AdaptHealth (AHCO) 10-K 27 Feb 24 2023 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Feb. 23, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2023
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-38399
Entity Registrant Name	AdaptHealth Corp.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	82-3677704
Entity Address, Address Line One	220 West Germantown Pike
Entity Address, Address Line Two	Suite 250
Entity Address, City or Town	Plymouth Meeting
Entity Address, State or Province	PA
Entity Address, Postal Zip Code	19462
City Area Code	610
Local Phone Number	424-4515
Title of 12(b) Security	Common Stock, par value $0.0001 per share
Trading Symbol	AHCO
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Entity Public Float			$ 1,260
Entity Common Stock, Shares Outstanding		132,907,103
Documents Incorporated by Reference	The information called for by Part III is incorporated by reference to the Definitive Proxy Statement for the 2024 Annual Meeting of Stockholders of the Registrant which will be filed with the U.S. Securities and Exchange Commission not later than April 29, 2024.
Entity Central Index Key	0001725255
Amendment Flag	false
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY

Audit Information

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

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Current assets:
Cash	$ 77,132	$ 46,272
Accounts receivable	388,910	359,146
Inventory	113,642	127,754
Prepaid and other current assets	69,338	52,136
Total current assets	649,022	585,308
Equipment and other fixed assets, net	495,101	487,079
Operating lease right-of-use assets	110,465	129,506
Finance lease right-of-use assets	31,962	5,423
Goodwill	2,724,958	3,545,297
Identifiable intangible assets, net	130,160	162,773
Other assets	21,128	22,415
Deferred tax assets	345,854	281,786
Total Assets	4,508,650	5,219,587
Current liabilities:
Accounts payable and accrued expenses	391,994	337,498
Current portion of long-term debt	53,368	35,000
Current portion of operating lease obligations	29,270	30,001
Current portion of finance lease obligations	9,122	2,211
Contract liabilities	38,570	31,641
Warrant liability	4,021	0
Other liabilities	10,654	19,863
Total current liabilities	536,999	456,214
Long-term debt, less current portion	2,094,614	2,153,267
Operating lease obligations, less current portion	85,529	104,394
Finance lease obligations, less current portion	22,746	3,950
Other long-term liabilities	302,093	305,501
Warrant liability	0	38,503
Total Liabilities	3,041,981	3,061,829
Commitments and contingencies (Note 16)
Stockholders' Equity:
Common Stock, par value of $0.0001 per share, 300,000,000 shares authorized and 132,634,850 and 134,435,119 shares issued and outstanding as of December 31, 2023 and 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 December 31, 2023 and 2022	1	1
Treasury stock, at cost (3,935,035 and 750,835 shares as of December 31, 2023 and 2022, respectively)	(43,267)	(13,992)
Additional paid-in capital	2,149,951	2,130,148
(Accumulated deficit) Retained earnings	(652,600)	26,295
Accumulated other comprehensive income	4,356	8,693
Total stockholders' equity attributable to AdaptHealth Corp.	1,458,454	2,151,158
Noncontrolling interest in subsidiary	8,215	6,600
Total Stockholders' Equity	1,466,669	2,157,758
Total Liabilities and Stockholders' Equity	$ 4,508,650	$ 5,219,587

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 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)	132,634,850	134,435,119
Common Stock, shares outstanding (in shares)	132,634,850	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)	3,935,035	750,835

Consolidated Statements of Oper

Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Statement [Abstract]
Net revenue	$ 3,200,177	$ 2,970,595	$ 2,454,535
Revenue, Product and Service [Extensible Enumeration]	Health Care, Patient Service [Member]	Health Care, Patient Service [Member]	Health Care, Patient Service [Member]
Grant income	$ 0	$ 0	$ 10,595
Costs and expenses:
Cost of net revenue	$ 2,720,613	$ 2,553,169	$ 2,008,925
Cost, Product and Service [Extensible Enumeration]	Health Care, Patient Service [Member]	Health Care, Patient Service [Member]	Health Care, Patient Service [Member]
General and administrative expenses	$ 190,091	$ 162,125	$ 167,505
Depreciation and amortization, excluding patient equipment depreciation	57,087	64,890	63,095
Goodwill impairment (note 5)	830,787	0	0
Total costs and expenses	3,798,578	2,780,184	2,239,525
Operating (loss) income	(598,401)	190,411	225,605
Interest expense, net	130,299	109,414	95,195
Change in fair value of warrant liability (note 11)	(34,482)	(17,158)	(53,181)
Change in fair value of contingent consideration common shares liability (note 11)	0	0	(29,389)
Loss on extinguishment of debt	0	0	20,189
Other loss, net	29,566	253	1,832
(Loss) income before income taxes	(723,784)	97,902	190,959
Income tax (benefit) expense	(49,004)	24,769	32,806
Net (loss) income	(674,780)	73,133	158,153
Income attributable to noncontrolling interest	4,115	3,817	1,978
Net (loss) income attributable to AdaptHealth Corp.	$ (678,895)	$ 69,316	$ 156,175
Weighted average common shares outstanding - basic (in shares)	134,156	134,175	126,306
Weighted average common shares outstanding - diluted (in shares)	134,418	138,988	133,034
Basic net income (loss) per share (note 12) (in dollars per share)	$ (5.06)	$ 0.47	$ 1.12
Diluted net income (loss) per share (note 12) (in dollars per share)	$ (5.31)	$ 0.33	$ 0.67

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Comprehensive Income [Abstract]
Net (loss) income	$ (674,780)	$ 73,133	$ 158,153
Other comprehensive (loss) income
(Gain) loss on interest rate swap agreements, inclusive of reclassification adjustment, net of tax	(4,337)	11,047	5,776
Comprehensive (loss) income	(679,117)	84,180	163,929
Income attributable to noncontrolling interest	4,115	3,817	1,978
Comprehensive (loss) income attributable to AdaptHealth Corp.	$ (683,232)	$ 80,363	$ 161,951

Consolidated Statements of Chan

Consolidated Statements of Changes in Stockholders’ Equity (Deficit) - USD ($) $ in Thousands	Total	Public Offering	Preferred Stock	Treasury Stock	Additional paid-in capital	Additional paid-in capital Public Offering	(Accumulated deficit) Retained earnings	Accumulated other comprehensive income (loss)	Noncontrolling interests in subsidiaries	Common Stock	Common Stock Common Stock and Class B Common Stock	Common Stock Common Stock and Class B Common Stock Public Offering	Class B Common Stock Common Stock and Class B Common Stock	Series C-1 Preferred Stock	Series C-1 Preferred Stock Preferred Stock	Series C-1 Preferred Stock Additional paid-in capital
Common Stock, beginning balance (in shares) at Dec. 31, 2020											76,458,000		13,219,000
Preferred Stock, beginning balance (in shares) at Dec. 31, 2020			164,000
Treasury Stock, beginning balance (in shares) at Dec. 31, 2020				0
Balance at beginning of period at Dec. 31, 2020	$ 280,845		$ 1	$ 0	$ 558,486		$ (199,196)	$ (4,411)	$ (74,044)		$ 8		$ 1
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of stock for acquisitions (in shares)											15,725,000				130,000
Issuance of stock for acquisitions	602,661				602,659						$ 2			$ 523,856		$ 523,856
Issuance of stock options for acquisitions	134,683				134,683
Exchange of Class B Common Stock for Class A Common Stock (in shares)											13,219,000		(13,219,000)
Exchange of Class B Common Stock for Class A Common Stock	77,900				(74,200)			(3,719)	77,919		$ 1		$ (1)
Exercise of warrants (in shares)											118,000
Reclassification of warrant liability to equity for exercised warrants	$ 2,960				2,960
Exercise of options (in shares)	1,447,000										1,139,000
Exercise of options	$ 12,320				12,320
Cashless exercise of stock options (in shares)											133,000
Equity-based compensation (in shares)											571,000
Equity-based compensation	$ 25,323				25,323
Issuance of Class A Common Stock, net of offering costs of $13,832 (in shares)												8,450,000
Issuance of Class A Common Stock, net of offering costs of $13,832		$ 265,018				$ 265,017						$ 1
Conversion of Series B-1 Preferred Stock to Class A Common Stock (in shares)			(40,000)							3,950,000	3,950,000
Conversion Of Series C-1 Preferred Stock to Class A Common Stock (in shares)			(130,000)								13,047,000
Conversion of Series C-1 Preferred Stock to Class A Common Stock					(1)						$ 1
Issuance of Common Stock in connection with Contingent Consideration Common Shares (in shares)	1,000,000										1,000,000
Issuance of Common Stock in connection with Contingent Consideration Common Shares	$ 41,088				41,088
Distribution to non-controlling interest	(1,070)								(1,070)
Common Stock issued in connection with employee stock purchase plan (in shares)											34,000
Common Stock issued in connection with employee stock purchase plan	1,016				1,016
Net (loss) income	158,153						156,175		1,978
Equity activity resulting from the Tax Receivable Agreement	17,617				17,617
Change in fair value of interest rate swaps, inclusive of reclassification adjustment	5,776							5,776
Payments for tax withholdings from restricted stock vestings and stock option exercises	(3,557)				(3,557)
Common Stock, ending balance (in shares) at Dec. 31, 2021											133,844,000		0
Preferred Stock, ending balance (in shares) at Dec. 31, 2021			124,000
Treasury Stock, ending balance (in shares) at Dec. 31, 2021				0
Balance at end of period at Dec. 31, 2021	2,066,689		$ 1	$ 0	2,107,267		(43,021)	(2,354)	4,783		$ 13		$ 0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Reclassification of warrant liability to equity for exercised warrants (in shares)											88,000
Reclassification of warrant liability to equity for exercised warrants	$ 2,103				2,103
Exercise of options (in shares)	804,000										621,000
Exercise of options	$ 2,510				2,510
Equity-based compensation (in shares)											555,000
Equity-based compensation	$ 22,397				22,397
Conversion of Series B-1 Preferred Stock to Class A Common Stock (in shares)										0
Issuance of Common Stock in connection with Contingent Consideration Common Shares (in shares)	0
Distribution to non-controlling interest	$ (2,000)								(2,000)
Common Stock issued in connection with employee stock purchase plan (in shares)											78,000
Common Stock issued in connection with employee stock purchase plan	1,616				1,616
Net (loss) income	73,133						69,316		3,817
Change in fair value of interest rate swaps, inclusive of reclassification adjustment	11,047							11,047
Payments for tax withholdings from restricted stock vestings and stock option exercises	(4,142)				(4,142)
Shares purchased under share repurchase program (in shares)				(750,835)							(751,000)
Shares purchased under share repurchase program	(13,992)			$ (13,992)
Deferred tax impact relating to contingent consideration common shares	$ (1,603)				(1,603)
Common Stock, ending balance (in shares) at Dec. 31, 2022	134,435,119										134,435,000		0
Preferred Stock, ending balance (in shares) at Dec. 31, 2022	124,060		124,000
Treasury Stock, ending balance (in shares) at Dec. 31, 2022	750,835			751,000
Balance at end of period at Dec. 31, 2022	$ 2,157,758		$ 1	$ (13,992)	2,130,148		26,295	8,693	6,600		$ 13		$ 0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of options (in shares)	1,553,000										440,000
Exercise of options	$ 587				587
Equity-based compensation (in shares)											808,000
Equity-based compensation	22,468				22,468
Conversion of Series B-1 Preferred Stock to Class A Common Stock (in shares)										0
Distribution to non-controlling interest	(2,500)								(2,500)
Common Stock issued in connection with employee stock purchase plan (in shares)											136,000
Common Stock issued in connection with employee stock purchase plan	2,031				2,031
Net (loss) income	(674,780)						(678,895)		4,115
Change in fair value of interest rate swaps, inclusive of reclassification adjustment	(4,337)							(4,337)
Payments for tax withholdings from restricted stock vestings and stock option exercises	(5,283)				(5,283)
Shares purchased under share repurchase program (in shares)				(3,184,200)							(3,184,000)
Shares purchased under share repurchase program	$ (29,275)			$ (29,275)
Common Stock, ending balance (in shares) at Dec. 31, 2023	132,634,850										132,635,000		0
Preferred Stock, ending balance (in shares) at Dec. 31, 2023	124,060		124,000
Treasury Stock, ending balance (in shares) at Dec. 31, 2023	3,935,035			3,935,000
Balance at end of period at Dec. 31, 2023	$ 1,466,669		$ 1	$ (43,267)	$ 2,149,951		$ (652,600)	$ 4,356	$ 8,215		$ 13		$ 0

Consolidated Statements of Ch_2

Consolidated Statements of Changes in Stockholders’ Equity (Deficit) (Parenthetical) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Jan. 31, 2021	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Offering costs		$ 0	$ 0	$ 13,832
Public Offering
Offering costs	$ 13,800			$ 13,832

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash flows from operating activities:
Net (loss) income	$ (674,780)	$ 73,133	$ 158,153
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization, including patient equipment depreciation	382,783	351,178	258,053
Goodwill impairment	830,787	0	0
Equity-based compensation	22,468	22,397	25,323
Change in fair value of warrant liability	(34,482)	(17,158)	(53,181)
Change in fair value of contingent consideration common shares liability	0	0	(29,389)
Reduction in the carrying amount of operating lease right-of-use assets	31,873	32,264	28,624
Reduction in the carrying amount of finance lease right-of-use assets	5,938	0	0
Deferred income tax (benefit) expense	(62,595)	18,036	22,380
Change in fair value of interest rate swaps, net of reclassification adjustment	(1,801)	(2,936)	(2,927)
Amortization of deferred financing costs	5,234	5,234	5,378
Write-off of deferred financing costs	0	0	4,054
Loss on extinguishment of debt from prepayment penalty	0	0	16,135
Other	350	(285)	(3,615)
Changes in operating assets and liabilities, net of effects from acquisitions:
Accounts receivable	(28,862)	(209)	(29,694)
Inventory	15,531	(6,300)	(14,920)
Prepaid and other assets	(20,305)	(13,143)	2,731
Operating lease obligations	(32,428)	(31,213)	(28,043)
Operating liabilities	40,955	(57,131)	(83,383)
Net cash provided by operating activities	480,666	373,867	275,679
Cash flows from investing activities:
Purchases of equipment and other fixed assets	(337,463)	(391,423)	(203,308)
Payments for business acquisitions, net of cash acquired	(19,687)	(19,017)	(1,620,320)
Payments for cost method investments	(128)	(731)	(1,125)
Net cash used in investing activities	(357,278)	(411,171)	(1,824,753)
Cash flows from financing activities:
Proceeds from borrowings on long-term debt and lines of credit	50,000	0	1,165,000
Repayments on long-term debt and lines of credit	(95,000)	(20,000)	(827,271)
Repayments of finance lease obligations	(6,769)	(16,176)	(42,164)
Payments for shares purchased under share repurchase program	(29,275)	(13,992)	0
Payments for tax withholdings from restricted stock vestings and stock option exercises	(5,843)	(3,516)	(3,557)
Payments of contingent consideration and deferred purchase price from acquisitions	(2,535)	(14,493)	(25,233)
Payments relating to the Tax Receivable Agreement	(3,224)	0	0
Distributions to noncontrolling interests	(2,500)	(2,000)	(1,070)
Proceeds from the exercise of stock options	587	2,510	12,320
Proceeds received in connection with employee stock purchase plan	2,031	1,616	1,016
Proceeds from the issuance of senior unsecured notes	0	0	1,100,000
Proceeds from the issuance of Class A Common Stock	0	0	278,850
Payments for equity issuance costs	0	0	(13,832)
Payments of deferred financing costs	0	0	(29,185)
Payments for debt prepayment penalties	0	0	(16,135)
Net cash (used in) provided by financing activities	(92,528)	(66,051)	1,598,739
Net increase (decrease) in cash	30,860	(103,355)	49,665
Cash at beginning of period	46,272	149,627	99,962
Cash at end of period	77,132	46,272	149,627
Supplemental disclosures:
Cash paid for interest	126,228	108,885	73,630
Cash paid for income taxes	14,756	14,949	14,792
Noncash investing and financing activities:
Equipment acquired under finance lease obligations	0	1,335	22,959
Unpaid equipment and other fixed asset purchases at end of period	35,867	24,221	13,936
Assets subject to operating lease obligations	22,000	22,543	12,777
Operating lease obligations	(22,000)	(22,543)	(12,777)
Write-off of assets subject to operating lease obligations	(14,675)	(8,532)	0
Write-off of operating lease obligations	14,675	8,532	0
Assets subject to finance lease obligations	32,101	0	0
Finance lease obligations	(32,101)	0	0
Equity consideration issued in connection with acquisitions	0	0	1,261,200
Contingent purchase price in connection with acquisitions	0	0	7,800
Deferred purchase price in connection with acquisitions	$ 137	$ 457	$ 4,478

Nature of Business

Nature of Business	12 Months Ended
	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of Business	Nature of Business AdaptHealth Corp. and subsidiaries ("AdaptHealth" or "the Company") is a national leader in providing patient-centered, healthcare-at-home solutions including home medical equipment ("HME"), medical supplies, and related services. AdaptHealth focuses primarily on providing (i) sleep therapy equipment, supplies and related services (including CPAP and bi PAP services) to individuals suffering from obstructive sleep apnea ("OSA"), (ii) medical devices and supplies to patients for the treatment of diabetes (including continuous glucose monitors ("CGM") and insulin pumps), (iii) home medical equipment to patients discharged from acute care and other facilities, (iv) oxygen and related chronic therapy services in the home, and (v) other HME devices and supplies on behalf of chronically ill patients with wound care, urological, incontinence, ostomy and nutritional supply needs. AdaptHealth services beneficiaries of Medicare, Medicaid and commercial insurance payors.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies (a) Basis of Presentation The consolidated financial statements of the Company have been prepared in accordance with accounting principles generally accepted in the United States of America (U.S. GAAP). In the opinion of management, the consolidated financial statements include all necessary adjustments for a fair presentation of the financial position and results of operations for the periods presented. (b) Basis of Consolidation The accompanying consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation. (c) 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 and the tax receivable agreement, equity-based compensation, warrant liability, long-lived assets, including goodwill and identifiable intangible assets, and contingencies. Actual results could differ from those estimates. (e) 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, over the fixed monthly service period for equipment, or in the month in which eligible members are entitled to receive healthcare services in connection with at-risk capitation arrangements. 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, referred to as explicit price concessions, adjusted for estimates of variable consideration, such as implicit price concessions, based on historical reimbursement experience. The Company utilizes the expected value method to determine the amount of variable consideration, including implicit and explicit price concessions, that should be included to arrive at the transaction price, using contractual agreements and historical reimbursement experience. 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 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 receives a per member per month (“PMPM”) fee under certain at-risk capitation arrangements, which refers to a model in which the Company receives a PMPM fee from the third-party payor, and is responsible for managing a range of healthcare services and associated costs of its members. In at-risk capitation arrangements, the Company is responsible for the cost of contracted healthcare services required by those members in accordance with the terms of each agreement. Capitated revenue contracts with payors are generally multi-year arrangements and have a single monthly stand ready performance obligation to provide all aspects of necessary medical care to members for the contracted period in accordance with the scope of the agreements. The Company recognizes revenue in the month in which eligible members are entitled to receive healthcare services during the contract term. The Company’s revenue recognized under its capitation arrangements is included in the “other” product category in net sales revenue in the table below. 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, referred to as an explicit price concession, 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 product lines. The Company believes that disaggregation of net revenue into these categories depicts how the nature, amount, timing and uncertainty of revenue and cash flows are affected by economic factors. The payment terms and conditions within the Company’s revenue-generating contracts vary by payor type and payor source. The composition of net revenue by payor type for the years ended December 31, 2023, 2022 and 2021 are as follows (in thousands): Year Ended December 31, 2023 2022 2021 Insurance $ 1,933,440 $ 1,808,633 $ 1,499,154 Government 852,789 781,975 685,513 Patient pay 413,948 379,987 269,868 Net revenue $ 3,200,177 $ 2,970,595 $ 2,454,535 The composition of net revenue by core product lines for the years ended December 31, 2023, 2022 and 2021 are as follows (in thousands): Year Ended December 31, 2023 2022 2021 Net sales revenue: Sleep $ 897,119 $ 794,021 $ 654,130 Diabetes 647,431 670,988 528,082 Supplies to the home 192,475 179,326 167,830 Respiratory 32,370 34,342 31,016 HME 110,197 118,542 113,805 Other 251,710 218,461 144,543 Total net sales revenue $ 2,131,302 $ 2,015,680 $ 1,639,406 Net revenue from fixed monthly equipment reimbursements: Sleep $ 344,049 $ 272,705 $ 237,252 Diabetes 12,608 16,103 13,123 Respiratory 566,450 520,697 427,270 HME 96,328 102,256 95,936 Other 49,440 43,154 41,548 Total net revenue from fixed monthly equipment reimbursements $ 1,068,875 $ 954,915 $ 815,129 Total net revenue: Sleep $ 1,241,168 $ 1,066,726 $ 891,382 Diabetes 660,039 687,091 541,205 Supplies to the home 192,475 179,326 167,830 Respiratory 598,820 555,039 458,286 HME 206,525 220,798 209,741 Other 301,150 261,615 186,091 Total net revenue $ 3,200,177 $ 2,970,595 $ 2,454,535 (f) 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 receivable estimates are considered implicit price concession adjustments and are recognized as an adjustment to net revenue in the period of revision. The Company does not have any material bad debt expense. Included in accounts receivable are earned but unbilled accounts receivables. Billing delays, ranging from several days to several weeks, can occur due to the Company’s policy of compiling required payor specific documentation prior to billing for its services rendered. As of December 31, 2023 and 2022, the Company’s unbilled accounts receivable was $68.4 million and $38.6 million, respectively. (g) COVID-19 Pandemic Federal, state, and local authorities have taken several actions designed to assist healthcare providers in providing care to COVID-19 and other patients and to mitigate the adverse economic impact of the COVID-19 pandemic. Legislative actions taken by the federal government include the Coronavirus Aid, Relief, and Economic Security Act (the "CARES Act"), which was signed into law on March 27, 2020. Through the CARES Act, the federal government authorized payments that were distributed to healthcare providers through the Public Health and Social Services Emergency Fund (Provider Relief Fund or PRF). Additionally, the CARES Act revised the Medicare accelerated and advance payment program in an attempt to disburse payments to healthcare providers more quickly to mitigate the financial impact on healthcare providers. The Company’s participation in these programs and related accounting policies are summarized below. Grant Income . In April 2020, the Company received distributions of the CARES Act PRF of $17.2 million, and subsequent to April 2020, the Company completed several acquisitions in which the acquired companies received a total of $22.2 million of PRF payments prior to the applicable dates of acquisition. In connection with the accounting for these acquisitions, the Company recorded assumed liabilities of $7.7 million relating to the PRF payments received by the acquired companies. The PRF payments were targeted to offset lost revenue and expenditures incurred in connection with the COVID-19 pandemic. The PRF payments are subject to certain restrictions and are subject to recoupment if not used for designated purposes. As a condition to receiving distributions, providers were required to agree to certain terms and conditions, including, among other things, that the funds would be used for lost revenues and unreimbursed COVID-19 related expenses as defined by the U.S. Department of Health and Human Services (HHS). All recipients of PRF payments were required to comply with the reporting requirements described in the terms and conditions and as determined by HHS. The Company recognizes grant payments as income when there is reasonable assurance that it has complied with the conditions associated with the grant. During the year ended December 31, 2021, the Company recognized grant income of $10.6 million related to the PRF payments determined to comply with conditions associated with the grant. (h) Fair Value Accounting Financial Accounting Standards Board ("FASB") Accounting Standards Codification ("ASC") Topic 820, Fair Value Measurements and Disclosures (ASC 820), creates a single definition of fair value, establishes a framework for measuring fair value in U.S. GAAP and expands disclosures about fair value measurements. ASC 820 emphasizes that fair value is a market-based measurement, not an entity specific measurement, and states that a fair value measurement is to estimate the price at which an orderly transaction to sell an asset or to transfer the liability would take place between market participants at the measurement date under current market conditions. Assets and liabilities adjusted to fair value in the balance sheet are categorized based upon the level of judgment associated with the inputs used to measure their fair value. Level inputs, as defined by ASC 820, are as follows: Level input Input Definition Level 1 Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. Level 2 Inputs, other than quoted prices included in Level 1 that are observable for the asset or liability through corroboration with market data at the measurement date. Level 3 Unobservable inputs that reflect management’s best estimate of what market participants would use in pricing the asset or liability at the measurement date. See Note 6, Fair Value of Assets and Liabilities , for additional information. (i) Fair Value of Financial Instruments The Company’s financial instruments consist of cash, accounts receivable, prepaid and other current assets, accounts payable and accrued expenses. The carrying values of the Company’s financial instruments approximate their fair value based on their short-term nature. The table below shows the carrying amounts and estimated fair values, net of unamortized deferred financing costs, of the Company’s long-term debt arrangements (in thousands): December 31, 2023 December 31, 2022 Carrying Value Fair Value Carrying Value Fair Value Secured term loan $ 717,679 $ 717,679 $ 761,547 $ 761,547 Senior unsecured notes 1,430,303 1,140,821 1,426,720 1,227,574 $ 2,147,982 $ 1,858,500 $ 2,188,267 $ 1,989,121 The borrowings under the Company’s secured term loan bears interest at the variable rates described in Note 10, Debt , which management believes approximates fair value. The fair value of the Company’s senior unsecured notes is based upon current market prices. (j) Cash and Cash Equivalents The Company considers all short-term highly liquid investments with a maturity of three months or less to be cash equivalents. Cash represents cash on hand and deposits held at banks. The Company maintains cash in demand deposit accounts with federally insured banks. At times, the balances in these accounts may be in excess of federally insured limits. The Company had no cash equivalents at December 31, 2023 and 2022. (k) Inventory Inventory consists of equipment and medical supplies to be sold to customers and is stated at the lower of cost or net realizable value. Cost is determined by the first-in-first-out method. These finished goods are charged to cost of net revenue in the period in which products and related services are provided to patients. (l) Equipment and Other Fixed Assets Equipment and other fixed assets are stated at cost less accumulated depreciation, or, when acquired as part of a business combination, fair value at the date of acquisition. Depreciation is computed using the straight-line method over the estimated useful lives of the related assets. The useful lives for patient medical equipment correlate with the medical reimbursement periods. Computer equipment, vehicles and other fixed assets are depreciated over the estimated useful lives of the assets. Major expenditures for property acquisitions and those expenditures that substantially increase useful lives are capitalized. Expenditures for maintenance, repairs and minor replacements are expensed as incurred. The useful lives of property and equipment for purposes of computing depreciation are: Patient medical equipment 13 months ‑ 5 years Computers and Software 5 ‑ 10 years Vehicles 5 years Other 2 ‑ 10 years (m) 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 - 10 years Payor contracts 10 years Developed technology 5 years The Company did not recognize any impairment charges on long-lived assets for the years ended December 31, 2023, 2022 and 2021. (n) 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 also 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, including the revenue growth rates, discount rate, and control premium used to estimate the 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 the year ended December 31, 2023, the Company experienced declines in its market capitalization as a result of sustained decreases in the Company's stock price and also revised its financial projections. The Company considered these items to represent triggering events and performed a goodwill impairment test at each quarterly reporting date during 2023. Based on the results of the tests performed as of September 30, 2023 and December 31, 2023, it was concluded that the estimated fair value of the Company’s reporting unit was less than its carrying values at such dates, and as such, the Company recognized an aggregate non-cash goodwill impairment charge of $830.8 million during the year ended December 31, 2023, which included an impairment charge of $318.9 million recognized during the fourth quarter. 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 an additional non-cash goodwill impairment charge at that time, which could be material. See Note 5, Goodwill and Identifiable Intangible Assets , for additional details. (o) Business Combinations The Company applies the acquisition method of accounting for business acquisitions. The results of operations of the businesses acquired by the Company are included as of the respective acquisition date. The acquisition-date fair value of the consideration transferred, including the fair value of any contingent consideration, is allocated to the underlying assets acquired and liabilities assumed based upon their estimated fair values at the date of acquisition. To the extent the acquisition-date fair value of the consideration transferred exceeds the fair value of the identifiable tangible and intangible assets acquired and liabilities assumed, such excess is allocated to goodwill. Patient relationships, medical records and patient lists are not reported as separate intangible assets due to the regulatory requirements and lack of contractual agreements but are part of goodwill. Customer related relationships are not reported as separate intangible assets but are part of goodwill as authorizing physicians are under no obligation to refer the Company’s services to their patients, who are free to change physicians and service providers at any time. The Company may adjust the preliminary purchase price allocation, as necessary, as it obtains more information regarding asset valuations and liabilities assumed that existed but were not available at the acquisition date, which is generally up to one year after the acquisition closing date. Acquisition related expenses are recognized separately from the business combination and are expensed as incurred. (p) Deferred Financing Costs Costs incurred in connection with the Company’s borrowings, referred to as financing costs, are capitalized and included on the accompanying consolidated balance sheets in Other assets for costs associated with revolving credit facilities, and as a reduction of the carrying value of debt for costs associated with secured term loans. The capitalized financing costs are amortized to interest expense using the effective interest method over the term of the related financing agreement. See Note 8, Deferred Financing Costs , for additional information. (q) Accounting for Leases The Company accounts for its leases in accordance with FASB Accounting Standards Codification Topic 842, Leases (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. See Note 13, Leases , for additional information. (r) 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. If there is no probable estimate within a range of reasonably possible outcomes, the Company’s policy is to record at the low end of the range of such reasonably possible outcomes. 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, e

Acquisitions

Acquisitions	12 Months Ended
	Dec. 31, 2023
Business Combination and Asset Acquisition [Abstract]
Acquisitions	Acquisitions During the years ended December 31, 2023, 2022 and 2021, the Company completed numerous acquisitions to strengthen its current market share in existing markets or to expand into new markets. Each of the Company’s acquisitions was accounted for using the acquisition method pursuant to the requirements of FASB ASC Topic 805, Business Combinations , and are included in the Company’s consolidated financial statements since the respective acquisition date. The goodwill generated from these acquisitions is attributable to expected growth and cost synergies and the expected contribution of each acquisition to the Company’s overall strategy. The goodwill recorded during the year ended December 31, 2023 is expected to be deductible for tax purposes. The estimated fair values of the net assets of acquired businesses during the year ended December 31, 2023 as described below are subject to change resulting from such items as final analysis of valuations and working capital adjustments post-acquisition. As a result, the acquisition accounting for certain acquired businesses could change in subsequent periods resulting in adjustments to goodwill once finalized. Year ended December 31, 2023 During the year ended December 31, 2023, the Company acquired 100% of the equity interests of two providers of home medical equipment ("HME") and acquired certain assets from four providers of home medical equipment. The following table summarizes the consideration paid at closing for all acquisitions during the year ended December 31, 2023 (in thousands): Cash $ 19,943 Deferred payments 137 Total $ 20,080 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 year ended December 31, 2023 was allocated as follows during the period (in thousands): Cash $ 256 Accounts receivable 1,264 Inventory 1,483 Prepaid and other current assets 10 Equipment and other fixed assets 9,011 Operating lease right-of-use assets 5,506 Finance lease right-of-use assets 200 Goodwill 9,616 Accounts payable and accrued expenses (713) Operating lease liabilities (5,506) Finance lease liabilities (200) Other current liabilities (847) Net assets acquired $ 20,080 Year ended December 31, 2022 During the year ended December 31, 2022, the Company acquired 100% of the equity interests of three providers of HME and acquired certain assets from five providers of home medical equipment. The following table summarizes the consideration paid at closing for all acquisitions during the year ended December 31, 2022 (in thousands): Cash $ 17,170 Deferred payments 457 Total $ 17,627 The Company allocated the consideration paid to the net assets acquired based on their estimated acquisition date fair values. Based upon management’s evaluation, the consideration paid for all acquisitions during 2022 was allocated as follows (in thousands): Cash $ 162 Accounts receivable 2,336 Inventory 771 Prepaid and other current assets 16 Equipment and other fixed assets 4,585 Goodwill 12,341 Identifiable intangible assets 500 Deferred tax assets 180 Accounts payable and accrued expenses (3,130) Contract liabilities (134) Net assets acquired $ 17,627 During the year ended December 31, 2022, the Company paid net cash of $2.0 million relating to working capital adjustments associated with businesses that were acquired during 2021, which was recorded as an increase to goodwill. Year ended December 31, 2021 On February 1, 2021, the Company acquired 100% of the equity interests of AeroCare Holdings, Inc. (AeroCare). AeroCare is a leading national technology-enabled respiratory and home medical equipment distribution platform in the United States and offers a comprehensive suite of direct-to-patient equipment and services including CPAP and BiPAP machines, oxygen concentrators, home ventilators, and other home medical equipment products. The total consideration paid consisted of (i) cash payments of $1.2 billion, (ii) the issuance of 13,992,615 shares of the Company’s Class A Common Stock, (iii) the issuance of 130,474.73 shares of the Company’s Series C Convertible Preferred Stock, and (iv) the issuance of 3,959,892 fully vested options to purchase shares of the Company’s Class A Common Stock in the future, which had a weighted-average exercise price of $6.24 per share and a weighted-average remaining exercise period of approximately 7 years from the date of closing. See Note 11, Stockholders’ Equity , for additional discussion of the Series C Convertible Preferred Stock issued in connection with the acquisition of AeroCare. On April 30, 2021, the Company acquired 100% of the equity interests of Spiro Health Services, LLC (Spiro). Spiro is a provider of home medical equipment and supplies. The total consideration paid consisted of a cash payment of $65.8 million, the issuance of 244,641 shares of the Company’s Class A Common Stock, and a potential contingent consideration payment of up to $1.0 million, which was determined to be the fair value at the acquisition date and such amount was recorded as a contingent consideration liability in connection with the Company’s acquisition accounting. On June 1, 2021, the Company acquired 100% of the equity interests of Healthy Living Medical Supply, LLC (Healthy Living). Healthy Living is a provider of continuous glucose monitors and insulin pumps. The total consideration paid consisted of a cash payment of $47.0 million and the issuance of 196,779 shares of the Company’s Class A Common Stock. On July 1, 2021, the Company acquired 100% of the equity interests of Agilis Med Holdings, LLC (Agilis). Agilis is an e-commerce retailer of sleep apnea and respiratory equipment in the United States. The total consideration paid consisted of a cash payment of $30.8 million, the issuance of 538,079 shares of the Company’s Class A Common Stock, and a potential contingent consideration payment of up to $1.0 million, which was determined to be the fair value at the acquisition date and such amount was recorded as a contingent consideration liability in connection with the Company’s acquisition accounting. In October 2020, the Company acquired a minority interest in Agilis, which was being accounted for under the equity method of accounting prior to the July 2021 transaction. The carrying value of such investment was $8.1 million at the July 2021 transaction date. The fair value of the equity method investment was $10.0 million at the July 2021 transaction date. In connection with the accounting for the July 2021 transaction, the Company recorded goodwill of $10.0 million and eliminated the carrying value of the equity method investment of $8.1 million and recorded a gain on equity method of investment of $1.9 million, which is included in Other loss (income), net in the accompanying consolidated statements of operations during the year ended December 31, 2021. On July 1, 2021, the Company acquired 100% of the equity interests of WeCare Medical, LLC (WeCare). WeCare is a distributor of durable medical equipment and supplies in the United States. The total consideration paid consisted of a cash payment of $34.8 million and the issuance of 231,866 shares of the Company’s Class A Common Stock. On December 30, 2021, the Company acquired 100% of the equity interests of Community Surgical Supply of Toms River, LLC (Community Surgical Supply). Community Surgical Supply is a supply company that provides oxygen, respiratory therapy services, infusion therapy services, and home medical equipment to its customers throughout the northeastern United States. The total consideration paid consisted of a cash payment of $129.4 million and a potential contingent consideration payment of up to $6.5 million. The Company determined that the potential contingent payment had an acquisition date fair value of $5.8 million, which was recorded as a contingent consideration liability in connection with the Company’s acquisition accounting. In addition, during 2021, the Company acquired 100% of the equity interests of certain providers of home medical equipment and distributors of diabetes management products and supplies, and acquired certain assets of the durable medical equipment businesses of certain providers of home medical equipment. The total consideration paid for these acquisitions consisted of cash payments of $196.7 million, the issuance of 306,569 shares of the Company’s Class A Common Stock, and deferred payment liabilities of $4.5 million. The following table summarizes the consideration paid for all acquisitions during the year ended December 31, 2021 (in thousands): AeroCare Spiro Healthy Living Agilis We Care Community Other Total Cash $ 1,153,409 $ 65,759 $ 47,048 $ 30,828 $ 34,834 $ 129,423 $ 196,669 $ 1,657,970 Equity 1,220,342 7,109 5,057 14,668 6,321 — 7,703 1,261,200 Contingent consideration — 1,000 — 1,000 — 5,800 — 7,800 Deferred payments — — — — — — 4,478 4,478 Total $ 2,373,751 $ 73,868 $ 52,105 $ 46,496 $ 41,155 $ 135,223 $ 208,850 $ 2,931,448 The Company allocated the consideration paid at closing to the net assets acquired based on their acquisition date fair values. Based upon management’s evaluation, the consideration paid for all acquisitions during 2021 was allocated as follows during the year ended December 31, 2021 (in thousands): AeroCare Spiro Healthy Living Agilis We Care Community Other Total Cash $ 27,686 $ 2,132 $ 579 $ 1,131 $ 458 $ 2 $ 5,005 $ 36,993 Accounts receivable 71,916 $ 5,756 5,838 — 2,007 15,798 25,587 126,902 Inventory 26,998 1,733 2,949 2,330 465 5,214 10,663 50,352 Prepaid and other current assets 3,522 152 1,088 — — 571 2,403 7,736 Equipment and other fixed assets 190,755 6,897 1,188 348 5,254 44,952 24,963 274,357 Operating lease right-of-use assets 52,927 2,581 1,366 490 970 4,412 15,897 78,643 Goodwill 2,083,423 64,380 44,095 55,375 35,971 88,393 164,929 2,536,566 Identifiable intangible assets 122,800 1,000 1,500 500 400 2,300 4,400 132,900 Other assets 1,178 16 — — — 2,505 — 3,699 Deferred tax liabilities (46,234) — — — (1,228) — (308) (47,770) Accounts payable and accrued expenses (82,722) (5,517) (3,363) (3,188) (1,389) (13,725) (21,679) (131,583) Contract liabilities (14,495) (486) (102) — (783) (3,156) (608) (19,630) Other current liabilities (10,021) — (1,667) — — (180) (1,833) (13,701) Other long-term liabilities (1,055) — — — — (2,683) — (3,738) Operating lease obligations (52,927) (2,581) (1,366) (490) (970) (4,412) (15,897) (78,643) Finance lease obligations — (2,195) — — — (4,768) (4,672) (11,635) Net assets acquired $ 2,373,751 $ 73,868 $ 52,105 $ 56,496 $ 41,155 $ 135,223 $ 208,850 $ 2,941,448 During the year ended December 31, 2021, the Company received net cash of $0.7 million relating to working capital adjustments associated with businesses that were acquired during 2020, which was recorded as a decrease to goodwill. Results of Businesses Acquired The following table presents the amount of Net revenue and Operating income in the period of acquisition since the respective acquisition dates for the acquisitions described above that is included in the Company’s consolidated statements of operations for the years ended December 31, 2023, 2022 and 2021: (in thousands) Year Ended December 31, 2023 2022 2021 Net revenue $ 7,246 $ 16,455 $ 1,005,097 Operating income $ 745 $ 767 $ 136,404

Equipment and Other Fixed Asset

Equipment and Other Fixed Assets	12 Months Ended
	Dec. 31, 2023
Property, Plant and Equipment [Abstract]
Equipment and Other Fixed Assets	Equipment and Other Fixed Assets Equipment and other fixed assets as of December 31, 2023 and 2022 are as follows (in thousands): December 31, December 31, Patient medical equipment $ 791,349 $ 747,985 Computers and software 85,509 70,897 Delivery vehicles 35,021 35,326 Other 20,203 16,059 Gross carrying value 932,082 870,267 Less accumulated depreciation (436,981) (383,188) Equipment and other fixed assets, net $ 495,101 $ 487,079 For the years ended December 31, 2023, 2022 and 2021, the Company recorded depreciation expense of $350.2 million, $311.2 million and $211.5 million, respectively.

Goodwill and Identifiable Intan

Goodwill and Identifiable Intangible Assets	12 Months Ended
	Dec. 31, 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 years ended December 31, 2023 and 2022 was as follows (in thousands): Gross carrying Balance at December 31, 2021 $ 3,512,567 Goodwill from acquisitions 12,341 Net cash payments relating to prior acquisitions 2,009 Net increase relating to measurement period adjustments 18,380 Balance at December 31, 2022 $ 3,545,297 Goodwill from acquisitions 9,616 Net increase relating to measurement period adjustments 832 Goodwill impairment (830,787) Balance at December 31, 2023 $ 2,724,958 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 the year ended December 31, 2023, the Company experienced declines in its market capitalization as a result of sustained decreases in the Company's stock price and also revised its financial projections. The Company considered these items to represent triggering events and performed a goodwill impairment test at each quarterly reporting date during 2023. Based on the results of the tests performed as of September 30, 2023 and December 31, 2023, it was concluded that the estimated fair value of the Company’s reporting unit was less than its carrying values at such dates, and as such, the Company recognized an aggregate non-cash goodwill impairment charge of $830.8 million during the year ended December 31, 2023, which included an impairment charge of $318.9 million recognized during the fourth quarter. 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 an additional non-cash goodwill impairment charge at that time, which could be material. As discussed in Note 3, Acquisitions , during 2022, the Company paid net cash of $2.0 million relating to working capital adjustments associated with businesses that were acquired during 2021 which were recorded as an increase to goodwill during the period . The net increase of $18.4 million during 2022 in the table above relates to measurement period adjustments attributed to businesses that were acquired by the Company during 2021, primarily related to the acquisition of Community. Based on available information obtained by the Company during 2022, the Company recorded certain adjustments to the acquisition accounting for Community, resulting in a decrease to accounts receivable of $0.9 million, a decrease to equipment and other fixed assets of $10.0 million, an increase to other current liabilities of $7.3 million, and a decrease to accounts payable and accrued expenses of $2.2 million, with a corresponding increase to goodwill of $16.0 million. Identifiable intangible assets that are separable and have determinable useful lives are valued separately and amortized over the period which reflects the pattern in which the economic benefits of the assets are expected to be consumed. Identifiable intangible assets consisted of the following at December 31, 2023 and 2022 (in thousands): December 31, 2023 Weighted-Average Tradenames, net of accumulated amortization of $38,314 $ 74,486 6.6 Payor contracts, net of accumulated amortization of $28,216 53,784 6.6 Developed technology, net of accumulated amortization of $4,410 1,890 1.5 Identifiable intangible assets, net $ 130,160 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 $32.6 million, $40.0 million and $46.5 million for the years ended December 31, 2023, 2022 and 2021 respectively. Future amortization expense related to identifiable intangible assets is estimated to be as follows (in thousands): Twelve months ending December 31, 2024 $ 22,276 2025 21,328 2026 19,263 2027 17,960 2028 17,936 Thereafter 31,397 Total $ 130,160 The Company did not recognize any impairment charges related to identifiable intangible assets during the years ended December 31, 2023, 2022 and 2021.

Fair Value of Assets and Liabil

Fair Value of Assets and Liabilities	12 Months Ended
	Dec. 31, 2023
Fair Value Disclosures [Abstract]
Fair Value of Assets and Liabilities	Fair Value of Assets and Liabilities Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability (i.e. the exit price) in an orderly transaction between market participants at the measurement date. In determining fair value, the Company uses various valuation approaches, including quoted market prices and discounted cash flows. A hierarchy for inputs is used in measuring fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs by requiring that the most observable inputs be used when available. Observable inputs are inputs that market participants would use in pricing the asset or liability developed based on market data obtained from independent sources. Unobservable inputs are inputs that reflect a company’s judgment concerning the assumptions that market participants would use in pricing the asset or liability developed based on the best information available under the circumstances. The fair value hierarchy is broken down into three levels based on the reliability of inputs. To the extent that valuation is based on models or inputs that are less observable or unobservable in the market, the determination of fair value requires more judgment. Accordingly, the Company’s degree of judgment exercised in determining fair value is greatest for instruments categorized in Level 3. In certain cases, the inputs used to measure fair value may fall into different levels of the fair value hierarchy. In such cases an asset or liability is classified in its entirety based on the lowest level of input that is significant to the measurement of fair value. Fair value is a market-based measure considered from the perspective of a market participant who holds the asset or owes the liability rather than an entity-specific measure. Therefore, even when market assumptions are not readily available, the Company’s own assumptions are set to reflect those that market participants would use in pricing the asset or liability at the measurement date. The Company uses prices and inputs that are current as of the measurement date, including periods of market dislocation. In periods of market dislocation, the observability of prices and inputs may be reduced for many instruments. This condition in the future may cause the Company’s financial instruments to be reclassified from Level 1 to Level 2 or from Level 2 to Level 3. During the years ended December 31, 2023, 2022 and 2021, the Company did not have any reclassifications in levels. The following table presents the valuation of the Company’s financial assets and liabilities as of December 31, 2023 and 2022 measured at fair value on a recurring basis. The fair value estimates presented herein are based on information available to management as of December 31, 2023 and 2022. These estimates are not necessarily indicative of the amounts the Company could ultimately realize. (in thousands) Level 1 Level 2 Level 3 December 31, 2023 Assets Interest rate swap agreements-short term $ — $ 4,482 $ — Interest rate swap agreements-long term — 986 — Total assets measured at fair value $ — $ 5,468 $ — Liabilities Acquisition-related contingent consideration-short term $ — $ — $ 6,850 Warrant liability — — 4,021 Total liabilities measured at fair value $ — $ — $ 10,871 (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 December 31, 2023 and 2022 were classified as Level 2 of the fair value hierarchy. See 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/loss in the Company’s consolidated statements of operations. At December 31, 2023 and 2022, contingent consideration liabilities of $6.9 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 years ended December 31, 2023 and 2022 is as follows (in thousands): Year Ended December 31 2023 Beginning Balance Additions Payments Change in Fair Value Other activity Ending Balance Contingent consideration - Level 3 liabilities $ 7,500 $ — $ (1,000) $ 350 $ — $ 6,850 Year Ended December 31 2022 Beginning Balance Additions Payments Change in Fair Value Other activity Ending Balance Contingent consideration - Level 3 liabilities $ 20,300 $ — $ (15,015) $ 2,215 $ — $ 7,500 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. See Note 11, 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 years ended December 31, 2023, 2022 and 2021, other than the non-cash goodwill impairment charge discussed in Note 5, Goodwill and Identifiable Intangible Assets , 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	12 Months Ended
	Dec. 31, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Instruments and Hedging Activities	Derivative Instruments and Hedging Activities FASB ASC Topic 815, Derivatives and Hedging (ASC 815), provides the disclosure requirements for derivatives and hedging activities with the intent to provide users of financial statements with an enhanced understanding of: (a) how and why an entity uses derivative instruments, (b) how the entity accounts for derivative instruments and related hedged items, and (c) how derivative instruments and related hedged items affect an entity’s financial position, financial performance, and cash flows. Further, qualitative disclosures are required that explain the Company’s objectives and strategies for using derivatives, as well as quantitative disclosures about the fair value of and gains and losses on derivative instruments, and disclosures about credit-risk-related contingent features in derivative instruments. As discussed in Note 6, Fair Value of Assets and Liabilities , and as required by ASC 815, the Company records all derivatives on its consolidated balance sheet at fair value. The accounting for changes in the fair value of derivatives depends on the intended use of the derivative, whether the Company has elected to designate a derivative in a hedging relationship and apply hedge accounting and whether the hedging relationship has satisfied the criteria necessary to apply hedge accounting. Derivatives designated and qualifying as a hedge of the exposure to variability in expected future cash flows, or other types of forecasted transactions, are considered cash flow hedges. Hedge accounting generally provides for the matching of the timing of gain or loss recognition on the hedging instrument with the recognition of the earnings effect of the hedged forecasted transactions in a cash flow hedge. The Company is exposed to certain risk arising from economic conditions. The Company principally manages its exposures to interest rate risk through the use of derivative financial instruments. Specifically, the Company enters into derivative financial instruments to manage differences in the amount, timing and duration of the Company’s known or expected cash payments principally related to the Company’s variable rate borrowings. The Company’s objectives in using interest rate derivatives are to add stability to interest expense and to manage its exposure to interest rate movements. To accomplish this objective, the Company primarily uses interest rate swaps as part of its interest rate risk management strategy. Interest rate swaps designated as cash flow hedges involve the receipt of variable amounts from a counterparty in exchange for the Company making fixed-rate payments over the life of the agreements without exchange of the underlying notional amount. For derivatives designated and that qualify as cash flow hedges of interest rate risk, the gain or loss on the derivative is recorded in accumulated other comprehensive income and subsequently reclassified into interest expense in the same period during which the hedged transaction affects earnings. Amounts reported in accumulated other comprehensive income related to derivatives will be reclassified to interest expense as interest payments are made on the Company’s variable-rate debt. In the twelve months subsequent to December 31, 2023, the Company estimates that an additional $4.9 million will be reclassified as a reduction to interest expense. As of December 31, 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 year ended December 31, 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(dd), Nature of Business - Recently Adopted Accounting Pronouncements , during the year ended December 31, 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 interest rate swap agreements that were outstanding as of December 31, 2023 was $250 million and have maturity dates in 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 the forward-dated interest rate swap agreements became effective in February 2023 and a portion will become effective in March 2024. The forward-dated interest rate swap agreements will mature in January 2026. The Company has designated its swaps as effective cash flow hedges of interest rate risk. Accordingly, changes in the fair value of the interest rate swaps are recorded as a component of accumulated other comprehensive income within stockholders’ equity and subsequently reclassified into interest expense in the same period during which the hedged transaction affects earnings. The table below presents the fair value of the Company’s derivatives related to its interest rate swap agreements, which are designated as hedging instruments, as well as their classification in the consolidated balance sheets at December 31, 2023 and 2022 (in thousands): December 31, 2023 December 31, 2022 Balance Sheet Location Asset Prepaid and other current assets $ 4,482 $ 5,748 Other assets 986 3,728 Total $ 5,468 $ 9,476 During the year ended December 31, 2023, as a result of the effect of cash flow hedge accounting, the Company recognized a loss, net of tax, of $2.5 million in other comprehensive income (loss)

Deferred Financing Costs

Deferred Financing Costs	12 Months Ended
	Dec. 31, 2023
Debt Issuance Costs, Net [Abstract]
Deferred Financing Costs	Deferred Financing Costs The change in the carrying amount of deferred financing costs for the years ended December 31, 2023 and 2022 was as follows (in thousands): Year Ended December 31, 2023 2022 Balance at beginning of period $ 28,229 $ 33,463 Amortization (5,234) (5,234) Balance at end of period $ 22,995 $ 28,229 Amortization expense relating to deferred financing costs was $5.2 million, $5.2 million and $5.4 million during the years ended December 31, 2023, 2022 and 2021, respectively, and is included in interest expense, net in the accompanying consolidated statements of operations. The December 31, 2023 balance of deferred financing costs of $23.0 million is estimated to be amortized to interest expense, net as follows (in thousands): Twelve months ending December 31, 2024 $ 5,234 2025 5,147 2026 3,659 2027 3,577 2028 3,139 Thereafter 2,239 $ 22,995

Accounts Payable and Accrued Ex

Accounts Payable and Accrued Expenses	12 Months Ended
	Dec. 31, 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 December 31, 2023 and 2022 consisted of the following (in thousands): December 31, December 31, Accounts payable $ 211,504 $ 222,505 Litigation settlement 57,340 — Employee-related accruals 47,462 41,872 Accrued interest 29,327 28,877 Other 46,361 44,244 Total $ 391,994 $ 337,498

Debt

Debt	12 Months Ended
	Dec. 31, 2023
Debt Disclosure [Abstract]
Debt	Debt The following is a summary of long-term debt as of December 31, 2023 and 2022 (in thousands): December 31, December 31, Secured term loan $ 720,000 $ 765,000 Senior unsecured notes 1,450,000 1,450,000 Unamortized deferred financing fees (22,018) (26,733) 2,147,982 2,188,267 Current portion (53,368) (35,000) Long-term portion $ 2,094,614 $ 2,153,267 Interest expense related to long-term debt agreements, including amortization of deferred financing costs and payments made or received under the Company’s interest rate swap agreements, for the years ended December 31, 2023, 2022 and 2021 was $131.0 million, $112.4 million and $97.9 million, respectively. 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. Borrowings under the 2021 Term Loan were used in part to partially finance the cash portion of the purchase price for the acquisition of AeroCare, to repay amounts outstanding under the Company’s then existing credit agreement of $301.9 million plus accrued interest, to repay amounts outstanding under revolving credit loans under the 2021 Credit Agreement which were borrowed prior to the April 2021 amendment, and to pay related fees and expenses. On March 31, 2023, the Company amended the 2021 Credit Agreement to change the base interest rate under the agreement from LIBOR 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, except in the case of Base Rate Loans (as defined), the sum of (a) the forward looking rate based on Term SOFR (subject to a zero percent floor) equal to Term SOFR plus a Term SOFR Adjustment (as defined) of 0.10%, 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). Prior to the March 31, 2023 amendment to the Company's credit agreement, the base 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. In connection with the 2021 Credit Agreement, the Company paid financing costs of $7.6 million. Further, in connection with executing the 2021 Credit Agreement, the Company recognized a loss on debt extinguishment of $2.1 million consisting of the write off of unamortized deferred financing costs related to the Company’s then existing credit agreement and other lender fees, which is included in Loss on extinguishment of debt in the accompanying consolidated statements of operations for the year ended December 31, 2021. On August 16, 2021, the Company amended the 2021 Credit Agreement to expressly permit the issuance of the 5.125% Senior Notes (see discussion below) and the prepayment of the outstanding principal amount under a then existing promissory note with the proceeds of the 5.125% Senior Notes. 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. There were no changes to these restrictive covenants in connection with the March 2023 amendment discussed above. The Company was in compliance with the applicable covenants in the aforementioned credit facility of December 31, 2023. 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 calculation of excess cash flow, as defined, if certain leverage tests are not met. As a result of the calculation of excess cash flow as of December 31, 2023, the Company is required to make a mandatory prepayment of $13.4 million. This amount is included in the current portion of long-term debt as of December 31, 2023 in the accompanying consolidated balance sheets, and the Company expects to make this payment by the end of March 2024. Secured Term Loan 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 December 31, 2023 and 2022, there was $720.0 million and $765.0 million, respectively, outstanding under the 2021 Term Loan. The interest rate under the 2021 Term Loan was 7.46% at December 31, 2023. Revolving Credit Facility During the year ended December 31, 2023, the Company borrowed $50 million under the 2021 Revolver, and repaid $50 million during the period. At December 31, 2023, there were no outstanding borrowings under the 2021 Revolver. During the year ended December 31, 2022, the Company had no borrowings under the 2021 Revolver, and there was no balance outstanding under the 2021 Revolver at December 31, 2022. Borrowings under the 2021 Revolver may be used for working capital and other general corporate purposes, including for capital expenditures and acquisitions permitted under the 2021 Credit Agreement. At December 31, 2023, based on the financial debt covenants under the 2021 Credit Agreement, the maximum amount the Company could borrow under the 2021 Revolver and remain in compliance with the financial debt covenants under the agreement was $226.2 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. 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. 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. 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. Note Payable In March 2019, the Company entered into a Note and Unit Purchase Agreement with an investor. Pursuant to the agreement, the Company issued a promissory note with a principal amount of $100 million (the Promissory Note). In November 2019, the Promissory Note was replaced with a new amended and restated promissory note with a principal amount of $100 million, and the investor converted certain of its members’ interests to a $43.5 million promissory note. The new $100 million promissory note, together with the $43.5 million promissory note, are collectively referred to herein as the New Promissory Note. During the year ended December 31, 2021, the Company repaid the outstanding principal balance of $143.5 million under the New Promissory Note. In connection with such repayment, the Company paid debt prepayment penalties of $16.2 million, reflecting the previously disclosed 10% prepayment penalty plus an incremental amount negotiated as part of the repayment transactions. In addition, the Company wrote off $2.0 million of unamortized deferred financing costs. The prepayment penalties and the write-off of the unamortized deferred financing costs are included in loss on extinguishment of debt in the accompanying consolidated statements of operations for the year ended December 31, 2021. The outstanding principal balance under the New Promissory Note bore interest at a rate of 12%. The future maturity of total debt, excluding unamortized deferred financing fees, at December 31, 2023 is as follows (in thousands). Twelve months ended December 31, 2024 $ 53,368 2025 40,000 2026 626,632 2027 — 2028 350,000 Thereafter 1,100,000 Total debt maturity $ 2,170,000

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2023
Equity [Abstract]
Stockholders' Equity	Stockholders' Equity AdaptHealth, f/k/a DFB Healthcare Acquisitions Corp. ("DFB"), was originally formed in November 2017 as a publicly traded special purpose acquisition company for the purpose of effecting a merger, capital stock exchange, asset acquisition, stock purchase, reorganization, or similar business combination involving one or more businesses. On July 8, 2019, AdaptHealth Holdings LLC ("AdaptHealth Holdings") entered into an Agreement and Plan of Merger (the "Merger Agreement"), as amended on October 15, 2019, with DFB, pursuant to which AdaptHealth Holdings combined with DFB (the "Business Combination"). The Business Combination closed on November 8, 2019. In connection with the Business Combination, the name of the combined company was changed to AdaptHealth Corp. Following the closing of the Business Combination, AdaptHealth Corp. owned 56% of the combined company with the remaining 44% owned by the former owners of AdaptHealth Holdings in the form of common units representing limited liability company interests in AdaptHealth Holdings from and after the closing of the Business Combination ("New AdaptHealth Units"). The former owners of AdaptHealth Holdings held New AdaptHealth Units and a corresponding number of non-economic Class B Common stock, which enabled the holder to one vote per share, and were exchangeable on a one-to-one basis for shares of Class A Common Stock. Subsequent to the Business Combination, all of the common unit interests of AdaptHealth Holdings and a corresponding number of shares of Class B Common Stock were exchanged for shares of Class A Common Stock, of which the final 13,218,758 of the exchanges occurred on January 1, 2021. As a result, the prior holders of the common unit interests of AdaptHealth Holdings no longer own a direct noncontrolling economic interest in AdaptHealth Holdings. In connection with the January 2021 exchanges, the Company recorded a decrease to the Noncontrolling interest in subsidiaries of $77.9 million in the accompanying consolidated statements of stockholders’ equity. The Company filed its Third Amended and Restated Certificate of Incorporation (the "Certificate of Incorporation") on July 28, 2021. Among other things, the Certificate of Incorporation (x) increased the authorized number of shares of Common Stock from 245,000,000 shares of Common Stock to 300,000,000 shares of Common Stock and (y) (i) deleted provisions no longer applicable following the exchange of all outstanding New AdaptHealth Units and shares of Class B Common Stock for shares of Class A Common Stock and (ii) renamed the Company’s Class A Common Stock to Common Stock. Holders of Common Stock are entitled to one vote for each share. The shares of Preferred Stock (see below) shall be issued with such designations, voting and other rights and preferences as may be determined from time to time by the Company’s board of directors. Common Stock In January 2021, the Company issued 8,450,000 shares of Class A Common Stock at a price of $33.00 per share pursuant to an underwritten public offering (the 2021 Stock Offering) for gross proceeds of $278.9 million. In connection with the 2021 Stock Offering, the Company received proceeds of $265.0 million, which is net of the underwriting discount. A portion of the proceeds from the 2021 Stock Offering were used to partially finance the cash portion of the purchase price for the acquisition of AeroCare, and to pay related fees and expenses. In connection with the 2021 Stock Offering, the Company paid offering costs, inclusive of the underwriting discount, of $13.8 million. Preferred Stock In June 2020, the Company entered into an exchange agreement ("the Exchange Agreement") with an investor pursuant to which the investor exchanged 15,810,547 shares of the Company’s Class A Common Stock for 158,105.47 shares of Series B-1 Preferred Stock, par value $0.0001 per share. The Series B-1 Preferred Stock liquidation preference is limited to its par value of $0.0001 per share. The Series B-1 Preferred Stock will participate equally and ratably on an as-converted basis with the holders of Common Stock in all cash dividends paid on the Common Stock. The Series B-1 Preferred Stock is non-voting. The holder may convert each share of Series B-1 Preferred Stock into 100 shares of Common Stock (subject to certain anti-dilution adjustments) at its election, except to the extent that following such conversion, the number of shares of Common Stock held by such holder and its affiliates exceed 4.9% of the outstanding Common Stock of the Company. During the year ended December 31, 2021, 39,500 shares of Series B-1 Preferred Stock were converted into 3,950,000 shares of Common Stock. There were no such conversions during the years ended December 31, 2023 and 2022. As discussed in Note 3, Acquisitions , the Company issued 130,474.73 shares of Series C Convertible Preferred Stock in connection with the acquisition of AeroCare. The Series C Convertible Preferred Stock liquidation preference was limited to its par value of $0.0001 per share. The Series C Convertible Preferred Stock participated equally and ratably on an as-converted basis with the holders of Common Stock in all potential cash dividends paid on the Common Stock. The Series C Convertible Preferred Stock was non-voting. On March 3, 2021, the Company’s stockholders approved, for purposes of complying with Nasdaq Listing Rule 5635, the issuance of shares of the Company’s Common Stock, representing equal to or greater than 20% of the outstanding common stock or voting power of the Company issuable upon conversion of the Series C Convertible Preferred Stock issued to the former equity holders of AeroCare, by removal of the conversion restriction that prohibits such conversion of Series C Convertible Preferred Stock. Following the receipt of the approval of the Company’s stockholders, the holders were able to elect to convert, and the Company was able to elect to effect a mandatory conversion of, each share of Series C Convertible Preferred Stock into 100 shares of Common Stock (subject to certain anti-dilution adjustments). The Company elected to effect a mandatory conversion of the Series C Convertible Preferred Stock, and the conversion of 130,474.73 shares of Series C Convertible Preferred Stock to 13,047,473 shares of Common Stock occurred on March 18, 2021. Treasury Stock 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, which expired on December 31, 2023 (the "Share Repurchase Program"). The timing and actual number of shares repurchased depended upon market conditions and other factors. Shares of the Company's Common Stock were repurchased from time to time on the open market, through privately negotiated transactions or otherwise. During the years ended December 31, 2023 and 2022, the Company purchased 3,184,200 and 750,835 shares of the Company's Common Stock, respectively, for $29.3 million and $14.0 million, respectively, under the Share Repurchase Program, which is reflected in Treasury Stock in the accompanying consolidated statements of stockholders' equity. Warrants At the closing of the Business Combination, the Company had 12,666,666 warrants outstanding. Each warrant is exercisable into one share of Common Stock at a price of $11.50 per share. The exercise price and number of shares of Common Stock issuable upon exercise of the warrants may be adjusted in certain circumstances including in the event of a share dividend, or recapitalization, reorganization, merger or consolidation. However, the warrants will not be adjusted for the issuance of common stock at a price below its exercise price. There were no warrants exercised during the year ended December 31, 2023. During the year ended December 31, 2022, 184,870 warrants were exercised in cashless transactions resulting in the issuance of 87,553 shares of Common Stock. During the year ended December 31, 2021, 224,121 warrants were exercised in a cashless transaction resulting in the issuance of 118,379 shares of Common Stock. As of December 31, 2023, the Company had 3,871,557 warrants outstanding, which have an expiration date of November 20, 2024. The Company classifies its warrants as a liability in its consolidated balance sheets because of certain terms included in the corresponding warrant agreement. The estimated fair value of the warrants is recorded as a liability, with such fair value reclassified to stockholders’ equity upon the exercise of such warrants. Prior to exercise, the change in the estimated fair value of such warrants each period is recognized as a non-cash charge or gain in the Company’s consolidated statements of operations. A reconciliation of the changes in the warrant liability during the years ended December 31, 2023, 2022 and 2021 was as follows (in thousands): Estimated fair value of warrant liability at December 31, 2020 $ 113,905 Change in estimated fair value of the warrant liability (53,181) Reclassification of warrant liability to equity for exercised warrants (2,960) Estimated fair value of warrant liability at December 31, 2021 57,764 Change in estimated fair value of the warrant liability (17,158) Reclassification of warrant liability to equity for exercised warrants (2,103) Estimated fair value of warrant liability at December 31, 2022 38,503 Change in estimated fair value of the warrant liability (34,482) Estimated fair value of warrant liability at December 31, 2023 $ 4,021 The warrant liability is classified as a current liability at December 31, 2023 in the accompanying consolidated balance sheets since the expiration date of the warrants is less than one year as of such date. Contingent Consideration Common Shares Pursuant to the Merger Agreement, the former owners of AdaptHealth Holdings who received Class A Common Stock and Class B Common Stock in connection with the Business Combination were entitled to receive earn-out consideration to be paid in the form of Common Stock, if the average price of the Company’s Common Stock for the month of December prior to each measurement date equaled or exceeded certain hurdles set forth in the Merger Agreement (Contingent Consideration Common Shares). The former owners of AdaptHealth Holdings were entitled to receive 1,000,000 shares of Common Stock on each of December 31, 2022, 2021, and 2020 based on an average stock price hurdle of $22, $18 and $15, respectively, during the applicable measurement period. The average stock price hurdle was achieved for the applicable measurement periods as of the December 31, 2021 and 2020 measurement dates, which triggered the issuance of 1,000,000 shares of Common Stock on such dates. The average stock price hurdle was not achieved for the applicable measurement period as of the December 31, 2022 measurement date; as such no shares of Common Stock were issued on such date. The Contingent Consideration Common Shares would have been issued immediately in the event of a change of control as defined in the Merger Agreement. The estimated fair value of the Contingent Consideration Common Shares was recorded as a liability in the Company’s consolidated balance sheets, with such fair value reclassified to stockholders’ equity upon the issuance of any shares that were earned. Prior to issuance, the change in the estimated fair value of such shares each period was recognized as a non-cash charge or gain in the Company’s consolidated statements of operations. The Company estimated the fair value of the contingent consideration common shares liability using a Monte-Carlo simulation analysis. A Monte-Carlo simulation is a tool used to project asset prices based on a widely accepted drift calculation, the volatility of the asset, incremental time-steps and a random component known as a Weiner process that introduces the dynamic behavior in the asset price. In this framework, asset prices follow a log-normal distribution as they fluctuate through time, which the simulation process captures. A specific model can be developed around the projected stock price to capture the effects of any market performance conditions on value. Price path specific conditions can be captured in this type of open form model. The Monte-Carlo process expresses potential future scenarios that when simulated thousands of times can be viewed statistically to ascertain fair value. The contingent consideration common shares contain market conditions to determine whether the shares are earned based on the Company’s Common Stock price during specified measurement periods. Given the path-dependent nature of the requirement in which the shares are earned, a Monte-Carlo simulation was used to estimate the fair value of the liability. The Company’s Common Stock price was simulated to each measurement period based on the methodology described above. In each iteration, the simulated stock price was compared to the conditions under which the shares are earned. In iterations where the stock price corresponded to shares being earned, the future value of the earned shares was discounted back to present value. The fair value of the liability was estimated based on the average of all iterations of the simulation. As discussed above, on each of December 31, 2021 and 2020, 1,000,000 shares of Common Stock were issued in connection with the portion of the Contingent Consideration Common Shares which were earned as of such dates. As a result, the estimated fair value related to such shares was reclassified to stockholders’ equity in the periods in which they were earned, with such shares reflected as issued and outstanding Common Stock. In accordance with U.S. GAAP, the estimated fair value related to the remaining 1,000,000 Contingent Consideration Common Shares was reclassified to stockholders’ equity at December 31, 2021. Since the fair value of these shares was reclassified to stockholders’ equity on December 31, 2021, these shares were no longer liability classified as of such date and therefore the changes in the estimated fair value of such shares were not recognized in the Company’s consolidated statements of operations subsequent to December 31, 2021. As of December 31, 2021, the Company recorded a deferred tax asset of $1.6 million in connection with the accounting for the Contingent Consideration Common Shares. As discussed above, the estimated fair value related to the unearned Contingent Consideration Common Shares was reclassified to stockholders’ equity as of December 31, 2021 and was settled without share issuance as of December 31, 2022 . Correspondingly, the Company reversed the $1.6 million deferred tax asset for the Contingent Consideration Common Shares through a reduction to Additional-paid-in capital during the year ended December 31, 2022. A reconciliation of the changes in the contingent consideration common shares liability related to the Contingent Consideration Common Shares during the year ended December 31, 2021 was as follows (in thousands): Estimated fair value of contingent consideration common shares liability at December 31, 2020 $ 70,477 Change in estimated fair value of the contingent consideration common shares liability (29,389) Reclassification of contingent consideration common shares liability to equity (41,088) Estimated fair value of contingent consideration common shares liability at December 31, 2021 $ — Equity-based Compensation In connection with the Company’s 2019 Stock Incentive Plan (the "2019 Plan"), the Company provides equity-based compensation to attract and retain employees while also aligning employees’ interest with the interests of its stockholders. The 2019 Plan permits the grant of various equity-based awards to selected employees and non-employee directors. The 2019 Plan permits the grant of up to 10,000,000 shares of Common Stock, subject to certain adjustments and limitations. At December 31, 2023, 1,039,484 shares of the Company’s Common Stock were available for issuance under the 2019 Plan. Stock Options In January 2021, the Company granted 703,170 options to purchase shares of the Company’s Common Stock to certain senior executives of the Company. The options vest ratably over a three-year period from the date of grant based on a service condition and have a contractual exercise period of five years from the date of grant. The total grant-date fair value of the options granted, using a Black-Scholes option pricing model, was $6.9 million. During the year ended December 31, 2021, 234,390 of the options from this grant were forfeited as a result of the resignation of the Company’s former Co-CEO (see discussion below). In November 2019, the Company granted 3,416,666 options to purchase shares of Common Stock of the Company to certain senior management employees that have an exercise price of $11.50 per share and a contractual exercise period of ten years from the date of grant. The grant-date fair value of the awards, using a Black-Scholes option pricing model, was $7.2 million. In April 2020, the Company granted 47,335 options to purchase shares of Common Stock of the Company to an employee that had an exercise price of $16.25 per share. The grant-date fair value of the awards, using a Black-Scholes option pricing model, was $0.3 million. The vesting conditions relating to the total 3,464,001 options included a defined performance condition with a measurement period during the year ended December 31, 2020 which was satisfied, and also a service condition. In June 2021, in connection with the resignation of the Company’s former Co-CEO (see discussion below), the Company accelerated the vesting of 184,932 options. In connection with the accelerated vesting, the Company recognized $1.9 million of equity-based compensation expense, which is included in general and administrative expenses during the year ended December 31, 2021 in the accompanying consolidated statements of operations. Of the total options granted, 722,222, 722,222 and 1,154,667 options vested on December 31, 2022, 2021 and 2020 respectively. In addition, 679,958 options were forfeited during the year ended December 31, 2021, primarily relating to the resignation of the Company’s former Co-CEO. On April 13, 2021, the Company placed its then Co-Chief Executive Officer, Luke McGee, on unpaid leave while a matter relating to his past private activity was pending. On April 20, 2021, the Company’s board of directors unanimously approved the formation of a Special Committee of Board members to conduct a full investigation of Mr. McGee’s alleged personal conduct. In addition, the Company’s board of directors also approved the retention of an independent law firm to assist the Special Committee in facilitating the investigation. Mr. McGee had no role in, and was entirely recused from, the investigation. On June 11, 2021, the independent law firm reported to the Special Committee that the investigation was substantially complete and that they could state with a high degree of confidence that the Company had no involvement in, or connection to, Mr. McGee’s alleged conduct. The investigation was completed in October 2021 resulting in no changes to the findings communicated in June 2021. On June 14, 2021, the Company and Mr. McGee agreed that Mr. McGee would resign from his positions as Co-CEO and a Director of the Company effective as of June 11, 2021. In connection with Mr. McGee’s resignation, the Company accelerated the vesting of certain unvested stock options as discussed above, and also accelerated the vesting of certain unvested shares of restricted stock (see discussion below). Other than the accelerated vesting of the stock options and shares of restricted stock, and back pay paid to Mr. McGee relating to his unpaid base wages from April 13, 2021 to June 11, 2021, no other compensation was paid to Mr. McGee in connection with his resignation. There were no stock options granted during the years ended December 31, 2023 and 2022. The assumptions used to determine the grant-date fair value of the stock options granted during the year ended December 31, 2021 were as follows: Year Ended December 31, 2021 Expected volatility 44.5 % Risk-free interest rate 0.2 % Expected term 4.0 years Dividend yield N/A The following table provides the activity regarding the Company’s outstanding stock options during the years ended December 31, 2023, 2022 and 2021 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, 2020 3,464 $ 2.18 $ 11.56 Granted 703 $ 9.81 $ 48.72 Exercised (1,034) $ 2.19 $ 11.57 Forfeited (914) $ 2.27 $ 11.66 Outstanding, December 31, 2021 2,219 $ 3.75 $ 19.36 Activity - none — Outstanding, December 31, 2022 2,219 $ 3.75 $ 19.36 Activity - none — Outstanding, December 31, 2023 2,219 $ 3.75 $ 19.36 5.1 Years The following table provides the activity for all outstanding stock options during the years ended December 31, 2023, 2022 and 2021 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Outstanding, December 31, 2020 3,464 $ 11.56 Granted 703 $ 48.72 Issued in connection with the AeroCare acquisition 3,960 $ 6.24 Exercised (1,447) $ 10.16 Forfeited (914) $ 11.66 Outstanding, December 31, 2021 5,766 $ 11.26 Exercised (804) $ 5.69 Outstanding, December 31, 2022 4,962 $ 12.19 Exercised (1,553) $ 6.24 Outstanding, December 31, 2023 3,409 $ 14.90 4.9 Years During the year ended December 31, 2023 , 211,185 stock options were exercised resulting in $0.6 million of cash proceeds received by the Company and the issuance of 211,185 shares of the Company's Common Stock. Also, during the year ended December 31, 2023, 1,341,770 stock options were exercised in cashless transactions resulting in the issuance of 228,466 shares of the Company's Common Stock. During the year ended December 31, 2022, 489,191 stock options were exercised resulting in $2.5 million of cash proceeds received by the Company and the issuance of 489,191 shares of the Company's Common Stock. Additionally, during the year ended December 31, 2022, 315,349 stock options were exercised in cashless transactions resulting in the issuance of 131,741 shares of Common Stock. During the year ended December 31, 2021, 1,138,982 stock options were exercised resulting in $12.3 million of cash proceeds received by the Company. Additionally, during the year ended December 31, 2021, 307,613 stock options were exercised in cashless transactions resulting in the issuance of 133,126 shares of Common Stock. The following table provides the activity for exercisable stock options during the years ended December 31, 2023, 2022, and 2021 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Exercisable, December 31, 2020 1,155 $ 11.56 Issued in connection with the AeroCare acquisition 3,960 $ 6.24 Vested 907 $ 11.50 Exercised (1,447) $ 10.16 Exercisable, December 31, 2021 4,575 $ 7.39 Vested 878 $ 18.12 Exercised (804) $ 5.69 Exercisable, December 31, 2022 4,649 $ 9.73 Vested 234 $ 48.72 Exercised (1,553) $ 6.24 Exercisable, December 31, 2023 3,330 $ 14.10 4.9 Years The following table provides the activity for unexercisable stock options during the years ended December 31, 2023, 2022 and 2021 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Unexercisable, December 31, 2020 2,309 $ 11.56 Granted 703 $ 48.72 Vested (907) $ 11.50 Forfeited (914) $ 11.66 Unexercisable, December 31, 2021 1,191 $ 26.15 Vested (878) $ 18.12 Unexercisable, December 31, 2022 313 $ 48.72 Vested (234) $ 48.72 Unexercisable, December 31, 2023 79 $ 48.72 2.1 Years Restricted Stock During the year ended December 31, 2023, the Company granted the following shares of restricted stock: • 732,810 shares 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 $9.3 million. • 58,795 shares to various employees which vested immediately on the grant date. The grant-date fair value of these awards was $0.5 million. • 139,190 shares to its non-employee directors, which vest one year following the grant date. The grant-date fair value of these awards was $1.4 million. • 53,732 shares to its interim CEO, which vest on the two-month anniversary following the grant date. The grant-date fair value of these awards was $0.5 million. • 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. The payout of shares on the vesting date are as follows based on the Company’s Relative TSR versus the Peer Group (for performance between the stated goals noted below, straight-line interpolation will be applied): ◦ Less than 25th Percentile – No payout ◦ Greater than or equal to 25th Percentile – 50% of Performance RSUs ◦ Equal to 50th Percentile – 100% of Performance RSUs ◦ Greater than or equal to 75th Percentile – 200% of Performance RSUs During the year ended December 31, 2022, the Company granted the following shares of restricted stock: • 562,686 shares to various employees which vest ratably over the three • 81,347 shares to its non-employee directors, which vest one year following the grant date. The grant-date fair value of these awards was $1.5 million. • 317,554 shares of Performance RSUs to senior executive management of the Company which will vest on the third anniversary of the grant date subject to the achievement of specified goals relative to the Company’s three-year Relative TSR performance versus the Company’s Peer Group, and is also subject to the employees’ continuous employment through the vesting date. The grant-date fair value of these awards, using a Monte-Carlo simulation analysis, was $8.7 million. The payout of shares on the vesting date are as follows based on the Company’s Relative TSR versus the Peer Group (for performance between the stated goals noted below, straight-line interpolation will be applied): ◦ Less than 25th Percentile – No payout ◦ Greater than or equal to 25th Percentile – 50% of Performance RSUs ◦ Equal to 50th Percentile – 100% of Performance RSUs ◦ Greater than or equal to 75th Percentile – 200% of Performance RSUs During the year ended December 31, 2021, the Company granted the following shares of restricted stock: • 1,266,846 shares to various employees which vest ratably over the three • 87,500 shares to various employees and non-employee directors which vest ratably over the one-year period following the grant dates. The grant-date fair value of these awards was $2.0 million. • 70,634 fully vested shares of Common Stock to various employees which had a grant-date fair value of $2.4 million. During the year ended December 31, 2021, in connection with the resignation of the Company’s former Co-CEO, the Company accelerated the vesting of 22,192 shares of restricted stock that were granted in November 2019, and the remaining 77,808 unvested shares from the November 2019 grant were forfeited. In connection with the accelerated vesting of the 22,192 shares, the Company recorded $0.5 million of equity-based compensation expense, which is included in general and administrative expenses during the year ended December 31, 2021 in the accompanying consolidated statements of operations. Activity related to the Company’s non-vested restricted stock grants for the years ended December 31, 2023, 2022 and 2021 is presented below (in thousands, except per share data): Number of Shares of Weighted-Average Grant Date Non-vested balance, December 31, 2020 2,248 $ 15.60 Granted 1,354 $ 28.92 Vested (556) $ 14.03 Forfeited (851) $ 17.64 Non-vested balance, December 31, 2021 2,195 $ 19.58 Granted 962 $ 21.26 Vested (700) $ 19.99 Forfeited (196) $ 20.60 Non-vested balance, December 31, 2022 2,261 $ 23.90 Granted 1,311 $ 13.85 Vested (1,063) $ 19.59 Forfeited (441) $ 25.95 Non-vested balance, December 31, 2023 2,068 $ 19.16 Incentive Units AdaptHealth Holdings granted Incentive Units in June 2019 (the "2019 Incentive Units") to certain members of management. The 2019 Incentive Units were intended to constitute profits interests and were granted for purposes of enabling such individuals to participate in the long-term growth and financial success of the Company and were issued in exchange for services to be performed. The grant date fair value of the 2019 Incentive Units, as calculated under an Option Pricing Method, was $4.5 million. With respect to the 2019 Incentive Units, 50% of the awards were scheduled to vest in equal annual installments on each of the first four Equity-Based Compensation Expense The table below presents the equity-based compensation expense recognized during the years ended December 31, 2023, 2022 and 2021, as well the classification of amounts in the consolidated statements of operations (in thousands): Year Ended December 31, 2023 2022 2021 General and administrative expense $ 19,586 $ 15,760 $ 18,021 Cost of net revenue $ 2,882 $ 6,637 $ 7,302 Total $ 22,468 $ 22,397 $ 25,323 The Company recognized an increase to income tax expense of $0.6 million for the year ended December 31, 2023 as a result of a shortfall associated with equity-based compensation. The Company recognized a reduction to income tax expense of $2.1 million and $4.6 million for the years ended December 31, 2022 and 2021, respectively, as a result of excess tax benefits associated with equity-based compensation. At December 31, 2023, there was $21.1 million of unrecognized compensation expense related to equity-based compensation awards, which is expected to be recognized over a weighted-average period of 1.7 years. 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 at the Company's annual shareholder meeting. 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 year ended December 31, 2023.

Earnings (Loss) Per Share

Earnings (Loss) Per Share	12 Months Ended
	Dec. 31, 2023
Earnings Per Share [Abstract]
Earnings (Loss) Per Share	Earnings (Loss) Per Share Earnings Per Share ("EPS") is computed by dividing net (loss) income by the weighted average number of common shares outstanding during the period on a basic and diluted basis. The Company computes diluted net (loss) 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, unvested restricted stock, outstanding stock options and outstanding preferred stock. See Note 11, Stockholders’ Equity , for additional discussion of these potential dilutive securities. Diluted net (loss) 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 (loss) income per share. Computation of diluted net (loss) 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 (loss) income per share were as follows (in thousands, except per share data): Year Ended December 31, 2023 2022 2021 Numerator Net (loss) income attributable to AdaptHealth Corp. $ (678,895) $ 69,316 $ 156,175 Less: Earnings allocated to participating securities (1) — 5,867 14,379 Net (loss) income for basic EPS $ (678,895) $ 63,449 $ 141,796 Change in fair value of warrant liability (2) (34,482) (17,158) (53,181) Net (loss) income for diluted EPS $ (713,377) $ 46,291 $ 88,615 Denominator (1) (2) Basic weighted-average common shares outstanding 134,156 134,175 126,306 Add: Warrants (2) 262 1,528 2,377 Add: Stock options — 2,512 3,782 Add: Unvested restricted stock — 773 569 Diluted weighted-average common shares outstanding 134,418 138,988 133,034 Basic net (loss) income per share $ (5.06) $ 0.47 $ 1.12 Diluted net (loss) income per share $ (5.31) $ 0.33 $ 0.67 (1) The Company's preferred stock are considered participating securities. Computation of EPS under the two-class method excludes from the numerator any dividends paid or owed on participating securities and any undistributed earnings considered to be attributable to participating securities. The related participating securities are similarly excluded from the denominator. There was no amount allocated to the participating securities during the year ended December 31, 2023 due to the net loss reported in that period. (2) For the years ended December 31, 2023, 2022 and 2021, the impact to earnings from the change in fair value of the Company’s warrant liability is excluded from the numerator, and the corresponding security is included in the denominator, for purposes of computing diluted net (loss) income per share. This adjustment is included as the effect of the numerator and denominator adjustments for this derivative instrument is dilutive as a result of the non-cash gains recorded for the change in fair value of this instrument during those periods. Due to the Company reporting a net loss attributable to AdaptHealth Corp. for the year ended December 31, 2023, all potentially dilutive securities related to unvested restricted stock and outstanding stock options were excluded from the computation of diluted net loss per share for that period as their inclusion would have been anti-dilutive. The table below provides the weighted-average number of potential common shares associated with outstanding securities not included in the Company’s computation of diluted net (loss) income per share for the years ended December 31, 2023, 2022 and 2021 because to do so would be antidilutive (in thousands): Year Ended December 31, 2023 2022 2021 Preferred Stock 12,406 12,406 12,808 Warrants — — — Stock Options 3,409 469 — Unvested restricted stock 1,993 — — Total 17,808 12,875 12,808

Leases

Leases	12 Months Ended
	Dec. 31, 2023
Leases [Abstract]
Leases	Leases The Company leases its operating locations and office facilities under noncancelable lease agreements which expire at various dates through May 2038. 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 December 31, 2023 and 2022 (in thousands): December 31, Consolidated Balance Sheets Line Item 2023 2022 Right-of-use ("ROU") assets: Operating lease ROU assets Operating lease right-of-use assets $ 110,465 $ 129,506 Finance lease ROU assets Finance lease right-of-use assets 31,962 5,423 Finance lease ROU assets Equipment and other fixed assets, net — 103 Total ROU assets $ 142,427 $ 135,032 Operating lease liabilities: Current operating lease liabilities Current portion of operating lease obligations $ 29,270 $ 30,001 Noncurrent operating lease liabilities Operating lease obligations, less current portion 85,529 104,394 Total operating lease liabilities $ 114,799 $ 134,395 Finance lease liabilities: Current finance lease liabilities Current portion of finance lease obligations $ 9,122 $ 2,211 Noncurrent finance lease liabilities Finance lease obligations, less current portion 22,746 3,950 Total finance lease liabilities $ 31,868 $ 6,161 The following table presents information about lease costs and expenses and sublease income for the years ended December 31, 2023 and 2022 (in thousands). The amounts below, with the exception of interest on lease liabilities, are included in cost of net revenue in the accompanying consolidated statements of operations for the periods presented. The interest on lease liabilities is included in interest expense, net in the accompanying consolidated statements of operations for the periods presented. Year Ended December 31, 2023 2022 2021 Operating lease costs $ 38,365 $ 37,822 $ 37,043 Finance lease costs: Reduction of ROU assets $ 5,761 $ 8,246 $ 33,689 Interest on lease liabilities $ 1,058 $ — $ — Other lease costs and income: Variable leases costs (1) $ 20,769 $ 17,758 $ 14,030 Sublease income $ 1,427 $ 1,380 $ 1,239 (1) Amounts represent variable costs incurred that were not included in the initial measurement of the lease liability such as common area maintenance and utilities costs associated with leased real estate. The following table provides the weighted average remaining lease terms and weighted average discount rates for the Company’s leases as of December 31, 2023 and 2022: December 31, 2023 2022 Weighted average remaining lease term, weighted based on lease liability balances: Operating leases 5.6 years 6.2 years Finance leases 3.6 years 3.7 years Weighted average discount rate, weighted based on remaining balance of lease payments: Operating leases 4.4 % 3.9 % Finance leases 6.7 % 3.5 % The following table provides the undiscounted amount of future cash flows related to the Company's operating and finance leases, as well as a reconciliation of such undiscounted cash flows to the amounts included in the Company’s lease liabilities as of December 31, 2023 (in thousands): Operating Leases Finance Leases 2024 $ 33,335 $ 10,782 2025 28,111 10,129 2026 20,306 9,095 2027 13,560 5,612 2028 10,634 44 Thereafter 24,217 — Total future undiscounted leases payments $ 130,163 $ 35,662 Less: amount representing interest (15,364) (3,794) Present value of future lease payments (lease liability) $ 114,799 $ 31,868 The following table provides certain cash flow and supplemental non-cash information related to the Company's lease liabilities for the years ended December 31, 2023 and 2022 (in thousands): Year Ended December 31, 2023 2022 2021 Cash paid for amounts included in the measurement of lease liabilities: Operating cash payments for operating leases $ 38,328 $ 37,486 $ 36,510 Financing cash payments for finance leases $ 6,769 $ 16,176 $ 42,164 Lease liabilities arising from obtaining right-of-use assets: Operating leases $ 22,000 $ 22,543 $ 91,420 Finance leases $ 32,101 $ 5,423 $ 22,959

Retirement Plans

Retirement Plans	12 Months Ended
	Dec. 31, 2023
Retirement Benefits [Abstract]
Retirement Plans	Retirement Plans At December 31, 2023, the Company had a single consolidated retirement plan (the "AdaptHealth Plan"). The AdaptHealth Plan allows employees to contribute up to the annual limitation imposed by the Internal Revenue Code. The Company makes matching contributions to the AdaptHealth Plan. During the years ended December 31, 2023, 2022, and 2021, the Company recorded matching contribution expense of $5.6 million, $4.7 million, and $2.9 million, respectively, related to the AdaptHealth Plan.

Self-Insured Plans

Self-Insured Plans	12 Months Ended
	Dec. 31, 2023
Self Insured Plans
Self-Insured Plans	Self-Insured Plans The Company was self-insured for its employees’ medical, auto and workers’ compensation claims during 2023, 2022 and 2021. The Company purchased medical stop loss insurance that covers the excess of each specific loss over $300,000 in 2023 and 2022, and $225,000 in 2021. In 2023, 2022 and 2021, the Company purchased workers’ compensation stop loss insurance which has occurrence-based limits that vary by state based on statutory rules. The Company is subject to an aggregate annual limit. Self-insurance reserves include estimates of both known claims filed and estimates of claims incurred but not reported. The Company uses historical paid claims information to estimate its claims liability. The liability for self-insurance reserves was $19.0 million and $15.6 million as of December 31, 2023 and 2022, respectively. This liability is included within accounts payable and accrued expenses in the accompanying consolidated balance sheets.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 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. If there is no probable estimate within a range of reasonably possible outcomes, the Company’s policy is to record at the low end of the range of such reasonably possible outcomes. 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, except as disclosed below. 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. Professional legal fees are expensed as they are incurred. 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 cooperated with the investigation and 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 sought 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 requested documents related to such oxygen tank content billing as well as other categories of information. AeroCare cooperated fully with the investigation and 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 for alleged violations of the federal securities laws arising from allegedly false and misleading statements and/or failures to disclose material information regarding changes made to the methodology used to calculate the Company’s organic growth trajectory. On October 14, 2021, the court appointed Delaware County Employees Retirement System and the Bucks County Employees Retirement System as Lead Plaintiffs. On November 22, 2021, Lead Plaintiffs filed a consolidated complaint against the Company and certain of its current and former officers and directors on behalf of shareholders that purchased or otherwise acquired the Company’s stock and options between November 8, 2019 and July 16, 2021 (as to the complaint, the “Consolidated Complaint”; as to the action, the “Consolidated Class Action”). The Consolidated Complaint generally alleges that the defendants violated federal securities laws by making allegedly false and misleading statements and/or failing to disclose material information regarding changes made to the methodology used to calculate the Company’s organic growth trajectory and the Company’s former Co-CEO’s alleged tax fraud arising from certain past private activity. The Consolidated Complaint seeks unspecified damages. On January 20, 2022, the defendants filed a motion to dismiss the Consolidated Complaint, which the court denied on June 9, 2022. On June 7, 2023, the court entered an order staying the Consolidated Class Action pending the outcome of a private mediation between the parties. On February 26, 2024, defendants entered into a stipulation and agreement of settlement with the Lead Plaintiffs. The Company’s portion of the proposed settlement is expected to be funded as follows (i) $32.2 million of cash from the Company’s insurance carriers; (ii) $17.8 million of cash from the Company; and (iii) 1 million shares of the Company’s Common Stock (the “Settlement Shares”). In addition, as part of the proposed settlement, the Company has agreed to the implementation of certain corporate governance reforms. At December 31, 2023, the Company recorded a liability of $57.3 million, consisting of the aggregate cash payments of $50.0 million and the fair value of the Settlement Shares, which was determined to be $7.3 million; such liability is included in accounts payable and accrued expenses in the accompanying consolidated balance sheets. In addition, at December 31, 2023, the Company recorded a receivable of $32.2 million, representing the amount to be received from the Company’s insurance carriers, which is included in prepaid expenses and other current assets in the accompanying consolidated balance sheets. For the year ended December 31, 2023, the Company recorded a pre-tax expense of $25.1 million associated with the proposed settlement, which is included in other loss, net in the accompanying consolidated statements of operations. The Company anticipates that the Settlement Shares will be issued from available Treasury Stock. Upon issuance of the Settlement Shares, $7.3 million will be reclassified from liabilities to stockholders' equity. The proposed settlement is subject to preliminary and final Court approval and other customary closing conditions. Upon the effectiveness of the proposed settlement, the Company and its directors and officers as well as the other defendants named in the Consolidated Complaint will be released from the claims that were asserted or could have been asserted in the Consolidated Class Action, with certain limitations, by class members participating in the settlement. The Company has always maintained, and continues to believe, that it did not engage in any wrongdoing or otherwise commit any violation of federal or state securities laws or other laws. The settlement includes no admission of liability or wrongdoing and is subject to court approval. There can be no assurance that the settlement will be finalized and approved and, even if approved, whether the conditions to closing will be satisfied, and the actual outcome of this matter may differ materially from the terms of the settlement described herein. The Company has also reached an agreement in principle with its directors and officers liability insurers to resolve a proceeding that the Company filed in Delaware Superior Court concerning coverage in connection with the Consolidated Class Action and the Derivative Action discussed immediately below. The proposed settlement will exhaust $35.0 million in D&O coverage limits available to the Company for the policy period from November 8, 2020 to November 8, 2021. There can be no assurance that the settlement will be finalized or the conditions to closing will be satisfied, and the actual outcome of this matter may differ materially from the terms of the settlement described herein 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 (as to the complaint, the “Derivative Complaint”; as to the action, the “Derivative Action”). The Derivative Complaint generally alleges that the defendants breached their fiduciary duties owed to the Company by, among other things, allegedly causing or allowing misrepresentations and/or omissions regarding changes made to the methodology used to calculate the Company’s organic growth and the Company’s former Co-CEO’s alleged criminal activity 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 to the Derivative Action stipulated to stay the Derivative Action pending final resolution of the Consolidated Class Action. On March 7, 2022, the court so-ordered the parties’ stipulation. The defendants have reached an agreement in principle with the derivative plaintiff to settle the Derivative Action. The settlement, which would include no admission of liability or wrongdoing by the defendants, is subject to negotiation and execution of definitive settlement documentation and court approval. The proposed settlement consideration would consist of certain corporate governance reforms and reasonable attorneys’ fees, at an amount to later be determined, to be approved by the court. Upon the effectiveness of the proposed settlement, the Company and its directors and officers as well as the other defendants named in the Derivative Complaint would be released from the claims that were asserted or could have been asserted in the Derivative Complaint. The proposed settlement is subject to court approval and other customary closing conditions. There can be no assurance that the settlement will be finalized and approved and, even if approved, whether the conditions to settlement will be satisfied, and the actual outcome of this matter may differ materially from the terms of the settlement described herein. 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 stage of the investigation, it is not possible to determine whether it will have a material adverse effect on the Company. On October 24, 2023, Allegheny County Employees’ Retirement System, a purported shareholder of the Company, filed a purported class action complaint against the Company and certain of its current and former officers, and certain underwriters in the United States District Court for the Eastern District of Pennsylvania (the “Allegheny County Complaint”). The Allegheny County Complaint purports to be asserted on behalf of a class of persons who purchased the Company’s stock between August 4, 2020 and February 27, 2023. The Allegheny County Complaint alleges, among other things, that the defendants violated federal securities laws by making allegedly false and misleading statements and/or failing to disclose material information regarding the Company’s organic growth in its diabetes business. The Allegheny County Complaint seeks unspecified damages. On January 23, 2024, the court entered an order appointing Allegheny County Employees' Retirement System, International Union of Operating Engineers, Local No. 793, Members Pension Benefit Trust of Ontario, and City of Tallahassee Pension Plan as Lead Plaintiffs. On February 6, 2024, the parties filed a joint stipulation outlining proposed deadlines for Lead Plaintiffs to identify an operative complaint or file an amended or consolidated complaint and for defendants to respond to the operative complaint. The Company intends to vigorously defend against the allegations contained in the Allegheny County Complaint, but there can be no assurance that the defense will be successful.

Related Party Transactions

Related Party Transactions	12 Months Ended
	Dec. 31, 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 $11.3 million, $7.0 million and $4.9 million for the years ended December 31, 2023, 2022 and 2021, respectively. The Company accounts for this investment under the cost method of accounting based on its level of equity ownership. As of December 31, 2023 and 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 years ended December 31, 2023, 2022 and 2021. As of December 31, 2023 and 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 December 31, 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 approximately $24.2 million, $80.3 million, and $12.3 million during the years ended December 31, 2023, 2022 and 2021, respectively. As of December 31, 2023 and 2022, the Company had $0.1 million and $2.1 million, respectively, in outstanding accounts payable 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 $21.8 million, $20.0 million, and $18.1 million, respectively, for the years ended December 31, 2023, 2022 and 2021. As of December 31, 2023 and 2022, the Company had $0.2 million and $2.2 million, respectively, in outstanding accounts payable to this service provider. 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.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The Company is subject to U.S. federal, state, and local income taxes. For the years ended December 31, 2023, 2022 and 2021, the Company recorded an income tax benefit of $49.0 million, income tax expense of $24.8 million, and income tax expense of $32.8 million, respectively. For the year ended December 31, 2023, the Company recognized a $64.8 million income tax benefit, and corresponding increase to net deferred tax assets, related to non-cash goodwill impairment charges of $830.8 million. See Note 5, Goodwill and Identifiable Intangible Assets , for additional details. The current and deferred income tax (benefit) expense for the years ended December 31, 2023, 2022 and 2021 is as follows (in thousands): Year Ended December 31, 2023 2022 2021 Current: Federal $ 5,689 $ (197) $ 2,356 State 7,902 6,930 8,070 13,591 6,733 10,426 Deferred: Federal (42,720) 12,205 22,891 State (19,875) 5,831 (511) (62,595) 18,036 22,380 Total income tax (benefit) expense $ (49,004) $ 24,769 $ 32,806 A reconciliation of the effective income tax rate with the applicable statutory federal income tax rate for the years ended December 31, 2023, 2022 and 2021 is as follows: Year Ended December 31, 2023 2022 2021 Federal statutory rate 21.0 % 21.0 % 21.0 % State income taxes, net of federal benefit 1.0 % 3.6 % 3.1 % Equity-based compensation (0.4) % (0.5) % (1.9) % Change in valuation allowance (0.3) % — % 0.1 % Change in fair value of warrant liability 1.0 % (3.7) % (5.9) % Change in fair value of contingent consideration — % — % (1.2) % Goodwill impairment (16.6) % — % — % Deferred tax only adjustment 1.1 % (2.6) % 0.3 % Deferred tax impact of state effective tax rate changes — % 8.6 % — % Other — % (1.1) % 1.7 % Effective income tax rate 6.8 % 25.3 % 17.2 % Deferred income tax assets and liabilities are comprised of the following at December 31, 2023 and 2022 (in thousands): December 31, 2023 2022 Deferred income tax assets: Accounts receivable $ 35,009 $ 37,363 Goodwill and intangible assets 293,022 262,501 Investment in partnership — 171 Inventory 1,926 1,841 Accruals 16,909 9,207 Net operating losses and credits 23,978 35,459 Transaction costs 455 417 Equity-based compensation 5,379 6,101 Excess business interest expense 46,273 27,918 Lease liability 37,069 35,431 Capital losses 792 817 Other 7 — Total deferred income tax assets 460,819 417,226 Valuation allowance (3,788) (1,812) Net deferred income tax assets $ 457,031 $ 415,414 Deferred income tax liabilities: Right-of-use assets $ (36,011) $ (34,201) Contingent consideration (2,112) (2,200) Investment in partnership (582) — Unrealized gains (1,479) (2,950) Equipment and other fixed assets (70,993) (94,277) Total deferred income tax liabilities (111,177) (133,628) Noncurrent net deferred income tax assets $ 345,854 $ 281,786 Deferred income taxes are determined based on the temporary differences between the financial statement book basis and the tax basis of assets and liabilities using enacted tax rates in effect in the years in which the differences are expected to reverse. In assessing the realizability of deferred income tax assets, management considers whether it is more likely than not that all, or some portion, of the deferred income tax assets will not be realized. The ultimate realization of deferred income tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers the scheduled reversal of deferred income tax liabilities and projected future taxable income in making this assessment. Management evaluates the need for valuation allowances on the deferred income tax assets according to the provisions of FASB ASC 740, Income Taxes . In making this determination, management assesses all available evidence, both positive and negative, available at the time balance sheet date. This includes, but is not limited to, recent earnings, internally prepared income projections, and historical financial performance. A history of cumulative losses is a significant piece of negative evidence used in the assessment. As of December 31, 2023 and 2022, the Company had a valuation allowance recorded against net deferred tax assets of $3.8 million, and $1.8 million, respectively. As of December 31, 2023 and 2022, the Company had federal net operating losses ("NOLs") carryforwards of $72.4 million and $138.2 million, respectively and state NOLs of $281.1 million and $150.7 million, respectively. Federal NOLs generated after December 31, 2017 do not expire and state rules vary. Of the Company’s total federal NOLs as of December 31, 2023, $3.2 million begin expiring in 2031 and $69.2 million do not expire and may be carried forward indefinitely. The Company believes $4.9 million of NOLs are fully limited as a result of ownership changes within the meaning of Internal Revenue Code Section 382 ("Section 382") and has maintained a valuation allowance against these NOL deferred tax assets. As of December 31, 2023 and 2022, the Company had interest expense carryforwards of $177.3 million and $109.9 million, which may be carried forward indefinitely. As of December 31, 2023, the Company had capital loss carryforwards of $3.1 million that are subject to expiration if unused as of December 31, 2025. The Company does not anticipate utilizing these carryforwards prior to expiration and has maintained a valuation allowance accordingly. The Company will recognize a tax benefit in the financial statements for an uncertain tax position only if management’s assessment is that the position is “more likely than not” (i.e., a likelihood greater than 50 percent) to be allowed by the tax jurisdiction based solely on the technical merits of the position. The term “tax position” refers to a position in a previously filed tax return or a position expected to be taken in a future tax return that is reflected in measuring current or deferred income tax assets and liabilities for financial reporting purposes. A reconciliation of the beginning and ending amount of unrecognized tax benefits for the years ended December 31, 2023, 2022 and 2021 is as follows (in thousands). Balance, December 31, 2020 $ 1,947 Additions for tax positions acquired 2,100 Balance, December 31, 2021 4,047 Additions for tax positions acquired 2,670 Reductions due to lapse of statute of limitations (78) Balance, December 31, 2022 6,639 Additions for tax positions acquired — Reductions due to lapse of statute of limitations (43) Balance, December 31, 2023 $ 6,596 The unrecognized tax benefit of $6.6 million at December 31, 2023 relates to tax positions taken in pre-closing tax periods of companies acquired in 2021 and 2020, for which the Company received tax indemnifications against any losses. As such, the Company recognized a corresponding asset on its consolidated balance sheet and no amount of the Company’s uncertain tax positions, if recognized, would impact the effective tax rate of the Company. As of December 31, 2023 and 2022, the Company’s accrued liability for interest and penalties is $2.8 million and $1.6 million, respectively. The Company files income tax returns in the U.S. federal jurisdiction and in various state jurisdictions. The Company generally is no longer subject to U.S. or state examinations by tax authorities for taxable years prior to 2019, based on the U.S. statute of limitations. However, net operating losses utilized from prior years in subsequent years’ tax returns are subject to examination until three years after the filing of subsequent years’ tax returns. Tax Receivable Agreement At the closing of the Business Combination, the Company and AdaptHealth Holdings entered into a Tax Receivable Agreement (TRA) with certain sellers and AdaptHealth Holdings members. The TRA will generally provide for the payment by the Company to the corresponding sellers and AdaptHealth Holdings members of 85% of the net cash savings, if any, in U.S. federal, state and local income tax that the Company actually realizes (or is deemed to realize in certain circumstances) in periods after the closing of the Business Combination as a result of: (i) certain tax attributes of the corresponding sellers existing prior to the Business Combination; (ii) certain increases in tax basis resulting from exchanges of New AdaptHealth Units and shares of Class B Common Stock; (iii) imputed interest deemed to be paid by the Company as a result of payments it makes under the TRA; and (iv) certain increases in tax basis resulting from payments the Company makes under the TRA. Under the TRA, the benefits deemed realized by the Company as a result of the increase in tax basis attributable to the AdaptHealth Holdings members generally will be computed by comparing the actual income tax liability of the Company to the amount of such taxes that the Company would have been required to pay had there been no such increase in tax basis. Estimating the amount of payments that may be made under the TRA depends on a variety of factors. The actual increase in tax basis and deductions, as well as the amount and timing of any payments under the TRA, will vary depending upon several factors, including: • The timing of such exchanges – for instance, the increase in any tax deductions will vary depending on the fair value of the depreciable or amortizable assets of AdaptHealth Holdings at the time of each exchange; • The price of the Company’s Common Stock at the time of the exchange – the increase in any tax deductions, and the tax basis increase in other assets of AdaptHealth Holdings is directly proportional to the price of the Company’s Common Stock at the time of the exchange; • The amount and timing of the Company’s income – the Company is required to pay 85% of the deemed benefits as and when deemed realized. If AdaptHealth Holdings does not have taxable income, the Company is generally not required (absent a change in control or circumstances requiring an early termination payment) to make payments under the TRA for that taxable year because no benefit will have been realized. However, any tax benefits that do not result in realized benefits in a given tax year likely will generate tax attributes that may be utilized to generate benefits in previous or future tax years. The utilization of such tax attributes will result in payments under the TRA; and • Future tax rates of jurisdictions in which the Company has tax liability. The TRA also provides that upon certain mergers, asset sales, other forms of business combinations or other changes of control, AdaptHealth Holdings’ (or its successor’s) obligations under the TRA would be based on certain assumptions defined in the TRA. As a result of these assumptions, AdaptHealth could be required to make payments under the TRA that are greater or less than the specified percentage of the actual benefits realized by the Company that are subject to the TRA. In addition, if AdaptHealth Holdings elects to terminate the TRA early, it would be required to make an early termination payment, which upfront payment may be made significantly in advance of the anticipated future tax benefits. Payments generally are due under the TRA within a specified period following the filing of AdaptHealth Holdings’ U.S. federal and state income tax returns for the taxable year with respect to which the payment obligation arises. Payments under the TRA generally will be based on the tax reporting positions that AdaptHealth Holdings will determine. Although AdaptHealth Holdings does not expect the Internal Revenue Service (IRS) to challenge the Company’s tax reporting positions, AdaptHealth Holdings will not be reimbursed for any overpayments previously made under the TRA, but instead the overpayments will reduce future payments. As a result, in certain circumstances, payments could be made under the TRA in excess of the benefits that AdaptHealth Holdings realizes in respect of the tax attributes subject to the TRA. The term of the TRA generally will continue until all applicable tax benefits have been utilized or expired, unless the Company exercises its right to terminate the TRA and make an early termination payment. In certain circumstances (such as certain changes in control, the election of the Company to exercise its right to terminate the agreement and make an early termination payment or an IRS challenge to a tax basis increase) it is possible that cash payments under the TRA may exceed actual cash savings. During the year ended December 31, 2021, the Company increased its TRA liability by $146.5 million through a reduction in additional-paid-in capital, resulting from additional exchanges of New AdaptHealth Units and shares of Class B Common Stock. Correspondingly, during the year ended December 31, 2021, the Company increased its deferred tax asset by $164.1 million through an increase in additional-paid-in-capital resulting from these exchanges. At December 31, 2023, the Company’s liability relating to the TRA was $291.6 million, of which $1.5 million and $290.1 million is included in other liabilities and other long-term liabilities, respectively, in the accompanying consolidated balance sheets. At December 31, 2022, the Company's liability relating to the TRA was $297.4 million, of which $3.3 million and $294.1 million is included in other liabilities and other long-term liabilities, respectively, in the accompanying consolidated balance sheets. During the year ended December 31, 2023, the Company recognized income of $2.5 million related to changes in the estimated TRA liability primarily as a result of a decrease in estimated effective tax rates in future years, which is included in other loss, net in the accompanying consolidated statement of operations. During the year ended December 31, 2022, the Company recognized income of $2.9 million related to changes in the estimated TRA liability primarily as a result of a decrease in estimated effective tax rates in future years, which is included in other loss, net in the accompanying consolidated statements of operations.

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2023
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events The Company evaluated subsequent events for the period from December 31, 2023 through the date that the Company’s consolidated financial statements were available to be issued. There were no subsequent events requiring adjustment to the Company’s consolidated financial statements or additional disclosure, other than as discussed in Note 16 , Commitments and Contingencies .

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Pay vs Performance Disclosure
Net (loss) income attributable to AdaptHealth Corp.	$ (678,895)	$ 69,316	$ 156,175

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended	12 Months Ended
	Dec. 31, 2023 shares	Dec. 31, 2023 shares
Trading Arrangements, by Individual
Non-Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Terminated	false
Albert Prast [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		On November 6, 2023, Albert Prast, the Company’s Chief Technology Officer, modified a trading arrangement he had previously adopted with respect to the sale of the Company’s common stock (a “Rule 10b5-1 Trading Plan”) to adjust the trading terms under the plan. Mr. Prast’s initial Rule 10b5-1 Trading Plan was adopted on March 17, 2023. Mr. Prast’s amended Rule 10b5-1 Trading Plan is intended to satisfy the affirmative defense conditions of Securities Exchange Act Rule 10b5-1(c). The plan provides for the potential exercise of vested stock options and the associated sale of up to 200,000 shares of the Company's common stock pursuant to its terms. The plan expires on March 21, 2024, or upon the earlier completion of all authorized transactions under the plan.
March 2023 Plan [Member] | Albert Prast [Member]
Trading Arrangements, by Individual
Name	Albert Prast
Title	Chief Technology Officer
Adoption Date	March 17, 2023
Rule 10b5-1 Arrangement Terminated	true
Termination Date	November 6, 2023
Aggregate Available	200,000	200,000
November 2023 Plan [Member] | Albert Prast [Member]
Trading Arrangements, by Individual
Name	Albert Prast
Title	Chief Technology Officer
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	November 6, 2023
Arrangement Duration	136 days
Aggregate Available	200,000	200,000

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The consolidated financial statements of the Company have been prepared in accordance with accounting principles generally accepted in the United States of America (U.S. GAAP). In the opinion of management, the consolidated financial statements include all necessary adjustments for a fair presentation of the financial position and results of operations for the periods presented.
Basis of Consolidation	Basis of Consolidation The accompanying consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.
Concentration of Credit Risk	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. 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. As of December 31, 2023 and 2022, approximately 10% of the Company’s net accounts receivable are from patients under co-pay or private plan arrangements.
Accounting Estimates	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 and the tax receivable agreement, equity-based compensation, warrant liability, long-lived assets, including goodwill and identifiable intangible assets, and contingencies. Actual results could differ from those estimates.
Revenue Recognition	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, over the fixed monthly service period for equipment, or in the month in which eligible members are entitled to receive healthcare services in connection with at-risk capitation arrangements. 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, referred to as explicit price concessions, adjusted for estimates of variable consideration, such as implicit price concessions, based on historical reimbursement experience. The Company utilizes the expected value method to determine the amount of variable consideration, including implicit and explicit price concessions, that should be included to arrive at the transaction price, using contractual agreements and historical reimbursement experience. 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 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 receives a per member per month (“PMPM”) fee under certain at-risk capitation arrangements, which refers to a model in which the Company receives a PMPM fee from the third-party payor, and is responsible for managing a range of healthcare services and associated costs of its members. In at-risk capitation arrangements, the Company is responsible for the cost of contracted healthcare services required by those members in accordance with the terms of each agreement. Capitated revenue contracts with payors are generally multi-year arrangements and have a single monthly stand ready performance obligation to provide all aspects of necessary medical care to members for the contracted period in accordance with the scope of the agreements. The Company recognizes revenue in the month in which eligible members are entitled to receive healthcare services during the contract term. The Company’s revenue recognized under its capitation arrangements is included in the “other” product category in net sales revenue in the table below. 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, referred to as an explicit price concession, 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 product 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.
Accounts Receivable	Accounts Receivable Due to the continuing changes in the healthcare industry and third-party reimbursement environment, certain estimates are required to record accounts receivable at their net realizable values. Inherent in these estimates is the risk that they will have to be revised or updated as additional information becomes available. The complexity of third-party billing arrangements and laws and regulations governing Medicare and Medicaid may result in adjustments to amounts originally recorded. The Company performs a periodic analysis to review the valuation of accounts receivable and collectability of outstanding balances. Management’s evaluation takes into consideration such factors as historical cash collections experience, business and economic conditions, trends in healthcare coverage, other collection indicators and information about specific receivables. The Company’s evaluation also considers the age and composition of the outstanding amounts in determining their estimated net realizable value. Receivables are considered past due when not collected by established due dates. Specific patient balances are written off after collection efforts have been followed and the account has been determined to be uncollectible. Revisions in receivable estimates are considered implicit price concession adjustments and are recognized as an adjustment to net revenue in the period of revision. The Company does not have any material bad debt expense.
COVID-19 Pandemic	COVID-19 Pandemic Federal, state, and local authorities have taken several actions designed to assist healthcare providers in providing care to COVID-19 and other patients and to mitigate the adverse economic impact of the COVID-19 pandemic. Legislative actions taken by the federal government include the Coronavirus Aid, Relief, and Economic Security Act (the "CARES Act"), which was signed into law on March 27, 2020. Through the CARES Act, the federal government authorized payments that were distributed to healthcare providers through the Public Health and Social Services Emergency Fund (Provider Relief Fund or PRF). Additionally, the CARES Act revised the Medicare accelerated and advance payment program in an attempt to disburse payments to healthcare providers more quickly to mitigate the financial impact on healthcare providers. The Company’s participation in these programs and related accounting policies are summarized below. Grant Income . In April 2020, the Company received distributions of the CARES Act PRF of $17.2 million, and subsequent to April 2020, the Company completed several acquisitions in which the acquired companies received a total of $22.2 million of PRF payments prior to the applicable dates of acquisition. In connection with the accounting for these acquisitions, the Company recorded assumed liabilities of $7.7 million relating to the PRF payments received by the acquired companies. The PRF payments were targeted to offset lost revenue and expenditures incurred in connection with the COVID-19 pandemic. The PRF payments are subject to certain restrictions and are subject to recoupment if not used for designated purposes. As a condition to receiving distributions, providers were required to agree to certain terms and conditions, including, among other things, that the funds would be used for lost revenues and unreimbursed COVID-19 related expenses as defined by the U.S. Department of Health and Human Services (HHS). All recipients of PRF payments were required to comply with the reporting requirements described in the terms and conditions and as determined by HHS. The Company recognizes grant payments as income when there is reasonable assurance that it has complied with the conditions associated with the grant. During the year ended December 31, 2021, the Company recognized grant income of $10.6 million related to the PRF payments determined to comply with conditions associated with the grant.
Fair Value Accounting	Fair Value Accounting Financial Accounting Standards Board ("FASB") Accounting Standards Codification ("ASC") Topic 820, Fair Value Measurements and Disclosures (ASC 820), creates a single definition of fair value, establishes a framework for measuring fair value in U.S. GAAP and expands disclosures about fair value measurements. ASC 820 emphasizes that fair value is a market-based measurement, not an entity specific measurement, and states that a fair value measurement is to estimate the price at which an orderly transaction to sell an asset or to transfer the liability would take place between market participants at the measurement date under current market conditions. Assets and liabilities adjusted to fair value in the balance sheet are categorized based upon the level of judgment associated with the inputs used to measure their fair value. Level inputs, as defined by ASC 820, are as follows: Level input Input Definition Level 1 Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. Level 2 Inputs, other than quoted prices included in Level 1 that are observable for the asset or liability through corroboration with market data at the measurement date. Level 3 Unobservable inputs that reflect management’s best estimate of what market participants would use in pricing the asset or liability at the measurement date. See Note 6, Fair Value of Assets and Liabilities , for additional information.
Fair Value of Financial Instruments	Fair Value of Financial Instruments The Company’s financial instruments consist of cash, accounts receivable, prepaid and other current assets, accounts payable and accrued expenses. The carrying values of the Company’s financial instruments approximate their fair value based on their short-term nature. The table below shows the carrying amounts and estimated fair values, net of unamortized deferred financing costs, of the Company’s long-term debt arrangements (in thousands): December 31, 2023 December 31, 2022 Carrying Value Fair Value Carrying Value Fair Value Secured term loan $ 717,679 $ 717,679 $ 761,547 $ 761,547 Senior unsecured notes 1,430,303 1,140,821 1,426,720 1,227,574 $ 2,147,982 $ 1,858,500 $ 2,188,267 $ 1,989,121 The borrowings under the Company’s secured term loan bears interest at the variable rates described in Note 10, Debt , which management believes approximates fair value. The fair value of the Company’s senior unsecured notes is based upon current market prices.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all short-term highly liquid investments with a maturity of three months or less to be cash equivalents. Cash represents cash on hand and deposits held at banks. The Company maintains cash in demand deposit accounts with federally insured banks. At times, the balances in these accounts may be in excess of federally insured limits. The Company had no cash equivalents at December 31, 2023 and 2022.
Inventory	Inventory Inventory consists of equipment and medical supplies to be sold to customers and is stated at the lower of cost or net realizable value. Cost is determined by the first-in-first-out method. These finished goods are charged to cost of net revenue in the period in which products and related services are provided to patients.
Equipment and Other Fixed Assets	Equipment and Other Fixed Assets Equipment and other fixed assets are stated at cost less accumulated depreciation, or, when acquired as part of a business combination, fair value at the date of acquisition. Depreciation is computed using the straight-line method over the estimated useful lives of the related assets. The useful lives for patient medical equipment correlate with the medical reimbursement periods. Computer equipment, vehicles and other fixed assets are depreciated over the estimated useful lives of the assets. Major expenditures for property acquisitions and those expenditures that substantially increase useful lives are capitalized. Expenditures for maintenance, repairs and minor replacements are expensed as incurred. The useful lives of property and equipment for purposes of computing depreciation are: Patient medical equipment 13 months ‑ 5 years Computers and Software 5 ‑ 10 years Vehicles 5 years Other 2 ‑ 10 years
Long Lived Assets	Long-Lived Assets The Company’s long-lived assets, such as equipment and other fixed assets, operating lease right-of-use assets, finance lease right-of-use assets and definite-lived identifiable intangible assets, are assessed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to estimated undiscounted future cash flows expected to be generated by the asset. If the carrying amount of an asset exceeds its estimated undiscounted future cash flows, an impairment charge is recognized by the amount by which the carrying amount of the asset exceeds the fair value of the asset. Definite-lived identifiable intangible assets consist of tradenames, payor contracts, contractual rental agreements and developed technology. These assets are amortized using the straight-line method over their estimated useful lives, which reflects the pattern in which the economic benefits of the assets are expected to be consumed. 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 - 10 years Payor contracts 10 years Developed technology 5 years The Company did not recognize any impairment charges on long-lived assets for the years ended December 31, 2023, 2022 and 2021.
Valuation of Goodwill	Valuation of Goodwill The Company has a significant amount of goodwill on its balance sheet that resulted from the business acquisitions the Company has made. Goodwill is not amortized, rather, it is assessed for impairment annually and also 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, including the revenue growth rates, discount rate, and control premium used to estimate the 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 the year ended December 31, 2023, the Company experienced declines in its market capitalization as a result of sustained decreases in the Company's stock price and also revised its financial projections. The Company considered these items to represent triggering events and performed a goodwill impairment test at each quarterly reporting date during 2023. Based on the results of the tests performed as of September 30, 2023 and December 31, 2023, it was concluded that the estimated fair value of the Company’s reporting unit was less than its carrying values at such dates, and as such, the Company recognized an aggregate non-cash goodwill impairment charge of $830.8 million during the year ended December 31, 2023, which included an impairment charge of $318.9 million recognized during the fourth quarter. 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 an additional non-cash goodwill impairment charge at that time, which could be material. See Note 5, Goodwill and Identifiable Intangible Assets , for additional details.
Business Combinations	Business Combinations The Company applies the acquisition method of accounting for business acquisitions. The results of operations of the businesses acquired by the Company are included as of the respective acquisition date. The acquisition-date fair value of the consideration transferred, including the fair value of any contingent consideration, is allocated to the underlying assets acquired and liabilities assumed based upon their estimated fair values at the date of acquisition. To the extent the acquisition-date fair value of the consideration transferred exceeds the fair value of the identifiable tangible and intangible assets acquired and liabilities assumed, such excess is allocated to goodwill. Patient relationships, medical records and patient lists are not reported as separate intangible assets due to the regulatory requirements and lack of contractual agreements but are part of goodwill. Customer related relationships are not reported as separate intangible assets but are part of goodwill as authorizing physicians are under no obligation to refer the Company’s services to their patients, who are free to change physicians and service providers at any time. The Company may adjust the preliminary purchase price allocation, as necessary, as it obtains more information regarding asset valuations and liabilities assumed that existed but were not available at the acquisition date, which is generally up to one year after the acquisition closing date. Acquisition related expenses are recognized separately from the business combination and are expensed as incurred.
Deferred Financing Costs	Deferred Financing Costs Costs incurred in connection with the Company’s borrowings, referred to as financing costs, are capitalized and included on the accompanying consolidated balance sheets in Other assets for costs associated with revolving credit facilities, and as a reduction of the carrying value of debt for costs associated with secured term loans. The capitalized financing costs are amortized to interest expense using the effective interest method over the term of the related financing agreement. See Note 8, Deferred Financing Costs , for additional information.
Accounting for Leases	Accounting for Leases The Company accounts for its leases in accordance with FASB Accounting Standards Codification Topic 842, Leases (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. See Note 13, Leases , for additional information.
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. If there is no probable estimate within a range of reasonably possible outcomes, the Company’s policy is to record at the low end of the range of such reasonably possible outcomes. 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, except as disclosed in Note 16, Commitments and Contingencies . 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. Professional legal fees are expensed as they are incurred. See Note 16, Commitments and Contingencies
Advertising Costs	Advertising Costs Advertising costs are charged to expense as incurred. The Company’s advertising costs for the years ended December 31, 2023, 2022 and 2021 were $22.8 million, $19.2 million and $18.5 million, respectively, and are included in Cost of net revenue in the accompanying consolidated statements of operations.
Equity-based Compensation	Equity-based Compensation The Company accounts for its equity-based compensation in accordance with FASB ASC Topic 718, Compensation Stock Compensation , which establishes accounting for share-based awards exchanged for employee services and requires companies to expense the estimated fair value of these awards over the requisite employee service period. Equity-based compensation expense related to these grants is included within 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. The Company does not estimate forfeitures in connection with its accounting for equity-based compensation, and instead accounts for forfeitures as they occur. See Note 11, Stockholders’ Equity , for additional information regarding the Company’s equity-based compensation expense.
Cost of Net Revenue	Cost of Net Revenue Cost of net revenue includes the cost of non-capitalized medical equipment and supplies sold to patients, depreciation for capitalized patient equipment, salaries, labor and benefits costs for service personnel at the Company’s operating facilities, offshore labor expenses, occupancy costs (such as rent, utilities, and property taxes), and other expenses incurred to operate the businesses (such as distribution expenses, billing fees, software expenses and general business supplies). Cost of net revenue for the years ended December 31, 2023, 2022 and 2021 consisted of the following (in thousands): Year Ended December 31, 2023 2022 2021 Cost of products and supplies $ 1,305,219 $ 1,199,481 $ 955,813 Salaries, labor and benefits 785,876 777,306 602,969 Patient equipment depreciation 325,696 286,288 194,958 Other operating expenses 236,039 225,719 206,599 Rent and occupancy 67,783 64,375 48,586 Total $ 2,720,613 $ 2,553,169 $ 2,008,925
General and Administrative Expenses	General and Administrative Expenses General and administrative expenses ("G&A") primarily include expenses related to corporate salaries and benefits, legal, consulting, equity-based compensation, transaction costs and other business support functions. Included in G&A during the years ended December 31, 2023, 2022 and 2021 are salaries, labor and benefits expenses (including equity-based compensation and severance) of $68.3 million, $60.6 million and $60.1 million, respectively.
Business Segment	Business Segment Operating segments are defined as components of an enterprise for which discrete financial information is available that is evaluated regularly by the Chief Operating Decision Maker (“CODM”) for the purposes of allocating resources and evaluating financial performance. The Company’s CODM is its Interim Chief Executive Officer, who reviews financial information on a consolidated level for purposes of allocating resources and evaluating financial performance, and as such, the Company’s operations constitute one operating segment and one reportable segment.
Concentration of Customers	Concentration of Customers The Company provides patient-centered, healthcare-at-home solutions including home medical equipment, medical supplies, and related services, to its customers. This results in a customer concentration relating to government healthcare reimbursement programs. During the years ended December 31, 2023, 2022 and 2021, the Company derived approximately 27%, 26% and 28% of its net revenue from government healthcare programs, including Medicare and Medicaid, respectively. Concentration of credit risk with respect to other payors is limited due to the large number of such payors and varied geographical locations.
Self-Insurance Risk	Self-Insurance Risk The Company is subject to workers’ compensation, auto liability and employee medical claims, which are primarily self-insured; however, the Company maintains certain stop-loss and other insurance coverage which it believes to be appropriate. Provisions for estimated settlements relating to the workers’ compensation and medical plans are provided in the period of the related claim on a case-by-case basis plus an amount for incurred but not reported claims. Differences between the amounts accrued and subsequent settlements are recorded in operations in the period of settlement.
Derivative Instruments	Derivative Instruments The Company recognizes all derivative instruments as either assets or liabilities in the accompanying consolidated balance sheets at fair value. Derivative instruments consist of interest rate swap agreements. The interest rate swap agreements are used to manage interest rate risk associated with the Company’s variable rate debt. The Company utilizes the interest rate swap agreements to modify the Company’s exposure to interest rate risk by converting a portion of its variable rate borrowings to a fixed rate. See Note 7, Derivative Instruments and Hedging Activities , for additional information.
Income Taxes	Income Taxes The Company uses the asset and liability method of accounting for income taxes, under which deferred tax assets and liabilities are recognized for the future tax consequences of (i) temporary differences between the financial statement carrying amounts and the tax basis of existing assets and liabilities and (ii) operating loss and tax credit carryforwards. Deferred income tax assets and liabilities are based on enacted tax rates applicable to the future period when those temporary differences are expected to be recovered or settled. The effect of a change in tax rates on deferred tax assets and liabilities is recognized in income in the period the rate change is enacted. A valuation allowance is provided for deferred tax assets when it is more likely than not the deferred tax assets will not be realized. The Company’s deferred tax calculations and valuation allowance requires management to make certain estimates about future operations. Changes in state or federal tax laws, as well as changes in the Company’s financial condition or the carrying value of existing assets and liabilities, could affect those estimates. The effect of a change in tax rates is recognized as income or expense in the period that the rate is enacted. FASB ASC 740, Income Taxes , prescribes a recognition threshold and a measurement attribute for the financial statement recognition and measurement of tax positions taken or expected to be taken in a tax return. For those benefits to be recognized, a tax position must be more-likely-than-not to be sustained upon examination by taxing authorities. The Company recognizes accrued interest and penalties related to unrecognized tax benefits as income tax expense. There was no material amount of expense for interest and penalties related to unrecognized tax benefits for the years ended December 31, 2023, 2022 and 2021.
Earnings (Loss) Per Share	Earnings (Loss) Per Share Earnings (loss) per share is based upon the weighted average number of common shares outstanding during the respective periods. The Company follows the provisions of the authoritative guidance for determining whether instruments granted in equity-based compensation transactions or other instruments are participating securities for purposes of calculating earnings (loss) per share. See Note 12, Earnings (Loss) Per Share , for additional information.
Recently Adopted Accounting Pronouncements and Recently Issued Accounting Pronouncements Not Yet Adopted	Recently Adopted Accounting Pronouncements In March 2020, the FASB issued Accounting Standards Update (“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 year ended December 31, 2023, which did not have a material impact on its consolidated financial statements and related disclosures. (ee) Recently Issued Accounting Pronouncements Not Yet Adopted In December 2023, the FASB issued ASU No. 2023-09, Income Taxes ("Topic 740") . This ASU improves the transparency of income tax disclosures by requiring public business entities to disclose specific categories in the annual rate reconciliation as well as disclose income tax expense (or benefit) and the amount of income taxes paid disaggregated by jurisdiction. ASU 2023-09 is effective on a prospective basis for fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the impact that this standard will have on its consolidated financial disclosures. In November 2023, the FASB issued ASU No. 2023-07, Segment Reporting ("Topic 280") , which requires disclosure of incremental segment information, including significant segment expenses that are regularly provided to the chief operating decision maker and to disclose how reported measures of segment profit or loss are used in assessing segment performance and allocating resources. ASU 2023-07 is effective for fiscal years beginning after December 15, 2023 and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the impact that this standard will have on its consolidated financial statements and related disclosures. In August 2023, the FASB issued ASU No. 2023-05, Business Combinations-Joint Venture Formations ("Topic 805-60") , which requires that all entities that qualifies as either a joint venture or a corporate joint venture are required to apply a new basis of accounting. Specifically, the ASU provides that a joint venture or a corporate joint venture must initially measure its assets and liabilities at fair value on the formation date. ASU 2023-05 is effective for all joint ventures that are formed on or after January 1, 2025, with early adoption permitted. The Company is currently evaluating the impact that this standard will have on its consolidated financial statements and related disclosures.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Schedule of composition of net revenues by payor type and core service lines	The composition of net revenue by payor type for the years ended December 31, 2023, 2022 and 2021 are as follows (in thousands): Year Ended December 31, 2023 2022 2021 Insurance $ 1,933,440 $ 1,808,633 $ 1,499,154 Government 852,789 781,975 685,513 Patient pay 413,948 379,987 269,868 Net revenue $ 3,200,177 $ 2,970,595 $ 2,454,535 The composition of net revenue by core product lines for the years ended December 31, 2023, 2022 and 2021 are as follows (in thousands): Year Ended December 31, 2023 2022 2021 Net sales revenue: Sleep $ 897,119 $ 794,021 $ 654,130 Diabetes 647,431 670,988 528,082 Supplies to the home 192,475 179,326 167,830 Respiratory 32,370 34,342 31,016 HME 110,197 118,542 113,805 Other 251,710 218,461 144,543 Total net sales revenue $ 2,131,302 $ 2,015,680 $ 1,639,406 Net revenue from fixed monthly equipment reimbursements: Sleep $ 344,049 $ 272,705 $ 237,252 Diabetes 12,608 16,103 13,123 Respiratory 566,450 520,697 427,270 HME 96,328 102,256 95,936 Other 49,440 43,154 41,548 Total net revenue from fixed monthly equipment reimbursements $ 1,068,875 $ 954,915 $ 815,129 Total net revenue: Sleep $ 1,241,168 $ 1,066,726 $ 891,382 Diabetes 660,039 687,091 541,205 Supplies to the home 192,475 179,326 167,830 Respiratory 598,820 555,039 458,286 HME 206,525 220,798 209,741 Other 301,150 261,615 186,091 Total net revenue $ 3,200,177 $ 2,970,595 $ 2,454,535
Schedule of carrying amounts and estimated fair values of debt	The table below shows the carrying amounts and estimated fair values, net of unamortized deferred financing costs, of the Company’s long-term debt arrangements (in thousands): December 31, 2023 December 31, 2022 Carrying Value Fair Value Carrying Value Fair Value Secured term loan $ 717,679 $ 717,679 $ 761,547 $ 761,547 Senior unsecured notes 1,430,303 1,140,821 1,426,720 1,227,574 $ 2,147,982 $ 1,858,500 $ 2,188,267 $ 1,989,121
Summary of useful lives of property and equipment for purposes of computing depreciation	The useful lives of property and equipment for purposes of computing depreciation are: Patient medical equipment 13 months ‑ 5 years Computers and Software 5 ‑ 10 years Vehicles 5 years Other 2 ‑ 10 years
Schedule of useful lives of intangible assets acquired	The following table summarizes the useful lives of the Company’s identifiable intangible assets: Tradenames 5 - 10 years Payor contracts 10 years Developed technology 5 years
Summary of cost of net revenue	Cost of net revenue for the years ended December 31, 2023, 2022 and 2021 consisted of the following (in thousands): Year Ended December 31, 2023 2022 2021 Cost of products and supplies $ 1,305,219 $ 1,199,481 $ 955,813 Salaries, labor and benefits 785,876 777,306 602,969 Patient equipment depreciation 325,696 286,288 194,958 Other operating expenses 236,039 225,719 206,599 Rent and occupancy 67,783 64,375 48,586 Total $ 2,720,613 $ 2,553,169 $ 2,008,925

Acquisitions (Tables)

Acquisitions (Tables)	12 Months Ended
	Dec. 31, 2023
Business Combination and Asset Acquisition [Abstract]
Summary of consideration	The following table summarizes the consideration paid at closing for all acquisitions during the year ended December 31, 2023 (in thousands): Cash $ 19,943 Deferred payments 137 Total $ 20,080 Cash $ 17,170 Deferred payments 457 Total $ 17,627 The following table summarizes the consideration paid for all acquisitions during the year ended December 31, 2021 (in thousands): AeroCare Spiro Healthy Living Agilis We Care Community Other Total Cash $ 1,153,409 $ 65,759 $ 47,048 $ 30,828 $ 34,834 $ 129,423 $ 196,669 $ 1,657,970 Equity 1,220,342 7,109 5,057 14,668 6,321 — 7,703 1,261,200 Contingent consideration — 1,000 — 1,000 — 5,800 — 7,800 Deferred payments — — — — — — 4,478 4,478 Total $ 2,373,751 $ 73,868 $ 52,105 $ 46,496 $ 41,155 $ 135,223 $ 208,850 $ 2,931,448
Summary of estimated fair values of the net assets acquired	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 year ended December 31, 2023 was allocated as follows during the period (in thousands): Cash $ 256 Accounts receivable 1,264 Inventory 1,483 Prepaid and other current assets 10 Equipment and other fixed assets 9,011 Operating lease right-of-use assets 5,506 Finance lease right-of-use assets 200 Goodwill 9,616 Accounts payable and accrued expenses (713) Operating lease liabilities (5,506) Finance lease liabilities (200) Other current liabilities (847) Net assets acquired $ 20,080 Cash $ 162 Accounts receivable 2,336 Inventory 771 Prepaid and other current assets 16 Equipment and other fixed assets 4,585 Goodwill 12,341 Identifiable intangible assets 500 Deferred tax assets 180 Accounts payable and accrued expenses (3,130) Contract liabilities (134) Net assets acquired $ 17,627 AeroCare Spiro Healthy Living Agilis We Care Community Other Total Cash $ 27,686 $ 2,132 $ 579 $ 1,131 $ 458 $ 2 $ 5,005 $ 36,993 Accounts receivable 71,916 $ 5,756 5,838 — 2,007 15,798 25,587 126,902 Inventory 26,998 1,733 2,949 2,330 465 5,214 10,663 50,352 Prepaid and other current assets 3,522 152 1,088 — — 571 2,403 7,736 Equipment and other fixed assets 190,755 6,897 1,188 348 5,254 44,952 24,963 274,357 Operating lease right-of-use assets 52,927 2,581 1,366 490 970 4,412 15,897 78,643 Goodwill 2,083,423 64,380 44,095 55,375 35,971 88,393 164,929 2,536,566 Identifiable intangible assets 122,800 1,000 1,500 500 400 2,300 4,400 132,900 Other assets 1,178 16 — — — 2,505 — 3,699 Deferred tax liabilities (46,234) — — — (1,228) — (308) (47,770) Accounts payable and accrued expenses (82,722) (5,517) (3,363) (3,188) (1,389) (13,725) (21,679) (131,583) Contract liabilities (14,495) (486) (102) — (783) (3,156) (608) (19,630) Other current liabilities (10,021) — (1,667) — — (180) (1,833) (13,701) Other long-term liabilities (1,055) — — — — (2,683) — (3,738) Operating lease obligations (52,927) (2,581) (1,366) (490) (970) (4,412) (15,897) (78,643) Finance lease obligations — (2,195) — — — (4,768) (4,672) (11,635) Net assets acquired $ 2,373,751 $ 73,868 $ 52,105 $ 56,496 $ 41,155 $ 135,223 $ 208,850 $ 2,941,448
Summary of results of business acquired	Results of Businesses Acquired The following table presents the amount of Net revenue and Operating income in the period of acquisition since the respective acquisition dates for the acquisitions described above that is included in the Company’s consolidated statements of operations for the years ended December 31, 2023, 2022 and 2021: (in thousands) Year Ended December 31, 2023 2022 2021 Net revenue $ 7,246 $ 16,455 $ 1,005,097 Operating income $ 745 $ 767 $ 136,404

Equipment and Other Fixed Ass_2

Equipment and Other Fixed Assets (Tables)	12 Months Ended
	Dec. 31, 2023
Property, Plant and Equipment [Abstract]
Schedule of equipment and other fixed assets	Equipment and other fixed assets as of December 31, 2023 and 2022 are as follows (in thousands): December 31, December 31, Patient medical equipment $ 791,349 $ 747,985 Computers and software 85,509 70,897 Delivery vehicles 35,021 35,326 Other 20,203 16,059 Gross carrying value 932,082 870,267 Less accumulated depreciation (436,981) (383,188) Equipment and other fixed assets, net $ 495,101 $ 487,079

Goodwill and Identifiable Int_2

Goodwill and Identifiable Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 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 years ended December 31, 2023 and 2022 was as follows (in thousands): Gross carrying Balance at December 31, 2021 $ 3,512,567 Goodwill from acquisitions 12,341 Net cash payments relating to prior acquisitions 2,009 Net increase relating to measurement period adjustments 18,380 Balance at December 31, 2022 $ 3,545,297 Goodwill from acquisitions 9,616 Net increase relating to measurement period adjustments 832 Goodwill impairment (830,787) Balance at December 31, 2023 $ 2,724,958
Schedule of identifiable intangible assets	Identifiable intangible assets consisted of the following at December 31, 2023 and 2022 (in thousands): December 31, 2023 Weighted-Average Tradenames, net of accumulated amortization of $38,314 $ 74,486 6.6 Payor contracts, net of accumulated amortization of $28,216 53,784 6.6 Developed technology, net of accumulated amortization of $4,410 1,890 1.5 Identifiable intangible assets, net $ 130,160 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 December 31, 2024 $ 22,276 2025 21,328 2026 19,263 2027 17,960 2028 17,936 Thereafter 31,397 Total $ 130,160

Fair Value of Assets and Liab_2

Fair Value of Assets and Liabilities (Tables)	12 Months Ended
	Dec. 31, 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 December 31, 2023 and 2022 measured at fair value on a recurring basis. The fair value estimates presented herein are based on information available to management as of December 31, 2023 and 2022. These estimates are not necessarily indicative of the amounts the Company could ultimately realize. (in thousands) Level 1 Level 2 Level 3 December 31, 2023 Assets Interest rate swap agreements-short term $ — $ 4,482 $ — Interest rate swap agreements-long term — 986 — Total assets measured at fair value $ — $ 5,468 $ — Liabilities Acquisition-related contingent consideration-short term $ — $ — $ 6,850 Warrant liability — — 4,021 Total liabilities measured at fair value $ — $ — $ 10,871 (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 years ended December 31, 2023 and 2022 is as follows (in thousands): Year Ended December 31 2023 Beginning Balance Additions Payments Change in Fair Value Other activity Ending Balance Contingent consideration - Level 3 liabilities $ 7,500 $ — $ (1,000) $ 350 $ — $ 6,850 Year Ended December 31 2022 Beginning Balance Additions Payments Change in Fair Value Other activity Ending Balance Contingent consideration - Level 3 liabilities $ 20,300 $ — $ (15,015) $ 2,215 $ — $ 7,500 A reconciliation of the changes in the contingent consideration common shares liability related to the Contingent Consideration Common Shares during the year ended December 31, 2021 was as follows (in thousands): Estimated fair value of contingent consideration common shares liability at December 31, 2020 $ 70,477 Change in estimated fair value of the contingent consideration common shares liability (29,389) Reclassification of contingent consideration common shares liability to equity (41,088) Estimated fair value of contingent consideration common shares liability at December 31, 2021 $ —

Derivative Instruments and He_2

Derivative Instruments and Hedging Activities (Tables)	12 Months Ended
	Dec. 31, 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 December 31, 2023 and 2022 (in thousands): December 31, 2023 December 31, 2022 Balance Sheet Location Asset Prepaid and other current assets $ 4,482 $ 5,748 Other assets 986 3,728 Total $ 5,468 $ 9,476

Deferred Financing Costs (Table

Deferred Financing Costs (Tables)	12 Months Ended
	Dec. 31, 2023
Debt Issuance Costs, Net [Abstract]
Summary of change in the carrying amount of deferred financing costs	The change in the carrying amount of deferred financing costs for the years ended December 31, 2023 and 2022 was as follows (in thousands): Year Ended December 31, 2023 2022 Balance at beginning of period $ 28,229 $ 33,463 Amortization (5,234) (5,234) Balance at end of period $ 22,995 $ 28,229
Schedule of amortization of deferred financing costs	The December 31, 2023 balance of deferred financing costs of $23.0 million is estimated to be amortized to interest expense, net as follows (in thousands): Twelve months ending December 31, 2024 $ 5,234 2025 5,147 2026 3,659 2027 3,577 2028 3,139 Thereafter 2,239 $ 22,995

Accounts Payable and Accrued _2

Accounts Payable and Accrued Expenses (Tables)	12 Months Ended
	Dec. 31, 2023
Accounts Payable and Accrued Liabilities, Current [Abstract]
Schedule of components accounts payable and accrued expenses	Accounts payable and accrued expenses as of December 31, 2023 and 2022 consisted of the following (in thousands): December 31, December 31, Accounts payable $ 211,504 $ 222,505 Litigation settlement 57,340 — Employee-related accruals 47,462 41,872 Accrued interest 29,327 28,877 Other 46,361 44,244 Total $ 391,994 $ 337,498

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2023
Debt Disclosure [Abstract]
Schedule of summary of long term debt	The following is a summary of long-term debt as of December 31, 2023 and 2022 (in thousands): December 31, December 31, Secured term loan $ 720,000 $ 765,000 Senior unsecured notes 1,450,000 1,450,000 Unamortized deferred financing fees (22,018) (26,733) 2,147,982 2,188,267 Current portion (53,368) (35,000) Long-term portion $ 2,094,614 $ 2,153,267
Schedule of maturity of total debt, excluding unamortized deferred financing fees	The future maturity of total debt, excluding unamortized deferred financing fees, at December 31, 2023 is as follows (in thousands). Twelve months ended December 31, 2024 $ 53,368 2025 40,000 2026 626,632 2027 — 2028 350,000 Thereafter 1,100,000 Total debt maturity $ 2,170,000

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	12 Months Ended
	Dec. 31, 2023
Equity [Abstract]
Schedule of changes in warrant liability	A reconciliation of the changes in the warrant liability during the years ended December 31, 2023, 2022 and 2021 was as follows (in thousands): Estimated fair value of warrant liability at December 31, 2020 $ 113,905 Change in estimated fair value of the warrant liability (53,181) Reclassification of warrant liability to equity for exercised warrants (2,960) Estimated fair value of warrant liability at December 31, 2021 57,764 Change in estimated fair value of the warrant liability (17,158) Reclassification of warrant liability to equity for exercised warrants (2,103) Estimated fair value of warrant liability at December 31, 2022 38,503 Change in estimated fair value of the warrant liability (34,482) Estimated fair value of warrant liability at December 31, 2023 $ 4,021
Reconciliation of contingent consideration liabilities	A reconciliation of the Company’s contingent consideration liabilities related to acquisitions for the years ended December 31, 2023 and 2022 is as follows (in thousands): Year Ended December 31 2023 Beginning Balance Additions Payments Change in Fair Value Other activity Ending Balance Contingent consideration - Level 3 liabilities $ 7,500 $ — $ (1,000) $ 350 $ — $ 6,850 Year Ended December 31 2022 Beginning Balance Additions Payments Change in Fair Value Other activity Ending Balance Contingent consideration - Level 3 liabilities $ 20,300 $ — $ (15,015) $ 2,215 $ — $ 7,500 A reconciliation of the changes in the contingent consideration common shares liability related to the Contingent Consideration Common Shares during the year ended December 31, 2021 was as follows (in thousands): Estimated fair value of contingent consideration common shares liability at December 31, 2020 $ 70,477 Change in estimated fair value of the contingent consideration common shares liability (29,389) Reclassification of contingent consideration common shares liability to equity (41,088) Estimated fair value of contingent consideration common shares liability at December 31, 2021 $ —
Schedule of assumptions used to determine the grant date fair value	The assumptions used to determine the grant-date fair value of the stock options granted during the year ended December 31, 2021 were as follows: Year Ended December 31, 2021 Expected volatility 44.5 % Risk-free interest rate 0.2 % Expected term 4.0 years Dividend yield N/A
Schedule of outstanding stock option activity	The following table provides the activity regarding the Company’s outstanding stock options during the years ended December 31, 2023, 2022 and 2021 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, 2020 3,464 $ 2.18 $ 11.56 Granted 703 $ 9.81 $ 48.72 Exercised (1,034) $ 2.19 $ 11.57 Forfeited (914) $ 2.27 $ 11.66 Outstanding, December 31, 2021 2,219 $ 3.75 $ 19.36 Activity - none — Outstanding, December 31, 2022 2,219 $ 3.75 $ 19.36 Activity - none — Outstanding, December 31, 2023 2,219 $ 3.75 $ 19.36 5.1 Years The following table provides the activity for all outstanding stock options during the years ended December 31, 2023, 2022 and 2021 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Outstanding, December 31, 2020 3,464 $ 11.56 Granted 703 $ 48.72 Issued in connection with the AeroCare acquisition 3,960 $ 6.24 Exercised (1,447) $ 10.16 Forfeited (914) $ 11.66 Outstanding, December 31, 2021 5,766 $ 11.26 Exercised (804) $ 5.69 Outstanding, December 31, 2022 4,962 $ 12.19 Exercised (1,553) $ 6.24 Outstanding, December 31, 2023 3,409 $ 14.90 4.9 Years
Schedules of exercisable and unexercisable stock option activity	The following table provides the activity for exercisable stock options during the years ended December 31, 2023, 2022, and 2021 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Exercisable, December 31, 2020 1,155 $ 11.56 Issued in connection with the AeroCare acquisition 3,960 $ 6.24 Vested 907 $ 11.50 Exercised (1,447) $ 10.16 Exercisable, December 31, 2021 4,575 $ 7.39 Vested 878 $ 18.12 Exercised (804) $ 5.69 Exercisable, December 31, 2022 4,649 $ 9.73 Vested 234 $ 48.72 Exercised (1,553) $ 6.24 Exercisable, December 31, 2023 3,330 $ 14.10 4.9 Years The following table provides the activity for unexercisable stock options during the years ended December 31, 2023, 2022 and 2021 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Unexercisable, December 31, 2020 2,309 $ 11.56 Granted 703 $ 48.72 Vested (907) $ 11.50 Forfeited (914) $ 11.66 Unexercisable, December 31, 2021 1,191 $ 26.15 Vested (878) $ 18.12 Unexercisable, December 31, 2022 313 $ 48.72 Vested (234) $ 48.72 Unexercisable, December 31, 2023 79 $ 48.72 2.1 Years
Schedule of restricted stock activity	Activity related to the Company’s non-vested restricted stock grants for the years ended December 31, 2023, 2022 and 2021 is presented below (in thousands, except per share data): Number of Shares of Weighted-Average Grant Date Non-vested balance, December 31, 2020 2,248 $ 15.60 Granted 1,354 $ 28.92 Vested (556) $ 14.03 Forfeited (851) $ 17.64 Non-vested balance, December 31, 2021 2,195 $ 19.58 Granted 962 $ 21.26 Vested (700) $ 19.99 Forfeited (196) $ 20.60 Non-vested balance, December 31, 2022 2,261 $ 23.90 Granted 1,311 $ 13.85 Vested (1,063) $ 19.59 Forfeited (441) $ 25.95 Non-vested balance, December 31, 2023 2,068 $ 19.16
Equity-based compensation expense	The table below presents the equity-based compensation expense recognized during the years ended December 31, 2023, 2022 and 2021, as well the classification of amounts in the consolidated statements of operations (in thousands): Year Ended December 31, 2023 2022 2021 General and administrative expense $ 19,586 $ 15,760 $ 18,021 Cost of net revenue $ 2,882 $ 6,637 $ 7,302 Total $ 22,468 $ 22,397 $ 25,323

Earnings (Loss) Per Share (Tabl

Earnings (Loss) Per Share (Tables)	12 Months Ended
	Dec. 31, 2023
Earnings Per Share [Abstract]
Schedule of calculation of basic and diluted earnings per share	Computations of basic and diluted net (loss) income per share were as follows (in thousands, except per share data): Year Ended December 31, 2023 2022 2021 Numerator Net (loss) income attributable to AdaptHealth Corp. $ (678,895) $ 69,316 $ 156,175 Less: Earnings allocated to participating securities (1) — 5,867 14,379 Net (loss) income for basic EPS $ (678,895) $ 63,449 $ 141,796 Change in fair value of warrant liability (2) (34,482) (17,158) (53,181) Net (loss) income for diluted EPS $ (713,377) $ 46,291 $ 88,615 Denominator (1) (2) Basic weighted-average common shares outstanding 134,156 134,175 126,306 Add: Warrants (2) 262 1,528 2,377 Add: Stock options — 2,512 3,782 Add: Unvested restricted stock — 773 569 Diluted weighted-average common shares outstanding 134,418 138,988 133,034 Basic net (loss) income per share $ (5.06) $ 0.47 $ 1.12 Diluted net (loss) income per share $ (5.31) $ 0.33 $ 0.67 (1) The Company's preferred stock are considered participating securities. Computation of EPS under the two-class method excludes from the numerator any dividends paid or owed on participating securities and any undistributed earnings considered to be attributable to participating securities. The related participating securities are similarly excluded from the denominator. There was no amount allocated to the participating securities during the year ended December 31, 2023 due to the net loss reported in that period. (2)
Schedule of antidilutive shares	The table below provides the weighted-average number of potential common shares associated with outstanding securities not included in the Company’s computation of diluted net (loss) income per share for the years ended December 31, 2023, 2022 and 2021 because to do so would be antidilutive (in thousands): Year Ended December 31, 2023 2022 2021 Preferred Stock 12,406 12,406 12,808 Warrants — — — Stock Options 3,409 469 — Unvested restricted stock 1,993 — — Total 17,808 12,875 12,808

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2023
Leases [Abstract]
Right-of-use asset and lease liabilities	The following table presents information about the Company’s right-of-use assets and lease liabilities as of December 31, 2023 and 2022 (in thousands): December 31, Consolidated Balance Sheets Line Item 2023 2022 Right-of-use ("ROU") assets: Operating lease ROU assets Operating lease right-of-use assets $ 110,465 $ 129,506 Finance lease ROU assets Finance lease right-of-use assets 31,962 5,423 Finance lease ROU assets Equipment and other fixed assets, net — 103 Total ROU assets $ 142,427 $ 135,032 Operating lease liabilities: Current operating lease liabilities Current portion of operating lease obligations $ 29,270 $ 30,001 Noncurrent operating lease liabilities Operating lease obligations, less current portion 85,529 104,394 Total operating lease liabilities $ 114,799 $ 134,395 Finance lease liabilities: Current finance lease liabilities Current portion of finance lease obligations $ 9,122 $ 2,211 Noncurrent finance lease liabilities Finance lease obligations, less current portion 22,746 3,950 Total finance lease liabilities $ 31,868 $ 6,161 The following table presents information about lease costs and expenses and sublease income for the years ended December 31, 2023 and 2022 (in thousands). The amounts below, with the exception of interest on lease liabilities, are included in cost of net revenue in the accompanying consolidated statements of operations for the periods presented. The interest on lease liabilities is included in interest expense, net in the accompanying consolidated statements of operations for the periods presented. Year Ended December 31, 2023 2022 2021 Operating lease costs $ 38,365 $ 37,822 $ 37,043 Finance lease costs: Reduction of ROU assets $ 5,761 $ 8,246 $ 33,689 Interest on lease liabilities $ 1,058 $ — $ — Other lease costs and income: Variable leases costs (1) $ 20,769 $ 17,758 $ 14,030 Sublease income $ 1,427 $ 1,380 $ 1,239 (1) Amounts represent variable costs incurred that were not included in the initial measurement of the lease liability such as common area maintenance and utilities costs associated with leased real estate.
Weighted average remaining lease terms and discount rates	The following table provides the weighted average remaining lease terms and weighted average discount rates for the Company’s leases as of December 31, 2023 and 2022: December 31, 2023 2022 Weighted average remaining lease term, weighted based on lease liability balances: Operating leases 5.6 years 6.2 years Finance leases 3.6 years 3.7 years Weighted average discount rate, weighted based on remaining balance of lease payments: Operating leases 4.4 % 3.9 % Finance leases 6.7 % 3.5 %
Undiscounted amount of future cash flows	The following table provides the undiscounted amount of future cash flows related to the Company's operating and finance leases, as well as a reconciliation of such undiscounted cash flows to the amounts included in the Company’s lease liabilities as of December 31, 2023 (in thousands): Operating Leases Finance Leases 2024 $ 33,335 $ 10,782 2025 28,111 10,129 2026 20,306 9,095 2027 13,560 5,612 2028 10,634 44 Thereafter 24,217 — Total future undiscounted leases payments $ 130,163 $ 35,662 Less: amount representing interest (15,364) (3,794) Present value of future lease payments (lease liability) $ 114,799 $ 31,868
Cash flow and supplemental non-cash information	The following table provides certain cash flow and supplemental non-cash information related to the Company's lease liabilities for the years ended December 31, 2023 and 2022 (in thousands): Year Ended December 31, 2023 2022 2021 Cash paid for amounts included in the measurement of lease liabilities: Operating cash payments for operating leases $ 38,328 $ 37,486 $ 36,510 Financing cash payments for finance leases $ 6,769 $ 16,176 $ 42,164 Lease liabilities arising from obtaining right-of-use assets: Operating leases $ 22,000 $ 22,543 $ 91,420 Finance leases $ 32,101 $ 5,423 $ 22,959

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Schedule of current and deferred income tax expense (benefit)	The current and deferred income tax (benefit) expense for the years ended December 31, 2023, 2022 and 2021 is as follows (in thousands): Year Ended December 31, 2023 2022 2021 Current: Federal $ 5,689 $ (197) $ 2,356 State 7,902 6,930 8,070 13,591 6,733 10,426 Deferred: Federal (42,720) 12,205 22,891 State (19,875) 5,831 (511) (62,595) 18,036 22,380 Total income tax (benefit) expense $ (49,004) $ 24,769 $ 32,806
Schedule of reconciliation of the effective income tax rate	A reconciliation of the effective income tax rate with the applicable statutory federal income tax rate for the years ended December 31, 2023, 2022 and 2021 is as follows: Year Ended December 31, 2023 2022 2021 Federal statutory rate 21.0 % 21.0 % 21.0 % State income taxes, net of federal benefit 1.0 % 3.6 % 3.1 % Equity-based compensation (0.4) % (0.5) % (1.9) % Change in valuation allowance (0.3) % — % 0.1 % Change in fair value of warrant liability 1.0 % (3.7) % (5.9) % Change in fair value of contingent consideration — % — % (1.2) % Goodwill impairment (16.6) % — % — % Deferred tax only adjustment 1.1 % (2.6) % 0.3 % Deferred tax impact of state effective tax rate changes — % 8.6 % — % Other — % (1.1) % 1.7 % Effective income tax rate 6.8 % 25.3 % 17.2 %
Schedule of deferred income tax assets and liabilities	Deferred income tax assets and liabilities are comprised of the following at December 31, 2023 and 2022 (in thousands): December 31, 2023 2022 Deferred income tax assets: Accounts receivable $ 35,009 $ 37,363 Goodwill and intangible assets 293,022 262,501 Investment in partnership — 171 Inventory 1,926 1,841 Accruals 16,909 9,207 Net operating losses and credits 23,978 35,459 Transaction costs 455 417 Equity-based compensation 5,379 6,101 Excess business interest expense 46,273 27,918 Lease liability 37,069 35,431 Capital losses 792 817 Other 7 — Total deferred income tax assets 460,819 417,226 Valuation allowance (3,788) (1,812) Net deferred income tax assets $ 457,031 $ 415,414 Deferred income tax liabilities: Right-of-use assets $ (36,011) $ (34,201) Contingent consideration (2,112) (2,200) Investment in partnership (582) — Unrealized gains (1,479) (2,950) Equipment and other fixed assets (70,993) (94,277) Total deferred income tax liabilities (111,177) (133,628) Noncurrent net deferred income tax assets $ 345,854 $ 281,786
Reconciliation of the beginning and ending amount of unrecognized tax benefits	A reconciliation of the beginning and ending amount of unrecognized tax benefits for the years ended December 31, 2023, 2022 and 2021 is as follows (in thousands). Balance, December 31, 2020 $ 1,947 Additions for tax positions acquired 2,100 Balance, December 31, 2021 4,047 Additions for tax positions acquired 2,670 Reductions due to lapse of statute of limitations (78) Balance, December 31, 2022 6,639 Additions for tax positions acquired — Reductions due to lapse of statute of limitations (43) Balance, December 31, 2023 $ 6,596

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Revenue Recognition, Accounts Receivable and COVID-19 (Details) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Apr. 30, 2020	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Revenue Recognition
Net revenue		$ 3,200,177	$ 2,970,595	$ 2,454,535
Unbilled revenue		68,400	38,600
CARES Act funding received	$ 17,200
CARES Act income recognized		0	0	10,595
Significant Acquisitions In 2020
Revenue Recognition
CARES Act funding received	22,200
Business combination, liabilities	$ 7,700
Transferred at Point in Time
Revenue Recognition
Net revenue		2,131,302	2,015,680	1,639,406
Transferred over Time
Revenue Recognition
Net revenue		1,068,875	954,915	815,129
Sleep
Revenue Recognition
Net revenue		1,241,168	1,066,726	891,382
Sleep | Transferred at Point in Time
Revenue Recognition
Net revenue		897,119	794,021	654,130
Sleep | Transferred over Time
Revenue Recognition
Net revenue		344,049	272,705	237,252
Diabetes
Revenue Recognition
Net revenue		660,039	687,091	541,205
Diabetes | Transferred at Point in Time
Revenue Recognition
Net revenue		647,431	670,988	528,082
Diabetes | Transferred over Time
Revenue Recognition
Net revenue		12,608	16,103	13,123
Supplies to the home
Revenue Recognition
Net revenue		192,475	179,326	167,830
Supplies to the home | Transferred at Point in Time
Revenue Recognition
Net revenue		192,475	179,326	167,830
Respiratory
Revenue Recognition
Net revenue		598,820	555,039	458,286
Respiratory | Transferred at Point in Time
Revenue Recognition
Net revenue		32,370	34,342	31,016
Respiratory | Transferred over Time
Revenue Recognition
Net revenue		566,450	520,697	427,270
HME
Revenue Recognition
Net revenue		206,525	220,798	209,741
HME | Transferred at Point in Time
Revenue Recognition
Net revenue		110,197	118,542	113,805
HME | Transferred over Time
Revenue Recognition
Net revenue		96,328	102,256	95,936
Other
Revenue Recognition
Net revenue		301,150	261,615	186,091
Other | Transferred at Point in Time
Revenue Recognition
Net revenue		251,710	218,461	144,543
Other | Transferred over Time
Revenue Recognition
Net revenue		49,440	43,154	41,548
Insurance
Revenue Recognition
Net revenue		1,933,440	1,808,633	1,499,154
Government
Revenue Recognition
Net revenue		852,789	781,975	685,513
Patient pay
Revenue Recognition
Net revenue		$ 413,948	$ 379,987	$ 269,868

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Fair Value of Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Carrying Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	$ 2,147,982	$ 2,188,267
Carrying Value | Secured term loan
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	717,679	761,547
Carrying Value | Senior unsecured notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	1,430,303	1,426,720
Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	1,858,500	1,989,121
Fair Value | Secured term loan
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	717,679	761,547
Fair Value | Senior unsecured notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	$ 1,140,821	$ 1,227,574

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Cash and Cash Equivalents (Details) - USD ($)	Dec. 31, 2023	Dec. 31, 2022
Accounting Policies [Abstract]
Cash equivalents	$ 0	$ 0

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Useful Lives and Long-Lived Assets and Valuation of Goodwill Narrative (Details) - USD ($)	3 Months Ended	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Equipment and Other Fixed Assets
Impairment of long-lived assets		$ 0	$ 0	$ 0
Goodwill impairment	$ 318,900,000	$ 830,787,000	$ 0	$ 0
Payor contracts
Equipment and Other Fixed Assets
Weighted-average useful life (in years)		10 years
Developed technology
Equipment and Other Fixed Assets
Weighted-average useful life (in years)		5 years
Vehicles
Equipment and Other Fixed Assets
Useful lives of property and equipment (in months and years)	5 years	5 years
Minimum | Tradenames
Equipment and Other Fixed Assets
Weighted-average useful life (in years)		5 years
Minimum | Patient medical equipment
Equipment and Other Fixed Assets
Useful lives of property and equipment (in months and years)	13 months	13 months
Minimum | Computers and Software
Equipment and Other Fixed Assets
Useful lives of property and equipment (in months and years)	5 years	5 years
Minimum | Other
Equipment and Other Fixed Assets
Useful lives of property and equipment (in months and years)	2 years	2 years
Maximum | Tradenames
Equipment and Other Fixed Assets
Weighted-average useful life (in years)		10 years
Maximum | Patient medical equipment
Equipment and Other Fixed Assets
Useful lives of property and equipment (in months and years)	5 years	5 years
Maximum | Computers and Software
Equipment and Other Fixed Assets
Useful lives of property and equipment (in months and years)	10 years	10 years
Maximum | Other
Equipment and Other Fixed Assets
Useful lives of property and equipment (in months and years)	10 years	10 years

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Advertising Costs, Cost of Net Revenue, General and Administrative Expenses (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Accounting Policies [Abstract]
Advertising costs	$ 22,800	$ 19,200	$ 18,500
Cost of products and supplies	1,305,219	1,199,481	955,813
Salaries, labor and benefits	785,876	777,306	602,969
Patient equipment depreciation	325,696	286,288	194,958
Other operating expenses	236,039	225,719	206,599
Rent and occupancy	67,783	64,375	48,586
Total	2,720,613	2,553,169	2,008,925
Salaries and benefits expenses	$ 68,300	$ 60,600	$ 60,100

Summary of Significant Accoun_9

Summary of Significant Accounting Policies - Business Segment, Concentration of Credit Risk, Customers (Details) - segment	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Concentration Risk [Line Items]
Number of operating segments	1
Number of reportable segments	1
Customer Concentration Risk | Accounts Receivable | Patient pay | Maximum
Concentration Risk [Line Items]
Concentration risk percentage	10%	10%
Customer Concentration Risk | Revenue Benchmark | Government
Concentration Risk [Line Items]
Concentration risk percentage	27%	26%	28%

Acquisitions - Narrative (Detai

Acquisitions - Narrative (Details) $ / shares in Units, $ in Thousands						12 Months Ended
	Dec. 30, 2021 USD ($)	Jul. 01, 2021 USD ($) shares	Jun. 01, 2021 USD ($) shares	Apr. 30, 2021 USD ($) shares	Feb. 01, 2021 USD ($) $ / shares shares	Dec. 31, 2023 USD ($) provider shares	Dec. 31, 2022 USD ($) provider shares	Dec. 31, 2021 USD ($) shares	Jul. 31, 2021 USD ($)	Nov. 08, 2019 $ / shares
Business Acquisition [Line Items]
Net cash (receipts) payments relating to prior acquisitions							$ 2,009
Issuance of preferred stock (in shares) | shares						124,060	124,060
Exercise price (in dollars per share) | $ / shares										$ 11.50
Deferred purchase price in connection with acquisitions						$ 137	$ 457	$ 4,478
Home Medical Equipment Provider Acquired In 2023
Business Acquisition [Line Items]
Interest acquired, as a percent						100%
Number of home medical providers acquired | provider						2
Number of entities acquired | provider						4
Home Medical Equipment Provider Acquired In 2022
Business Acquisition [Line Items]
Interest acquired, as a percent							100%
Number of home medical providers acquired | provider							3
Number of entities acquired | provider							5
Significant Acquisitions In 2022
Business Acquisition [Line Items]
Net cash (receipts) payments relating to prior acquisitions							$ 2,000
Cash payment							17,170
Significant Acquisitions In 2021
Business Acquisition [Line Items]
Net cash (receipts) payments relating to prior acquisitions							$ 2,000	(700)
Cash payment								1,657,970
Contingent consideration liability								7,800
AeroCare
Business Acquisition [Line Items]
Interest acquired, as a percent					100%
Cash payment					$ 1,200,000			1,153,409
Options issued in acquisition (in shares) | shares					3,959,892
Exercise price (in dollars per share) | $ / shares					$ 6.24
Weighted average exercise period (in years)					7 years
Contingent consideration liability								0
AeroCare | Common Stock
Business Acquisition [Line Items]
Issuance of stock for acquisitions (in shares) | shares					13,992,615
AeroCare | Preferred Stock
Business Acquisition [Line Items]
Issuance of preferred stock (in shares) | shares					130,474.73
Spiro
Business Acquisition [Line Items]
Interest acquired, as a percent				100%
Cash payment				$ 65,800				65,759
Issuance of stock for acquisitions (in shares) | shares				244,641
Maximum potential contingent consideration				$ 1,000
Contingent consideration liability								1,000
Healthy Living
Business Acquisition [Line Items]
Interest acquired, as a percent			100%
Cash payment			$ 47,000					47,048
Issuance of stock for acquisitions (in shares) | shares			196,779
Contingent consideration liability								0
Agilis
Business Acquisition [Line Items]
Interest acquired, as a percent		100%
Cash payment		$ 30,800						30,828
Issuance of stock for acquisitions (in shares) | shares		538,079
Maximum potential contingent consideration		$ 1,000
Investment carrying value									$ 8,100
Fair value of investment									$ 10,000
Gain on equity method investment								1,900
Contingent consideration liability								1,000
We Care
Business Acquisition [Line Items]
Interest acquired, as a percent		100%
Cash payment		$ 34,800						34,834
Issuance of stock for acquisitions (in shares) | shares		231,866
Contingent consideration liability								0
Community
Business Acquisition [Line Items]
Interest acquired, as a percent	100%
Cash payment	$ 129,400							129,423
Maximum potential contingent consideration	6,500
Contingent consideration liability	$ 5,800							$ 5,800
Home Medical Equipment Provider and Diabetes Management Products and Supplies Acquired in 2021
Business Acquisition [Line Items]
Interest acquired, as a percent								100%
Cash payment								$ 196,700
Issuance of stock for acquisitions (in shares) | shares								306,569
Deferred purchase price in connection with acquisitions								$ 4,500

Acquisitions - Consideration Pa

Acquisitions - Consideration Paid (Details) - USD ($) $ in Thousands						12 Months Ended
	Dec. 30, 2021	Jul. 01, 2021	Jun. 01, 2021	Apr. 30, 2021	Feb. 01, 2021	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Significant Acquisitions In 2023
Business Acquisition [Line Items]
Cash						$ 19,943
Deferred payments						137
Total						$ 20,080
Significant Acquisitions In 2022
Business Acquisition [Line Items]
Cash							$ 17,170
Deferred payments							457
Total							$ 17,627
Significant Acquisitions In 2021
Business Acquisition [Line Items]
Cash								$ 1,657,970
Equity								1,261,200
Contingent consideration								7,800
Deferred payments								4,478
Total								2,931,448
AeroCare
Business Acquisition [Line Items]
Cash					$ 1,200,000			1,153,409
Equity								1,220,342
Contingent consideration								0
Deferred payments								0
Total								2,373,751
Spiro
Business Acquisition [Line Items]
Cash				$ 65,800				65,759
Equity								7,109
Contingent consideration								1,000
Deferred payments								0
Total								73,868
Healthy Living
Business Acquisition [Line Items]
Cash			$ 47,000					47,048
Equity								5,057
Contingent consideration								0
Deferred payments								0
Total								52,105
Agilis
Business Acquisition [Line Items]
Cash		$ 30,800						30,828
Equity								14,668
Contingent consideration								1,000
Deferred payments								0
Total								46,496
We Care
Business Acquisition [Line Items]
Cash		$ 34,800						34,834
Equity								6,321
Contingent consideration								0
Deferred payments								0
Total								41,155
Community
Business Acquisition [Line Items]
Cash	$ 129,400							129,423
Equity								0
Contingent consideration	$ 5,800							5,800
Deferred payments								0
Total								135,223
Other
Business Acquisition [Line Items]
Cash								196,669
Equity								7,703
Contingent consideration								0
Deferred payments								4,478
Total								$ 208,850

Acquisitions - Net Assets Acqui

Acquisitions - Net Assets Acquired (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Business Acquisition [Line Items]
Goodwill	$ 2,724,958	$ 3,545,297	$ 3,512,567
Significant Acquisitions In 2023
Business Acquisition [Line Items]
Cash	256
Accounts receivable	1,264
Inventory	1,483
Prepaid and other current assets	10
Equipment and other fixed assets	9,011
Operating lease right-of-use assets	5,506
Finance lease right-of-use assets	200
Goodwill	9,616
Accounts payable and accrued expenses	(713)
Other current liabilities	(847)
Operating lease liabilities	(5,506)
Finance lease liabilities	(200)
Net assets acquired	$ 20,080
Significant Acquisitions In 2022
Business Acquisition [Line Items]
Cash		162
Accounts receivable		2,336
Inventory		771
Prepaid and other current assets		16
Equipment and other fixed assets		4,585
Goodwill		12,341
Identifiable intangible assets		500
Deferred tax assets		180
Accounts payable and accrued expenses		(3,130)
Contract liabilities		(134)
Net assets acquired		$ 17,627
Significant Acquisitions In 2021
Business Acquisition [Line Items]
Cash			36,993
Accounts receivable			126,902
Inventory			50,352
Prepaid and other current assets			7,736
Equipment and other fixed assets			274,357
Operating lease right-of-use assets			78,643
Goodwill			2,536,566
Identifiable intangible assets			132,900
Other assets			3,699
Deferred tax liabilities			(47,770)
Accounts payable and accrued expenses			(131,583)
Contract liabilities			(19,630)
Other current liabilities			(13,701)
Other long-term liabilities			(3,738)
Operating lease liabilities			(78,643)
Finance lease liabilities			(11,635)
Net assets acquired			2,941,448
AeroCare
Business Acquisition [Line Items]
Cash			27,686
Accounts receivable			71,916
Inventory			26,998
Prepaid and other current assets			3,522
Equipment and other fixed assets			190,755
Operating lease right-of-use assets			52,927
Goodwill			2,083,423
Identifiable intangible assets			122,800
Other assets			1,178
Deferred tax liabilities			(46,234)
Accounts payable and accrued expenses			(82,722)
Contract liabilities			(14,495)
Other current liabilities			(10,021)
Other long-term liabilities			(1,055)
Operating lease liabilities			(52,927)
Finance lease liabilities			0
Net assets acquired			2,373,751
Spiro
Business Acquisition [Line Items]
Cash			2,132
Accounts receivable			5,756
Inventory			1,733
Prepaid and other current assets			152
Equipment and other fixed assets			6,897
Operating lease right-of-use assets			2,581
Goodwill			64,380
Identifiable intangible assets			1,000
Other assets			16
Deferred tax liabilities			0
Accounts payable and accrued expenses			(5,517)
Contract liabilities			(486)
Other current liabilities			0
Other long-term liabilities			0
Operating lease liabilities			(2,581)
Finance lease liabilities			(2,195)
Net assets acquired			73,868
Healthy Living
Business Acquisition [Line Items]
Cash			579
Accounts receivable			5,838
Inventory			2,949
Prepaid and other current assets			1,088
Equipment and other fixed assets			1,188
Operating lease right-of-use assets			1,366
Goodwill			44,095
Identifiable intangible assets			1,500
Other assets			0
Deferred tax liabilities			0
Accounts payable and accrued expenses			(3,363)
Contract liabilities			(102)
Other current liabilities			(1,667)
Other long-term liabilities			0
Operating lease liabilities			(1,366)
Finance lease liabilities			0
Net assets acquired			52,105
Agilis
Business Acquisition [Line Items]
Cash			1,131
Accounts receivable			0
Inventory			2,330
Prepaid and other current assets			0
Equipment and other fixed assets			348
Operating lease right-of-use assets			490
Goodwill			55,375
Identifiable intangible assets			500
Other assets			0
Deferred tax liabilities			0
Accounts payable and accrued expenses			(3,188)
Contract liabilities			0
Other current liabilities			0
Other long-term liabilities			0
Operating lease liabilities			(490)
Finance lease liabilities			0
Net assets acquired			56,496
We Care
Business Acquisition [Line Items]
Cash			458
Accounts receivable			2,007
Inventory			465
Prepaid and other current assets			0
Equipment and other fixed assets			5,254
Operating lease right-of-use assets			970
Goodwill			35,971
Identifiable intangible assets			400
Other assets			0
Deferred tax liabilities			(1,228)
Accounts payable and accrued expenses			(1,389)
Contract liabilities			(783)
Other current liabilities			0
Other long-term liabilities			0
Operating lease liabilities			(970)
Finance lease liabilities			0
Net assets acquired			41,155
Community
Business Acquisition [Line Items]
Cash			2
Accounts receivable			15,798
Inventory			5,214
Prepaid and other current assets			571
Equipment and other fixed assets			44,952
Operating lease right-of-use assets			4,412
Goodwill			88,393
Identifiable intangible assets			2,300
Other assets			2,505
Deferred tax liabilities			0
Accounts payable and accrued expenses			(13,725)
Contract liabilities			(3,156)
Other current liabilities			(180)
Other long-term liabilities			(2,683)
Operating lease liabilities			(4,412)
Finance lease liabilities			(4,768)
Net assets acquired			135,223
Other
Business Acquisition [Line Items]
Cash			5,005
Accounts receivable			25,587
Inventory			10,663
Prepaid and other current assets			2,403
Equipment and other fixed assets			24,963
Operating lease right-of-use assets			15,897
Goodwill			164,929
Identifiable intangible assets			4,400
Other assets			0
Deferred tax liabilities			(308)
Accounts payable and accrued expenses			(21,679)
Contract liabilities			(608)
Other current liabilities			(1,833)
Other long-term liabilities			0
Operating lease liabilities			(15,897)
Finance lease liabilities			(4,672)
Net assets acquired			$ 208,850

Acquisitions - Results of Busin

Acquisitions - Results of Business Acquired (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Business Combination and Asset Acquisition [Abstract]
Net revenue	$ 7,246	$ 16,455	$ 1,005,097
Operating income	$ 745	$ 767	$ 136,404

Equipment and Other Fixed Ass_3

Equipment and Other Fixed Assets (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Equipment and Other Fixed Assets
Gross carrying value	$ 932,082	$ 870,267
Less accumulated depreciation	(436,981)	(383,188)
Equipment and other fixed assets, net	495,101	487,079
Depreciation and amortization, including patient equipment depreciation	350,200	311,200	$ 211,500
Patient medical equipment
Equipment and Other Fixed Assets
Gross carrying value	791,349	747,985
Computers and software
Equipment and Other Fixed Assets
Gross carrying value	85,509	70,897
Delivery vehicles
Equipment and Other Fixed Assets
Gross carrying value	35,021	35,326
Other
Equipment and Other Fixed Assets
Gross carrying value	$ 20,203	$ 16,059

Goodwill and Identifiable Int_3

Goodwill and Identifiable Intangible Assets - Change in Goodwill (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Goodwill [Roll Forward]
Beginning balance		$ 3,545,297	$ 3,512,567
Goodwill from acquisitions		9,616	12,341
Net cash payments relating to prior acquisitions			2,009
Net increase relating to measurement period adjustments		832	18,380
Goodwill impairment	$ 318,900	830,787	0	$ 0
Ending balance	$ 2,724,958	$ 2,724,958	$ 3,545,297	$ 3,512,567

Goodwill and Identifiable Int_4

Goodwill and Identifiable Intangible Assets - Narrative (Details) - USD ($)	3 Months Ended	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Goodwill [Line Items]
Goodwill impairment	$ 318,900,000	$ 830,787,000	$ 0	$ 0
Net cash payments relating to prior acquisitions			2,009,000
Net increase (reductions) relating to measurement period adjustments			18,400,000
Decrease to accounts receivable			900,000
Decrease to equipment and other fixed assets, net			10,000,000
Increase to other current liabilities			7,300,000
Decrease to accounts payable and accrued expenses			2,200,000
Increase to goodwill			16,000,000
Amortization of intangible assets		32,600,000	40,000,000	46,500,000
Impairment charges to identifiable intangible assets		$ 0	0	0
Significant Acquisitions In 2021
Goodwill [Line Items]
Net cash payments relating to prior acquisitions			$ 2,000,000	$ (700,000)

Goodwill and Identifiable Int_5

Goodwill and Identifiable Intangible Assets - Identified Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Identifiable intangible assets, net	$ 130,160	$ 162,773
Tradenames
Finite-Lived Intangible Assets [Line Items]
Accumulated amortization	38,314	25,498
Identifiable intangible assets, net	$ 74,486	$ 87,302
Weighted-Average Remaining Life (Years)	6 years 7 months 6 days	7 years 6 months
Payor contracts
Finite-Lived Intangible Assets [Line Items]
Accumulated amortization	$ 28,216	$ 20,016
Identifiable intangible assets, net	$ 53,784	$ 61,984
Weighted-Average Remaining Life (Years)	6 years 7 months 6 days	7 years 7 months 6 days
Contractual rental agreements
Finite-Lived Intangible Assets [Line Items]
Accumulated amortization		$ 43,863
Identifiable intangible assets, net		$ 10,337
Weighted-Average Remaining Life (Years)		9 months 18 days
Developed technology
Finite-Lived Intangible Assets [Line Items]
Accumulated amortization	$ 4,410	$ 3,150
Identifiable intangible assets, net	$ 1,890	$ 3,150
Weighted-Average Remaining Life (Years)	1 year 6 months	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	Dec. 31, 2023	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
2024	$ 22,276
2025	21,328
2026	19,263
2027	17,960
2028	17,936
Thereafter	31,397
Total	$ 130,160	$ 162,773

Fair Value of Assets and Liab_3

Fair Value of Assets and Liabilities - Valuation of Financial Assets and Liabilities (Details) - Fair Value, Recurring - USD ($) $ in Thousands	Dec. 31, 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	5,468	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	4,482	5,748
Level 2 | Interest rate swap agreements-long term
Assets
Total assets measured at fair value	986	3,728
Level 3
Assets
Total assets measured at fair value	0	0
Liabilities
Total liabilities measured at fair value	10,871	46,003
Level 3 | Acquisition-related contingent consideration-short term
Liabilities
Total liabilities measured at fair value	6,850	7,500
Level 3 | Warrant liability
Liabilities
Total liabilities measured at fair value	4,021	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 Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Fair Value Disclosures [Abstract]
Contingent consideration liability	$ 6,850	$ 7,500	$ 20,300

Fair Value of Assets and Liab_5

Fair Value of Assets and Liabilities - Contingent Consideration Rollforward (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Contingent Consideration Liability Rollforward [Roll Forward]
Beginning Balance	$ 7,500	$ 20,300
Additions	0	0
Payments	(1,000)	(15,015)
Change in Fair Value	350	2,215
Other activity	0	0
Ending Balance	$ 6,850	$ 7,500

Derivative Instruments and He_3

Derivative Instruments and Hedging Activities - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Derivative [Line Items]
Estimated reclassification to interest expense	$ 4.9
Notional amount	$ 250
Gain (loss) in other comprehensive income (loss)		$ 14	$ 8.7
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
Amount reclassified from other comprehensive income (loss)	$ 1.8	$ 2.9	$ 2.9
Cash Flow Hedging
Derivative [Line Items]
Gain (loss) in other comprehensive income (loss)	$ (2.5)

Derivative Instruments and He_4

Derivative Instruments and Hedging Activities - Financial instruments (Details) - Designated as Hedging Instrument - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Asset	$ 5,468	$ 9,476
Interest Rate Swap | Prepaid and other current assets
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Asset	4,482	5,748
Interest Rate Swap | Other assets
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Asset	$ 986	$ 3,728

Deferred Financing Costs - Chan

Deferred Financing Costs - Change in Deferred Financing Costs (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Movement In Deferred Finance Costs [Roll Forward]
Balance at beginning of period	$ 28,229	$ 33,463
Amortization	(5,234)	(5,234)	$ (5,378)
Balance at end of period	$ 22,995	$ 28,229	$ 33,463

Deferred Financing Costs - Narr

Deferred Financing Costs - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Debt Issuance Costs, Net [Abstract]
Amortization	$ 5,234	$ 5,234	$ 5,378
Deferred financing costs	$ 22,995	$ 28,229	$ 33,463

Deferred Financing Costs - Amor

Deferred Financing Costs - Amortization of Deferred Financing Costs (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Debt Issuance Costs, Net [Abstract]
2024	$ 5,234
2025	5,147
2026	3,659
2027	3,577
2028	3,139
Thereafter	2,239
Deferred financing costs	$ 22,995	$ 28,229	$ 33,463

Accounts Payable and Accrued _3

Accounts Payable and Accrued Expenses (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Accounts Payable and Accrued Liabilities, Current [Abstract]
Accounts payable	$ 211,504	$ 222,505
Litigation settlement	57,340	0
Employee-related accruals	47,462	41,872
Accrued interest	29,327	28,877
Other	46,361	44,244
Total	$ 391,994	$ 337,498

Debt - Summary of Long-Term Deb

Debt - Summary of Long-Term Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Gross long-term debt	$ 2,170,000
Unamortized deferred financing fees	(22,018)	$ (26,733)
Net long-term debt	2,147,982	2,188,267
Current portion	(53,368)	(35,000)
Long-term debt, less current portion	2,094,614	2,153,267
Secured term loan
Debt Instrument [Line Items]
Gross long-term debt	720,000	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			12 Months Ended
	Mar. 31, 2023	Aug. 31, 2021	Jan. 31, 2021	Jul. 31, 2020	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Aug. 16, 2021	Nov. 30, 2019	Mar. 31, 2019
Debt Instrument [Line Items]
Interest expense					$ 131,000	$ 112,400	$ 97,900
Repayment of loan					95,000	20,000	827,271
Write-off of deferred financing costs					0	0	4,054
Gross long-term debt					2,170,000
Proceeds on lines of credit					50,000	0	1,165,000
Gain (loss) on extinguishment of debt					0	0	(16,135)
Secured term loan
Debt Instrument [Line Items]
Borrowing capacity			$ 800,000
Gross long-term debt					$ 720,000	765,000
Credit facility interest rate					7.46%
Secured term loan | First Specified Repayment Period
Debt Instrument [Line Items]
Quarterly principal repayments					$ 5,000
Secured term loan | Second Specified Repayment Period
Debt Instrument [Line Items]
Quarterly principal repayments					10,000
Revolving Credit Loans 2021
Debt Instrument [Line Items]
Borrowing capacity			450,000
Proceeds on lines of credit					50,000	0
Repayment of credit facility					50,000
Revolver balance					0	0
Remaining maximum borrowings available					226,200
Letter Of Credit 2021
Debt Instrument [Line Items]
Borrowing capacity			55,000
Credit Agreement 2021
Debt Instrument [Line Items]
Repayment of loan			$ 301,900
Financing costs							7,600
Write-off of deferred financing costs							2,100
Mandatory prepayment					13,400
Credit Agreement 2021 | Term Secured Overnight Financing Rate (SOFR) Adjustment
Debt Instrument [Line Items]
Applicable margin	0.10%
Credit Agreement 2021 | Minimum
Debt Instrument [Line Items]
Commitment fee (as a percent)	0.25%
Credit Agreement 2021 | Minimum | Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Applicable margin	1.50%
Credit Agreement 2021 | Maximum
Debt Instrument [Line Items]
Commitment fee (as a percent)	0.50%
Credit Agreement 2021 | Maximum | Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Applicable margin	3.25%
Senior Unsecured Notes 5.125 Per Cent Due 2030
Debt Instrument [Line Items]
Debt interest rate		5.125%						5.125%
Face amount		$ 600,000
Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Redemption price		102.563%
Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period Three
Debt Instrument [Line Items]
Redemption price		101.281%
Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period Four
Debt Instrument [Line Items]
Redemption price		100%
Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Redemption price		100%
Percentage redeemed		40%
Percentage of proceeds from equity offerings		105.125%
Senior unsecured notes
Debt Instrument [Line Items]
Debt interest rate			4.625%
Gross long-term debt					$ 1,450,000	$ 1,450,000
Face amount			$ 500,000
Percentage redeemed			40%
Percentage of proceeds from equity offerings			104.625%
Senior unsecured notes | Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Redemption price			102.313%
Senior unsecured notes | Debt Instrument, Redemption, Period Three
Debt Instrument [Line Items]
Redemption price			101.156%
Senior unsecured notes | Debt Instrument, Redemption, Period Four
Debt Instrument [Line Items]
Redemption price			100%
Senior unsecured notes | Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Redemption price			100%
Senior Notes 6.125 Percent Due 2028
Debt Instrument [Line Items]
Debt interest rate				6.125%
Face amount				$ 350,000
Percentage redeemed				40%
Percentage of proceeds from equity offerings				106.125%
Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Two
Debt Instrument [Line Items]
Redemption price				103.063%
Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Three
Debt Instrument [Line Items]
Redemption price				102.042%
Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Four
Debt Instrument [Line Items]
Redemption price				101.021%
Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Redemption price				100%
Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Five
Debt Instrument [Line Items]
Redemption price				100%
Note payable
Debt Instrument [Line Items]
Face amount									$ 100,000
Note payable | Period starting on the closing date and ending on the seventh anniversary
Debt Instrument [Line Items]
Debt interest rate									12%
Promissory Note From Members Interest
Debt Instrument [Line Items]
Face amount									$ 43,500	$ 100,000
Notes Payable, Other Payables
Debt Instrument [Line Items]
Write-off of deferred financing costs							2,000
Gross long-term debt							143,500
Gain (loss) on extinguishment of debt							$ (16,200)
Make-whole premium, as a percent							10%

Debt - Future Maturity of Total

Debt - Future Maturity of Total Debt (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Debt Disclosure [Abstract]
2024	$ 53,368
2025	40,000
2026	626,632
2027	0
2028	350,000
Thereafter	1,100,000
Total debt maturity	$ 2,170,000

Stockholders' Equity - Common S

Stockholders' Equity - Common Stock, Preferred Stock, Treasury Stock and Warrants Narrative (Details) $ / shares in Units, $ in Thousands					1 Months Ended		12 Months Ended
	Jul. 28, 2021 vote shares	Mar. 18, 2021 shares	Jan. 01, 2021 shares	Nov. 08, 2019 vote $ / shares shares	Jan. 31, 2021 USD ($) $ / shares shares	Jun. 30, 2020 $ / shares shares	Dec. 31, 2023 USD ($) $ / shares shares	Dec. 31, 2022 USD ($) $ / shares shares	Dec. 31, 2021 USD ($) shares	May 31, 2022 USD ($)	Jul. 27, 2021 shares	Feb. 01, 2021 $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock exchange ratio				1
Exchange of Class B Common Stock for Class A Common Stock | $									$ 77,900
Common Stock, shares authorized (in shares)	300,000,000						300,000,000	300,000,000			245,000,000
Vote for each share | vote	1
Proceeds from the issuance of Class A Common Stock | $							$ 0	$ 0	278,850
Offering costs | $							$ 0	$ 0	$ 13,832
Preferred Stock, par value (in dollars per share) | $ / shares							$ 0.0001	$ 0.0001
Preferred Stock, shares issued (in shares)							124,060	124,060
Authorized purchase amount | $										$ 200,000
Warrants outstanding (in shares)				12,666,666			3,871,557
Common stock for each warrant exercised (in shares)				1
Exercise price (in dollars per share) | $ / shares				$ 11.50
Warrants exercised in cashless transaction, number exercised (in shares)							0	184,870	224,121
Shares issued in cashless exercise of warrants (in shares)								87,553
Treasury Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares purchased under share repurchase program (in shares)							3,184,200	750,835
Value of repurchase | $							$ 29,300	$ 14,000
AeroCare
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise price (in dollars per share) | $ / shares												$ 6.24
Public Offering
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Sale of stock, net of offering costs (in shares)					8,450,000
Share price (in dollars per share) | $ / shares					$ 33
Proceeds from sale of stock | $					$ 278,900				$ 265,018
Proceeds from the issuance of Class A Common Stock | $					265,000
Offering costs | $					$ 13,800				$ 13,832
Class B Common Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exchange of Class B Common Stock for Class A Common Stock (in shares)			13,218,758
Common Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exchange of Class A Common Stock for Series B-1 Preferred Stock (in shares)						15,810,547
Conversion of Series B-1 Preferred Stock to Class A Common Stock (in shares)							0	0	3,950,000
Conversion Of Series C-1 Preferred Stock to Class A Common Stock (in shares)		13,047,473
Shares issued in cashless exercise of warrants (in shares)									118,379
Series B-1 Preferred Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exchange of Class A Common Stock for Series B-1 Preferred Stock (in shares)						158,105.47
Preferred Stock, par value (in dollars per share) | $ / shares						$ 0.0001
Preferred stock, liquidation preference (in dollars per share) | $ / shares						$ 0.0001
Shares of common stock received in conversion for each share of preferred stock (in shares)						100
Preferred stock conversion, ceiling as a percent of outstanding common stock						0.049
Conversion of Series B-1 Preferred Stock to Class A Common Stock (in shares)							0	0	39,500
Preferred Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares of common stock received in conversion for each share of preferred stock (in shares)		100
Conversion Of Series C-1 Preferred Stock to Class A Common Stock (in shares)		130,474.73
Preferred Stock | AeroCare
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Preferred stock, liquidation preference (in dollars per share) | $ / shares												$ 0.0001
Preferred Stock, shares issued (in shares)												130,474.73
Adapt Health Holdings LLC
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Controlling interest, as a percent				56%
Adapt Health Holdings LLC | Shareholders of Adapt Health Holdings LLC
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Noncontrolling interest, as a percent				44%
Number of votes per share | vote				1

Stockholders' Equity - Warrants

Stockholders' Equity - Warrants (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Warrant Rollforward [Roll Forward]
Estimated fair value of warrant liability, beginning	$ 38,503	$ 57,764	$ 113,905
Change in estimated fair value of the warrant liability	(34,482)	(17,158)	(53,181)
Reclassification of warrant liability to equity for exercised warrants		(2,103)	(2,960)
Estimated fair value of warrant liability, ending	$ 4,021	$ 38,503	$ 57,764

Stockholders' Equity - Continge

Stockholders' Equity - Contingent Consideration Common Shares, Equity-based Compensation and Stock Options Narrative (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended				12 Months Ended
	Jun. 30, 2021	Jan. 31, 2021	Apr. 30, 2020	Nov. 30, 2019	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Earn-out consideration, shares per annual installment (in shares)						1,000,000	1,000,000	1,000,000
Second stock price hurdle (in dollars per share)						$ 22	$ 18	$ 15
Issuance of shares in contingent consideration (in shares)						0	1,000,000	1,000,000
Remaining contingent consideration (in shares)							1,000,000
Increase (decrease) in deferred tax assets						$ 1,600	$ (1,600)
Granted (in shares)		703,170	47,335	3,416,666	0	0	703,000
Vesting period (in years)		3 years
Exercise period (in years)		5 years
Options granted, grant date fair value		$ 6,900	$ 300	$ 7,200
Options forfeited (in shares)							914,000
Granted (in dollars per share)			$ 16.25	$ 11.50			$ 48.72
Options outstanding (in shares)					3,409,000	4,962,000	5,766,000	3,464,001
Number of shares issued for options exercised on a cash basis (in shares)					211,185	489,191	1,138,982
Exercise of options					$ 587	$ 2,510	$ 12,320
Options exercised in cashless basis (in shares)					1,341,770	315,349	307,613
Options exercised cashless basis (in shares)					228,466	131,741	133,126
Chief Executive Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options forfeited (in shares)							234,390
2019 Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares authorized for issuance (in shares)					10,000,000
Stock available for issuance (in shares)					1,039,484
Granted (in shares)							703,000
Options forfeited (in shares)							914,000
Granted (in dollars per share)							$ 48.72
Options outstanding (in shares)					2,219,000	2,219,000	2,219,000	3,464,000
Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise period (in years)				10 years
Options forfeited (in shares)							679,958
Accelerated vesting, number of shares (in shares)	184,932
Accelerated vesting cost	$ 1,900
Vested (in shares)						722,222	722,222	1,154,667

Stockholders' Equity - Contin_2

Stockholders' Equity - Contingent Consideration (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Contingent Consideration Common Share Liability Rollforward [Roll Forward]
Estimated fair value of contingent consideration common shares liability, beginning balance		$ 0	$ 70,477
Change in estimated fair value of the contingent consideration common shares liability	$ 0	$ 0	(29,389)
Reclassification of contingent consideration common shares liability to equity			(41,088)
Estimated fair value of contingent consideration common shares liability, ending balance			$ 0

Stockholders' Equity - Assumpti

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

Stockholders' Equity - Stock Op

Stockholders' Equity - Stock Option Activity (Details) - $ / shares	1 Months Ended			12 Months Ended
	Jan. 31, 2021	Apr. 30, 2020	Nov. 30, 2019	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Number of Options
Outstanding at beginning of period (in shares)	3,464,001			4,962,000	5,766,000	3,464,001
Granted (in shares)	703,170	47,335	3,416,666	0	0	703,000
Exercised (in shares)				(1,553,000)	(804,000)	(1,447,000)
Forfeited (in shares)						(914,000)
Outstanding at end of period (in shares)				3,409,000	4,962,000	5,766,000
Weighted-Average Exercise Price per Share
Outstanding at beginning of period (in dollars per share)	$ 11.56			$ 12.19	$ 11.26	$ 11.56
Granted (in dollars per share)		$ 16.25	$ 11.50			48.72
Exercised (in dollars per share)				6.24	5.69	10.16
Forfeited (in dollars per share)						11.66
Outstanding at end of period (in dollars per share)				$ 14.90	$ 12.19	$ 11.26
Weighted-Average Remaining Contractual Term
Weighted average remaining contractual term (in years)				4 years 10 months 24 days
Stock Options Exercisable
Number of Options
Outstanding at beginning of period (in shares)	1,155,000			4,649,000	4,575,000	1,155,000
Vested (in shares)				234,000	878,000	907,000
Exercised (in shares)				(1,553,000)	(804,000)	(1,447,000)
Outstanding at end of period (in shares)				3,330,000	4,649,000	4,575,000
Weighted-Average Grant Date Fair Value per Share
Vested (in dollars per share)				$ 48.72	$ 18.12	$ 11.50
Weighted-Average Exercise Price per Share
Outstanding at beginning of period (in dollars per share)	$ 11.56			9.73	7.39	11.56
Granted (in dollars per share)						6.24
Exercised (in dollars per share)				6.24	5.69	10.16
Outstanding at end of period (in dollars per share)				$ 14.10	$ 9.73	$ 7.39
Weighted-Average Remaining Contractual Term
Weighted average remaining contractual term (in years)				4 years 10 months 24 days
Stock Options Unexercisable
Number of Options
Outstanding at beginning of period (in shares)	2,309,000			313,000	1,191,000	2,309,000
Granted (in shares)						703,000
Vested (in shares)				234,000	878,000	907,000
Forfeited (in shares)						(914,000)
Outstanding at end of period (in shares)				79,000	313,000	1,191,000
Weighted-Average Grant Date Fair Value per Share
Vested (in dollars per share)				$ 48.72	$ 18.12	$ 11.50
Weighted-Average Exercise Price per Share
Outstanding at beginning of period (in dollars per share)	$ 11.56			48.72	26.15	11.56
Granted (in dollars per share)						48.72
Forfeited (in dollars per share)						11.66
Outstanding at end of period (in dollars per share)				$ 48.72	$ 48.72	$ 26.15
Weighted-Average Remaining Contractual Term
Weighted average remaining contractual term (in years)				2 years 1 month 6 days
AeroCare
Number of Options
Granted (in shares)						3,960,000
Weighted-Average Exercise Price per Share
Granted (in dollars per share)						$ 6.24
AeroCare | Stock Options Exercisable
Number of Options
Granted (in shares)						3,960,000
2019 Incentive Plan
Number of Options
Outstanding at beginning of period (in shares)	3,464,000			2,219,000	2,219,000	3,464,000
Granted (in shares)						703,000
Exercised (in shares)						(1,034,000)
Forfeited (in shares)						(914,000)
Outstanding at end of period (in shares)				2,219,000	2,219,000	2,219,000
Weighted-Average Grant Date Fair Value per Share
Outstanding at beginning of period (in dollars per share)	$ 2.18			$ 3.75	$ 3.75	$ 2.18
Granted (in dollars per share)						9.81
Exercised (in dollars per share)						2.19
Forfeited (in dollars per share)						2.27
Outstanding at end of period (in dollars per share)				3.75	3.75	3.75
Weighted-Average Exercise Price per Share
Outstanding at beginning of period (in dollars per share)	$ 11.56			19.36	19.36	11.56
Granted (in dollars per share)						48.72
Exercised (in dollars per share)						11.57
Forfeited (in dollars per share)						11.66
Outstanding at end of period (in dollars per share)				$ 19.36	$ 19.36	$ 19.36
Weighted-Average Remaining Contractual Term
Weighted average remaining contractual term (in years)				5 years 1 month 6 days

Stockholders' Equity - Restrict

Stockholders' Equity - Restricted Stock, Incentive Units and Equity-Based Compensation Expense Narrative (Details) - USD ($) $ in Thousands		1 Months Ended			12 Months Ended				26 Months Ended
	Jun. 30, 2023	Jun. 30, 2021	Jan. 31, 2021	May 31, 2020	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2019	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)			3 years
Equity-based compensation expense					$ 22,468	$ 22,397	$ 25,323
Increase (decrease) to income tax expense					(600)	$ 2,100	$ 4,600
Unrecognized compensation expense					$ 21,100
Recognition period (in years)					1 year 8 months 12 days
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%
2019 Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Grant date fair value								$ 4,500
Unvested restricted stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)					1,311,000	962,000	1,354,000
Equity-based compensation expense							$ 500
Accelerated vesting (in shares)									22,192
Forfeited (in shares)					441,000	196,000	851,000		77,808
Retention Program Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)							70,634
Equity-based compensation expense							$ 2,400
Share-based Payment Arrangement
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Equity-based compensation expense							$ 1,500
Share-based Payment Arrangement | Share-based Payment Arrangement, Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)								1 year
Share-based Payment Arrangement | 2019 Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)								4 years
Vesting percentage				25%
Share-based Payment Arrangement | 2019 Incentive Plan | Share-based Payment Arrangement, Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage								50%
Share-based Payment Arrangement | 2019 Incentive Plan | Share-based Payment Arrangement, Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage								50%
Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Accelerated vesting, number of shares (in shares)		184,932
Various Employees | Unvested restricted stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)					732,810	562,686	1,266,846
Vesting period (in years)					3 years
Grant date fair value					$ 9,300	$ 10,300	$ 37,100
Various Employees | Unvested restricted stock | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)						3 years	3 years
Various Employees | Unvested restricted stock | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)						4 years	4 years
Various Employees, Immediate Vesting | Unvested restricted stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)					58,795
Grant date fair value					$ 500
Various Employees Non Employee Directors | Unvested restricted stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)					139,190	81,347	87,500
Vesting period (in years)					1 year	1 year	1 year
Grant date fair value					$ 1,400	$ 1,500	$ 2,000
Interim CEO | Unvested restricted stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)					53,732
Vesting period (in years)					2 months
Grant date fair value					$ 500
Management | Unvested restricted stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)					3 years
Management | Performance Based Restricted Stock Unit
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)					327,000	317,554
Vesting period (in years)						3 years
Grant date fair value					$ 6,600	$ 8,700
Prior CEO
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Equity-based compensation expense					$ 4,000
Prior CEO | Unvested restricted stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Accelerated vesting, number of shares (in shares)	143,739
Prior CEO | Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Accelerated vesting, number of shares (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

Stockholders' Equity - Restri_2

Stockholders' Equity - Restricted Stock (Details) - Unvested restricted stock - $ / shares	12 Months Ended			26 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2021
Number of Shares of Restricted Stock
Non-vested balance at beginning of period (in shares)	2,261,000	2,195,000	2,248,000
Granted (in shares)	1,311,000	962,000	1,354,000
Vested (in shares)	(1,063,000)	(700,000)	(556,000)
Forfeited (in shares)	(441,000)	(196,000)	(851,000)	(77,808)
Non-vested balance at end of period (in shares)	2,068,000	2,261,000	2,195,000	2,195,000
Weighted-Average Grant Date Fair Value per Share
Non-vested, grant date fair value at beginning of period (in dollars per share)	$ 23.90	$ 19.58	$ 15.60
Granted (in dollars per share)	13.85	21.26	28.92
Vested (in dollars per share)	19.59	19.99	14.03
Forfeited (in dollars per share)	25.95	20.60	17.64
Non-vested, grant date fair value at end of period (in dollars per share)	$ 19.16	$ 23.90	$ 19.58	$ 19.58
Various Employees, Immediate Vesting
Number of Shares of Restricted Stock
Granted (in shares)	58,795

Stockholders' Equity - Equity-B

Stockholders' Equity - Equity-Based Compensation Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Equity-based compensation expense	$ 22,468	$ 22,397	$ 25,323
General and administrative expense
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Equity-based compensation expense	19,586	15,760	18,021
Cost of net revenue
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Equity-based compensation expense	$ 2,882	$ 6,637	$ 7,302

Earnings (Loss) Per Share - Bas

Earnings (Loss) Per Share - Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Numerator
Net (loss) income attributable to AdaptHealth Corp.	$ (678,895)	$ 69,316	$ 156,175
Less: Earnings allocated to participating securities	0	5,867	14,379
Net (loss) income for basic EPS	(678,895)	63,449	141,796
Change in fair value of warrant liability	(34,482)	(17,158)	(53,181)
Net (loss) income for diluted EPS	$ (713,377)	$ 46,291	$ 88,615
Denominator
Basic weighted-average common shares outstanding (in shares)	134,156	134,175	126,306
Add: Warrants (in shares)	262	1,528	2,377
Add: Stock options (in shares)	0	2,512	3,782
Add: Unvested restricted stock (in shares)	0	773	569
Diluted weighted-average common shares outstanding (in shares)	134,418	138,988	133,034
Basic net income (loss) per share (in dollars per share)	$ (5.06)	$ 0.47	$ 1.12
Diluted net income (loss) per share (in dollars per share)	$ (5.31)	$ 0.33	$ 0.67

Earnings (Loss) Per Share - Ant

Earnings (Loss) Per Share - Antidilutive Shares (Details) - shares shares in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities excluded (in shares)	17,808	12,875	12,808
Preferred Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities excluded (in shares)	12,406	12,406	12,808
Warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities excluded (in shares)	0	0	0
Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities excluded (in shares)	3,409	469	0
Unvested restricted stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities excluded (in shares)	1,993	0	0

Leases - Right-Of-Use Assets an

Leases - Right-Of-Use Assets and Lease Liabilities (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Right-of-use ("ROU") assets:
Operating lease right-of-use assets	$ 110,465	$ 129,506
Finance lease right-of-use assets	31,962	5,423
Equipment and other fixed assets, net	0	103
Total ROU assets	142,427	135,032
Operating lease liabilities:
Current operating lease liabilities	29,270	30,001
Noncurrent operating lease liabilities	85,529	104,394
Total operating lease liabilities	114,799	134,395
Finance lease liabilities:
Current portion of finance lease obligations	9,122	2,211
Finance lease obligations, less current portion	22,746	3,950
Total finance lease liabilities	31,868	6,161
Operating lease costs	38,365	37,822	$ 37,043
Reduction of ROU assets	5,761	8,246	33,689
Finance lease costs:
Interest on lease liabilities	1,058	0	0
Other lease costs and income:
Variable lease costs	20,769	17,758	14,030
Sublease income	$ 1,427	$ 1,380	$ 1,239

Leases - Weighted Average Remai

Leases - Weighted Average Remaining Lease Terms and Discount Rates (Details)	Dec. 31, 2023	Dec. 31, 2022
Weighted average remaining lease term, weighted based on lease liability balances:
Operating leases (in years)	5 years 7 months 6 days	6 years 2 months 12 days
Finance leases (in years)	3 years 7 months 6 days	3 years 8 months 12 days
Weighted average discount rate, weighted based on remaining balance of lease payments:
Operating leases	4.40%	3.90%
Finance leases	6.70%	3.50%

Leases - Lease Maturity (Detail

Leases - Lease Maturity (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Operating Leases
2024	$ 33,335
2025	28,111
2026	20,306
2027	13,560
2028	10,634
Thereafter	24,217
Total future undiscounted leases payments	130,163
Less: amount representing interest	(15,364)
Present value of future lease payments (lease liability)	114,799	$ 134,395
Finance Leases
2024	10,782
2025	10,129
2026	9,095
2027	5,612
2028	44
Thereafter	0
Total future undiscounted leases payments	35,662
Less: amount representing interest	(3,794)
Present value of future lease payments (lease liability)	$ 31,868	$ 6,161

Leases - Cash Flow and Suppleme

Leases - Cash Flow and Supplemental Non-Cash Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash payments for operating leases	$ 38,328	$ 37,486	$ 36,510
Financing cash payments for finance leases	6,769	16,176	42,164
Lease liabilities arising from obtaining right-of-use assets:
Operating leases	22,000	22,543	91,420
Finance leases	$ 32,101	$ 5,423	$ 22,959

Retirement Plans (Details)

Retirement Plans (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Retirement Benefits [Abstract]
Matching or profit sharing expense	$ 5.6	$ 4.7	$ 2.9

Self-Insured Plans (Details)

Self-Insured Plans (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Self Insured Plans
Stop-loss threshold	$ 300	$ 300	$ 225
Liability for self-insurance reserves	$ 19,000	$ 15,600

Commitments and Contingencies (

Commitments and Contingencies (Details) - USD ($) $ in Thousands, shares in Millions			12 Months Ended
	Feb. 26, 2024	Apr. 21, 2023	Dec. 31, 2023	Dec. 31, 2022	Nov. 08, 2021
Loss Contingencies [Line Items]
Litigation settlement			$ 57,340	$ 0
Pending Litigation
Loss Contingencies [Line Items]
Payment on legal proceeding			50,000
Receivable from insurance carriers			32,200
Litigation settlement			57,300
Fair value of settlement shares			7,300
Pre-tax expense			$ 25,100
Director and officer coverage limits available					$ 35,000
Pending Litigation | Subsequent Event
Loss Contingencies [Line Items]
Payment on legal proceeding	$ 17,800
Receivable from insurance carriers	$ 32,200
Settlement shares (in shares)	1
Reclassification from liabilities to stockholders' equity	$ 7,300
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		$ 5,300

Related Party Transactions (Det

Related Party Transactions (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) executive	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Related Party Transaction [Line Items]
Expense for related party	$ 3,798,578	$ 2,780,184	$ 2,239,525
Related Party | Vendor Two
Related Party Transaction [Line Items]
Number of executives | executive	1
Equity ownership percentage	1%
Expense for related party	$ 11,300	7,000	4,900
Related Party | Vendor Three
Related Party Transaction [Line Items]
Equity ownership percentage	5%
Expense for related party	$ 24,200	80,300	12,300
Outstanding accounts payable	100	2,100
Related Party | Shareholder Of Contract Labor Service Provider
Related Party Transaction [Line Items]
Outstanding accounts payable	200	2,200
Payments to service provider	$ 21,800	$ 20,000	$ 18,100
Related Party | Maximum | Third Party Payor
Related Party Transaction [Line Items]
Net revenue related party	1%	1%	1%

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details) - USD ($) $ in Thousands		3 Months Ended	12 Months Ended
	Nov. 08, 2019	Dec. 31, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Contingency [Line Items]
Income tax (benefit) expense			$ (49,004)	$ 24,769	$ 32,806
Income tax benefit			64,800
Goodwill impairment		$ 318,900	830,787	0	0
Valuation allowance		3,788	3,788	1,812
Interest expense carryforward		177,300	177,300	109,900
Additions for tax positions acquired			0	2,670	2,100
Accrued liability for interest and penalties		2,800	2,800	1,600
Tax receivable agreement percentage	85%
Increase in liability due to additional exchanges					146,500
Increase in deferred tax asset					$ 164,100
Liability related to TRA			291,600	297,400
Income related to changes in estimated TRA liability			2,500	2,900
Other liabilities
Income Tax Contingency [Line Items]
Liability related to TRA			1,500	3,300
Other long-term liabilities
Income Tax Contingency [Line Items]
Liability related to TRA			290,100	294,100
Pinnacle Medical Solutions, Inc.
Income Tax Contingency [Line Items]
Additions for tax positions acquired			6,600
Capital Loss Carryforward
Income Tax Contingency [Line Items]
Capital loss carryforward		3,100	3,100
Domestic Tax Authority
Income Tax Contingency [Line Items]
Operating loss carryforwards		72,400	72,400	138,200
Domestic Tax Authority | Subject to Expiration Starting in 2031
Income Tax Contingency [Line Items]
Operating loss carryforwards		3,200	3,200
Domestic Tax Authority | Not Subject to Expiration Carryforward Indefinitely
Income Tax Contingency [Line Items]
Operating loss carryforwards		69,200	69,200
Domestic Tax Authority | SEC Schedule, 12-09, Valuation Allowance, Operating Loss Carryforward
Income Tax Contingency [Line Items]
Operating loss carryforwards		4,900	4,900
State and Local Jurisdiction
Income Tax Contingency [Line Items]
Operating loss carryforwards		$ 281,100	$ 281,100	$ 150,700

Income Taxes - Current and Defe

Income Taxes - Current and Deferred Income Tax Expense (Benefit) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Current:
Federal	$ 5,689	$ (197)	$ 2,356
State	7,902	6,930	8,070
Current income tax (benefit) expense	13,591	6,733	10,426
Deferred:
Federal	(42,720)	12,205	22,891
State	(19,875)	5,831	(511)
Deferred income tax (benefit) expense	(62,595)	18,036	22,380
Total income tax (benefit) expense	$ (49,004)	$ 24,769	$ 32,806

Income Taxes - Reconciliation o

Income Taxes - Reconciliation of Effective Income Tax Rate (Details)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Federal statutory rate	21%	21%	21%
State income taxes, net of federal benefit	1%	3.60%	3.10%
Equity-based compensation	(0.40%)	(0.50%)	(1.90%)
Change in valuation allowance	(0.30%)	0%	0.10%
Change in fair value of warrant liability	1%	(3.70%)	(5.90%)
Change in fair value of contingent consideration	0%	0%	(1.20%)
Goodwill impairment	(16.60%)	0%	0%
Deferred tax only adjustment	1.10%	(2.60%)	0.30%
Deferred tax impact of state effective tax rate changes	0%	8.60%	0%
Other	0%	(1.10%)	1.70%
Effective income tax rate	6.80%	25.30%	17.20%

Income Taxes - Deferred Tax Ass

Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Deferred income tax assets:
Accounts receivable	$ 35,009	$ 37,363
Goodwill and intangible assets	293,022	262,501
Investment in partnership	0	171
Inventory	1,926	1,841
Accruals	16,909	9,207
Net operating losses and credits	23,978	35,459
Transaction costs	455	417
Equity-based compensation	5,379	6,101
Excess business interest expense	46,273	27,918
Lease liability	37,069	35,431
Capital losses	792	817
Other	7	0
Total deferred income tax assets	460,819	417,226
Valuation allowance	(3,788)	(1,812)
Net deferred income tax assets	457,031	415,414
Deferred income tax liabilities:
Right-of-use assets	(36,011)	(34,201)
Contingent consideration	(2,112)	(2,200)
Investment in partnership	(582)	0
Unrealized gains	(1,479)	(2,950)
Equipment and other fixed assets	(70,993)	(94,277)
Total deferred income tax liabilities	(111,177)	(133,628)
Noncurrent net deferred income tax assets	$ 345,854	$ 281,786

Income Taxes - Unrecognized Tax

Income Taxes - Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Unrecognized tax benefits, beginning balance	$ 6,639	$ 4,047	$ 1,947
Additions for tax positions acquired	0	2,670	2,100
Reductions due to lapse of statute of limitations	(43)	(78)
Unrecognized tax benefits, ending balance	$ 6,596	$ 6,639	$ 4,047