance share award agreement. In the event the financial results of the Company exceed the predetermined targets, additional shares up to the maximum award may be issued. In the event the financial results of the Company fall below the predetermined targets, a reduced number of shares may be issued. If the financial results of the Company fall below the threshold performance levels, no shares may be issued. The total number of shares issued for the performance share award may be increased, decreased, or unchanged based on the TSR modifier described above. The recipients of performance share awards do not receive dividends or possess voting rights during the performance period and, accordingly, the fair value of the performance share awards is the quoted market value of TruBridge’s common stock on the grant date less the present value of the expected dividends not received during the relevant period. The TSR modifier applicable to the performance share awards is considered a market condition and therefore is reflected in the grant date fair value of the award. A Monte Carlo simulation has been used to account for this market condition in the grant date fair value of the award. Expense related to performance share awards is recognized using ratable straight-line amortization over the three-year performance period. In the event the Company determines it is no longer probable that the minimum performance level will be achieved, all previously recognized compensation expense related to the applicable awards is reversed in the period such a determination is made. A summary of performance share award activity under the Plan during the three months ended March 31, 2024 and 2023 is as follows, based on the target award amounts set forth in the performance share award agreements: Three Months Ended March 31, 2024 Three Months Ended March 31, 2023 Shares Weighted-Average Shares Weighted-Average Performance share awards outstanding at beginning of period 273,791 $ 33.17 252,375 $ 31.84 Granted 323,461 10.03 123,406 31.21 Forfeited or unearned (85,149) 37.98 (96,069) 26.96 Performance share awards outstanding at end of period 512,103 $ 18.24 279,712 $ 33.24 Stock Repurchases On September 4, 2020, our Board of Directors approved a stock repurchase program under which we were authorized to repurchase up to $30.0 million of our common stock through September 3, 2022. On July 27, 2022, the Board of Directors extended the expiration date of the stock repurchase program to September 4, 2024. We repurchased 49,789 shares for the three months ended March 31, 2023, and there were no shares repurchased for three months ended March 31, 2024. The approximate dollar value of shares that may yet be repurchased under the stock repurchase program was $16.5 million as of March 31, 2024. Any future stock repurchase transactions may be made through open market purchases, privately-negotiated transactions, or otherwise in compliance with Rule 10b-18 under the Securities Exchange Act of 1934, as amended. Any repurchase activity will depend on many factors, such as the availability of shares of our common stock, general market conditions, the trading price of our common stock, alternative uses for capital, the Company’s financial performance, compliance with the terms of our Amended and Restated Credit Agreement and other factors. Concurrent with the authorization of this stock repurchase program in September 2020, the Board of Directors opted to indefinitely suspend all quarterly dividends. In addition to shares repurchased under the approved stock repurchase program, we purchased 41,000 and 39,716 shares as of March 31, 2024 and 2023, respectively, to fund required tax withholdings. Shares withheld to cover required tax withholdings related to the vesting of restricted stock do not reduce our total share repurchase authority. Common Stock Rights Agreement On March 26, 2024, the Company’s board of directors declared a dividend of one right (a “Right”) for each of the Company’s issued and outstanding shares of common stock. The dividend was paid to the stockholders of record at the close of business on April 4, 2024. Each Right initially entitles the registered holder, subject to the terms of the Rights Agreement (as defined below), to purchase from the Company one half of a share of common stock, at an exercise price of $28.00 for each one half of a share of common stock (equivalent to $56.00 for each whole share of common stock), subject to certain adjustments. The Rights currently are not exercisable and will only become exercisable upon the occurrence of certain events as described in the Rights Agreement. The Rights will expire prior to the earliest of (i) the close of business on March 25, 2025, or such later date as may be established by the Board prior to the expiration of the Rights; (ii) the time at which the Rights are redeemed pursuant to the Rights Agreement; (iii) the time at which the Rights are exchanged pursuant to the Rights Agreement; and (iv) upon the occurrence of certain transactions (the earliest of (i), (ii), (iii) and (iv) is referred to as the “Expiration Date”). The complete description and terms of the Rights are set forth in the Rights Agreement, dated as of March 26, 2024, by and between the Company and Computershare Trust Company, N.A. as rights agent, as amended by the Amendment to the Rights Agreement dated as of April 22, 2024 (as amended, the “Rights Agreement”). Given the nature of the Rights and their contingent activation, which has been deemed remote, no value is recognized in stockholders’ equity.

FINANCING RECEIVABLES

FINANCING RECEIVABLES	3 Months Ended
	Mar. 31, 2024
Receivables [Abstract]
FINANCING RECEIVABLES	FINANCING RECEIVABLES Short-Term Payment Plans The Company provides fixed monthly payment arrangements ("short-term payment plans") over terms ranging from three (In thousands) March 31, December 31, 2023 Short-term payment plans, gross $ 666 $ 788 Less: allowance for losses (33) (39) Short-term payment plans, net $ 633 $ 749 Long-Term Financing Arrangements Additionally, the Company provides financing for purchases of its information and patient care systems to certain healthcare providers under long-term financing arrangements expiring in various years through 2030. Under long-term financing arrangements, the transaction price is adjusted by a discount rate that reflects market conditions that would be used for a separate financing transaction between the Company and licensee at contract inception, and takes into account the credit characteristics of the licensee and market interest rates as of the date of the agreement. As such, the amount of fixed fee revenue recognized at the beginning of the license term will be reduced by the calculated financing component. As payments are received from the licensee, the Company recognizes a portion of the financing component as interest income, reported as other income in the condensed consolidated statements of income. These receivables typically have terms from two The components of these receivables were as follows at March 31, 2024 and December 31, 2023: (In thousands) March 31, December 31, 2023 Long-term financing arrangements, gross $ 4,660 $ 5,212 Less: allowance for expected credit losses (350) (377) Less: unearned income (316) (361) Long-term financing arrangements, net $ 3,994 $ 4,474 Future minimum payments to be received subsequent to March 31, 2024 are as follows: (In thousands) Years Ending December 31, 2024 $ 2,375 2025 1,938 2026 206 2027 69 2028 62 Thereafter 10 Total minimum payments to be received 4,660 Less: allowance for expected credit losses (350) Less: unearned income (316) Receivables, net $ 3,994 Credit Quality of Financing Receivables and Allowance for Expected Credit Losses The following table is a roll-forward of the allowance for expected credit losses for the three months ended March 31, 2024 and year ended December 31, 2023: (In thousands) Balance at Beginning of Period Provision Charge-offs Recoveries Sale of AHT Balance at End of Period March 31, 2024 $ 416 $ (31) $ — $ — $ (2) $ 383 December 31, 2023 $ 549 $ (133) $ — $ — $ — $ 416 The Company’s financing receivables are comprised of a single portfolio segment, as the balances are all derived from short-term payment plan arrangements and long-term financing arrangements within our target market of community hospitals. The Company evaluates the credit quality of its financing receivables based on a combination of factors, including, but not limited to, customer collection experience, current and future economic conditions, the customer’s financial condition, and known risk characteristics impacting the respective customer base of community hospitals, the most notable of which relate to enacted and potential changes in Medicare and Medicaid reimbursement rates as community hospitals typically generate a significant portion of their revenues and related cash flows from beneficiaries of these programs. In addition to specific account identification, the Company utilizes historical collection experience to establish the allowance for expected credit losses. Financing receivables are written off only after the Company has exhausted all collection efforts. Customer payments are considered past due if a scheduled payment is not received within contractually agreed upon terms. To facilitate customer collection and credit monitoring efforts, financing receivable amounts are invoiced and reclassified to trade accounts receivable when they become due, with all invoiced amounts placed on nonaccrual status. As a result, all past due amounts related to the Company’s financing receivables are included in trade accounts receivable in the accompanying condensed consolidated balance sheets. The following is an analysis of the age of financing receivables amounts (excluding short-term payment plans) that have been reclassified to trade accounts receivable and were past due as of March 31, 2024 and December 31, 2023: (In thousands) 1 to 90 Days Past Due 91 to 180 Days Past Due 181 + Days Past Due Total Past Due March 31, 2024 $ 532 $ 275 $ 495 $ 1,302 December 31, 2023 $ 857 $ 231 $ 323 $ 1,411 From time to time, the Company may agree to alternative payment terms outside of the terms of the original financing receivable agreement due to customer difficulties in achieving the original terms. In general, such alternative payment arrangements do not result in a re-aging of the related receivables. Rather, payments pursuant to any alternative payment arrangements are applied to the already outstanding invoices beginning with the oldest outstanding invoices as the payments are received. Because amounts are reclassified to trade accounts receivable when they become due, there are no past due amounts included within financing receivables, current portion, net or financing receivables, net of current portion in the accompanying condensed consolidated balance sheets. The Company utilizes an aging of trade accounts receivable as the primary credit quality indicator for its financing receivables, which is facilitated by the reclassification of customer payment amounts to trade accounts receivable when they become due. The table below categorizes customer financing receivable balances (excluding short-term payment plans) based on the age of the oldest payment outstanding that has been reclassified to trade accounts receivable: (In thousands) March 31, December 31, 2023 Stratification of uninvoiced client financing receivables based on aging of related trade accounts receivable: Uninvoiced client financing receivables related to trade accounts receivable that are 1 to 90 Days Past Due $ 984 $ 1,068 Uninvoiced client financing receivables related to trade accounts receivable that are 91 to 180 Days Past Due 839 1,720 Uninvoiced client financing receivables related to trade accounts receivable that are 181 + Days Past Due 1,348 965 Total uninvoiced client financing receivables balances of clients with a trade accounts receivable $ 3,171 $ 3,753 Total uninvoiced client financing receivables of clients with no related trade accounts receivable 1,173 1,098 Total financing receivables with contractual maturities of one year or less 666 788 Less: allowance for expected credit losses (383) (416) Total financing receivables $ 4,627 $ 5,223

INTANGIBLE ASSETS AND GOODWILL

INTANGIBLE ASSETS AND GOODWILL	3 Months Ended
	Mar. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
INTANGIBLE ASSETS AND GOODWILL	INTANGIBLE ASSETS AND GOODWILL The following tables summarize the gross carrying amounts, accumulated amortization and accumulated impairment of identifiable intangible assets with definite lives by major class as of March 31, 2024 and December 31, 2023: March 31, 2024 (In thousands) Customer Relationships Trademark Developed Technology Non-Compete Agreements Total Gross carrying amount, beginning of period $ 116,470 $ 7,720 $ 31,900 $ 1,620 $ 157,710 Accumulated amortization (43,031) (5,378) (20,269) (604) (69,282) Accumulated impairment — (2,342) — — (2,342) Net intangible assets as of March 31, 2024 $ 73,439 $ — $ 11,631 $ 1,016 $ 86,086 Weighted average remaining years of useful life 8.2 0.0 8.3 3.2 8.2 December 31, 2023 (In thousands) Customer Relationships Trademark Developed Technology Non-Compete Agreements Total Gross carrying amount, beginning of period $ 132,170 $ 12,320 $ 40,800 $ 1,400 $ 186,690 Intangible assets acquired 16,100 — 1,400 220 17,720 Accumulated amortization (63,686) (6,974) (29,934) (522) (101,116) Accumulated impairment — (2,342) (2,342) Held for sale (8,735) (3,004) (11,739) Net intangible assets as of December 31, 2023 $ 75,849 $ — $ 12,266 $ 1,098 $ 89,213 During the fourth quarter of 2023, the Company committed to the Company-wide rebranding and legal entity consolidation initiative that culminated in the change of the Company’s corporate name to “TruBridge, Inc.” on March 4, 2024. As a result of this initiative, it was expected that certain of the Company’s brand names and related trademarks would cease to be used, resulting in total trademark impairment recorded during the year ended December 31, 2023 of $2.3 million. Of the total trademark impairment charge, $1.0 million is derived from our RCM segment, $1.2 million is derived from our EHR segment, and $0.1 million is derived from our Patient Engagement segment. The following table represents the remaining amortization of definite-lived intangible assets as of March 31, 2024: (In thousands) For the year ended December 31, 2024 $ 9,379 2025 12,190 2026 11,517 2027 10,497 2028 10,203 Thereafter 32,300 Total $ 86,086 The following table sets forth the change in the carrying value of our goodwill balances by reportable segment for the three months ended March 31, 2024: (In thousands) RCM EHR Patient Engagement Total Gross value at December 31, 2023 $ 79,084 $ 126,665 $ 9,767 $ 215,516 Accumulated impairment — (28,307) (7,606) (35,913) Held for sale — (7,694) — (7,694) Carrying value at December 31, 2023 79,084 90,664 2,161 171,909 Purchase price adjustment (Viewgol) 664 — — 664 Gross value at March 31, 2024 79,748 118,971 9,767 208,486 Accumulated impairment — (28,307) (7,606) (35,913) Carrying value as of March 31, 2024 $ 79,748 $ 90,664 $ 2,161 $ 172,573 Goodwill is evaluated for impairment annually on October 1, or more frequently if indicators of impairment are present or changes in circumstances suggest that impairment may exist. During the three months ended March 31, 2024, our share price experienced a sustained decline resulting in a decrease in our market capitalization. This decline in share price was identified as a triggering event requiring a quantitative assessment for goodwill impairment in each of our reporting units.

LONG-TERM DEBT

LONG-TERM DEBT	3 Months Ended
	Mar. 31, 2024
Debt Disclosure [Abstract]
LONG-TERM DEBT	LONG-TERM DEBT Long-term debt was comprised of the following at March 31, 2024 and December 31, 2023: (In thousands) March 31, December 31, 2023 Term loan facility $ 63,000 $ 63,875 Revolving credit facility 123,416 135,723 Debt obligations 186,416 199,598 Less: unamortized debt issuance costs (1,610) (1,187) Debt obligation, net 184,806 198,411 Less: current portion (3,074) (3,141) Long-term debt $ 181,732 $ 195,270 As of March 31, 2024, the carrying value of debt approximated the fair value due to the variable interest rate, which reflected the market rate. Credit Agreement In conjunction with our acquisition of Healthland Holding Inc. ("HHI") in January 2016, we entered into a syndicated credit agreement with Regions Bank ("Regions") serving as administrative agent, which provided for a $125 million term loan facility and a $50 million revolving credit facility. On June 16, 2020, we entered into an Amended and Restated Credit Agreement that increased the aggregate principal amount of our credit facilities to $185 million, including a $75 million term loan facility and a $110 million revolving credit facility. On May 2, 2022, we entered into a First Amendment (the "First Amendment") to the Credit Agreement that increased the aggregate principal amount of our credit facilities to $230 million, which includes a $70 million term loan facility and a $160 million revolving credit facility. In addition, the interest rate provisions of the First Amendment reflect the transition from the London Interbank Offered Rate ("LIBOR") to the Secured Overnight Financing Rate ("SOFR") as the new benchmark interest rate for each loan. Each of our credit facilities continues to bear interest at a rate per annum equal to an applicable margin plus, at our option, either (1) the Adjusted SOFR rate for the relevant interest period, subject to a floor of 0.50%, (2) an alternate base rate determined by reference to the greater of (a) the prime lending rate of Regions, (b) the federal funds rate for the relevant interest period plus one half of one percent per annum and (c) the one month SOFR rate, subject to the aforementioned floor, plus one percent per annum, or (3) a combination of (1) and (2). The applicable margin range for SOFR loans and the letter of credit fee ranges from 1.8% to 3.0%. The applicable margin range for base rate loans ranges from 0.8% to 2.0%, in each case based on the Company's consolidated net leverage ratio. Principal payments with respect to the term loan facility are due on the last day of each fiscal quarter beginning June 30, 2022, with quarterly principal payments of approximately $0.9 million through March 31, 2027, with maturity on May 2, 2027 or such earlier date as the obligations under the Amended and Restated Credit Agreement, as amended by the First Amendment, become due and payable pursuant to the terms of such agreement. Any principal outstanding under the revolving credit facility is due and payable on the maturity date. Anticipated annual future maturities of the term loan facility and revolving credit facility are as follows as of March 31, 2024: (In thousands) 2024 $ 2,625 2025 3,500 2026 3,500 2027 176,791 $ 186,416 Our credit facilities are secured pursuant to the Amended and Restated Credit Agreement, dated as of June 16, 2020, among the parties identified as obligors therein and Regions, as collateral agent, on a first priority basis by a security interest in substantially all of the tangible and intangible assets (subject to certain exceptions) of the Company and certain subsidiaries of the Company, as guarantors (collectively, the “Subsidiary Guarantors”), including certain registered intellectual property and the capital stock of certain of the Company’s direct and indirect subsidiaries. Our obligations under the Amended and Restated Credit Agreement are also guaranteed by the Subsidiary Guarantors. The First Amendment provides incremental facility capacity of $75 million, subject to certain conditions. The Amended and Restated Credit Agreement, as amended by the First Amendment, includes a number of restrictive covenants that, among other things and in each case subject to certain exceptions and baskets, impose operating and financial restrictions on the Company and the Subsidiary Guarantors, including the ability to incur additional debt; incur liens and encumbrances; make certain restricted payments, including paying dividends on the Company's equity securities or payments to redeem, repurchase, or retire the Company's equity securities (which are subject to our compliance, on a pro forma basis to give effect to the restricted payment, with the fixed charge coverage ratio and consolidated net leverage ratio described below); enter into certain restrictive agreements; make investments, loans and acquisitions; merge or consolidate with any other person; dispose of assets; enter into sale and leaseback transactions; engage in transactions with affiliates; and materially alter the business we conduct. The First Amendment requires the Company to maintain a minimum fixed charge coverage ratio of 1.25:1.00 throughout the duration of such agreement. Under the First Amendment, the Company is required to comply with a maximum consolidated net leverage ratio of 3.50:1.00. Further, under the First Amendment, in connection with any acquisition by the Company exceeding $25 million, the Company may elect to increase the maximum permitted consolidated net leverage ratio for the fiscal quarter in which the acquisition occurs and each of the following three fiscal quarters by 0.50:1.00 above the otherwise permitted maximum. If the consolidated net leverage ratio is less than 2.50:1.00, there is no limit on the amount of incremental facilities. The Amended and Restated Credit Agreement also contains customary representations and warranties, affirmative covenants and events of default. On March 10, 2023, the calculation of the fixed charge coverage ratio was amended to specifically exclude from the definition of fixed charges the Company's share repurchases conducted during the third and fourth quarters of 2022. As of September 30, 2023, we were not in compliance with the fixed charge coverage ratio required by the Amended and Restated Credit Agreement. On November 8, 2023, the Company and the subsidiary guarantors entered into a Waiver with Regions Bank, as administrative agent, and various other lenders, which provided for a one-time waiver of this failure as an event of default. As of December 31, 2023, the Company was similarly not in compliance with the fixed charge coverage ratio required by the Amended and Restated Credit Agreement, and a one-time waiver was provided in conjunction with the Fourth Amendment to the Amended and Restated Credit Agreement (described below). Any failure by us to comply with this or another covenant in the future may result in an event of default. There can be no assurance that we will be able to continue to comply with this covenant or obtain amendments to avoid future covenant violations, or that such amendments will be available on commercially acceptable terms. The First Amendment removed the requirement of mandatory prepayment of the credit facilities with excess cash flow generated during the prior fiscal year. The Company is permitted to voluntarily prepay the credit facilities at any time without penalty, subject to customary “breakage” costs with respect to prepayments of SOFR rate loans made on a day other than the last day of any applicable interest period. Credit Facility Third Amendment On January 16, 2024, the Company entered into a Third Amendment (the “Third Amendment”) to the Amended and Restated Credit Agreement, dated as of June 16, 2020, by and among the Company; the Subsidiary Guarantors; Regions Bank, as administrative agent and collateral agent; and various other lenders from time to time. Capitalized terms used but not defined herein shall have the meanings ascribed to them in the Credit Agreement. The Third Amendment modified the term “Consolidated EBITDA” to provide that the following amounts will be added back to Consolidated Net Income: (i) the reasonably expected value of all earn-out consideration in connection with any Permitted Acquisition, provided that the aggregate amount of fees and out-of-pocket expenses incurred in connection with anticipated Permitted Acquisitions which are not consummated during any period of four fiscal quarters ending on or after the Closing Date will not exceed the greater of $7 million and 10% of Consolidated EBITDA; (ii) any fees, costs or expenses related to the implementation of cost savings, operating expense reductions and synergies related to Permitted Acquisitions, restructurings and other initiatives; and (iii) costs and expenses related to the previously disclosed U.S. Securities and Exchange Commission investigation that occurred during the fiscal year ended December 31, 2023, in an aggregate amount not to exceed $1.25 million. Additionally, the Third Amendment (y) removed from the maximum aggregate amount of fees and expenses that can be added back to Consolidated Net Income any losses resulting from any Asset Sales or Involuntary Disposition and (z) increased the maximum amount of fees and expenses that can be added back to Consolidated Net Income related to savings initiatives, Equity Transactions, the incurrence of Indebtedness and amendments to the Credit Documents from 10% to 15% of Consolidated EBITDA (determined prior to giving effect to such adjustments). Credit Facility Fourth Amendment On February 29, 2024, the Company entered into a Fourth Amendment (the “Fourth Amendment”) to the Credit Agreement, by and among the Company; the Subsidiary Guarantors; the Administrative Agent; and various other lenders. Capitalized terms used but not defined herein shall have the meanings ascribed to them in the Credit Agreement. The Fourth Amendment modified the term “Consolidated EBITDA” to provide that the additional following amounts will be added back to Consolidated Net Income: (i) costs and expenses related to the voluntary early retirement program during the fiscal year ending December 31, 2023; and (ii) fees, costs and expenses in categories identified to the Administrative Agent to the extent incurred during the fiscal year ending December 31, 2024, in an aggregate amount not to exceed $7.25 million. Additionally, the modified definition of “Consolidated EBITDA” limits the amount of pro forma “run rate” cost savings, operating expense reductions and synergies (collectively, “Savings”) related to the Viewgol acquisition that can be added back to Consolidated Net Income to an aggregate amount not to exceed $6.6 million; however, Savings related to the Viewgol acquisition are not subject to the cap of 15% of Consolidated EBITDA that otherwise applies to Savings related to Permitted Acquisitions, restructurings or cost savings initiatives.

OPERATING LEASES

OPERATING LEASES	3 Months Ended
	Mar. 31, 2024
Leases [Abstract]
OPERATING LEASES	OPERATING LEASES The Company leases office space in various locations in Alabama, Pennsylvania, Maryland, Mississippi, and Washington. These leases have terms expiring from 2024 through 2029 but do contain optional extension terms. Leases with an initial term of 12 months or less are not recorded on the balance sheet; we recognize lease expense for these leases on a straight-line basis over the lease term. On April 30, 2023, the company terminated its lease agreement for approximately 12,500 square feet of office space in Plymouth, Minnesota. Pursuant to a Termination of Lease Agreement dated April 18, 2023, the Company paid $1.1 million to the landlord as consideration for the early termination. In connection with the lease termination, the Company derecognized the assets and liabilities associated with the operating lease and recorded a $0.1 million loss on the disposal of leasehold improvement. Supplemental balance sheet information related to operating leases was as follows: (In thousands) March 31, December 31, Operating lease assets: Operating lease assets $ 4,672 $ 5,192 Operating lease liabilities: Other accrued liabilities 1,601 1,804 Operating lease liabilities, net of current portion 2,848 3,074 Total operating lease liabilities $ 4,449 $ 4,878 Weighted average remaining lease term in years 3.9 4 Weighted average discount rate 4.1% 4.2% Because our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available at the lease commencement date in determining the present value of lease payments. We used the incremental borrowing rate on January 1, 2019, for operating leases that commenced prior to that date. The future minimum lease payments payable under these operating leases subsequent to March 31, 2024 are as follows: (In thousands) 2024 $ 1,326 2025 1,063 2026 1,025 2027 706 2028 462 Thereafter 231 Total lease payments 4,813 Less imputed interest (364) Total $ 4,449 Total lease expense for the three months ended March 31, 2024 and 2023 was $0.5 million and $0.6 million, respectively. Total cash paid for amounts included in the measurement of lease liabilities within operating cash flows from operating leases for the three months ended March 31, 2024 and 2023 was $0.5 million and $0.6 million, respectively.

COMMITMENTS AND CONTINGENCIES

COMMITMENTS AND CONTINGENCIES	3 Months Ended
	Mar. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	COMMITMENTS AND CONTINGENCIESFrom time to time, the Company is involved in routine litigation that arises in the ordinary course of business. Management does not believe it is reasonably possible that such matters will have a material adverse effect on the Company’s financial statements. The Company recorded a liability of $1.0 million related to contingent consideration for Viewgol's former equity holders as of December 31, 2023 and March 31, 2024.

FAIR VALUE

FAIR VALUE	3 Months Ended
	Mar. 31, 2024
Fair Value Disclosures [Abstract]
FAIR VALUE	FAIR VALUE FASB Codification topic, Fair Value Measurements and Disclosures, establishes a framework for measuring fair value and expands financial statement disclosures about fair value measurements. Fair value is the price that would be received to sell an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants at the measurement date. The Codification does not require any new fair value measurements, but rather applies to all other accounting pronouncements that require or permit fair value measurements. The Codification requires that assets and liabilities carried at fair value be classified and disclosed in one of the following three categories: Level 1: Quoted market prices in active markets for identical assets or liabilities. Level 2: Observable market-based inputs or unobservable inputs that are corroborated by market data. Level 3: Unobservable inputs that are not corroborated by market data. At March 31, 2024, we measured the fair value of contingent consideration that represents the potential earnout incentive for Viewgol’s former equity holders. We estimated the fair value of these contingent consideration based on the probability of Viewgol meeting EBITDA targets (subject to certain pro-forma adjustments). The following table summarizes the carrying amount and fair value of the contingent consideration at March 31, 2024: Fair Value at March 31, 2024 Using (In thousands) Carrying Amount at March 31, 2024 Quoted Price in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Description Contingent consideration $ 1,044 $ — $ — $ 1,044 Total $ 1,044 $ — $ — $ 1,044

SEGMENT REPORTING

SEGMENT REPORTING	3 Months Ended
	Mar. 31, 2024
Segment Reporting [Abstract]
SEGMENT REPORTING	SEGMENT REPORTING Our chief operating decision makers (“CODM”) identifies the following three operating segments “RCM”, “EHR”, and “Patient Engagement”. These segments represent the components of the Company for which separate financial information is available that is utilized on a regular basis by the CODM in assessing segment performance and in allocating the Company's resources. Management evaluates the performance of the segments based on revenues and adjusted EBITDA. The Company previously evaluated the performance of the segments based on segment gross profit. Management believes adjusted EBITDA is a useful measure to assess the performance and liquidity of the Company as it provides meaningful operating results by excluding the effects of expenses that are not reflective of its operating business performance. Our CODM group is comprised of the Chief Executive Officer, Chief Operating Officer, and Chief Financial Officer. Accounting policies for each of the reportable segments are the same as those used on a consolidated basis. Adjusted EBITDA consists of GAAP net income (loss) as reported and adjusts for (i) depreciation expense; (ii) amortization of software development costs; (iii) amortization of acquisition-related intangible assets; (iv) stock-based compensation; (v) severance and other non-recurring charges; (vi) interest expense and other, net; and (ix) the provision (benefit) for income taxes. There are no intersegment revenues to be eliminated in computing segment revenue. The CODM do not evaluate operating segments nor make decisions regarding operating segments based on assets. Consequently, we do not disclose total assets by reportable segment. The following table presents a summary of the revenues and adjusted EBITDA of our three operating segments for the three months ended March 31, 2024 and 2023: Three Months Ended March 31, (In thousands) 2024 2023 Revenues by segment: RCM $ 53,038 $ 48,631 EHR Recurring revenue Acute EHR 25,910 27,613 Post-acute EHR 582 3,906 Total recurring EHR revenue 26,492 31,519 Non-recurring revenue Acute EHR 1,449 3,292 Post-acute EHR 81 380 Total non-recurring EHR revenue 1,530 3,672 Total EHR revenue $ 28,022 $ 35,191 Patient Engagement 2,187 2,411 Total revenues $ 83,247 $ 86,233 Adjusted EBITDA by segment: RCM $ 6,396 $ 7,898 EHR 2,929 6,157 Patient Engagement 129 588 Total adjusted EBITDA $ 9,454 $ 14,643 The following table reconciles net income to adjusted EBITDA: Three Months Ended March 31, (In thousands) 2024 2023 Net income (loss), as reported $ (2,516) $ 3,084 Depreciation expense 400 499 Amortization of software development costs 2,742 1,486 Amortization of acquisition-related intangibles 3,127 4,014 Stock-based compensation 800 1,247 Severance and other non-recurring charges 3,844 1,104 Interest expense 4,072 2,669 Gain on sale of AHT (1,250) — Other (173) (269) Provision (benefit) for income taxes (1,592) 809 Total adjusted EBITDA $ 9,454 $ 14,643 Certain of the items excluded or adjusted to arrive at adjusted EBITDA are described below: • Amortization of acquisition-related intangibles - Acquisition-related amortization expense is a non-cash expense arising primarily from the acquisition of intangibles in connection with acquisitions or investments. We exclude acquisition-related amortization expense from adjusted EBITDA because we believe (i) the amount of such expenses in any specific period may not directly correlate to the underlying performance of our business operations and (ii) such expenses can vary significantly between periods as a result of new acquisitions and full amortization of previously acquired intangible assets. • Stock-based compensation - Stock-based compensation expense is a non-cash expense arising from the grant of stock-based awards. We exclude stock-based compensation expense from adjusted EBITDA because we believe (i) the amount of such expenses in any specific period may not directly correlate to the underlying performance of our business operations and (ii) such expenses can vary significantly between periods as a result of the timing and valuation of grants of new stock-based awards, including grants in connection with acquisitions. • Severance and other non-recurring charges - Non-recurring charges relate to certain severance and other charges incurred in connection with activities that are considered non-recurring. We exclude non-recurring expenses (primarily related to costs associated with our recent business transformation initiative and non-recurring lease termination costs) and transaction-related costs from adjusted EBITDA because we believe (i) the amount of such expenses in any specific period may not directly correlate to the underlying performance of our business operations and (ii) such expenses can vary significantly between periods. •

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Pay vs Performance Disclosure
Net income (loss)	$ (2,516)	$ 3,084

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Mar. 31, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

BASIS OF PRESENTATION (Policies

BASIS OF PRESENTATION (Policies)	3 Months Ended
	Mar. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (the “SEC”) and include all adjustments that, in the opinion of management, are necessary for a fair presentation of the results of the periods presented. All such adjustments are considered of a normal recurring nature. Quarterly results of operations are not necessarily indicative of annual results. Certain footnote disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”) have been condensed or omitted. The condensed consolidated balance sheet as of December 31, 2023 was derived from the audited consolidated balance sheet at that date. These unaudited condensed consolidated financial statements should be read in conjunction with the audited financial statements of TruBridge, Inc. (“TruBridge” or the “Company”) for the year ended December 31, 2023 and the notes thereto contained in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023.
Principles of Consolidation	Principles of Consolidation The condensed consolidated financial statements of TruBridge include the accounts of the Company and its wholly-owned subsidiaries. All significant intercompany balances and transactions have been eliminated.
Recent Account Pronouncements	RECENT ACCOUNTING PRONOUNCEMENTS New Accounting Standards Adopted in 2024 There were no new accounting standards required to be adopted in 2024 that would have a material impact on our consolidated financial statements. New Accounting Standards Yet to be Adopted We do not believe that any other recently issued but not yet effective accounting standards, if adopted, would have a material impact on our consolidated financial statements.
Revenue Recognition	Revenue is recognized upon transfer of control of promised products or services to clients in an amount that reflects the consideration we expect to receive in exchange for those products and services. We enter into contracts that can include various combinations of products and services, which are generally distinct and accounted for as separate performance obligations. The Company employs the 5-step revenue recognition model under ASC 606, Revenue from Contracts with Customers , to: (1) identify the contract with the client, (2) identify the performance obligations in the contract, (3) determine the transaction price, (4) allocate the transaction price to the performance obligations in the contract, and (5) recognize revenue when (or as) the entity satisfies a performance obligation. Revenue is recognized net of shipping charges and any taxes collected from clients, which are subsequently remitted to governmental authorities. • Revenue Cycle Management Our revenue cycle management (“RCM”) business unit provides an array of business processing services (“BPS'’) consisting of accounts receivable management, private pay services, insurance services, medical coding, electronic billing, statement processing, payroll processing, and contract management. Fees are recognized over the period of the client contractual relationship as the services are performed based on the stand-alone selling price (“SSP”), net of discounts. SSP for BPS services is determined based on observable stand-alone selling prices. Fees for many of these services are invoiced, and revenue recognized accordingly, based on the volume of transactions or a percentage of client accounts receivable collections. Payment is due monthly for BPS with certain amounts varying based on utilization and/or volumes. Our RCM business unit also provides professional IT services. Revenue from professional IT services is recognized as the services are performed based on SSP, which is determined by observable stand-alone selling prices. Payment is due monthly as services are performed. Lastly, our RCM business unit also provides certain software solutions and related support under Software as a Service (“SaaS”) arrangements and time-based software licenses. Revenue from SaaS arrangements is recognized in a manner consistent with SaaS arrangements for electronic health records (“EHR”) software, as discussed below. Revenue from time-based software licenses is recognized upon delivery to the client (“point in time”) and revenue from non-license components (i.e., support) is recognized ratably over the respective contract term (“over time”). SSP for time-based licenses is determined using the residual approach, while the non-license component is based on cost plus reasonable margin. • Electronic Health Records The Company enters into contractual obligations to sell perpetual software licenses, installation, conversion, and related training services, software application support, hardware, and hardware maintenance services to acute care community hospitals and post-acute providers. • Non-recurring Revenues • Perpetual software licenses and installation, conversion, and related training services are not considered separate and distinct performance obligations due to the proprietary nature of our software and are, therefore, accounted for as a single performance obligation on a module-by-module basis. Revenue is recognized as each module's implementation is completed based on the module's SSP, net of discounts. We determine each module's SSP using the residual method. Fees for licenses and installation, conversion, and related training services are typically due in three installments: (1) at placement of order, (2) upon installation of software and commencement of training, and (3) upon satisfactory completion of monthly accounting cycle or end-of-month operation by application and as applicable for each application. Often, short-term and/or long-term financing arrangements are provided for software implementations; refer to Note 11 - Financing Receivables for further information. EHR implementations include a system warranty that terminates thirty days from the software go-live date, the date which the client begins using the system in a live environment. • Hardware revenue is recognized separately from software licenses at the point in time it is delivered to the client. The SSP of hardware is cost plus a reasonable margin and revenue is recognized on a gross basis. Payment is generally due upon delivery of the hardware to the client. Standard manufacturer warranties apply to hardware. • Recurring Revenues • Software application support and hardware maintenance services sold with software licenses and hardware are separate and distinct performance obligations. Revenue for support and maintenance services is recognized based on SSP, which is the renewal price, ratably over the life of the contract, which is generally three • Subscriptions to third-party content revenue is recognized as a separate performance obligation ratably over the subscription term based on SSP, which is cost plus a reasonable margin, and revenue is recognized on a gross basis. Payment is due monthly for subscriptions to third party content. • SaaS arrangements for EHR software and related conversion and training services are considered a single performance obligation. Revenue is recognized on a monthly basis as the SaaS service is provided to the client over the contract term. Payment is due monthly for SaaS services provided. Refer to Note 17 - Segment Reporting for further information, including revenue by client base (acute care or post-acute care) bifurcated by recurring and non-recurring revenue. • Patient Engagement The Company enters into contractual obligations to sell perpetual and term-based software licenses, implementation and customization professional services, and software application support services to a variety of healthcare organizations including hospital systems, health ministries, and government and non-profit organizations. • Non-recurring Revenues • Perpetual software licenses are sold only to one re-seller client and are considered a separate and distinct performance obligation. Revenue is recognized at the point in time perpetual licenses are delivered to the client, which occurs at the time of sale. The SSP of perpetual licenses is directly observable. Payment is generally due upon delivery of licenses. • Implementation and customization services are considered a separate and distinct performance obligation. Revenue is recognized over time based on SSP, which is generally directly observable. Payment for professional services is typically due in two installments: (1) upon signature of the agreement and (2) upon customer acceptance of the delivered services. • Recurring Revenues • Term-based software licenses are considered a separate and distinct performance obligation. Revenue is recognized based on SSP, which is directly observable, at the point in time the term-based licenses are delivered to the client or upon annual renewal. Payment is generally due upon delivery of licenses or upon annual renewal. • Software application support services sold with software licenses are separate and distinct performance obligations. The related revenues are recognized based on SSP, which is the renewal price, ratably over the life of the contract, which is generally three Refer to Note 17 - Segment Reporting for further information. Deferred Revenue Deferred revenue represents amounts invoiced to clients for which the services under contract have not been completed and revenue has not been recognized, including annual renewals of certain software subscriptions and customer deposits for implementations to be performed at a later date. Revenue is recognized ratably over the life of the software subscriptions as services are provided and at the point-in-time when implementations have been completed. The deferred revenue recorded during the three months ended March 31, 2024 and 2023 is comprised primarily of the annual renewals of certain software subscriptions billed during the first quarter of each year and deposits collected for future EHR installations. The deferred revenue recognized as revenue during the three months ended March 31, 2024 and 2023 is comprised primarily of the periodic recognition of annual renewals that were deferred until earned and deposits for future EHR installations that were earned during the period. Costs to Obtain and Fulfill a Contract with a Customer Costs to obtain a contract include the commission costs related to SaaS and RCM arrangements, which are capitalized and amortized ratably over the expected life of the customer contract. As a practical expedient, we generally recognize the incremental costs of obtaining a contract as an expense when incurred if the amortization period of the asset would have been one year or less. Costs to obtain a contract are expensed within the caption “Expenses - Sales and marketing” in the accompanying condensed consolidated statements of income. Contract fulfillment costs related to the implementation of SaaS arrangements are capitalized and amortized ratably over the expected life of the customer contract. Costs to fulfill contracts consist of the payroll costs for the implementation of SaaS arrangements, including time for training, conversions, and installation that is necessary for the software to be utilized. Contract fulfillment costs are expensed within the caption “Costs of revenue (exclusive of amortization and depreciation) - EHR” in the accompanying condensed consolidated statements of income. Disclosures regarding remaining performance obligations are not considered material as the overwhelming majority of the Company's remaining performance obligations either (a) are related to contracts with an expected duration of one year or less, or (b) exhibit revenue recognition in the amount to which the Company has the right to invoice.
Net Income (Loss) Per Share	The Company presents basic and diluted earnings per share (“EPS”) data for its common stock. Basic EPS is calculated by dividing the net income attributable to stockholders of the Company by the weighted average number of shares of common stock outstanding during the period. Diluted EPS is determined by adjusting the net income attributable to stockholders of the Company and the weighted average number of shares of common stock outstanding during the period for the effects of all dilutive potential common shares, including awards under stock-based compensation arrangements. The Company's unvested restricted stock awards (see Note 10 - Stock-Based Compensation and Equity) are considered participating securities under ASC 260, Earnings Per Share , because they entitle holders to non-forfeitable rights to dividends until the awards vest or are forfeited. When a company has a security that qualifies as a “participating security,” the Codification requires the use of the two-class method when computing basic EPS. The two-class method is an earnings allocation formula that determines EPS for each class of common stock and participating security according to dividends declared (or accumulated) and participation rights in undistributed earnings. In determining the amount of net income to allocate to common stockholders, income is allocated to both common stock and participating securities based on their respective weighted average shares outstanding for the period, with net income attributable to common stockholders ultimately equaling net income less net income attributable to participating securities. Diluted EPS for the Company's common stock is computed using the more dilutive of the two-class method or the treasury stock method.
Income Taxes	The Company determines the tax provision for interim periods using an estimate of our annual effective tax rate ("ETR"), adjusted for discrete items, if any, that are taken into account in the relevant period. Each quarter we update our estimate of the annual ETR, and if our estimated tax rate changes, we make a cumulative adjustment. If a reliable estimate of the annual ETR cannot be made, the actual ETR for the year to date may be the best estimate of the annual ETR.
Fair Value	FASB Codification topic, Fair Value Measurements and Disclosures, establishes a framework for measuring fair value and expands financial statement disclosures about fair value measurements. Fair value is the price that would be received to sell an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants at the measurement date. The Codification does not require any new fair value measurements, but rather applies to all other accounting pronouncements that require or permit fair value measurements. The Codification requires that assets and liabilities carried at fair value be classified and disclosed in one of the following three categories: Level 1: Quoted market prices in active markets for identical assets or liabilities. Level 2: Observable market-based inputs or unobservable inputs that are corroborated by market data. Level 3: Unobservable inputs that are not corroborated by market data.

BASIS OF PRESENTATION (Tables)

BASIS OF PRESENTATION (Tables)	3 Months Ended
	Mar. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Amounts Reclassified	The following table provides the amounts reclassified for the three months ended March 31, 2023. Three Months Ended March 31, 2023 (in thousands) As previously reported Re-classifications As reclassified As currently reported Costs of revenue (exclusive of amortization and depreciation) RCM $ 27,183 $ — $ 27,183 $ 27,183 EHR 16,348 — 16,348 16,348 Patient engagement 646 — 646 646 Other expenses Product development 9,836 (1,484) 8,352 8,352 Sale and marketing 6,959 (2) 6,957 6,957 General and administrative 14,952 (499) 14,453 14,453 Amortization of acquisition-related intangibles 4,014 (4,014) — — Amortization — 5,500 5,500 5,500 Depreciation — 499 499 499

REVENUE RECOGNITION (Tables)

REVENUE RECOGNITION (Tables)	3 Months Ended
	Mar. 31, 2024
Revenue from Contract with Customer [Abstract]
Schedule of Contract with Customer, Asset and Liability	The following table details deferred revenue for the three months ended March 31, 2024 and 2023, included in the condensed consolidated balance sheets: (In thousands) Three Months Ended March 31, 2024 Three Months Ended March 31, 2023 Beginning balance $ 8,677 $ 11,590 Deferred revenue recorded 4,360 6,490 Less deferred revenue recognized as revenue (3,958) (6,443) Ending balance $ 9,079 $ 11,637
Schedule of Capitalized Contract Cost	Costs to obtain and fulfill contracts related to SaaS and RCM arrangements are included within the “Prepaid expenses and other current assets” and "Other assets, net of current portion" line items on our condensed consolidated balance sheets as shown in the table below for the three months ended March 31, 2024 and 2023: (In thousands) Three Months Ended March 31, 2024 Three Months Ended March 31, 2023 Beginning balance $ 13,115 $ 11,557 Costs to obtain and fulfill contracts capitalized 1,703 1,824 Less costs to obtain and fulfill contracts recognized as expense (1,884) (1,264) Ending balance $ 12,934 $ 12,117

BUSINESS COMBINATIONS AND DIS_2

BUSINESS COMBINATIONS AND DISPOSITIONS (Tables)	3 Months Ended
	Mar. 31, 2024
Business Combination and Asset Acquisition [Abstract]
Schedule of Assets and Liabilities of Held for Sale Disposal Group	The accompanying condensed consolidated balance sheet as of December 31, 2023 includes amounts related to this Transaction under the captions "Assets of held for sale disposal group" and "Liabilities of held for sale disposal group", the details of which are as follows as of December 31, 2023: (In thousands) Assets of held for sale disposal group Accounts receivable, net $ 3,087 Financing receivables, net 37 Prepaid expenses 34 Software costs, net 3,386 Intangibles, net 11,739 Goodwill 7,694 Total $ 25,977 Liabilities of held for sale disposal group Accounts payable $ 178 Other accrued liabilities 576 Deferred tax liability 223 Total $ 977
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The preliminary estimated fair values of assets acquired and liabilities assumed as of December 31, 2023, and as updated through March 31, 2024, are as follows: (In thousands) Purchase Price Allocation as of December 31, 2023 Purchase Price Allocation as of March 31, 2024 Acquired cash $ 1,449 $ 1,449 Accounts receivable 2,233 2,233 Prepaid expenses 132 132 Property and equipment 1,112 1,112 Intangible assets 17,720 17,720 Goodwill 17,263 17,927 Accounts payable and accrued liabilities (711) (711) Contingent consideration (1,044) (1,044) Net assets acquired $ 38,154 $ 38,818

PROPERTY AND EQUIPMENT (Tables)

PROPERTY AND EQUIPMENT (Tables)	3 Months Ended
	Mar. 31, 2024
Property, Plant and Equipment [Abstract]
Schedule of Property and Equipment	Property and equipment, net was comprised of the following at March 31, 2024 and December 31, 2023: (In thousands) March 31, December 31, 2023 Land $ 2,848 $ 2,848 Buildings and improvements 8,487 8,481 Computer equipment 10,241 10,104 Leasehold improvements 631 631 Office furniture and fixtures 618 586 Automobiles 18 18 Property and equipment, gross 22,843 22,668 Less: accumulated depreciation (14,093) (13,694) Property and equipment, net $ 8,750 $ 8,974

SOFTWARE DEVELOPMENT (Tables)

SOFTWARE DEVELOPMENT (Tables)	3 Months Ended
	Mar. 31, 2024
Research and Development [Abstract]
Schedule of Software Development, Net	Software development costs, net was comprised of the following at March 31, 2024 and December 31, 2023: (In thousands) March 31, December 31, 2023 Software development costs $ 56,188 $ 51,349 Less: accumulated amortization (14,951) (12,210) Software development costs, net $ 41,237 $ 39,139

OTHER ACCRUED LIABILITIES (Tabl

OTHER ACCRUED LIABILITIES (Tables)	3 Months Ended
	Mar. 31, 2024
Payables and Accruals [Abstract]
Schedule of Other Accrued Liabilities	Other accrued liabilities was comprised of the following at March 31, 2024 and December 31, 2023: (In thousands) March 31, December 31, 2023 Salaries and benefits $ 9,125 $ 5,194 Severance 3,359 5,806 Commissions 714 1,185 Contingent consideration 1,044 1,044 Operating lease liabilities, current portion 1,601 1,804 Other 2,383 4,859 Other accrued liabilities $ 18,226 $ 19,892

NET INCOME (LOSS) PER SHARE (Ta

NET INCOME (LOSS) PER SHARE (Tables)	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	The following is a calculation of the basic and diluted EPS for the Company's common stock, including a reconciliation between net income and net income attributable to common stockholders: Three Months Ended March 31, (In thousands, except per share data) 2024 2023 Net income (loss) $ (2,516) $ 3,084 Less: Net (income) loss attributable to participating securities 68 (63) Net income (loss) attributable to common stockholders $ (2,448) $ 3,021 Weighted average shares outstanding used in basic per common share computations 14,234 14,136 Add: Dilutive potential common shares — — Weighted average shares outstanding used in diluted per common share computations 14,234 14,136 Basic EPS $ (0.17) $ 0.21 Diluted EPS $ (0.17) $ 0.21

STOCK-BASED COMPENSATION AND _2

STOCK-BASED COMPENSATION AND EQUITY (Tables)	3 Months Ended
	Mar. 31, 2024
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Schedule of Stock-Based Compensation Expense	The following table details total stock-based compensation expense for the three months ended March 31, 2024 and 2023, included in the condensed consolidated statements of income: Three Months Ended March 31, (In thousands) 2024 2023 Costs of revenue (exclusive of amortization and depreciation) $ 36 $ 181 Other expenses 764 1,066 Pre-tax stock-based compensation expense 800 1,247 Less: income tax effect (168) (274) Net stock-based compensation expense $ 632 $ 973
Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Schedule of Activity Under Restricted Stock Plans	A summary of restricted stock activity under the Plan during the three months ended March 31, 2024 and 2023 is as follows: Three Months Ended March 31, 2024 Three Months Ended March 31, 2023 Shares Weighted-Average Shares Weighted-Average Unvested restricted stock outstanding at beginning of period 343,315 $ 29.08 281,161 $ 32.24 Granted 495,003 10.03 185,487 29.23 Vested (145,180) 31.90 (133,298) 31.33 Forfeited (44,122) 31.32 — — Unvested restricted stock outstanding at end of period 649,016 $ 14.73 333,350 $ 30.93
Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Schedule of Activity Under Restricted Stock Plans	A summary of performance share award activity under the Plan during the three months ended March 31, 2024 and 2023 is as follows, based on the target award amounts set forth in the performance share award agreements: Three Months Ended March 31, 2024 Three Months Ended March 31, 2023 Shares Weighted-Average Shares Weighted-Average Performance share awards outstanding at beginning of period 273,791 $ 33.17 252,375 $ 31.84 Granted 323,461 10.03 123,406 31.21 Forfeited or unearned (85,149) 37.98 (96,069) 26.96 Performance share awards outstanding at end of period 512,103 $ 18.24 279,712 $ 33.24

FINANCING RECEIVABLES (Tables)

FINANCING RECEIVABLES (Tables)	3 Months Ended
	Mar. 31, 2024
Receivables [Abstract]
Schedule of Components of Short Term Payment Plans	These receivables, included in the current portion of financing receivables, were comprised of the following at March 31, 2024 and December 31, 2023: (In thousands) March 31, December 31, 2023 Short-term payment plans, gross $ 666 $ 788 Less: allowance for losses (33) (39) Short-term payment plans, net $ 633 $ 749
Schedule of Components of Lease Receivables	The components of these receivables were as follows at March 31, 2024 and December 31, 2023: (In thousands) March 31, December 31, 2023 Long-term financing arrangements, gross $ 4,660 $ 5,212 Less: allowance for expected credit losses (350) (377) Less: unearned income (316) (361) Long-term financing arrangements, net $ 3,994 $ 4,474
Schedule of Future Minimum Lease Payments to be Received	Future minimum payments to be received subsequent to March 31, 2024 are as follows: (In thousands) Years Ending December 31, 2024 $ 2,375 2025 1,938 2026 206 2027 69 2028 62 Thereafter 10 Total minimum payments to be received 4,660 Less: allowance for expected credit losses (350) Less: unearned income (316) Receivables, net $ 3,994
Schedule of Allowance for Financing Credit Losses	The following table is a roll-forward of the allowance for expected credit losses for the three months ended March 31, 2024 and year ended December 31, 2023: (In thousands) Balance at Beginning of Period Provision Charge-offs Recoveries Sale of AHT Balance at End of Period March 31, 2024 $ 416 $ (31) $ — $ — $ (2) $ 383 December 31, 2023 $ 549 $ (133) $ — $ — $ — $ 416
Schedule of Analysis of Age of Financing Receivables Amounts	The following is an analysis of the age of financing receivables amounts (excluding short-term payment plans) that have been reclassified to trade accounts receivable and were past due as of March 31, 2024 and December 31, 2023: (In thousands) 1 to 90 Days Past Due 91 to 180 Days Past Due 181 + Days Past Due Total Past Due March 31, 2024 $ 532 $ 275 $ 495 $ 1,302 December 31, 2023 $ 857 $ 231 $ 323 $ 1,411
Schedule of Financing Receivable Credit Quality Indicators	The table below categorizes customer financing receivable balances (excluding short-term payment plans) based on the age of the oldest payment outstanding that has been reclassified to trade accounts receivable: (In thousands) March 31, December 31, 2023 Stratification of uninvoiced client financing receivables based on aging of related trade accounts receivable: Uninvoiced client financing receivables related to trade accounts receivable that are 1 to 90 Days Past Due $ 984 $ 1,068 Uninvoiced client financing receivables related to trade accounts receivable that are 91 to 180 Days Past Due 839 1,720 Uninvoiced client financing receivables related to trade accounts receivable that are 181 + Days Past Due 1,348 965 Total uninvoiced client financing receivables balances of clients with a trade accounts receivable $ 3,171 $ 3,753 Total uninvoiced client financing receivables of clients with no related trade accounts receivable 1,173 1,098 Total financing receivables with contractual maturities of one year or less 666 788 Less: allowance for expected credit losses (383) (416) Total financing receivables $ 4,627 $ 5,223

INTANGIBLE ASSETS AND GOODWILL

INTANGIBLE ASSETS AND GOODWILL (Tables)	3 Months Ended
	Mar. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Definite-lived Intangible Assets	The following tables summarize the gross carrying amounts, accumulated amortization and accumulated impairment of identifiable intangible assets with definite lives by major class as of March 31, 2024 and December 31, 2023: March 31, 2024 (In thousands) Customer Relationships Trademark Developed Technology Non-Compete Agreements Total Gross carrying amount, beginning of period $ 116,470 $ 7,720 $ 31,900 $ 1,620 $ 157,710 Accumulated amortization (43,031) (5,378) (20,269) (604) (69,282) Accumulated impairment — (2,342) — — (2,342) Net intangible assets as of March 31, 2024 $ 73,439 $ — $ 11,631 $ 1,016 $ 86,086 Weighted average remaining years of useful life 8.2 0.0 8.3 3.2 8.2 December 31, 2023 (In thousands) Customer Relationships Trademark Developed Technology Non-Compete Agreements Total Gross carrying amount, beginning of period $ 132,170 $ 12,320 $ 40,800 $ 1,400 $ 186,690 Intangible assets acquired 16,100 — 1,400 220 17,720 Accumulated amortization (63,686) (6,974) (29,934) (522) (101,116) Accumulated impairment — (2,342) (2,342) Held for sale (8,735) (3,004) (11,739) Net intangible assets as of December 31, 2023 $ 75,849 $ — $ 12,266 $ 1,098 $ 89,213
Schedule of Remaining Amortization of Definite-lived Intangible Assets	The following table represents the remaining amortization of definite-lived intangible assets as of March 31, 2024: (In thousands) For the year ended December 31, 2024 $ 9,379 2025 12,190 2026 11,517 2027 10,497 2028 10,203 Thereafter 32,300 Total $ 86,086
Schedule of Rollforward of Goodwill Balances	The following table sets forth the change in the carrying value of our goodwill balances by reportable segment for the three months ended March 31, 2024: (In thousands) RCM EHR Patient Engagement Total Gross value at December 31, 2023 $ 79,084 $ 126,665 $ 9,767 $ 215,516 Accumulated impairment — (28,307) (7,606) (35,913) Held for sale — (7,694) — (7,694) Carrying value at December 31, 2023 79,084 90,664 2,161 171,909 Purchase price adjustment (Viewgol) 664 — — 664 Gross value at March 31, 2024 79,748 118,971 9,767 208,486 Accumulated impairment — (28,307) (7,606) (35,913) Carrying value as of March 31, 2024 $ 79,748 $ 90,664 $ 2,161 $ 172,573

LONG-TERM DEBT (Tables)

LONG-TERM DEBT (Tables)	3 Months Ended
	Mar. 31, 2024
Debt Disclosure [Abstract]
Schedule of Long-term Debt	Long-term debt was comprised of the following at March 31, 2024 and December 31, 2023: (In thousands) March 31, December 31, 2023 Term loan facility $ 63,000 $ 63,875 Revolving credit facility 123,416 135,723 Debt obligations 186,416 199,598 Less: unamortized debt issuance costs (1,610) (1,187) Debt obligation, net 184,806 198,411 Less: current portion (3,074) (3,141) Long-term debt $ 181,732 $ 195,270
Schedule of Annual Future Maturities of the Term Loan Facility and Revolving Credit Facility	Anticipated annual future maturities of the term loan facility and revolving credit facility are as follows as of March 31, 2024: (In thousands) 2024 $ 2,625 2025 3,500 2026 3,500 2027 176,791 $ 186,416

OPERATING LEASES (Tables)

OPERATING LEASES (Tables)	3 Months Ended
	Mar. 31, 2024
Leases [Abstract]
Schedule of Lease, Supplemental Balance Sheet Information	Supplemental balance sheet information related to operating leases was as follows: (In thousands) March 31, December 31, Operating lease assets: Operating lease assets $ 4,672 $ 5,192 Operating lease liabilities: Other accrued liabilities 1,601 1,804 Operating lease liabilities, net of current portion 2,848 3,074 Total operating lease liabilities $ 4,449 $ 4,878 Weighted average remaining lease term in years 3.9 4 Weighted average discount rate 4.1% 4.2%
Schedule of Operating Lease, Liability, Maturity	The future minimum lease payments payable under these operating leases subsequent to March 31, 2024 are as follows: (In thousands) 2024 $ 1,326 2025 1,063 2026 1,025 2027 706 2028 462 Thereafter 231 Total lease payments 4,813 Less imputed interest (364) Total $ 4,449

FAIR VALUE (Tables)

FAIR VALUE (Tables)	3 Months Ended
	Mar. 31, 2024
Fair Value Disclosures [Abstract]
Carrying Amounts and Fair Value of the Contingent Consideration	The following table summarizes the carrying amount and fair value of the contingent consideration at March 31, 2024: Fair Value at March 31, 2024 Using (In thousands) Carrying Amount at March 31, 2024 Quoted Price in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Description Contingent consideration $ 1,044 $ — $ — $ 1,044 Total $ 1,044 $ — $ — $ 1,044

SEGMENT REPORTING (Tables)

SEGMENT REPORTING (Tables)	3 Months Ended
	Mar. 31, 2024
Segment Reporting [Abstract]
Schedule of Segment Reporting Information, by Segment	The following table presents a summary of the revenues and adjusted EBITDA of our three operating segments for the three months ended March 31, 2024 and 2023: Three Months Ended March 31, (In thousands) 2024 2023 Revenues by segment: RCM $ 53,038 $ 48,631 EHR Recurring revenue Acute EHR 25,910 27,613 Post-acute EHR 582 3,906 Total recurring EHR revenue 26,492 31,519 Non-recurring revenue Acute EHR 1,449 3,292 Post-acute EHR 81 380 Total non-recurring EHR revenue 1,530 3,672 Total EHR revenue $ 28,022 $ 35,191 Patient Engagement 2,187 2,411 Total revenues $ 83,247 $ 86,233 Adjusted EBITDA by segment: RCM $ 6,396 $ 7,898 EHR 2,929 6,157 Patient Engagement 129 588 Total adjusted EBITDA $ 9,454 $ 14,643
Schedule of Reconciliation of Net Income from Continuing Operations to Adjusted Income (Loss) from Before Interest, Taxes, Depreciation and Amortization	The following table reconciles net income to adjusted EBITDA: Three Months Ended March 31, (In thousands) 2024 2023 Net income (loss), as reported $ (2,516) $ 3,084 Depreciation expense 400 499 Amortization of software development costs 2,742 1,486 Amortization of acquisition-related intangibles 3,127 4,014 Stock-based compensation 800 1,247 Severance and other non-recurring charges 3,844 1,104 Interest expense 4,072 2,669 Gain on sale of AHT (1,250) — Other (173) (269) Provision (benefit) for income taxes (1,592) 809 Total adjusted EBITDA $ 9,454 $ 14,643

BASIS OF PRESENTATION - Amounts

BASIS OF PRESENTATION - Amounts Reclassified (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized	$ 41,759	$ 44,177
Other expenses
Product development	10,689	8,352
Sales and marketing	6,592	6,957
General and administrative	19,396	14,453
Amortization of acquisition-related intangibles		0
Amortization	5,869	5,500
Depreciation	400	499
RCM
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized	29,597	27,183
EHR
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized	11,287	16,348
Patient Engagement
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized	$ 875	646
As previously reported
Other expenses
Product development		9,836
Sales and marketing		6,959
General and administrative		14,952
Amortization of acquisition-related intangibles		4,014
Amortization		0
Depreciation		0
As previously reported | RCM
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized		27,183
As previously reported | EHR
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized		16,348
As previously reported | Patient Engagement
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized		646
Re-classifications
Other expenses
Product development		(1,484)
Sales and marketing		(2)
General and administrative		(499)
Amortization of acquisition-related intangibles		(4,014)
Amortization		5,500
Depreciation		499
Re-classifications | RCM
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized		0
Re-classifications | EHR
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized		0
Re-classifications | Patient Engagement
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized		$ 0

REVENUE RECOGNITION - Narrative

REVENUE RECOGNITION - Narrative (Details)	3 Months Ended
	Mar. 31, 2024 installment
EHR
Revenue from External Customer [Line Items]
Revenue from contract with customer, payment, number of installments	3
Revenue from contract with customer, warranty, term	30 days
EHR | Minimum
Revenue from External Customer [Line Items]
Revenue performance obligation, description of timing (in years)	3 years
EHR | Maximum
Revenue from External Customer [Line Items]
Revenue performance obligation, description of timing (in years)	5 years
Patient Engagement
Revenue from External Customer [Line Items]
Revenue from contract with customer, payment, number of installments	2
Patient Engagement | Minimum
Revenue from External Customer [Line Items]
Revenue performance obligation, description of timing (in years)	3 years
Patient Engagement | Maximum
Revenue from External Customer [Line Items]
Revenue performance obligation, description of timing (in years)	5 years

REVENUE RECOGNITION - Deferred

REVENUE RECOGNITION - Deferred Revenue (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Change in Contract with Customer, Liability [Roll Forward]
Beginning balance	$ 8,677	$ 11,590
Deferred revenue recorded	4,360	6,490
Less deferred revenue recognized as revenue	(3,958)	(6,443)
Ending balance	$ 9,079	$ 11,637

REVENUE RECOGNITION - Costs to

REVENUE RECOGNITION - Costs to Obtain and Fulfill Contracts (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Capitalized Contract Cost [Roll Forward]
Beginning balance	$ 13,115	$ 11,557
Costs to obtain and fulfill contracts capitalized	1,703	1,824
Less costs to obtain and fulfill contracts recognized as expense	(1,884)	(1,264)
Ending balance	$ 12,934	$ 12,117

BUSINESS COMBINATIONS AND DIS_3

BUSINESS COMBINATIONS AND DISPOSITIONS - Narrative (Details) - USD ($) $ in Thousands			1 Months Ended	3 Months Ended		12 Months Ended
	Jan. 16, 2024	Oct. 16, 2023	Mar. 31, 2024	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Business Acquisition [Line Items]
Gain on sale of business				$ 1,250	$ 0
Acquisition, contingent earnout liability			$ 1,044	1,044
Viewgol, LLC
Business Acquisition [Line Items]
Acquisition, cash consideration		$ 37,400
Acquisition related costs						$ 4,700
Payment for working capital adjustments			$ 664
Net sales of acquiree since acquisition				4,800
Gross profit of acquiree since acquisition				2,100
Net income of acquiree since acquisition				800
Adjusted EBITDA of acquiree since acquisition				1,000
Viewgol, LLC | EBTIDA Earnout
Business Acquisition [Line Items]
Acquisition, contingent earnout liability		21,500
Acquisition, contingent consideration, EBITDA target		6,000
Viewgol, LLC | Offshore Earnout
Business Acquisition [Line Items]
Acquisition, contingent earnout liability		$ 10,000
American HealthTech, Inc.
Business Acquisition [Line Items]
Sale, cash consideration	$ 25,000
Sale, cash consideration held in escrow	3,750
Sale, cash consideration held in indemnity escrow	2,500
Sale, cash consideration held in special indemnity escrow	1,000
Sale, cash consideration, net	$ 21,410
Transition services agreement, period	18 months
Gain on sale of business				$ 1,250

BUSINESS COMBINATIONS AND DIS_4

BUSINESS COMBINATIONS AND DISPOSITIONS - Schedule of Assets and Liabilities of Held for Sale Disposal Group (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Assets of held for sale disposal group
Total	$ 0	$ 25,977
Liabilities of held for sale disposal group
Total	$ 0	977
American HealthTech, Inc.
Assets of held for sale disposal group
Accounts receivable, net		3,087
Financing receivables, net		37
Prepaid expenses		34
Software costs, net		3,386
Intangibles, net		11,739
Goodwill		7,694
Total		25,977
Liabilities of held for sale disposal group
Accounts payable		178
Other accrued liabilities		576
Deferred tax liability		223
Total		$ 977

BUSINESS COMBINATIONS AND DIS_5

BUSINESS COMBINATIONS AND DISPOSITIONS - Preliminary Allocation of the Purchase Price Paid (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Business Acquisition [Line Items]
Goodwill	$ 172,573	$ 171,909
Viewgol, LLC
Business Acquisition [Line Items]
Acquired cash	1,449	1,449
Accounts receivable	2,233	2,233
Prepaid expenses	132	132
Property and equipment	1,112	1,112
Intangible assets	17,720	17,720
Goodwill	17,927	17,263
Accounts payable and accrued liabilities	(711)	(711)
Contingent consideration	(1,044)	(1,044)
Net assets acquired	$ 38,818	$ 38,154

PROPERTY AND EQUIPMENT (Details

PROPERTY AND EQUIPMENT (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 22,843	$ 22,668
Less: accumulated depreciation	(14,093)	(13,694)
Property and equipment, net	8,750	8,974
Land
Property, Plant and Equipment [Line Items]
Property and equipment, gross	2,848	2,848
Buildings and improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	8,487	8,481
Computer equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	10,241	10,104
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	631	631
Office furniture and fixtures
Property, Plant and Equipment [Line Items]
Property and equipment, gross	618	586
Automobiles
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 18	$ 18

SOFTWARE DEVELOPMENT - Narrativ

SOFTWARE DEVELOPMENT - Narrative (Details)	Mar. 31, 2024
Software Development
Finite-Lived Intangible Assets [Line Items]
Estimated useful life (in years)	5 years

SOFTWARE DEVELOPMENT - Schedule

SOFTWARE DEVELOPMENT - Schedule of Software Development Costs, Net (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Research and Development [Abstract]
Software development costs	$ 56,188	$ 51,349
Less: accumulated amortization	(14,951)	(12,210)
Software development costs, net	$ 41,237	$ 39,139

OTHER ACCRUED LIABILITIES (Deta

OTHER ACCRUED LIABILITIES (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Payables and Accruals [Abstract]
Salaries and benefits	$ 9,125	$ 5,194
Severance	3,359	5,806
Commissions	714	1,185
Contingent consideration	1,044	1,044
Operating lease liabilities, current portion	1,601	1,804
Other	2,383	4,859
Other accrued liabilities	$ 18,226	$ 19,892

NET INCOME (LOSS) PER SHARE - C

NET INCOME (LOSS) PER SHARE - Computation (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Earnings Per Share [Abstract]
Net income (loss)	$ (2,516)	$ 3,084
Less: Net (income) loss attributable to participating securities	68	(63)
Net income (loss) attributable to common stockholders	$ (2,448)	$ 3,021
Weighted average shares outstanding used in basic per common share computations (in shares)	14,234	14,136
Add: Dilutive potential common shares (in shares)	0	0
Weighted average shares outstanding used in diluted per common share computations (in shares)	14,234	14,136
Basic EPS (in dollars per share)	$ (0.17)	$ 0.21
Diluted EPS (in dollars per share)	$ (0.17)	$ 0.21

NET INCOME (LOSS) PER SHARE - N

NET INCOME (LOSS) PER SHARE - Narrative (Details) - shares	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Aggregate target (in shares)	512,103
Dilutive potential common shares included in the calculation of diluted earnings per share (in shares)	0	0
Performance Shares
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Dilutive potential common shares included in the calculation of diluted earnings per share (in shares)	0

INCOME TAXES (Details)

INCOME TAXES (Details)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Tax Disclosure [Abstract]
Effective tax rate (as a percent)	38.80%	20.80%
R&D tax credits (as a percent)	24.20%

STOCK-BASED COMPENSATION AND _3

STOCK-BASED COMPENSATION AND EQUITY - Stock-Based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Pre-tax stock-based compensation expense	$ 800	$ 1,247
Less: income tax effect	(168)	(274)
Net stock-based compensation expense	632	973
Costs of revenue (exclusive of amortization and depreciation)
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Pre-tax stock-based compensation expense	36	181
Other expenses
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Pre-tax stock-based compensation expense	$ 764	$ 1,066

STOCK-BASED COMPENSATION AND _4

STOCK-BASED COMPENSATION AND EQUITY - Narrative (Details) - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Mar. 26, 2024	Sep. 04, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost related to non-vested share-based compensation	$ 12,400,000
Unrecognized compensation cost related to non-vested share-based compensation period of recognition (in years)	2 years 4 months 24 days
Stock repurchase program, authorized amount				$ 30,000,000
Stock repurchased during period (in shares)	0	49,789
Stock repurchase program, remaining authorized repurchase amount	$ 16,500,000
Shares purchased for award (in shares)	41,000	39,716
Dividends declared (in shares)			1
One half of common stock (as a percent)			50%
Half of exercise price of rights (in dollars per share)			$ 28
Whole of exercise price of rights (in dollars per share)			$ 56
Maximum | Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	3 years
Maximum | Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	3 years
Minimum | Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	1 year

STOCK-BASED COMPENSATION AND _5

STOCK-BASED COMPENSATION AND EQUITY - Summary of Activity Under Restricted and Performance Stock Plans (Details) - $ / shares	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Restricted Stock
Shares
Outstanding at beginning of period (in shares)	343,315	281,161
Granted (in shares)	495,003	185,487
Vested/Earned and issued (in shares)	(145,180)	(133,298)
Forfeited (in shares)	(44,122)	0
Outstanding at end of period (in shares)	649,016	333,350
Weighted-Average Grant-Date Fair Value
Outstanding at beginning of the period (in dollars per share)	$ 29.08	$ 32.24
Granted (in dollars per share)	10.03	29.23
Vested/Earned and issued (in dollars per share)	31.90	31.33
Forfeited (in dollars per share)	31.32	0
Outstanding at end of the period in dollars per share)	$ 14.73	$ 30.93
Performance Shares
Shares
Outstanding at beginning of period (in shares)	273,791	252,375
Granted (in shares)	323,461	123,406
Forfeited or unearned (in shares)	(85,149)	(96,069)
Outstanding at end of period (in shares)	512,103	279,712
Weighted-Average Grant-Date Fair Value
Outstanding at beginning of the period (in dollars per share)	$ 33.17	$ 31.84
Granted (in dollars per share)	10.03	31.21
Forfeited or unearned (in dollars per share)	37.98	26.96
Outstanding at end of the period in dollars per share)	$ 18.24	$ 33.24

FINANCING RECEIVABLES - Narrati

FINANCING RECEIVABLES - Narrative (Details)	3 Months Ended
	Mar. 31, 2024
Minimum | Short-Term Payment Plans
Accounts, Notes, Loans and Financing Receivable [Line Items]
Receivable term	3 months
Minimum | Long-Term Financing Arrangement
Accounts, Notes, Loans and Financing Receivable [Line Items]
Financial receivable lease term (in years)	2 years
Maximum | Short-Term Payment Plans
Accounts, Notes, Loans and Financing Receivable [Line Items]
Receivable term	12 months
Maximum | Long-Term Financing Arrangement
Accounts, Notes, Loans and Financing Receivable [Line Items]
Financial receivable lease term (in years)	7 years

FINANCING RECEIVABLES - Short t

FINANCING RECEIVABLES - Short term Payment Plans (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Financing Receivable, Allowance for Credit Loss [Line Items]
Less: allowance for losses	$ (304)	$ (319)
Short-term payment plans, net	3,668	3,997
Short-Term Payment Plans
Financing Receivable, Allowance for Credit Loss [Line Items]
Short-term payment plans, gross	666	788
Less: allowance for losses	(33)	(39)
Short-term payment plans, net	$ 633	$ 749

FINANCING RECEIVABLES - Compone

FINANCING RECEIVABLES - Components of Receivables (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Financing Receivable, Recorded Investment, Past Due [Line Items]
Less: allowance for expected credit losses	$ (383)	$ (416)	$ (549)
Total financing receivables	4,627	5,223
Long-Term Financing Arrangement
Financing Receivable, Recorded Investment, Past Due [Line Items]
Long-term financing arrangements, gross	4,660	5,212
Less: allowance for expected credit losses	(350)	(377)
Less: unearned income	(316)	(361)
Total financing receivables	$ 3,994	$ 4,474

FINANCING RECEIVABLES - Future

FINANCING RECEIVABLES - Future Minimum Lease Payments (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Financing Receivable, Recorded Investment, Past Due [Line Items]
Less: allowance for expected credit losses	$ (383)	$ (416)	$ (549)
Total financing receivables	4,627	5,223
Long-Term Financing Arrangement
Financing Receivable, Recorded Investment, Past Due [Line Items]
2024	2,375
2025	1,938
2026	206
2027	69
2028	62
Thereafter	10
Total minimum payments to be received	4,660
Less: allowance for expected credit losses	(350)	(377)
Less: unearned income	(316)	(361)
Total financing receivables	$ 3,994	$ 4,474

FINANCING RECEIVABLES - Allowan

FINANCING RECEIVABLES - Allowance for Financing Credit Losses (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Allowance for Doubtful Accounts Receivable [Roll Forward]
Balance at Beginning of Period	$ 416	$ 549
Provision	(31)	(133)
Charge-offs	0	0
Recoveries	0	0
Sale of AHT	(2)	0
Balance at End of Period	$ 383	$ 416

FINANCING RECEIVABLES - Analysi

FINANCING RECEIVABLES - Analysis of Age of Financing Receivables Amounts (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Total Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Long-term financing arrangements, gross	$ 1,302	$ 1,411
1 to 90 Days Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Long-term financing arrangements, gross	532	857
91 to 180 Days Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Long-term financing arrangements, gross	275	231
181 + Days Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Long-term financing arrangements, gross	$ 495	$ 323

FINANCING RECEIVABLES - Schedul

FINANCING RECEIVABLES - Schedule of Financing Receivables (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total financing receivables with contractual maturities of one year or less	$ 666	$ 788
Less: allowance for expected credit losses	(383)	(416)	$ (549)
Total financing receivables	4,627	5,223
Total Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	1,302	1,411
Total Past Due | Trade Accounts Receivable
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	3,171	3,753
Uninvoiced client financing receivables related to trade accounts receivable that are 1 to 90 Days Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	532	857
Uninvoiced client financing receivables related to trade accounts receivable that are 1 to 90 Days Past Due | Trade Accounts Receivable
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	984	1,068
Uninvoiced client financing receivables related to trade accounts receivable that are 91 to 180 Days Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	275	231
Uninvoiced client financing receivables related to trade accounts receivable that are 91 to 180 Days Past Due | Trade Accounts Receivable
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	839	1,720
Uninvoiced client financing receivables related to trade accounts receivable that are 181 + Days Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	495	323
Uninvoiced client financing receivables related to trade accounts receivable that are 181 + Days Past Due | Trade Accounts Receivable
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	1,348	965
Total Not Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	$ 1,173	$ 1,098

INTANGIBLE ASSETS AND GOODWIL_2

INTANGIBLE ASSETS AND GOODWILL - Definite-Lived Intangible Assets (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount		$ 157,710	$ 186,690
Intangible assets acquired		17,720
Accumulated amortization	$ (69,282)	(101,116)
Accumulated impairment	(2,342)	(2,342)
Held for sale		(11,739)
Net intangible assets	$ 86,086	89,213
Weighted average remaining years of useful life	8 years 2 months 12 days
Customer Relationships
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount		116,470	132,170
Intangible assets acquired		16,100
Accumulated amortization	$ (43,031)	(63,686)
Accumulated impairment	0	0
Held for sale		(8,735)
Net intangible assets	$ 73,439	75,849
Weighted average remaining years of useful life	8 years 2 months 12 days
Trademark
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount		7,720	12,320
Intangible assets acquired		0
Accumulated amortization	$ (5,378)	(6,974)
Accumulated impairment	(2,342)	(2,342)
Held for sale		(3,004)
Net intangible assets	$ 0	0
Weighted average remaining years of useful life	0 years
Developed Technology
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount		31,900	40,800
Intangible assets acquired		1,400
Accumulated amortization	$ (20,269)	(29,934)
Accumulated impairment	0
Net intangible assets	$ 11,631	12,266
Weighted average remaining years of useful life	8 years 3 months 18 days
Non-Compete Agreements
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount		1,620	$ 1,400
Intangible assets acquired		220
Accumulated amortization	$ (604)	(522)
Accumulated impairment	0
Net intangible assets	$ 1,016	$ 1,098
Weighted average remaining years of useful life	3 years 2 months 12 days

INTANGIBLE ASSETS AND GOODWIL_3

INTANGIBLE ASSETS AND GOODWILL - Narrative (Details) - USD ($) $ in Millions	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Finite-Lived Intangible Assets [Line Items]
Goodwill impairment	$ 0
Trademark
Finite-Lived Intangible Assets [Line Items]
Trademark impairment		$ 2.3
Trademark | RCM
Finite-Lived Intangible Assets [Line Items]
Trademark impairment		1
Trademark | EHR
Finite-Lived Intangible Assets [Line Items]
Trademark impairment		1.2
Trademark | Patient Engagement
Finite-Lived Intangible Assets [Line Items]
Trademark impairment		$ 0.1

INTANGIBLE ASSETS AND GOODWIL_4

INTANGIBLE ASSETS AND GOODWILL - Remaining Amortization of Definite-lived Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
2024	$ 9,379
2025	12,190
2026	11,517
2027	10,497
2028	10,203
Thereafter	32,300
Intangible assets, net	$ 86,086	$ 89,213

INTANGIBLE ASSETS AND GOODWIL_5

INTANGIBLE ASSETS AND GOODWILL - Schedule of Goodwill (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Goodwill [Roll Forward]
Gross value at December 31, 2023	$ 215,516
Held for sale		$ (7,694)
Purchase price adjustment (Viewgol)	664
Gross value at March 31, 2024	208,486	215,516
Accumulated impairment	(35,913)	(35,913)
Goodwill	172,573	171,909
RCM
Goodwill [Roll Forward]
Gross value at December 31, 2023	79,084
Held for sale		0
Purchase price adjustment (Viewgol)	664
Gross value at March 31, 2024	79,748	79,084
Accumulated impairment	0	0
Goodwill	79,748	79,084
EHR
Goodwill [Roll Forward]
Gross value at December 31, 2023	126,665
Held for sale		(7,694)
Purchase price adjustment (Viewgol)	0
Gross value at March 31, 2024	118,971	126,665
Accumulated impairment	(28,307)	(28,307)
Goodwill	90,664	90,664
Patient Engagement
Goodwill [Roll Forward]
Gross value at December 31, 2023	9,767
Held for sale		0
Purchase price adjustment (Viewgol)	0
Gross value at March 31, 2024	9,767	9,767
Accumulated impairment	(7,606)	(7,606)
Goodwill	$ 2,161	$ 2,161

LONG-TERM DEBT - Schedule of De

LONG-TERM DEBT - Schedule of Debt (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Less: unamortized debt issuance costs	$ (1,610)	$ (1,187)
Debt obligation, net	184,806	198,411
Less: current portion	(3,074)	(3,141)
Long-term debt	181,732	195,270
Line of Credit
Debt Instrument [Line Items]
Debt obligations	186,416	199,598
Line of Credit | Term loan facility
Debt Instrument [Line Items]
Debt obligations	63,000	63,875
Line of Credit | Revolving credit facility
Debt Instrument [Line Items]
Debt obligations	$ 123,416	$ 135,723

LONG-TERM DEBT - Narrative (Det

LONG-TERM DEBT - Narrative (Details) - Line of Credit				3 Months Ended
	Feb. 29, 2024 USD ($)	Jan. 16, 2024 USD ($)	May 02, 2022 USD ($)	Mar. 31, 2024	May 22, 2022	Jun. 16, 2020 USD ($)	Jan. 31, 2016 USD ($)
Debt Instrument [Line Items]
Line of credit facility, incremental facility capacity			$ 75,000,000
Fixed charge coverage ratio, minimum	1.15		1.25	1.25
Consolidated leverage ratio, maximum			3.50
Line of credit facility, acquisition connection incremental facility capacity			$ 25,000,000
Quarterly increase in consolidated leverage ratio after acquisition			0.50
Minimum consolidated leverage ratio			2.50
Credit facility, covenant, acquisitions costs, maximum		$ 7,000,000
Credit facility, covenant, acquisitions costs, maximum, percent of consolidated EBITDA (as a percent)		10%
Credit facility, covenant, SEC investigation costs and expenses, maximum		$ 1,250,000
Credit facility, covenant, percentage of consolidated EBITDA (as a percent)		15%			10%
Credit facility, covenant, EBITDA calculation, Administrative Agent expenses, maximum	$ 7,250,000
Credit facility, covenant, EBITDA calculation, savings add back limitation for acquisition	$ 6,600,000
Credit facility, covenant, EBITDA calculation, acquisitions savings add back, percentage, maximum	15%
Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)			0.50%
Term loan facility
Debt Instrument [Line Items]
Amount of credit facility			$ 70,000,000			$ 75,000,000	$ 125,000,000
Periodic payment, principal			900,000
Revolving credit facility
Debt Instrument [Line Items]
Amount of credit facility			$ 160,000,000			110,000,000	$ 50,000,000
Revolving credit facility | Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)			1%
Revolving credit facility | Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate | Minimum
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)			1.80%
Revolving credit facility | Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate | Maximum
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)			3%
Revolving credit facility | Federal Funds Rate
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)			0.50%
Revolving credit facility | Base Rate | Minimum
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)			0.80%
Revolving credit facility | Base Rate | Maximum
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)			2%
Amended and Restated Credit Agreement
Debt Instrument [Line Items]
Amount of credit facility						$ 185,000,000
First Amended and Restated Credit Agreement
Debt Instrument [Line Items]
Amount of credit facility			$ 230,000,000

LONG-TERM DEBT - Annual Future

LONG-TERM DEBT - Annual Future Maturities (Details) - Line of Credit - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
2024	$ 2,625
2025	3,500
2026	3,500
2027	176,791
Debt obligation, net	$ 186,416	$ 199,598

OPERATING LEASES - Narrative (D

OPERATING LEASES - Narrative (Details) $ in Millions		3 Months Ended
	Apr. 30, 2023 USD ($) ft²	Mar. 31, 2024 USD ($)	Mar. 31, 2023 USD ($)
Lessee, Lease, Description [Line Items]
Lease expense		$ 0.5	$ 0.6
Operating lease, payments		$ 0.5	$ 0.6
Plymouth, Minnesota Lease
Lessee, Lease, Description [Line Items]
Area of real estate property | ft²	12,500
Payment to terminate lease	$ 1.1
Plymouth, Minnesota Lease | Leasehold improvements
Lessee, Lease, Description [Line Items]
Loss on disposal of PP&E	$ 0.1

OPERATING LEASES - Supplemental

OPERATING LEASES - Supplemental Balance Sheet Information (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Leases [Abstract]
Operating lease assets	$ 4,672	$ 5,192
Operating lease liabilities:
Operating lease liabilities, current portion	$ 1,601	$ 1,804
Operating lease liabilities, current portion, location	Other accrued liabilities	Other accrued liabilities
Operating lease liabilities, net of current portion	$ 2,848	$ 3,074
Total operating lease liabilities	$ 4,449	$ 4,878
Weighted average remaining lease term in years	3 years 10 months 24 days	4 years
Weighted average discount rate	4.10%	4.20%

OPERATING LEASES - Future Minim

OPERATING LEASES - Future Minimum Lease Payments Payable Under these Operating Leases (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Leases [Abstract]
2024	$ 1,326
2025	1,063
2026	1,025
2027	706
2028	462
Thereafter	231
Total lease payments	4,813
Less imputed interest	(364)
Total	$ 4,449	$ 4,878

COMMITMENTS AND CONTINGENCIES (

COMMITMENTS AND CONTINGENCIES (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Business Acquisition [Line Items]
Contingent consideration	$ 1,044	$ 1,044
Viewgol, LLC
Business Acquisition [Line Items]
Contingent consideration	$ 1,000	$ 1,000

FAIR VALUE (Details)

FAIR VALUE (Details) $ in Thousands	Mar. 31, 2024 USD ($)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration	$ 1,044
Total	1,044
Quoted Price in Active Markets for Identical Assets (Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration	0
Total	0
Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration	0
Total	0
Significant Unobservable Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration	1,044
Total	$ 1,044

SEGMENT REPORTING - Narrative (

SEGMENT REPORTING - Narrative (Details)	3 Months Ended
	Mar. 31, 2024 segment
Segment Reporting [Abstract]
Number of operating segments	3

SEGMENT REPORTING - Schedule of

SEGMENT REPORTING - Schedule of Segment Reporting Information, by Segment (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Segment Reporting Information [Line Items]
Total revenues	$ 83,247	$ 86,233
Total adjusted EBITDA	9,454	14,643
RCM
Segment Reporting Information [Line Items]
Total revenues	53,038	48,631
Total adjusted EBITDA	6,396	7,898
EHR
Segment Reporting Information [Line Items]
Total revenues	28,022	35,191
Total adjusted EBITDA	2,929	6,157
Patient Engagement
Segment Reporting Information [Line Items]
Total revenues	2,187	2,411
Total adjusted EBITDA	129	588
Recurring revenue | EHR
Segment Reporting Information [Line Items]
Total revenues	26,492	31,519
Recurring revenue | Acute EHR
Segment Reporting Information [Line Items]
Total revenues	25,910	27,613
Recurring revenue | Post-acute EHR
Segment Reporting Information [Line Items]
Total revenues	582	3,906
Non-recurring revenue | EHR
Segment Reporting Information [Line Items]
Total revenues	1,530	3,672
Non-recurring revenue | Acute EHR
Segment Reporting Information [Line Items]
Total revenues	1,449	3,292
Non-recurring revenue | Post-acute EHR
Segment Reporting Information [Line Items]
Total revenues	$ 81	$ 380

SEGMENT REPORTING - Reconciliat

SEGMENT REPORTING - Reconciliation of Adjusted Income (Loss) From Before Interest, Taxes, Depreciation And Amortization (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Segment Reporting [Abstract]
Net income (loss)	$ (2,516)	$ 3,084
Depreciation expense	400	499
Amortization of software development costs	2,742	1,486
Amortization of acquisition-related intangibles	3,127	4,014
Stock-based compensation	800	1,247
Severance and other non-recurring charges	3,844	1,104
Interest expense	4,072	2,669
Gain on sale of business	(1,250)	0
Other	(173)	(269)
Provision (benefit) for income taxes	(1,592)	809
Total adjusted EBITDA	$ 9,454	$ 14,643