AdaptHealth (AHCO) 10-K 28 Feb 23 2022 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Feb. 24, 2023	Jun. 30, 2022
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2022
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-38399
Entity Registrant Name	AdaptHealth Corp.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	82-3677704
Entity Address, Address Line One	220 West Germantown Pike
Entity Address, Address Line Two	Suite 250
Entity Address, City or Town	Plymouth Meeting
Entity Address, State or Province	PA
Entity Address, Postal Zip Code	19462
City Area Code	610
Local Phone Number	424-4515
Title of 12(b) Security	Common Stock, par value $0.0001 per share
Trading Symbol	AHCO
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Entity Shell Company	false
Entity Public Float			$ 1,510
Entity Common Stock, Shares Outstanding		135,451,062
Documents Incorporated by Reference	The information called for by Part III is incorporated by reference to the Definitive Proxy Statement for the 2023 Annual Meeting of Stockholders of the Registrant which will be filed with the U.S. Securities and Exchange Commission not later than May 1, 2023.
Entity Central Index Key	0001725255
Amendment Flag	false
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	FY

Audit Information

Audit Information	12 Months Ended
	Dec. 31, 2022
Audit Information [Abstract]
Auditor Name	KPMG LLP
Auditor Location	Philadelphia, Pennsylvania
Auditor Firm ID	185

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 46,272	$ 149,627
Accounts receivable	359,146	359,896
Inventory	127,754	123,095
Prepaid and other current assets	52,136	37,440
Total current assets	585,308	670,058
Equipment and other fixed assets, net	487,079	398,577
Operating lease right-of-use assets	129,506	147,760
Finance Lease, Right-Of-Use Asset, After Accumulated Amortization, Excluding Portion Within Equipment And Other Fixed Assets, Net	5,423	0
Goodwill	3,545,297	3,512,567
Identifiable intangible assets, net	162,773	202,231
Other assets	22,415	15,098
Deferred tax assets	281,786	304,193
Total Assets	5,219,587	5,250,484
Current liabilities:
Accounts payable and accrued expenses	337,498	358,384
Current portion of long-term debt	35,000	20,000
Current portion of operating lease obligations	30,001	31,418
Current portion of finance lease obligations	2,211	15,446
Contract liabilities	31,641	31,370
Other liabilities	19,863	43,194
Total current liabilities	456,214	499,812
Long-term debt, less current portion	2,153,267	2,183,552
Operating lease obligations, less current portion	104,394	120,180
Finance lease obligations, less current portion	3,950	0
Other long-term liabilities	305,501	322,487
Warrant liability	38,503	57,764
Total Liabilities	3,061,829	3,183,795
Commitments and contingencies (Note 16)
Stockholders' Equity:
Common Stock, par value of $0.0001 per share, 300,000,000 shares authorized and 134,435,119 and 133,843,732 shares issued and outstanding as of December 31, 2022 and 2021, respectfully,	13	13
Preferred Stock, par value of $0.0001 per share, 5,000,000 shares authorized; 124,060 shares issued and outstanding as of December 31, 2022 and 2021	1	1
Treasury stock, at cost (750,835 shares as of December 31, 2022)	(13,992)	0
Additional paid-in capital	2,130,148	2,107,267
Retained earnings (Accumulated deficit)	26,295	(43,021)
Accumulated other comprehensive income (loss)	8,693	(2,354)
Total stockholders' equity attributable to AdaptHealth Corp.	2,151,158	2,061,906
Noncontrolling interests in subsidiaries	6,600	4,783
Total Stockholders' Equity	2,157,758	2,066,689
Total Liabilities and Stockholders' Equity	$ 5,219,587	$ 5,250,484

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Common Stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common Stock, shares authorized (in shares)	300,000,000
Common Stock, shares issued (in shares)	134,435,119	133,843,732
Common Stock, shares outstanding (in shares)	134,435,119	133,843,732
Preferred Stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Preferred Stock, shares authorized (in shares)	5,000,000	5,000,000
Preferred Stock, shares issued (in shares)	124,060
Preferred Stock, shares outstanding (in shares)	124,060
Treasury stock, at cost (in shares)	750,835

Consolidated Statements of Oper

Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Statement [Abstract]
Net revenue	$ 2,970,595	$ 2,454,535	$ 1,056,389
Revenue, Product and Service [Extensible Enumeration]	Health Care, Patient Service [Member]	Health Care, Patient Service [Member]	Health Care, Patient Service [Member]
Grant income	$ 0	$ 10,595	$ 14,277
Costs and expenses:
Cost of net revenue	$ 2,553,169	$ 2,008,925	$ 898,601
Cost, Product and Service [Extensible Enumeration]	Health Care, Patient Service [Member]	Health Care, Patient Service [Member]	Health Care, Patient Service [Member]
General and administrative expenses	$ 162,125	$ 167,505	$ 89,346
Depreciation and amortization, excluding patient equipment depreciation	64,890	63,095	11,373
Total costs and expenses	2,780,184	2,239,525	999,320
Operating income	190,411	225,605	71,346
Interest expense, net	109,414	95,195	41,430
Change in fair value of warrant liability (note 11)	(17,158)	(53,181)	135,368
Change in fair value of contingent consideration common shares liability (note 11)	0	(29,389)	98,717
Loss on extinguishment of debt	0	20,189	5,316
Other loss (income), net	253	1,832	(3,444)
Income (loss) before income taxes	97,902	190,959	(206,041)
Income tax expense (benefit)	24,769	32,806	(11,955)
Net income (loss)	73,133	158,153	(194,086)
Income (loss) attributable to noncontrolling interests	3,817	1,978	(32,454)
Net income (loss) attributable to AdaptHealth Corp.	$ 69,316	$ 156,175	$ (161,632)
Weighted average common shares outstanding - basic (in shares)	134,175	126,306	52,488
Weighted average common shares outstanding - diluted (in shares)	138,988	133,034	52,488
Basic net income (loss) per share (note 12) (in dollars per share)	$ 0.47	$ 1.12	$ (3.08)
Diluted net income (loss) per share (note 12) (in dollars per share)	$ 0.33	$ 0.67	$ (3.08)

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Statement of Comprehensive Income [Abstract]
Net income (loss)	$ 73,133	$ 158,153	$ (194,086)
Other comprehensive income (loss)
Interest rate swap agreements, inclusive of reclassification adjustment, net of tax	11,047	5,776	(10,667)
Comprehensive income (loss)	84,180	163,929	(204,753)
Income (loss) attributable to noncontrolling interests	3,817	1,978	(32,454)
Comprehensive income (loss) attributable to AdaptHealth Corp.	$ 80,363	$ 161,951	$ (172,299)

Consolidated Statements of Chan

Consolidated Statements of Changes in Stockholders’ Equity (Deficit) / Members’ Equity (Deficit) - USD ($) $ in Thousands	Total	Private Placement	Public Offering	Common Stock and Class B Common Stock	Preferred Stock	Preferred Stock Private Placement	Treasury Stock	Additional paid-in capital	Additional paid-in capital Private Placement	Additional paid-in capital Public Offering	Retained earnings (Accumulated deficit)	Accumulated other comprehensive income (loss)	Noncontrolling interests in subsidiaries	Common Stock	Common Stock Common Stock and Class B Common Stock	Common Stock Common Stock and Class B Common Stock Private Placement	Common Stock Common Stock and Class B Common Stock Public Offering	Class B Common Stock Common Stock and Class B Common Stock	Series C-1 Preferred Stock	Series C-1 Preferred Stock Preferred Stock	Series C-1 Preferred Stock Additional paid-in capital
Common Stock, beginning balance (in shares) at Dec. 31, 2019															40,816,000			31,564,000
Preferred Stock, beginning balance (in shares) at Dec. 31, 2019					0
Treasury Stock, beginning balance (in shares) at Dec. 31, 2019							0
Balance at beginning of period at Dec. 31, 2019	$ (65,783)				$ 0		$ 0	$ 0			$ (40,258)	$ 1,431	$ (26,963)		$ 4			$ 3
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of stock for acquisitions (in shares)															5,927,000
Issuance of stock for acquisitions	$ 123,887							123,886							$ 1
Exchange of Class B Common Stock for Class A Common Stock (in shares)	18,167,547														16,660,000			(16,660,000)
Exchange of Class B Common Stock for Class A Common Stock								(35,271)					35,271		$ 2			$ (2)
Exchange of Class B Common Stock for cash (in shares)																		(1,508,000)
Exchange of Class B Common Stock for cash	$ (44,273)												(44,273)
Forfeiture of Class B Common Stock (in shares)																		(177,000)
Exercise of warrants (in shares)	881,239														4,105,000
Exercise of warrants	$ 24,495							24,494							$ 1
Reclassification of warrant liability to equity for exercised warrants	49,098							49,098
Equity-based compensation (in shares)															635,000
Equity-based compensation	$ 18,670							18,670
Exchange of Class A Common Stock for Series B-1 Preferred Stock (in shares)					158,000										(15,810,000)
Exchange of Class A Common Stock for Series B-1 Preferred Stock					$ 1			1							$ (2)
Sale of stock, net of offering costs (in shares)						75,000										10,930,000	9,200,000
Sale of stock, net of offering costs		$ 223,361	$ 132,514						$ 223,360	$ 132,513						$ 1	$ 1
Conversion of Series B-2 Preferred Stock to Series B-1 Preferred Stock (in shares)					(9,000)
Conversion of Series A Preferred Stock to Class A Common Stock (in shares)					(40,000)										2,888,000
Conversion of Series B-1 Preferred Stock to Class A Common Stock (in shares)					(20,000)									2,000,000	2,000,000
Issuance of Common Stock in connection with Contingent Consideration Shares (in shares)	1,000,000														1,000,000
Issuance of Common Stock in connection with Contingent Consideration Common Shares	$ 37,556							37,556
Distributions to noncontrolling interests	(800)												(800)
Common Stock issued in connection with employee stock purchase plan (in shares)															6,000
Common Stock issued in connection with employee stock purchase plan	101							101
Net income (loss)	(194,086)										(161,632)		(32,454)
Equity activity resulting from Tax Receivable Agreement	24,787							24,787
Equity activity resulting from other increases in AdaptHealth Corp.'s ownership in AdaptHealth Holdings	(8,088)							(8,088)
Equity impact resulting from the Put/Call Agreement (in shares)															(1,899,000)
Equity impact resulting from the Put/Call Agreement	(29,927)							(32,621)			2,694
Change in fair value of interest rate swaps, inclusive of reclassification adjustment	(10,667)											(5,842)	(4,825)
Common Stock, ending balance (in shares) at Dec. 31, 2020															76,458,000			13,219,000
Preferred Stock, ending balance (in shares) at Dec. 31, 2020					164,000
Treasury Stock, ending balance (in shares) at Dec. 31, 2020							0
Balance at end of period at Dec. 31, 2020	280,845				$ 1		$ 0	558,486			(199,196)	(4,411)	(74,044)		$ 8			$ 1
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Offering costs	11,725	$ 1,639	10,086
Issuance of stock for acquisitions (in shares)															15,725,000					130,000
Issuance of stock for acquisitions	602,661							602,659							$ 2				$ 523,856		$ 523,856
Issuance of stock options for acquisitions	$ 134,683							134,683
Exchange of Class B Common Stock for Class A Common Stock (in shares)	13,218,758														13,219,000			(13,219,000)
Exchange of Class B Common Stock for Class A Common Stock	$ 77,900							(74,200)				(3,719)	77,919		$ 1			$ (1)
Exercise of warrants (in shares)															118,000
Reclassification of warrant liability to equity for exercised warrants	2,960							2,960
Equity-based compensation (in shares)															571,000
Equity-based compensation	$ 25,323							25,323
Exercise of stock options (in shares)	1,447,000														1,139,000
Exercise of options	$ 12,320							12,320
Cashless exercise of stock options (in shares)															133,000
Sale of stock, net of offering costs (in shares)																	8,450,000
Sale of stock, net of offering costs			265,018							$ 265,017							$ 1
Conversion of Series B-1 Preferred Stock to Class A Common Stock (in shares)					(40,000)									3,950,000	3,950,000
Conversion Of Series C-1 Preferred Stock to Class A Common Stock (in shares)					(130,000)										13,047,000
Conversion of Series C-1 Preferred Stock to Class A Common Stock								(1)							$ 1
Issuance of Common Stock in connection with Contingent Consideration Shares (in shares)	1,000,000														1,000,000
Issuance of Common Stock in connection with Contingent Consideration Common Shares	$ 41,088							41,088
Distributions to noncontrolling interests	(1,070)												(1,070)
Common Stock issued in connection with employee stock purchase plan (in shares)															34,000
Common Stock issued in connection with employee stock purchase plan	1,016							1,016
Net income (loss)	158,153										156,175		1,978
Equity activity resulting from Tax Receivable Agreement	17,617							17,617
Change in fair value of interest rate swaps, inclusive of reclassification adjustment	5,776											5,776
Tax withholdings	$ (3,557)							(3,557)
Common Stock, ending balance (in shares) at Dec. 31, 2021	133,843,732														133,844,000			0
Preferred Stock, ending balance (in shares) at Dec. 31, 2021					124,000
Treasury Stock, ending balance (in shares) at Dec. 31, 2021							0
Balance at end of period at Dec. 31, 2021	$ 2,066,689				$ 1		$ 0	2,107,267			(43,021)	(2,354)	4,783		$ 13			$ 0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Offering costs	13,832		$ 13,832
Shares purchased under share repurchase program (in shares)				751,000			750,835
Shares purchased under share repurchase program	(13,992)						$ (13,992)
Reclassification of warrant liability to equity for exercised warrants (in shares)															88,000
Reclassification of warrant liability to equity for exercised warrants	2,103							2,103
Deferred tax impact relating to contingent consideration common shares	(1,603)							(1,603)
Equity-based compensation (in shares)															555,000
Equity-based compensation	$ 22,397							22,397
Exercise of stock options (in shares)	804,000														621,000
Exercise of options	$ 2,510							2,510
Conversion of Series B-1 Preferred Stock to Class A Common Stock (in shares)														0
Issuance of Common Stock in connection with Contingent Consideration Shares (in shares)	0
Distributions to noncontrolling interests	$ (2,000)												(2,000)
Common Stock issued in connection with employee stock purchase plan (in shares)															78,000
Common Stock issued in connection with employee stock purchase plan	1,616							1,616
Net income (loss)	73,133										69,316		3,817
Change in fair value of interest rate swaps, inclusive of reclassification adjustment	11,047											11,047
Tax withholdings	$ (4,142)							(4,142)
Common Stock, ending balance (in shares) at Dec. 31, 2022	134,435,119														134,435,000			0
Preferred Stock, ending balance (in shares) at Dec. 31, 2022	124,060				124,000
Treasury Stock, ending balance (in shares) at Dec. 31, 2022	750,835						751,000
Balance at end of period at Dec. 31, 2022	$ 2,157,758				$ 1		$ (13,992)	$ 2,130,148			$ 26,295	$ 8,693	$ 6,600		$ 13			$ 0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Offering costs	$ 0

Consolidated Statements of Ch_2

Consolidated Statements of Changes in Stockholders’ Equity (Deficit) / Members’ Equity (Deficit) (Parenthetical) - USD ($) $ in Thousands	1 Months Ended		12 Months Ended
	Jan. 31, 2021	Jul. 31, 2020	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Offering costs			$ 0	$ 13,832	$ 11,725
Private Placement
Offering costs		$ 1,600			1,639
Public Offering
Offering costs	$ 13,800			$ 13,832	$ 10,086

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash flows from operating activities:
Net income (loss)	$ 73,133	$ 158,153	$ (194,086)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization, including patient equipment depreciation	351,178	258,053	82,445
Equity-based compensation	22,397	25,323	18,670
Change in fair value of warrant liability	(17,158)	(53,181)	135,368
Change in fair value of contingent consideration common shares liability	0	(29,389)	98,717
Reduction in the carrying amount of operating lease right-of-use assets	32,264	28,624	0
Deferred income tax expense (benefit)	18,036	22,380	(21,101)
Change in fair value of interest rate swaps, net of reclassification adjustment	(2,936)	(2,927)	(2,845)
Amortization of deferred financing costs	5,234	5,378	1,876
Write-off of deferred financing costs	0	4,054	5,316
Loss on extinguishment of debt from prepayment penalty	0	16,135	0
Other	(285)	(3,615)	(5,636)
Changes in operating assets and liabilities, net of effects from acquisitions:
Accounts receivable	(209)	(29,694)	(29,517)
Inventory	(6,300)	(14,920)	(19,434)
Prepaid and other assets	(13,143)	2,731	(10,767)
Operating lease obligations	(31,213)	(28,043)	0
Operating liabilities	(57,131)	(83,383)	136,628
Net cash provided by operating activities	373,867	275,679	195,634
Cash flows from investing activities:
Payments for business acquisitions, net of cash acquired	(19,017)	(1,620,320)	(769,337)
Purchases of equipment and other fixed assets	(391,423)	(203,308)	(39,755)
Payments for cost method investments	(731)	(1,125)	(8,657)
Proceeds from sale of investment	0	0	2,046
Net cash used in investing activities	(411,171)	(1,824,753)	(815,703)
Cash flows from financing activities:
Proceeds from borrowings on long-term debt and lines of credit	0	1,165,000	591,275
Repayments on long-term debt and lines of credit	(20,000)	(827,271)	(547,480)
Repayments of finance lease obligations	(16,176)	(42,164)	(39,051)
Payments for shares purchased under share repurchase program	(13,992)	0	0
Proceeds from the exercise of stock options	2,510	12,320	0
Proceeds received in connection with employee stock purchase plan	1,616	1,016	101
Payments for tax withholdings from equity-based compensation and stock option exercises	(3,516)	(3,557)	(59)
Payments of contingent consideration and deferred purchase price from acquisitions	(14,493)	(25,233)	(3,954)
Distributions to noncontrolling interests	(2,000)	(1,070)	(800)
Proceeds from the issuance of senior unsecured notes	0	1,100,000	350,000
Proceeds from the issuance of Class A Common Stock	0	278,850	142,600
Payments for equity issuance costs	0	(13,832)	(11,725)
Payments of deferred financing costs	0	(29,185)	(13,049)
Payments for debt prepayment penalties	0	(16,135)	0
Proceeds from the sale of Class A Common Stock and Series A Preferred Stock	0	0	225,000
Proceeds from the exercise of warrants	0	0	24,495
Exchange of Class B Common Stock for cash	0	0	(44,273)
Payment for exercise of call option relating to the Put/Call Agreement	0	0	(29,927)
Net cash (used in) provided by financing activities	(66,051)	1,598,739	643,153
Net (decrease) increase in cash and cash equivalents	(103,355)	49,665	23,084
Cash and cash equivalents at beginning of period	149,627	99,962	76,878
Cash and cash equivalents at end of period	46,272	149,627	99,962
Supplemental disclosures:
Cash paid for interest	108,885	73,630	35,771
Cash paid for income taxes	14,949	14,792	7,480
Noncash investing and financing activities:
Equipment acquired under finance lease obligations	1,335	22,959	40,012
Unpaid equipment and other fixed asset purchases at end of period	24,221	13,936	7,869
Assets subject to operating lease obligations	22,543	12,777	0
Operating lease obligations	(22,543)	(12,777)	0
Write-off of assets subject to operating lease obligations	(8,532)	0	0
Write-off of operating lease obligations	8,532	0	0
Equity consideration issued in connection with acquisitions	0	1,261,200	123,887
Contingent purchase price in connection with acquisitions	0	7,800	27,064
Deferred purchase price in connection with acquisitions	$ 457	$ 4,478	$ 33

Nature of Business

Nature of Business	12 Months Ended
	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of Business	Nature of Business AdaptHealth Corp. and subsidiaries ("AdaptHealth" or "the Company") is a national leader in providing patient-centered, healthcare-at-home solutions including home medical equipment (HME), medical supplies, and related services. AdaptHealth focuses primarily on providing (i) sleep therapy equipment, supplies and related services (including CPAP and bi PAP services) to individuals suffering from obstructive sleep apnea (OSA), (ii) medical devices and supplies to patients for the treatment of diabetes (including continuous glucose monitors (CGM) and insulin pumps), (iii) home medical equipment to patients discharged from acute care and other facilities, (iv) oxygen and related chronic therapy services in the home, and (v) other HME devices and supplies on behalf of chronically ill patients with wound care, urological, incontinence, ostomy and nutritional supply needs. AdaptHealth services beneficiaries of Medicare, Medicaid and commercial insurance payors.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2022
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies (a) Basis of Presentation The consolidated financial statements of the Company have been prepared in accordance with accounting principles generally accepted in the United States of America (U.S. GAAP). In the opinion of management, the consolidated financial statements include all necessary adjustments for a fair presentation of the financial position and results of operations for the periods presented. Prior to August 19, 2021, the Company was an “emerging growth company,” as defined in Section 2(a) of the Securities Act of 1933, as amended, (the Securities Act), as modified by the Jumpstart our Business Startups Act of 2012, (the JOBS Act), and took advantage of certain exemptions from various reporting requirements that are applicable to other public companies that are not emerging growth companies, including, but not limited to, not being required to comply with the auditor attestation requirements of Section 404 of the Sarbanes-Oxley Act, reduced disclosure obligations regarding executive compensation in its periodic reports and proxy statements, and other exemptions. As of August 19, 2021, the Company no longer qualified as an emerging growth company due to issuing more than $1.0 billion in non-convertible debt in the prior three-year period as of that date, and as a result is no longer exempt from the reporting requirements discussed above. (b) Basis of Consolidation The accompanying consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation. (c) Accounting Estimates The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, and the disclosure of contingent assets and liabilities at the date of the consolidated financial statements, and reported amounts of revenues and expenses during the reporting period. Management bases these estimates and assumptions upon historical experience, existing and known circumstances, authoritative accounting pronouncements and other factors that management believes to be reasonable. Significant areas requiring the use of management estimates relate to revenue recognition and the valuation of accounts receivable (implicit price concession), income taxes, equity-based compensation, warrant liability and long-lived assets, including goodwill and identifiable intangible assets. Actual results could differ from those estimates. (d) Revenue Recognition The Company generates revenues for services and related products that the Company provides to patients for home medical equipment, related supplies, and other items. The Company’s revenues are recognized in the period in which services and related products are provided to customers and are recorded either at a point in time for the sale of supplies and disposables, or over the fixed monthly service period for equipment. Revenues are recognized when control of the promised good or service is transferred to customers, in an amount that reflects the consideration to which the Company expects to receive from patients or under reimbursement arrangements with Medicare, Medicaid and third-party payors, in exchange for those goods and services. The Company determines the transaction price based on contractually agreed-upon amounts or rates, adjusted for estimates of variable consideration, such as implicit price concessions. The Company utilizes the expected value method to determine the amount of variable consideration that should be included to arrive at the transaction price, using contractual agreements and historical reimbursement experience within each payor type. The Company applies constraint to the transaction price, such that net revenue is recorded only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in the future. If actual amounts of consideration ultimately received differ from the Company’s estimates, the Company adjusts these estimates, which would affect net revenue in the period such adjustments become known. Sales revenue is recognized upon transfer of control of products or services to customers in an amount that reflects the consideration the Company expects to receive in exchange for those products or services. Revenues for the sale of sleep therapy equipment supplies (including CPAP resupply products), durable medical equipment and related supplies (including wheelchairs, hospital beds and infusion pumps), diabetic medical devices and supplies (including continuous glucose monitors (CGM) and insulin pumps), and other HME products and supplies are recognized when control of the promised good or service is transferred to customers, which is generally upon shipment for direct to consumer medical devices and supplies and upon delivery to the home for durable medical equipment. The Company provides certain equipment to patients which is reimbursed periodically in fixed monthly payments for as long as the patient is using the equipment and medical necessity continues (in certain cases, the fixed monthly payments are capped at a certain amount). The equipment provided to the patient is based upon medical necessity as documented by prescriptions and other documentation received from the patient’s physician. The patient generally does not negotiate or select the manufacturer or model of the equipment prescribed by their physician and delivered by the Company. Once initial delivery of this equipment is made to the patient for initial setup, a monthly billing process is established based on the initial setup service date. The Company recognizes the fixed monthly revenue ratably over the service period as earned, less estimated adjustments, and defers revenue for the portion of the monthly bill that is unearned. No separate revenue is earned from the initial setup process. Included in fixed monthly revenue are unbilled amounts for which the revenue recognition criteria had been met as of period-end but were not yet billed to the payor. The estimate of net unbilled fixed monthly revenue recognized is based on historical trends and estimates of future collectability. The Company’s billing system contains payor-specific price tables that reflect the fee schedule amounts in effect or contractually agreed upon by various government and commercial insurance payors for each item of equipment or supply provided to a customer. Revenues are recorded based on the applicable fee schedule. The Company has established a contractual allowance to account for adjustments that result from differences between the payment amount received and the expected realizable amount. If the payment amount received differs from the net realizable amount, an adjustment is recorded to revenues in the period that these payment differences are determined. The Company reports revenues in its consolidated financial statements net of such adjustments. The Company recognizes revenue in the consolidated statements of operations and contract assets on the consolidated balance sheets only when services have been provided. Since the Company has performed its obligation under the contract, it has unconditional rights to the consideration recorded as contract assets and therefore classifies those billed and unbilled contract assets as accounts receivable. Fixed monthly payments that the Company receives from customers in advance of providing services represent contract liabilities. Such payments primarily relate to patients who are billed monthly in advance and are recognized over the period as earned. The Company disaggregates net revenue from contracts with customers by payor type and by core service lines. The Company believes that disaggregation of net revenue into these categories depicts how the nature, amount, timing and uncertainty of revenue and cash flows are affected by economic factors. The payment terms and conditions within the Company’s revenue-generating contracts vary by payor type and payor source. The composition of net revenue by payor type for the years ended December 31, 2022, 2021 and 2020 are as follows (in thousands): Year Ended December 31, 2022 2021 2020 Insurance $ 1,808,633 $ 1,499,154 $ 657,033 Government 781,975 685,513 295,657 Patient pay 379,987 269,868 103,699 Net revenue $ 2,970,595 $ 2,454,535 $ 1,056,389 The composition of net revenue by core service lines for the years ended December 31, 2022, 2021 and 2020 are as follows (in thousands): Year Ended December 31, 2022 2021 2020 Net sales revenue: Sleep $ 794,021 $ 654,130 $ 312,860 Diabetes 670,988 528,082 159,490 Supplies to the home 179,326 167,830 145,624 Respiratory 34,342 31,016 28,605 HME 118,542 113,805 58,029 Other 218,461 144,543 54,689 Total net sales revenue $ 2,015,680 $ 1,639,406 $ 759,297 Net revenue from fixed monthly equipment reimbursements: Sleep $ 272,705 $ 237,252 $ 98,361 Diabetes 16,103 13,123 2,467 Respiratory 520,697 427,270 123,860 HME 102,256 95,936 55,847 Other 43,154 41,548 16,557 Total net revenue from fixed monthly equipment reimbursements $ 954,915 $ 815,129 $ 297,092 Total net revenue: Sleep $ 1,066,726 $ 891,382 $ 411,221 Diabetes 687,091 541,205 161,957 Supplies to the home 179,326 167,830 145,624 Respiratory 555,039 458,286 152,465 HME 220,798 209,741 113,876 Other 261,615 186,091 71,246 Total net revenue $ 2,970,595 $ 2,454,535 $ 1,056,389 Certain prior period amounts in the table above have been reclassified to conform to the current period presentation. These reclassifications are considered immaterial to all periods presented. (e) Accounts Receivable Due to the continuing changes in the healthcare industry and third-party reimbursement environment, certain estimates are required to record accounts receivable at their net realizable values. Inherent in these estimates is the risk that they will have to be revised or updated as additional information becomes available. The complexity of third-party billing arrangements and laws and regulations governing Medicare and Medicaid may result in adjustments to amounts originally recorded. The Company performs a periodic analysis to review the valuation of accounts receivable and collectability of outstanding balances. Management’s evaluation takes into consideration such factors as historical cash collections experience, business and economic conditions, trends in healthcare coverage, other collection indicators and information about specific receivables. The Company’s evaluation also considers the age and composition of the outstanding amounts in determining their estimated net realizable value. Receivables are considered past due when not collected by established due dates. Specific patient balances are written off after collection efforts have been followed and the account has been determined to be uncollectible. Revisions in reserve estimates are recorded as an adjustment to net revenue in the period of revision. Included in accounts receivable are earned but unbilled accounts receivables. Billing delays, ranging from several days to several weeks, can occur due to the Company’s policy of compiling required payor specific documentation prior to billing for its services rendered. As of December 31, 2022 and 2021, the Company’s unbilled accounts receivable was $38.6 million and $23.8 million, respectively. (f) COVID-19 Pandemic Federal, state, and local authorities have taken several actions designed to assist healthcare providers in providing care to COVID-19 and other patients and to mitigate the adverse economic impact of the COVID-19 pandemic. Legislative actions taken by the federal government include the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act), which was signed into law on March 27, 2020. Through the CARES Act, the federal government authorized payments that were distributed to healthcare providers through the Public Health and Social Services Emergency Fund (Provider Relief Fund or PRF). Additionally, the CARES Act revised the Medicare accelerated and advance payment program in an attempt to disburse payments to healthcare providers more quickly to mitigate the financial impact on healthcare providers. The Company’s participation in these programs and related accounting policies are summarized below. Grant Income . In April 2020, the Company received distributions of the CARES Act PRF of $17.2 million, and subsequent to April 2020, the Company completed several acquisitions in which the acquired companies received a total of $22.2 million of PRF payments prior to the applicable dates of acquisition. In connection with the accounting for these acquisitions, the Company recorded assumed liabilities of $7.7 million relating to the PRF payments received by the acquired companies. The PRF payments were targeted to offset lost revenue and expenditures incurred in connection with the COVID-19 pandemic. The PRF payments are subject to certain restrictions and are subject to recoupment if not used for designated purposes. As a condition to receiving distributions, providers were required to agree to certain terms and conditions, including, among other things, that the funds would be used for lost revenues and unreimbursed COVID-19 related expenses as defined by the U.S. Department of Health and Human Services (HHS). All recipients of PRF payments were required to comply with the reporting requirements described in the terms and conditions and as determined by HHS. The Company recognizes grant payments as income when there is reasonable assurance that it has complied with the conditions associated with the grant. During the years ended December 31, 2021 and 2020, the Company recognized grant income of $10.6 million and $14.3 million, respectively, related to the PRF payments determined to comply with conditions associated with the grant. HHS has indicated that the CARES Act PRF are subject to ongoing reporting and changes to the terms and conditions, and there have been several updates to such reporting requirements and terms and conditions since they were issued by HHS. Such updates have related to changes to the guidance regarding utilization of the funds granted from the PRF and updates to the reporting requirements of such funds, among other updates. To the extent that there is any future updated guidance from HHS or modifications to the terms and conditions, it may affect AdaptHealth's ability to comply and the Company could be required to reverse the recognition of the grant income recorded and return a portion of the funds received, which could be material to the Company. The Company is continuing to monitor the terms and conditions issued by HHS. Furthermore, HHS has indicated that it will be closely monitoring and, along with the Office of Inspector General (United States) (OIG) , auditing providers to ensure that recipients comply with the terms and conditions of relief programs and to prevent fraud and abuse. All providers will be subject to civil and criminal penalties for any deliberate omissions, misrepresentations or falsifications of any information given to HHS. Medicare Accelerated Payment Program . In certain circumstances, when a healthcare provider is experiencing financial difficulty due to delays in receiving payment for the Medicare services it provided, it may be eligible for an accelerated or advance payment pursuant to the Medicare accelerated payment program. The CARES Act revised the Medicare accelerated and advance payment program in an attempt to disburse payments to healthcare providers more quickly to mitigate the financial impact on healthcare providers. In April 2020, the Company received recoupable advance payments of $45.8 million, which were made available by CMS under the CARES Act. In addition, in connection with an acquisition completed in July 2020, the Company assumed a liability of $3.7 million relating to CMS recoupable advance payments received by the acquired company prior to the date of acquisition. The recoupment of the advance payments by CMS began in April 2021 and were applied to services provided and revenue recognized during the period in which the recoupment occurred, which impacted the Company’s cash receipts for services provided during the period in which the amounts were recouped. During the years ended December 31, 2022 and 2021, $12.8 million and $36.7 million, respectively, was recouped by or repaid to CMS. As of December 31, 2022, the CMS advance payments have been recouped by or repaid to CMS in full and there is no liability to CMS for these amounts as of such date. Deferral of Employment Tax Payments . As permitted under the CARES Act, the Company elected to defer certain portions of employer-paid FICA taxes otherwise payable from March 27, 2020 to January 1, 2021. In total, the Company deferred $8.6 million under this provision, and paid $4.3 million on January 4, 2022 and $4.3 million on December 14, 2022. There are no further amounts due under this provision as of December 31, 2022. The full extent of the impact of the COVID-19 pandemic on the Company’s business, results of operations, and financial condition is highly uncertain and will depend on future developments and numerous evolving factors that it may not be able to accurately predict, and could be material to the Company’s consolidated financial statements in future reporting periods. (g) Fair Value Accounting Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 820, Fair Value Measurements and Disclosures (ASC 820), creates a single definition of fair value, establishes a framework for measuring fair value in U.S. GAAP and expands disclosures about fair value measurements. ASC 820 emphasizes that fair value is a market-based measurement, not an entity specific measurement, and states that a fair value measurement is to estimate the price at which an orderly transaction to sell an asset or to transfer the liability would take place between market participants at the measurement date under current market conditions. Assets and liabilities adjusted to fair value in the balance sheet are categorized based upon the level of judgment associated with the inputs used to measure their fair value. Level inputs, as defined by ASC 820, are as follows: Level input Input Definition Level 1 Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. Level 2 Inputs, other than quoted prices included in Level 1 that are observable for the asset or liability through corroboration with market data at the measurement date. Level 3 Unobservable inputs that reflect management’s best estimate of what market participants would use in pricing the asset or liability at the measurement date. Refer to Note 6, Fair Value of Assets and Liabilities , for additional information. (h) Fair Value of Financial Instruments The Company’s financial instruments consist of cash and cash equivalents, accounts receivable, prepaid and other current assets, accounts payable and accrued expenses. The carrying values of the Company’s financial instruments approximate their fair value based on their short-term nature. The table below shows the carrying amounts and estimated fair values, net of unamortized deferred financing costs, of the Company’s long-term debt arrangements (in thousands): December 31, 2022 December 31, 2021 Carrying Value Fair Value Carrying Value Fair Value Secured term loan $ 761,547 $ 761,547 $ 780,414 $ 780,414 Senior unsecured notes 1,426,720 1,227,574 1,423,138 1,459,137 $ 2,188,267 $ 1,989,121 $ 2,203,552 $ 2,239,551 The borrowings under the Company’s secured term loan, which was entered into in January 2021, bears interest at the variable rates described in Note 10, Debt , which management believes approximates fair value. The fair value of the Company’s senior unsecured notes is based upon current market prices. (i) Cash and Cash Equivalents The Company considers all short-term highly liquid investments with a maturity of three months or less to be cash equivalents. Cash represents cash on hand and deposits held at banks. The Company maintains cash in demand deposit accounts with federally insured banks. At times, the balances in these accounts may be in excess of federally insured limits. Cash and cash equivalents consist of the following: December 31, (in thousands) 2022 2021 Cash $ 46,272 $ 149,613 Money market accounts — 14 Total $ 46,272 $ 149,627 (j) Inventory Inventory consists of equipment and medical supplies to be sold to customers and is stated at the lower of cost or market value. Cost is determined by the first-in-first-out method. These finished goods are charged to cost of net revenue in the period in which products and related services are provided to customers. (k) Equipment and Other Fixed Assets Equipment and other fixed assets are stated at cost less accumulated depreciation or, when acquired as part of a business combination, fair value at date of acquisition. Depreciation is computed using the straight-line method over the estimated useful lives of the related assets. The useful lives for patient medical equipment correlate with the medical reimbursement periods. Computer equipment, vehicles and other fixed assets are depreciated over the estimated useful lives of the assets. Major expenditures for property acquisitions and those expenditures that substantially increase useful lives are capitalized. Expenditures for maintenance, repairs and minor replacements are expensed as incurred. The useful lives of property and equipment for purposes of computing depreciation are: Patient medical equipment 13 months ‑ 5 years Vehicles 5 years Other 2 ‑ 10 years (l) Long-Lived Assets The Company’s long-lived assets, such as equipment and other fixed assets, operating lease right-of-use assets, finance lease right-of-use assets and definite-lived identifiable intangible assets, are assessed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to estimated undiscounted future cash flows expected to be generated by the asset. If the carrying amount of an asset exceeds its estimated undiscounted future cash flows, an impairment charge is recognized by the amount by which the carrying amount of the asset exceeds the fair value of the asset. Definite-lived identifiable intangible assets consist of tradenames, payor contracts, contractual rental agreements and developed technology. These assets are amortized using the straight-line method over their estimated useful lives, which reflects the pattern in which the economic benefits of the assets are expected to be consumed. These assets are assessed for impairment consistent with the Company’s long-lived assets. The following table summarizes the useful lives of the Company's identifiable intangible assets: Tradenames 5 to 10 years Payor contracts 10 years Contractual rental agreements 2 years Developed technology 5 years The Company did not incur any impairment charges on long-lived assets for the years ended December 31, 2022, 2021 and 2020. In addition to consideration of impairment upon the events or changes in circumstances described above, management regularly evaluates the remaining lives of its long-lived assets. (m) Valuation of Goodwill The Company has a significant amount of goodwill on its balance sheet that resulted from the business acquisitions the Company has made. Goodwill is not amortized and is assessed for impairment annually and upon the occurrence of a triggering event or change in circumstances indicating a possible impairment. Such triggering events potentially warranting an annual or interim goodwill impairment assessment include, among other factors, declines in historical or projected revenue, operating income or cash flows, and declines in the Company’s stock price or market capitalization. Such changes in circumstance can include, among others, changes in the legal environment, reimbursement environment, operating performance, and/or future prospects. The Company performs its annual impairment assessment of goodwill during the fourth quarter of each year. The impairment assessment can be performed on either a quantitative or qualitative basis. The Company first assesses qualitative factors to determine whether it is necessary to perform a quantitative goodwill impairment analysis. If determined necessary, the Company applies the quantitative impairment test to identify and measure the amount of impairment, if any. Fair value determinations require considerable judgment and are sensitive to changes in underlying assumptions and factors, such as estimates of a reporting unit's fair value and judgment about impairment triggering events. As a result, there can be no assurance that the estimates and assumptions made for purposes of the annual goodwill impairment test will prove to be accurate predictions of the future. During the three months ended March 31, 2022, the Company experienced a decline in its market capitalization as a result of a decline in the Company’s stock price. The Company considered such decline to represent a triggering event requiring management to perform a quantitative goodwill impairment analysis as of March 31, 2022. No such triggering events were identified during the remainder of 2022. Refer to Note 5, Goodwill and Identifiable Intangible Assets , for additional details. (n) Business Combinations The Company applies the acquisition method of accounting for business acquisitions. The results of operations of the businesses acquired by the Company are included as of the respective acquisition date. The acquisition-date fair value of the consideration transferred, including the fair value of any contingent consideration, is allocated to the underlying assets acquired and liabilities assumed based upon their estimated fair values at the date of acquisition. To the extent the acquisition-date fair value of the consideration transferred exceeds the fair value of the identifiable tangible and intangible assets acquired and liabilities assumed, such excess is allocated to goodwill. Patient relationships, medical records and patient lists are not reported as separate intangible assets due to the regulatory requirements and lack of contractual agreements but are part of goodwill. Customer related relationships are not reported as separate intangible assets but are part of goodwill as authorizing physicians are under no obligation to refer the Company’s services to their patients, who are free to change physicians and service providers at any time. The Company may adjust the preliminary purchase price allocation, as necessary, as it obtains more information regarding asset valuations and liabilities assumed that existed but were not available at the acquisition date, which is generally up to one year after the acquisition closing date. Acquisition related expenses are recognized separately from the business combination and are expensed as incurred. (o) Deferred Financing Costs Costs incurred in connection with the Company’s borrowings, referred to as financing costs, are capitalized and included on the accompanying consolidated balance sheets in Other assets for costs associated with revolving credit facilities, and as a reduction of the carrying value of debt for costs associated with secured term loans. The capitalized financing costs are amortized to interest expense using the effective interest method over the term of the related financing agreement. Refer to Note 8, Deferred Financing Costs , for additional information. (p) Accounting for Leases During the year ended December 31, 2021, the Company adopted FASB Accounting Standards Update (ASU) No. 2016-02, Leases (Topic 842) (ASC 842) with an effective date of January 1, 2021, using the modified retrospective approach, for leases that existed on January 1, 2021. ASC 842 requires the Company to recognize a lease liability, which represents the discounted obligation to make future minimum lease payments, and a corresponding right-of-use (ROU) asset on its consolidated balance sheet for most leases, and disclose key information about leasing arrangements. The Company elected to apply certain practical expedients permitted under the transition guidance within ASC 842 to leases that commenced before January 1, 2021, including the package of practical expedients, which, among other things, permits lease agreements that are twelve months or less to be excluded from the balance sheet, and permits the Company not to reassess under the new standard its prior conclusions about lease identification, lease classification and initial direct costs. Due to the Company’s election of these practical expedients, the Company carried forward certain historical conclusions for existing contracts, including conclusions related to the existence and classification of leases and to initial direct costs. ASC 842 applies to a number of arrangements to which the Company is a party. Whenever the Company enters into a new arrangement, it must determine, at the inception date, whether the arrangement is or contains a lease. This determination generally depends on whether the arrangement conveys to the Company the right to control the use of an explicitly or implicitly identified asset for a period of time in exchange for consideration. Control of an underlying asset is conveyed to the Company if the Company obtains the rights to direct the use of and obtain substantially all the economic benefits from the use of the underlying asset. If a lease exists, the Company must then determine the separate lease and non-lease components of the arrangement. Each right to use an underlying asset conveyed by a lease arrangement should generally be considered a separate lease component if it both: (i) can benefit the Company without depending on other resources not readily available to the Company and (ii) does not significantly affect and is not significantly affected by other rights of use conveyed by the lease. Aspects of a lease arrangement that transfer other goods or services to the Company but do not meet the definition of lease components are considered non-lease components. The consideration owed by the Company pursuant to a lease arrangement is generally allocated to each lease and non-lease component for accounting purposes. However, the Company has elected, for all of its leases, to not separate lease and non-lease components. Each lease component is accounted for separately from other lease components, but together with the associated non-lease components. For each lease, the Company must then determine the lease term, the present value of lease payments and the classification of the lease as either an operating or finance lease. The lease term is the period of the lease not cancellable by the Company, together with periods covered by: (i) renewal options the Company is reasonably certain to exercise, (ii) termination options the Company is reasonably certain not to exercise, and (iii) renewal or termination options that are controlled by the lessor. The present value of lease payments is calculated based on: • Lease payments – lease payments include fixed and certain variable payments, less lease incentives, together with amounts probable of being owed by the Company under residual value guarantees and, if reasonably certain of being paid, the cost of certain renewal options and early termination penalties set forth in the lease arrangement. Lease payments exclude consideration that is not related to the transfer of goods and services of the Company. • Discount rate – the discount rate must be determined based on information available to the Company upon the commencement of the lease. Lessees are required to use the rate implicit in the lease whenever such rate is readily available; however, as the implicit rate in the Company’s leases is generally not readily determinable, the Company generally uses the hypothetical incremental borrowing rate it would have to pay to borrow an amount equal to the lease payments, on a collateralized basis, over a timeframe similar to the lease term. In making the determination of whether a lease is an operating lease or a finance lease, the Company considers the lease term in relation to the economic life of the leased asset, the present value of lease payments in relation to the fair value of t

Acquisitions

Acquisitions	12 Months Ended
	Dec. 31, 2022
Business Combination and Asset Acquisition [Abstract]
Acquisitions	Acquisitions During the years ended December 31, 2022, 2021 and 2020, the Company completed numerous acquisitions to strengthen its current market share in existing markets or to expand into new markets. Each of the Company’s acquisitions was accounted for using the acquisition method pursuant to the requirements of FASB ASC Topic 805, Business Combinations , and are included in the Company’s consolidated financial statements since the respective acquisition date. The goodwill generated from these acquisitions is attributable to expected growth and cost synergies and the expected contribution of each acquisition to the Company’s overall strategy. The goodwill recorded during the year ended December 31, 2022 is not expected to be deductible for tax purposes. The estimated fair values of the net assets of acquired businesses as described below are subject to change resulting from such items as final analysis of valuations and working capital adjustments post-acquisition. As a result, the acquisition accounting for certain acquired businesses could change in subsequent periods resulting in adjustments to goodwill once finalized. Year ended December 31, 2022 During the year ended December 31, 2022, the Company acquired 100% of the equity interests of three providers of HME and acquired certain assets of the home medical equipment businesses of five providers of HME. The following table summarizes the consideration paid for all acquisitions during the year ended December 31, 2022 (in thousands): Cash $ 17,170 Deferred payments 457 Total $ 17,627 The Company allocated the consideration paid to the net assets acquired based on their estimated acquisition date fair values. Based upon management’s evaluation, the consideration paid for all acquisitions during 2022 was allocated as follows (in thousands): Cash $ 162 Accounts receivable 2,336 Inventory 771 Prepaid and other current assets 16 Equipment and other fixed assets 4,585 Goodwill 12,341 Identifiable intangible assets 500 Deferred tax assets 180 Accounts payable and accrued expenses (3,130) Contract liabilities (134) Net assets acquired $ 17,627 During the year ended December 31, 2022, the Company paid net cash of $2.0 million relating to working capital adjustments associated with businesses that were acquired during 2021, which was recorded as an increase to goodwill. Year ended December 31, 2021 On February 1, 2021, the Company acquired 100% of the equity interests of AeroCare Holdings, Inc. (AeroCare). AeroCare is a leading national technology-enabled respiratory and home medical equipment distribution platform in the United States and offers a comprehensive suite of direct-to-patient equipment and services including CPAP and BiPAP machines, oxygen concentrators, home ventilators, and other home medical equipment products. The total consideration paid consisted of (i) cash payments of $1.2 billion, (ii) the issuance of 13,992,615 shares of the Company’s Class A Common Stock, (iii) the issuance of 130,474.73 shares of the Company’s Series C Convertible Preferred Stock, and (iv) the issuance of 3,959,892 fully vested options to purchase shares of the Company’s Class A Common Stock in the future, which had a weighted-average exercise price of $6.24 per share and a weighted-average remaining exercise period of approximately 7 years from the date of closing. Refer to Note 11, Stockholders’ Equity , for additional discussion of the Series C Convertible Preferred Stock issued in connection with the acquisition of AeroCare. On April 30, 2021, the Company acquired 100% of the equity interests of Spiro Health Services, LLC (Spiro). Spiro is a provider of home medical equipment and supplies. The total consideration paid consisted of a cash payment of $65.8 million, the issuance of 244,641 shares of the Company’s Class A Common Stock, and a potential contingent consideration payment of up to $1.0 million, which was determined to be the fair value at the acquisition date and such amount was recorded as a contingent consideration liability in connection with the Company’s acquisition accounting. On June 1, 2021, the Company acquired 100% of the equity interests of Healthy Living Medical Supply, LLC (Healthy Living). Healthy Living is a provider of continuous glucose monitors and insulin pumps. The total consideration paid consisted of a cash payment of $47.0 million and the issuance of 196,779 shares of the Company’s Class A Common Stock. On July 1, 2021, the Company acquired 100% of the equity interests of Agilis Med Holdings, LLC (Agilis). Agilis is an e-commerce retailer of sleep apnea and respiratory equipment in the United States. The total consideration paid consisted of a cash payment of $30.8 million, the issuance of 538,079 shares of the Company’s Class A Common Stock, and a potential contingent consideration payment of up to $1.0 million, which was determined to be the fair value at the acquisition date and such amount was recorded as a contingent consideration liability in connection with the Company’s acquisition accounting. In October 2020, the Company acquired a minority interest in Agilis, which was being accounted for under the equity method of accounting prior to the July 2021 transaction. The carrying value of such investment was $8.1 million at the July 2021 transaction date. The fair value of the equity method investment was $10.0 million at the July 2021 transaction date. In connection with the accounting for the July 2021 transaction, the Company recorded goodwill of $10.0 million and eliminated the carrying value of the equity method investment of $8.1 million and recorded a gain on equity method of investment of $1.9 million, which is included in Other loss (income), net in the accompanying consolidated statements of operations during the year ended December 31, 2021. On July 1, 2021, the Company acquired 100% of the equity interests of WeCare Medical, LLC (WeCare). WeCare is a distributor of durable medical equipment and supplies in the United States. The total consideration paid consisted of a cash payment of $34.8 million and the issuance of 231,866 shares of the Company’s Class A Common Stock. On December 30, 2021, the Company acquired 100% of the equity interests of Community Surgical Supply of Toms River, LLC (Community Surgical Supply). Community Surgical Supply is a supply company that provides oxygen, respiratory therapy services, infusion therapy services, and home medical equipment to its customers throughout the northeastern United States. The total consideration paid consisted of a cash payment of $129.4 million and a potential contingent consideration payment of up to $6.5 million. The Company determined that the potential contingent payment had an acquisition date fair value of $5.8 million, which was recorded as a contingent consideration liability in connection with the Company’s acquisition accounting. In addition, during 2021, the Company acquired 100% of the equity interests of certain providers of home medical equipment and distributors of diabetes management products and supplies, and acquired certain assets of the durable medical equipment businesses of certain providers of home medical equipment. The total consideration paid for these acquisitions consisted of cash payments of $196.7 million, the issuance of 306,569 shares of the Company’s Class A Common Stock, and deferred payment liabilities of $4.5 million. The following table summarizes the consideration paid for all acquisitions during the year ended December 31, 2021 (in thousands): AeroCare Spiro Healthy Living Agilis We Care Community Other Total Cash $ 1,153,409 $ 65,759 $ 47,048 $ 30,828 $ 34,834 $ 129,423 $ 196,669 $ 1,657,970 Equity 1,220,342 7,109 5,057 14,668 6,321 — 7,703 1,261,200 Contingent consideration — 1,000 — 1,000 — 5,800 — 7,800 Deferred payments — — — — — — 4,478 4,478 Total $ 2,373,751 $ 73,868 $ 52,105 $ 46,496 $ 41,155 $ 135,223 $ 208,850 $ 2,931,448 The Company allocated the consideration paid to the net assets acquired based on their estimated acquisition date fair values. Based upon management’s evaluation, the consideration paid for all acquisitions during 2021 was allocated as follows during the year ended December 31, 2021 (in thousands): AeroCare Spiro Healthy Living Agilis We Care Community Other Total Cash $ 27,686 $ 2,132 $ 579 $ 1,131 $ 458 $ 2 $ 5,005 $ 36,993 Accounts receivable 71,916 $ 5,756 5,838 — 2,007 15,798 25,587 126,902 Inventory 26,998 1,733 2,949 2,330 465 5,214 10,663 50,352 Prepaid and other current assets 3,522 152 1,088 — — 571 2,403 7,736 Equipment and other fixed assets 190,755 6,897 1,188 348 5,254 44,952 24,963 274,357 Operating lease right-of-use assets 52,927 2,581 1,366 490 970 4,412 15,897 78,643 Goodwill 2,083,423 64,380 44,095 55,375 35,971 88,393 164,929 2,536,566 Identifiable intangible assets 122,800 1,000 1,500 500 400 2,300 4,400 132,900 Other assets 1,178 16 — — — 2,505 — 3,699 Deferred tax liabilities (46,234) — — — (1,228) — (308) (47,770) Accounts payable and accrued expenses (82,722) (5,517) (3,363) (3,188) (1,389) (13,725) (21,679) (131,583) Contract liabilities (14,495) (486) (102) — (783) (3,156) (608) (19,630) Other current liabilities (10,021) — (1,667) — — (180) (1,833) (13,701) Other long-term liabilities (1,055) — — — — (2,683) — (3,738) Operating lease obligations (52,927) (2,581) (1,366) (490) (970) (4,412) (15,897) (78,643) Finance lease obligations — (2,195) — — — (4,768) (4,672) (11,635) Net assets acquired $ 2,373,751 $ 73,868 $ 52,105 $ 56,496 $ 41,155 $ 135,223 $ 208,850 $ 2,941,448 During the year ended December 31, 2021, the Company received net cash of $0.7 million relating to working capital adjustments associated with businesses that were acquired during 2020, which was recorded as a decrease to goodwill. Year ended December 31, 2020 On January 2, 2020, the Company purchased 100% of the equity interests of the Patient Care Solutions business (PCS), which was a subsidiary of McKesson Corporation. PCS is a home medical equipment supplies business. The total consideration paid consisted of a cash payment of $14.0 million. On March 2, 2020, the Company purchased certain assets of the durable medical equipment business of Advanced Home Care, Inc. (Advanced). The total consideration paid consisted of a cash payment of $58.5 million. The acquisition also included a potential contingent payment of up to $9.0 million. The Company determined that the potential contingent payment had an acquisition date fair value of $5.0 million which was recorded as a contingent consideration liability in connection with the Company’s acquisition accounting. On July 1, 2020, the Company acquired 100% of the equity interests in Solara Medical Supplies, LLC (Solara). Solara is an independent distributor of continuous glucose monitors (CGM) in the United States and offers a comprehensive suite of direct-to-patient diabetes management supplies to patients throughout the country, including CGMs, insulin pumps and other diabetic supplies. The total consideration paid consisted of a cash payment of $380.7 million and the issuance of 3,906,250 shares of the Company’s Class A Common Stock. The acquisition also included a potential contingent payment based on certain conditions after closing, which was determined to have an acquisition date fair value of $1.3 million, which was recorded as a contingent consideration liability in connection with the Company’s acquisition accounting. July 1, 2020, the Company acquired 100% of the equity interests of ActivStyle, Inc. (ActivStyle). ActivStyle is a leading direct-to-consumer supply company that provides incontinence and urology products to patients throughout the United States. The total consideration paid consisted of a cash payment of $65.5 million. On October 1, 2020, the Company acquired 100% of the equity interests of Pinnacle Medical Solutions, Inc. (Pinnacle). Pinnacle is a distributor of insulin pumps, insulin pump supplies, continuous glucose monitoring systems and diabetes test strips in the United States. The total consideration paid consisted of a cash payment of $80.4 million and the issuance of 997,067 shares of the Company’s Class A Common Stock. The acquisition also included a potential contingent payment of up to $15.0 million, which was determined to have an acquisition date fair value of $14.3 million, which was recorded as a contingent consideration liability in connection with the Company’s acquisition accounting. In addition, during 2020, the Company acquired 100% of the equity interests of certain other providers of home medical equipment and distributors of diabetes management products and supplies, and acquired certain assets of the durable medical equipment businesses of certain providers of home medical equipment. The total consideration paid for these acquisitions consisted of cash payments of $191.4 million, the issuance of 1,023,434 shares of the Company’s Class A Common Stock, and deferred payment liabilities of less than $0.1 million. Certain of the acquisitions also included potential contingent consideration payments of up to $8.0 million in the aggregate, which was determined to have an acquisition date fair value of $6.5 million, which was recorded as contingent consideration liabilities in connection with the Company’s acquisition accounting for such acquisitions. The following table summarizes the consideration paid for all acquisitions during the year ended December 31, 2020 (in thousands): PCS Advanced Solara ActivStyle Pinnacle Other Total Cash $ 14,008 $ 58,517 $ 380,735 $ 65,512 $ 80,377 $ 191,415 $ 790,564 Equity — — 73,359 — 28,182 22,346 123,887 Contingent consideration — 5,000 1,300 — 14,300 6,464 27,064 Deferred payments — — — — — 33 33 Total $ 14,008 $ 63,517 $ 455,394 $ 65,512 $ 122,859 $ 220,258 $ 941,548 The Company allocated the consideration paid to the net assets acquired based on their estimated acquisition date fair values. Based upon management’s evaluation, the consideration paid for all acquisitions during 2020 was allocated as follows during the year ended December 31, 2020 (in thousands): PCS Advanced Solara ActivStyle Pinnacle Other Total Cash $ 61 $ — $ 12,069 $ 4,993 $ 1,193 $ 2,911 $ 21,227 Accounts receivable 14,925 7 17,411 5,158 4,174 21,265 62,940 Inventory — 2,727 14,376 471 101 8,436 26,111 Prepaid and other current assets 943 127 2,113 955 612 4,810 9,560 Equipment and other fixed assets 535 19,783 3,473 992 — 20,886 45,669 Goodwill 988 41,712 347,718 49,643 107,706 184,252 732,019 Intangible assets — 600 85,700 9,400 15,200 11,200 122,100 Other assets — — — — 2,921 — 2,921 Deferred tax assets (liabilities) — 1,240 — (108) 1,132 Accounts payable and accrued expenses (2,025) (35) (22,464) (7,155) (5,777) (23,740) (61,196) Contract liabilities — (1,404) (167) — — (1,773) (3,344) Other liabilities (233) — (4,835) (185) (350) (5,675) (11,278) Other long-term liabilities (1,186) — — — (2,921) — (4,107) Finance lease obligations — — — — — (2,206) (2,206) Net assets acquired $ 14,008 $ 63,517 $ 455,394 $ 65,512 $ 122,859 $ 220,258 $ 941,548 Results of Businesses Acquired The following table presents the amount of Net revenue and Operating income in the period of acquisition since the respective acquisition dates for the acquisitions described above that is included in the Company’s consolidated statements of operations for the years ended December 31, 2022, 2021 and 2020: (in thousands) Year Ended December 31, 2022 2021 2020 Net revenue $ 16,455 $ 1,005,097 $ 427,352 Operating income $ 767 $ 136,404 $ 17,673

Equipment and Other Fixed Asset

Equipment and Other Fixed Assets	12 Months Ended
	Dec. 31, 2022
Property, Plant and Equipment [Abstract]
Equipment and Other Fixed Assets	Equipment and Other Fixed Assets Equipment and other fixed assets as of December 31, 2022 and 2021 are as follows (in thousands): December 31, December 31, Patient medical equipment $ 747,985 $ 533,760 Delivery vehicles 35,326 36,213 Other 86,956 50,208 870,267 620,181 Less accumulated depreciation (383,188) (221,604) $ 487,079 $ 398,577 For the years ended December 31, 2022, 2021 and 2020, the Company recorded depreciation expense of $311.2 million, $211.5 million and $76.4 million, respectively. During the years ended December 31, 2022, 2021 and 2020, the Company removed from service $275.1 million, $71.9 million and $62.6 million of fully depreciated patient medical equipment, respectively.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	12 Months Ended
	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Goodwill and Intangible Assets Goodwill is an asset representing the future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized. The change in the carrying amount of goodwill for the years ended December 31, 2022 and 2021 was as follows (in thousands): Gross carrying Balance at December 31, 2020 $ 998,810 Goodwill from acquisitions 2,536,566 Net cash receipts relating to prior acquisitions (657) Net reductions relating to measurement period adjustments (22,152) Balance at December 31, 2021 $ 3,512,567 Goodwill from acquisitions 12,341 Net cash payments relating to prior acquisitions 2,009 Net increase relating to measurement period adjustments 18,380 Balance at December 31, 2022 $ 3,545,297 Management is required to perform an assessment of the recoverability of goodwill on an annual basis and upon the identification of a triggering event. Triggering events potentially warranting an interim goodwill impairment assessment include, among other factors, declines in historical or projected revenue, operating results or cash flows, and declines in the Company’s stock price or market capitalization. While management cannot predict if or when future goodwill impairments may occur, a non-cash goodwill impairment charge could have a material adverse effect on the Company’s operating results, net assets and the Company’s cost of, or access to, capital. During the three months ended March 31, 2022, the Company experienced a decline in its market capitalization as a result of a decline in the Company’s stock price. The Company considered such decline to represent a triggering event requiring management to perform a quantitative goodwill impairment assessment as of March 31, 2022. Based on the results of the quantitative goodwill impairment assessment, it was concluded that the estimated fair value of the Company’s reporting unit was greater than its carrying value, as such, the Company did not record a goodwill impairment charge during the three months ended March 31, 2022. No such triggering events were identified during the remainder of 2022. The Company did not record a goodwill impairment charge during the years ended December 31, 2022, 2021 and 2020. If the Company were to experience a decline in its market capitalization for a sustained period of time, the Company may be required to perform a quantitative goodwill impairment assessment at an interim or annual period and could be required to recognize a non-cash goodwill impairment charge at that time, which could be material. As discussed in Note 3, Acquisitions , during 2022, the Company paid net cash of $2.0 million relating to working capital adjustments associated with businesses that were acquired during 2021 which were recorded as an increase to goodwill during the period . The net increase of $18.4 million during 2022 in the table above relates to measurement period adjustments attributed to businesses that were acquired by the Company during 2021, primarily related to the Community acquisition. Based on available information obtained by the Company during 2022, the Company recorded certain adjustments to the acquisition accounting for Community, resulting in a decrease to accounts receivable of $0.9 million, a decrease to equipment and other fixed assets of $10.0 million, an increase to other current liabilities of $7.3 million, and a decrease to accounts payable and accrued expenses of $2.2 million, with a corresponding increase to goodwill of $16.0 million. As discussed in Note 3, Acquisitions , during 2021, the Company received net cash of $0.7 million relating to working capital adjustments associated with businesses that were acquired during 2020 which were recorded as a decrease to goodwill during the period. The net reductions of $22.2 million during 2021 in the table above relates to measurement period adjustments attributed to businesses that were acquired by the Company during 2020, primarily related to the Solara acquisition. Based on available information obtained by the Company during 2021, the Company recorded certain adjustments to the acquisition accounting for Solara, resulting in an increase to accounts receivable of $28.9 million and an increase to accounts payable and accrued expenses of $6.3 million, with a corresponding decrease to goodwill of $22.6 million. Identifiable intangible assets that are separable and have determinable useful lives are valued separately and amortized over the period which reflects the pattern in which the economic benefits of the assets are expected to be consumed. Identifiable intangible assets consisted of the following at December 31, 2022 and 2021 (in thousands): December 31, 2022 Weighted-Average Tradenames, net of accumulated amortization of $25,498 $ 87,302 7.5 Payor contracts, net of accumulated amortization of $20,016 61,984 7.6 Contractual rental agreements, net of accumulated amortization of $43,863 10,337 0.8 Developed technology, net of accumulated amortization of $3,150 3,150 2.5 Identifiable intangible assets, net $ 162,773 December 31, 2021 Weighted-Average Tradenames, net of accumulated amortization of $12,705 $ 99,595 8.4 Payor contracts, net of accumulated amortization of $11,816 70,184 8.6 Contractual rental agreements, net of accumulated amortization of $26,158 28,042 1.8 Developed technology, net of accumulated amortization of $1,890 4,410 3.5 Identifiable intangible assets, net $ 202,231 Amortization expense related to identifiable intangible assets, which is included in Depreciation and amortization, excluding patient equipment depreciation, in the accompanying statements of operations, was $40.0 million, $46.5 million and $6.0 million for the years ended December 31, 2022, 2021 and 2020 respectively. Future amortization expense related to identifiable intangible assets is estimated to be as follows (in thousands): Twelve months ending December 31, 2023 $ 32,613 2024 22,276 2025 21,328 2026 19,263 2027 17,960 Thereafter 49,333 Total $ 162,773 The Company recorded no impairment charges related to identifiable intangible assets during the years ended December 31, 2022, 2021 and 2020.

Fair Value of Assets and Liabil

Fair Value of Assets and Liabilities	12 Months Ended
	Dec. 31, 2022
Fair Value Disclosures [Abstract]
Fair Value of Assets and Liabilities	Fair Value of Assets and Liabilities Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability (i.e. the exit price) in an orderly transaction between market participants at the measurement date. In determining fair value, the Company uses various valuation approaches, including quoted market prices and discounted cash flows. A hierarchy for inputs is used in measuring fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs by requiring that the most observable inputs be used when available. Observable inputs are inputs that market participants would use in pricing the asset or liability developed based on market data obtained from independent sources. Unobservable inputs are inputs that reflect a company’s judgment concerning the assumptions that market participants would use in pricing the asset or liability developed based on the best information available under the circumstances. The fair value hierarchy is broken down into three levels based on the reliability of inputs. To the extent that valuation is based on models or inputs that are less observable or unobservable in the market, the determination of fair value requires more judgment. Accordingly, the Company’s degree of judgment exercised in determining fair value is greatest for instruments categorized in Level 3. In certain cases, the inputs used to measure fair value may fall into different levels of the fair value hierarchy. In such cases an asset or liability is classified in its entirety based on the lowest level of input that is significant to the measurement of fair value. Fair value is a market-based measure considered from the perspective of a market participant who holds the asset or owes the liability rather than an entity-specific measure. Therefore, even when market assumptions are not readily available, the Company’s own assumptions are set to reflect those that market participants would use in pricing the asset or liability at the measurement date. The Company uses prices and inputs that are current as of the measurement date, including periods of market dislocation. In periods of market dislocation, the observability of prices and inputs may be reduced for many instruments. This condition in the future may cause the Company’s financial instruments to be reclassified from Level 1 to Level 2 or from Level 2 to Level 3. During the years ended December 31, 2022, 2021 and 2020, the Company did not have any reclassifications in levels. The following table presents the valuation of the Company’s financial assets and liabilities as of December 31, 2022 and 2021 measured at fair value on a recurring basis. The fair value estimates presented herein are based on information available to management as of December 31, 2022 and 2021. These estimates are not necessarily indicative of the amounts the Company could ultimately realize. (in thousands) Level 1 Level 2 Level 3 December 31, 2022 Assets Interest rate swap agreements-short term $ — $ 5,748 $ — Interest rate swap agreements-long term — 3,728 — Total assets measured at fair value $ — $ 9,476 $ — Liabilities Acquisition-related contingent consideration-short term $ — $ — $ 7,500 Warrant liability — — 38,503 Total liabilities measured at fair value $ — $ — $ 46,003 (in thousands) Level 1 Level 2 Level 3 December 31, 2021 Assets Money market accounts $ 14 $ — $ — Total assets measured at fair value $ 14 $ — $ — Liabilities Acquisition-related contingent consideration-short term $ — $ — $ 13,500 Acquisition-related contingent consideration-long term — — 6,800 Interest rate swap agreements-short term — 5,098 — Interest rate swap agreements-long term — 2,359 — Warrant liability — — 57,764 Total liabilities measured at fair value $ — $ 7,457 $ 78,064 Interest Rate Swaps The Company uses interest rate swap agreements to manage interest rate risk by converting a portion of its variable rate borrowings to a fixed rate and recognizes these derivative instruments as either assets or liabilities in the accompanying consolidated balance sheets at fair value. The valuation of these derivative instruments is determined using widely accepted valuation techniques, including discounted cash flow analysis on the expected cash flows of each derivative. This analysis reflects the contractual terms of the derivatives, including the period to maturity, and uses observable market-based inputs, including interest rate curves and implied volatilities. The fair value of the Company’s interest rate swaps are determined using the market standard methodology of netting the discounted future fixed cash payments and the discounted expected variable cash payments receipts. The variable cash receipts are based on an expectation of future interest rates (forward curves) derived from observable market interest rate curves. To comply with the provisions of FASB ASC Topic 820, Fair Value Measurement , the Company incorporates credit valuation adjustments to appropriately reflect both its own nonperformance risk and the respective counterparty’s nonperformance risk in the fair value measurements. In adjusting the fair value of its derivative contracts for the effect of nonperformance risk, the Company has considered the impact of netting and any applicable credit enhancements, such as collateral postings, thresholds, mutual puts and guarantees. Although the Company has determined that the majority of the inputs used to value its derivatives fall within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with the Company’s derivatives utilize Level 3 inputs, such as estimates of current credit spreads to evaluate the likelihood of default by the Company and the respective counterparties. The Company has determined that the significance of the impact of the credit valuation adjustments made to its derivative contracts, which determination was based on the fair value of each individual contract, was not significant to the overall valuation. As a result, all of the Company’s derivatives held as of December 31, 2022 and 2021 were classified as Level 2 of the fair value hierarchy. Refer to Note 7, Derivative Instruments and Hedging Activities , for additional information regarding the Company’s derivative instruments. Acquisition-Related Contingent Consideration The Company estimates the fair value of acquisition-related contingent consideration liabilities by applying the income approach using a probability-weighted discounted cash flow model. This fair value measurement is based on significant inputs not observed in the market and thus represents a Level 3 measurement. Level 3 instruments are valued based on unobservable inputs that are supported by little or no market activity and reflect the Company’s own assumptions in measuring fair value. Each period, the Company evaluates the fair value of acquisition-related contingent consideration obligations and records any changes in the fair value of such liabilities in Other income in the Company’s consolidated statements of operations. At December 31, 2022, contingent consideration liabilities of $7.5 million were included in Other current liabilities in the accompanying consolidated balance sheets. At December 31, 2021, contingent consideration liabilities of $13.5 million and $6.8 million were included in Other liabilities and Other long-term liabilities, respectively, in the accompanying consolidated balance sheets. A reconciliation of the Company’s contingent consideration liabilities related to acquisitions for the years ended December 31, 2022 and 2021 is as follows (in thousands): Year Ended December 31 2022 Beginning Balance Additions Payments Change in Fair Value Other activity Ending Balance Contingent consideration - Level 3 liabilities $ 20,300 $ — $ (15,015) $ 2,215 $ — $ 7,500 Year Ended December 31 2021 Beginning Balance Additions Payments Change in Fair Value Other activity Ending Balance Contingent consideration - Level 3 liabilities $ 33,540 $ 7,800 $ (20,347) $ (866) $ 173 $ 20,300 Warrant Liability The warrant liability represents the estimated fair value of the Company’s outstanding private warrants. The fair value of the private warrants was estimated using the Black-Scholes option pricing model. Refer to Note 11, Stockholders’ Equity , for additional discussion of the warrant liability. Non-Financial Assets Measured at Fair Value on a Non-Recurring Basis The following table presents the Company’s hierarchy for non-financial assets measured at fair value on a non-recurring basis (in thousands): December 31, December 31, Assets: Goodwill (Level 3) $ 3,545,297 $ 3,512,567 Identifiable intangible assets, net (Level 3) $ 162,773 $ 202,231 The fair value allocation related to the Company’s acquisitions are determined using a discounted cash flow approach, or a replacement cost approach, which are based on significant unobservable inputs (Level 3). These valuation methods required management to make various assumptions, including, but not limited to, future profitability, cash flows, replacement costs, and discount rates. The Company’s estimates are based upon historical trends, management’s knowledge and experience and overall economic factors, including projections of future earnings potential. Developing discounted future cash flows in applying the income approach requires the Company to evaluate its intermediate to longer-term strategies, including, but not limited to, estimates of revenue growth, operating margins, capital requirements, inflation and working capital management. The development of appropriate rates to discount the estimated future cash flows requires the selection of risk premiums, which can materially impact the present value of future cash flows. The Company estimated the fair value of acquired identifiable intangible assets using discounted cash flow techniques that included an estimate of future cash flows, consistent with overall cash flow projections used to determine the purchase price paid to acquire the business, discounted at a rate of return that reflects the relative risk of the cash flows. The Company estimated the fair value of certain acquired identifiable intangible assets based on the cost approach using estimated costs consistent with historical experience. The Company believes the estimates and assumptions used in the valuation methods are reasonable.

Derivative Instruments and Hedg

Derivative Instruments and Hedging Activities	12 Months Ended
	Dec. 31, 2022
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Instruments and Hedging Activities	Derivative Instruments and Hedging Activities FASB ASC Topic 815, Derivatives and Hedging (ASC 815), provides the disclosure requirements for derivatives and hedging activities with the intent to provide users of financial statements with an enhanced understanding of: (a) how and why an entity uses derivative instruments, (b) how the entity accounts for derivative instruments and related hedged items, and (c) how derivative instruments and related hedged items affect an entity’s financial position, financial performance, and cash flows. Further, qualitative disclosures are required that explain the Company’s objectives and strategies for using derivatives, as well as quantitative disclosures about the fair value of and gains and losses on derivative instruments, and disclosures about credit-risk-related contingent features in derivative instruments. As discussed in Note 6, Fair Value of Assets and Liabilities , and as required by ASC 815, the Company records all derivatives on its consolidated balance sheet at fair value. The accounting for changes in the fair value of derivatives depends on the intended use of the derivative, whether the Company has elected to designate a derivative in a hedging relationship and apply hedge accounting and whether the hedging relationship has satisfied the criteria necessary to apply hedge accounting. Derivatives designated and qualifying as a hedge of the exposure to variability in expected future cash flows, or other types of forecasted transactions, are considered cash flow hedges. Hedge accounting generally provides for the matching of the timing of gain or loss recognition on the hedging instrument with the recognition of the earnings effect of the hedged forecasted transactions in a cash flow hedge. The Company is exposed to certain risk arising from economic conditions. The Company principally manages its exposures to interest rate risk through the use of derivative financial instruments. Specifically, the Company enters into derivative financial instruments to manage differences in the amount, timing and duration of the Company’s known or expected cash payments principally related to the Company’s variable rate borrowings. The Company’s objectives in using interest rate derivatives are to add stability to interest expense and to manage its exposure to interest rate movements. To accomplish this objective, the Company primarily uses interest rate swaps as part of its interest rate risk management strategy. Interest rate swaps designated as cash flow hedges involve the receipt of variable amounts from a counterparty in exchange for the Company making fixed-rate payments over the life of the agreements without exchange of the underlying notional amount. For derivatives designated and that qualify as cash flow hedges of interest rate risk, the gain or loss on the derivative is recorded in accumulated other comprehensive income and subsequently reclassified into interest expense in the same period during which the hedged transaction affects earnings. Amounts reported in accumulated other comprehensive income related to derivatives will be reclassified to interest expense as interest payments are made on the Company’s variable-rate debt. In the twelve months subsequent to December 31, 2022, the Company estimates that an additional $7.6 million will be reclassified as a reduction to interest expense. As of December 31, 2022 and 2021, the Company had outstanding interest rate derivatives with third parties in which the Company pays a fixed interest rate and receives a rate equal to the one-month LIBOR. The notional amount associated with interest rate swap agreements that were outstanding as of December 31, 2022 and 2021 was $250 million and have maturity dates in February 2023 and March 2024. In April 2022, the Company entered into additional forward-dated interest rate swap agreements with third parties in which the Company will pay a fixed interest rate and receive a rate equal to the one month-LIBOR. The purpose of these forward-dated interest rate swap agreements is to ensure that the Company operates within its derivatives policy by maintaining a total notional amount of $250 million under the Company’s outstanding interest rate swap agreements through the maturity date of the Company’s current credit agreement. A portion of the forward-dated interest rate swap agreements became effective on February 16, 2023 and a portion will become effective in March 2024. The forward-dated interest rate swap agreements will mature in January 2026. The Company has designated its swaps as effective cash flow hedges of interest rate risk. Accordingly, changes in the fair value of the interest rate swaps are recorded as a component of accumulated other comprehensive income within stockholders’ equity and subsequently reclassified into interest expense in the same period during which the hedged transaction affects earnings. The table below presents the fair value of the Company’s derivatives related to its interest rate swap agreements, which are designated as hedging instruments, as well as their classification in the consolidated balance sheets at December 31, 2022 and 2021 (in thousands): December 31, 2022 December 31, 2021 Balance Sheet Location Asset (Liability) Prepaid and other current assets $ 5,748 $ — Other assets 3,728 — Other liabilities — (5,098) Other long-term liabilities — (2,359) Total $ 9,476 $ (7,457) During the year ended December 31, 2022, as a result of the effect of cash flow hedge accounting, the Company recognized a gain, net of tax, of $14.0 million in Other comprehensive income (loss)

Deferred Financing Costs

Deferred Financing Costs	12 Months Ended
	Dec. 31, 2022
Debt Issuance Costs, Net [Abstract]
Deferred Financing Costs	Deferred Financing Costs The change in the carrying amount of deferred financing costs for the years ended December 31, 2022 and 2021 was as follows (in thousands): Year Ended December 31, 2022 2021 Balance at beginning of period $ 33,463 $ 13,710 Capitalized fees — 29,185 Amortization (5,234) (5,378) Write-off due to debt refinancing — (4,054) Balance at end of period $ 28,229 $ 33,463 Amortization expense relating to deferred financing costs was $5.2 million, $5.4 million and $1.9 million during the years ended December 31, 2022, 2021 and 2020, respectively, and is included in Interest expense, net in the accompanying consolidated statements of operations. The write-off of deferred financing costs is included in Loss on extinguishment of debt in the accompanying consolidated statements of operations for the year ended December 31, 2021. The December 31, 2022 balance of deferred financing costs of $28.2 million is estimated to be amortized to interest expense, net as follows (in thousands): 2023 $ 5,234 2024 5,234 2025 5,147 2026 3,659 2027 3,577 Thereafter 5,378 $ 28,229

Accounts Payable and Accrued Ex

Accounts Payable and Accrued Expenses	12 Months Ended
	Dec. 31, 2022
Accounts Payable and Accrued Liabilities, Current [Abstract]
Accounts Payable and Accrued Expenses	Accounts Payable and Accrued Expenses Accounts payable and accrued expenses as of December 31, 2022 and 2021 consisted of the following (in thousands): December 31, December 31, Accounts payable $ 222,505 $ 248,027 Employee-related accruals 41,872 34,370 Accrued interest 28,877 30,103 Other 44,244 45,884 Total $ 337,498 $ 358,384

Debt

Debt	12 Months Ended
	Dec. 31, 2022
Debt Disclosure [Abstract]
Debt	Debt The following is a summary of long-term debt as of December 31, 2022 and 2021 (in thousands): December 31, December 31, Secured term loan $ 765,000 $ 785,000 Senior unsecured notes 1,450,000 1,450,000 Unamortized deferred financing fees (26,733) (31,448) 2,188,267 2,203,552 Current portion (35,000) (20,000) Long-term portion $ 2,153,267 $ 2,183,552 Interest expense related to long-term debt agreements, including amortization of deferred financing costs and payments made or received under the Company’s interest rate swap agreements, for the years ended December 31, 2022, 2021 and 2020 was $112.4 million, $97.9 million and $42.0 million, respectively. On January 20, 2021, the Company refinanced its then existing debt borrowings and entered into a new credit agreement with its existing bank group, which was amended in April 2021 (the 2021 Credit Agreement). The 2021 Credit Agreement included borrowings of $800 million under a secured term loan (the 2021 Term Loan), and $450 million in commitments for revolving credit loans (the 2021 Revolver). The 2021 Revolver has a $55 million letter of credit sublimit. The 2021 Term Loan and the 2021 Revolver both have maturities in January 2026. Borrowings under the 2021 Term Loan were used in part to partially finance the cash portion of the purchase price for the acquisition of AeroCare, to repay amounts outstanding under the Company’s then existing credit agreement of $301.9 million plus accrued interest, to repay amounts outstanding under revolving credit loans under the 2021 Credit Agreement which were borrowed prior to the April 2021 amendment, and to pay related fees and expenses. Amounts borrowed under the 2021 Credit Agreement bear interest quarterly at variable rates based upon the sum of (a) the Adjusted LIBOR Rate (subject to a zero percent floor) equal to the LIBOR (as defined) for the applicable interest period multiplied by the statutory reserve rate, plus (b) an applicable margin (as defined) ranging from 1.50% to 3.25% per annum based on the Consolidated Senior Secured Leverage Ratio (as defined). The 2021 Revolver carries a commitment fee during the term of the 2021 Credit Agreement ranging from 0.25% to 0.50% per annum of the average daily undrawn portion of the 2021 Revolver based on the Consolidated Senior Secured Leverage Ratio. On August 16, 2021, the Company amended the 2021 Credit Agreement to expressly permit the issuance of the 5.125% Senior Notes (see discussion below) and the prepayment of the outstanding principal amount under a then existing promissory note with the proceeds of the 5.125% Senior Notes. In connection with the 2021 Credit Agreement, the Company paid financing costs of $7.6 million. Further, in connection with executing the 2021 Credit Agreement, the Company recognized a loss on debt extinguishment of $2.1 million consisting of the write off of unamortized deferred financing costs related to the Company’s then existing credit agreement and other lender fees, which is included in Loss on extinguishment of debt in the accompanying consolidated statements of operations for the year ended December 31, 2021. Under the 2021 Credit Agreement, the Company is subject to a number of restrictive covenants that, among other things, impose operating and financial restrictions on the Company. Financial covenants include a Consolidated Total Leverage Ratio and a Consolidated Interest Coverage Ratio, both as defined in the 2021 Credit Agreement. The 2021 Credit Agreement also contains certain customary events of default, including, among other things, failure to make payments when due thereunder, failure to observe or perform certain covenants, cross-defaults, bankruptcy and insolvency-related events, and non-compliance with healthcare laws. Any borrowing under the 2021 Credit Agreement may be repaid, in whole or in part, at any time and from time to time without premium or penalty, other than customary breakage costs, and any amounts repaid under the 2021 Revolver may be reborrowed. Mandatory prepayments are required under the 2021 Revolver when borrowings and letter of credit usage exceed the total commitments for revolving credit loans. Mandatory prepayments are also required in connection with the disposition of assets to the extent not reinvested, unpermitted debt transactions, and excess cash flow, as defined, if certain leverage tests are not met. The Company was in compliance with all debt covenants as of December 31, 2022. In July 2020, the Company refinanced its then existing debt borrowings and entered into a new credit agreement with a new bank group (the 2020 Credit Agreement). The 2020 Credit Agreement consisted of a $250 million term loan (the 2020 Term Loan) and $200 million in commitments for revolving credit loans (the 2020 Revolver). The borrowings under the 2020 Term Loan bore interest quarterly at variable rates based upon the sum of (a) the Adjusted LIBOR Rate (subject to a floor) equal to the LIBOR (as defined in the 2020 Credit Agreement) for the applicable interest period, plus (b) an applicable margin ranging from 2.50% to 3.75% per annum based on the Consolidated Total Leverage Ratio (as defined in the 2020 Credit Agreement). The 2020 Revolver carried a commitment fee during the term of the 2020 Credit Agreement ranging from 0.25% to 0.50% per annum of the average daily undrawn portion of the 2020 Revolver based on the Consolidated Total Leverage Ratio. In connection with the 2020 Credit Agreement, the Company paid financing costs of $2.7 million. As discussed above, in January 2021, the Company refinanced its debt borrowings under the 2020 Credit Agreement. A portion of the net proceeds from such refinancing was used to repay existing amounts outstanding under the 2020 Credit Agreement of $301.9 million plus accrued interest. Further, in connection with executing the 2020 Credit Agreement, the Company wrote off unamortized deferred financing costs of $5.3 million, which is included in Loss on extinguishment of debt in the accompanying consolidated statements of operations for the year ended December 31, 2020. Secured Term Loan The borrowings under the 2021 Term Loan require quarterly principal repayments of $5.0 million during June 30, 2021 through March 31, 2023, increasing to $10.0 million beginning June 30, 2023 through December 31, 2025, and the unpaid principal balance is due at maturity in January 2026. At December 31, 2022 and 2021, there was $765.0 million and $785.0 million, respectively, outstanding under the 2021 Term Loan. The interest rate under the 2021 Term Loan was 6.13% at December 31, 2022. Revolving Credit Facility During the year ended December 31, 2022, the Company had no borrowings under the 2021 Revolver, and there was $0 outstanding under the 2021 Revolver at December 31, 2022. Subsequent to December 31, 2022, the Company borrowed $25.0 million under the 2021 Revolver. During the year ended December 31, 2021, the Company borrowed $365.0 million under the 2021 Revolver, which was repaid in full during 2021. Borrowings under the 2021 Revolver may be used for working capital and other general corporate purposes, including for capital expenditures and acquisitions permitted under the 2021 Credit Agreement. At December 31, 2022, after consideration of stand-by letters of credit outstanding of $17.4 million, the remaining maximum borrowings available pursuant to the 2021 Revolver was $432.6 million. Senior Unsecured Notes On August 19, 2021, the Company issued $600.0 million aggregate principal amount of 5.125% senior unsecured notes (the 5.125% Senior Notes). The 5.125% Senior Notes will mature on March 1, 2030. Interest on the 5.125% Senior Notes is payable on March 1st and September 1st of each year, beginning on March 1, 2022. The 5.125% Senior Notes will be redeemable at the Company’s option, in whole or in part, at any time on or after March 1, 2025, and the redemption price for the 5.125% Senior Notes if redeemed during the 12 months beginning (i) March 1, 2025 is 102.563%, (ii) March 1, 2026 is 101.281%, (iii) March 1, 2027 and thereafter is 100.000%, in each case together with accrued and unpaid interest. The Company may also redeem some or all of the 5.125% Senior Notes before March 1, 2025 at a redemption price of 100% of the principal amount of the 5.125% Senior Notes, plus a “make-whole” premium, together with accrued and unpaid interest. In addition, the Company may redeem up to 40% of the original aggregate principal amount of the 5.125% Senior Notes before March 1, 2025 with the proceeds from certain equity offerings at a redemption price equal to 105.125% of the principal amount of the 5.125% Senior Notes, together with accrued and unpaid interest. Furthermore, the Company may be required to make an offer to purchase the 5.125% Senior Notes upon the sale of certain assets or upon specific kinds of changes of control. Borrowings under the 5.125% Senior Notes were used to repay existing amounts outstanding under the 2021 Revolver, to prepay the outstanding principal amount under a then existing promissory note (see discussion below), and to pay related fees and expenses. In connection with the issuance of the 5.125% Senior Notes, the Company paid financing costs of $11.1 million. On January 4, 2021, the Company issued $500.0 million aggregate principal amount of 4.625% senior unsecured notes (the 4.625% Senior Notes). The 4.625% Senior Notes will mature on August 1, 2029. Interest on the 4.625% Senior Notes is payable on February 1st and August 1st of each year, beginning on August 1, 2021. The 4.625% Senior Notes will be redeemable at the Company’s option, in whole or in part, at any time on or after February 1, 2024, and the redemption price for the 4.625% Senior Notes if redeemed during the 12 months beginning (i) February 1, 2024 is 102.313%, (ii) February 1, 2025 is 101.156%, (iii) February 1, 2026 and thereafter is 100.000%, in each case together with accrued and unpaid interest. The Company may also redeem some or all of the 4.625% Senior Notes before February 1, 2024 at a redemption price of 100% of the principal amount of the 4.625% Senior Notes, plus a “make-whole” premium, together with accrued and unpaid interest. In addition, the Company may redeem up to 40% of the original aggregate principal amount of the 4.625% Senior Notes before February 1, 2024 with the proceeds from certain equity offerings at a redemption price equal to 104.625% of the principal amount of the 4.625% Senior Notes, together with accrued and unpaid interest. Furthermore, the Company may be required to make an offer to purchase the 4.625% Senior Notes upon the sale of certain assets or upon specific kinds of changes of control. Borrowings under the 4.625% Senior Notes were used to partially finance the cash portion of the purchase price for the acquisition of AeroCare, and to pay related fees and expenses. In connection with the issuance of the 4.625% Senior Notes, the Company paid financing costs of $10.4 million. On July 29, 2020, the Company issued $350.0 million aggregate principal amount of 6.125% senior unsecured notes (the 6.125% Senior Notes). The 6.125% Senior Notes will mature on August 1, 2028. Interest on the 6.125% Senior Notes is payable on February 1st and August 1st of each year, beginning on February 1, 2021. The 6.125% Senior Notes will be redeemable at the Company’s option, in whole or in part, at any time on or after August 1, 2023, and the redemption price for the 6.125% Senior Notes if redeemed during the 12 months beginning (i) August 1, 2023 is 103.063%, (ii) August 1, 2024 is 102.042%, (iii) August 1, 2025 is 101.021% and (iv) August 1, 2026 and thereafter is 100.000%, in each case together with accrued and unpaid interest. The Company may also redeem some or all of the 6.125% Senior Notes before August 1, 2023 at a redemption price of 100% of the principal amount of the 6.125% Senior Notes , plus a “make-whole” premium, together with accrued and unpaid interest. In addition, the Company may redeem up to 40% of the original aggregate principal amount of the 6.125% Senior Notes before August 1, 2023 with the proceeds from certain equity offerings at a redemption price equal to 106.125% of the principal amount of the 6.125% Senior Notes, together with accrued and unpaid interest. Furthermore, the Company may be required to make an offer to purchase the 6.125% Senior Notes upon the sale of certain assets or upon specific kinds of changes of control. Borrowings under the 6.125% Senior Notes were used to partially finance the cash portion of the purchase price for an acquisition and to pay related fees and expenses. In connection with the 6.125% Senior Notes, the Company paid financing costs of $8.4 million. Note Payable In March 2019, the Company entered into a Note and Unit Purchase Agreement with an investor. Pursuant to the agreement, the Company issued a promissory note with a principal amount of $100 million (the Promissory Note). In November 2019, the Promissory Note was replaced with a new amended and restated promissory note with a principal amount of $100 million, and the investor converted certain of its members’ interests to a $43.5 million promissory note. The new $100 million promissory note, together with the $43.5 million promissory note, are collectively referred to herein as the New Promissory Note. During the year ended December 31, 2021, the Company repaid the outstanding principal balance of $143.5 million under the New Promissory Note. In connection with such repayment, the Company paid debt prepayment penalties of $16.2 million, reflecting the previously disclosed 10% prepayment penalty plus an incremental amount negotiated as part of the repayment transactions. In addition, the Company wrote off $2.0 million of unamortized deferred financing costs. The prepayment penalties and the write-off of the unamortized deferred financing costs are included in Loss on extinguishment of debt in the accompanying consolidated statements of operations for the year ended December 31, 2021. The outstanding principal balance under the New Promissory Note bore interest at a rate of 12%. In May 2020, the Company and the investor entered into a Put/Call Option and Consent Agreement (the Put/Call Agreement), pursuant to which certain put and call rights were granted to the parties with respect to shares of Class A Common Stock, shares of Class B Common Stock, and common units of AdaptHealth Holdings (each such common unit, together with one share of Class B Common Stock, a Consideration Unit) held by the investor at the time. Pursuant to the Put/Call Agreement, which was amended in October 2020, during the period from July 1, 2020 to December 31, 2020 (the Option Period), the investor could require the Company to purchase up to 1,898,967 shares of Class A Common Stock and/or Consideration Units held by the investor (such shares of Class A Common Stock and Consideration Units, collectively, Interests) at a price per share of Class A Common Stock or per Consideration Unit equal to the greater of (x) $14.50 and (y) 85% of the 30-day volume-weighted average price per share of the Company’s Class A Common Stock on the date the exercise notice is delivered. During the Option Period, the Company could also require the investor to sell up to 1,898,967 of the Interests held by the investor to the Company at a price per share of Class A Common Stock or per Consideration Unit of $15.76. In addition, under the Put/Call Agreement, the investor waived certain consent rights under the New Promissory Note. In connection with the accounting for the Put/Call Agreement, during the year ended December 31, 2020, the Company recorded a decrease to Additional paid-in capital of $29.9 million, representing the settlement amount of the related call option, and classified such amount as mezzanine equity. In addition, during the year ended December 31, 2020, the Company recorded a decrease to Additional paid-in capital and accumulated deficit of $2.7 million, representing the estimated net fair value of the related call and put option. In December 2020, the Company exercised its call option and purchased 1,898,967 shares of Class A Common Stock from the investor for $29.9 million, which was recorded as a decrease to Additional paid-in capital during the year ended December 31, 2020. The future maturity of total debt, excluding unamortized deferred financing fees, at December 31, 2022 is as follows (in thousands). Twelve months ended December 31, 2023 $ 35,000 2024 40,000 2025 40,000 2026 650,000 2027 — Thereafter 1,450,000 Total debt maturity $ 2,215,000

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2022
Equity [Abstract]
Stockholders' Equity	Stockholders' Equity AdaptHealth, f/k/a DFB Healthcare Acquisitions Corp. (DFB), was originally formed in November 2017 as a publicly traded special purpose acquisition company for the purpose of effecting a merger, capital stock exchange, asset acquisition, stock purchase, reorganization, or similar business combination involving one or more businesses. On July 8, 2019, AdaptHealth Holdings LLC (AdaptHealth Holdings) entered into an Agreement and Plan of Merger (the Merger Agreement), as amended on October 15, 2019, with DFB, pursuant to which AdaptHealth Holdings combined with DFB (the Business Combination). The Business Combination closed on November 8, 2019. In connection with the Business Combination, the name of the combined company was changed to AdaptHealth Corp. Following the closing of the Business Combination, AdaptHealth Corp. owned 56% of the combined company with the remaining 44% owned by the former owners of AdaptHealth Holdings in the form of common units representing limited liability company interests in AdaptHealth Holdings from and after the closing of the Business Combination (New AdaptHealth Units). The former owners of AdaptHealth Holdings held New AdaptHealth Units and a corresponding number of non-economic Class B Common stock, which enabled the holder to one vote per share, and were exchangeable on a one-to-one basis for shares of Class A Common Stock. Subsequent to the Business Combination, all of the common unit interests of AdaptHealth Holdings and a corresponding number of shares of Class B Common Stock were exchanged for shares of Class A Common Stock, of which the final 13,218,758 of the exchanges occurred on January 1, 2021. As a result, the prior holders of the common unit interests of AdaptHealth Holdings no longer own a direct noncontrolling economic interest in AdaptHealth Holdings. In connection with the January 2021 exchanges, the Company recorded a decrease to the Noncontrolling interest in subsidiaries of $77.9 million in the accompanying consolidated statements of stockholders’ equity (deficit). The Company filed its Third Amended and Restated Certificate of Incorporation (the Certificate of Incorporation) on July 28, 2021. Among other things, the Certificate of Incorporation (x) increased the authorized number of shares of Common Stock from 245,000,000 shares of Common Stock to 300,000,000 shares of Common Stock and (y) (i) deleted provisions no longer applicable following the exchange of all outstanding New AdaptHealth Units and shares of Class B Common Stock for shares of Class A Common Stock and (ii) renamed the Company’s Class A Common Stock to Common Stock. Holders of Common Stock are entitled to one vote for each share. The shares of Preferred Stock (see below) shall be issued with such designations, voting and other rights and preferences as may be determined from time to time by the Company’s board of directors. Common Stock In January 2021, the Company issued 8,450,000 shares of Class A Common Stock at a price of $33.00 per share pursuant to an underwritten public offering (the 2021 Stock Offering) for gross proceeds of $278.9 million. In connection with 2021 Stock Offering, the Company received proceeds of $265.0 million which is net of the underwriting discount. A portion of the proceeds from the 2021 Stock Offering were used to partially finance the cash portion of the purchase price for the acquisition of AeroCare, and to pay related fees and expenses. In connection with the 2021 Stock Offering, the Company paid offering costs, inclusive of the underwriting discount, of $13.8 million. In July 2020, the Company received gross proceeds of $190.0 million in connection with the sale of 10,930,471 shares of Class A Common Stock and 39,706 shares of Series A Preferred Stock pursuant to a private placement transaction. In addition, in July 2020, the Company received gross proceeds of $35.0 million in connection with the sale of 35,000 shares of Series B-2 Preferred Stock pursuant to a private placement transaction. The proceeds from these transactions were used to partially fund an acquisition. In connection with these transactions, the Company paid offering costs of $1.6 million. In September 2020, the 39,706 shares of Series A Preferred Stock were converted into 2,887,709 shares of Class A Common Stock. In addition, in September 2020, the 35,000 shares of Series B-2 Preferred Stock were converted into 25,454.55 shares of Series B-1 Preferred Stock (see below for a discussion of the Company’s outstanding Series B-1 Preferred Stock). In July 2020, the Company issued 9,200,000 shares of Class A Common Stock at a price of $15.50 per share pursuant to an underwritten public offering and received gross proceeds of $142.6 million. In connection with this transaction, the Company paid offering costs, inclusive of the underwriting discount, of $10.1 million. Preferred Stock In June 2020, the Company entered into an exchange agreement (the Exchange Agreement) with an investor pursuant to which the investor exchanged 15,810,547 shares of the Company’s Class A Common Stock for 158,105.47 shares of Series B-1 Preferred Stock, par value $0.0001 per share. The Series B-1 Preferred Stock liquidation preference is limited to its par value of $0.0001 per share. The Series B-1 Preferred Stock will participate equally and ratably on an as-converted basis with the holders of Common Stock in all cash dividends paid on the Common Stock. The Series B-1 Preferred Stock is non-voting. The holder may convert each share of Series B-1 Preferred Stock into 100 shares of Common Stock (subject to certain anti-dilution adjustments) at its election, except to the extent that following such conversion, the number of shares of Common Stock held by such holder and its affiliates exceed 4.9% of the outstanding Common Stock of the Company. During the years ended December 31, 2021 and 2020, 39,500 and 20,000 shares of Series B-1 Preferred Stock were converted into 3,950,000 and 2,000,000 shares of Common Stock, respectively. There were no such conversions during the year ended December 31, 2022. As discussed in Note 3, Acquisitions , the Company issued 130,474.73 shares of Series C Convertible Preferred Stock in connection with the acquisition of AeroCare. The Series C Convertible Preferred Stock liquidation preference was limited to its par value of $0.0001 per share. The Series C Convertible Preferred Stock participated equally and ratably on an as-converted basis with the holders of Common Stock in all potential cash dividends paid on the Common Stock. The Series C Convertible Preferred Stock was non-voting. On March 3, 2021, the Company’s stockholders approved, for purposes of complying with Nasdaq Listing Rule 5635, the issuance of shares of the Company’s Common Stock, representing equal to or greater than 20% of the outstanding common stock or voting power of the Company issuable upon conversion of the Series C Convertible Preferred Stock issued to the former equity holders of AeroCare, by removal of the conversion restriction that prohibits such conversion of Series C Convertible Preferred Stock. Following the receipt of the approval of the Company’s stockholders, the holders were able to elect to convert, and the Company was able to elect to effect a mandatory conversion of, each share of Series C Convertible Preferred Stock into 100 shares of Common Stock (subject to certain anti-dilution adjustments). The Company elected to effect a mandatory conversion of the Series C Convertible Preferred Stock, and the conversion of 130,474.73 shares of Series C Convertible Preferred Stock to 13,047,473 shares of Common Stock occurred on March 18, 2021. Treasury Stock The Company's board of directors authorized a share repurchase program for up to $200 million of the Company's Common Stock through December 31, 2023 (the Share Repurchase Program). The timing and actual number of shares to be repurchased will depend upon market conditions and other factors. Shares of the Company's Common Stock may be purchased from time to time on the open market, through privately negotiated transactions or otherwise. Purchases of the Company's Common Stock may be started or stopped at any time without prior notice depending on market conditions and other factors. During the year ended December 31, 2022, the Company purchased 750,835 shares of the Company's Common Stock for $14.0 million under the Share Repurchase Program, which is reflected in Treasury Stock in the accompanying consolidated statements of stockholders' equity (deficit). Warrants At the closing of the Business Combination, the Company had 12,666,666 warrants outstanding. Each warrant is exercisable into one share of Common Stock at a price of $11.50 per share. The exercise price and number of shares of Common Stock issuable upon exercise of the warrants may be adjusted in certain circumstances including in the event of a share dividend, or recapitalization, reorganization, merger or consolidation. However, the warrants will not be adjusted for the issuance of common stock at a price below its exercise price. During the year ended December 31, 2022, 184,870 warrants were exercised in cashless transactions resulting in the issuance of 87,553 shares of Common Stock. During the year ended December 31, 2021, 224,121 warrants were exercised in a cashless transaction resulting in the issuance of 118,379 shares of Common Stock. During the year ended December 31, 2020, 6,254,803 warrants were exercised in cashless transactions resulting in the issuance of 1,973,707 shares of Common Stock, which included the redemption of Public Warrants (see below). In addition, during the year ended December 31, 2020, 2,131,315 warrants were exercised for cash proceeds of $24.5 million, resulting in the issuance of 2,131,315 shares of Common Stock. As of December 31, 2022, the Company had 3,871,557 warrants outstanding, which have an expiration date of November 20, 2024. The Company classifies its warrants as a liability in its consolidated balance sheets because of certain terms included in the corresponding warrant agreement. The estimated fair value of the warrants is recorded as a liability, with such fair value reclassified to stockholders’ equity upon the exercise of such warrants. Prior to exercise, the change in the estimated fair value of such warrants each period is recognized as a non-cash charge or gain in the Company’s consolidated statements of operations. A reconciliation of the changes in the warrant liability during the years ended December 31, 2022, 2021 and 2020 was as follows (in thousands): Estimated fair value of warrant liability at December 31, 2019 $ 27,635 Change in estimated fair value of the warrant liability 135,368 Reclassification of warrant liability to equity for exercised warrants (49,098) Estimated fair value of warrant liability at December 31, 2020 113,905 Change in estimated fair value of the warrant liability (53,181) Reclassification of warrant liability to equity for exercised warrants (2,960) Estimated fair value of warrant liability at December 31, 2021 57,764 Change in estimated fair value of the warrant liability (17,158) Reclassification of warrant liability to equity for exercised warrants (2,103) Estimated fair value of warrant liability at December 31, 2022 $ 38,503 Redemption of Public Warrants On August 4, 2020, the Company announced its intention to redeem all of its outstanding public warrants (the Public Warrants) to purchase shares of the Company’s Class A Common Stock, that were issued under the Warrant Agreement, dated February 15, 2018 (the Warrant Agreement), by and between the Company and Continental Stock Transfer & Trust Company, as warrant agent (the Warrant Agent), as part of the units sold in the Company’s initial public offering (the IPO), for a redemption price of $0.01 per Public Warrant (the Redemption Price), that remained outstanding on September 2, 2020 (the Redemption Date). Warrants to purchase common stock that were issued under the Warrant Agreement in a private placement simultaneously with the IPO and still held by the initial holders thereof or their permitted transferees were not subject to this redemption. Under the terms of the Warrant Agreement, the Company was entitled to redeem all of the outstanding Public Warrants if the last sales price of the Company’s Class A Common Stock was at least $18.00 per share on each of twenty trading days within any thirty In addition, in accordance with the Warrant Agreement, the Company elected to require that, upon delivery of the notice of redemption, all Public Warrants were to be exercised only on a “cashless basis.” Accordingly, holders were no longer able to exercise Public Warrants and receive common stock in exchange for payment in cash of the $11.50 per warrant exercise price. Instead, a holder exercising a Public Warrant was deemed to pay the $11.50 per warrant exercise price by the surrender of 0.6144 of a share of common stock (such fraction determined as described below) that such holder would have been entitled to receive upon a cash exercise of a Public Warrant. Accordingly, by virtue of the cashless exercise of the Public Warrants, exercising warrant holders received 0.3856 of a share of common Stock for each Public Warrant surrendered for exercise. Any Public Warrants that remained unexercised on the Redemption Date were voided and no longer exercisable, and the holders will have no rights with respect to those Public Warrants, except to receive the Redemption Price. The number of shares of Class A Common Stock that each exercising warrant holder received by virtue of the cashless exercise (instead of paying the $11.50 per Public Warrant cash exercise price) was calculated in accordance with the terms of the Warrant Agreement and was equal to the quotient obtained by dividing (x) the product of the number of shares underlying the Public Warrants held by such warrant holder, multiplied by the difference between $18.7175, the average last sale price of the Company’s Class A Common Stock for the ten receive was rounded down to the nearest whole number of shares. During the year ended December 31, 2020, 2,285,410 Public Warrants were redeemed resulting in the issuance of 881,239 shares of Class A Common Stock. As a result of these transactions, there are no Public Warrants outstanding. Contingent Consideration Common Shares Pursuant to the Merger Agreement, the former owners of AdaptHealth Holdings who received Class A Common Stock and Class B Common Stock in connection with the Business Combination were entitled to receive earn-out consideration to be paid in the form of Common Stock, if the average price of the Company’s Common Stock for the month of December prior to each measurement date equaled or exceeded certain hurdles set forth in the Merger Agreement (Contingent Consideration Common Shares). The former owners of AdaptHealth Holdings were entitled to receive 1,000,000 shares of Common Stock on each of December 31, 2022, 2021, and 2020 based on an average stock price hurdle of $22, $18 and $15, respectively, during the applicable measurement period. The average stock price hurdle was achieved for the applicable measurement periods as of the December 31, 2021 and 2020 measurement dates, which triggered the issuance of 1,000,000 shares of Common Stock on such dates. The average stock price hurdle was not achieved for the applicable measurement period as of the December 31, 2022 measurement date; as such no shares of Common Stock were issued on such date. The Contingent Consideration Common Shares would have been issued immediately in the event of a change of control as defined in the Merger Agreement. The estimated fair value of the Contingent Consideration Common Shares was recorded as a liability in the Company’s consolidated balance sheets, with such fair value reclassified to stockholders’ equity upon the issuance of any shares that were earned. Prior to issuance, the change in the estimated fair value of such shares each period was recognized as a non-cash charge or gain in the Company’s consolidated statements of operations. The Company estimated the fair value of the contingent consideration common shares liability using a Monte-Carlo simulation analysis. A Monte-Carlo simulation is a tool used to project asset prices based on a widely accepted drift calculation, the volatility of the asset, incremental time-steps and a random component known as a Weiner process that introduces the dynamic behavior in the asset price. In this framework, asset prices follow a log-normal distribution as they fluctuate through time, which the simulation process captures. A specific model can be developed around the projected stock price to capture the effects of any market performance conditions on value. Price path specific conditions can be captured in this type of open form model. The Monte-Carlo process expresses potential future scenarios that when simulated thousands of times can be viewed statistically to ascertain fair value. The contingent consideration common shares contain market conditions to determine whether the shares are earned based on the Company’s Common Stock price during specified measurement periods. Given the path-dependent nature of the requirement in which the shares are earned, a Monte-Carlo simulation was used to estimate the fair value of the liability. The Company’s Common Stock price was simulated to each measurement period based on the methodology described above. In each iteration, the simulated stock price was compared to the conditions under which the shares are earned. In iterations where the stock price corresponded to shares being earned, the future value of the earned shares was discounted back to present value. The fair value of the liability was estimated based on the average of all iterations of the simulation. As discussed above, on each of December 31, 2021 and 2020, 1,000,000 shares of Common Stock were issued in connection with the portion of the Contingent Consideration Common Shares which were earned as of such dates. As a result, the estimated fair value related to such shares was reclassified to stockholders’ equity in the periods in which they were earned, with such shares reflected as issued and outstanding Common Stock. In accordance with U.S. GAAP, the estimated fair value related to the remaining 1,000,000 Contingent Consideration Common Shares was reclassified to stockholders’ equity at December 31, 2021. Since the fair value of these shares was reclassified to stockholders’ equity on December 31, 2021, these shares were no longer liability classified as of such date and therefore the changes in the estimated fair value of such shares were not recognized in the Company’s consolidated statements of operations subsequent to December 31, 2021. As of December 31, 2021, the Company recorded a deferred tax asset of $1.6 million in connection with the accounting for the Contingent Consideration Common Shares. As discussed above, the estimated fair value related to the unearned Contingent Consideration Common Shares was reclassified to stockholders’ equity as of December 31, 2021 and was settled without share issuance as of December 31, 2022 . Correspondingly, the Company reversed the $1.6 million deferred tax asset for the Contingent Consideration Common Shares through a reduction to Additional-paid-in capital during the year ended December 31, 2022 . A reconciliation of the changes in the contingent consideration common shares liability related to the Contingent Consideration Common Shares during the years ended December 31, 2021 and 2020 was as follows (in thousands): Estimated fair value of contingent consideration common shares liability at December 31, 2019 $ 9,316 Change in estimated fair value of the contingent consideration common shares liability 98,717 Reclassification of contingent consideration common shares liability to equity (37,556) Estimated fair value of contingent consideration common shares liability at December 31, 2020 70,477 Change in estimated fair value of the contingent consideration common shares liability (29,389) Reclassification of contingent consideration common shares liability to equity (41,088) Estimated fair value of contingent consideration common shares liability at December 31, 2021 $ — Equity-based Compensation In connection with the Company’s 2019 Stock Incentive Plan (the 2019 Plan), the Company provides equity-based compensation to attract and retain employees while also aligning employees’ interest with the interests of its stockholders. The 2019 Plan permits the grant of various equity-based awards to selected employees and non-employee directors. At December 31, 2022, the 2019 Plan permits the grant of up to 10,000,000 shares of Common Stock, subject to certain adjustments and limitations. At December 31, 2022, 2,191,908 shares of the Company’s Common Stock were available for issuance under the 2019 Plan. Stock Options In January 2021, the Company granted 703,170 options to purchase shares of the Company’s Common Stock to certain senior executives of the Company. The options vest ratably over a three-year period from the date of grant based on a service condition and have a contractual exercise period of five years from the date of grant. The total grant-date fair value of the options granted, using a Black-Scholes option pricing model, was $6.9 million. During the year ended December 31, 2021, 234,390 of the options from this grant were forfeited as a result of the resignation of the Company’s former Co-CEO (see discussion below). In November 2019, the Company granted 3,416,666 options to purchase shares of Common Stock of the Company to certain senior management employees that have an exercise price of $11.50 per share and a contractual exercise period of ten years from the date of grant. The grant-date fair value of the awards, using a Black-Scholes option pricing model, was $7.2 million. In April 2020, the Company granted 47,335 options to purchase shares of Common Stock of the Company to an employee that had an exercise price of $16.25 per share. The grant-date fair value of the awards, using a Black-Scholes option pricing model, was $0.3 million. The vesting conditions relating to the total 3,464,001 options included a defined performance condition with a measurement period during the year ended December 31, 2020 which was satisfied, and also a service condition. In June 2021, in connection with the resignation of the Company’s former Co-CEO (see discussion below), the Company accelerated the vesting of 184,932 options. In connection with the accelerated vesting, the Company recognized $1.9 million of equity-based compensation expense, which is included in General and administrative expenses during the year ended December 31, 2021 in the accompanying consolidated statements of operations. Of the total options granted, 722,222, 722,222 and 1,154,667 options vested on December 31, 2022, 2021 and 2020 respectively. In addition, 679,958 options were forfeited during the year ended December 31, 2021, primarily relating to the resignation of the Company’s former Co-CEO. On April 13, 2021, the Company placed its then Co-Chief Executive Officer, Luke McGee, on unpaid leave while a matter relating to his past private activity was pending. On April 20, 2021, the Company’s board of directors unanimously approved the formation of a Special Committee of Board members to conduct a full investigation of Mr. McGee’s alleged personal conduct. In addition, the Company’s board of directors also approved the retention of an independent law firm to assist the Special Committee in facilitating the investigation. Mr. McGee had no role in, and was entirely recused from, the investigation. On June 11, 2021, the independent law firm reported to the Special Committee that the investigation was substantially complete and that they could state with a high degree of confidence that the Company had no involvement in, or connection to, Mr. McGee’s alleged conduct. The investigation was completed in October 2021 resulting in no changes to the findings communicated in June 2021. On June 14, 2021, the Company and Mr. McGee agreed that Mr. McGee would resign from his positions as Co-CEO and a Director of the Company effective as of June 11, 2021. In connection with Mr. McGee’s resignation, the Company accelerated the vesting of certain unvested stock options as discussed above, and also accelerated the vesting of certain unvested shares of restricted stock (see discussion below). Other than the accelerated vesting of the stock options and shares of restricted stock, and back pay paid to Mr. McGee relating to his unpaid base wages from April 13, 2021 to June 11, 2021, no other compensation was paid to Mr. McGee in connection with his resignation. The assumptions used to determine the grant-date fair value of the stock options granted during the years ended December 31, 2021and 2020 were as follows: Year Ended December 31, 2021 2020 Expected volatility 44.5 % 40.7 % Risk-free interest rate 0.2 % 0.4 % Expected term 4.0 years 6.0 years Dividend yield N/A N/A The following table provides the activity regarding the Company’s outstanding stock options during the years ended December 31, 2022, 2021 and 2020 that were granted in connection with the 2019 Plan (in thousands, except per share data): Number of Weighted-Average Weighted-Average Weighted-Average Outstanding, December 31, 2019 3,417 $ 2.12 $ 11.50 Granted 47 $ 6.34 $ 16.25 Outstanding, December 31, 2020 3,464 $ 2.18 $ 11.56 Granted 703 $ 9.81 $ 48.72 Exercised (1,034) $ 2.19 $ 11.57 Forfeited (914) $ 2.27 $ 11.66 Outstanding, December 31, 2021 2,219 $ 3.75 $ 19.36 Activity - none — Outstanding, December 31, 2022 2,219 $ 3.75 $ 19.36 6.1 Years The following table provides the activity for all outstanding stock options during the years ended December 31, 2022, 2021 and 2020 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Outstanding, December 31, 2019 3,417 $ 11.50 Granted 47 $ 16.25 Outstanding, December 31, 2020 3,464 $ 11.56 Granted 703 $ 48.72 Issued in connection with the AeroCare acquisition 3,960 $ 6.24 Exercised (1,447) $ 10.16 Forfeited (914) $ 11.66 Outstanding, December 31, 2021 5,766 $ 11.26 Exercised (804) $ 5.69 Outstanding, December 31, 2022 4,962 $ 12.19 5.6 Years During the year ended December 31, 2022, 489,191 stock options were exercised resulting in $2.5 million of cash proceeds received by the Company and the issuance of 489,191 shares of the Company's Common Stock. Also, during the year ended December 31, 2022, 315,349 stock options were exercised in cashless transactions resulting in the issuance of 131,741 shares of the Company's Common Stock. During the year ended December 31, 2021, 1,138,982 stock options were exercised resulting in $12.3 million of cash proceeds received by the Company. Additionally, during the year ended December 31, 2021, 307,613 stock options were exercised in cashless transactions resulting in the issuance of 133,126 shares of Common Stock. There were no stock option exercises during the year ended December 31, 2020. The following table provides the activity for exercisable stock options during the years ended December 31, 2022, 2021, and 2020 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Exercisable, December 31, 2019 — $ — Vested 1,155 $ 11.56 Exercisable, December 31, 2020 1,155 $ 11.56 Issued in connection with the AeroCare acquisition 3,960 $ 6.24 Vested 907 $ 11.50 Exercised (1,447) $ 10.16 Exercisable, December 31, 2021 4,575 $ 7.39 Vested 878 $ 18.12 Exercised (804) $ 5.69 Exercisable, December 31, 2022 4,649 $ 9.73 5.8 Years The following table provides the activity for unexercisable stock options during the years ended December 31, 2022, 2021 and 2020 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Unexercisable, December 31, 2019 3,417 $ 11.50 Granted 47 $ 16.25 Vested (1,155) $ 11.56 Unexercisable, December 31, 2020 2,309 $ 11.56 Granted 703 $ 48.72 Vested (907) $ 11.50 Forfeited (914) $ 11.66 Unexercisable, December 31, 2021 1,191 $ 26.15 Vested (878) $ 18.12 Unexercisable, December 31, 2022 313 $ 48.72 3.1 Years Restricted Stock During the year ended December 31, 2022, the Company granted the following shares of restricted stock: • 562,686 shares to various employees which vest ratably over the three • 81,347 shares to its non-employee directors, which vest one year following the grant date. The grant-date fair value of these awards was $1.5 million. • 317,554 shares of performance-vested restricted stock units (Performance RSUs) to senior executive management of the Company which will vest on the third anniversary of the grant date subject to the achievement of specified goals relative to the Company’s three-year relative total shareholder return (Relative TSR) performance versus the Company’s defined peer group (the Peer Group), and is also subject to the employees’ continuous employment through the vesting date. The grant-date fair value of these awards, using a Monte-Carlo simulation analysis, was $8.7 million. The payout of shares on the vesting date are as follows based on the Company’s Relative TSR versus the Peer Group (for performance between the stated goals noted below, straight-line interpolation will be applied): ◦ Less than 25th Percentile – No payout ◦ Greater than or equal to 25th Percentile – 50% of Performance RSUs ◦ Equal to 50th Percentile – 100% of Performance RSUs ◦ Greater than or equal to 75th Percentile – 200% of Performance RSUs During the year ended December 31, 2021, the Company granted the following shares of restricted stock: • 1,266,846 shares to various employees which vest ratably over the three employment through the applicable vesting date, and if applicable, subject to certain performance conditions. The grant-date fair value of these awards was $37.1 million. • 87,500 shares to various employees and non-employee directors which vest ratably over the one-year period following the grant dates. The grant-date fair value of these awards was $2.0 million. • 70,634 fully vested shares of Common Stock to various employees which had a grant-date fair value of $2.4 million. During the year ended December 31, 2021, in connection with the resignation of the Company’s former Co-CEO, the Company accelerated the vesting of 22,192 shares of restricted stock that were granted in November 2019, and the remaining 77,808 unvested shares from the November 2019 grant were forfeited. In connection with the accelerated vesting of the 22,192 shares, the Company recorded $0.5 million of equity-based compensation expense, which is included in General and administrative expenses during the year ended December 31, 2021 in the accompanying consolidated statements of operations. During the year ended December 31, 2020, the Company granted the following shares of restricted stock: • 2,082,604 shares to various employees which primarily vest ratably over the three • 37,198 shares to various non-employee directors which vest ratably over the one-year period following the grant date. The grant-date fair value of these awards was $0.8 million. • 57,069 fully vested shares of Common Stock to various employees which had a grant-date fair value of $1.1 million. Activity related to the Company’s non-vested restricted stock grants for the years ended December 31, 2022, 2021 and 2020 is presented below (in thousands, except per share data): Number of Shares of Weighted-Average Grant Date Non-vested balance, December 31, 2019 901 $ 5.83 Granted 2,120 $ 18.60 Vested (541) $ 10.78 Forfeited (232) $ 15.97 Non-vested balance, December 31, 2020 2,248 $ 15.60 Granted 1,354 $ 28.92 Vested (556) $ 14.03 Forfeited (851) $ 17.64 Non-vested balance, December 31, 2021 2,195 $ 19.58 Granted 962 $ 21.26 Vested (700) $ 19.99 Forfeited (196) $ 20.60 Non-vested balance, December 31, 2022 2,261 $ 23.90 Incentive Units AdaptHealth Holdings granted Incentive Units in June 2019 (the 2019 Incentive Units) to certain members of management. The 2019 Incentive Units were intended to constitute profits interests and were granted for purposes of enabling such individuals to participate in the long-term growth and financial success of the Company and were issued in exchange for services to be performed. The grant date fair value of the 2019 Incentive Units, as calculated under an Option Pricing Method, was $4.5 million. With respect to the 2019 Incentive Units, 50% of the awards were scheduled to vest in equal annual installments

Earnings (Loss) Per Share

Earnings (Loss) Per Share	12 Months Ended
	Dec. 31, 2022
Earnings Per Share [Abstract]
Earnings (Loss) Per Share	Earnings (Loss) Per Share Earnings Per Share (EPS) is computed by dividing Net income (loss) by the weighted average number of common shares outstanding during the period on a basic and diluted basis. The Company computes diluted net income (loss) per share using the more dilutive of the treasury stock method and the two-class method after giving effect to all potential dilutive common stock. The Company’s potentially dilutive securities during the periods presented below include potential common shares related to outstanding warrants, contingent consideration common shares, unvested restricted stock, outstanding stock options and outstanding preferred stock. Refer to Note 11 , Stockholders’ Equity , for additional discussion of these potential dilutive securities. Diluted net income (loss) per share considers the impact of potentially dilutive securities except when the potential common shares have an antidilutive effect. The Company’s outstanding preferred stock are considered participating securities, thus requiring the two-class method of computing diluted net income (loss) per share. Computation of diluted net income (loss) per share under the two-class method excludes from the numerator any dividends paid or owed on participating securities and any undistributed earnings considered to be attributable to participating securities. The related participating securities are similarly excluded from the denominator. Computations of basic and diluted net income (loss) per share were as follows (in thousands, except per share data): Year Ended December 31, 2022 2021 2020 Numerator Net income (loss) attributable to AdaptHealth Corp. $ 69,316 $ 156,175 $ (161,632) Less: Earnings allocated to participating securities (1) 5,867 14,379 — Net income (loss) for basic EPS $ 63,449 $ 141,796 $ (161,632) Change in fair value of warrant liability (2) (17,158) (53,181) — Net income (loss) for diluted EPS $ 46,291 $ 88,615 $ (161,632) Denominator (1) (2) Basic weighted-average common shares outstanding 134,175 126,306 52,488 Add: Warrants (2) 1,528 2,377 — Add: Stock options 2,512 3,782 — Add: Unvested restricted stock 773 569 — Diluted weighted-average common shares outstanding 138,988 133,034 52,488 Basic net income (loss) per share $ 0.47 $ 1.12 $ (3.08) Diluted net income (loss) per share $ 0.33 $ 0.67 $ (3.08) (1) The Company's preferred stock are considered participating securities. Computation of EPS under the two-class method excludes from the numerator any dividends paid or owed on participating securities and any undistributed earnings considered to be attributable to participating securities. The related participating securities are similarly excluded from the denominator. There was no amount allocated to the participating securities during the year ended December 31, 2020 due to the net loss reported in that period. (2) For the years ended December 31, 2022 and 2021, the impact to earnings from the change in fair value of the Company’s warrant liability is excluded from the numerator, and the corresponding security is included in the denominator, for purposes of computing diluted net income per share. This adjustment is included as the effect of the numerator and denominator adjustments for this derivative instrument is dilutive as a result of the non-cash gains recorded for the change in fair value of this instrument during those periods. For the year ended December 31, 2020, the numerator and denominator for the diluted net loss per share computation is the same as used in the basic net loss per share computation and therefore excludes the effect of potential dilutive securities as their inclusion would have been anti-dilutive. Due to the Company reporting a net loss attributable to AdaptHealth Corp. for the year ended December 31, 2020, all potentially dilutive securities related to outstanding warrants, contingent consideration common shares, unvested restricted stock, and outstanding stock options were excluded from the computation of diluted net loss per share for that period as their inclusion would have been anti-dilutive. The table below provides the weighted-average number of potential common shares associated with outstanding securities not included in the Company’s computation of diluted net income (loss) per share for the years ended December 31, 2022, 2021 and 2020 because to do so would be anti-dilutive (in thousands): Year Ended December 31, 2022 2021 2020 Preferred Stock 12,406 12,808 10,077 Warrants — — 1,902 Stock Options 469 — 1,539 Unvested restricted stock — — 659 Contingent Consideration Common Shares — — 2,000 Total 12,875 12,808 16,177

Leases

Leases	12 Months Ended
	Dec. 31, 2022
Leases [Abstract]
Leases	Leases The Company leases its office facilities and office equipment under noncancellable lease agreements which expire at various dates through March 2033. Some of these lease agreements include an option to renew at the end of the term. The Company also leases certain office facilities on a month-to-month basis. In some instances, the Company is also required to pay its pro rata share of real estate taxes and utility costs in connection with the premises. Some of the leases contain fixed annual increases of minimum rent. The Company’s leases frequently allow for lease payments that could vary based on factors such as inflation and the incurrence of contractual charges such as those for common area maintenance or utilities. Renewal and/or early termination options are common in the lease arrangements, particularly with respect to real estate leases. The Company’s right-of-use assets and lease liabilities generally include periods covered by renewal options and exclude periods covered by early termination options (based on the conclusion that it is reasonably certain that the Company will exercise such renewal options and not exercise such early termination options). The Company is also party to certain sublease arrangements related to real estate leases, where the Company acts as the lessee and intermediate lessor. The Company has acquired patient medical equipment and supplies, and office equipment through multiple finance leases. The finance lease obligations represent the present value of minimum lease payments under the respective agreement, payable monthly at various interest rates. The following table presents information about the Company’s right-of-use assets and lease liabilities as of December 31, 2022 and 2021 (in thousands): December 31, Consolidated Balance Sheets Line Item 2022 2021 Right-of-use (ROU) assets: Operating lease ROU assets Operating lease right-of-use assets $ 129,506 $ 147,760 Finance lease ROU assets Finance lease right-of-use assets 5,423 — Finance lease ROU assets Equipment and other fixed assets, net 103 17,410 Total ROU assets $ 135,032 $ 165,170 Operating lease liabilities: Current operating lease liabilities Current portion of operating lease obligations $ 30,001 $ 31,418 Noncurrent operating lease liabilities Operating lease obligations, less current portion 104,394 120,180 Total operating lease liabilities $ 134,395 $ 151,598 Finance lease liabilities: Current finance lease liabilities Current portion of finance lease obligations $ 2,211 $ 15,446 Noncurrent finance lease liabilities Finance lease obligations, less current portion 3,950 — Noncurrent finance lease liabilities Other long-term liabilities — 132 Total finance lease liabilities $ 6,161 $ 15,578 The following table presents information about lease costs and expenses and sublease income for the years ended December 31, 2022 and 2021 (in thousands). The amounts below are included in cost of net revenue in the accompanying consolidated statements of operations for the periods presented. Year Ended December 31, 2022 2021 Operating lease costs $ 37,822 $ 37,043 Finance lease costs: Amortization of ROU assets $ 8,246 $ 33,689 Other lease costs and income: Variable leases costs (1) $ 17,758 $ 14,030 Sublease income $ 1,380 $ 1,239 Short-term lease costs $ — $ 19,905 (1) Amounts represent variable costs incurred that were not included in the initial measurement of the lease liability such as common area maintenance and utilities costs associated with leased real estate. The following table provides the weighted average remaining lease terms and weighted average discount rates for the Company’s leases as of December 31, 2022 and 2021: December 31, 2022 2021 Weighted average remaining lease term, weighted based on lease liability balances: Operating leases 6.2 years 6.7 years Finance leases 3.7 years 1.0 year Weighted average discount rate, weighted based on remaining balance of lease payments: Operating leases 3.9 % 3.8 % The following table provides the undiscounted amount of future cash flows related to the Company's operating and finance leases, as well as a reconciliation of such undiscounted cash flows to the amounts included in the Company’s lease liabilities as of December 31, 2022 (in thousands): Operating Leases Finance Leases 2023 $ 34,446 $ 2,318 2024 28,100 1,567 2025 24,354 1,566 2026 17,484 1,074 2027 12,139 10 Thereafter 36,089 — Total future undiscounted leases payments $ 152,612 $ 6,535 Less: amount representing interest (18,217) (374) Present value of future lease payments (lease liability) $ 134,395 $ 6,161 The following table provides certain cash flow and supplemental non-cash information related to the Company's lease liabilities for the years ended December 31, 2022 and 2021 (in thousands): Year Ended December 31, 2022 2021 Cash paid for amounts included in the measurement of lease liabilities: Operating cash payments for operating leases $ 37,486 $ 36,510 Financing cash payments for finance leases $ 16,176 $ 42,164 Lease liabilities arising from obtaining right-of-use assets: Operating leases $ 22,543 $ 91,420 Finance leases $ 5,423 $ 22,959

Retirement Plans

Retirement Plans	12 Months Ended
	Dec. 31, 2022
Retirement Benefits [Abstract]
Retirement Plans	Retirement PlansAt December 31, 2022, the Company had a single consolidated retirement plan (the AdaptHealth Plan) which included its subsidiaries’ 401(k) plans, with one exception: the Royal Homestar 401(k) plan (the RH Plan). At December 31, 2021, the Company had the AdaptHealth Plan which included its subsidiaries’ 401(k) plans, with two exceptions: the AeroCare Holdings, Inc. 401(k) Profit Sharing Plan and Trust (the AeroCare Plan) and the RH Plan. The AdaptHealth Plan allows employees to contribute up to the annual limitation imposed by the Internal Revenue Code. The Company makes matching contributions to the AdaptHealth Plan. The AeroCare Plan was a single employer qualified defined contribution plan with no participating employers and allowed participants to elect pre-tax deferrals and Roth contributions to the stated Internal Revenue Code 402g limits. The AeroCare Plan was merged into the AdaptHealth Plan effective January 21, 2022. The RH Plan is administered by a noncontrolling interest. During the years ended December 31, 2022, 2021, and 2020, the Company recorded matching contribution expense of $4.7 million

Self-Insured Plans

Self-Insured Plans	12 Months Ended
	Dec. 31, 2022
Self Insured Plans
Self-Insured Plans	Self-Insured PlansThe Company was self-insured for its employees’ medical, auto and workers’ compensation claims during 2022, 2021 and 2020. The Company purchased medical stop loss insurance that covers the excess of each specific loss over $300,000 in 2022, $225,000 in 2021 and $175,000 in 2020, and aggregate losses that exceed the greater of the calculated aggregate stop loss threshold or the minimum aggregate stop loss threshold. In 2022, 2021 and 2020, the Company purchased workers’ compensation stop loss insurance which has occurrence-based limits that vary by state based on statutory rules. The Company is subject to an aggregate annual limit. Self-insurance reserves include estimates of both known claims filed and estimates of claims incurred but not reported. The Company uses historical paid claims information to estimate its claims liability. The liability for self-insurance reserves was $15.6 million and $11.7 million as of December 31, 2022 and 2021, respectively. This liability is included within Accounts payable and accrued expenses in the accompanying consolidated balance sheets.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies In the normal course of business, the Company is subject to loss contingencies, such as legal proceedings and claims arising out of its business that cover a wide range of matters. In accordance with FASB ASC Topic 450, Accounting for Contingencies, the Company records accruals for such loss contingencies when it is probable that a liability has been incurred and the amount of loss can be reasonably estimated. Significant judgment is required to determine both probability and the estimated amount. The Company reviews its accruals at least quarterly and adjusts accordingly to reflect the impact of negotiations, settlements, rulings, advice of legal counsel, and updated information. At this time, the Company has no material accruals related to lawsuits, claims, investigations and proceedings. While there can be no assurance, based on the Company’s evaluation of information currently available, the Company’s management believes any liability that may ultimately result from resolution of such loss contingencies will not have a material adverse effect on the Company’s financial conditions or results of operations. However, the Company’s assessment may be affected by limited information. Accordingly, the Company’s assessment may change in the future based upon availability of new information and further developments in the proceedings of such matters. The results of legal proceedings are inherently uncertain, and material adverse outcomes are possible. In connection with the Company’s acquisition of PPS HME Holdings LLC (PPS), in May 2018, the Company assumed a Corporate Integrity Agreement (CIA) at one of PPS’ subsidiaries, Braden Partners L.P. d/b/a Pacific Pulmonary Services (BP). The CIA was entered into with the Office of Inspector General of the U.S. Department of Health and Human Services (OIG). The CIA had a five-year term which expired in April 2022. In connection with the acquisition and integration of PPS by AdaptHealth, the OIG confirmed that the requirements of the CIA imposed upon BP would only apply to the operations of BP and therefore no operations of any other AdaptHealth affiliate are subject to the requirements of the CIA following the acquisition. On December 16, 2021, the OIG notified PPS that its report for the period ended March 31, 2021 had been accepted and PPS had satisfied its obligations under the CIA as of such date. On May 24, 2022, the Company submitted its final report under the CIA for the period ended March 31, 2022. On January 12, 2023, the OIG notified PPS that its report for the period ended March 31, 2022 had been accepted and PPS had satisfied its obligations under the CIA as of such date. As a result, the OIG also advised PPS that it had complied with its obligations under the CIA and therefore the term of the CIA had concluded. On July 25, 2017, AdaptHealth Holdings LLC, a Delaware limited liability company (AdaptHealth Holdings), was served with a subpoena by the U.S. Attorney’s Office for the United States District Court for the Eastern District of Pennsylvania (EDPA) pursuant to 18 U.S.C. §3486 to produce certain audit records and internal communications regarding ventilator billing. The investigation focused on billing practices regarding one payor that contracted for bundled payments for certain ventilators. AdaptHealth Holdings has cooperated with investigators and, through agreement with the EDPA, has submitted all information requested in the Company's possession. An independent third party was retained by AdaptHealth Holdings that identified overpayments and underpayments for ventilator billings related to the payor, and a remittance was sent to reconcile that account. On October 3, 2019, the Company received a follow-up civil investigative demand from the EDPA regarding a document previously produced to the EDPA and patients included in the review by the independent third party. The Company has responded to the EDPA and supplemented its production as requested with any relevant documents in the Company’s possession. During subsequent communications, the EDPA indicated to the Company that the investigation remained ongoing. The EDPA also requested additional information regarding certain patient services and claims refunds processed by the Company in 2017. The Company produced this information in coordination with the EDPA. The EDPA has also raised questions regarding other aspects of ventilator billing. While the Company cannot provide any assurance as to whether the EDPA will seek additional information or pursue this matter further, it does not believe that the investigation will have a material adverse effect on the Company. In March 2019, prior to its acquisition by the Company, AeroCare was served with a civil investigative demand (CID) issued by the United States Attorney for the Western District of Kentucky (WDKY). The CID seeks to investigate allegations that AeroCare improperly billed, or caused others to improperly bill, for oxygen tank contents that were not delivered to beneficiaries. The WDKY has requested documents related to such oxygen tank content billing as well as other categories of information. AeroCare has cooperated with the WDKY and has produced documents and provided explanations of its billing practices. In September 2020, the WDKY indicated the investigation includes alleged violations of the federal False Claims Act and as well as alleged violations of state Medicaid false claims acts in ten states. AeroCare has cooperated fully with the investigation and has indicated to the WDKY that concerns raised do not accurately identify Medicare coverage criteria and that state Medicaid coverage requirements generally do not provide for separate reimbursement for portable gaseous oxygen contents in the circumstances at issue. While the Company cannot provide any assurance as to whether the WDKY will seek additional information or pursue this matter further, it does not believe that the investigation will have a material adverse effect on the Company. On July 29, 2021, Robert Charles Faille Jr., a purported shareholder of the Company, filed a purported class action complaint against the Company and certain of its current and former officers in the United States District Court for the Eastern District of Pennsylvania (the Complaint). The Complaint purports to be asserted on behalf of a class of persons who purchased the Company’s stock between November 11, 2019 and July 16, 2021. The Complaint generally alleges that the Company and certain of its current and former officers violated federal securities laws by making allegedly false and misleading statements and/or failing to disclose material information regarding the Company’s organic growth trajectory. The Complaint seeks unspecified damages. On October 14, 2021, the Delaware County Employees Retirement System and the Bucks County Employees Retirement System were named Lead Plaintiffs. Pursuant to the scheduling order, Lead Plaintiffs filed a consolidated complaint on November 22, 2021 (the Consolidated Complaint), which asserts substantially the same claim, but adds a number of current and former directors of the Company as additional defendants and a new theory of recovery based on the Company’s alleged failure to disclose information concerning the Company’s former Co-CEO’s alleged tax fraud arising from certain past private activity (the Consolidated Class Action). On January 20, 2022, the defendants filed a motion to dismiss the Consolidated Complaint. Lead Plaintiffs’ opposition to defendants’ motion was filed on March 21, 2022, and defendants’ reply was filed on April 15, 2022. On June 9, 2022, the court issued an opinion and order denying the defendants’ motion to dismiss the Consolidated Complaint. On July 15, 2022, the court entered a scheduling order providing for, inter alia, a schedule for completing class certification discovery, as well as setting a briefing schedule for motions for class certification. Pursuant to the scheduling order, Lead Plaintiffs filed their motion for class certification on July 28, 2022. On December 12, 2022, the court entered an amended scheduling order with respect to class certification discovery and remaining briefing on Lead Plaintiffs’ motion for class certification. Pursuant to the amended scheduling order, the defendants’ opposition to Lead Plaintiffs’ motion for class certification is due to be filed on March 30, 2023; and Lead Plaintiffs’ reply is due to be filed on May 22, 2023. The Company intends to vigorously defend against the allegations contained in the Consolidated Complaint, but there can be no assurance that the defense will be successful. On December 6, 2021, a putative shareholder of the Company, Carol Hessler, filed a shareholder derivative complaint against certain current and former directors and officers of the Company in the United States District Court for the Eastern District of Pennsylvania (the Derivative Complaint). The Derivative Complaint generally alleges that the defendants breached their fiduciary duties owed to the Company by allegedly causing or allowing misrepresentations and/or omissions regarding the Company’s organic growth and the Company’s former Co-CEO’s alleged criminal activity, failing to maintain an adequate system of oversight, disclosure controls and procedures, and internal controls over financial reporting and due diligence into the Company’s management team, and engaging in insider trading. The Derivative Complaint also alleges claims for waste of corporate assets and unjust enrichment. Finally, the Derivative Complaint alleges that certain of the individual defendants violated Section 14(a) of the Securities Exchange Act by allegedly negligently issuing, causing to be issued, and participating in the issuance of materially misleading statements to stockholders in the Company’s Proxy Statements on Schedule DEF 14A in connection with a Special Meeting of Stockholders, held on March 3, 2021, and the 2021 Annual Meeting of Stockholders, held on July 27, 2021. The Derivative Complaint seeks, among other things, an award of money damages. On March 4, 2022, the parties stipulated to stay the Hessler action pending final resolution of the Consolidated Class Action. On March 7, 2022, the court so-ordered the parties’ stipulation. The Company intends to vigorously defend against the allegations contained in the Derivative Complaint, but there can be no assurance that the defense will be successful. On May 2, 2022, the U.S. Attorney’s Office for the Southern District of New York issued a civil investigative demand to a subsidiary of the Company, pursuant to the False Claims Act, 31 U.S.C. § 3733 (FCA) surrounding whether the subsidiary submitted false claims in violation of the FCA related to it’s billing of, and reimbursements from, federal health care programs for ventilators provided to patients from January 1, 2015 to the present. The Company is fully cooperating with the investigation. Given the investigation is in the early stages, it is not possible to determine whether it will have a material adverse effect on the Company.

Related Party Transactions

Related Party Transactions	12 Months Ended
	Dec. 31, 2022
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions The Company and an executive officer and shareholder of the Company own an equity interest in a vendor of the Company that provides automated order intake software. The individual’s equity ownership is less than 1%. The expense related to this vendor was $7.0 million, $4.9 million and $2.6 million for the years ended December 31, 2022, 2021 and 2020, respectively. The Company accounts for this investment under the cost method of accounting based on its level of equity ownership. As of December 31, 2022 and 2021, the Company had an immaterial outstanding accounts payable balance to this vendor. A director of the Company serves on the board of directors of a third-party payor that does business with the Company in the normal course of providing services to patients. Net revenue from this third-party payor was less than 1.0% of the Company’s consolidated net revenue during the years ended December 31, 2022, 2021 and 2020. As of December 31, 2022 and 2021, the Company had an immaterial outstanding accounts receivable balance from this third-party payor. A director of the Company is an employee of a beneficial owner of more than 5% of the Company’s Common Stock as of December 31, 2022. This beneficial owner is also a minority shareholder of a vendor that provides equipment and supplies to the Company in the normal course of business. Purchases from this vendor were approximately $80.3 million and $12.3 million during the years ended December 31, 2022 and 2021, respectively. Purchases from this vendor for the year ended December 31, 2020 were immaterial. As of December 31, 2022, the Company had $2.1 million in outstanding accounts payable to this vendor. As of December 31, 2021, the Company had an immaterial outstanding accounts payable balance to this vendor. A regional manager of the Company is a shareholder of a business which provides contract labor to the Company. Payments to this service provider were $20.0 million, $18.1 million, and $15.9 million, respectively, for the years ended December 31, 2022, 2021 and 2020. As of December 31, 2022, the Company had $2.2 million in outstanding accounts

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes On January 2, 2021, the Company completed a corporate restructuring to simplify its tax structure (the Tax Restructuring). In connection with the Tax Restructuring, on January, 1, 2021, all remaining outstanding shares of Class B Common Stock, together with a corresponding number of New AdaptHealth Units, were exchanged for shares of Class A Common Stock. After these exchanges, AdaptHealth Holdings filed an entity classification election with the Internal Revenue Service, electing to be treated as a taxable corporation for U.S. federal income tax purposes effective January 2, 2021 As a result of the Business Combination and prior to the Tax Restructuring, the Company was subject to U.S. federal, state, and local income taxes with respect to its allocable share of any taxable income or loss of AdaptHealth Holdings. AdaptHealth Holdings was treated as a partnership for U.S. income tax purposes and generally did not pay income taxes in most jurisdictions. Instead, AdaptHealth Holdings’ taxable income or loss was passed through to its members, including the Company. Additionally, the Company was subject to U.S. federal, state, and local income taxes on the taxable income or loss of the underlying C-corporations in the AdaptHealth group where taxes are paid at the entity level. As a result of the Tax Restructuring, the Company is subject to U.S. federal, state, and local income taxes on substantially all of its earnings. The current and deferred income tax expense (benefit) for the years ended December 31, 2022, 2021 and 2020 is as follows (in thousands): Year Ended December 31, 2022 2021 2020 Current: Federal $ (197) $ 2,356 $ 5,608 State 6,930 8,070 3,538 6,733 10,426 9,146 Deferred: Federal 12,205 22,891 (16,587) State 5,831 (511) (4,514) 18,036 22,380 (21,101) Total Income tax expense (benefit) $ 24,769 $ 32,806 $ (11,955) A reconciliation of the effective income tax rate with the applicable statutory federal income tax rate for the years ended December 31, 2022, 2021 and 2020 is as follows: Year Ended December 31, 2022 2021 2020 Federal statutory rate 21.0 % 21.0 % 21.0 % State income taxes, net of federal benefit 3.6 % 3.1 % 4.7 % Equity-based compensation (0.5) % (1.9) % — % Change in valuation allowance — % 0.1 % (0.4) % Change in fair value of warrant liability (3.7) % (5.9) % (17.1) % Change in fair value of contingent consideration — % (1.2) % (4.4) % Deferred tax only adjustment (2.6) % 0.3 % 1.7 % Deferred tax impact of state effective tax rate changes 8.6 % — % — % Other (1.1) % 1.7 % 0.3 % Effective income tax rate 25.3 % 17.2 % 5.8 % Deferred income tax assets and liabilities are comprised of the following at December 31, 2022 and 2021 (in thousands): December 31, 2022 2021 Deferred income tax assets: Accounts receivable $ 37,363 $ 51,115 Goodwill and intangible assets 262,501 291,331 Investment in partnership 171 4,218 Inventory 1,841 561 Accruals 9,207 6,845 Net operating losses and credits 35,459 32,926 Transaction costs 417 7,580 Contract liabilities — 3,041 Equity-based compensation 6,101 3,801 Excess business interest expense 27,918 — Lease liability 35,431 40,683 Contingent consideration — 3,541 Capital losses 817 817 Total deferred income tax assets 417,226 446,459 Valuation allowance (1,812) (1,812) Net deferred income tax assets $ 415,414 $ 444,647 Deferred income tax liabilities: Right-of-use assets $ (34,201) $ (39,760) Contingent consideration (2,200) — Unrealized gains (2,950) — Equipment and other fixed assets (94,277) (100,694) Total deferred income tax liabilities (133,628) (140,454) Noncurrent net deferred income tax assets $ 281,786 $ 304,193 Deferred income taxes are determined based on the temporary differences between the financial statement book basis and the tax basis of assets and liabilities using enacted tax rates in effect in the years in which the differences are expected to reverse. In assessing the realizability of deferred income tax assets, management considers whether it is more likely than not that all, or some portion, of the deferred income tax assets will not be realized. The ultimate realization of deferred income tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers the scheduled reversal of deferred income tax liabilities and projected future taxable income in making this assessment. Management evaluates the need for valuation allowances on the deferred income tax assets according to the provisions of FASB ASC 740, Income Taxes . In making this determination, management assesses all available evidence, both positive and negative, available at the time balance sheet date. This includes, but is not limited to, recent earnings, internally prepared income projections, and historical financial performance. A history of cumulative losses is a significant piece of negative evidence used in the assessment. As of December 31, 2022, and 2021, the Company had a valuation allowance recorded against net deferred tax assets of $1.8 million, and $1.8 million, respectively. As a result of the Tax Restructuring, AdaptHealth Holdings is treated as a taxable corporation for U.S. federal income tax purposes effective January 2, 2021. The Company’s deferred tax asset related to investment in partnership has been allocated to underlying assets of AdaptHealth Holdings which primarily relates to goodwill. As of December 31, 2022 and 2021, the Company had federal net operating losses (NOLs) carryforwards of $138.2 million and $139.6 million, respectively and state NOLs of $150.7 million and $85.7 million, respectively. As of December 31, 2022, the Company had interest expense carryforwards of $109.9 million, which may be carried forward indefinitely. As of December 31, 2021, the Company had no interest expense carryforwards. Federal NOLs generated after December 31, 2017 do not expire and state rules vary. Of the Company’s total federal NOLs, $3.2 million were acquired as part of the acquisition of Pinnacle and begin expiring in 2031, $103.6 million were acquired as part of the acquisition of AeroCare and may be carried forward indefinitely, and $31.4 million are historical AdaptHealth NOLs which may be carried forward indefinitely. The Company believes (i) approximately $3.1 million of acquired Pinnacle NOLs will expire before utilization and (ii) $1.8 million of the Company’s historical NOLs are fully limited as a result of ownership changes within the meaning of Internal Revenue Code Section 382 (Section 382) prior to December 31, 2021 and has accordingly maintained a valuation allowance against these NOL deferred tax assets. The Company is evaluating whether a Section 382 ownership change has occurred during 2022. There was no impact, however, to current or deferred tax expense resulting from this potential ownership change. As of December 31, 2022, the Company had capital loss carryforwards of $3.1 million that are subject to expiration if unused as of December 31, 2025. The Company does not anticipate utilizing these carryforwards prior to expiration and has maintained a valuation allowance accordingly. The Company will recognize a tax benefit in the financial statements for an uncertain tax position only if management’s assessment is that the position is “more likely than not” (i.e., a likelihood greater than 50 percent) to be allowed by the tax jurisdiction based solely on the technical merits of the position. The term “tax position” refers to a position in a previously filed tax return or a position expected to be taken in a future tax return that is reflected in measuring current or deferred income tax assets and liabilities for financial reporting purposes. A reconciliation of the beginning and ending amount of unrecognized tax benefits for the years ended December 31, 2022, 2021 and 2020 is as follows (in thousands). Balance, December 31, 2019 $ — Additions for tax positions acquired 1,947 Balance, December 31, 2020 1,947 Additions for tax positions acquired 2,100 Balance, December 31, 2021 4,047 Additions for tax positions acquired 2,670 Reductions due to lapse of statute of limitations (78) Balance, December 31, 2022 $ 6,639 The unrecognized tax benefit of $6.6 million at December 31, 2022 relates to tax positions taken in pre-closing tax periods of companies acquired in 2021 and 2020, for which the Company received tax indemnifications against any losses. As such, the Company recognized a corresponding asset on its consolidated balance sheet and no amount of the Company’s uncertain tax positions, if recognized, would impact the effective tax rate of the Company. As of December 31, 2022 and 2021, the Company’s accrued liability for interest and penalties is $1.6 million and $0.9 million, respectively. The Company files income tax returns in the U.S. federal jurisdiction and in various state jurisdictions. The Company generally is no longer subject to U.S. or state examinations by tax authorities for taxable years prior to 2018, based on the U.S. statute of limitations. However, net operating losses utilized from prior years in subsequent years’ tax returns are subject to examination until three years after the filing of subsequent years’ tax returns. Tax Receivable Agreement Prior to the Tax Restructuring, the owners of AdaptHealth Holdings had the right to exchange their New AdaptHealth Units for shares of Class A Common Stock of the Company. As a result of such exchanges, the Company’s membership interest in AdaptHealth Holdings increased and its purchase price was reflected in its share of the tax basis of AdaptHealth Holdings’ tangible and intangible assets. Any resulting increases in tax basis were likely to increase tax depreciation and amortization deductions and, therefore, reduce the amount of income tax the Company would otherwise be required to pay in the future. Any such increase also decreased gain (or increased loss) on future dispositions of the affected assets. At the closing of the Business Combination, there were exchanges of 3,480,466 New AdaptHealth Units resulting in approximately $33.6 million of amortizable IRC Section 754 tax basis step-up in the tax-deductible goodwill of AdaptHealth Holdings. Subsequent to the closing of the Business Combination and through December 31, 2021, there were an additional 31,936,305 exchanges of New AdaptHealth Units that increased the amortizable IRC Section 754 tax basis step-up of tax-deductible goodwill by approximately $1,029.6 million, of which $537.9 million and $485.7 million was recorded during the years ended December 31, 2021 and 2020, respectively. Of these exchanges, 13,218,758 and 18,167,547 occurred during the years ended December 31, 2021 and 2020, respectively. At the closing of the Business Combination, the Company and AdaptHealth Holdings entered into a Tax Receivable Agreement (TRA) with certain sellers and AdaptHealth Holdings members. The TRA will generally provide for the payment by the Company to the corresponding sellers and AdaptHealth Holdings members of 85% of the net cash savings, if any, in U.S. federal, state and local income tax that the Company actually realizes (or is deemed to realize in certain circumstances) in periods after the closing of the Business Combination as a result of: (i) certain tax attributes of the corresponding sellers existing prior to the Business Combination; (ii) certain increases in tax basis resulting from exchanges of New AdaptHealth Units and shares of Class B Common Stock; (iii) imputed interest deemed to be paid by the Company as a result of payments it makes under the TRA; and (iv) certain increases in tax basis resulting from payments the Company makes under the TRA. Under the TRA, the benefits deemed realized by the Company as a result of the increase in tax basis attributable to the AdaptHealth Holdings members generally will be computed by comparing the actual income tax liability of the Company to the amount of such taxes that the Company would have been required to pay had there been no so increase in tax basis. Estimating the amount of payments that may be made under the TRA depends on a variety of factors. The actual increase in tax basis and deductions, as well as the amount and timing of any payments under the TRA, will vary depending upon several factors, including: • The timing of such exchanges – for instance, the increase in any tax deductions will vary depending on the fair value of the depreciable or amortizable assets of AdaptHealth Holdings at the time of each exchange; • The price of the Company’s Common Stock at the time of the exchange – the increase in any tax deductions, and the tax basis increase in other assets of AdaptHealth Holdings is directly proportional to the price of the Company’s Common Stock at the time of the exchange; • The amount and timing of the Company’s income – the Company is required to pay 85% of the deemed benefits as and when deemed realized. If AdaptHealth Holdings does not have taxable income, the Company is generally not required (absent a change in control or circumstances requiring an early termination payment) to make payments under the TRA for that taxable year because no benefit will have been realized. However, any tax benefits that do not result in realized benefits in a given tax year likely will generate tax attributes that may be utilized to generate benefits in previous or future tax years. The utilization of such tax attributes will result in payments under the TRA; and • Future tax rates of jurisdictions in which the Company has tax liability. The TRA also provides that upon certain mergers, asset sales, other forms of business combinations or other changes of control, AdaptHealth Holdings’ (or its successor’s) obligations under the TRA would be based on certain assumptions defined in the TRA. As a result of these assumptions, AdaptHealth could be required to make payments under the TRA that are greater or less than the specified percentage of the actual benefits realized by the Company that are subject to the TRA. In addition, if AdaptHealth Holdings elects to terminate the TRA early, it would be required to make an early termination payment, which upfront payment may be made significantly in advance of the anticipated future tax benefits. Payments generally are due under the TRA within a specified period following the filing of AdaptHealth Holdings’ U.S. federal and state income tax returns for the taxable year with respect to which the payment obligation arises. Payments under the TRA generally will be based on the tax reporting positions that AdaptHealth Holdings will determine. Although AdaptHealth Holdings does not expect the Internal Revenue Service (IRS) to challenge the Company’s tax reporting positions, AdaptHealth Holdings will not be reimbursed for any overpayments previously made under the TRA, but instead the overpayments will reduce future payments. As a result, in certain circumstances, payments could be made under the TRA in excess of the benefits that AdaptHealth Holdings realizes in respect of the tax attributes subject to the TRA. The term of the TRA generally will continue until all applicable tax benefits have been utilized or expired, unless the Company exercises its right to terminate the TRA and make an early termination payment. In certain circumstances (such as certain changes in control, the election of the Company to exercise its right to terminate the agreement and make an early termination payment or an IRS challenge to a tax basis increase) it is possible that cash payments under the TRA may exceed actual cash savings. During the years ended December 31, 2021 and 2020, the Company increased its TRA liability by $146.5 million and $140.4 million, respectively, through a reduction in additional-paid-in capital, resulting from additional exchanges of New AdaptHealth Units and shares of Class B Common Stock. Correspondingly, during the years ended December 31, 2021 and 2020, the Company increased its deferred tax asset by $164.1 million and $165.2 million, respectively, through an increase in Additional-paid-in-capital resulting from these exchanges. At December 31, 2022, the Company’s liability relating to the TRA was $297.4 million, of which $3.3 million and $294.1 million is included in Other liabilities and Other long-term liabilities, respectively, in the accompanying consolidated balance sheets. At December 31, 2021, the Company's liability relating to the TRA was $300.3 million, which is included in Other long-term liabilities in the accompanying consolidated balance sheets. During the year ended December 31, 2022, the Company recognized income of $2.9 million related to changes in the estimated TRA liability primarily as a result of a decrease in estimated effective tax rates in future years, which is included in Other loss (income), net in the accompanying consolidated statements of operations.

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2022
Subsequent Events [Abstract]
Subsequent Events	Subsequent EventsThe Company evaluated subsequent events for the period from December 31, 2022 through the date that the Company’s consolidated financial statements were available to be issued. There were no subsequent events requiring adjustment to the Company’s consolidated financial statements or additional disclosure.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2022
Accounting Policies [Abstract]
Basis of Presentation	Basis of PresentationThe consolidated financial statements of the Company have been prepared in accordance with accounting principles generally accepted in the United States of America (U.S. GAAP). In the opinion of management, the consolidated financial statements include all necessary adjustments for a fair presentation of the financial position and results of operations for the periods presented.Prior to August 19, 2021, the Company was an “emerging growth company,” as defined in Section 2(a) of the Securities Act of 1933, as amended, (the Securities Act), as modified by the Jumpstart our Business Startups Act of 2012, (the JOBS Act), and took advantage of certain exemptions from various reporting requirements that are applicable to other public companies that are not emerging growth companies, including, but not limited to, not being required to comply with the auditor attestation requirements of Section 404 of the Sarbanes-Oxley Act, reduced disclosure obligations regarding executive compensation in its periodic reports and proxy statements, and other exemptions. As of August 19, 2021, the Company no longer qualified as an emerging growth company due to issuing more than $1.0 billion in non-convertible debt in the prior three-year period as of that date, and as a result is no longer exempt from the reporting requirements discussed above.
Basis of Consolidation	Basis of ConsolidationThe accompanying consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.
Accounting Estimates	Accounting EstimatesThe preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, and the disclosure of contingent assets and liabilities at the date of the consolidated financial statements, and reported amounts of revenues and expenses during the reporting period. Management bases these estimates and assumptions upon historical experience, existing and known circumstances, authoritative accounting pronouncements and other factors that management believes to be reasonable. Significant areas requiring the use of management estimates relate to revenue recognition and the valuation of accounts receivable (implicit price concession), income taxes, equity-based compensation, warrant liability and long-lived assets, including goodwill and identifiable intangible assets. Actual results could differ from those estimates.
Revenue Recognition	Revenue RecognitionThe Company generates revenues for services and related products that the Company provides to patients for home medical equipment, related supplies, and other items. The Company’s revenues are recognized in the period in which services and related products are provided to customers and are recorded either at a point in time for the sale of supplies and disposables, or over the fixed monthly service period for equipment. Revenues are recognized when control of the promised good or service is transferred to customers, in an amount that reflects the consideration to which the Company expects to receive from patients or under reimbursement arrangements with Medicare, Medicaid and third-party payors, in exchange for those goods and services. The Company determines the transaction price based on contractually agreed-upon amounts or rates, adjusted for estimates of variable consideration, such as implicit price concessions. The Company utilizes the expected value method to determine the amount of variable consideration that should be included to arrive at the transaction price, using contractual agreements and historical reimbursement experience within each payor type. The Company applies constraint to the transaction price, such that net revenue is recorded only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in the future. If actual amounts of consideration ultimately received differ from the Company’s estimates, the Company adjusts these estimates, which would affect net revenue in the period such adjustments become known. Sales revenue is recognized upon transfer of control of products or services to customers in an amount that reflects the consideration the Company expects to receive in exchange for those products or services. Revenues for the sale of sleep therapy equipment supplies (including CPAP resupply products), durable medical equipment and related supplies (including wheelchairs, hospital beds and infusion pumps), diabetic medical devices and supplies (including continuous glucose monitors (CGM) and insulin pumps), and other HME products and supplies are recognized when control of the promised good or service is transferred to customers, which is generally upon shipment for direct to consumer medical devices and supplies and upon delivery to the home for durable medical equipment. The Company provides certain equipment to patients which is reimbursed periodically in fixed monthly payments for as long as the patient is using the equipment and medical necessity continues (in certain cases, the fixed monthly payments are capped at a certain amount). The equipment provided to the patient is based upon medical necessity as documented by prescriptions and other documentation received from the patient’s physician. The patient generally does not negotiate or select the manufacturer or model of the equipment prescribed by their physician and delivered by the Company. Once initial delivery of this equipment is made to the patient for initial setup, a monthly billing process is established based on the initial setup service date. The Company recognizes the fixed monthly revenue ratably over the service period as earned, less estimated adjustments, and defers revenue for the portion of the monthly bill that is unearned. No separate revenue is earned from the initial setup process. Included in fixed monthly revenue are unbilled amounts for which the revenue recognition criteria had been met as of period-end but were not yet billed to the payor. The estimate of net unbilled fixed monthly revenue recognized is based on historical trends and estimates of future collectability. The Company’s billing system contains payor-specific price tables that reflect the fee schedule amounts in effect or contractually agreed upon by various government and commercial insurance payors for each item of equipment or supply provided to a customer. Revenues are recorded based on the applicable fee schedule. The Company has established a contractual allowance to account for adjustments that result from differences between the payment amount received and the expected realizable amount. If the payment amount received differs from the net realizable amount, an adjustment is recorded to revenues in the period that these payment differences are determined. The Company reports revenues in its consolidated financial statements net of such adjustments. The Company recognizes revenue in the consolidated statements of operations and contract assets on the consolidated balance sheets only when services have been provided. Since the Company has performed its obligation under the contract, it has unconditional rights to the consideration recorded as contract assets and therefore classifies those billed and unbilled contract assets as accounts receivable. Fixed monthly payments that the Company receives from customers in advance of providing services represent contract liabilities. Such payments primarily relate to patients who are billed monthly in advance and are recognized over the period as earned. The Company disaggregates net revenue from contracts with customers by payor type and by core service lines. The Company believes that disaggregation of net revenue into these categories depicts how the nature, amount, timing and uncertainty of revenue and cash flows are affected by economic factors. The payment terms and conditions within the Company’s revenue-generating contracts vary by payor type and payor source. The composition of net revenue by payor type for the years ended December 31, 2022, 2021 and 2020 are as follows (in thousands): Year Ended December 31, 2022 2021 2020 Insurance $ 1,808,633 $ 1,499,154 $ 657,033 Government 781,975 685,513 295,657 Patient pay 379,987 269,868 103,699 Net revenue $ 2,970,595 $ 2,454,535 $ 1,056,389 The composition of net revenue by core service lines for the years ended December 31, 2022, 2021 and 2020 are as follows (in thousands): Year Ended December 31, 2022 2021 2020 Net sales revenue: Sleep $ 794,021 $ 654,130 $ 312,860 Diabetes 670,988 528,082 159,490 Supplies to the home 179,326 167,830 145,624 Respiratory 34,342 31,016 28,605 HME 118,542 113,805 58,029 Other 218,461 144,543 54,689 Total net sales revenue $ 2,015,680 $ 1,639,406 $ 759,297 Net revenue from fixed monthly equipment reimbursements: Sleep $ 272,705 $ 237,252 $ 98,361 Diabetes 16,103 13,123 2,467 Respiratory 520,697 427,270 123,860 HME 102,256 95,936 55,847 Other 43,154 41,548 16,557 Total net revenue from fixed monthly equipment reimbursements $ 954,915 $ 815,129 $ 297,092 Total net revenue: Sleep $ 1,066,726 $ 891,382 $ 411,221 Diabetes 687,091 541,205 161,957 Supplies to the home 179,326 167,830 145,624 Respiratory 555,039 458,286 152,465 HME 220,798 209,741 113,876 Other 261,615 186,091 71,246 Total net revenue $ 2,970,595 $ 2,454,535 $ 1,056,389
Accounts Receivable	Accounts Receivable Due to the continuing changes in the healthcare industry and third-party reimbursement environment, certain estimates are required to record accounts receivable at their net realizable values. Inherent in these estimates is the risk that they will have to be revised or updated as additional information becomes available. The complexity of third-party billing arrangements and laws and regulations governing Medicare and Medicaid may result in adjustments to amounts originally recorded. The Company performs a periodic analysis to review the valuation of accounts receivable and collectability of outstanding balances. Management’s evaluation takes into consideration such factors as historical cash collections experience, business and economic conditions, trends in healthcare coverage, other collection indicators and information about specific receivables. The Company’s evaluation also considers the age and composition of the outstanding amounts in determining their estimated net realizable value. Receivables are considered past due when not collected by established due dates. Specific patient balances are written off after collection efforts have been followed and the account has been determined to be uncollectible. Revisions in reserve estimates are recorded as an adjustment to net revenue in the period of revision.
COVID-19 Pandemic	COVID-19 Pandemic Federal, state, and local authorities have taken several actions designed to assist healthcare providers in providing care to COVID-19 and other patients and to mitigate the adverse economic impact of the COVID-19 pandemic. Legislative actions taken by the federal government include the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act), which was signed into law on March 27, 2020. Through the CARES Act, the federal government authorized payments that were distributed to healthcare providers through the Public Health and Social Services Emergency Fund (Provider Relief Fund or PRF). Additionally, the CARES Act revised the Medicare accelerated and advance payment program in an attempt to disburse payments to healthcare providers more quickly to mitigate the financial impact on healthcare providers. The Company’s participation in these programs and related accounting policies are summarized below. Grant Income . In April 2020, the Company received distributions of the CARES Act PRF of $17.2 million, and subsequent to April 2020, the Company completed several acquisitions in which the acquired companies received a total of $22.2 million of PRF payments prior to the applicable dates of acquisition. In connection with the accounting for these acquisitions, the Company recorded assumed liabilities of $7.7 million relating to the PRF payments received by the acquired companies. The PRF payments were targeted to offset lost revenue and expenditures incurred in connection with the COVID-19 pandemic. The PRF payments are subject to certain restrictions and are subject to recoupment if not used for designated purposes. As a condition to receiving distributions, providers were required to agree to certain terms and conditions, including, among other things, that the funds would be used for lost revenues and unreimbursed COVID-19 related expenses as defined by the U.S. Department of Health and Human Services (HHS). All recipients of PRF payments were required to comply with the reporting requirements described in the terms and conditions and as determined by HHS. The Company recognizes grant payments as income when there is reasonable assurance that it has complied with the conditions associated with the grant. During the years ended December 31, 2021 and 2020, the Company recognized grant income of $10.6 million and $14.3 million, respectively, related to the PRF payments determined to comply with conditions associated with the grant. HHS has indicated that the CARES Act PRF are subject to ongoing reporting and changes to the terms and conditions, and there have been several updates to such reporting requirements and terms and conditions since they were issued by HHS. Such updates have related to changes to the guidance regarding utilization of the funds granted from the PRF and updates to the reporting requirements of such funds, among other updates. To the extent that there is any future updated guidance from HHS or modifications to the terms and conditions, it may affect AdaptHealth's ability to comply and the Company could be required to reverse the recognition of the grant income recorded and return a portion of the funds received, which could be material to the Company. The Company is continuing to monitor the terms and conditions issued by HHS. Furthermore, HHS has indicated that it will be closely monitoring and, along with the Office of Inspector General (United States) (OIG) , auditing providers to ensure that recipients comply with the terms and conditions of relief programs and to prevent fraud and abuse. All providers will be subject to civil and criminal penalties for any deliberate omissions, misrepresentations or falsifications of any information given to HHS. Medicare Accelerated Payment Program . In certain circumstances, when a healthcare provider is experiencing financial difficulty due to delays in receiving payment for the Medicare services it provided, it may be eligible for an accelerated or advance payment pursuant to the Medicare accelerated payment program. The CARES Act revised the Medicare accelerated and advance payment program in an attempt to disburse payments to healthcare providers more quickly to mitigate the financial impact on healthcare providers. In April 2020, the Company received recoupable advance payments of $45.8 million, which were made available by CMS under the CARES Act. In addition, in connection with an acquisition completed in July 2020, the Company assumed a liability of $3.7 million relating to CMS recoupable advance payments received by the acquired company prior to the date of acquisition. The recoupment of the advance payments by CMS began in April 2021 and were applied to services provided and revenue recognized during the period in which the recoupment occurred, which impacted the Company’s cash receipts for services provided during the period in which the amounts were recouped. During the years ended December 31, 2022 and 2021, $12.8 million and $36.7 million, respectively, was recouped by or repaid to CMS. As of December 31, 2022, the CMS advance payments have been recouped by or repaid to CMS in full and there is no liability to CMS for these amounts as of such date. Deferral of Employment Tax Payments . As permitted under the CARES Act, the Company elected to defer certain portions of employer-paid FICA taxes otherwise payable from March 27, 2020 to January 1, 2021. In total, the Company deferred $8.6 million under this provision, and paid $4.3 million on January 4, 2022 and $4.3 million on December 14, 2022. There are no further amounts due under this provision as of December 31, 2022. The full extent of the impact of the COVID-19 pandemic on the Company’s business, results of operations, and financial condition is highly uncertain and will depend on future developments and numerous evolving factors that it may not be able to accurately predict, and could be material to the Company’s consolidated financial statements in future reporting periods.
Fair Value Accounting	Fair Value Accounting Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 820, Fair Value Measurements and Disclosures (ASC 820), creates a single definition of fair value, establishes a framework for measuring fair value in U.S. GAAP and expands disclosures about fair value measurements. ASC 820 emphasizes that fair value is a market-based measurement, not an entity specific measurement, and states that a fair value measurement is to estimate the price at which an orderly transaction to sell an asset or to transfer the liability would take place between market participants at the measurement date under current market conditions. Assets and liabilities adjusted to fair value in the balance sheet are categorized based upon the level of judgment associated with the inputs used to measure their fair value. Level inputs, as defined by ASC 820, are as follows: Level input Input Definition Level 1 Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. Level 2 Inputs, other than quoted prices included in Level 1 that are observable for the asset or liability through corroboration with market data at the measurement date. Level 3 Unobservable inputs that reflect management’s best estimate of what market participants would use in pricing the asset or liability at the measurement date. Refer to Note 6, Fair Value of Assets and Liabilities , for additional information.
Fair Value of Financial Instruments	Fair Value of Financial InstrumentsThe Company’s financial instruments consist of cash and cash equivalents, accounts receivable, prepaid and other current assets, accounts payable and accrued expenses. The carrying values of the Company’s financial instruments approximate their fair value based on their short-term nature.
Cash and Cash Equivalents	Cash and Cash EquivalentsThe Company considers all short-term highly liquid investments with a maturity of three months or less to be cash equivalents. Cash represents cash on hand and deposits held at banks. The Company maintains cash in demand deposit accounts with federally insured banks. At times, the balances in these accounts may be in excess of federally insured limits.
Inventory	InventoryInventory consists of equipment and medical supplies to be sold to customers and is stated at the lower of cost or market value. Cost is determined by the first-in-first-out method. These finished goods are charged to cost of net revenue in the period in which products and related services are provided to customers.
Equipment and Other Fixed Assets	Equipment and Other Fixed Assets Equipment and other fixed assets are stated at cost less accumulated depreciation or, when acquired as part of a business combination, fair value at date of acquisition. Depreciation is computed using the straight-line method over the estimated useful lives of the related assets. The useful lives for patient medical equipment correlate with the medical reimbursement periods. Computer equipment, vehicles and other fixed assets are depreciated over the estimated useful lives of the assets. Major expenditures for property acquisitions and those expenditures that substantially increase useful lives are capitalized. Expenditures for maintenance, repairs and minor replacements are expensed as incurred. The useful lives of property and equipment for purposes of computing depreciation are: Patient medical equipment 13 months ‑ 5 years Vehicles 5 years Other 2 ‑ 10 years
Long Lived Assets	Long-Lived Assets The Company’s long-lived assets, such as equipment and other fixed assets, operating lease right-of-use assets, finance lease right-of-use assets and definite-lived identifiable intangible assets, are assessed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to estimated undiscounted future cash flows expected to be generated by the asset. If the carrying amount of an asset exceeds its estimated undiscounted future cash flows, an impairment charge is recognized by the amount by which the carrying amount of the asset exceeds the fair value of the asset. Definite-lived identifiable intangible assets consist of tradenames, payor contracts, contractual rental agreements and developed technology. These assets are amortized using the straight-line method over their estimated useful lives, which reflects the pattern in which the economic benefits of the assets are expected to be consumed. These assets are assessed for impairment consistent with the Company’s long-lived assets. The following table summarizes the useful lives of the Company's identifiable intangible assets: Tradenames 5 to 10 years Payor contracts 10 years Contractual rental agreements 2 years Developed technology 5 years
Valuation of Goodwill	Valuation of Goodwill The Company has a significant amount of goodwill on its balance sheet that resulted from the business acquisitions the Company has made. Goodwill is not amortized and is assessed for impairment annually and upon the occurrence of a triggering event or change in circumstances indicating a possible impairment. Such triggering events potentially warranting an annual or interim goodwill impairment assessment include, among other factors, declines in historical or projected revenue, operating income or cash flows, and declines in the Company’s stock price or market capitalization. Such changes in circumstance can include, among others, changes in the legal environment, reimbursement environment, operating performance, and/or future prospects. The Company performs its annual impairment assessment of goodwill during the fourth quarter of each year. The impairment assessment can be performed on either a quantitative or qualitative basis. The Company first assesses qualitative factors to determine whether it is necessary to perform a quantitative goodwill impairment analysis. If determined necessary, the Company applies the quantitative impairment test to identify and measure the amount of impairment, if any. Fair value determinations require considerable judgment and are sensitive to changes in underlying assumptions and factors, such as estimates of a reporting unit's fair value and judgment about impairment triggering events. As a result, there can be no assurance that the estimates and assumptions made for purposes of the annual goodwill impairment test will prove to be accurate predictions of the future. During the three months ended March 31, 2022, the Company experienced a decline in its market capitalization as a result of a decline in the Company’s stock price. The Company considered such decline to represent a triggering event requiring management to perform a quantitative goodwill impairment analysis as of March 31, 2022. No such triggering events were identified during the remainder of 2022. Refer to Note 5, Goodwill and Identifiable Intangible Assets , for additional details.
Business Combinations	Business CombinationsThe Company applies the acquisition method of accounting for business acquisitions. The results of operations of the businesses acquired by the Company are included as of the respective acquisition date. The acquisition-date fair value of the consideration transferred, including the fair value of any contingent consideration, is allocated to the underlying assets acquired and liabilities assumed based upon their estimated fair values at the date of acquisition. To the extent the acquisition-date fair value of the consideration transferred exceeds the fair value of the identifiable tangible and intangible assets acquired and liabilities assumed, such excess is allocated to goodwill. Patient relationships, medical records and patient lists are not reported as separate intangible assets due to the regulatory requirements and lack of contractual agreements but are part of goodwill. Customer related relationships are not reported as separate intangible assets but are part of goodwill as authorizing physicians are under no obligation to refer the Company’s services to their patients, who are free to change physicians and service providers at any time. The Company may adjust the preliminary purchase price allocation, as necessary, as it obtains more information regarding asset valuations and liabilities assumed that existed but were not available at the acquisition date, which is generally up to one year after the acquisition closing date. Acquisition related expenses are recognized separately from the business combination and are expensed as incurred.
Deferred Financing Costs	Deferred Financing Costs Costs incurred in connection with the Company’s borrowings, referred to as financing costs, are capitalized and included on the accompanying consolidated balance sheets in Other assets for costs associated with revolving credit facilities, and as a reduction of the carrying value of debt for costs associated with secured term loans. The capitalized financing costs are amortized to interest expense using the effective interest method over the term of the related financing agreement. Refer to Note 8, Deferred Financing Costs , for additional information.
Accounting for Leases	Accounting for Leases During the year ended December 31, 2021, the Company adopted FASB Accounting Standards Update (ASU) No. 2016-02, Leases (Topic 842) (ASC 842) with an effective date of January 1, 2021, using the modified retrospective approach, for leases that existed on January 1, 2021. ASC 842 requires the Company to recognize a lease liability, which represents the discounted obligation to make future minimum lease payments, and a corresponding right-of-use (ROU) asset on its consolidated balance sheet for most leases, and disclose key information about leasing arrangements. The Company elected to apply certain practical expedients permitted under the transition guidance within ASC 842 to leases that commenced before January 1, 2021, including the package of practical expedients, which, among other things, permits lease agreements that are twelve months or less to be excluded from the balance sheet, and permits the Company not to reassess under the new standard its prior conclusions about lease identification, lease classification and initial direct costs. Due to the Company’s election of these practical expedients, the Company carried forward certain historical conclusions for existing contracts, including conclusions related to the existence and classification of leases and to initial direct costs. ASC 842 applies to a number of arrangements to which the Company is a party. Whenever the Company enters into a new arrangement, it must determine, at the inception date, whether the arrangement is or contains a lease. This determination generally depends on whether the arrangement conveys to the Company the right to control the use of an explicitly or implicitly identified asset for a period of time in exchange for consideration. Control of an underlying asset is conveyed to the Company if the Company obtains the rights to direct the use of and obtain substantially all the economic benefits from the use of the underlying asset. If a lease exists, the Company must then determine the separate lease and non-lease components of the arrangement. Each right to use an underlying asset conveyed by a lease arrangement should generally be considered a separate lease component if it both: (i) can benefit the Company without depending on other resources not readily available to the Company and (ii) does not significantly affect and is not significantly affected by other rights of use conveyed by the lease. Aspects of a lease arrangement that transfer other goods or services to the Company but do not meet the definition of lease components are considered non-lease components. The consideration owed by the Company pursuant to a lease arrangement is generally allocated to each lease and non-lease component for accounting purposes. However, the Company has elected, for all of its leases, to not separate lease and non-lease components. Each lease component is accounted for separately from other lease components, but together with the associated non-lease components. For each lease, the Company must then determine the lease term, the present value of lease payments and the classification of the lease as either an operating or finance lease. The lease term is the period of the lease not cancellable by the Company, together with periods covered by: (i) renewal options the Company is reasonably certain to exercise, (ii) termination options the Company is reasonably certain not to exercise, and (iii) renewal or termination options that are controlled by the lessor. The present value of lease payments is calculated based on: • Lease payments – lease payments include fixed and certain variable payments, less lease incentives, together with amounts probable of being owed by the Company under residual value guarantees and, if reasonably certain of being paid, the cost of certain renewal options and early termination penalties set forth in the lease arrangement. Lease payments exclude consideration that is not related to the transfer of goods and services of the Company. • Discount rate – the discount rate must be determined based on information available to the Company upon the commencement of the lease. Lessees are required to use the rate implicit in the lease whenever such rate is readily available; however, as the implicit rate in the Company’s leases is generally not readily determinable, the Company generally uses the hypothetical incremental borrowing rate it would have to pay to borrow an amount equal to the lease payments, on a collateralized basis, over a timeframe similar to the lease term. In making the determination of whether a lease is an operating lease or a finance lease, the Company considers the lease term in relation to the economic life of the leased asset, the present value of lease payments in relation to the fair value of the leased asset and certain other factors, including the lessee’s and lessor’s rights, obligations, and economic incentives over the term of the lease. Generally, upon the commencement of a lease, the Company will record a lease liability and a ROU asset. However, the Company has elected, for all underlying leases with initial terms of twelve months or less (known as short-term leases), to not recognize a lease liability or ROU asset. Lease liabilities are initially recorded at lease commencement as the present value of future lease payments. ROU assets are initially recorded at lease commencement as the initial amount of the lease liability, together with the following, if applicable: (i) initial direct costs incurred by the lessee and (ii) lease payments made by the lessor net of lease incentives received, prior to lease commencement. Over the lease term, the Company generally increases its lease liabilities using the effective interest method and decreases its lease liabilities for lease payments made. For finance leases, amortization and interest expense are recognized separately in the consolidated statements of operations, with amortization expense generally recorded on a straight-line basis over the lease term and interest expense recorded using the effective interest method. For operating leases, a single lease cost is generally recognized in the consolidated statements of operations on a straight-line basis over the lease term unless an impairment has been recorded with respect to a leased asset. Lease costs for short-term leases not recognized in the consolidated balance sheets are recognized in the consolidated statements of operations on a straight-line basis over the lease term. Variable lease costs not initially included in the lease liability and ROU asset impairment charges are expensed as incurred. ROU assets are assessed for impairment, similar to other long-lived assets. Refer to Note 13, Leases , for additional information. Prior to the adoption of ASC 842, the Company accounted for leases under FASB ASC Topic 840, Leases (“ASC 840”).
Commitments and Contingencies	Commitments and Contingencies In the normal course of business, the Company is subject to loss contingencies, such as legal proceedings and claims arising out of its business that cover a wide range of matters. In accordance with FASB ASC Topic 450, Accounting for Contingencies , the Company records accruals for such loss contingencies when it is probable that a liability has been incurred and the amount of loss can be reasonably estimated. Significant judgment is required to determine both probability and the estimated amount. The Company reviews its accruals at least quarterly and adjusts accordingly to reflect the impact of negotiations, settlements, rulings, advice of legal counsel, and updated information. At this time, the Company has no material accruals related to lawsuits, claims, investigations and proceedings. While there can be no assurance, based on the Company’s evaluation of information currently available, the Company’s management believes any liability that may ultimately result from resolution of such loss contingencies will not have a material adverse effect on the Company’s financial conditions or results of operations. However, the Company’s assessment may be affected by limited information. Accordingly, the Company’s assessment may change in the future based upon availability of new information and further developments in the proceedings of such matters. The results of legal proceedings are inherently uncertain, and material adverse outcomes are possible. Refer to Note 16, Commitments and Contingencies , for additional information.
Advertising Costs	Advertising CostsAdvertising costs are charged to expense as incurred. The Company’s advertising costs for the years ended December 31, 2022, 2021 and 2020 were $19.2 million, $18.5 million and $5.3 million, respectively, and are included in Cost of net revenue in the accompanying consolidated statements of operations.
Equity based Compensation	Equity-based Compensation The Company accounts for its equity-based compensation in accordance with FASB ASC Topic 718, Compensation Stock Compensation , which establishes accounting for share based awards exchanged for employee services and requires companies to expense the estimated fair value of these awards over the requisite employee service period. Equity-based compensation expense related to these grants is included within cost of net revenue and general and administrative expenses in the accompanying consolidated statements of operations. The Company measures and recognizes equity-based-compensation expense for such awards granted to employees based on their estimated fair values on the date of grant. The value of the portion of the award that is ultimately expected to vest is recognized as expense over the requisite service period in the Company’s consolidated financial statements. Equity-based compensation expense is recognized on a straight-line basis over the requisite service period. For awards with performance conditions, equity-based compensation expense is recognized on a straight-line basis over the employees’ requisite service period subject to management’s estimation of the probability of vesting of such awards. Refer to Note 11, Stockholders’ Equity , for additional information regarding the Company’s equity-based compensation expense.
Cost of Net Revenue	Cost of Net RevenueCost of net revenue includes the cost of non-capitalized medical equipment and supplies sold to patients, depreciation for capitalized patient equipment, salaries, labor and benefits costs for service personnel at the Company’s operating facilities, offshore labor expenses, occupancy costs (such as rent, utilities, and property taxes), and other expenses incurred to operate the businesses (such as distribution expenses, billing fees, software expenses and general business supplies).
General and Administrative Expenses	General and Administrative ExpensesGeneral and administrative expenses (G&A) primarily include expenses related to corporate salaries and benefits, legal, consulting, equity-based compensation, transaction costs and other business support functions.
Business Segment	Business SegmentThe Company’s chief operating decision-makers are its Chief Executive Officer and President, who make resource allocation decisions and assess performance based on financial information presented on an aggregate basis. There are no segment managers who are held accountable by the chief operating decision-makers, or anyone else, for any planning, strategy and key decision-making regarding operations. The corporate office is responsible for contract negotiation with vendors and payors, corporate compliance with healthcare laws and regulations, and revenue cycle management, among other corporate supporting functions. Accordingly, the Company has a single reportable segment and operating segment structure.
Concentration of Credit Risk	Concentration of Credit RiskFinancial instruments which potentially subject the Company to concentrations of credit risk consist principally of cash and cash equivalents and trade accounts receivable. The Company maintains its cash in bank deposit accounts, which, at times, may exceed federally insured limits. The Company has not experienced any losses in such accounts and believes it is not exposed to any significant credit risk on cash and cash equivalents. As of December 31, 2022 and 2021, less than 10% of the Company’s net accounts receivable are from patients under co-pay or private plan arrangements.
Concentration of Customers	Concentration of CustomersThe Company provides patient-centered, healthcare-at-home solutions including home medical equipment, medical supplies, and related services, to its customers. This results in a customer concentration relating to government healthcare reimbursement programs. During the years ended December 31, 2022, 2021 and 2020, the Company derived approximately 26%, 28% and 28% of its net revenue from government healthcare programs, including Medicare and Medicaid, respectively. Concentration of credit risk with respect to other payors is limited due to the large number of such payors and varied geographical locations.
Self-Insurance Risk	Self-Insurance RiskThe Company is subject to workers’ compensation, auto liability and employee medical claims, which are primarily self-insured; however, the Company maintains certain stop-loss and other insurance coverage which it believes to be appropriate. Provisions for estimated settlements relating to the workers’ compensation and medical plans are provided in the period of the related claim on a case-by-case basis plus an amount for incurred but not reported claims. Differences between the amounts accrued and subsequent settlements are recorded in operations in the period of settlement.
Derivative Instruments	Derivative Instruments The Company recognizes all derivative instruments as either assets or liabilities in the accompanying consolidated balance sheets at fair value. Derivative instruments consist of interest rate swap agreements. The interest rate swap agreements are used to manage interest rate risk associated with the Company’s variable rate debt. The Company utilizes the interest rate swap agreements to modify the Company’s exposure to interest rate risk by converting a portion of its variable rate borrowings to a fixed rate. Refer to Note 7, Derivative Instruments and Hedging Activities , for additional information.
Income Taxes	Income Taxes The Company uses the asset and liability method of accounting for income taxes, under which deferred tax assets and liabilities are recognized for the future tax consequences of (i) temporary differences between the financial statement carrying amounts and the tax basis of existing assets and liabilities and (ii) operating loss and tax credit carryforwards. Deferred income tax assets and liabilities are based on enacted tax rates applicable to the future period when those temporary differences are expected to be recovered or settled. The effect of a change in tax rates on deferred tax assets and liabilities is recognized in income in the period the rate change is enacted. A valuation allowance is provided for deferred tax assets when it is more likely than not the deferred tax assets will not be realized. The Company’s deferred tax calculations and valuation allowance requires management to make certain estimates about future operations. Changes in state or federal tax laws, as well as changes in the Company’s financial condition or the carrying value of existing assets and liabilities, could affect those estimates. The effect of a change in tax rates is recognized as income or expense in the period that the rate is enacted. FASB ASC 740, Income Taxes , prescribes a recognition threshold and a measurement attribute for the financial statement recognition and measurement of tax positions taken or expected to be taken in a tax return. For those benefits to be recognized, a tax position must be more-likely-than-not to be sustained upon examination by taxing authorities. The Company recognizes accrued interest and penalties related to unrecognized tax benefits as income tax expense. There was no material amount of expense for interest and penalties related to unrecognized tax benefits for the years ended December 31, 2022, 2021 and 2020.
Earnings (Loss) Per Share	Earnings (Loss) Per Share Earnings (loss) per share is based upon the weighted average number of common shares outstanding during the respective periods. The Company follows the provisions of the authoritative guidance for determining whether instruments granted in equity-based compensation transactions or other instruments are participating securities for purposes of calculating earnings (loss) per share. Refer to Note 12, Earnings (Loss) Per Share , for additional information.
Recent Issued Accounting Pronouncements	Recently Issued Accounting Pronouncements In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848) , which provides optional guidance to ease the potential burden in accounting for (or recognizing the effects of) reference rate reform on financial reporting. Specifically, the guidance permits an entity, when certain criteria are met, to consider amendments to contracts

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2022
Accounting Policies [Abstract]
Schedule of composition of net revenues by payor type and core service lines	The composition of net revenue by payor type for the years ended December 31, 2022, 2021 and 2020 are as follows (in thousands): Year Ended December 31, 2022 2021 2020 Insurance $ 1,808,633 $ 1,499,154 $ 657,033 Government 781,975 685,513 295,657 Patient pay 379,987 269,868 103,699 Net revenue $ 2,970,595 $ 2,454,535 $ 1,056,389 The composition of net revenue by core service lines for the years ended December 31, 2022, 2021 and 2020 are as follows (in thousands): Year Ended December 31, 2022 2021 2020 Net sales revenue: Sleep $ 794,021 $ 654,130 $ 312,860 Diabetes 670,988 528,082 159,490 Supplies to the home 179,326 167,830 145,624 Respiratory 34,342 31,016 28,605 HME 118,542 113,805 58,029 Other 218,461 144,543 54,689 Total net sales revenue $ 2,015,680 $ 1,639,406 $ 759,297 Net revenue from fixed monthly equipment reimbursements: Sleep $ 272,705 $ 237,252 $ 98,361 Diabetes 16,103 13,123 2,467 Respiratory 520,697 427,270 123,860 HME 102,256 95,936 55,847 Other 43,154 41,548 16,557 Total net revenue from fixed monthly equipment reimbursements $ 954,915 $ 815,129 $ 297,092 Total net revenue: Sleep $ 1,066,726 $ 891,382 $ 411,221 Diabetes 687,091 541,205 161,957 Supplies to the home 179,326 167,830 145,624 Respiratory 555,039 458,286 152,465 HME 220,798 209,741 113,876 Other 261,615 186,091 71,246 Total net revenue $ 2,970,595 $ 2,454,535 $ 1,056,389
Schedule of carrying amounts and estimated fair values of debt	The table below shows the carrying amounts and estimated fair values, net of unamortized deferred financing costs, of the Company’s long-term debt arrangements (in thousands): December 31, 2022 December 31, 2021 Carrying Value Fair Value Carrying Value Fair Value Secured term loan $ 761,547 $ 761,547 $ 780,414 $ 780,414 Senior unsecured notes 1,426,720 1,227,574 1,423,138 1,459,137 $ 2,188,267 $ 1,989,121 $ 2,203,552 $ 2,239,551
Summary of cash and cash equivalents	Cash and cash equivalents consist of the following: December 31, (in thousands) 2022 2021 Cash $ 46,272 $ 149,613 Money market accounts — 14 Total $ 46,272 $ 149,627
Summary of useful lives of property and equipment for purposes of computing depreciation	The useful lives of property and equipment for purposes of computing depreciation are: Patient medical equipment 13 months ‑ 5 years Vehicles 5 years Other 2 ‑ 10 years
Schedule of useful lives of intangible assets acquired	The following table summarizes the useful lives of the Company's identifiable intangible assets: Tradenames 5 to 10 years Payor contracts 10 years Contractual rental agreements 2 years Developed technology 5 years
Summary of cost of net revenue	Cost of net revenue for the years ended December 31, 2022, 2021 and 2020 consisted of the following (in thousands): Year Ended December 31, 2022 2021 2020 Cost of products and supplies $ 1,199,481 $ 955,813 $ 441,931 Salaries, labor and benefits 770,669 595,668 257,898 Patient equipment depreciation 286,288 194,958 71,072 Rent and occupancy 64,375 48,586 22,344 Other operating expenses 225,719 206,599 97,511 Equity-based compensation 6,637 7,301 7,845 Total $ 2,553,169 $ 2,008,925 $ 898,601

Acquisitions (Tables)

Acquisitions (Tables)	12 Months Ended
	Dec. 31, 2022
Business Combination and Asset Acquisition [Abstract]
Summary of consideration	The following table summarizes the consideration paid for all acquisitions during the year ended December 31, 2022 (in thousands): Cash $ 17,170 Deferred payments 457 Total $ 17,627 The following table summarizes the consideration paid for all acquisitions during the year ended December 31, 2021 (in thousands): AeroCare Spiro Healthy Living Agilis We Care Community Other Total Cash $ 1,153,409 $ 65,759 $ 47,048 $ 30,828 $ 34,834 $ 129,423 $ 196,669 $ 1,657,970 Equity 1,220,342 7,109 5,057 14,668 6,321 — 7,703 1,261,200 Contingent consideration — 1,000 — 1,000 — 5,800 — 7,800 Deferred payments — — — — — — 4,478 4,478 Total $ 2,373,751 $ 73,868 $ 52,105 $ 46,496 $ 41,155 $ 135,223 $ 208,850 $ 2,931,448 The following table summarizes the consideration paid for all acquisitions during the year ended December 31, 2020 (in thousands): PCS Advanced Solara ActivStyle Pinnacle Other Total Cash $ 14,008 $ 58,517 $ 380,735 $ 65,512 $ 80,377 $ 191,415 $ 790,564 Equity — — 73,359 — 28,182 22,346 123,887 Contingent consideration — 5,000 1,300 — 14,300 6,464 27,064 Deferred payments — — — — — 33 33 Total $ 14,008 $ 63,517 $ 455,394 $ 65,512 $ 122,859 $ 220,258 $ 941,548
Summary of estimated fair values of the net assets acquired	Based upon management’s evaluation, the consideration paid for all acquisitions during 2022 was allocated as follows (in thousands): Cash $ 162 Accounts receivable 2,336 Inventory 771 Prepaid and other current assets 16 Equipment and other fixed assets 4,585 Goodwill 12,341 Identifiable intangible assets 500 Deferred tax assets 180 Accounts payable and accrued expenses (3,130) Contract liabilities (134) Net assets acquired $ 17,627 AeroCare Spiro Healthy Living Agilis We Care Community Other Total Cash $ 27,686 $ 2,132 $ 579 $ 1,131 $ 458 $ 2 $ 5,005 $ 36,993 Accounts receivable 71,916 $ 5,756 5,838 — 2,007 15,798 25,587 126,902 Inventory 26,998 1,733 2,949 2,330 465 5,214 10,663 50,352 Prepaid and other current assets 3,522 152 1,088 — — 571 2,403 7,736 Equipment and other fixed assets 190,755 6,897 1,188 348 5,254 44,952 24,963 274,357 Operating lease right-of-use assets 52,927 2,581 1,366 490 970 4,412 15,897 78,643 Goodwill 2,083,423 64,380 44,095 55,375 35,971 88,393 164,929 2,536,566 Identifiable intangible assets 122,800 1,000 1,500 500 400 2,300 4,400 132,900 Other assets 1,178 16 — — — 2,505 — 3,699 Deferred tax liabilities (46,234) — — — (1,228) — (308) (47,770) Accounts payable and accrued expenses (82,722) (5,517) (3,363) (3,188) (1,389) (13,725) (21,679) (131,583) Contract liabilities (14,495) (486) (102) — (783) (3,156) (608) (19,630) Other current liabilities (10,021) — (1,667) — — (180) (1,833) (13,701) Other long-term liabilities (1,055) — — — — (2,683) — (3,738) Operating lease obligations (52,927) (2,581) (1,366) (490) (970) (4,412) (15,897) (78,643) Finance lease obligations — (2,195) — — — (4,768) (4,672) (11,635) Net assets acquired $ 2,373,751 $ 73,868 $ 52,105 $ 56,496 $ 41,155 $ 135,223 $ 208,850 $ 2,941,448 The Company allocated the consideration paid to the net assets acquired based on their estimated acquisition date fair values. Based upon management’s evaluation, the consideration paid for all acquisitions during 2020 was allocated as follows during the year ended December 31, 2020 (in thousands): PCS Advanced Solara ActivStyle Pinnacle Other Total Cash $ 61 $ — $ 12,069 $ 4,993 $ 1,193 $ 2,911 $ 21,227 Accounts receivable 14,925 7 17,411 5,158 4,174 21,265 62,940 Inventory — 2,727 14,376 471 101 8,436 26,111 Prepaid and other current assets 943 127 2,113 955 612 4,810 9,560 Equipment and other fixed assets 535 19,783 3,473 992 — 20,886 45,669 Goodwill 988 41,712 347,718 49,643 107,706 184,252 732,019 Intangible assets — 600 85,700 9,400 15,200 11,200 122,100 Other assets — — — — 2,921 — 2,921 Deferred tax assets (liabilities) — 1,240 — (108) 1,132 Accounts payable and accrued expenses (2,025) (35) (22,464) (7,155) (5,777) (23,740) (61,196) Contract liabilities — (1,404) (167) — — (1,773) (3,344) Other liabilities (233) — (4,835) (185) (350) (5,675) (11,278) Other long-term liabilities (1,186) — — — (2,921) — (4,107) Finance lease obligations — — — — — (2,206) (2,206) Net assets acquired $ 14,008 $ 63,517 $ 455,394 $ 65,512 $ 122,859 $ 220,258 $ 941,548
Summary of results of business acquired	The following table presents the amount of Net revenue and Operating income in the period of acquisition since the respective acquisition dates for the acquisitions described above that is included in the Company’s consolidated statements of operations for the years ended December 31, 2022, 2021 and 2020: (in thousands) Year Ended December 31, 2022 2021 2020 Net revenue $ 16,455 $ 1,005,097 $ 427,352 Operating income $ 767 $ 136,404 $ 17,673

Equipment and Other Fixed Ass_2

Equipment and Other Fixed Assets (Tables)	12 Months Ended
	Dec. 31, 2022
Property, Plant and Equipment [Abstract]
Schedule of equipment and other fixed assets	Equipment and other fixed assets as of December 31, 2022 and 2021 are as follows (in thousands): December 31, December 31, Patient medical equipment $ 747,985 $ 533,760 Delivery vehicles 35,326 36,213 Other 86,956 50,208 870,267 620,181 Less accumulated depreciation (383,188) (221,604) $ 487,079 $ 398,577

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of change in the carrying amount of goodwill	The change in the carrying amount of goodwill for the years ended December 31, 2022 and 2021 was as follows (in thousands): Gross carrying Balance at December 31, 2020 $ 998,810 Goodwill from acquisitions 2,536,566 Net cash receipts relating to prior acquisitions (657) Net reductions relating to measurement period adjustments (22,152) Balance at December 31, 2021 $ 3,512,567 Goodwill from acquisitions 12,341 Net cash payments relating to prior acquisitions 2,009 Net increase relating to measurement period adjustments 18,380 Balance at December 31, 2022 $ 3,545,297
Schedule of identifiable intangible assets	Identifiable intangible assets consisted of the following at December 31, 2022 and 2021 (in thousands): December 31, 2022 Weighted-Average Tradenames, net of accumulated amortization of $25,498 $ 87,302 7.5 Payor contracts, net of accumulated amortization of $20,016 61,984 7.6 Contractual rental agreements, net of accumulated amortization of $43,863 10,337 0.8 Developed technology, net of accumulated amortization of $3,150 3,150 2.5 Identifiable intangible assets, net $ 162,773 December 31, 2021 Weighted-Average Tradenames, net of accumulated amortization of $12,705 $ 99,595 8.4 Payor contracts, net of accumulated amortization of $11,816 70,184 8.6 Contractual rental agreements, net of accumulated amortization of $26,158 28,042 1.8 Developed technology, net of accumulated amortization of $1,890 4,410 3.5 Identifiable intangible assets, net $ 202,231
Schedule of future amortization expense related to identifiable intangible assets	Future amortization expense related to identifiable intangible assets is estimated to be as follows (in thousands): Twelve months ending December 31, 2023 $ 32,613 2024 22,276 2025 21,328 2026 19,263 2027 17,960 Thereafter 49,333 Total $ 162,773

Fair Value of Assets and Liab_2

Fair Value of Assets and Liabilities (Tables)	12 Months Ended
	Dec. 31, 2022
Fair Value Disclosures [Abstract]
Summary of financial assets and liabilities measured at fair value on a recurring basis	The following table presents the valuation of the Company’s financial assets and liabilities as of December 31, 2022 and 2021 measured at fair value on a recurring basis. The fair value estimates presented herein are based on information available to management as of December 31, 2022 and 2021. These estimates are not necessarily indicative of the amounts the Company could ultimately realize. (in thousands) Level 1 Level 2 Level 3 December 31, 2022 Assets Interest rate swap agreements-short term $ — $ 5,748 $ — Interest rate swap agreements-long term — 3,728 — Total assets measured at fair value $ — $ 9,476 $ — Liabilities Acquisition-related contingent consideration-short term $ — $ — $ 7,500 Warrant liability — — 38,503 Total liabilities measured at fair value $ — $ — $ 46,003 (in thousands) Level 1 Level 2 Level 3 December 31, 2021 Assets Money market accounts $ 14 $ — $ — Total assets measured at fair value $ 14 $ — $ — Liabilities Acquisition-related contingent consideration-short term $ — $ — $ 13,500 Acquisition-related contingent consideration-long term — — 6,800 Interest rate swap agreements-short term — 5,098 — Interest rate swap agreements-long term — 2,359 — Warrant liability — — 57,764 Total liabilities measured at fair value $ — $ 7,457 $ 78,064
Reconciliation of contingent consideration liabilities	A reconciliation of the Company’s contingent consideration liabilities related to acquisitions for the years ended December 31, 2022 and 2021 is as follows (in thousands): Year Ended December 31 2022 Beginning Balance Additions Payments Change in Fair Value Other activity Ending Balance Contingent consideration - Level 3 liabilities $ 20,300 $ — $ (15,015) $ 2,215 $ — $ 7,500 Year Ended December 31 2021 Beginning Balance Additions Payments Change in Fair Value Other activity Ending Balance Contingent consideration - Level 3 liabilities $ 33,540 $ 7,800 $ (20,347) $ (866) $ 173 $ 20,300 A reconciliation of the changes in the contingent consideration common shares liability related to the Contingent Consideration Common Shares during the years ended December 31, 2021 and 2020 was as follows (in thousands): Estimated fair value of contingent consideration common shares liability at December 31, 2019 $ 9,316 Change in estimated fair value of the contingent consideration common shares liability 98,717 Reclassification of contingent consideration common shares liability to equity (37,556) Estimated fair value of contingent consideration common shares liability at December 31, 2020 70,477 Change in estimated fair value of the contingent consideration common shares liability (29,389) Reclassification of contingent consideration common shares liability to equity (41,088) Estimated fair value of contingent consideration common shares liability at December 31, 2021 $ —
Summary of non-financial assets measured on a non-recurring basis	The following table presents the Company’s hierarchy for non-financial assets measured at fair value on a non-recurring basis (in thousands): December 31, December 31, Assets: Goodwill (Level 3) $ 3,545,297 $ 3,512,567 Identifiable intangible assets, net (Level 3) $ 162,773 $ 202,231

Derivative Instruments and He_2

Derivative Instruments and Hedging Activities (Tables)	12 Months Ended
	Dec. 31, 2022
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Summary of fair value of derivative financial instruments as well as their classification on the consolidated balance sheets	The table below presents the fair value of the Company’s derivatives related to its interest rate swap agreements, which are designated as hedging instruments, as well as their classification in the consolidated balance sheets at December 31, 2022 and 2021 (in thousands): December 31, 2022 December 31, 2021 Balance Sheet Location Asset (Liability) Prepaid and other current assets $ 5,748 $ — Other assets 3,728 — Other liabilities — (5,098) Other long-term liabilities — (2,359) Total $ 9,476 $ (7,457)

Deferred Financing Costs (Table

Deferred Financing Costs (Tables)	12 Months Ended
	Dec. 31, 2022
Debt Issuance Costs, Net [Abstract]
Summary of change in the carrying amount of deferred financing costs	The change in the carrying amount of deferred financing costs for the years ended December 31, 2022 and 2021 was as follows (in thousands): Year Ended December 31, 2022 2021 Balance at beginning of period $ 33,463 $ 13,710 Capitalized fees — 29,185 Amortization (5,234) (5,378) Write-off due to debt refinancing — (4,054) Balance at end of period $ 28,229 $ 33,463
Schedule of amortization of deferred financing costs	The December 31, 2022 balance of deferred financing costs of $28.2 million is estimated to be amortized to interest expense, net as follows (in thousands): 2023 $ 5,234 2024 5,234 2025 5,147 2026 3,659 2027 3,577 Thereafter 5,378 $ 28,229

Accounts Payable and Accrued _2

Accounts Payable and Accrued Expenses (Tables)	12 Months Ended
	Dec. 31, 2022
Accounts Payable and Accrued Liabilities, Current [Abstract]
Schedule of components accounts payable and accrued expenses	Accounts payable and accrued expenses as of December 31, 2022 and 2021 consisted of the following (in thousands): December 31, December 31, Accounts payable $ 222,505 $ 248,027 Employee-related accruals 41,872 34,370 Accrued interest 28,877 30,103 Other 44,244 45,884 Total $ 337,498 $ 358,384

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2022
Debt Disclosure [Abstract]
Schedule of summary of long term debt	The following is a summary of long-term debt as of December 31, 2022 and 2021 (in thousands): December 31, December 31, Secured term loan $ 765,000 $ 785,000 Senior unsecured notes 1,450,000 1,450,000 Unamortized deferred financing fees (26,733) (31,448) 2,188,267 2,203,552 Current portion (35,000) (20,000) Long-term portion $ 2,153,267 $ 2,183,552
Schedule of maturity of total debt, excluding unamortized deferred financing fees	The future maturity of total debt, excluding unamortized deferred financing fees, at December 31, 2022 is as follows (in thousands). Twelve months ended December 31, 2023 $ 35,000 2024 40,000 2025 40,000 2026 650,000 2027 — Thereafter 1,450,000 Total debt maturity $ 2,215,000

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	12 Months Ended
	Dec. 31, 2022
Equity [Abstract]
Schedule of changes in warrant liability	A reconciliation of the changes in the warrant liability during the years ended December 31, 2022, 2021 and 2020 was as follows (in thousands): Estimated fair value of warrant liability at December 31, 2019 $ 27,635 Change in estimated fair value of the warrant liability 135,368 Reclassification of warrant liability to equity for exercised warrants (49,098) Estimated fair value of warrant liability at December 31, 2020 113,905 Change in estimated fair value of the warrant liability (53,181) Reclassification of warrant liability to equity for exercised warrants (2,960) Estimated fair value of warrant liability at December 31, 2021 57,764 Change in estimated fair value of the warrant liability (17,158) Reclassification of warrant liability to equity for exercised warrants (2,103) Estimated fair value of warrant liability at December 31, 2022 $ 38,503
Reconciliation of contingent consideration liabilities	A reconciliation of the Company’s contingent consideration liabilities related to acquisitions for the years ended December 31, 2022 and 2021 is as follows (in thousands): Year Ended December 31 2022 Beginning Balance Additions Payments Change in Fair Value Other activity Ending Balance Contingent consideration - Level 3 liabilities $ 20,300 $ — $ (15,015) $ 2,215 $ — $ 7,500 Year Ended December 31 2021 Beginning Balance Additions Payments Change in Fair Value Other activity Ending Balance Contingent consideration - Level 3 liabilities $ 33,540 $ 7,800 $ (20,347) $ (866) $ 173 $ 20,300 A reconciliation of the changes in the contingent consideration common shares liability related to the Contingent Consideration Common Shares during the years ended December 31, 2021 and 2020 was as follows (in thousands): Estimated fair value of contingent consideration common shares liability at December 31, 2019 $ 9,316 Change in estimated fair value of the contingent consideration common shares liability 98,717 Reclassification of contingent consideration common shares liability to equity (37,556) Estimated fair value of contingent consideration common shares liability at December 31, 2020 70,477 Change in estimated fair value of the contingent consideration common shares liability (29,389) Reclassification of contingent consideration common shares liability to equity (41,088) Estimated fair value of contingent consideration common shares liability at December 31, 2021 $ —
Schedule of assumptions used to determine the grant date fair value	The assumptions used to determine the grant-date fair value of the stock options granted during the years ended December 31, 2021and 2020 were as follows: Year Ended December 31, 2021 2020 Expected volatility 44.5 % 40.7 % Risk-free interest rate 0.2 % 0.4 % Expected term 4.0 years 6.0 years Dividend yield N/A N/A
Schedule of outstanding stock option activity	The following table provides the activity regarding the Company’s outstanding stock options during the years ended December 31, 2022, 2021 and 2020 that were granted in connection with the 2019 Plan (in thousands, except per share data): Number of Weighted-Average Weighted-Average Weighted-Average Outstanding, December 31, 2019 3,417 $ 2.12 $ 11.50 Granted 47 $ 6.34 $ 16.25 Outstanding, December 31, 2020 3,464 $ 2.18 $ 11.56 Granted 703 $ 9.81 $ 48.72 Exercised (1,034) $ 2.19 $ 11.57 Forfeited (914) $ 2.27 $ 11.66 Outstanding, December 31, 2021 2,219 $ 3.75 $ 19.36 Activity - none — Outstanding, December 31, 2022 2,219 $ 3.75 $ 19.36 6.1 Years The following table provides the activity for all outstanding stock options during the years ended December 31, 2022, 2021 and 2020 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Outstanding, December 31, 2019 3,417 $ 11.50 Granted 47 $ 16.25 Outstanding, December 31, 2020 3,464 $ 11.56 Granted 703 $ 48.72 Issued in connection with the AeroCare acquisition 3,960 $ 6.24 Exercised (1,447) $ 10.16 Forfeited (914) $ 11.66 Outstanding, December 31, 2021 5,766 $ 11.26 Exercised (804) $ 5.69 Outstanding, December 31, 2022 4,962 $ 12.19 5.6 Years
Schedules of exercisable and unexercisable stock option activity	The following table provides the activity for exercisable stock options during the years ended December 31, 2022, 2021, and 2020 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Exercisable, December 31, 2019 — $ — Vested 1,155 $ 11.56 Exercisable, December 31, 2020 1,155 $ 11.56 Issued in connection with the AeroCare acquisition 3,960 $ 6.24 Vested 907 $ 11.50 Exercised (1,447) $ 10.16 Exercisable, December 31, 2021 4,575 $ 7.39 Vested 878 $ 18.12 Exercised (804) $ 5.69 Exercisable, December 31, 2022 4,649 $ 9.73 5.8 Years The following table provides the activity for unexercisable stock options during the years ended December 31, 2022, 2021 and 2020 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Unexercisable, December 31, 2019 3,417 $ 11.50 Granted 47 $ 16.25 Vested (1,155) $ 11.56 Unexercisable, December 31, 2020 2,309 $ 11.56 Granted 703 $ 48.72 Vested (907) $ 11.50 Forfeited (914) $ 11.66 Unexercisable, December 31, 2021 1,191 $ 26.15 Vested (878) $ 18.12 Unexercisable, December 31, 2022 313 $ 48.72 3.1 Years
Schedule of restricted stock activity	Activity related to the Company’s non-vested restricted stock grants for the years ended December 31, 2022, 2021 and 2020 is presented below (in thousands, except per share data): Number of Shares of Weighted-Average Grant Date Non-vested balance, December 31, 2019 901 $ 5.83 Granted 2,120 $ 18.60 Vested (541) $ 10.78 Forfeited (232) $ 15.97 Non-vested balance, December 31, 2020 2,248 $ 15.60 Granted 1,354 $ 28.92 Vested (556) $ 14.03 Forfeited (851) $ 17.64 Non-vested balance, December 31, 2021 2,195 $ 19.58 Granted 962 $ 21.26 Vested (700) $ 19.99 Forfeited (196) $ 20.60 Non-vested balance, December 31, 2022 2,261 $ 23.90

Earnings (Loss) Per Share (Tabl

Earnings (Loss) Per Share (Tables)	12 Months Ended
	Dec. 31, 2022
Earnings Per Share [Abstract]
Schedule of calculation of basic and diluted earnings per share	Computations of basic and diluted net income (loss) per share were as follows (in thousands, except per share data): Year Ended December 31, 2022 2021 2020 Numerator Net income (loss) attributable to AdaptHealth Corp. $ 69,316 $ 156,175 $ (161,632) Less: Earnings allocated to participating securities (1) 5,867 14,379 — Net income (loss) for basic EPS $ 63,449 $ 141,796 $ (161,632) Change in fair value of warrant liability (2) (17,158) (53,181) — Net income (loss) for diluted EPS $ 46,291 $ 88,615 $ (161,632) Denominator (1) (2) Basic weighted-average common shares outstanding 134,175 126,306 52,488 Add: Warrants (2) 1,528 2,377 — Add: Stock options 2,512 3,782 — Add: Unvested restricted stock 773 569 — Diluted weighted-average common shares outstanding 138,988 133,034 52,488 Basic net income (loss) per share $ 0.47 $ 1.12 $ (3.08) Diluted net income (loss) per share $ 0.33 $ 0.67 $ (3.08) (1) The Company's preferred stock are considered participating securities. Computation of EPS under the two-class method excludes from the numerator any dividends paid or owed on participating securities and any undistributed earnings considered to be attributable to participating securities. The related participating securities are similarly excluded from the denominator. There was no amount allocated to the participating securities during the year ended December 31, 2020 due to the net loss reported in that period. (2) For the years ended December 31, 2022 and 2021, the impact to earnings from the change in fair value of the Company’s warrant liability is excluded from the numerator, and the corresponding security is included in the denominator, for purposes of computing diluted net income per share. This adjustment is included as the effect of the numerator and denominator adjustments for this derivative instrument is dilutive as a result of the non-cash gains recorded for the change in fair value of this instrument during those periods. For the year ended December 31, 2020, the numerator and denominator for the diluted net loss per share computation is the same as used in the basic net loss per share computation and therefore excludes the effect of potential dilutive securities as their inclusion would have been anti-dilutive.
Schedule of antidilutive shares	The table below provides the weighted-average number of potential common shares associated with outstanding securities not included in the Company’s computation of diluted net income (loss) per share for the years ended December 31, 2022, 2021 and 2020 because to do so would be anti-dilutive (in thousands): Year Ended December 31, 2022 2021 2020 Preferred Stock 12,406 12,808 10,077 Warrants — — 1,902 Stock Options 469 — 1,539 Unvested restricted stock — — 659 Contingent Consideration Common Shares — — 2,000 Total 12,875 12,808 16,177

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2022
Leases [Abstract]
Right-of-use asset and lease liabilities	The following table presents information about the Company’s right-of-use assets and lease liabilities as of December 31, 2022 and 2021 (in thousands): December 31, Consolidated Balance Sheets Line Item 2022 2021 Right-of-use (ROU) assets: Operating lease ROU assets Operating lease right-of-use assets $ 129,506 $ 147,760 Finance lease ROU assets Finance lease right-of-use assets 5,423 — Finance lease ROU assets Equipment and other fixed assets, net 103 17,410 Total ROU assets $ 135,032 $ 165,170 Operating lease liabilities: Current operating lease liabilities Current portion of operating lease obligations $ 30,001 $ 31,418 Noncurrent operating lease liabilities Operating lease obligations, less current portion 104,394 120,180 Total operating lease liabilities $ 134,395 $ 151,598 Finance lease liabilities: Current finance lease liabilities Current portion of finance lease obligations $ 2,211 $ 15,446 Noncurrent finance lease liabilities Finance lease obligations, less current portion 3,950 — Noncurrent finance lease liabilities Other long-term liabilities — 132 Total finance lease liabilities $ 6,161 $ 15,578 The following table presents information about lease costs and expenses and sublease income for the years ended December 31, 2022 and 2021 (in thousands). The amounts below are included in cost of net revenue in the accompanying consolidated statements of operations for the periods presented. Year Ended December 31, 2022 2021 Operating lease costs $ 37,822 $ 37,043 Finance lease costs: Amortization of ROU assets $ 8,246 $ 33,689 Other lease costs and income: Variable leases costs (1) $ 17,758 $ 14,030 Sublease income $ 1,380 $ 1,239 Short-term lease costs $ — $ 19,905 (1) Amounts represent variable costs incurred that were not included in the initial measurement of the lease liability such as common area maintenance and utilities costs associated with leased real estate.
Weighted average remaining lease terms and discount rates	The following table provides the weighted average remaining lease terms and weighted average discount rates for the Company’s leases as of December 31, 2022 and 2021: December 31, 2022 2021 Weighted average remaining lease term, weighted based on lease liability balances: Operating leases 6.2 years 6.7 years Finance leases 3.7 years 1.0 year Weighted average discount rate, weighted based on remaining balance of lease payments: Operating leases 3.9 % 3.8 %
Undiscounted amount of future cash flows	The following table provides the undiscounted amount of future cash flows related to the Company's operating and finance leases, as well as a reconciliation of such undiscounted cash flows to the amounts included in the Company’s lease liabilities as of December 31, 2022 (in thousands): Operating Leases Finance Leases 2023 $ 34,446 $ 2,318 2024 28,100 1,567 2025 24,354 1,566 2026 17,484 1,074 2027 12,139 10 Thereafter 36,089 — Total future undiscounted leases payments $ 152,612 $ 6,535 Less: amount representing interest (18,217) (374) Present value of future lease payments (lease liability) $ 134,395 $ 6,161
Cash flow and supplemental non-cash information	The following table provides certain cash flow and supplemental non-cash information related to the Company's lease liabilities for the years ended December 31, 2022 and 2021 (in thousands): Year Ended December 31, 2022 2021 Cash paid for amounts included in the measurement of lease liabilities: Operating cash payments for operating leases $ 37,486 $ 36,510 Financing cash payments for finance leases $ 16,176 $ 42,164 Lease liabilities arising from obtaining right-of-use assets: Operating leases $ 22,543 $ 91,420 Finance leases $ 5,423 $ 22,959

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Schedule of current and deferred income tax expense (benefit)	The current and deferred income tax expense (benefit) for the years ended December 31, 2022, 2021 and 2020 is as follows (in thousands): Year Ended December 31, 2022 2021 2020 Current: Federal $ (197) $ 2,356 $ 5,608 State 6,930 8,070 3,538 6,733 10,426 9,146 Deferred: Federal 12,205 22,891 (16,587) State 5,831 (511) (4,514) 18,036 22,380 (21,101) Total Income tax expense (benefit) $ 24,769 $ 32,806 $ (11,955)
Schedule of reconciliation of the effective income tax rate	A reconciliation of the effective income tax rate with the applicable statutory federal income tax rate for the years ended December 31, 2022, 2021 and 2020 is as follows: Year Ended December 31, 2022 2021 2020 Federal statutory rate 21.0 % 21.0 % 21.0 % State income taxes, net of federal benefit 3.6 % 3.1 % 4.7 % Equity-based compensation (0.5) % (1.9) % — % Change in valuation allowance — % 0.1 % (0.4) % Change in fair value of warrant liability (3.7) % (5.9) % (17.1) % Change in fair value of contingent consideration — % (1.2) % (4.4) % Deferred tax only adjustment (2.6) % 0.3 % 1.7 % Deferred tax impact of state effective tax rate changes 8.6 % — % — % Other (1.1) % 1.7 % 0.3 % Effective income tax rate 25.3 % 17.2 % 5.8 %
Schedule of deferred income tax assets and liabilities	Deferred income tax assets and liabilities are comprised of the following at December 31, 2022 and 2021 (in thousands): December 31, 2022 2021 Deferred income tax assets: Accounts receivable $ 37,363 $ 51,115 Goodwill and intangible assets 262,501 291,331 Investment in partnership 171 4,218 Inventory 1,841 561 Accruals 9,207 6,845 Net operating losses and credits 35,459 32,926 Transaction costs 417 7,580 Contract liabilities — 3,041 Equity-based compensation 6,101 3,801 Excess business interest expense 27,918 — Lease liability 35,431 40,683 Contingent consideration — 3,541 Capital losses 817 817 Total deferred income tax assets 417,226 446,459 Valuation allowance (1,812) (1,812) Net deferred income tax assets $ 415,414 $ 444,647 Deferred income tax liabilities: Right-of-use assets $ (34,201) $ (39,760) Contingent consideration (2,200) — Unrealized gains (2,950) — Equipment and other fixed assets (94,277) (100,694) Total deferred income tax liabilities (133,628) (140,454) Noncurrent net deferred income tax assets $ 281,786 $ 304,193
Reconciliation of the beginning and ending amount of unrecognized tax benefits	A reconciliation of the beginning and ending amount of unrecognized tax benefits for the years ended December 31, 2022, 2021 and 2020 is as follows (in thousands). Balance, December 31, 2019 $ — Additions for tax positions acquired 1,947 Balance, December 31, 2020 1,947 Additions for tax positions acquired 2,100 Balance, December 31, 2021 4,047 Additions for tax positions acquired 2,670 Reductions due to lapse of statute of limitations (78) Balance, December 31, 2022 $ 6,639

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Basis of Presentation (Details) $ in Billions	Aug. 19, 2021 USD ($)
Minimum
Debt Instrument [Line Items]
Proceeds from issuance of debt	$ 1

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Revenue Recognition, Accounts Receivable and COVID-19 (Details) - USD ($) $ in Thousands			1 Months Ended	12 Months Ended			33 Months Ended
	Dec. 14, 2022	Jan. 04, 2022	Apr. 30, 2020	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2022
Revenue Recognition
Net revenue				$ 2,970,595	$ 2,454,535	$ 1,056,389
Unbilled revenue				38,600	23,800		$ 38,600
CARES Act funding received			$ 17,200
CARES Act income recognized				0	10,595	14,277
Recoupable advance payment under CARES Act			45,800
CARES Act funding recouped				12,800	36,700
Employment taxes deferred, CARES Act							$ 8,600
Payment of deferred employment tax	$ 4,300	$ 4,300
Significant Acquisitions In 2020
Revenue Recognition
CARES Act funding received			22,200
Business combination, liabilities			7,700
Business combination, recoupable advances			$ 3,700
Transferred at Point in Time
Revenue Recognition
Net revenue				2,015,680	1,639,406	759,297
Transferred over Time
Revenue Recognition
Net revenue				954,915	815,129	297,092
Sleep
Revenue Recognition
Net revenue				1,066,726	891,382	411,221
Sleep | Transferred at Point in Time
Revenue Recognition
Net revenue				794,021	654,130	312,860
Sleep | Transferred over Time
Revenue Recognition
Net revenue				272,705	237,252	98,361
Diabetes
Revenue Recognition
Net revenue				687,091	541,205	161,957
Diabetes | Transferred at Point in Time
Revenue Recognition
Net revenue				670,988	528,082	159,490
Diabetes | Transferred over Time
Revenue Recognition
Net revenue				16,103	13,123	2,467
Supplies to the home
Revenue Recognition
Net revenue				179,326	167,830	145,624
Supplies to the home | Transferred at Point in Time
Revenue Recognition
Net revenue				179,326	167,830	145,624
Respiratory
Revenue Recognition
Net revenue				555,039	458,286	152,465
Respiratory | Transferred at Point in Time
Revenue Recognition
Net revenue				34,342	31,016	28,605
Respiratory | Transferred over Time
Revenue Recognition
Net revenue				520,697	427,270	123,860
HME
Revenue Recognition
Net revenue				220,798	209,741	113,876
HME | Transferred at Point in Time
Revenue Recognition
Net revenue				118,542	113,805	58,029
HME | Transferred over Time
Revenue Recognition
Net revenue				102,256	95,936	55,847
Other
Revenue Recognition
Net revenue				261,615	186,091	71,246
Other | Transferred at Point in Time
Revenue Recognition
Net revenue				218,461	144,543	54,689
Other | Transferred over Time
Revenue Recognition
Net revenue				43,154	41,548	16,557
Insurance
Revenue Recognition
Net revenue				1,808,633	1,499,154	657,033
Government
Revenue Recognition
Net revenue				781,975	685,513	295,657
Patient pay
Revenue Recognition
Net revenue				$ 379,987	$ 269,868	$ 103,699

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Fair Value of Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Carrying Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	$ 2,188,267	$ 2,203,552
Carrying Value | Secured term loan
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	761,547	780,414
Carrying Value | Senior unsecured notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	1,426,720	1,423,138
Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	1,989,121	2,239,551
Fair Value | Secured term loan
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	761,547	780,414
Fair Value | Senior unsecured notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	$ 1,227,574	$ 1,459,137

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Cash and Cash Equivalents (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Accounting Policies [Abstract]
Cash	$ 46,272	$ 149,613
Money market accounts	0	14
Total	$ 46,272	$ 149,627	$ 99,962	$ 76,878

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Useful Lives (Details) - USD ($)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Equipment and Other Fixed Assets
Impairment of long-lived assets	$ 0	$ 0	$ 0
Payor contracts
Equipment and Other Fixed Assets
Weighted-average useful life (in years)	10 years
Contractual rental agreements
Equipment and Other Fixed Assets
Weighted-average useful life (in years)	2 years
Developed technology
Equipment and Other Fixed Assets
Weighted-average useful life (in years)	5 years
Vehicles
Equipment and Other Fixed Assets
Useful lives of property and equipment (in months and years)	5 years
Minimum | Tradenames
Equipment and Other Fixed Assets
Weighted-average useful life (in years)	5 years
Minimum | Patient medical equipment
Equipment and Other Fixed Assets
Useful lives of property and equipment (in months and years)	13 months
Minimum | Other
Equipment and Other Fixed Assets
Useful lives of property and equipment (in months and years)	2 years
Maximum | Tradenames
Equipment and Other Fixed Assets
Weighted-average useful life (in years)	10 years
Maximum | Patient medical equipment
Equipment and Other Fixed Assets
Useful lives of property and equipment (in months and years)	5 years
Maximum | Other
Equipment and Other Fixed Assets
Useful lives of property and equipment (in months and years)	10 years

Summary of Significant Accoun_9

Summary of Significant Accounting Policies - Advertising Costs, Cost of Net Revenue, General and Administrative Expenses (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Accounting Policies [Abstract]
Advertising costs	$ 19,200	$ 18,500	$ 5,300
Cost of products and supplies	1,199,481	955,813	441,931
Salaries, labor and benefits	770,669	595,668	257,898
Patient equipment depreciation	286,288	194,958	71,072
Rent and occupancy	64,375	48,586	22,344
Other operating expenses	225,719	206,599	97,511
Equity-based compensation	6,637	7,301	7,845
Total	2,553,169	2,008,925	898,601
Salaries and benefits expenses	$ 60,600	$ 60,100	$ 35,800

Summary of Significant Accou_10

Summary of Significant Accounting Policies - Concentration of Credit Risk, Customers (Details) - Customer Concentration Risk	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Accounts Receivable | Patient pay | Maximum
Concentration Risk [Line Items]
Concentration risk percentage	10%	10%
Revenue Benchmark | Government
Concentration Risk [Line Items]
Concentration risk percentage	26%	28%	28%

Acquisitions - Narrative (Detai

Acquisitions - Narrative (Details) $ / shares in Units, $ in Thousands										12 Months Ended
	Dec. 30, 2021 USD ($)	Jul. 01, 2021 USD ($) shares	Jun. 01, 2021 USD ($) shares	Apr. 30, 2021 USD ($) shares	Feb. 01, 2021 USD ($) $ / shares shares	Oct. 01, 2020 USD ($) shares	Jul. 01, 2020 USD ($) shares	Mar. 02, 2020 USD ($)	Jan. 02, 2020 USD ($)	Dec. 31, 2022 USD ($) provider shares	Dec. 31, 2021 USD ($) shares	Dec. 31, 2020 USD ($) shares	Jul. 31, 2021 USD ($)	Aug. 04, 2020 $ / shares	Nov. 08, 2019 $ / shares
Business Acquisition [Line Items]
Net cash (receipts) payments relating to prior acquisitions										$ 2,009	$ (657)
Issuance of preferred stock (in shares) | shares										124,060
Exercise price (in dollars per share) | $ / shares														$ 11.50	$ 11.50
Deferred purchase price in connection with acquisitions										$ 457	4,478	$ 33
Home Medical Equipment
Business Acquisition [Line Items]
Interest acquired, as a percent										100%
Number of home medical providers acquired | provider										3
Number of entities acquired | provider										5
Significant Acquisitions In 2021
Business Acquisition [Line Items]
Net cash (receipts) payments relating to prior acquisitions										$ 2,000
Cash payment											1,657,970
Contingent consideration liability											7,800
Identifiable intangible assets											132,900
AeroCare
Business Acquisition [Line Items]
Interest acquired, as a percent					100%
Cash payment					$ 1,200,000						1,153,409
Options issued in acquisition (in shares) | shares					3,959,892
Exercise price (in dollars per share) | $ / shares					$ 6.24
Weighted average exercise period (in years)					7 years
Contingent consideration liability											0
Identifiable intangible assets											122,800
AeroCare | Common Stock
Business Acquisition [Line Items]
Issuance of stock for acquisitions (in shares) | shares					13,992,615
AeroCare | Preferred Stock
Business Acquisition [Line Items]
Issuance of preferred stock (in shares) | shares					130,474.73
Spiro
Business Acquisition [Line Items]
Interest acquired, as a percent				100%
Cash payment				$ 65,800							65,759
Issuance of stock for acquisitions (in shares) | shares				244,641
Maximum potential contingent consideration				$ 1,000
Contingent consideration liability											1,000
Identifiable intangible assets											1,000
Healthy Living
Business Acquisition [Line Items]
Interest acquired, as a percent			100%
Cash payment			$ 47,000								47,048
Issuance of stock for acquisitions (in shares) | shares			196,779
Contingent consideration liability											0
Identifiable intangible assets											1,500
Agilis
Business Acquisition [Line Items]
Interest acquired, as a percent		100%
Cash payment		$ 30,800									30,828
Issuance of stock for acquisitions (in shares) | shares		538,079
Maximum potential contingent consideration		$ 1,000
Investment carrying value													$ 8,100
Fair value of investment													$ 10,000
Gain on equity method investment											1,900
Contingent consideration liability											1,000
Identifiable intangible assets											500
We Care
Business Acquisition [Line Items]
Interest acquired, as a percent		100%
Cash payment		$ 34,800									34,834
Issuance of stock for acquisitions (in shares) | shares		231,866
Contingent consideration liability											0
Identifiable intangible assets											400
Community
Business Acquisition [Line Items]
Interest acquired, as a percent	100%
Cash payment	$ 129,400										129,423
Maximum potential contingent consideration	6,500
Contingent consideration liability	$ 5,800										$ 5,800
Home Medical Equipment
Business Acquisition [Line Items]
Interest acquired, as a percent											100%
Cash payment											$ 196,700
Issuance of stock for acquisitions (in shares) | shares											306,569
Deferred purchase price in connection with acquisitions											$ 4,500
PCS
Business Acquisition [Line Items]
Interest acquired, as a percent									100%
Cash payment									$ 14,000			14,008
Contingent consideration liability												0
Identifiable intangible assets												0
Advanced
Business Acquisition [Line Items]
Cash payment								$ 58,500				58,517
Maximum potential contingent consideration								9,000
Contingent consideration liability								$ 5,000				5,000
Identifiable intangible assets												600
Solara
Business Acquisition [Line Items]
Interest acquired, as a percent							100%
Cash payment							$ 380,700					380,735
Issuance of stock for acquisitions (in shares) | shares							3,906,250
Contingent consideration liability							$ 1,300					1,300
Identifiable intangible assets												85,700
ActivStyle
Business Acquisition [Line Items]
Interest acquired, as a percent							100%
Cash payment							$ 65,500					65,512
Contingent consideration liability												0
Identifiable intangible assets												9,400
Pinnacle
Business Acquisition [Line Items]
Interest acquired, as a percent						100%
Cash payment						$ 80,400						80,377
Issuance of stock for acquisitions (in shares) | shares						997,067
Maximum potential contingent consideration						$ 15,000
Contingent consideration liability												14,300
Contingent consideration liability at fair value						$ 14,300
Identifiable intangible assets												$ 15,200
Other
Business Acquisition [Line Items]
Interest acquired, as a percent												100%
Cash payment												$ 191,415
Issuance of stock for acquisitions (in shares) | shares												1,023,434
Maximum potential contingent consideration												$ 8,000
Contingent consideration liability												6,464
Contingent consideration liability at fair value												6,500
Identifiable intangible assets												11,200
Other | Maximum
Business Acquisition [Line Items]
Deferred purchase price in connection with acquisitions												100
Significant Acquisitions In 2020
Business Acquisition [Line Items]
Net cash (receipts) payments relating to prior acquisitions											$ (700)
Cash payment												790,564
Contingent consideration liability												27,064
Identifiable intangible assets												$ 122,100

Acquisitions - Consideration Pa

Acquisitions - Consideration Paid (Details) - USD ($) $ in Thousands										12 Months Ended
	Dec. 30, 2021	Jul. 01, 2021	Jun. 01, 2021	Apr. 30, 2021	Feb. 01, 2021	Oct. 01, 2020	Jul. 01, 2020	Mar. 02, 2020	Jan. 02, 2020	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Significant Acquisitions In 2022
Business Acquisition [Line Items]
Cash										$ 17,170
Deferred payments										457
Total										$ 17,627
Significant Acquisitions In 2021
Business Acquisition [Line Items]
Cash											$ 1,657,970
Equity											1,261,200
Contingent consideration											7,800
Deferred payments											4,478
Total											2,931,448
AeroCare
Business Acquisition [Line Items]
Cash					$ 1,200,000						1,153,409
Equity											1,220,342
Contingent consideration											0
Deferred payments											0
Total											2,373,751
Spiro
Business Acquisition [Line Items]
Cash				$ 65,800							65,759
Equity											7,109
Contingent consideration											1,000
Deferred payments											0
Total											73,868
Healthy Living
Business Acquisition [Line Items]
Cash			$ 47,000								47,048
Equity											5,057
Contingent consideration											0
Deferred payments											0
Total											52,105
Agilis
Business Acquisition [Line Items]
Cash		$ 30,800									30,828
Equity											14,668
Contingent consideration											1,000
Deferred payments											0
Total											46,496
We Care
Business Acquisition [Line Items]
Cash		$ 34,800									34,834
Equity											6,321
Contingent consideration											0
Deferred payments											0
Total											41,155
Community
Business Acquisition [Line Items]
Cash	$ 129,400										129,423
Equity											0
Contingent consideration	$ 5,800										5,800
Deferred payments											0
Total											135,223
Other
Business Acquisition [Line Items]
Cash											196,669
Equity											7,703
Contingent consideration											0
Deferred payments											4,478
Total											208,850
Significant Acquisitions In 2020
Business Acquisition [Line Items]
Cash												$ 790,564
Equity												123,887
Contingent consideration												27,064
Deferred payments												33
Total												941,548
PCS
Business Acquisition [Line Items]
Cash									$ 14,000			14,008
Equity												0
Contingent consideration												0
Deferred payments												0
Total												14,008
Advanced
Business Acquisition [Line Items]
Cash								$ 58,500				58,517
Equity												0
Contingent consideration								$ 5,000				5,000
Deferred payments												0
Total												63,517
Solara
Business Acquisition [Line Items]
Cash							$ 380,700					380,735
Equity												73,359
Contingent consideration							1,300					1,300
Deferred payments												0
Total												455,394
ActivStyle
Business Acquisition [Line Items]
Cash							$ 65,500					65,512
Equity												0
Contingent consideration												0
Deferred payments												0
Total												65,512
Pinnacle
Business Acquisition [Line Items]
Cash						$ 80,400						80,377
Equity												28,182
Contingent consideration												14,300
Deferred payments												0
Total												122,859
Other
Business Acquisition [Line Items]
Cash												191,415
Equity												22,346
Contingent consideration												6,464
Deferred payments												33
Total												$ 220,258
Home Medical Equipment
Business Acquisition [Line Items]
Cash											$ 196,700

Acquisitions - Net Assets Acqui

Acquisitions - Net Assets Acquired (Details) - USD ($) $ in Thousands									12 Months Ended
	Jul. 01, 2021	Jun. 01, 2021	Apr. 30, 2021	Feb. 01, 2021	Oct. 01, 2020	Jul. 01, 2020	Mar. 02, 2020	Jan. 02, 2020	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Business Acquisition [Line Items]
Goodwill									$ 3,545,297	$ 3,512,567	$ 998,810
Significant Acquisitions In 2022
Business Acquisition [Line Items]
Cash									162
Accounts receivable									2,336
Inventory									771
Prepaid and other current assets									16
Equipment and other fixed assets									4,585
Goodwill									12,341
Identifiable intangible assets									500
Deferred tax assets									180
Accounts payable and accrued expenses									(3,130)
Contract liabilities									(134)
Net assets acquired									17,627
Cash payment									$ 17,170
Significant Acquisitions In 2021
Business Acquisition [Line Items]
Cash										36,993
Accounts receivable										126,902
Inventory										50,352
Prepaid and other current assets										7,736
Equipment and other fixed assets										274,357
Operating lease right-of-use assets										78,643
Goodwill										2,536,566
Identifiable intangible assets										132,900
Other assets										3,699
Deferred tax (liabilities)										(47,770)
Accounts payable and accrued expenses										(131,583)
Contract liabilities										(19,630)
Other current liabilities										(13,701)
Other long-term liabilities										(3,738)
Operating lease obligations										(78,643)
Finance lease obligations										(11,635)
Net assets acquired										2,941,448
Cash payment										1,657,970
AeroCare
Business Acquisition [Line Items]
Cash										27,686
Accounts receivable										71,916
Inventory										26,998
Prepaid and other current assets										3,522
Equipment and other fixed assets										190,755
Operating lease right-of-use assets										52,927
Goodwill										2,083,423
Identifiable intangible assets										122,800
Other assets										1,178
Deferred tax (liabilities)										(46,234)
Accounts payable and accrued expenses										(82,722)
Contract liabilities										(14,495)
Other current liabilities										(10,021)
Other long-term liabilities										(1,055)
Operating lease obligations										(52,927)
Finance lease obligations										0
Net assets acquired										2,373,751
Cash payment				$ 1,200,000						1,153,409
Spiro
Business Acquisition [Line Items]
Cash										2,132
Accounts receivable										5,756
Inventory										1,733
Prepaid and other current assets										152
Equipment and other fixed assets										6,897
Operating lease right-of-use assets										2,581
Goodwill										64,380
Identifiable intangible assets										1,000
Other assets										16
Deferred tax (liabilities)										0
Accounts payable and accrued expenses										(5,517)
Contract liabilities										(486)
Other current liabilities										0
Other long-term liabilities										0
Operating lease obligations										(2,581)
Finance lease obligations										(2,195)
Net assets acquired										73,868
Cash payment			$ 65,800							65,759
Healthy Living
Business Acquisition [Line Items]
Cash										579
Accounts receivable										5,838
Inventory										2,949
Prepaid and other current assets										1,088
Equipment and other fixed assets										1,188
Operating lease right-of-use assets										1,366
Goodwill										44,095
Identifiable intangible assets										1,500
Other assets										0
Deferred tax (liabilities)										0
Accounts payable and accrued expenses										(3,363)
Contract liabilities										(102)
Other current liabilities										(1,667)
Other long-term liabilities										0
Operating lease obligations										(1,366)
Finance lease obligations										0
Net assets acquired										52,105
Cash payment		$ 47,000								47,048
Agilis
Business Acquisition [Line Items]
Cash										1,131
Accounts receivable										0
Inventory										2,330
Prepaid and other current assets										0
Equipment and other fixed assets										348
Operating lease right-of-use assets										490
Goodwill										55,375
Identifiable intangible assets										500
Other assets										0
Deferred tax (liabilities)										0
Accounts payable and accrued expenses										(3,188)
Contract liabilities										0
Other current liabilities										0
Other long-term liabilities										0
Operating lease obligations										(490)
Finance lease obligations										0
Net assets acquired										56,496
Cash payment	$ 30,800									30,828
We Care
Business Acquisition [Line Items]
Cash										458
Accounts receivable										2,007
Inventory										465
Prepaid and other current assets										0
Equipment and other fixed assets										5,254
Operating lease right-of-use assets										970
Goodwill										35,971
Identifiable intangible assets										400
Other assets										0
Deferred tax (liabilities)										(1,228)
Accounts payable and accrued expenses										(1,389)
Contract liabilities										(783)
Other current liabilities										0
Other long-term liabilities										0
Operating lease obligations										(970)
Finance lease obligations										0
Net assets acquired										41,155
Cash payment	$ 34,800									34,834
Community
Business Acquisition [Line Items]
Cash										2
Accounts receivable										15,798
Inventory										5,214
Prepaid and other current assets										571
Equipment and other fixed assets										44,952
Operating lease right-of-use assets										4,412
Goodwill										88,393
Identifiable intangible assets										2,300
Other assets										2,505
Deferred tax (liabilities)										0
Accounts payable and accrued expenses										(13,725)
Contract liabilities										(3,156)
Other current liabilities										(180)
Other long-term liabilities										(2,683)
Operating lease obligations										(4,412)
Finance lease obligations										(4,768)
Net assets acquired										135,223
Other
Business Acquisition [Line Items]
Cash										5,005
Accounts receivable										25,587
Inventory										10,663
Prepaid and other current assets										2,403
Equipment and other fixed assets										24,963
Operating lease right-of-use assets										15,897
Goodwill										164,929
Identifiable intangible assets										4,400
Other assets										0
Deferred tax (liabilities)										(308)
Accounts payable and accrued expenses										(21,679)
Contract liabilities										(608)
Other current liabilities										(1,833)
Other long-term liabilities										0
Operating lease obligations										(15,897)
Finance lease obligations										(4,672)
Net assets acquired										208,850
Cash payment										$ 196,669
Significant Acquisitions In 2020
Business Acquisition [Line Items]
Cash											21,227
Accounts receivable											62,940
Inventory											26,111
Prepaid and other current assets											9,560
Equipment and other fixed assets											45,669
Goodwill											732,019
Identifiable intangible assets											122,100
Other assets											2,921
Deferred tax assets											1,132
Accounts payable and accrued expenses											(61,196)
Contract liabilities											(3,344)
Other current liabilities											(11,278)
Other long-term liabilities											(4,107)
Finance lease obligations											(2,206)
Net assets acquired											941,548
Cash payment											790,564
PCS
Business Acquisition [Line Items]
Cash											61
Accounts receivable											14,925
Inventory											0
Prepaid and other current assets											943
Equipment and other fixed assets											535
Goodwill											988
Identifiable intangible assets											0
Other assets											0
Deferred tax assets											0
Accounts payable and accrued expenses											(2,025)
Contract liabilities											0
Other current liabilities											(233)
Other long-term liabilities											(1,186)
Finance lease obligations											0
Net assets acquired											14,008
Cash payment								$ 14,000			14,008
Advanced
Business Acquisition [Line Items]
Cash											0
Accounts receivable											7
Inventory											2,727
Prepaid and other current assets											127
Equipment and other fixed assets											19,783
Goodwill											41,712
Identifiable intangible assets											600
Other assets											0
Deferred tax assets
Accounts payable and accrued expenses											(35)
Contract liabilities											(1,404)
Other current liabilities											0
Other long-term liabilities											0
Finance lease obligations											0
Net assets acquired											63,517
Cash payment							$ 58,500				58,517
Solara
Business Acquisition [Line Items]
Cash											12,069
Accounts receivable											17,411
Inventory											14,376
Prepaid and other current assets											2,113
Equipment and other fixed assets											3,473
Goodwill											347,718
Identifiable intangible assets											85,700
Other assets											0
Deferred tax assets
Accounts payable and accrued expenses											(22,464)
Contract liabilities											(167)
Other current liabilities											(4,835)
Other long-term liabilities											0
Finance lease obligations											0
Net assets acquired											455,394
Cash payment						$ 380,700					380,735
ActivStyle
Business Acquisition [Line Items]
Cash											4,993
Accounts receivable											5,158
Inventory											471
Prepaid and other current assets											955
Equipment and other fixed assets											992
Goodwill											49,643
Identifiable intangible assets											9,400
Other assets											0
Deferred tax assets											1,240
Accounts payable and accrued expenses											(7,155)
Contract liabilities											0
Other current liabilities											(185)
Other long-term liabilities											0
Finance lease obligations											0
Net assets acquired											65,512
Cash payment						$ 65,500					65,512
Pinnacle
Business Acquisition [Line Items]
Cash											1,193
Accounts receivable											4,174
Inventory											101
Prepaid and other current assets											612
Equipment and other fixed assets											0
Goodwill											107,706
Identifiable intangible assets											15,200
Other assets											2,921
Deferred tax assets											0
Accounts payable and accrued expenses											(5,777)
Contract liabilities											0
Other current liabilities											(350)
Other long-term liabilities											(2,921)
Finance lease obligations											0
Net assets acquired											122,859
Cash payment					$ 80,400						80,377
Other
Business Acquisition [Line Items]
Cash											2,911
Accounts receivable											21,265
Inventory											8,436
Prepaid and other current assets											4,810
Equipment and other fixed assets											20,886
Goodwill											184,252
Identifiable intangible assets											11,200
Other assets											0
Deferred tax (liabilities)											(108)
Accounts payable and accrued expenses											(23,740)
Contract liabilities											(1,773)
Other current liabilities											(5,675)
Other long-term liabilities											0
Finance lease obligations											(2,206)
Net assets acquired											220,258
Cash payment											$ 191,415

Acquisitions - Results of Busin

Acquisitions - Results of Business Acquired (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Business Combination and Asset Acquisition [Abstract]
Net revenue	$ 16,455	$ 1,005,097	$ 427,352
Operating income	$ 767	$ 136,404	$ 17,673

Equipment and Other Fixed Ass_3

Equipment and Other Fixed Assets (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Equipment and Other Fixed Assets
Equipment and other fixed assets, gross	$ 870,267	$ 620,181
Less accumulated depreciation	(383,188)	(221,604)
Equipment and other fixed assets, net	487,079	398,577
Depreciation and amortization, including patient equipment depreciation	311,200	211,500	$ 76,400
Fully-depreciated assets written off	275,100	71,900	$ 62,600
Patient medical equipment
Equipment and Other Fixed Assets
Equipment and other fixed assets, gross	747,985	533,760
Delivery vehicles
Equipment and Other Fixed Assets
Equipment and other fixed assets, gross	35,326	36,213
Other
Equipment and Other Fixed Assets
Equipment and other fixed assets, gross	$ 86,956	$ 50,208

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Change in Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Goodwill [Roll Forward]
Beginning balance	$ 3,512,567	$ 998,810
Goodwill from acquisitions	12,341	2,536,566
Net cash (receipts) payments relating to prior acquisitions	2,009	(657)
Net increase (reductions) relating to measurement period adjustments	18,380	(22,152)
Ending balance	$ 3,545,297	$ 3,512,567

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Goodwill [Line Items]
Goodwill impairment charge	$ 0	$ 0	$ 0	$ 0
Net cash (receipts) payments relating to prior acquisitions		2,009	(657)
Net increase (reductions) relating to measurement period adjustments		18,380	(22,152)
Increase (decrease) to accounts receivable		(900)
Decrease to equipment and other fixed assets, net		10,000
Increase to other current liabilities		7,300
Increase (decrease) to accounts payable and accrued expenses		(2,200)
Increase (decrease) to goodwill		16,000
Amortization of intangible assets		40,000	46,500	6,000
Impairment charges to identifiable intangible assets		0	0	$ 0
Significant Acquisitions In 2021
Goodwill [Line Items]
Net cash (receipts) payments relating to prior acquisitions		$ 2,000
Significant Acquisitions In 2020
Goodwill [Line Items]
Net cash (receipts) payments relating to prior acquisitions			(700)
Solara
Goodwill [Line Items]
Increase (decrease) to accounts receivable			28,900
Increase (decrease) to accounts payable and accrued expenses			6,300
Increase (decrease) to goodwill			$ (22,600)

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Identified Intangible Assets (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Finite-Lived Intangible Assets [Line Items]
Identifiable intangible assets, net	$ 162,773	$ 202,231
Tradenames
Finite-Lived Intangible Assets [Line Items]
Accumulated amortization	25,498	12,705
Identifiable intangible assets, net	$ 87,302	$ 99,595
Weighted-Average Remaining Life (Years)	7 years 6 months	8 years 4 months 24 days
Payor contracts
Finite-Lived Intangible Assets [Line Items]
Accumulated amortization	$ 20,016	$ 11,816
Identifiable intangible assets, net	$ 61,984	$ 70,184
Weighted-Average Remaining Life (Years)	7 years 7 months 6 days	8 years 7 months 6 days
Contractual rental agreements
Finite-Lived Intangible Assets [Line Items]
Accumulated amortization	$ 43,863	$ 26,158
Identifiable intangible assets, net	$ 10,337	$ 28,042
Weighted-Average Remaining Life (Years)	9 months 18 days	1 year 9 months 18 days
Developed technology
Finite-Lived Intangible Assets [Line Items]
Accumulated amortization	$ 3,150	$ 1,890
Identifiable intangible assets, net	$ 3,150	$ 4,410
Weighted-Average Remaining Life (Years)	2 years 6 months	3 years 6 months

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets - Future Amortization Expense of Identified Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
2023	$ 32,613
2024	22,276
2025	21,328
2026	19,263
2027	17,960
Thereafter	49,333
Total	$ 162,773	$ 202,231

Fair Value of Assets and Liab_3

Fair Value of Assets and Liabilities - Valuation of Financial Assets and Liabilities (Details) - Fair Value, Recurring - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Level 1
Assets
Total assets measured at fair value	$ 0	$ 14
Liabilities
Total liabilities measured at fair value	0	0
Level 1 | Acquisition-related contingent consideration-short term
Liabilities
Total liabilities measured at fair value	0	0
Level 1 | Acquisition-related contingent consideration-long term
Liabilities
Total liabilities measured at fair value		0
Level 1 | Interest rate swap agreements-short term
Liabilities
Total liabilities measured at fair value		0
Level 1 | Interest rate swap agreements-long term
Liabilities
Total liabilities measured at fair value		0
Level 1 | Warrant liability
Liabilities
Total liabilities measured at fair value	0	0
Level 1 | Money market accounts
Assets
Total assets measured at fair value		14
Level 1 | Interest rate swap agreements-short term
Assets
Total assets measured at fair value	0
Level 1 | Interest rate swap agreements-long term
Assets
Total assets measured at fair value	0
Level 2
Assets
Total assets measured at fair value	9,476	0
Liabilities
Total liabilities measured at fair value	0	7,457
Level 2 | Acquisition-related contingent consideration-short term
Liabilities
Total liabilities measured at fair value	0	0
Level 2 | Acquisition-related contingent consideration-long term
Liabilities
Total liabilities measured at fair value		0
Level 2 | Interest rate swap agreements-short term
Liabilities
Total liabilities measured at fair value		5,098
Level 2 | Interest rate swap agreements-long term
Liabilities
Total liabilities measured at fair value		2,359
Level 2 | Warrant liability
Liabilities
Total liabilities measured at fair value	0	0
Level 2 | Money market accounts
Assets
Total assets measured at fair value		0
Level 2 | Interest rate swap agreements-short term
Assets
Total assets measured at fair value	5,748
Level 2 | Interest rate swap agreements-long term
Assets
Total assets measured at fair value	3,728
Level 3
Assets
Total assets measured at fair value	0	0
Liabilities
Total liabilities measured at fair value	46,003	78,064
Level 3 | Acquisition-related contingent consideration-short term
Liabilities
Total liabilities measured at fair value	7,500	13,500
Level 3 | Acquisition-related contingent consideration-long term
Liabilities
Total liabilities measured at fair value		6,800
Level 3 | Interest rate swap agreements-short term
Liabilities
Total liabilities measured at fair value		0
Level 3 | Interest rate swap agreements-long term
Liabilities
Total liabilities measured at fair value		0
Level 3 | Warrant liability
Liabilities
Total liabilities measured at fair value	38,503	57,764
Level 3 | Money market accounts
Assets
Total assets measured at fair value		$ 0
Level 3 | Interest rate swap agreements-short term
Assets
Total assets measured at fair value	0
Level 3 | Interest rate swap agreements-long term
Assets
Total assets measured at fair value	$ 0

Fair Value of Assets and Liab_4

Fair Value of Assets and Liabilities - Narrative (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability	$ 7,500	$ 20,300	$ 33,540
Other liabilities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability	$ 7,500	13,500
Other long-term liabilities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability		$ 6,800

Fair Value of Assets and Liab_5

Fair Value of Assets and Liabilities - Contingent Consideration Rollforward (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Contingent Consideration Liability Rollforward [Roll Forward]
Beginning Balance	$ 20,300	$ 33,540
Additions	0	7,800
Payments	(15,015)	(20,347)
Change in Fair Value	2,215	(866)
Other activity	0	173
Ending Balance	$ 7,500	$ 20,300

Fair Value of Assets and Liab_6

Fair Value of Assets and Liabilities - Non-financial Assets Measured on Non-recurring Basis (Details) - Fair Value, Nonrecurring - Level 3 - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Assets:
Goodwill (Level 3)	$ 3,545,297	$ 3,512,567
Identifiable intangible assets, net (Level 3)	$ 162,773	$ 202,231

Derivative Instruments and He_3

Derivative Instruments and Hedging Activities - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Derivative [Line Items]
Estimated reclassification to interest expense	$ 7.6
Notional amount	$ 250	$ 250
Gain (loss) in other comprehensive income (loss)		$ 8.7	$ (7.8)
Derivative, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Interest rate swap agreements, inclusive of reclassification adjustment, net of tax	Interest rate swap agreements, inclusive of reclassification adjustment, net of tax	Interest rate swap agreements, inclusive of reclassification adjustment, net of tax
Amount reclassified from other comprehensive income (loss)	$ 2.9	$ 2.9	$ 2.8
Cash Flow Hedging
Derivative [Line Items]
Gain (loss) in other comprehensive income (loss)	$ 14

Derivative Instruments and He_4

Derivative Instruments and Hedging Activities - Financial instruments (Details) - Designated as Hedging Instrument - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Asset (Liability)	$ 9,476	$ (7,457)
Interest Rate Swap | Prepaid and other current assets
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Asset (Liability)	5,748	0
Interest Rate Swap | Other assets
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Asset (Liability)	3,728	0
Interest Rate Swap | Other liabilities
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Asset (Liability)	0	(5,098)
Interest Rate Swap | Other long-term liabilities
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Asset (Liability)	$ 0	$ (2,359)

Deferred Financing Costs - Chan

Deferred Financing Costs - Change in Deferred Financing Costs (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Movement In Deferred Finance Costs [Roll Forward]
Balance at beginning of period	$ 33,463	$ 13,710
Capitalized fees	0	29,185
Amortization	(5,234)	(5,378)	$ (1,876)
Write-off due to debt refinancing	0	(4,054)	(5,316)
Balance at end of period	$ 28,229	$ 33,463	$ 13,710

Deferred Financing Costs - Narr

Deferred Financing Costs - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Debt Issuance Costs, Net [Abstract]
Amortization	$ 5,234	$ 5,378	$ 1,876
Deferred financing costs	$ 28,229	$ 33,463	$ 13,710

Deferred Financing Costs - Amor

Deferred Financing Costs - Amortization of Deferred Financing Costs (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Debt Issuance Costs, Net [Abstract]
2023	$ 5,234
2024	5,234
2025	5,147
2026	3,659
2027	3,577
Thereafter	5,378
Deferred financing costs	$ 28,229	$ 33,463	$ 13,710

Accounts Payable and Accrued _3

Accounts Payable and Accrued Expenses (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Accounts Payable and Accrued Liabilities, Current [Abstract]
Accounts payable	$ 222,505	$ 248,027
Employee-related accruals	41,872	34,370
Accrued interest	28,877	30,103
Other	44,244	45,884
Total	$ 337,498	$ 358,384

Debt - Summary of Long-Term Deb

Debt - Summary of Long-Term Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Gross long-term debt	$ 2,215,000
Unamortized deferred financing fees	(26,733)	$ (31,448)
Net long-term debt	2,188,267	2,203,552
Current portion	(35,000)	(20,000)
Long-term portion	2,153,267	2,183,552
Secured term loan
Debt Instrument [Line Items]
Gross long-term debt	765,000	785,000
Senior unsecured notes
Debt Instrument [Line Items]
Gross long-term debt	$ 1,450,000	$ 1,450,000

Debt - Narrative (Details)

Debt - Narrative (Details) - USD ($) $ / shares in Units, $ in Thousands

1 Months Ended

2 Months Ended

12 Months Ended

Aug. 19, 2021

Jan. 20, 2021

Jan. 04, 2021

Jul. 29, 2020

Jan. 31, 2021

Dec. 31, 2020

Oct. 31, 2020

Jul. 31, 2020

May 31, 2020

Feb. 28, 2023

Dec. 31, 2022

Dec. 31, 2021

Dec. 31, 2020

Aug. 16, 2021

Nov. 30, 2019

Mar. 31, 2019

Debt Instrument [Line Items]

Interest expense

$ 112,400

$ 97,900

$ 42,000

Repayment of loan

20,000

827,271

547,480

Write-off due to debt refinancing

0

4,054

5,316

Gross long-term debt

2,215,000

Proceeds from borrowings on long-term debt and lines of credit

0

1,165,000

591,275

Deferred financing costs

$ 13,710

28,229

33,463

13,710

Gain (loss) on extinguishment of debt

0

(16,135)

0

Number of shares in Consideration Unit (in shares)

1

Number of shares under Put/Call Option and Consent Agreement (in shares)

1,898,967

Minimum fixed purchase price (in dollars per share)

$ 14.50

Minimum variable price, as percent of weighted average price

85%

Sales price (in dollars per share)

$ 15.76

Equity impact resulting from the Put/Call Agreement

$ (29,900)

(29,927)

Retained earnings (Accumulated deficit)

Debt Instrument [Line Items]

Equity impact resulting from the Put/Call Agreement

2,694

Secured term loan

Debt Instrument [Line Items]

Borrowing capacity

$ 800,000

Gross long-term debt

$ 765,000

785,000

Credit facility interest rate

6.13%

Secured term loan | First Specified Repayment Period

Debt Instrument [Line Items]

Quarterly principal repayments

$ 5,000

Secured term loan | Second Specified Repayment Period

Debt Instrument [Line Items]

Quarterly principal repayments

10,000

Revolving Credit Loans 2021

Debt Instrument [Line Items]

Borrowing capacity

450,000

Revolver balance

0

Proceeds from borrowings on long-term debt and lines of credit

365,000

Remaining maximum borrowings available

432,600

Revolving Credit Loans 2021 | Subsequent Event

Debt Instrument [Line Items]

Proceeds from borrowings on long-term debt and lines of credit

$ 25,000

Letter Of Credit 2021

Debt Instrument [Line Items]

Borrowing capacity

$ 55,000

Credit Agreement 2021

Debt Instrument [Line Items]

Repayment of loan

$ 301,900

Financing costs

7,600

Write-off due to debt refinancing

2,100

Credit Agreement 2021 | Minimum

Debt Instrument [Line Items]

Commitment fee (as a percent)

0.25%

Credit Agreement 2021 | Minimum | London Interbank Offered Rate (LIBOR)

Debt Instrument [Line Items]

Applicable margin

1.50%

Credit Agreement 2021 | Maximum

Debt Instrument [Line Items]

Commitment fee (as a percent)

0.50%

Credit Agreement 2021 | Maximum | London Interbank Offered Rate (LIBOR)

Debt Instrument [Line Items]

Applicable margin

3.25%

Senior Unsecured Notes 5.125 Per Cent Due 2030

Debt Instrument [Line Items]

Debt interest rate

5.125%

5.125%

Face amount

$ 600,000

Deferred financing costs

$ 11,100

Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period Two

Debt Instrument [Line Items]

Redemption price

102.563%

Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period Three

Debt Instrument [Line Items]

Redemption price

101.281%

Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period Four

Debt Instrument [Line Items]

Redemption price

100%

Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period One

Debt Instrument [Line Items]

Redemption price

100%

Percentage redeemed

40%

Percentage of proceeds from equity offerings

105.125%

Term Loan 2020

Debt Instrument [Line Items]

Face amount

$ 250,000

Term Loan 2020 | Minimum | London Interbank Offered Rate (LIBOR)

Debt Instrument [Line Items]

Applicable margin

2.50%

Term Loan 2020 | Maximum | London Interbank Offered Rate (LIBOR)

Debt Instrument [Line Items]

Applicable margin

3.75%

Revolving Credit Loans 2020

Debt Instrument [Line Items]

Borrowing capacity

$ 200,000

Revolving Credit Loans 2020 | Minimum

Debt Instrument [Line Items]

Commitment fee (as a percent)

0.25%

Revolving Credit Loans 2020 | Maximum

Debt Instrument [Line Items]

Commitment fee (as a percent)

0.50%

Credit Agreement 2020

Debt Instrument [Line Items]

Repayment of loan

$ 301,900

Financing costs

$ 2,700

Term loan and revolver

Debt Instrument [Line Items]

Write-off due to debt refinancing

$ 5,300

Revolver Letter Of Credit Sublimit Maturing July 2025

Debt Instrument [Line Items]

Gross long-term debt

17,400

Senior unsecured notes

Debt Instrument [Line Items]

Debt interest rate

4.625%

Face amount

$ 500,000

Gross long-term debt

$ 1,450,000

1,450,000

Percentage redeemed

40%

Percentage of proceeds from equity offerings

104.625%

Deferred financing costs

$ 10,400

Senior unsecured notes | Debt Instrument, Redemption, Period Two

Debt Instrument [Line Items]

Redemption price

102.313%

Senior unsecured notes | Debt Instrument, Redemption, Period Three

Debt Instrument [Line Items]

Redemption price

101.156%

Senior unsecured notes | Debt Instrument, Redemption, Period Four

Debt Instrument [Line Items]

Redemption price

100%

Senior unsecured notes | Debt Instrument, Redemption, Period One

Debt Instrument [Line Items]

Redemption price

100%

Senior Notes 6.125 Percent Due 2028

Debt Instrument [Line Items]

Debt interest rate

6.125%

Face amount

$ 350,000

Percentage redeemed

40%

Percentage of proceeds from equity offerings

106.125%

Deferred financing costs

$ 8,400

Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Two

Debt Instrument [Line Items]

Redemption price

103.063%

Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Three

Debt Instrument [Line Items]

Redemption price

102.042%

Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Four

Debt Instrument [Line Items]

Redemption price

101.021%

Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period One

Debt Instrument [Line Items]

Redemption price

100%

Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Five

Debt Instrument [Line Items]

Redemption price

100%

Note payable

Debt Instrument [Line Items]

Face amount

$ 100,000

Note payable | Period starting on the closing date and ending on the seventh anniversary

Debt Instrument [Line Items]

Debt interest rate

12%

Promissory Note From Members Interest

Debt Instrument [Line Items]

Face amount

$ 43,500

$ 100,000

Notes Payable, Other Payables

Debt Instrument [Line Items]

Write-off due to debt refinancing

2,000

Gross long-term debt

143,500

Gain (loss) on extinguishment of debt

$ (16,200)

Make-whole premium, as a percent

10%

Debt - Future Maturity of Total

Debt - Future Maturity of Total Debt (Details) $ in Thousands	Dec. 31, 2022 USD ($)
Debt Disclosure [Abstract]
2023	$ 35,000
2024	40,000
2025	40,000
2026	650,000
2027	0
Thereafter	1,450,000
Total debt maturity	$ 2,215,000

Stockholders' Equity - Narrativ

Stockholders' Equity - Narrative (Details)					1 Months Ended								12 Months Ended				26 Months Ended
	Mar. 18, 2021 shares	Jan. 01, 2021 shares	Aug. 04, 2020 USD ($) $ / shares shares	Nov. 08, 2019 Vote $ / shares shares	Jun. 30, 2021 USD ($) shares	Jan. 31, 2021 USD ($) $ / shares shares	Sep. 30, 2020 shares	Jul. 31, 2020 USD ($) $ / shares shares	Jun. 30, 2020 $ / shares shares	May 31, 2020	Apr. 30, 2020 USD ($) $ / shares shares	Nov. 30, 2019 USD ($) $ / shares shares	Dec. 31, 2022 USD ($) $ / shares shares	Dec. 31, 2021 USD ($) $ / shares shares	Dec. 31, 2020 USD ($) $ / shares shares	Dec. 31, 2019 USD ($) shares	Dec. 31, 2021 USD ($) $ / shares shares	Dec. 31, 2021 USD ($) $ / shares shares	Jul. 28, 2021 shares	Jul. 27, 2021 shares	Feb. 01, 2021 $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock exchange ratio				1
Exchange of Class B Common Stock for Class A Common Stock (in shares)				3,480,466										13,218,758	18,167,547		31,936,305
Exchange of Class B Common Stock for Class A Common Stock | $														$ 77,900,000
Common stock, shares authorized (in shares)													300,000,000						300,000,000	245,000,000
Vote for each share | Vote				1
Share price (in dollars per share) | $ / shares			$ 18.7175
Proceeds from the issuance of Class A Common Stock | $													$ 0	278,850,000	$ 142,600,000
Offering costs | $													$ 0	$ 13,832,000	$ 11,725,000
Preferred Stock, par value (in dollars per share) | $ / shares													$ 0.0001	$ 0.0001			$ 0.0001	$ 0.0001
Preferred Stock, shares issued (in shares)													124,060
Authorized purchase amount | $													$ 200,000,000
Warrants outstanding (in shares)				12,666,666									3,871,557
Common stock for each warrant exercised (in shares)			0.3856	1
Exercise price (in dollars per share) | $ / shares			$ 11.50	$ 11.50
Warrants exercised in cashless transaction, number exercised (in shares)													184,870	224,121	6,254,803
Shares issued in cashless exercise of warrants (in shares)													87,553	118,379
Warrants exercised for cash, number exercised (in shares)															2,131,315
Proceeds from the exercise of warrants | $													$ 0	$ 0	$ 24,495,000
Warrant redemption price (in dollars per share) | $ / shares			0.01
Stock trigger price (in dollars per share) | $ / shares			$ 18
Threshold trading days (in trading days) | $			20
Threshold consecutive trading days (in trading days)			30 days
Warrant exercise price (in dollars per share)			0.6144
Price period (in trading days)			10 days
Public warrants, number redeemed (in shares)															2,285,410
Exercise of warrants (in shares)															881,239
Earn-out consideration, shares per annual installment (in shares)													1,000,000	1,000,000	1,000,000
Second stock price hurdle (in dollars per share) | $ / shares													$ 22	$ 18	$ 15
Issuance of shares in contingent consideration (in shares)													0	1,000,000	1,000,000
Remaining contingent consideration (in shares)														1,000,000
Increase (decrease) in deferred tax assets | $													$ 1,600,000	$ (1,600,000)			$ (1,600,000)	$ (1,600,000)
Granted (in shares)						703,170					47,335	3,416,666		703,000	47,000
Vesting period (in years)						3 years
Exercise period (in years)						5 years
Options granted, grant date fair value | $						$ 6,900,000					$ 300,000	$ 7,200,000
Options forfeited (in shares)													914,000
Granted (in dollars per share) | $ / shares											$ 16.25	$ 11.50		$ 48.72	$ 16.25
Options outstanding (in shares)													4,962,000	5,766,000	3,464,001	3,417,000	5,766,000	5,766,000
Number of shares issued for options exercised on a cash basis (in shares)													489,191	1,138,982	0
Exercise of options | $													$ 2,510,000	$ 12,320,000
Options exercised in cashless basis (in shares)													315,349	307,613
Options exercised cashless basis (in shares)													131,741	133,126
Equity-based compensation expense | $													$ 22,400,000	$ 25,300,000	$ 18,700,000
Excess tax benefits associated with equity-based compensation | $													2,100,000	4,600,000	2,100,000
Unrecognized compensation expense | $													$ 34,400,000
Recognition period (in years)													1 year 10 months 24 days
Noncontrolling interests in subsidiaries
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exchange of Class B Common Stock for Class A Common Stock | $														77,919,000	35,271,000
Treasury Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares purchased under share repurchase program (in shares)													750,835
Value of repurchase | $													$ 14,000,000
Performance Percentage Less Than 25
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Performance payout percentage													0%
Performance Percentage Greater Than Or Equal To 25
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Performance payout percentage													50%
Performance Percentage Equal To 50
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Performance payout percentage													100%
Performance Percentage Greater Than Or Equal To 75
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Performance payout percentage													200%
General and Administrative Expense
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Equity-based compensation expense | $													$ 15,800,000	18,000,000	10,800,000
Cost of Sales
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Equity-based compensation expense | $													$ 6,600,000	$ 7,300,000	$ 7,900,000
Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise period (in years)												10 years
Options forfeited (in shares)														679,958
Accelerated vesting, number of shares (in shares)					184,932
Accelerated vesting cost | $					$ 1,900,000
Vested (in shares)													(722,222)	(722,222)	(1,154,667)
Unvested restricted stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)													962,000	1,354,000	2,120,000
Equity-based compensation expense | $														$ 500,000
Accelerated vesting (in shares)														22,192				22,192
Forfeited (in shares)													196,000	851,000	232,000			77,808
Vested (in shares)													(700,000)	(556,000)	(541,000)
Unvested restricted stock | Share-based Payment Arrangement, Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)															2,082,604
Grant date fair value | $															$ 38,700,000
Unvested restricted stock | Share-based Payment Arrangement, Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Grant date fair value | $															$ 800,000
Unvested restricted stock | Minimum | Share-based Payment Arrangement, Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)															3 years
Unvested restricted stock | Maximum | Share-based Payment Arrangement, Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)															4 years
Retention Program Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)														70,634	57,069
Equity-based compensation expense | $														$ 2,400,000	$ 1,100,000
Share-based Payment Arrangement
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Equity-based compensation expense | $														$ 1,500,000
Share-based Payment Arrangement | Share-based Payment Arrangement, Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)																1 year
Chief Executive Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options forfeited (in shares)														234,390
Various Employees | Share-based Payment Arrangement, Tranche Three
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)															1 year
Granted (in shares)															37,198
Various Employees | Unvested restricted stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)													562,686	1,266,846
Grant date fair value | $													$ 10,300,000	$ 37,100,000
Various Employees | Unvested restricted stock | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)													3 years	3 years
Various Employees | Unvested restricted stock | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)													4 years	4 years
Various Employees Non Employee Directors | Unvested restricted stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)													1 year	1 year
Granted (in shares)													81,347	87,500
Grant date fair value | $													$ 1,500,000	$ 2,000,000
Management | Performance Based Restricted Stock Unit
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)													3 years
Granted (in shares)													317,554
Grant date fair value | $													$ 8,700,000
Employee Of Acquired Entity | Unvested restricted stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)															300,000
Equity-based compensation expense | $															$ 3,900,000
Accelerated vesting (in shares)															50,000
Forfeited (in shares)															125,000
Vested (in shares)															(125,000)
Employee Of Acquired Entity | Unvested restricted stock | Share-based Payment Arrangement, Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)															50,000
Vesting percentage															25%
Employee Of Acquired Entity | Unvested restricted stock | Share-based Payment Arrangement, Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)															250,000
2019 Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares authorized for issuance (in shares)													10,000,000
Stock available for issuance (in shares)													2,191,908
Granted (in shares)														703,000	47,000
Options forfeited (in shares)														914,000
Granted (in dollars per share) | $ / shares														$ 48.72	$ 16.25
Options outstanding (in shares)													2,219,000	2,219,000	3,464,000	3,417,000	2,219,000	2,219,000
Grant date fair value | $																$ 4,500,000
2019 Incentive Plan | Share-based Payment Arrangement
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)																4 years
Vesting percentage										25%
2019 Incentive Plan | Share-based Payment Arrangement | Share-based Payment Arrangement, Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage																50%
2019 Incentive Plan | Share-based Payment Arrangement | Share-based Payment Arrangement, Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage																50%
AeroCare
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise price (in dollars per share) | $ / shares																					$ 6.24
Granted (in shares)														3,960,000
Granted (in dollars per share) | $ / shares														$ 6.24
Class B Common Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exchange of Class B Common Stock for Class A Common Stock (in shares)		13,218,758
Common Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Conversion of Series A Preferred Stock to Class A Common Stock (in shares)							2,887,709
Exchange of Class A Common Stock for Series B-1 Preferred Stock (in shares)									15,810,547
Conversion of Series B-1 Preferred Stock to Class A Common Stock (in shares)													0	3,950,000	2,000,000
Conversion Of Series C-1 Preferred Stock to Class A Common Stock (in shares)	13,047,473
Shares issued in cashless exercise of warrants (in shares)															1,973,707
Shares issued in cash exercise of warrants (in shares)															2,131,315
Preferred Class A
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Conversion of Series A Preferred Stock to Class A Common Stock (in shares)							39,706
Series B-2 Preferred Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Sale of stock, net of offering costs (in shares)								35,000
Proceeds from sale of stock | $								$ 35,000,000
Conversion of Series B-2 Preferred Stock to Series B-1 Preferred Stock (in shares)							35,000
Series B-1 Preferred Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Conversion of Series B-2 Preferred Stock to Series B-1 Preferred Stock (in shares)							25,454.55
Exchange of Class A Common Stock for Series B-1 Preferred Stock (in shares)									158,105.47
Preferred Stock, par value (in dollars per share) | $ / shares									$ 0.0001
Preferred stock, liquidation preference (in dollars per share) | $ / shares									$ 0.0001
Shares of common stock received in conversion for each share of preferred stock (in shares)									100
Preferred stock conversion, ceiling as a percent of outstanding common stock									0.049
Conversion of Series B-1 Preferred Stock to Class A Common Stock (in shares)													0	39,500	20,000
Preferred Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares of common stock received in conversion for each share of preferred stock (in shares)	100
Conversion Of Series C-1 Preferred Stock to Class A Common Stock (in shares)	130,474.73
Preferred Stock | AeroCare
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Preferred stock, liquidation preference (in dollars per share) | $ / shares																					$ 0.0001
Preferred Stock, shares issued (in shares)																					130,474.73
Public Offering
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Sale of stock, net of offering costs (in shares)						8,450,000
Share price (in dollars per share) | $ / shares						$ 33
Proceeds from sale of stock | $						$ 278,900,000								$ 265,018,000	$ 132,514,000
Proceeds from the issuance of Class A Common Stock | $						265,000,000
Offering costs | $						$ 13,800,000								$ 13,832,000	10,086,000
Public Offering | Common Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Sale of stock, net of offering costs (in shares)								9,200,000
Share price (in dollars per share) | $ / shares								$ 15.50
Proceeds from sale of stock | $								$ 142,600,000
Offering costs | $								10,100,000
Private Placement
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Proceeds from sale of stock | $								190,000,000							223,361,000
Offering costs | $								$ 1,600,000							$ 1,639,000
Private Placement | Common Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Sale of stock, net of offering costs (in shares)								10,930,471
Private Placement | Preferred Class A
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Sale of stock, net of offering costs (in shares)								39,706
Adapt Health Holdings LLC
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Controlling interest, as a percent				56%
Adapt Health Holdings LLC | Shareholders of Adapt Health Holdings LLC
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Noncontrolling interest, as a percent				44%
Number of votes per share | Vote				1

Stockholders' Equity - Warrants

Stockholders' Equity - Warrants (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Warrant Rollforward [Roll Forward]
Estimated fair value of warrant liability, beginning	$ 57,764	$ 113,905	$ 27,635
Change in estimated fair value of the warrant liability	(17,158)	(53,181)	135,368
Reclassification of warrant liability to equity for exercised warrants	(2,103)	(2,960)	(49,098)
Estimated fair value of warrant liability, ending	$ 38,503	$ 57,764	$ 113,905

Stockholders' Equity - Continge

Stockholders' Equity - Contingent Consideration (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Contingent Consideration Common Share Liability Rollforward [Roll Forward]
Estimated fair value of contingent consideration common shares liability, beginning balance	$ 0	$ 70,477	$ 9,316
Change in estimated fair value of the contingent consideration common shares liability	$ 0	(29,389)	98,717
Reclassification of contingent consideration common shares liability to equity		(41,088)	(37,556)
Estimated fair value of contingent consideration common shares liability, ending balance		$ 0	$ 70,477

Stockholders' Equity - Assumpti

Stockholders' Equity - Assumptions Used to Determine Grant Date Fair Value (Details) - Stock Options	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility	44.50%	40.70%
Risk-free interest rate	0.20%	0.40%
Expected term (in years)	4 years	6 years

Stockholders' Equity - Stock Op

Stockholders' Equity - Stock Option Activity (Details) - $ / shares	1 Months Ended			12 Months Ended
	Jan. 31, 2021	Apr. 30, 2020	Nov. 30, 2019	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Number of Options
Outstanding at beginning of period (in shares)	3,464,001			5,766,000	3,464,001	3,417,000
Granted (in shares)	703,170	47,335	3,416,666		703,000	47,000
Exercised (in shares)				(804,000)	(1,447,000)
Forfeited (in shares)				(914,000)
Outstanding at end of period (in shares)				4,962,000	5,766,000	3,464,001
Weighted-Average Exercise Price per Share
Outstanding at beginning of period (in dollars per share)	$ 11.56			$ 11.26	$ 11.56	$ 11.50
Granted (in dollars per share)		$ 16.25	$ 11.50		48.72	16.25
Exercised (in dollars per share)				5.69	10.16
Forfeited (in dollars per share)				11.66
Outstanding at end of period (in dollars per share)				$ 12.19	$ 11.26	$ 11.56
Weighted-Average Remaining Contractual Term
Weighted average remaining contractual term (in years)				5 years 7 months 6 days
Stock Options Exercisable
Number of Options
Outstanding at beginning of period (in shares)	1,155,000			4,575,000	1,155,000	0
Granted (in shares)					3,960,000
Vested (in shares)				878,000	907,000	1,155,000
Exercised (in shares)				(804,000)	(1,447,000)
Outstanding at end of period (in shares)				4,649,000	4,575,000	1,155,000
Weighted-Average Grant Date Fair Value per Share
Vested (in dollars per share)				$ 18.12	$ 11.50	$ 11.56
Weighted-Average Exercise Price per Share
Outstanding at beginning of period (in dollars per share)	$ 11.56			7.39	11.56	0
Granted (in dollars per share)					6.24
Exercised (in dollars per share)				5.69	10.16
Outstanding at end of period (in dollars per share)				$ 9.73	$ 7.39	$ 11.56
Weighted-Average Remaining Contractual Term
Weighted average remaining contractual term (in years)				5 years 9 months 18 days
Stock Options Unexercisable
Number of Options
Outstanding at beginning of period (in shares)	2,309,000			1,191,000	2,309,000	3,417,000
Granted (in shares)					703,000	47,000
Vested (in shares)				878,000	907,000	1,155,000
Forfeited (in shares)					(914,000)
Outstanding at end of period (in shares)				313,000	1,191,000	2,309,000
Weighted-Average Grant Date Fair Value per Share
Vested (in dollars per share)				$ 18.12	$ 11.50	$ 11.56
Weighted-Average Exercise Price per Share
Outstanding at beginning of period (in dollars per share)	$ 11.56			26.15	11.56	11.50
Granted (in dollars per share)					48.72	16.25
Forfeited (in dollars per share)					11.66
Outstanding at end of period (in dollars per share)				$ 48.72	$ 26.15	$ 11.56
Weighted-Average Remaining Contractual Term
Weighted average remaining contractual term (in years)				3 years 1 month 6 days
AeroCare
Number of Options
Granted (in shares)					3,960,000
Weighted-Average Exercise Price per Share
Granted (in dollars per share)					$ 6.24
2019 Incentive Plan
Number of Options
Outstanding at beginning of period (in shares)	3,464,000			2,219,000	3,464,000	3,417,000
Granted (in shares)					703,000	47,000
Exercised (in shares)					(1,034,000)
Forfeited (in shares)					(914,000)
Outstanding at end of period (in shares)				2,219,000	2,219,000	3,464,000
Weighted-Average Grant Date Fair Value per Share
Outstanding at beginning of period (in dollars per share)	$ 2.18			$ 3.75	$ 2.18	$ 2.12
Granted (in dollars per share)					9.81	6.34
Exercised (in dollars per share)					2.19
Forfeited (in dollars per share)					2.27
Outstanding at end of period (in dollars per share)				3.75	3.75	2.18
Weighted-Average Exercise Price per Share
Outstanding at beginning of period (in dollars per share)	$ 11.56			19.36	11.56	11.50
Granted (in dollars per share)					48.72	16.25
Exercised (in dollars per share)					11.57
Forfeited (in dollars per share)					11.66
Outstanding at end of period (in dollars per share)				$ 19.36	$ 19.36	$ 11.56
Weighted-Average Remaining Contractual Term
Weighted average remaining contractual term (in years)				6 years 1 month 6 days

Stockholders' Equity - Restrict

Stockholders' Equity - Restricted Stock (Details) - Unvested restricted stock - $ / shares	12 Months Ended			26 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2021
Number of Shares of Restricted Stock
Non-vested balance at beginning of period (in shares)	2,195,000	2,248,000	901,000
Granted (in shares)	962,000	1,354,000	2,120,000
Vested (in shares)	(700,000)	(556,000)	(541,000)
Forfeited (in shares)	(196,000)	(851,000)	(232,000)	(77,808)
Non-vested balance at end of period (in shares)	2,261,000	2,195,000	2,248,000	2,195,000
Weighted-Average Grant Date Fair Value per Share
Non-vested, grant date fair value at beginning of period (in dollars per share)	$ 19.58	$ 15.60	$ 5.83
Granted (in dollars per share)	21.26	28.92	18.60
Vested (in dollars per share)	19.99	14.03	10.78
Forfeited (in dollars per share)	20.60	17.64	15.97
Non-vested, grant date fair value at end of period (in dollars per share)	$ 23.90	$ 19.58	$ 15.60	$ 19.58

Earnings (Loss) Per Share - Bas

Earnings (Loss) Per Share - Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Numerator
Net income (loss) attributable to AdaptHealth Corp.	$ 69,316	$ 156,175	$ (161,632)
Less: Earnings allocated to participating securities	5,867	14,379	0
Net income (loss) for basic EPS	63,449	141,796	(161,632)
Change in fair value of warrant liability	(17,158)	(53,181)	135,368
Net income (loss) for diluted EPS	$ 46,291	$ 88,615	$ (161,632)
Denominator
Basic weighted-average common shares outstanding (in shares)	134,175	126,306	52,488
Add: Warrants (in shares)	1,528	2,377	0
Add: Stock options (in shares)	2,512	3,782	0
Add: Unvested restricted stock (in shares)	773	569	0
Diluted weighted-average common shares outstanding (in shares)	138,988	133,034	52,488
Basic net income (loss) per share (in dollars per share)	$ 0.47	$ 1.12	$ (3.08)
Diluted net income (loss) per share (in dollars per share)	$ 0.33	$ 0.67	$ (3.08)

Earnings (Loss) Per Share - Ant

Earnings (Loss) Per Share - Antidilutive Shares (Details) - shares shares in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities excluded (in shares)	12,875	12,808	16,177
Preferred Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities excluded (in shares)	12,406	12,808	10,077
Warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities excluded (in shares)	0	0	1,902
Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities excluded (in shares)	469	0	1,539
Unvested restricted stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities excluded (in shares)	0	0	659
Contingent Consideration Common Shares
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities excluded (in shares)	0	0	2,000

Leases - Right-Of-Use Assets an

Leases - Right-Of-Use Assets and Lease Liabilities (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Right-of-use (ROU) assets:
Operating lease right-of-use assets	$ 129,506	$ 147,760
Total ROU assets	135,032	165,170
Operating lease liabilities:
Current operating lease liabilities	30,001	31,418
Noncurrent operating lease liabilities	104,394	120,180
Total operating lease liabilities	134,395	151,598
Finance lease liabilities:
Current portion of finance lease obligations	2,211	15,446
Total finance lease liabilities	6,161	15,578
Operating lease costs	37,822	37,043
Finance lease costs:
Amortization of ROU assets	8,246	33,689
Other lease costs and income:
Variable lease costs	17,758	14,030
Sublease income	1,380	1,239
Short-term lease costs	0	19,905
Finance lease right-of-use assets
Right-of-use (ROU) assets:
Finance lease right-of-use assets	5,423	0
Equipment and other fixed assets, net
Right-of-use (ROU) assets:
Finance lease right-of-use assets	103	17,410
Finance lease obligations, less current portion
Finance lease liabilities:
Finance lease obligations, less current portion	3,950	0
Other long-term liabilities
Finance lease liabilities:
Finance lease obligations, less current portion	$ 0	$ 132

Leases - Weighted Average Remai

Leases - Weighted Average Remaining Lease Terms and Discount Rates (Details)	Dec. 31, 2022	Dec. 31, 2021
Weighted average remaining lease term, weighted based on lease liability balances:
Operating leases (in years)	6 years 2 months 12 days	6 years 8 months 12 days
Finance leases (in years)	3 years 8 months 12 days	1 year
Weighted average discount rate, weighted based on remaining balance of lease payments:
Operating leases	3.90%	3.80%

Leases - Lease Maturity (Detail

Leases - Lease Maturity (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Operating Leases
2023	$ 34,446
2024	28,100
2025	24,354
2026	17,484
2027	12,139
Thereafter	36,089
Total future undiscounted leases payments	152,612
Less: amount representing interest	(18,217)
Present value of future lease payments (lease liability)	134,395	$ 151,598
Finance Leases
2023	2,318
2024	1,567
2025	1,566
2026	1,074
2027	10
Thereafter	0
Total future undiscounted leases payments	6,535
Less: amount representing interest	(374)
Present value of future lease payments (lease liability)	$ 6,161	$ 15,578

Leases - Cash Flow and Suppleme

Leases - Cash Flow and Supplemental Non-Cash Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash payments for operating leases	$ 37,486	$ 36,510
Financing cash payments for finance leases	16,176	42,164	$ 39,051
Lease liabilities arising from obtaining right-of-use assets:
Operating leases	22,543	91,420
Finance leases	$ 5,423	$ 22,959

Retirement Plans (Details)

Retirement Plans (Details) $ in Millions	12 Months Ended
	Dec. 31, 2022 USD ($) plan	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)
Retirement Benefits [Abstract]
Number of plans administered by others | plan	2
Matching or profit sharing expense | $	$ 4.7	$ 2.9	$ 1.5

Self-Insured Plans (Details)

Self-Insured Plans (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Self Insured Plans
Stop-loss threshold	$ 300	$ 225	$ 175
Liability for self-insurance reserves	$ 15,600	$ 11,700

Commitments and Contingencies (

Commitments and Contingencies (Details)	1 Months Ended
	May 31, 2018 subsidiary
Commitments and Contingencies Disclosure [Abstract]
Number of subsidiaries	1
Agreement term (in years)	5 years

Related Party Transactions (Det

Related Party Transactions (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Vendor two
Related Party Transaction [Line Items]
Equity ownership percentage	1%
Expense for related party	$ 7	$ 4.9	$ 2.6
Third Party Payor | Maximum
Related Party Transaction [Line Items]
Net revenue related party	1%	1%	1%
Vendor Three
Related Party Transaction [Line Items]
Equity ownership percentage	5%
Expense for related party	$ 80.3	$ 12.3	$ 0
Outstanding accounts payable	2.1	0
Shareholder Of Contract Labor Service Provider
Related Party Transaction [Line Items]
Outstanding accounts payable	2.2	0
Payments to service provider	$ 20	$ 18.1	$ 15.9

Income Taxes - Current and Defe

Income Taxes - Current and Deferred Income Tax Expense (Benefit) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Current:
Federal	$ (197)	$ 2,356	$ 5,608
State	6,930	8,070	3,538
Current income tax (benefit) expense	6,733	10,426	9,146
Deferred:
Federal	12,205	22,891	(16,587)
State	5,831	(511)	(4,514)
Deferred income tax (benefit) expense	18,036	22,380	(21,101)
Total Income tax expense (benefit)	$ 24,769	$ 32,806	$ (11,955)

Income Taxes - Reconciliation o

Income Taxes - Reconciliation of Effective Income Tax Rate (Details)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Federal statutory rate	21%	21%	21%
State income taxes, net of federal benefit	3.60%	3.10%	4.70%
Equity-based compensation	(0.50%)	(1.90%)	0%
Change in valuation allowance	0%	0.10%	(0.40%)
Change in fair value of warrant liability	(3.70%)	(5.90%)	(17.10%)
Change in fair value of contingent consideration	0%	(1.20%)	(4.40%)
Deferred tax only adjustment	(2.60%)	0.30%	1.70%
Deferred tax impact of state effective tax rate changes	8.60%	0%	0%
Other	(1.10%)	1.70%	0.30%
Effective income tax rate	25.30%	17.20%	5.80%

Income Taxes - Deferred Tax Ass

Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Deferred income tax assets:
Accounts receivable	$ 37,363	$ 51,115
Goodwill and intangible assets	262,501	291,331
Investment in partnership	171	4,218
Inventory	1,841	561
Accruals	9,207	6,845
Net operating losses and credits	35,459	32,926
Transaction costs	417	7,580
Contract liabilities	0	3,041
Equity-based compensation	6,101	3,801
Excess business interest expense	27,918	0
Lease liability	35,431	40,683
Contingent consideration	0	3,541
Capital losses	817	817
Total deferred income tax assets	417,226	446,459
Valuation allowance	(1,812)	(1,812)
Net deferred income tax assets	415,414	444,647
Deferred income tax liabilities:
Right-of-use assets	(34,201)	(39,760)
Contingent consideration	(2,200)	0
Unrealized gains	(2,950)	0
Equipment and other fixed assets	(94,277)	(100,694)
Total deferred income tax liabilities	(133,628)	(140,454)
Noncurrent net deferred income tax assets	$ 281,786	$ 304,193

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details) - USD ($) $ in Thousands		12 Months Ended			26 Months Ended
	Nov. 08, 2019	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2021
Income Tax Contingency [Line Items]
Valuation allowance		$ (1,812)	$ (1,812)		$ (1,812)
Interest expense carryforward		109,900	0		0
Historical net operating losses fully limited due to ownership changes		1,800
Additions for tax positions acquired		2,670	2,100	$ 1,947
Accrued liability for interest and penalties		1,600	$ 900		$ 900
Exchange of Class B Common Stock for Class A Common Stock (in shares)	3,480,466		13,218,758	18,167,547	31,936,305
Increase in tax basis step-up, goodwill	$ 33,600		$ 537,900	$ 485,700	$ 1,029,600
Tax receivable agreement percentage	85%
Increase in liability due to additional exchanges			146,500	140,400
Increase in deferred tax asset			164,100	$ 165,200
Liability related to TRA		297,400	300,300
Income related to changes in estimated TRA liability		2,900
Other liabilities
Income Tax Contingency [Line Items]
Liability related to TRA		3,300
Other long-term liabilities
Income Tax Contingency [Line Items]
Liability related to TRA		294,100
Pinnacle
Income Tax Contingency [Line Items]
NOLs expected to expire		3,100
Additions for tax positions acquired		6,600
Capital Loss Carryforward
Income Tax Contingency [Line Items]
Capital loss carryforward		3,100
Domestic Tax Authority
Income Tax Contingency [Line Items]
Operating loss carryforwards		138,200	139,600		139,600
NOLs not subject to expiration		31,400
Domestic Tax Authority | Pinnacle
Income Tax Contingency [Line Items]
Operating loss carryforwards		3,200
Domestic Tax Authority | AeroCare
Income Tax Contingency [Line Items]
Operating loss carryforwards		103,600
State and Local Jurisdiction
Income Tax Contingency [Line Items]
Operating loss carryforwards		$ 150,700	$ 85,700		$ 85,700

Income Taxes - Unrecognized Tax

Income Taxes - Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Unrecognized tax benefits, beginning balance	$ 4,047	$ 1,947	$ 0
Additions for tax positions acquired	2,670	2,100	1,947
Reductions due to lapse of statute of limitations	(78)
Unrecognized tax benefits, ending balance	$ 6,639	$ 4,047	$ 1,947