AdaptHealth (AHCO) 10-Q 8 Aug 23 2023 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2023	Aug. 04, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Jun. 30, 2023
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 Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		136,106,010
Entity Central Index Key	0001725255
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q2
Amendment Flag	false

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Current assets:
Cash	$ 45,126	$ 46,272
Accounts receivable	365,708	359,146
Inventory	114,882	127,754
Prepaid and other current assets	42,572	52,136
Total current assets	568,288	585,308
Equipment and other fixed assets, net	504,356	487,079
Operating lease right-of-use assets	117,798	129,506
Finance lease right-of-use assets	14,819	5,423
Goodwill	3,552,311	3,545,297
Identifiable intangible assets, net	142,774	162,773
Other assets	22,175	22,415
Deferred tax assets	280,491	281,786
Total Assets	5,203,012	5,219,587
Current liabilities:
Accounts payable and accrued expenses	337,700	337,498
Current portion of long-term debt	40,000	35,000
Current portion of operating lease obligations	29,579	30,001
Current portion of finance lease obligations	4,246	2,211
Contract liabilities	34,748	31,641
Other liabilities	11,705	19,863
Total current liabilities	457,978	456,214
Long-term debt, less current portion	2,135,624	2,153,267
Operating lease obligations, less current portion	93,241	104,394
Finance lease obligations, less current portion	10,638	3,950
Other long-term liabilities	302,683	305,501
Warrant liability	15,777	38,503
Total Liabilities	3,015,941	3,061,829
Commitments and contingencies (note 14)
Stockholders' Equity:
Common Stock, par value of $0.0001 per share, 300,000,000 shares authorized; 134,517,446 and 134,435,119 shares issued and outstanding as of June 30, 2023 and December 31, 2022, respectively	13	13
Preferred Stock, par value of $0.0001 per share, 5,000,000 shares authorized; 124,060 shares issued and outstanding as of June 30, 2023 and December 31, 2022	1	1
Treasury stock, at cost (1,382,788 and 750,835 shares at June 30, 2023 and December 31, 2022, respectively)	(23,216)	(13,992)
Additional paid-in capital	2,139,820	2,130,148
Retained earnings	55,979	26,295
Accumulated other comprehensive income	8,342	8,693
Total stockholders' equity attributable to AdaptHealth Corp.	2,180,939	2,151,158
Noncontrolling interest in subsidiary	6,132	6,600
Total Stockholders' Equity	2,187,071	2,157,758
Total Liabilities and Stockholders' Equity	$ 5,203,012	$ 5,219,587

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Jun. 30, 2023	Dec. 31, 2022
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	300,000,000
Common Stock, shares issued (in shares)	134,517,446	134,435,119
Common Stock, shares outstanding (in shares)	134,517,446	134,435,119
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	124,060
Preferred Stock, shares outstanding (in shares)	124,060	124,060
Treasury stock, at cost (in shares)	1,382,788	750,835

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Income Statement [Abstract]
Net revenue	$ 793,286	$ 727,614	$ 1,537,912	$ 1,433,817
Revenue, Product and Service [Extensible Enumeration]	Health Care, Patient Service [Member]	Health Care, Patient Service [Member]	Health Care, Patient Service [Member]	Health Care, Patient Service [Member]
Costs and expenses:
Cost of net revenue	$ 673,397	$ 610,011	$ 1,328,793	$ 1,207,133
Cost, Product and Service [Extensible Enumeration]	Health Care, Patient Service [Member]	Health Care, Patient Service [Member]	Health Care, Patient Service [Member]	Health Care, Patient Service [Member]
General and administrative expenses	$ 50,078	$ 42,548	$ 97,599	$ 83,992
Depreciation and amortization, excluding patient equipment depreciation	15,549	15,877	31,081	31,962
Total costs and expenses	739,024	668,436	1,457,473	1,323,087
Operating income	54,262	59,178	80,439	110,730
Interest expense, net	32,552	25,608	64,507	50,384
Change in fair value of warrant liability (note 10)	(812)	8,208	(22,726)	(18,509)
Other loss, net	2,082	1,262	3,257	6,922
Income before income taxes	20,440	24,100	35,401	71,933
Income tax expense	5,399	8,853	3,685	14,456
Net income	15,041	15,247	31,716	57,477
Income attributable to noncontrolling interest	1,064	1,215	2,032	1,695
Net income attributable to AdaptHealth Corp.	$ 13,977	$ 14,032	$ 29,684	$ 55,782
Weighted average common shares outstanding - basic (in shares)	134,295	134,332	134,409	134,178
Weighted average common shares outstanding - diluted (in shares)	136,233	137,015	138,000	138,335
Basic net income per share (note 11) (in dollars per share)	$ 0.10	$ 0.10	$ 0.20	$ 0.38
Diluted net income per share (note 11) (in dollars per share)	$ 0.09	$ 0.09	$ 0.03	$ 0.24

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Statement of Comprehensive Income [Abstract]
Net income	$ 15,041	$ 15,247	$ 31,716	$ 57,477
Other comprehensive income (loss):
Gain (loss) on interest rate swap agreements, inclusive of reclassification adjustment, net of tax	2,454	1,593	(351)	7,591
Comprehensive income	17,495	16,840	31,365	65,068
Income attributable to noncontrolling interest	1,064	1,215	2,032	1,695
Comprehensive income attributable to AdaptHealth Corp.	$ 16,431	$ 15,625	$ 29,333	$ 63,373

CONSOLIDATED STATEMENTS OF CHAN

CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Common Stock	Preferred Stock	Treasury Stock	Additional paid-in capital	Retained Earnings (Accumulated deficit)	Accumulated other comprehensive income (loss)	Noncontrolling interest in subsidiary
Common Stock, beginning balance (in shares) at Dec. 31, 2021		133,844,000
Preferred Stock, beginning balance (in shares) at Dec. 31, 2021			124,000
Treasury Stock, beginning balance (in shares) at Dec. 31, 2021				0
Balance at beginning of period at Dec. 31, 2021	$ 2,066,689	$ 13	$ 1	$ 0	$ 2,107,267	$ (43,021)	$ (2,354)	$ 4,783
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Equity-based compensation (in shares)		187,000
Equity-based compensation	5,502				5,502
Exercise of stock options (in shares)		184,000
Exercise of stock options	723				723
Payments for tax withholdings from restricted stock vesting and stock option exercises	(1,269)				(1,269)
Common Stock issued in connection with employee stock purchase plan (in shares)		31,000
Common Stock issued in connection with employee stock purchase plan	753				753
Net income	42,230					41,750		480
Change in fair value of interest rate swaps, inclusive of reclassification adjustment	5,998						5,998
Common Stock, ending balance (in shares) at Mar. 31, 2022		134,246,000
Preferred Stock, ending balance (in shares) at Mar. 31, 2022			124,000
Treasury Stock, ending balance (in shares) at Mar. 31, 2022				0
Balance at end of period at Mar. 31, 2022	2,120,626	$ 13	$ 1	$ 0	2,112,976	(1,271)	3,644	5,263
Common Stock, beginning balance (in shares) at Dec. 31, 2021		133,844,000
Preferred Stock, beginning balance (in shares) at Dec. 31, 2021			124,000
Treasury Stock, beginning balance (in shares) at Dec. 31, 2021				0
Balance at beginning of period at Dec. 31, 2021	2,066,689	$ 13	$ 1	$ 0	2,107,267	(43,021)	(2,354)	4,783
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options	$ 700
Shares purchased under share repurchase program (in shares)				199,418
Reclassification of warrant liability to equity for exercised warrants (in shares)	18,667
Reclassification of warrant liability to equity for exercised warrants	$ 495
Net income	57,477
Common Stock, ending balance (in shares) at Jun. 30, 2022		134,425,000
Preferred Stock, ending balance (in shares) at Jun. 30, 2022			124,000
Treasury Stock, ending balance (in shares) at Jun. 30, 2022				199,000
Balance at end of period at Jun. 30, 2022	2,137,693	$ 13	$ 1	$ (3,375)	2,118,578	12,761	5,237	4,478
Common Stock, beginning balance (in shares) at Mar. 31, 2022		134,246,000
Preferred Stock, beginning balance (in shares) at Mar. 31, 2022			124,000
Treasury Stock, beginning balance (in shares) at Mar. 31, 2022				0
Balance at beginning of period at Mar. 31, 2022	2,120,626	$ 13	$ 1	$ 0	2,112,976	(1,271)	3,644	5,263
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Equity-based compensation (in shares)		117,000
Equity-based compensation	5,720				5,720
Exercise of stock options (in shares)		43,000
Payments for tax withholdings from restricted stock vesting and stock option exercises	(613)				(613)
Shares purchased under share repurchase program (in shares)				199,000
Shares purchased under share repurchase program	(3,375)			$ (3,375)
Reclassification of warrant liability to equity for exercised warrants (in shares)		19,000
Reclassification of warrant liability to equity for exercised warrants	495				495
Distribution to non-controlling interest	(2,000)							(2,000)
Net income	15,247					14,032		1,215
Change in fair value of interest rate swaps, inclusive of reclassification adjustment	1,593						1,593
Common Stock, ending balance (in shares) at Jun. 30, 2022		134,425,000
Preferred Stock, ending balance (in shares) at Jun. 30, 2022			124,000
Treasury Stock, ending balance (in shares) at Jun. 30, 2022				199,000
Balance at end of period at Jun. 30, 2022	$ 2,137,693	$ 13	$ 1	$ (3,375)	2,118,578	12,761	5,237	4,478
Common Stock, beginning balance (in shares) at Dec. 31, 2022	134,435,119	134,435,000
Preferred Stock, beginning balance (in shares) at Dec. 31, 2022	124,060		124,000
Treasury Stock, beginning balance (in shares) at Dec. 31, 2022	750,835			751,000
Balance at beginning of period at Dec. 31, 2022	$ 2,157,758	$ 13	$ 1	$ (13,992)	2,130,148	26,295	8,693	6,600
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Equity-based compensation (in shares)		292,000
Equity-based compensation	5,916				5,916
Payments for tax withholdings from restricted stock vesting and stock option exercises	(1,883)				(1,883)
Common Stock issued in connection with employee stock purchase plan (in shares)		53,000
Common Stock issued in connection with employee stock purchase plan	1,021				1,021
Shares purchased under share repurchase program (in shares)		632,000		632,000
Shares purchased under share repurchase program	(9,224)			$ (9,224)
Net income	16,675					15,707		968
Change in fair value of interest rate swaps, inclusive of reclassification adjustment	(2,805)						(2,805)
Common Stock, ending balance (in shares) at Mar. 31, 2023		134,148,000
Preferred Stock, ending balance (in shares) at Mar. 31, 2023			124,000
Treasury Stock, ending balance (in shares) at Mar. 31, 2023				1,383,000
Balance at end of period at Mar. 31, 2023	$ 2,167,458	$ 13	$ 1	$ (23,216)	2,135,202	42,002	5,888	7,568
Common Stock, beginning balance (in shares) at Dec. 31, 2022	134,435,119	134,435,000
Preferred Stock, beginning balance (in shares) at Dec. 31, 2022	124,060		124,000
Treasury Stock, beginning balance (in shares) at Dec. 31, 2022	750,835			751,000
Balance at beginning of period at Dec. 31, 2022	$ 2,157,758	$ 13	$ 1	$ (13,992)	2,130,148	26,295	8,693	6,600
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options (in shares)	559,000
Shares purchased under share repurchase program (in shares)				631,953
Net income	$ 31,716
Common Stock, ending balance (in shares) at Jun. 30, 2023	134,517,446	134,518,000
Preferred Stock, ending balance (in shares) at Jun. 30, 2023	124,060		124,000
Treasury Stock, ending balance (in shares) at Jun. 30, 2023	1,382,788			1,383,000
Balance at end of period at Jun. 30, 2023	$ 2,187,071	$ 13	$ 1	$ (23,216)	2,139,820	55,979	8,342	6,132
Common Stock, beginning balance (in shares) at Mar. 31, 2023		134,148,000
Preferred Stock, beginning balance (in shares) at Mar. 31, 2023			124,000
Treasury Stock, beginning balance (in shares) at Mar. 31, 2023				1,383,000
Balance at beginning of period at Mar. 31, 2023	2,167,458	$ 13	$ 1	$ (23,216)	2,135,202	42,002	5,888	7,568
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Equity-based compensation (in shares)		156,000
Equity-based compensation	6,847				6,847
Exercise of stock options (in shares)		214,000
Payments for tax withholdings from restricted stock vesting and stock option exercises	(2,229)				(2,229)
Distribution to non-controlling interest	(2,500)							(2,500)
Net income	15,041					13,977		1,064
Change in fair value of interest rate swaps, inclusive of reclassification adjustment	$ 2,454						2,454
Common Stock, ending balance (in shares) at Jun. 30, 2023	134,517,446	134,518,000
Preferred Stock, ending balance (in shares) at Jun. 30, 2023	124,060		124,000
Treasury Stock, ending balance (in shares) at Jun. 30, 2023	1,382,788			1,383,000
Balance at end of period at Jun. 30, 2023	$ 2,187,071	$ 13	$ 1	$ (23,216)	$ 2,139,820	$ 55,979	$ 8,342	$ 6,132

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Cash flows from operating activities:
Net income	$ 31,716	$ 57,477
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization, including patient equipment depreciation	193,109	156,504
Equity-based compensation	12,763	11,222
Change in fair value of warrant liability	(22,726)	(18,509)
Reduction in the carrying amount of operating lease right-of-use assets	16,794	9,530
Reduction in the carrying amount of finance lease right-of-use assets	3,007	0
Deferred income tax expense	1,413	11,975
Change in fair value of interest rate swaps, net of reclassification adjustment	(987)	(1,460)
Amortization of deferred financing costs	2,617	2,617
Other	0	(2,262)
Changes in operating assets and liabilities, net of effects from acquisitions:
Accounts receivable	(5,011)	7,027
Inventory	13,808	18,807
Prepaid and other assets	10,199	10,406
Operating lease obligations	(16,662)	(9,452)
Operating liabilities	(13,473)	(83,958)
Net cash provided by operating activities	226,567	169,924
Cash flows from investing activities:
Purchases of equipment and other fixed assets	(171,730)	(154,340)
Payments for business acquisitions, net of cash acquired	(17,905)	(15,324)
Payments for cost method investments	(128)	(367)
Net cash used in investing activities	(189,763)	(170,031)
Cash flows from financing activities:
Proceeds from borrowings on long-term debt	50,000	0
Repayments on long-term debt	(65,000)	(10,000)
Repayments of finance lease liabilities	(3,679)	(12,547)
Payments for shares purchased under share repurchase program	(9,224)	(3,375)
Proceeds from the exercise of stock options	0	723
Proceeds received in connection with employee stock purchase plan	1,021	753
Payments relating to the Tax Receivable Agreement	(3,202)	0
Distributions to noncontrolling interest	(2,500)	(2,000)
Payments for tax withholdings from restricted stock vesting and stock option exercises	(4,366)	(1,882)
Payments of contingent consideration and deferred purchase price from acquisitions	(1,000)	(2,383)
Net cash used in financing activities	(37,950)	(30,711)
Net decrease in cash	(1,146)	(30,818)
Cash at beginning of period	46,272	149,627
Cash at end of period	45,126	118,809
Supplemental disclosures:
Cash paid for interest	62,782	50,503
Cash paid for income taxes	5,567	9,828
Noncash investing and financing activities:
Equipment acquired under finance lease obligations	0	1,335
Unpaid equipment and other fixed asset purchases at end of period	32,942	37,704
Assets subject to operating lease obligations	5,112	4,582
Operating lease obligations	(5,112)	(4,582)
Assets subject to finance lease obligations	12,203	0
Finance lease obligations	(12,203)	0
Deferred purchase price in connection with acquisitions	$ 50	$ 422

General Information

General Information	6 Months Ended
	Jun. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
General Information	General Information 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. As previously disclosed, by mutual agreement with the Company, effective June 30, 2023, Stephen Griggs resigned as Chief Executive Officer and did not stand for reelection as a member of the Company’s Board of Directors (the “Board”) at the Company’s annual meeting. On June 27, 2023, the Company announced the appointment of Crispin Teufel to serve as Chief Executive Officer of the Company effective September 1, 2023. Richard Barasch, Chairman of the Board of the Company, will serve as interim Chief Executive Officer of the Company, effective July 1, 2023 through August 31, 2023. The interim consolidated financial statements are unaudited, but reflect all normal recurring adjustments that are, in the opinion of management, necessary to fairly present the information set forth herein. The interim consolidated financial statements should be read in conjunction with the audited consolidated financial statements and related notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2022. Interim results are not necessarily indicative of the results for a full year. There have been no material changes in the Company’s significant accounting policies as compared to the significant accounting policies described in the Company’s Annual Report on Form 10-K for the year ended December 31, 2022. (a) Basis of Presentation The interim 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 interim consolidated financial statements include all necessary adjustments for a fair presentation of the financial position and results of operations for the periods presented. (b) Basis of Consolidation The accompanying interim 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) Concentration of Credit Risk Financial instruments which potentially subject the Company to concentrations of credit risk consist principally of cash 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. (d) 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. (e) 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, rather, it 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 sustained decreases 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 or interim goodwill impairment test will prove to be accurate predictions of the future. During 2023, the Company experienced a decline in its market capitalization as a result of a sustained decrease in the Company’s stock price. The Company considered such sustained decrease to represent a triggering event and performed goodwill impairment tests as of March 31, 2023 and June 30, 2023. The Company did not recognize any impairment charges of goodwill during the six months ended June 30, 2023 and 2022. Refer to Note 5, Goodwill and Identifiable Intangible Assets , for additional details. (f) 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. In addition to consideration of impairment upon the events or changes in circumstances described above, management regularly evaluates the remaining useful lives of its 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 recognize any impairment charges on long-lived assets for the six months ended June 30, 2023 and 2022. (g) 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 general and administrative expenses and cost of net revenue in the accompanying consolidated statements of operations. The Company measures and recognizes equity-based compensation expense for such awards based on their estimated fair values on the date of grant. For share based awards with service only or service and performance conditions, 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. For share based awards with only a service condition, 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 straight-line on a tranche-by-tranche basis over the employees’ requisite service period subject to management’s estimation of the probability of vesting of such awards. If management determines that the performance conditions are no longer probable of achievement, the Company will reverse the previously recognized equity-based compensation expense in the period of determination. For awards with market conditions, the grant-date fair value is estimated using a monte-carlo simulation analysis, which is recognized straight-line on a tranche-by-tranche basis over the employees’ requisite service period regardless of whether or the extent to which the awards ultimately vest. Refer to Note 10, Stockholders’ Equity , for additional information regarding the Company’s equity-based compensation expense. (h) Business Segment The Company’s chief operating decision-makers are its Interim 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. (i) Accounting for Leases The Company accounts for its leases in accordance with FASB Accounting Standards Update ("ASU") No. 2016-02, Leases (Topic 842) (ASC 842). 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. 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 to 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 12, Leases, for additional information. (j) 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 made to comply with reference rate reform to meet the definition of a modification under U.S. GAAP. It further allows hedge accounting to be maintained and a one-time transfer or sale of qualifying held-to-maturity securities. The expedients and exceptions provided by the amendments are permitted to be adopted any time through December 31, 2024, with early adoption permitted, and do not apply to contract modifications made and hedging relationships entered into or evaluated after December 31, 2022, except for certain optional expedients elected for certain hedging relationships existing as of December 31, 2022. The Company adopted this standard during the six months ended June 30, 2023, which did not have a material impact on its consolidated financial statements and related disclosures.

Revenue Recognition and Account

Revenue Recognition and Accounts Receivable	6 Months Ended
	Jun. 30, 2023
Revenue from Contract with Customer [Abstract]
Revenue Recognition and Accounts Receivable	Revenue Recognition and Accounts Receivable 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), home 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 home 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 three and six months ended June 30, 2023 and 2022 are as follows (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Insurance $ 474,828 $ 436,179 $ 911,612 $ 857,069 Government 209,662 196,338 398,509 377,988 Patient pay 108,796 95,097 227,791 198,760 Net revenue $ 793,286 $ 727,614 $ 1,537,912 $ 1,433,817 The composition of net revenue by core service lines for the three and six months ended June 30, 2023 and 2022 are as follows (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Net sales revenue: Sleep $ 215,849 $ 194,693 $ 429,306 $ 387,028 Diabetes 165,021 162,259 307,565 313,618 Supplies to the home 48,323 43,881 94,878 83,746 Respiratory 8,191 7,891 16,120 16,036 HME 27,237 30,313 55,800 60,365 Other 57,012 53,617 110,219 107,816 Total net sales revenue $ 521,633 $ 492,654 $ 1,013,888 $ 968,609 Net revenue from fixed monthly equipment reimbursements: Sleep $ 86,783 $ 65,661 $ 167,705 $ 123,599 Diabetes 3,886 4,034 7,717 7,980 Respiratory 145,889 128,865 280,612 261,445 HME 23,974 25,547 46,315 51,272 Other 11,121 10,853 21,675 20,912 Total net revenue from fixed monthly equipment reimbursements $ 271,653 $ 234,960 $ 524,024 $ 465,208 Total net revenue: Sleep $ 302,632 $ 260,354 $ 597,011 $ 510,627 Diabetes 168,907 166,293 315,282 321,598 Supplies to the home 48,323 43,881 94,878 83,746 Respiratory 154,080 136,756 296,732 277,481 HME 51,211 55,860 102,115 111,637 Other 68,133 64,470 131,894 128,728 Total net revenue $ 793,286 $ 727,614 $ 1,537,912 $ 1,433,817 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 June 30, 2023 and December 31, 2022, the Company’s unbilled accounts receivable was $37.4 million and $38.6 million, respectively.

Acquisitions

Acquisitions	6 Months Ended
	Jun. 30, 2023
Business Combination and Asset Acquisition [Abstract]
Acquisitions	Acquisitions During the six months ended June 30, 2023 and 2022, the Company completed certain acquisitions to strengthen its current market share in existing 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 six months ended June 30, 2023 is 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. Six Months Ended June 30, 2023 During the six months ended June 30, 2023, the Company acquired 100% of the equity interests of three providers of home medical equipment ("HME") and acquired certain assets of the home medical equipment businesses of two providers of HME. The following table summarizes the consideration paid at closing for all acquisitions during the six months ended June 30, 2023 (in thousands): Cash $ 18,173 Deferred payments 50 Total $ 18,223 The Company allocated the consideration paid to the net assets acquired based on their estimated acquisition date fair values. Based upon management’s evaluation, which is preliminary and subject to completion of working capital and other adjustments, the consideration paid for all acquisitions during the six months ended June 30, 2023 was allocated as follows during the period (in thousands): Cash $ 268 Accounts receivable 1,798 Inventory 1,001 Prepaid and other current assets 10 Equipment and other fixed assets 9,863 Operating lease right-of-use assets 5,506 Finance lease right-of-use assets 200 Goodwill 6,796 Accounts payable and accrued expenses (667) Other current liabilities (846) Operating lease liabilities (5,506) Finance lease liabilities (200) Net assets acquired $ 18,223 Six Months Ended June 30, 2022 During the six months ended June 30, 2022, the Company acquired 100% of the equity interests of two providers of HME and acquired certain assets of the home medical equipment businesses of four providers of HME. The following table summarizes the consideration paid at closing for all acquisitions during the six months ended June 30, 2022 (in thousands): Cash $ 16,377 Deferred payments 422 Total $ 16,799 The Company allocated the consideration paid to the net assets acquired based on their estimated acquisition date fair values. Based upon management’s evaluation, which was preliminary and subject to completion of working capital and other adjustments, the consideration paid for all acquisitions during the six months ended June 30, 2022 was allocated as follows during that period (in thousands): Cash $ 155 Accounts receivable 2,476 Inventory 797 Prepaid and other current assets 3 Equipment and other fixed assets 11,219 Goodwill 4,591 Identifiable intangible assets 500 Accounts payable and accrued expenses (2,942) Net assets acquired $ 16,799 During the six months ended June 30, 2022, the Company received net cash of $0.9 million relating to working capital and other adjustments associated with businesses that were acquired during 2021, which was recorded as a decrease to goodwill during the period. Net revenue and operating income in the period of acquisition since the respective acquisition dates for the acquisitions described above were immaterial for the three and six months ended June 30, 2023 and 2022.

Equipment and Other Fixed Asset

Equipment and Other Fixed Assets	6 Months Ended
	Jun. 30, 2023
Property, Plant and Equipment [Abstract]
Equipment and Other Fixed Assets	Equipment and Other Fixed Assets Equipment and other fixed assets as of June 30, 2023 and December 31, 2022 are as follows (in thousands): June 30, December 31, Patient medical equipment $ 802,119 $ 747,985 Computers and Software 86,862 70,897 Delivery vehicles 43,048 35,326 Other 20,056 16,059 952,085 870,267 Less accumulated depreciation (447,729) (383,188) $ 504,356 $ 487,079 For the three months ended June 30, 2023 and 2022, the Company recorded depreciation expense of $89.3 million and $69.4 million. For the six months ended June 30, 2023 and 2022 , the Company recorded depreciation expense of $173.1 million and $136.5 million, respectively.

Goodwill and Identifiable Intan

Goodwill and Identifiable Intangible Assets	6 Months Ended
	Jun. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Identifiable Intangible Assets	Goodwill and Identifiable 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 six months ended June 30, 2023 was as follows (in thousands): Gross carrying Balance at December 31, 2022 $ 3,545,297 Goodwill from acquisitions 6,796 Net increase relating to measurement period adjustments 218 Balance at June 30, 2023 $ 3,552,311 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 sustained decreases 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 2023, the Company experienced a decline in its market capitalization as a result of a sustained decrease in the Company’s stock price. The Company considered such sustained decrease to represent a triggering event and performed goodwill impairment tests as of March 31, 2023 and June 30, 2023. Based on the results of these tests, 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 recognize a goodwill impairment charge during the periods ended March 31, 2023 or June 30, 2023. While the Company's goodwill impairment test did not result in an impairment charge, based on the results of such tests, the excess of the estimated fair value of the Company's reporting unit over its carrying value was less than 20% of such carrying value. If in future periods the Company were to experience a further decline in its market capitalization or expected results for a sustained period of time, the Company may be required to perform an additional goodwill impairment test 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. Identifiable intangible assets that are separable and have determinable useful lives are valued separa tely 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 June 30, 2023 and December 31, 2022 (dollars in thousands): June 30, 2023 Weighted-Average Tradenames, net of accumulated amortization of $31,907 $ 80,893 7.1 Payor contracts, net of accumulated amortization of $24,116 57,884 7.1 Contractual rental agreements, net of accumulated amortization of $52,723 1,477 0.3 Developed technology, net of accumulated amortization of $3,780 2,520 2.0 Identifiable intangible assets, net $ 142,774 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 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 $10.0 million and $20.0 million for the three and six months ended June 30, 2023, respectively, and was $10.0 million and $20.0 million for the three and six months ended June 30, 2022, respectively. Future amortization expense related to identifiable intangible assets is estimated to be as follows (in thousands): Twelve months ending June 30, 2024 $ 23,753 2025 22,217 2026 20,119 2027 18,384 2028 17,936 Thereafter 40,365 Total $ 142,774 The Company did not recognize any impairment charges related to identifiable intangible assets during the six months ended June 30, 2023 and 2022.

Fair Value of Assets and Liabil

Fair Value of Assets and Liabilities	6 Months Ended
	Jun. 30, 2023
Fair Value Disclosures [Abstract]
Fair Value of Assets and Liabilities	Fair Value of Assets and Liabilities FASB 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. 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. The following table presents the valuation of the Company’s financial assets and liabilities as of June 30, 2023 and December 31, 2022 measured at fair value on a recurring basis. The fair value estimates presented herein are based on information available to management as of June 30, 2023 and December 31, 2022. These estimates are not necessarily indicative of the amounts the Company could ultimately realize. (in thousands) Level 1 Level 2 Level 3 June 30, 2023 Assets Interest rate swap agreements-short term $ — $ 6,423 $ — Interest rate swap agreements-long term — 3,568 — Total assets measured at fair value $ — $ 9,991 $ — Liabilities Acquisition-related contingent consideration-short term $ — $ — $ 7,500 Warrant liability — — 15,777 Total liabilities measured at fair value $ — $ — $ 23,277 (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 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 June 30, 2023 and December 31, 2022 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 June 30, 2023 and December 31, 2022, contingent consideration liabilities of $7.5 million and $7.5 million were included in other current liabilities, respectively, in the accompanying consolidated balance sheets. A reconciliation of the Company’s contingent consideration liabilities related to acquisitions for the six months ended June 30, 2023 and 2022 is as follows (in thousands): Six Months Ended June 30, 2023 Beginning Balance Payments Change in Fair Value Ending Balance Contingent consideration - Level 3 liabilities $ 7,500 $ — $ — $ 7,500 Six Months Ended June 30, 2022 Contingent consideration - Level 3 liabilities $ 20,300 $ (3,250) $ 238 $ 17,288 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 10 , Stockholders' Equity , for additional discussion of the warrant liability and the material assumptions leveraged for the pricing model . Non-Financial Assets Measured at Fair Value on a Non-Recurring Basis During the six months ended June 30, 2023 and 2022, there were no fair value measurements on a non-recurring basis for the Company’s non-financial assets.

Derivative Instruments and Hedg

Derivative Instruments and Hedging Activities	6 Months Ended
	Jun. 30, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Instruments and Hedging Activities	Derivative Instruments and Hedging ActivitiesThe Company records all derivatives on its consolidated balance sheet at fair value. As of June 30, 2023, 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 Secured Overnight Financing Rate ("Term SOFR"). As of December 31, 2022, the Company had outstanding interest rate derivatives with third parties in which the Company paid a fixed interest rate and received a rate equal to the one-month LIBOR. During the six months ended June 30, 2023 , the Company amended its interest rate swap agreements to change the benchmark rate under the agreements from LIBOR to Term SOFR. As discussed in Note 1(j), General Information - Recently Adopted Accounting Pronouncements, during the six months ended June 30, 2023 , the Company adopted ASU No. 2020-04, Reference Rate Reform ("Topic 848"). As a result of the adoption of this standard, the amendments to the Company's interest rate swap agreements did not have an impact on the accounting for such derivative instruments. The notional amount associated with the Company's interest rate swap agreements that were outstanding as of June 30, 2023 was $250 million and have maturity dates in and March 2024 and January 2026. In April 2022, the Company entered into forward-dated interest rate swap agreements with third parties. 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 these forward-dated interest rate swap agreements became effective in February 2023 and a portion will become effective in March 2024, and 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 June 30, 2023 and December 31, 2022 (in thousands): June 30, 2023 December 31, 2022 Balance Sheet Location Asset (Liability) Prepaid and other current assets $ 6,423 $ 5,748 Other assets 3,568 3,728 Total $ 9,991 $ 9,476 During the three months ended June 30, 2023 and 2022, as a result of the effect of cash flow hedge accounting, the Company recognized a gain, net of tax, of $2.8 million and $2.3 million, respectively, in other comprehensive income. In addition, during the three months ended June 30, 2023 and 2022, $0.4 million and $0.7 million, respectively, was reclassified from other comprehensive income June 30, 2023 and 2022, as a result of the effect of cash flow hedge accounting, the Company recognized a gain, net of tax, of $0.6 million and $9.0 million, respectively, in other comprehensive income June 30, 2023 and 2022, $1.0 million and $1.4 million, respectively, was reclassified from other comprehensive income and recognized as a reduction to interest expense, net, in the accompanying consolidated statements of operations.

Accounts Payable and Accrued Ex

Accounts Payable and Accrued Expenses	6 Months Ended
	Jun. 30, 2023
Accounts Payable and Accrued Liabilities, Current [Abstract]
Accounts Payable and Accrued Expenses	Accounts Payable and Accrued Expenses Accounts payable and accrued expenses as of June 30, 2023 and December 31, 2022 consisted of the following (in thousands): June 30, December 31, Accounts payable $ 226,533 $ 222,505 Employee-related accruals 36,651 41,872 Accrued interest 28,968 28,877 Other 45,548 44,244 Total $ 337,700 $ 337,498

Debt

Debt	6 Months Ended
	Jun. 30, 2023
Debt Disclosure [Abstract]
Debt	Debt The following is a summary of long term-debt as of June 30, 2023 and December 31, 2022 (in thousands): June 30, December 31, Secured term loans $ 750,000 $ 765,000 Senior unsecured notes 1,450,000 1,450,000 Unamortized deferred financing fees (24,376) (26,733) 2,175,624 2,188,267 Current portion (40,000) (35,000) Long-term portion $ 2,135,624 $ 2,153,267 In January 2021, the Company entered into a credit agreement, as amended, (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. On March 31, 2023, the Company amended the 2021 Credit Agreement to change the variable interest rate under the agreement to be based on Term SOFR. In connection with the amendment, amounts borrowed under the 2021 Credit Agreement bear interest quarterly at variable rates based upon the sum of (a) Term SOFR (subject to a zero percent floor) equal to Term SOFR (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), plus (c) a Term SOFR Adjustment (as defined) of 0.1%. Prior to the March 31, 2023 amendment to the Company's credit agreement, the variable interest rate for amounts borrowed under the 2021 Credit Agreement was based on Adjusted LIBOR. 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. 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. There were no changes to these restrictive covenants per the March 2023 amendment. The Company was in compliance with all debt covenants as of June 30, 2023. Secured Term Loans The borrowings under the 2021 Term Loan require quarterly principal repayments of $5.0 million beginning 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 June 30, 2023 and December 31, 2022, there was $750 million and $765 million, respectively, outstanding under the 2021 Term Loan. The interest rate under the 2021 Term Loan was 7.25% at June 30, 2023. Revolving Credit Facility During the six months ended June 30, 2023, the Company borrowed $50.0 million under the 2021 Revolver, and repaid $50.0 million during the period. At June 30, 2023, there were no outstanding borrowings under the 2021 Revolver. During the six months ended June 30, 2022, the Company had no borrowings under the 2021 Revolver. At June 30, 2023, based on the financial debt covenants under the 2021 Credit Agreement, the maximum borrowings available pursuant to the 2021 Revolver was $124.2 million. Senior Unsecured Notes In August 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. In January 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. In July 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.

Stockholders' Equity

Stockholders' Equity	6 Months Ended
	Jun. 30, 2023
Equity [Abstract]
Stockholders' Equity	Stockholders' EquityUnder the Company's Third Amended and Restated Certificate of Incorporation, there are 300,000,000 shares of authorized Common Stock and 5,000,000 shares of authorized Preferred Stock. Holders of Common Stock are entitled to one vote for each share. The shares of Preferred Stock 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. Treasury Stock In May 2022, the Company’s board of directors authorized a share repurchase program for up to $200.0 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 six months ended June 30, 2023 and 2022, the Company purchased 631,953 and 199,418 shares of the Company’s Common Stock for $9.2 million and $3.4 million, respectively, under the Share Repurchase Program, which is reflected in Treasury Stock in the accompanying consolidated statements of stockholders’ equity. As of June 30, 2023, there was $176.8 million remaining that may be used to purchase shares under the Share Repurchase Program. Warrants As of June 30, 2023, the Company had 3,871,557 warrants outstanding, which have an expiration date of November 20, 2024. 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. There were no warrants exercised during the six months ended June 30, 2023. During the six months ended June 30, 2022, 52,785 warrants were exercised in a cashless transaction resulting in the issuance of 18,667 shares of Common Stock. 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 six months ended June 30, 2023 and 2022 was as follows (in thousands): Estimated fair value of warrant liability at December 31, 2022 $ 38,503 Change in estimated fair value of the warrant liability (22,726) Estimated fair value of warrant liability at June 30, 2023 $ 15,777 Estimated fair value of warrant liability at December 31, 2021 $ 57,764 Change in estimated fair value of the warrant liability (18,509) Reclassification of warrant liability to equity for exercised warrants (495) Estimated fair value of warrant liability at June 30, 2022 $ 38,760 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 June 30, 2023, the 2019 Plan permits the grant of up to 10,000,000 shares of Common Stock, subject to certain adjustments and limitations. At June 30, 2023, 1,205,431 shares of the Company’s Common Stock were available for issuance under the 2019 Plan. Stock Options There were no stock options granted during the six months ended June 30, 2023 and 2022. The following table provides the activity regarding the Company’s outstanding stock options during the six months ended June 30, 2023 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, 2022 2,219 $ 3.75 $ 19.36 Activity - none — Outstanding, June 30, 2023 2,219 $ 3.75 $ 19.36 5.6 Years The following table provides the activity for all outstanding stock options during the six months ended June 30, 2023 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Outstanding, December 31, 2022 4,962 $ 12.19 Exercised (559) $ 4.38 Outstanding, June 30, 2023 4,403 $ 13.18 5.4 Years During the six months ended June 30, 2023, 559,071 stock options were exercised on a cashless basis resulting in the issuance of 213,852 shares of the Company's Common Stock. During the six months ended June 30, 2022, 115,732 stock options were exercised resulting in $0.7 million of cash proceeds received by the Company and the issuance of 115,732 shares of the Company’s Common Stock. Also, during the six months ended June 30, 2022, 258,352 stock options were exercised on a cashless basis resulting in the issuance of 111,071 shares of the Company’s Common Stock. Restricted Stock During the six months ended June 30, 2023, the Company granted 140,556 shares of restricted stock to various employees which vest ratably over the three-year period following the vesting commencement date (which is generally the grant date), subject to the employees’ continuous employment through the applicable vesting date. The grant-date fair value of these awards was $2.1 million. During the six months ended June 30, 2023, the Company granted 139,190 shares of restricted stock to its non-employee directors, which vest approximately one year following the grant date. The grant-date fair value of these awards was $1.4 million. During the six months ended June 30, 2023, the Company granted 17,143 shares of restricted stock to its interim CEO, which vest on August 31, 2023. The grant-date fair value of these awards was $0.2 million. During the six months ended June 30, 2023, the Company granted 327,000 restricted stock units to senior executive management of the Company. These awards vest ratably over the three-year period following the vesting commencement date (February 1, 2023), subject to the employees’ continuous employment through the applicable vesting date. The grant-date fair value of these awards was $4.9 million. In addition, during the six months ended June 30, 2023, the Company granted 327,000 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 vesting commencement date (February 1, 2023) 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"), which is considered a market condition, 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 $6.6 million, which will be recognized as equity-based compensation expense from the date of grant through the third anniversary of the vesting commencement date, regardless of whether or the extent to which the awards ultimately vest. 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 25 th Percentile – No payout • Greater than or equal to 25 th Percentile – 50% of Performance RSUs • Equal to 50 th Percentile – 100% of Performance RSUs • Greater than or equal to 75 th Percentile – 200% of Performance RSUs Activity related to the Company’s non-vested restricted stock grants for the six months ended June 30, 2023 is presented below (in thousands, except per share data): Number of Shares of Weighted-Average Grant Date Non-vested balance, December 31, 2022 2,261 $ 23.90 Granted 951 $ 15.89 Vested (665) $ 21.52 Forfeited (303) $ 28.09 Non-vested balance, June 30, 2023 2,244 $ 20.52 Equity-Based Compensation Expense The Company recognized equity-based compensation expense of $6.8 million during the three months ended June 30, 2023, of which $7.7 million is included in general and administrative expenses in the accompanying consolidated statements of operations. The equity-based compensation expense recognized during the three months ended June 30, 2023 includes a net reduction to expense of $0.9 million included in cost of net revenue in the accompanying consolidated statements of operations. As a result of the change in the probability asses sment of the vesting of certain unvested shares of restricted stock in which vesting was based on the achievement of a performance condition, during the three months ended June 30, 2023, the Company reversed $2.2 million of previously recognized equity-based compensation expense related to performance conditions no longer deemed probable, which is included in cost of net revenue in the accompanying consolidated statements of operations. The Company recognized equity-based compensation expense of $5.7 million during the three months ended June 30, 2022, of which $3.9 million and $1.8 million is included in general and administrative expenses and cost of net revenue, respectively, in the accompanying consolidated statements of operations. The Company recognized equity-based compensation expense of $12.8 million during the six months ended June 30, 2023, of which $12.3 million and $0.5 million is included in general and administrative expenses and cost of net revenue, respectively, in the accompanying consolidated statements of operations. The Company recognized equity-based compensation expense of $11.2 million during the six months ended June 30, 2022 , of which $7.5 million and $3.7 million is included in general and administrative expenses and cost of net revenue, respectively, in the accompanying consolidated statements of operations. At June 30, 2023, there was $30.9 million of unrecognized compensation expense related to equity-based compensation awards, which is expected to be recognized over a weighted-average period of 1.9 years. As previously disclosed, by mutual agreement with the Company, effective June 30, 2023, Stephen Griggs resigned as Chief Executive Officer of the Company. In connection with Mr. Griggs’ separation, the Company accelerated the vesting of 78,130 unvested stock options and 143,739 unvested shares of restricted stock which were subject to time-based vesting conditions only. In addition, the Company modified the vesting conditions for 159,555 shares of Performance RSU's to allow for vesting based on the achievement of the applicable Relative TSR, but no longer requires continuous employment through the applicable vesting date. In connection with the accelerated vesting and modification, the Company recognized $4.0 million of equity-based compensation expense, which is included in general and administrative expenses in the accompanying consolidated statements of operations for the three and six m onths ended June 30, 2023 .

Earnings Per Share

Earnings Per Share	6 Months Ended
	Jun. 30, 2023
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share Earnings Per Share ("EPS") is computed by dividing net income by the weighted average number of common shares outstanding during the period on a basic and diluted basis. The Company computes diluted net income 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 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 10, Stockholders' Equity , for additional discussion of these potential dilutive securities. Diluted net income 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 per share. Computation of diluted net income 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 per share were as follows (in thousands, except per share data): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Numerator Net income attributable to AdaptHealth Corp. $ 13,977 $ 14,032 $ 29,684 $ 55,782 Less: Earnings allocated to participating securities (1) 1,182 1,186 2,508 4,721 Net income for basic EPS $ 12,795 $ 12,846 $ 27,176 $ 51,061 Change in fair value of warrant liability (2) — — (22,726) (18,509) Net income for diluted EPS $ 12,795 $ 12,846 $ 4,450 $ 32,552 Denominator (1) (2) Basic weighted-average common shares outstanding 134,295 134,332 134,409 134,178 Add: Warrants (2) — — 857 1,313 Add: Stock options 833 2,472 1,552 2,597 Add: Unvested restricted stock 1,105 211 1,182 247 Diluted weighted-average common shares outstanding 136,233 137,015 138,000 138,335 Basic net income per share $ 0.10 $ 0.10 $ 0.20 $ 0.38 Diluted net income per share $ 0.09 $ 0.09 $ 0.03 $ 0.24 (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. (2) For the six months ended June 30, 2023 and 2022 , the impact to earnings from the change in fa ir 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. These adjustments are included as the effect of the numerator and denominator adjustments for these derivative instruments is dilutive as a result of the non-cash gains recorded for the change in fair value of these instruments during the periods. For the three months ended June 30, 2023, these adjustments are excluded from the computation of diluted net income per share under the treasury stock method since the warrants were out-of-the money in that period. 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 per share for the three and six months ended June 30, 2023 and 2022 because to do so would be antidilutive (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Preferred Stock 12,406 12,406 12,406 12,406 Warrants — 1,168 — — Stock options 2,219 468 468 468 Unvested restricted stock — 391 — 336 Total 14,625 14,433 12,874 13,210

Leases

Leases	6 Months Ended
	Jun. 30, 2023
Leases [Abstract]
Leases	Leases The Company leases its operating locations and office facilities under noncancelable 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 leases certain of its vehicles through 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 June 30, 2023 and December 31, 2022 (in thousands): Consolidated Balance Sheets Line Item June 30, 2023 December 31, 2022 Right-of-use (ROU) assets: Operating lease ROU assets Operating lease right-of-use assets $ 117,798 $ 129,506 Finance lease ROU assets Finance lease right-of-use assets 14,819 5,423 Finance lease ROU assets Equipment and other fixed assets, net — 103 Total ROU assets $ 132,617 $ 135,032 Operating lease liabilities: Current operating lease liabilities Current portion of operating lease obligations $ 29,579 $ 30,001 Noncurrent operating lease liabilities Operating lease obligations, less current portion 93,241 104,394 Total operating lease liabilities $ 122,820 $ 134,395 Finance lease liabilities: Current finance lease liabilities Current portion of finance lease obligations $ 4,246 $ 2,211 Noncurrent finance lease liabilities Finance lease obligations, less current portion 10,638 3,950 Total finance lease liabilities $ 14,884 $ 6,161 The following table presents information about lease costs and expenses and sublease income for the three and six months ended June 30, 2023 and 2022 (in thousands). The amounts below are included in cost of net revenue in the accompanying consolidated statements of operations for the periods presented. Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Operating lease costs $ 10,598 $ 9,661 $ 21,072 $ 19,299 Finance lease costs: Amortization of ROU assets $ 2,477 $ 2,165 $ 3,007 $ 6,626 Other lease costs and income: Variable leases costs (1) $ 4,538 $ 4,707 $ 10,559 $ 8,952 Sublease income $ 409 $ 348 $ 787 $ 683 (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 June 30, 2023 and December 31, 2022: June 30, 2023 December 31, 2022 Weighted average remaining lease term, weighted based on lease liability balances: Operating leases 5.9 years 6.2 years Finance leases 3.7 years 3.7 years Weighted average discount rate, weighted based on remaining balance of lease payments: Operating leases 4.1 % 3.9 % 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 June 30, 2023 (in thousands): Operating Leases Finance Leases 2023 (remaining six months) $ 20,749 $ 3,098 2024 30,847 4,740 2025 25,988 4,439 2026 18,162 3,768 2027 11,780 964 Thereafter 35,119 — Total future undiscounted lease payments $ 142,645 $ 17,009 Less: amount representing interest (19,825) (2,125) Present value of future lease payments (lease liability) $ 122,820 $ 14,884 The following table provides certain cash flow and supplemental non-cash information related to the Company’s lease liabilities for the six months ended June 30, 2023 and 2022, respectively (in thousands): Six Months Ended June 30, Cash paid for amounts included in the measurement of lease liabilities: 2023 2022 Operating cash payments for operating leases $ 20,847 $ 19,220 Financing cash payments for finance leases $ 3,679 $ 12,547 Lease liabilities arising from obtaining right-of-use assets: Operating leases $ 5,112 $ 4,582 Finance leases $ 12,203 $ 1,335

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2023
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The Company is subject to U.S. federal, state, and local income taxes. For the three months ended June 30, 2023 and 2022, the Company recorded income tax expense of $5.4 million and $8.9 million, respectively. For the six months ended June 30, 2023 and 2022, the Company recorded income tax expense of $3.7 million and $14.5 million, respectively. As of June 30, 2023 and December 31, 2022, the Company had an unrecognized tax benefit of $6.6 million. Tax Receivable Agreement AdaptHealth Corp. is party to a Tax Receivable Agreement ("TRA") with certain current and former members of AdaptHealth Holdings LLC, a Delaware limited liability company ("AdaptHealth Holdings"). The TRA provides for the payment by AdaptHealth Corp. of 85% of the tax savings, if any, that AdaptHealth Corp. realizes (or is deemed to realize in certain circumstances) as a result of (i) certain increases in tax basis resulting from two exchanges of common units representing limited liability company interests in AdaptHealth Holdings and shares of Class B Common Stock, par value $0.0001 per share (which, as of July 28, 2021, no longer exists); (ii) certain tax attributes of the corresponding sellers existing prior to an exchange; (iii) imputed interest deemed to be paid by AdaptHealth Corp. as a result of payments it makes under the TRA; and (iv) certain increases in tax basis resulting from payments AdaptHealth Corp. makes under the TRA. During the six months ended June 30, 2022, the Company recognized an expense of $4.5 million related to changes in the estimated liability related to the TRA as a result of settling the current portion of contingent consideration common shares during that period, which is included in Other loss (income), net in the accompanying consolidated statement of operations.

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2023
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. On July 25, 2017, 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 also raised questions regarding other aspects of ventilator billing. On April 21, 2023, the Company entered into a settlement agreement with the EDPA resolving all allegations and claims related to the investigation without a determination of liability on the part of the Company. In connection with the settlement, the Company made a payment of $5.3 million, which was fully accrued as of December 31, 2022, and was not required to enter into any post-settlement agreements related to the settlement. In March 2019, prior to its acquisition by the Company, AeroCare Holdings, Inc. ("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. On June 23, 2022, the complaint filed in connection with this investigation was dismissed by the United States District Court in the Western District of Kentucky with the consent of the WDKY. 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 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 filed their opposition to Lead Plaintiffs’ motion for class certification on March 30, 2023, and Lead Plaintiffs filed their reply on May 22, 2023. On June 7, 2023, the court entered as order staying the Consolidated Class Action pending the outcome of a private mediation between the parties. 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 its 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	6 Months Ended
	Jun. 30, 2023
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions The Company and one of its executive officers and shareholder 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 $2.7 million and $1.7 million for the three months ended June 30, 2023 and 2022, respectively, and $5.0 million and $3.1 million for the six months ended June 30, 2023 and 2022, respectively. The Company accounts for this investment under the cost method of accounting based on its level of equity ownership. As of June 30, 2023 and December 31, 2022, 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 three and six months ended June 30, 2023 and 2022 . As of June 30, 2023 and December 31, 2022, 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 June 30, 2023. This beneficial owner is also a minority shareholder of a vendor that provides medical equipment and supplies to the Company in the normal course of business. Purchases from this vendor were $9.4 million and $15.6 million for the three months ended June 30, 2023 and 2022, respectively, and $20.6 million and $29.6 million, for the six months ended June 30, 2023 and 2022, respectively. As of June 30, 2023 and December 31, 2022, the Company had an immaterial outstanding accounts payable balance to this vendor. A former regional manager of the Company is a shareholder of a business which provides contract labor to the Company. Payments to this service provider were $7.3 million and $5.7 million for the three months ended June 30, 2023 and 2022, respectively, and $11.2 million and $10.5 million for the six months ended June 30, 2023 and 2022, respectively. As of June 30, 2023 and December 31, 2022, the Company had $0.2 million and $2.2 million, respectively, in outstanding accounts payable to this service provid er. The regional manager left the Company effective March 31, 2023 via a separation agreement which provides severance and separation benefits, including a pro rata bonus. Also, the Company and the former employee have entered into a short-term consulting agreement whereby the former employee's services will be available to the Company through March 2024.

Subsequent Events

Subsequent Events	6 Months Ended
	Jun. 30, 2023
Subsequent Events [Abstract]
Subsequent Events	Subsequent EventsThe Company evaluated subsequent events for the period from June 30, 2023 through the date that the Company’s interim consolidated financial statements were available to be issued. There were no subsequent events requiring adjustment to the Company’s interim consolidated financial statements or additional disclosure.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Pay vs Performance Disclosure
Net income attributable to AdaptHealth Corp.	$ 13,977	$ 14,032	$ 29,684	$ 55,782

Insider Trading Arrangements

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

General Information (Policies)

General Information (Policies)	6 Months Ended
	Jun. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	Basis of PresentationThe interim 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 interim consolidated financial statements include all necessary adjustments for a fair presentation of the financial position and results of operations for the periods presented.
Basis of Consolidation	Basis of ConsolidationThe accompanying interim consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.
Concentration of Credit Risk	Concentration of Credit RiskFinancial instruments which potentially subject the Company to concentrations of credit risk consist principally of cash 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.
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.
Valuation of Goodwill	Valuation of GoodwillThe 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, rather, it 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 sustained decreases 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 or interim goodwill impairment test will prove to be accurate predictions of the future.
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. In addition to consideration of impairment upon the events or changes in circumstances described above, management regularly evaluates the remaining useful lives of its 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
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 general and administrative expenses and cost of net revenue in the accompanying consolidated statements of operations. The Company measures and recognizes equity-based compensation expense for such awards based on their estimated fair values on the date of grant. For share based awards with service only or service and performance conditions, 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. For share based awards with only a service condition, 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 straight-line on a tranche-by-tranche basis over the employees’ requisite service period subject to management’s estimation of the probability of vesting of such awards. If management determines that the performance conditions are no longer probable of achievement, the Company will reverse the previously recognized equity-based compensation expense in the period of determination. For awards with market conditions, the grant-date fair value is estimated using a monte-carlo simulation analysis, which is recognized straight-line on a tranche-by-tranche basis over the employees’ requisite service period regardless of whether or the extent to which the awards ultimately vest. Refer to Note 10, Stockholders’ Equity , for additional information regarding the Company’s equity-based compensation expense.
Business Segment	Business SegmentThe Company’s chief operating decision-makers are its Interim 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.
Accounting for Leases	Accounting for Leases The Company accounts for its leases in accordance with FASB Accounting Standards Update ("ASU") No. 2016-02, Leases (Topic 842) (ASC 842). 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. 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 to 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 12, Leases, for additional information.
Recent Adopted Accounting Pronouncements	Recently Adopted 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 made to comply with reference rate reform to meet the definition of a modification under U.S. GAAP. It further allows hedge accounting to be maintained and a one-time transfer or sale of qualifying held-to-maturity securities. The expedients and exceptions provided by the amendments are permitted to be adopted any time through December 31, 2024, with early adoption permitted, and do not apply to contract modifications made and hedging relationships entered into or evaluated after December 31, 2022, except for certain optional expedients elected for certain hedging relationships existing as of December 31, 2022. The Company adopted this standard during the six months ended June 30, 2023, which did not have a material impact on its consolidated financial statements and related disclosures.

General Information (Tables)

General Information (Tables)	6 Months Ended
	Jun. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of useful lives of acquired intangible 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

Revenue Recognition and Accou_2

Revenue Recognition and Accounts Receivable (Tables)	6 Months Ended
	Jun. 30, 2023
Revenue from Contract with Customer [Abstract]
Schedule of composition of net revenues by payor type and core service lines	The composition of net revenue by payor type for the three and six months ended June 30, 2023 and 2022 are as follows (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Insurance $ 474,828 $ 436,179 $ 911,612 $ 857,069 Government 209,662 196,338 398,509 377,988 Patient pay 108,796 95,097 227,791 198,760 Net revenue $ 793,286 $ 727,614 $ 1,537,912 $ 1,433,817 The composition of net revenue by core service lines for the three and six months ended June 30, 2023 and 2022 are as follows (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Net sales revenue: Sleep $ 215,849 $ 194,693 $ 429,306 $ 387,028 Diabetes 165,021 162,259 307,565 313,618 Supplies to the home 48,323 43,881 94,878 83,746 Respiratory 8,191 7,891 16,120 16,036 HME 27,237 30,313 55,800 60,365 Other 57,012 53,617 110,219 107,816 Total net sales revenue $ 521,633 $ 492,654 $ 1,013,888 $ 968,609 Net revenue from fixed monthly equipment reimbursements: Sleep $ 86,783 $ 65,661 $ 167,705 $ 123,599 Diabetes 3,886 4,034 7,717 7,980 Respiratory 145,889 128,865 280,612 261,445 HME 23,974 25,547 46,315 51,272 Other 11,121 10,853 21,675 20,912 Total net revenue from fixed monthly equipment reimbursements $ 271,653 $ 234,960 $ 524,024 $ 465,208 Total net revenue: Sleep $ 302,632 $ 260,354 $ 597,011 $ 510,627 Diabetes 168,907 166,293 315,282 321,598 Supplies to the home 48,323 43,881 94,878 83,746 Respiratory 154,080 136,756 296,732 277,481 HME 51,211 55,860 102,115 111,637 Other 68,133 64,470 131,894 128,728 Total net revenue $ 793,286 $ 727,614 $ 1,537,912 $ 1,433,817

Acquisitions (Tables)

Acquisitions (Tables)	6 Months Ended
	Jun. 30, 2023
Business Combination and Asset Acquisition [Abstract]
Summary of consideration	The following table summarizes the consideration paid at closing for all acquisitions during the six months ended June 30, 2023 (in thousands): Cash $ 18,173 Deferred payments 50 Total $ 18,223 The following table summarizes the consideration paid at closing for all acquisitions during the six months ended June 30, 2022 (in thousands): Cash $ 16,377 Deferred payments 422 Total $ 16,799
Summary of estimated fair values of the net assets acquired	The Company allocated the consideration paid to the net assets acquired based on their estimated acquisition date fair values. Based upon management’s evaluation, which is preliminary and subject to completion of working capital and other adjustments, the consideration paid for all acquisitions during the six months ended June 30, 2023 was allocated as follows during the period (in thousands): Cash $ 268 Accounts receivable 1,798 Inventory 1,001 Prepaid and other current assets 10 Equipment and other fixed assets 9,863 Operating lease right-of-use assets 5,506 Finance lease right-of-use assets 200 Goodwill 6,796 Accounts payable and accrued expenses (667) Other current liabilities (846) Operating lease liabilities (5,506) Finance lease liabilities (200) Net assets acquired $ 18,223 Cash $ 155 Accounts receivable 2,476 Inventory 797 Prepaid and other current assets 3 Equipment and other fixed assets 11,219 Goodwill 4,591 Identifiable intangible assets 500 Accounts payable and accrued expenses (2,942) Net assets acquired $ 16,799

Equipment and Other Fixed Ass_2

Equipment and Other Fixed Assets (Tables)	6 Months Ended
	Jun. 30, 2023
Property, Plant and Equipment [Abstract]
Schedule of equipment and other fixed assets	Equipment and other fixed assets as of June 30, 2023 and December 31, 2022 are as follows (in thousands): June 30, December 31, Patient medical equipment $ 802,119 $ 747,985 Computers and Software 86,862 70,897 Delivery vehicles 43,048 35,326 Other 20,056 16,059 952,085 870,267 Less accumulated depreciation (447,729) (383,188) $ 504,356 $ 487,079

Goodwill and Identifiable Int_2

Goodwill and Identifiable Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2023
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 six months ended June 30, 2023 was as follows (in thousands): Gross carrying Balance at December 31, 2022 $ 3,545,297 Goodwill from acquisitions 6,796 Net increase relating to measurement period adjustments 218 Balance at June 30, 2023 $ 3,552,311
Schedule of identifiable intangible assets	Identifiable intangible assets consisted of the following at June 30, 2023 and December 31, 2022 (dollars in thousands): June 30, 2023 Weighted-Average Tradenames, net of accumulated amortization of $31,907 $ 80,893 7.1 Payor contracts, net of accumulated amortization of $24,116 57,884 7.1 Contractual rental agreements, net of accumulated amortization of $52,723 1,477 0.3 Developed technology, net of accumulated amortization of $3,780 2,520 2.0 Identifiable intangible assets, net $ 142,774 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
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 June 30, 2024 $ 23,753 2025 22,217 2026 20,119 2027 18,384 2028 17,936 Thereafter 40,365 Total $ 142,774

Fair Value of Assets and Liab_2

Fair Value of Assets and Liabilities (Tables)	6 Months Ended
	Jun. 30, 2023
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 June 30, 2023 and December 31, 2022 measured at fair value on a recurring basis. The fair value estimates presented herein are based on information available to management as of June 30, 2023 and December 31, 2022. These estimates are not necessarily indicative of the amounts the Company could ultimately realize. (in thousands) Level 1 Level 2 Level 3 June 30, 2023 Assets Interest rate swap agreements-short term $ — $ 6,423 $ — Interest rate swap agreements-long term — 3,568 — Total assets measured at fair value $ — $ 9,991 $ — Liabilities Acquisition-related contingent consideration-short term $ — $ — $ 7,500 Warrant liability — — 15,777 Total liabilities measured at fair value $ — $ — $ 23,277 (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
Reconciliation of contingent consideration liabilities	A reconciliation of the Company’s contingent consideration liabilities related to acquisitions for the six months ended June 30, 2023 and 2022 is as follows (in thousands): Six Months Ended June 30, 2023 Beginning Balance Payments Change in Fair Value Ending Balance Contingent consideration - Level 3 liabilities $ 7,500 $ — $ — $ 7,500 Six Months Ended June 30, 2022 Contingent consideration - Level 3 liabilities $ 20,300 $ (3,250) $ 238 $ 17,288

Derivative Instruments and He_2

Derivative Instruments and Hedging Activities (Tables)	6 Months Ended
	Jun. 30, 2023
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 June 30, 2023 and December 31, 2022 (in thousands): June 30, 2023 December 31, 2022 Balance Sheet Location Asset (Liability) Prepaid and other current assets $ 6,423 $ 5,748 Other assets 3,568 3,728 Total $ 9,991 $ 9,476

Accounts Payable and Accrued _2

Accounts Payable and Accrued Expenses (Tables)	6 Months Ended
	Jun. 30, 2023
Accounts Payable and Accrued Liabilities, Current [Abstract]
Schedule of components accounts payable and accrued expenses	Accounts payable and accrued expenses as of June 30, 2023 and December 31, 2022 consisted of the following (in thousands): June 30, December 31, Accounts payable $ 226,533 $ 222,505 Employee-related accruals 36,651 41,872 Accrued interest 28,968 28,877 Other 45,548 44,244 Total $ 337,700 $ 337,498

Debt (Tables)

Debt (Tables)	6 Months Ended
	Jun. 30, 2023
Debt Disclosure [Abstract]
Schedule of summary of long term debt	The following is a summary of long term-debt as of June 30, 2023 and December 31, 2022 (in thousands): June 30, December 31, Secured term loans $ 750,000 $ 765,000 Senior unsecured notes 1,450,000 1,450,000 Unamortized deferred financing fees (24,376) (26,733) 2,175,624 2,188,267 Current portion (40,000) (35,000) Long-term portion $ 2,135,624 $ 2,153,267

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	6 Months Ended
	Jun. 30, 2023
Equity [Abstract]
Schedule of changes in warrant liability	A reconciliation of the changes in the warrant liability during the six months ended June 30, 2023 and 2022 was as follows (in thousands): Estimated fair value of warrant liability at December 31, 2022 $ 38,503 Change in estimated fair value of the warrant liability (22,726) Estimated fair value of warrant liability at June 30, 2023 $ 15,777 Estimated fair value of warrant liability at December 31, 2021 $ 57,764 Change in estimated fair value of the warrant liability (18,509) Reclassification of warrant liability to equity for exercised warrants (495) Estimated fair value of warrant liability at June 30, 2022 $ 38,760
Schedule of stock option activity	The following table provides the activity regarding the Company’s outstanding stock options during the six months ended June 30, 2023 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, 2022 2,219 $ 3.75 $ 19.36 Activity - none — Outstanding, June 30, 2023 2,219 $ 3.75 $ 19.36 5.6 Years The following table provides the activity for all outstanding stock options during the six months ended June 30, 2023 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Outstanding, December 31, 2022 4,962 $ 12.19 Exercised (559) $ 4.38 Outstanding, June 30, 2023 4,403 $ 13.18 5.4 Years
Schedule of restricted stock activity	Activity related to the Company’s non-vested restricted stock grants for the six months ended June 30, 2023 is presented below (in thousands, except per share data): Number of Shares of Weighted-Average Grant Date Non-vested balance, December 31, 2022 2,261 $ 23.90 Granted 951 $ 15.89 Vested (665) $ 21.52 Forfeited (303) $ 28.09 Non-vested balance, June 30, 2023 2,244 $ 20.52

Earnings Per Share (Tables)

Earnings Per Share (Tables)	6 Months Ended
	Jun. 30, 2023
Earnings Per Share [Abstract]
Schedule of calculation of basic and diluted earnings per share	Computations of basic and diluted net income per share were as follows (in thousands, except per share data): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Numerator Net income attributable to AdaptHealth Corp. $ 13,977 $ 14,032 $ 29,684 $ 55,782 Less: Earnings allocated to participating securities (1) 1,182 1,186 2,508 4,721 Net income for basic EPS $ 12,795 $ 12,846 $ 27,176 $ 51,061 Change in fair value of warrant liability (2) — — (22,726) (18,509) Net income for diluted EPS $ 12,795 $ 12,846 $ 4,450 $ 32,552 Denominator (1) (2) Basic weighted-average common shares outstanding 134,295 134,332 134,409 134,178 Add: Warrants (2) — — 857 1,313 Add: Stock options 833 2,472 1,552 2,597 Add: Unvested restricted stock 1,105 211 1,182 247 Diluted weighted-average common shares outstanding 136,233 137,015 138,000 138,335 Basic net income per share $ 0.10 $ 0.10 $ 0.20 $ 0.38 Diluted net income per share $ 0.09 $ 0.09 $ 0.03 $ 0.24 (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. (2) For the six months ended June 30, 2023 and 2022 , the impact to earnings from the change in fa ir 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. These adjustments are included as the effect of the numerator and denominator adjustments for these derivative instruments is dilutive as a result of the non-cash
Schedule of antidilutive securities excluded from computation of earnings per share	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 per share for the three and six months ended June 30, 2023 and 2022 because to do so would be antidilutive (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Preferred Stock 12,406 12,406 12,406 12,406 Warrants — 1,168 — — Stock options 2,219 468 468 468 Unvested restricted stock — 391 — 336 Total 14,625 14,433 12,874 13,210

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 2023
Leases [Abstract]
Right-of-use assets and lease liabilities	The following table presents information about the Company’s right-of-use assets and lease liabilities as of June 30, 2023 and December 31, 2022 (in thousands): Consolidated Balance Sheets Line Item June 30, 2023 December 31, 2022 Right-of-use (ROU) assets: Operating lease ROU assets Operating lease right-of-use assets $ 117,798 $ 129,506 Finance lease ROU assets Finance lease right-of-use assets 14,819 5,423 Finance lease ROU assets Equipment and other fixed assets, net — 103 Total ROU assets $ 132,617 $ 135,032 Operating lease liabilities: Current operating lease liabilities Current portion of operating lease obligations $ 29,579 $ 30,001 Noncurrent operating lease liabilities Operating lease obligations, less current portion 93,241 104,394 Total operating lease liabilities $ 122,820 $ 134,395 Finance lease liabilities: Current finance lease liabilities Current portion of finance lease obligations $ 4,246 $ 2,211 Noncurrent finance lease liabilities Finance lease obligations, less current portion 10,638 3,950 Total finance lease liabilities $ 14,884 $ 6,161 The following table presents information about lease costs and expenses and sublease income for the three and six months ended June 30, 2023 and 2022 (in thousands). The amounts below are included in cost of net revenue in the accompanying consolidated statements of operations for the periods presented. Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Operating lease costs $ 10,598 $ 9,661 $ 21,072 $ 19,299 Finance lease costs: Amortization of ROU assets $ 2,477 $ 2,165 $ 3,007 $ 6,626 Other lease costs and income: Variable leases costs (1) $ 4,538 $ 4,707 $ 10,559 $ 8,952 Sublease income $ 409 $ 348 $ 787 $ 683 (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 weighted average discount rates	The following table provides the weighted average remaining lease terms and weighted average discount rates for the Company’s leases as of June 30, 2023 and December 31, 2022: June 30, 2023 December 31, 2022 Weighted average remaining lease term, weighted based on lease liability balances: Operating leases 5.9 years 6.2 years Finance leases 3.7 years 3.7 years Weighted average discount rate, weighted based on remaining balance of lease payments: Operating leases 4.1 % 3.9 %
Schedule of operating lease liability maturity	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 June 30, 2023 (in thousands): Operating Leases Finance Leases 2023 (remaining six months) $ 20,749 $ 3,098 2024 30,847 4,740 2025 25,988 4,439 2026 18,162 3,768 2027 11,780 964 Thereafter 35,119 — Total future undiscounted lease payments $ 142,645 $ 17,009 Less: amount representing interest (19,825) (2,125) Present value of future lease payments (lease liability) $ 122,820 $ 14,884
Schedule of finance lease liability maturity	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 June 30, 2023 (in thousands): Operating Leases Finance Leases 2023 (remaining six months) $ 20,749 $ 3,098 2024 30,847 4,740 2025 25,988 4,439 2026 18,162 3,768 2027 11,780 964 Thereafter 35,119 — Total future undiscounted lease payments $ 142,645 $ 17,009 Less: amount representing interest (19,825) (2,125) Present value of future lease payments (lease liability) $ 122,820 $ 14,884
Cash flow and supplemental non-cash information related to our lease liabilities	The following table provides certain cash flow and supplemental non-cash information related to the Company’s lease liabilities for the six months ended June 30, 2023 and 2022, respectively (in thousands): Six Months Ended June 30, Cash paid for amounts included in the measurement of lease liabilities: 2023 2022 Operating cash payments for operating leases $ 20,847 $ 19,220 Financing cash payments for finance leases $ 3,679 $ 12,547 Lease liabilities arising from obtaining right-of-use assets: Operating leases $ 5,112 $ 4,582 Finance leases $ 12,203 $ 1,335

General Information - Useful Li

General Information - Useful Lives Of Identifiable Intangible Assets (Details)	Jun. 30, 2023
Payor contracts
Property, Plant and Equipment [Line Items]
Useful lives of identifiable intangible assets (in years)	10 years
Contractual rental agreements
Property, Plant and Equipment [Line Items]
Useful lives of identifiable intangible assets (in years)	2 years
Developed technology
Property, Plant and Equipment [Line Items]
Useful lives of identifiable intangible assets (in years)	5 years
Minimum | Tradenames
Property, Plant and Equipment [Line Items]
Useful lives of identifiable intangible assets (in years)	5 years
Maximum | Tradenames
Property, Plant and Equipment [Line Items]
Useful lives of identifiable intangible assets (in years)	10 years

General Information - Narrative

General Information - Narrative (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2023	Jun. 30, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Goodwill impairment charge	$ 0	$ 0	$ 0	$ 0
Impairment of long-lived assets			$ 0	$ 0

Revenue Recognition and Accou_3

Revenue Recognition and Accounts Receivable - Composition of Net Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Disaggregation of Revenue [Line Items]
Total net revenue	$ 793,286	$ 727,614	$ 1,537,912	$ 1,433,817
Transferred at Point in Time
Disaggregation of Revenue [Line Items]
Total net revenue	521,633	492,654	1,013,888	968,609
Transferred over Time
Disaggregation of Revenue [Line Items]
Total net revenue	271,653	234,960	524,024	465,208
Sleep
Disaggregation of Revenue [Line Items]
Total net revenue	302,632	260,354	597,011	510,627
Sleep | Transferred at Point in Time
Disaggregation of Revenue [Line Items]
Total net revenue	215,849	194,693	429,306	387,028
Sleep | Transferred over Time
Disaggregation of Revenue [Line Items]
Total net revenue	86,783	65,661	167,705	123,599
Diabetes
Disaggregation of Revenue [Line Items]
Total net revenue	168,907	166,293	315,282	321,598
Diabetes | Transferred at Point in Time
Disaggregation of Revenue [Line Items]
Total net revenue	165,021	162,259	307,565	313,618
Diabetes | Transferred over Time
Disaggregation of Revenue [Line Items]
Total net revenue	3,886	4,034	7,717	7,980
Supplies to the home
Disaggregation of Revenue [Line Items]
Total net revenue	48,323	43,881	94,878	83,746
Supplies to the home | Transferred at Point in Time
Disaggregation of Revenue [Line Items]
Total net revenue	48,323	43,881	94,878	83,746
Respiratory
Disaggregation of Revenue [Line Items]
Total net revenue	154,080	136,756	296,732	277,481
Respiratory | Transferred at Point in Time
Disaggregation of Revenue [Line Items]
Total net revenue	8,191	7,891	16,120	16,036
Respiratory | Transferred over Time
Disaggregation of Revenue [Line Items]
Total net revenue	145,889	128,865	280,612	261,445
HME
Disaggregation of Revenue [Line Items]
Total net revenue	51,211	55,860	102,115	111,637
HME | Transferred at Point in Time
Disaggregation of Revenue [Line Items]
Total net revenue	27,237	30,313	55,800	60,365
HME | Transferred over Time
Disaggregation of Revenue [Line Items]
Total net revenue	23,974	25,547	46,315	51,272
Other
Disaggregation of Revenue [Line Items]
Total net revenue	68,133	64,470	131,894	128,728
Other | Transferred at Point in Time
Disaggregation of Revenue [Line Items]
Total net revenue	57,012	53,617	110,219	107,816
Other | Transferred over Time
Disaggregation of Revenue [Line Items]
Total net revenue	11,121	10,853	21,675	20,912
Insurance
Disaggregation of Revenue [Line Items]
Total net revenue	474,828	436,179	911,612	857,069
Government
Disaggregation of Revenue [Line Items]
Total net revenue	209,662	196,338	398,509	377,988
Patient pay
Disaggregation of Revenue [Line Items]
Total net revenue	$ 108,796	$ 95,097	$ 227,791	$ 198,760

Revenue Recognition and Accou_4

Revenue Recognition and Accounts Receivable - Narrative (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Revenue from Contract with Customer [Abstract]
Unbilled revenue	$ 37.4	$ 38.6

Acquisitions - Narrative (Detai

Acquisitions - Narrative (Details) $ in Millions	6 Months Ended
	Jun. 30, 2023 provider	Jun. 30, 2022 USD ($) provider
Home Medical Equipment Provider Acquired In 2023
Business Acquisition [Line Items]
Percentage of interest acquired	100%
Number of home medical equipment providers acquired	3
Number of entities acquired	2
Home Medical Equipment Provider Acquired In 2022
Business Acquisition [Line Items]
Percentage of interest acquired		100%
Number of home medical equipment providers acquired		2
Number of entities acquired		4
Significant Acquisitions In 2021
Business Acquisition [Line Items]
Receipt of working capital adjustment from prior year acquisitions | $		$ 0.9

Acquisitions - Consideration an

Acquisitions - Consideration and Allocation (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Significant Acquisitions In 2023
Business Acquisition [Line Items]
Cash	$ 18,173
Deferred payments	50
Total	$ 18,223
Significant Acquisitions In 2022
Business Acquisition [Line Items]
Cash		$ 16,377
Deferred payments		422
Total		$ 16,799

Acquisitions - Fair Value of Ne

Acquisitions - Fair Value of Net Assets Acquired (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022	Jun. 30, 2022
Business Acquisition [Line Items]
Goodwill	$ 3,552,311	$ 3,545,297
Significant Acquisitions In 2023
Business Acquisition [Line Items]
Cash	268
Accounts receivable	1,798
Inventory	1,001
Prepaid and other current assets	10
Equipment and other fixed assets	9,863
Operating lease right-of-use assets	5,506
Finance lease right-of-use assets	200
Goodwill	6,796
Accounts payable and accrued expenses	(667)
Other current liabilities	(846)
Operating lease liabilities	(5,506)
Finance lease liabilities	(200)
Net assets acquired	$ 18,223
Significant Acquisitions In 2022
Business Acquisition [Line Items]
Cash			$ 155
Accounts receivable			2,476
Inventory			797
Prepaid and other current assets			3
Equipment and other fixed assets			11,219
Goodwill			4,591
Identifiable intangible assets			500
Accounts payable and accrued expenses			(2,942)
Net assets acquired			$ 16,799

Equipment and Other Fixed Ass_3

Equipment and Other Fixed Assets (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Equipment and other fixed assets, gross	$ 952,085		$ 952,085		$ 870,267
Less accumulated depreciation	(447,729)		(447,729)		(383,188)
Equipment and other fixed assets, net	504,356		504,356		487,079
Depreciation expense	89,300	$ 69,400	173,100	$ 136,500
Patient medical equipment
Property, Plant and Equipment [Line Items]
Equipment and other fixed assets, gross	802,119		802,119		747,985
Computers and Software
Property, Plant and Equipment [Line Items]
Equipment and other fixed assets, gross	86,862		86,862		70,897
Delivery vehicles
Property, Plant and Equipment [Line Items]
Equipment and other fixed assets, gross	43,048		43,048		35,326
Other
Property, Plant and Equipment [Line Items]
Equipment and other fixed assets, gross	$ 20,056		$ 20,056		$ 16,059

Goodwill and Identifiable Int_3

Goodwill and Identifiable Intangible Assets - Change in Goodwill (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2023 USD ($)
Goodwill [Roll Forward]
Beginning balance	$ 3,545,297
Goodwill from acquisitions	6,796
Net increase relating to measurement period adjustments	218
Ending balance	$ 3,552,311

Goodwill and Identifiable Int_4

Goodwill and Identifiable Intangible Assets - Narrative (Details) - USD ($)	3 Months Ended			6 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill impairment charge	$ 0	$ 0		$ 0	$ 0
Percentage of estimated fair value of reporting unit over carrying value	20%	20%		20%
Amortization of intangible assets	$ 10,000,000		$ 10,000,000	$ 20,000,000	20,000,000
Impairment charges				$ 0	$ 0

Goodwill and Identifiable Int_5

Goodwill and Identifiable Intangible Assets - Intangible Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Total	$ 142,774	$ 162,773
Tradenames
Finite-Lived Intangible Assets [Line Items]
Accumulated amortization	31,907	25,498
Total	$ 80,893	$ 87,302
Weighted-Average Remaining Life (Years)	7 years 1 month 6 days	7 years 6 months
Payor contracts
Finite-Lived Intangible Assets [Line Items]
Accumulated amortization	$ 24,116	$ 20,016
Total	$ 57,884	$ 61,984
Weighted-Average Remaining Life (Years)	7 years 1 month 6 days	7 years 7 months 6 days
Contractual rental agreements
Finite-Lived Intangible Assets [Line Items]
Accumulated amortization	$ 52,723	$ 43,863
Total	$ 1,477	$ 10,337
Weighted-Average Remaining Life (Years)	3 months 18 days	9 months 18 days
Developed technology
Finite-Lived Intangible Assets [Line Items]
Accumulated amortization	$ 3,780	$ 3,150
Total	$ 2,520	$ 3,150
Weighted-Average Remaining Life (Years)	2 years	2 years 6 months

Goodwill and Identifiable Int_6

Goodwill and Identifiable Intangible Assets - Future Amortization Expense of Identified Intangible Assets (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
2024	$ 23,753		$ 23,753
2025	22,217		22,217
2026	20,119		20,119
2027	18,384		18,384
2028	17,936		17,936
Thereafter	40,365		40,365
Total	142,774		142,774		$ 162,773
Amortization of intangible assets	$ 10,000	$ 10,000	$ 20,000	$ 20,000

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	Jun. 30, 2023	Dec. 31, 2022
Level 1
Assets
Total assets measured at fair value	$ 0	$ 0
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 | Warrant liability
Liabilities
Total liabilities measured at fair value	0	0
Level 1 | Interest rate swap agreements-short term
Assets
Total assets measured at fair value	0	0
Level 1 | Interest rate swap agreements-long term
Assets
Total assets measured at fair value	0	0
Level 2
Assets
Total assets measured at fair value	9,991	9,476
Liabilities
Total liabilities measured at fair value	0	0
Level 2 | Acquisition-related contingent consideration-short term
Liabilities
Total liabilities measured at fair value	0	0
Level 2 | Warrant liability
Liabilities
Total liabilities measured at fair value	0	0
Level 2 | Interest rate swap agreements-short term
Assets
Total assets measured at fair value	6,423	5,748
Level 2 | Interest rate swap agreements-long term
Assets
Total assets measured at fair value	3,568	3,728
Level 3
Assets
Total assets measured at fair value	0	0
Liabilities
Total liabilities measured at fair value	23,277	46,003
Level 3 | Acquisition-related contingent consideration-short term
Liabilities
Total liabilities measured at fair value	7,500	7,500
Level 3 | Warrant liability
Liabilities
Total liabilities measured at fair value	15,777	38,503
Level 3 | Interest rate swap agreements-short term
Assets
Total assets measured at fair value	0	0
Level 3 | Interest rate swap agreements-long term
Assets
Total assets measured at fair value	$ 0	$ 0

Fair Value of Assets and Liab_4

Fair Value of Assets and Liabilities - Narrative (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Fair Value Disclosures [Abstract]
Contingent consideration liability	$ 7.5	$ 7.5

Fair Value of Assets and Liab_5

Fair Value of Assets and Liabilities - Contingent Consideration Rollforward (Details) - Contingent Consideration Liabilities - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning Balance	$ 7,500	$ 20,300
Payments	0	(3,250)
Change in Fair Value	0	238
Ending Balance	$ 7,500	$ 17,288

Derivative Instruments and He_3

Derivative Instruments and Hedging Activities - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Derivative [Line Items]
Amount reclassified from other comprehensive income	$ 0.4	$ 0.7	$ 1	$ 1.4
Derivative, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Gain (loss) on interest rate swap agreements, inclusive of reclassification adjustment, net of tax	Gain (loss) on interest rate swap agreements, inclusive of reclassification adjustment, net of tax	Gain (loss) on interest rate swap agreements, inclusive of reclassification adjustment, net of tax	Gain (loss) on interest rate swap agreements, inclusive of reclassification adjustment, net of tax
Cash Flow Hedging
Derivative [Line Items]
Gain in other comprehensive income	$ 2.8	$ 2.3	$ 0.6	$ 9
Interest Rate Swap | Designated as Hedging Instrument
Derivative [Line Items]
Notional amount	250		250
Forward-dated interest rate swap agreements | Designated as Hedging Instrument
Derivative [Line Items]
Notional amount	$ 250		$ 250		$ 250

Derivative Instruments and He_4

Derivative Instruments and Hedging Activities - Financial Instruments (Details) - Designated as Hedging Instrument - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Asset	$ 9,991	$ 9,476
Interest Rate Swap | Prepaid and other current assets
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Asset	6,423	5,748
Interest Rate Swap | Other assets
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Asset	$ 3,568	$ 3,728

Accounts Payable and Accrued _3

Accounts Payable and Accrued Expenses (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Accounts Payable and Accrued Liabilities, Current [Abstract]
Accounts payable	$ 226,533	$ 222,505
Employee-related accruals	36,651	41,872
Accrued interest	28,968	28,877
Other	45,548	44,244
Total	$ 337,700	$ 337,498

Debt - Summary of Long-Term Deb

Debt - Summary of Long-Term Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Unamortized deferred financing fees	$ (24,376)	$ (26,733)
Net long-term debt	2,175,624	2,188,267
Current portion	(40,000)	(35,000)
Long-term portion	2,135,624	2,153,267
Secured term loans
Debt Instrument [Line Items]
Gross long-term debt	750,000	765,000
Senior unsecured notes
Debt Instrument [Line Items]
Gross long-term debt	$ 1,450,000	$ 1,450,000

Debt - Narrative (Details)

Debt - Narrative (Details) - USD ($) $ in Thousands		1 Months Ended			6 Months Ended
	Mar. 31, 2023	Aug. 31, 2021	Jan. 31, 2021	Jul. 31, 2020	Jun. 30, 2023	Dec. 31, 2022	Jun. 30, 2022
Secured term loans
Debt Instrument [Line Items]
Borrowing capacity			$ 800,000
Debt balance outstanding					$ 750,000	$ 765,000
Credit facility interest rate					7.25%
Secured term loans | First Specified Repayment Period
Debt Instrument [Line Items]
Quarterly principal repayments					$ 5,000
Secured term loans | 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
Borrowings on lines of credit					50,000
Repayments on lines of credit					50,000
Revolver balance					0		$ 0
Remaining maximum borrowings available					124,200
Letter Of Credit 2021
Debt Instrument [Line Items]
Borrowing capacity			55,000
Credit Agreement 2021 | Minimum
Debt Instrument [Line Items]
Commitment fee (as a percent)	0.25%
Credit Agreement 2021 | Maximum
Debt Instrument [Line Items]
Commitment fee (as a percent)	0.50%
Credit Agreement 2021 | Secured Overnight Financing Rate (SOFR) | Minimum
Debt Instrument [Line Items]
Rate margin (as a percent)	1.50%
Credit Agreement 2021 | Secured Overnight Financing Rate (SOFR) | Maximum
Debt Instrument [Line Items]
Rate margin (as a percent)	3.25%
Credit Agreement 2021 | Term SOFR Adjustment
Debt Instrument [Line Items]
Rate margin (as a percent)	0.10%
Senior Unsecured Notes 5.125 Per Cent Due 2030
Debt Instrument [Line Items]
Face amount		$ 600,000
Debt interest rate		5.125%
Percentage of original principal that may be redeemed		40%
Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Redemption price, as percent of principal		102.563%
Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period Three
Debt Instrument [Line Items]
Redemption price, as percent of principal		101.281%
Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period Four
Debt Instrument [Line Items]
Redemption price, as percent of principal		100%
Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Redemption price, as percent of principal		100%
Redemption price, as percent of principal, proceeds from equity offerings		105.125%
Senior unsecured notes
Debt Instrument [Line Items]
Debt balance outstanding					$ 1,450,000	$ 1,450,000
Face amount			$ 500,000
Debt interest rate			4.625%
Percentage of original principal that may be redeemed			40%
Redemption price, as percent of principal, proceeds from equity offerings			104.625%
Senior unsecured notes | Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Redemption price, as percent of principal			102.313%
Senior unsecured notes | Debt Instrument, Redemption, Period Three
Debt Instrument [Line Items]
Redemption price, as percent of principal			101.156%
Senior unsecured notes | Debt Instrument, Redemption, Period Four
Debt Instrument [Line Items]
Redemption price, as percent of principal			100%
Senior unsecured notes | Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Redemption price, as percent of principal			100%
Senior Notes 6.125 Percent Due 2028
Debt Instrument [Line Items]
Face amount				$ 350,000
Debt interest rate				6.125%
Percentage of original principal that may be redeemed				40%
Redemption price, as percent of principal, proceeds from equity offerings				106.125%
Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Redemption price, as percent of principal				103.063%
Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Three
Debt Instrument [Line Items]
Redemption price, as percent of principal				102.042%
Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Four
Debt Instrument [Line Items]
Redemption price, as percent of principal				101.021%
Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Redemption price, as percent of principal				100%
Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Five
Debt Instrument [Line Items]
Redemption price, as percent of principal				100%

Stockholders' Equity - Narrativ

Stockholders' Equity - Narrative (Details) $ / shares in Units, $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2023 USD ($) $ / shares shares	Mar. 31, 2023 shares	Jun. 30, 2022 USD ($) shares	Mar. 31, 2022 USD ($)	Jun. 30, 2023 USD ($) vote $ / shares shares	Jun. 30, 2022 USD ($) shares	Dec. 31, 2022 shares	May 31, 2022 USD ($)
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Common stock shares authorized (in shares)	300,000,000				300,000,000		300,000,000
Preferred stock, shares authorized (in shares)	5,000,000				5,000,000		5,000,000
Number of votes per share | vote					1
Amount of cash authorized for stock repurchase program | $								$ 200,000
Amount remaining to be repurchased | $	$ 176,800				$ 176,800
Warrants outstanding (in shares)	3,871,557				3,871,557
Common stock for each warrant exercised (in shares)	1				1
Exercise price (in dollars per share) | $ / shares	$ 11.50				$ 11.50
Warrants exercised in cashless transaction, number exercised (in shares)					0	52,785
Reclassification of warrant liability to equity for exercised warrants (in shares)						18,667
Granted (in shares)					0	0
Options exercised in cashless basis (in shares)					559,071	258,352
Options exercised cashless basis (in shares)					213,852	111,071
Number of shares issued for options exercised on a cash basis (in shares)						115,732
Exercise of stock options | $				$ 723		$ 700
Equity-based compensation expense | $	$ 6,800		$ 5,700		$ 12,800	11,200
Unrecognized compensation expense | $	30,900				$ 30,900
Recognition period (in years)					1 year 10 months 24 days
General and Administrative Expense
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Equity-based compensation expense | $	7,700		3,900		$ 12,300	7,500
Cost of Sales
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Equity-based compensation expense | $	(900)		$ 1,800		$ 500	$ 3,700
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%
Unvested restricted stock
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Granted (in shares)					951,000
Performance Shares | Cost of Sales
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Equity-based compensation expense | $	(2,200)
Various Employees | Unvested restricted stock
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Granted (in shares)					140,556
Vesting period (in years)					3 years
Grant date fair value | $					$ 2,100
Director | Unvested restricted stock
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Granted (in shares)					139,190
Vesting period (in years)					1 year
Grant date fair value | $					$ 1,400
Interim CEO | Unvested restricted stock
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Granted (in shares)					17,143
Grant date fair value | $					$ 200
Management | Unvested restricted stock
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Granted (in shares)					327,000
Vesting period (in years)					3 years
Grant date fair value | $					$ 4,900
Management | Performance Based Restricted Stock Unit
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Granted (in shares)					327,000
Vesting period (in years)					3 years
Grant date fair value | $					$ 6,600
Term of relative total shareholder return v. defined peer group (in years)					3 years
Prior CEO
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Equity-based compensation expense | $	$ 4,000				$ 4,000
Prior CEO | Unvested restricted stock
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Accelerated vesting (in shares)					143,739
Prior CEO | Stock options
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Accelerated vesting (in shares)					78,130
Prior CEO | Performance Shares
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Increase in shares (in shares)					159,555
2019 Incentive Plan
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Shares authorized for issuance (in shares)	10,000,000				10,000,000
Stock available for issuance (in shares)	1,205,431				1,205,431
Treasury Stock
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Number of shares purchased under repurchase program (in shares)		632,000	199,000		631,953	199,418
Value of shares repurchase | $	$ 9,200		$ 3,400		$ 9,200	$ 3,400

Stockholders' Equity - Warrants

Stockholders' Equity - Warrants (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Warrant [Roll Forward]
Estimated fair value of warrant liability, beginning			$ 38,503	$ 57,764
Change in estimated fair value of the warrant liability	$ (812)	$ 8,208	(22,726)	(18,509)
Reclassification of warrant liability to equity for exercised warrants		(495)		(495)
Estimated fair value of warrant liability, ending	$ 15,777	$ 38,760	$ 15,777	$ 38,760

Stockholders' Equity - Stock Op

Stockholders' Equity - Stock Option Activity (Details) - $ / shares	6 Months Ended
	Jun. 30, 2023
Number of Options
Outstanding at beginning of period (in shares)	4,962,000
Exercised (in shares)	(559,000)
Outstanding at end of period (in shares)	4,403,000
Weighted-Average Exercise Price per Share
Outstanding at beginning of period (in dollars per share)	$ 12.19
Exercised (in dollars per share)	4.38
Outstanding at end of period (in dollars per share)	$ 13.18
Weighted-Average Remaining Contractual Term
Weighted average remaining contractual term (in years)	5 years 4 months 24 days
2019 Incentive Plan
Number of Options
Outstanding at beginning of period (in shares)	2,219,000
Outstanding at end of period (in shares)	2,219,000
Weighted-Average Grant Date Fair Value per Share
Outstanding at beginning of period (in dollars per share)	$ 3.75
Outstanding at end of period (in dollars per share)	3.75
Weighted-Average Exercise Price per Share
Outstanding at beginning of period (in dollars per share)	19.36
Outstanding at end of period (in dollars per share)	$ 19.36
Weighted-Average Remaining Contractual Term
Weighted average remaining contractual term (in years)	5 years 7 months 6 days

Stockholders' Equity - Restrict

Stockholders' Equity - Restricted Stock (Details) - Unvested restricted stock $ / shares in Units, $ in Millions	6 Months Ended
	Jun. 30, 2023 USD ($) $ / shares shares
Number of Shares of Restricted Stock
Non-vested balance at beginning of period (in shares)	2,261,000
Granted (in shares)	951,000
Vested (in shares)	(665,000)
Forfeited (in shares)	(303,000)
Non-vested balance at end of period (in shares)	2,244,000
Weighted-Average Grant Date Fair Value per Share
Non-vested, grant date fair value at beginning of period (in dollars per share) | $ / shares	$ 23.90
Granted (in dollars per share) | $ / shares	15.89
Vested (in dollars per share) | $ / shares	21.52
Forfeited (in dollars per share) | $ / shares	28.09
Non-vested, grant date fair value at end of period (in dollars per share) | $ / shares	$ 20.52
Interim CEO
Number of Shares of Restricted Stock
Granted (in shares)	17,143
Weighted-Average Grant Date Fair Value per Share
Grant date fair value | $	$ 0.2
Various Employees
Number of Shares of Restricted Stock
Granted (in shares)	140,556
Weighted-Average Grant Date Fair Value per Share
Grant date fair value | $	$ 2.1
Director
Number of Shares of Restricted Stock
Granted (in shares)	139,190
Weighted-Average Grant Date Fair Value per Share
Grant date fair value | $	$ 1.4

Earnings Per Share - Basic and

Earnings Per Share - Basic and Diluted Earnings per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Numerator
Net income attributable to AdaptHealth Corp.	$ 13,977	$ 14,032	$ 29,684	$ 55,782
Less: Earnings allocated to participating securities	1,182	1,186	2,508	4,721
Net income for basic EPS	12,795	12,846	27,176	51,061
Change in fair value of warrant liability	(812)	8,208	(22,726)	(18,509)
Net income for diluted EPS	$ 12,795	$ 12,846	$ 4,450	$ 32,552
Denominator
Basic weighted-average common shares outstanding (in shares)	134,295	134,332	134,409	134,178
Add: Warrants (in shares)	0	0	857	1,313
Diluted weighted-average common shares outstanding (in shares)	136,233	137,015	138,000	138,335
Basic net income per share (in dollars per share)	$ 0.10	$ 0.10	$ 0.20	$ 0.38
Diluted net income per share (in dollars per share)	$ 0.09	$ 0.09	$ 0.03	$ 0.24
Stock options
Denominator
Add: Stock options (in shares)	833	2,472	1,552	2,597
Unvested restricted stock
Denominator
Add: Unvested restricted stock (in shares)	1,105	211	1,182	247

Earnings Per Share - Antidiluti

Earnings Per Share - Antidilutive Securities (Details) - shares shares in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share
Antidilutive securities excluded (in shares)	14,625	14,433	12,874	13,210
Preferred Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share
Antidilutive securities excluded (in shares)	12,406	12,406	12,406	12,406
Warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share
Antidilutive securities excluded (in shares)	0	1,168	0	0
Stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share
Antidilutive securities excluded (in shares)	2,219	468	468	468
Unvested restricted stock
Antidilutive Securities Excluded from Computation of Earnings Per Share
Antidilutive securities excluded (in shares)	0	391	0	336

Leases - Right-Of-Use Assets an

Leases - Right-Of-Use Assets and Lease Liabilities (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Right-of-use (ROU) assets:
Operating lease right-of-use assets	$ 117,798		$ 117,798		$ 129,506
Total ROU assets	132,617		132,617		135,032
Operating lease liabilities:
Current portion of operating lease obligations	29,579		29,579		30,001
Operating lease obligations, less current portion	93,241		93,241		104,394
Total operating lease liabilities	122,820		122,820		134,395
Finance lease liabilities:
Current portion of finance lease obligations	4,246		4,246		2,211
Finance lease obligations, less current portion	10,638		10,638		3,950
Total finance lease liabilities	14,884		14,884		6,161
Operating lease costs	10,598	$ 9,661	21,072	$ 19,299
Finance lease costs:
Amortization of ROU assets			3,007	0
Other lease costs and income:
Variable leases costs	4,538	4,707	10,559	8,952
Sublease income	409	348	787	683
Cost of Sales
Finance lease costs:
Amortization of ROU assets	2,477	$ 2,165	3,007	$ 6,626
Finance lease right-of-use assets
Right-of-use (ROU) assets:
Finance lease right-of-use assets	14,819		14,819		5,423
Equipment and other fixed assets, net
Right-of-use (ROU) assets:
Finance lease right-of-use assets	$ 0		$ 0		$ 103

Leases - Weighted Average Remai

Leases - Weighted Average Remaining Lease Terms and Discount Rates (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Weighted average remaining lease term, weighted based on lease liability balances:
Operating leases (in years)	5 years 10 months 24 days		5 years 10 months 24 days		6 years 2 months 12 days
Finance leases (in years)	3 years 8 months 12 days		3 years 8 months 12 days		3 years 8 months 12 days
Weighted average discount rate, weighted based on remaining balance of lease payments:
Operating leases	4.10%		4.10%		3.90%
Operating Leased Assets [Line Items]
Reduction in the carrying amount of finance lease right-of-use assets			$ 3,007	$ 0
Cost of Sales
Operating Leased Assets [Line Items]
Reduction in the carrying amount of finance lease right-of-use assets	$ 2,477	$ 2,165	$ 3,007	$ 6,626

Leases - Lease Maturity (Detail

Leases - Lease Maturity (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Operating Leases
2023 (remaining six months)	$ 20,749
2024	30,847
2025	25,988
2026	18,162
2027	11,780
Thereafter	35,119
Total future undiscounted lease payments	142,645
Less: amount representing interest	(19,825)
Present value of future lease payments (lease liability)	122,820	$ 134,395
Finance Leases
2023 (remaining six months)	3,098
2024	4,740
2025	4,439
2026	3,768
2027	964
Thereafter	0
Total future undiscounted lease payments	17,009
Less: amount representing interest	(2,125)
Present value of future lease payments (lease liability)	$ 14,884	$ 6,161

Leases - Cash Flow and Suppleme

Leases - Cash Flow and Supplemental Non-Cash Information (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash payments for operating leases	$ 20,847	$ 19,220
Financing cash payments for finance leases	3,679	12,547
Lease liabilities arising from obtaining right-of-use assets:
Operating leases	5,112	4,582
Finance leases	$ 12,203	$ 1,335

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Income Taxes
Income tax expense	$ 5,399	$ 8,853	$ 3,685	$ 14,456
Unrecognized tax benefits	$ 6,600		$ 6,600		$ 6,600
Payout percentage			85%
Class B Common Stock par value (in dollars per share)	$ 0.0001		$ 0.0001		$ 0.0001
Expenses recognized related to changes in the estimated TRA liability				$ 4,500
Liability related to TRA			$ 294,200		$ 297,400
Common Class B
Income Taxes
Class B Common Stock par value (in dollars per share)	$ 0.0001		$ 0.0001
Other Current Liabilities
Income Taxes
Liability related to TRA			$ 2,300		3,300
Other Noncurrent Liabilities
Income Taxes
Liability related to TRA			$ 291,900		$ 294,100

Commitments and Contingencies (

Commitments and Contingencies (Details) $ in Millions	Apr. 21, 2023 USD ($)
AdaptHealth Holdings LLC v.s. United States District Court For The Eastern District Of Pennsylvania (EDPA) | Settled Litigation
Loss Contingencies [Line Items]
Payment on legal proceeding	$ 5.3

Related Party Transactions (Det

Related Party Transactions (Details) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023 USD ($)	Jun. 30, 2022 USD ($)	Jun. 30, 2023 USD ($) executive	Jun. 30, 2022 USD ($)	Dec. 31, 2022 USD ($)
Vendor Two
Related Party Transactions
Number of executives | executive			1
Ownership interest, as a percent			1%
Expenses, related party	$ 2.7	$ 1.7	$ 5	$ 3.1
Third-Party Payor | Maximum
Related Party Transactions
Net revenue related party	1%	1%	1%	1%
Vendor Three
Related Party Transactions
Ownership interest, as a percent			5%
Expenses, related party	$ 9.4	$ 15.6	$ 20.6	$ 29.6
Business process outsourcing services
Related Party Transactions
Outstanding payables	0.2		0.2		$ 2.2
Purchases from related party	$ 7.3	$ 5.7	$ 11.2	$ 10.5