COVER
COVER - shares | 6 Months Ended | |
Jun. 30, 2024 | Aug. 02, 2024 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Jun. 30, 2024 | |
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 $0.0001 per share | |
Trading Symbol | AHCO | |
Security Exchange Name | NASDAQ | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding | 134,469,847 | |
Amendment Flag | false | |
Document Fiscal Period Focus | Q2 | |
Document Fiscal Year Focus | 2024 | |
Current Fiscal Year End Date | --12-31 | |
Entity Central Index Key | 0001725255 |
CONSOLIDATED BALANCE SHEETS
CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands | Jun. 30, 2024 | Dec. 31, 2023 |
Current assets: | ||
Cash | $ 69,832 | $ 77,132 |
Accounts receivable | 437,077 | 388,910 |
Inventory | 123,896 | 113,642 |
Prepaid and other current assets | 55,623 | 69,338 |
Total current assets | 686,428 | 649,022 |
Equipment and other fixed assets, net | 496,136 | 495,101 |
Operating lease right-of-use assets | 106,816 | 110,465 |
Finance lease right-of-use assets | 37,660 | 31,962 |
Goodwill | 2,711,880 | 2,724,958 |
Identifiable intangible assets, net | 119,021 | 130,160 |
Other assets | 19,418 | 21,128 |
Deferred tax assets | 333,553 | 345,854 |
Total Assets | 4,510,912 | 4,508,650 |
Current liabilities: | ||
Accounts payable and accrued expenses | 446,560 | 391,994 |
Current portion of long-term debt | 40,000 | 53,368 |
Current portion of operating lease obligations | 30,785 | 29,270 |
Current portion of finance lease obligations | 11,587 | 9,122 |
Contract liabilities | 36,245 | 38,570 |
Warrant liability | 4,464 | 4,021 |
Other liabilities | 26,383 | 10,654 |
Total current liabilities | 596,024 | 536,999 |
Long-term debt, less current portion | 2,040,451 | 2,094,614 |
Operating lease obligations, less current portion | 80,249 | 85,529 |
Finance lease obligations, less current portion | 25,933 | 22,746 |
Other long-term liabilities | 275,602 | 302,093 |
Total Liabilities | 3,018,259 | 3,041,981 |
Commitments and contingencies (note 14) | ||
Stockholders' Equity: | ||
Common Stock, par value of $0.0001 per share, 300,000,000 shares authorized; 133,376,523 and 132,634,850 shares issued and outstanding as of June 30, 2024 and December 31, 2023, respectively | 13 | 13 |
Preferred Stock, par value of $0.0001 per share, 5,000,000 shares authorized; 124,060 shares issued and outstanding as of June 30, 2024 and December 31, 2023 | 1 | 1 |
Treasury stock, at cost (3,935,035 shares at June 30, 2024 and December 31, 2023) | (43,267) | (43,267) |
Additional paid-in capital | 2,159,521 | 2,149,951 |
Accumulated deficit | (635,299) | (652,600) |
Accumulated other comprehensive income | 4,848 | 4,356 |
Total stockholders' equity attributable to AdaptHealth Corp. | 1,485,817 | 1,458,454 |
Noncontrolling interest in subsidiary | 6,836 | 8,215 |
Total Stockholders' Equity | 1,492,653 | 1,466,669 |
Total Liabilities and Stockholders' Equity | $ 4,510,912 | $ 4,508,650 |
CONSOLIDATED BALANCE SHEETS (Pa
CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares | Jun. 30, 2024 | Dec. 31, 2023 |
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) | 133,376,523 | 132,634,850 |
Common Stock, shares outstanding (in shares) | 133,376,523 | 132,634,850 |
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 | 3,935,035 |
CONSOLIDATED STATEMENTS OF OPER
CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2024 | Jun. 30, 2023 | Jun. 30, 2024 | Jun. 30, 2023 | |
Income Statement [Abstract] | ||||
Net revenue | $ 805,975 | $ 793,286 | $ 1,598,472 | $ 1,537,912 |
Revenue, Product and Service [Extensible Enumeration] | Health Care, Patient Service [Member] | Health Care, Patient Service [Member] | ||
Costs and expenses: | ||||
Cost of net revenue | 678,973 | 673,397 | $ 1,354,666 | $ 1,328,793 |
Cost, Product and Service [Extensible Enumeration] | Health Care, Patient Service [Member] | Health Care, Patient Service [Member] | ||
General and administrative expenses | 57,012 | 50,078 | $ 105,390 | $ 97,599 |
Depreciation and amortization, excluding patient equipment depreciation | 11,395 | 15,549 | 22,760 | 31,081 |
Goodwill impairment (note 5) | 6,548 | 0 | 13,078 | 0 |
Total costs and expenses | 753,928 | 739,024 | 1,495,894 | 1,457,473 |
Operating income | 52,047 | 54,262 | 102,578 | 80,439 |
Interest expense, net | 33,038 | 32,552 | 65,510 | 64,507 |
Change in fair value of warrant liability (note 10) | (7,010) | (812) | 443 | (22,726) |
Other (income) loss, net | (1,760) | 2,082 | 3,345 | 3,257 |
Income before income taxes | 27,779 | 20,440 | 33,280 | 35,401 |
Income tax expense | 7,248 | 5,399 | 13,858 | 3,685 |
Net income | 20,531 | 15,041 | 19,422 | 31,716 |
Income attributable to noncontrolling interest | 1,096 | 1,064 | 2,121 | 2,032 |
Net income attributable to AdaptHealth Corp. | $ 19,435 | $ 13,977 | $ 17,301 | $ 29,684 |
Weighted average common shares outstanding - basic (in shares) | 133,218 | 134,295 | 133,066 | 134,409 |
Weighted average common shares outstanding - diluted (in shares) | 136,029 | 136,233 | 135,698 | 138,000 |
Basic net income per share (note 11) (in dollars per share) | $ 0.13 | $ 0.10 | $ 0.12 | $ 0.20 |
Diluted net income per share (note 11) (in dollars per share) | $ 0.13 | $ 0.09 | $ 0.12 | $ 0.03 |
CONSOLIDATED STATEMENTS OF COMP
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2024 | Jun. 30, 2023 | Jun. 30, 2024 | Jun. 30, 2023 | |
Statement of Comprehensive Income [Abstract] | ||||
Net income | $ 20,531 | $ 15,041 | $ 19,422 | $ 31,716 |
Other comprehensive income (loss): | ||||
Gain (loss) on interest rate swap agreements, inclusive of reclassification adjustment, net of tax | (364) | 2,454 | 492 | (351) |
Comprehensive income | 20,167 | 17,495 | 19,914 | 31,365 |
Income attributable to noncontrolling interest | 1,096 | 1,064 | 2,121 | 2,032 |
Comprehensive income attributable to AdaptHealth Corp. | $ 19,071 | $ 16,431 | $ 17,793 | $ 29,333 |
CONSOLIDATED STATEMENTS OF CHAN
CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS' EQUITY - USD ($) $ in Thousands | Total | Common Stock | Preferred Stock | Treasury Stock | Additional paid-in capital | Accumulated deficit | Accumulated other comprehensive income | Noncontrolling interest in subsidiary |
Common Stock, beginning balance (in shares) at Dec. 31, 2022 | 134,435,000 | |||||||
Preferred Stock, beginning balance (in shares) at Dec. 31, 2022 | 124,000 | |||||||
Treasury Stock, beginning balance (in shares) at Dec. 31, 2022 | 751,000 | |||||||
Balance at beginning of period at Dec. 31, 2022 | $ 2,157,758 | $ 13 | $ 1 | $ (13,992) | $ 2,130,148 | $ 26,295 | $ 8,693 | $ 6,600 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||||
Equity-based compensation (in shares) | 292,000 | |||||||
Equity-based compensation | 5,916 | 5,916 | ||||||
Payments for tax withholdings from restricted stock vesting | (1,883) | (1,883) | ||||||
Common Stock issued in connection with employee stock purchase plan (in shares) | 53,000 | |||||||
Common Stock issued in connection with employee stock purchase plan | 1,021 | 1,021 | ||||||
Shares purchased under share repurchase program (in shares) | 632,000 | 632,000 | ||||||
Shares purchased under share repurchase program | (9,224) | $ (9,224) | ||||||
Net (loss) income | 16,675 | 15,707 | 968 | |||||
Change in fair value of interest rate swaps, inclusive of reclassification adjustment | (2,805) | (2,805) | ||||||
Common Stock, ending balance (in shares) at Mar. 31, 2023 | 134,148,000 | |||||||
Preferred Stock, ending balance (in shares) at Mar. 31, 2023 | 124,000 | |||||||
Treasury Stock, ending balance (in shares) at Mar. 31, 2023 | 1,383,000 | |||||||
Balance at end of period at Mar. 31, 2023 | 2,167,458 | $ 13 | $ 1 | $ (23,216) | 2,135,202 | 42,002 | 5,888 | 7,568 |
Common Stock, beginning balance (in shares) at Dec. 31, 2022 | 134,435,000 | |||||||
Preferred Stock, beginning balance (in shares) at Dec. 31, 2022 | 124,000 | |||||||
Treasury Stock, beginning balance (in shares) at Dec. 31, 2022 | 751,000 | |||||||
Balance at beginning of period at Dec. 31, 2022 | $ 2,157,758 | $ 13 | $ 1 | $ (13,992) | 2,130,148 | 26,295 | 8,693 | 6,600 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||||
Shares purchased under share repurchase program (in shares) | 631,953 | |||||||
Shares purchased under share repurchase program | $ (9,200) | |||||||
Net (loss) income | 31,716 | |||||||
Common Stock, ending balance (in shares) at Jun. 30, 2023 | 134,518,000 | |||||||
Preferred Stock, ending balance (in shares) at Jun. 30, 2023 | 124,000 | |||||||
Treasury Stock, ending balance (in shares) at Jun. 30, 2023 | 1,383,000 | |||||||
Balance at end of period at Jun. 30, 2023 | 2,187,071 | $ 13 | $ 1 | $ (23,216) | 2,139,820 | 55,979 | 8,342 | 6,132 |
Common Stock, beginning balance (in shares) at Mar. 31, 2023 | 134,148,000 | |||||||
Preferred Stock, beginning balance (in shares) at Mar. 31, 2023 | 124,000 | |||||||
Treasury Stock, beginning balance (in shares) at Mar. 31, 2023 | 1,383,000 | |||||||
Balance at beginning of period at Mar. 31, 2023 | 2,167,458 | $ 13 | $ 1 | $ (23,216) | 2,135,202 | 42,002 | 5,888 | 7,568 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||||
Equity-based compensation (in shares) | 156,000 | |||||||
Equity-based compensation | 6,847 | 6,847 | ||||||
Exercise of stock options (in shares) | 214,000 | |||||||
Payments for tax withholdings from restricted stock vesting | (2,229) | (2,229) | ||||||
Distribution to non-controlling interest | (2,500) | (2,500) | ||||||
Net (loss) income | 15,041 | 13,977 | 1,064 | |||||
Change in fair value of interest rate swaps, inclusive of reclassification adjustment | 2,454 | 2,454 | ||||||
Common Stock, ending balance (in shares) at Jun. 30, 2023 | 134,518,000 | |||||||
Preferred Stock, ending balance (in shares) at Jun. 30, 2023 | 124,000 | |||||||
Treasury Stock, ending balance (in shares) at Jun. 30, 2023 | 1,383,000 | |||||||
Balance at end of period at Jun. 30, 2023 | $ 2,187,071 | $ 13 | $ 1 | $ (23,216) | 2,139,820 | 55,979 | 8,342 | 6,132 |
Common Stock, beginning balance (in shares) at Dec. 31, 2023 | 132,634,850 | 132,635,000 | ||||||
Preferred Stock, beginning balance (in shares) at Dec. 31, 2023 | 124,060 | 124,000 | ||||||
Treasury Stock, beginning balance (in shares) at Dec. 31, 2023 | 3,935,035 | 3,935,000 | ||||||
Balance at beginning of period at Dec. 31, 2023 | $ 1,466,669 | $ 13 | $ 1 | $ (43,267) | 2,149,951 | (652,600) | 4,356 | 8,215 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||||
Equity-based compensation (in shares) | 300,000 | |||||||
Equity-based compensation | 4,533 | 4,533 | ||||||
Exercise of stock options (in shares) | 177,000 | |||||||
Exercise of stock options | 545 | 545 | ||||||
Payments for tax withholdings from restricted stock vesting | (1,072) | (1,072) | ||||||
Common Stock issued in connection with employee stock purchase plan (in shares) | 83,000 | |||||||
Common Stock issued in connection with employee stock purchase plan | 607 | 607 | ||||||
Net (loss) income | (1,109) | (2,134) | 1,025 | |||||
Change in fair value of interest rate swaps, inclusive of reclassification adjustment | 856 | 856 | ||||||
Common Stock, ending balance (in shares) at Mar. 31, 2024 | 133,195,000 | |||||||
Preferred Stock, ending balance (in shares) at Mar. 31, 2024 | 124,000 | |||||||
Treasury Stock, ending balance (in shares) at Mar. 31, 2024 | 3,935,000 | |||||||
Balance at end of period at Mar. 31, 2024 | $ 1,471,029 | $ 13 | $ 1 | $ (43,267) | 2,154,564 | (654,734) | 5,212 | 9,240 |
Common Stock, beginning balance (in shares) at Dec. 31, 2023 | 132,634,850 | 132,635,000 | ||||||
Preferred Stock, beginning balance (in shares) at Dec. 31, 2023 | 124,060 | 124,000 | ||||||
Treasury Stock, beginning balance (in shares) at Dec. 31, 2023 | 3,935,035 | 3,935,000 | ||||||
Balance at beginning of period at Dec. 31, 2023 | $ 1,466,669 | $ 13 | $ 1 | $ (43,267) | 2,149,951 | (652,600) | 4,356 | 8,215 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||||
Exercise of stock options (in shares) | 177,000 | |||||||
Exercise of stock options | $ 500 | |||||||
Net (loss) income | $ 19,422 | |||||||
Common Stock, ending balance (in shares) at Jun. 30, 2024 | 133,376,523 | 133,377,000 | ||||||
Preferred Stock, ending balance (in shares) at Jun. 30, 2024 | 124,060 | 124,000 | ||||||
Treasury Stock, ending balance (in shares) at Jun. 30, 2024 | 3,935,035 | 3,935,000 | ||||||
Balance at end of period at Jun. 30, 2024 | $ 1,492,653 | $ 13 | $ 1 | $ (43,267) | 2,159,521 | (635,299) | 4,848 | 6,836 |
Common Stock, beginning balance (in shares) at Mar. 31, 2024 | 133,195,000 | |||||||
Preferred Stock, beginning balance (in shares) at Mar. 31, 2024 | 124,000 | |||||||
Treasury Stock, beginning balance (in shares) at Mar. 31, 2024 | 3,935,000 | |||||||
Balance at beginning of period at Mar. 31, 2024 | 1,471,029 | $ 13 | $ 1 | $ (43,267) | 2,154,564 | (654,734) | 5,212 | 9,240 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||||
Equity-based compensation (in shares) | 182,000 | |||||||
Equity-based compensation | 5,218 | 5,218 | ||||||
Payments for tax withholdings from restricted stock vesting | (261) | (261) | ||||||
Distribution to non-controlling interest | (3,500) | (3,500) | ||||||
Net (loss) income | 20,531 | 19,435 | 1,096 | |||||
Change in fair value of interest rate swaps, inclusive of reclassification adjustment | $ (364) | (364) | ||||||
Common Stock, ending balance (in shares) at Jun. 30, 2024 | 133,376,523 | 133,377,000 | ||||||
Preferred Stock, ending balance (in shares) at Jun. 30, 2024 | 124,060 | 124,000 | ||||||
Treasury Stock, ending balance (in shares) at Jun. 30, 2024 | 3,935,035 | 3,935,000 | ||||||
Balance at end of period at Jun. 30, 2024 | $ 1,492,653 | $ 13 | $ 1 | $ (43,267) | $ 2,159,521 | $ (635,299) | $ 4,848 | $ 6,836 |
CONSOLIDATED STATEMENTS OF CASH
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2024 | Jun. 30, 2023 | |
Cash flows from operating activities: | ||
Net income | $ 19,422 | $ 31,716 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization, including patient equipment depreciation | 184,038 | 193,109 |
Goodwill impairment | 13,078 | 0 |
Equity-based compensation | 9,751 | 12,763 |
Change in fair value of warrant liability | 443 | (22,726) |
Reduction in the carrying amount of operating lease right-of-use assets | 17,770 | 16,794 |
Reduction in the carrying amount of finance lease right-of-use assets | 4,793 | 3,007 |
Deferred income tax expense | 12,103 | 1,413 |
Change in fair value of interest rate swaps, net of reclassification adjustment | (367) | (987) |
Amortization of deferred financing costs | 2,729 | 2,617 |
Payment of contingent consideration from an acquisition | (1,850) | 0 |
Changes in operating assets and liabilities, net of effects from acquisitions: | ||
Accounts receivable | (48,166) | (5,011) |
Inventory | (10,254) | 13,808 |
Prepaid and other assets | 16,225 | 10,199 |
Operating lease obligations | (17,887) | (16,662) |
Operating liabilities | 45,191 | (13,473) |
Net cash provided by operating activities | 247,019 | 226,567 |
Cash flows from investing activities: | ||
Purchases of equipment and other fixed assets | (169,163) | (171,730) |
Payments for business acquisitions, net of cash acquired | 0 | (17,905) |
Payments for cost method investments | 0 | (128) |
Net cash used in investing activities | (169,163) | (189,763) |
Cash flows from financing activities: | ||
Proceeds from borrowings on lines of credit | 75,000 | 50,000 |
Repayments on long-term debt and lines of credit | (145,000) | (65,000) |
Repayments of finance lease obligations | (4,890) | (3,679) |
Payments for shares purchased under share repurchase program | 0 | (9,224) |
Proceeds from the exercise of stock options | 545 | 0 |
Proceeds received in connection with employee stock purchase plan | 607 | 1,021 |
Payments relating to the Tax Receivable Agreement | (1,432) | (3,202) |
Distributions to noncontrolling interest | (3,500) | (2,500) |
Payments for tax withholdings from restricted stock vesting and stock option exercises | (1,399) | (4,366) |
Payments of contingent consideration and deferred purchase price from acquisitions | (5,087) | (1,000) |
Net cash used in financing activities | (85,156) | (37,950) |
Net decrease in cash | (7,300) | (1,146) |
Cash at beginning of period | 77,132 | 46,272 |
Cash at end of period | 69,832 | 45,126 |
Supplemental disclosures: | ||
Cash paid for interest | 63,276 | 62,782 |
Cash paid for income taxes, net of refunds | 12,098 | 5,567 |
Noncash investing and financing activities: | ||
Unpaid equipment and other fixed asset purchases at end of period | 40,639 | 32,942 |
Assets subject to operating lease obligations | 15,967 | 5,112 |
Operating lease obligations | (15,967) | (5,112) |
Write-off of assets subject to operating lease obligations | (1,845) | 0 |
Write-off of operating lease obligations | 1,845 | 0 |
Assets subject to finance lease obligations | 10,895 | 12,203 |
Finance lease obligations | (10,895) | (12,203) |
Deferred purchase price in connection with acquisitions | $ 0 | $ 50 |
General Information
General Information | 6 Months Ended |
Jun. 30, 2024 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
General Information | General Information AdaptHealth Corp. and subsidiaries ("AdaptHealth" or the "Company") is a national leader in providing patient-centered, healthcare-at-home solutions including home medical equipment ("HME"), medical supplies, and related services. AdaptHealth focuses primarily on providing (i) sleep therapy equipment, supplies and related services (including CPAP and bi PAP services) to individuals suffering from obstructive sleep apnea ("OSA"), (ii) medical devices and supplies to patients for the treatment of diabetes (including continuous glucose monitors ("CGM") and insulin pumps), (iii) home medical equipment to patients discharged from acute care and other facilities, (iv) oxygen and related chronic therapy services in the home, and (v) other HME devices and supplies on behalf of chronically ill patients with wound care, urological, incontinence, ostomy and nutritional supply needs. AdaptHealth services beneficiaries of Medicare, Medicaid and commercial insurance payors. Richard Barasch, former Chair of the Board of Directors of AdaptHealth, served as the Company's Interim Chief Executive Officer from June 30, 2023 through May 19, 2024. Effective May 20, 2024, Suzanne Foster was hired as Chief Executive Officer and appointed as a member of the board of directors of the Company. On April 10, 2024, the Company entered into an employment agreement with Ms. Foster (the “CEO Employment Agreement”) that governs the terms of her employment as the Chief Executive Officer of the Company. Effective June 30, 2024, Mr. Barasch resigned as a director of the Company. For the period from May 20, 2024 through June 30, 2024, in his role as Chair of the Board of Directors, Mr. Barasch actively assisted with the transition of his duties and responsibilities as the Interim CEO to Ms. Foster. On July 2, 2024, the Company announced the appointment of Dale Wolf as Chair of the Board effective July 1, 2024. On July 2, 2024, the Company announced that Joshua Parnes, President and a member of the board of directors of the Company, will resign from all positions that he holds with the Company effective August 31, 2024, and will continue to serve as a non-executive member of the board of directors until December 31, 2024. The interim consolidated financial statements are unaudited, but reflect all normal recurring adjustments that are, in the opinion of management, necessary to fairly present the information set forth herein. The interim consolidated financial statements should be read in conjunction with the audited consolidated financial statements and related notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023. Interim results are not necessarily indicative of the results for a full year. There have been no material changes in the Company’s significant accounting policies as compared to the significant accounting policies described in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023. (a) Basis of Presentation The interim consolidated financial statements of the Company have been prepared in accordance with accounting principles generally accepted in the United States of America ("U.S. GAAP"). In the opinion of management, the interim consolidated financial statements include all necessary adjustments for a fair presentation of the financial position and results of operations for the periods presented. (b) Basis of Consolidation The accompanying interim consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation. (c) Concentration of Credit Risk Financial instruments which potentially subject the Company to concentrations of credit risk consist principally of cash and trade accounts receivable. The Company maintains its cash in bank deposit accounts, which, at times, may exceed federally insured limits. The Company has not experienced any losses in such accounts and believes it is not exposed to any significant credit risk on cash. (d) Accounting Estimates The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, and the disclosure of contingent assets and liabilities at the date of the consolidated financial statements, and reported amounts of revenues and expenses during the reporting period. Management bases these estimates and assumptions upon historical experience, existing and known circumstances, authoritative accounting pronouncements and other factors that management believes to be reasonable. Significant areas requiring the use of management estimates relate to revenue recognition and the valuation of accounts receivable (implicit price concession), income taxes 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) 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, a nd/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. (f) Long-Lived Assets The Company’s long-lived assets, such as equipment and other fixed assets, operating lease right-of-use assets, finance lease right-of-use assets and definite-lived identifiable intangible assets, are assessed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to estimated undiscounted future cash flows expected to be generated by the asset. If the carrying amount of an asset exceeds its estimated undiscounted future cash flows, an impairment charge is recognized by the amount by which the carrying amount of the asset exceeds the fair value of the asset. Definite-lived identifiable intangible assets consist of tradenames, payor contracts, contractual rental agreements and developed technology. These assets are amortized using the straight-line method over their estimated useful lives, which reflects the pattern in which the economic benefits of the assets are expected to be consumed. In addition to consideration of impairment upon the events or changes in circumstances described above, management regularly evaluates the remaining useful lives of its long-lived assets. The following table summarizes the useful lives of the Company’s identifiable intangible assets: Tradenames 5 to 10 years Payor contracts 10 years Developed technology 5 years The Company did not recognize any impairment charges on long-lived assets for the six months ended June 30, 2024 and 2023. (g) Equity-based Compensation The Company accounts for its equity-based compensation in accordance with Financial Accounting Standards Board ("FASB") Accounting Standards Codification ("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 10, Stockholders’ Equity , for additional information regarding the Company’s equity-based compensation expense. (h) 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 Chief Executive Officer, who currently 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. (i) Accounting for Leases The Company accounts for its leases in accordance with FASB ASC 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. 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 12, Leases, for additional information. (j) Recently Issued Accounting Pronouncements Not Yet Adopted In March 2024, the FASB issued Accounting Standards update "ASU" No. 2024-02, Codification Improvements-Amendments to Remove References to the Concepts Statements , which removes various references to concepts statements from the FASB Accounting Standards Codification. This ASU is effective for the Company beginning in the first quarter of fiscal year 2026, with early adoption permitted. The Company does not expect that the new guidance will have a material impact on its consolidated financial statements, and intends to adopt the guidance when it becomes effective in the first quarter of fiscal year 2026. In March 2024, the FASB issued ASU No. 2024-01, Compensation-Stock Compensation ("Topic 718") , which provides illustrative guidance to help entities determine whether profits interest and similar awards should be accounted for as share-based payment arrangements within the scope of ASC 718. ASU 2024-01 is effective for annual periods beginning after December 15, 2024, and interim periods within those annual periods. The Company is currently evaluating the impact that this standard will have on its consolidated financial statements and related disclosures. 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 statements and related 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. In March 2024, the SEC issued its final climate disclosure rule, which requires registrants to provide climate-related disclosures in their annual reports and registration statements. The new disclosure requirements will be effective for the Company beginning with its annual report for the year ending December 31, 2025. In April 2024, the SEC stayed its final climate rule to allow for a judicial review of pending legal challenges. The Company is currently evaluating the impact these rules will have on its consolidated financial statements and related disclosures and will monitor the litigation progress relating to these rules for possible impacts on the disclosure requirements under the rules. |
Revenue Recognition and Account
Revenue Recognition and Accounts Receivable | 6 Months Ended |
Jun. 30, 2024 | |
Revenue from Contract with Customer [Abstract] | |
Revenue Recognition and Accounts Receivable | Revenue Recognition and Accounts Receivable Revenue Recognition The Company generates revenues for services and related products that the Company provides to patients for home medical equipment, related supplies, and other items. The Company’s revenues are recognized in the period in which services and related products are provided to customers and are recorded either at a point in time for the sale of supplies and disposables, 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 by core product line for the three and six months ended June 30, 2024 is included in the table below. The Company’s revenue recognized under its capitation arrangements for the three and six months ended June 30, 2023 is included in net sales revenue and net revenue from fixed monthly equipment reimbursements by core product line in the table below, which was immaterial for those periods. 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 three and six months ended June 30, 2024 and 2023 are as follows (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Insurance $ 487,787 $ 474,828 $ 971,152 $ 911,612 Government 210,946 209,662 409,344 398,509 Patient pay 107,242 108,796 217,976 227,791 Net revenue $ 805,975 $ 793,286 $ 1,598,472 $ 1,537,912 The composition of net revenue by core product lines for the three and six months ended June 30, 2024 and 2023 are as follows (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Net sales revenue: Sleep $ 233,361 $ 215,849 $ 458,887 $ 429,306 Diabetes 147,261 165,021 294,240 307,565 Supplies to the home 44,265 48,323 88,913 94,878 Respiratory 7,871 8,191 15,575 16,120 HME 25,963 27,237 51,585 55,800 Other 57,684 57,012 113,345 110,219 Total net sales revenue $ 516,405 $ 521,633 $ 1,022,545 $ 1,013,888 Net revenue from fixed monthly equipment reimbursements: Sleep $ 82,053 $ 86,783 $ 162,743 $ 167,705 Diabetes 2,382 3,886 4,661 7,717 Respiratory 138,899 145,889 276,131 280,612 HME 23,355 23,974 45,921 46,315 Other 11,637 11,121 23,208 21,675 Total net revenue from fixed monthly equipment reimbursements $ 258,326 $ 271,653 $ 512,664 $ 524,024 Net revenue from capitated revenue arrangements: Sleep $ 6,976 $ — $ 14,028 $ — Diabetes 1,546 $ — 3,144 — Supplies to the home 3,080 $ — 6,290 — Respiratory 14,456 $ — 29,582 — HME 3,712 $ — 7,210 — Other 1,474 $ — 3,009 — Total net revenue from capitated revenue arrangements $ 31,244 $ — $ 63,263 $ — Total net revenue: Sleep $ 322,390 $ 302,632 $ 635,658 $ 597,011 Diabetes 151,189 168,907 302,045 315,282 Supplies to the home 47,345 48,323 95,203 94,878 Respiratory 161,226 154,080 321,288 296,732 HME 53,030 51,211 104,716 102,115 Other 70,795 68,133 139,562 131,894 Total net revenue $ 805,975 $ 793,286 $ 1,598,472 $ 1,537,912 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 June 30, 2024 and December 31, 2023, the Company’s unbilled accounts receivable was $40.2 million and $68.4 million, respectively. |
Acquisitions
Acquisitions | 6 Months Ended |
Jun. 30, 2024 | |
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract] | |
Acquisitions | Acquisitions The Company’s acquisitions are 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 Company did not complete any acquisitions during the six months ended June 30, 2024. During the six months ended June 30, 2023, the Company acquired 100% of the equity interests of three providers of home medical equipment ("HME") and acquired certain assets of the home medical equipment businesses of two providers of HME. The following table summarizes the consideration paid at closing for all acquisitions during the six months ended June 30, 2023 (in thousands): Cash $ 18,173 Deferred payments 50 Total $ 18,223 The Company allocated the consideration paid to the net assets acquired based on their estimated acquisition date fair values. Based upon management’s evaluation, the consideration paid for all acquisitions during the six months ended June 30, 2023 was allocated as follows during the period (in thousands): Cash $ 268 Accounts receivable 1,798 Inventory 1,001 Prepaid and other current assets 10 Equipment and other fixed assets 9,863 Operating lease right-of-use assets 5,506 Finance lease right-of-use assets 200 Goodwill 6,796 Accounts payable and accrued expenses (667) Other current liabilities (846) Operating lease liabilities (5,506) Finance lease liabilities (200) Net assets acquired $ 18,223 Net revenue and operating income in the period of acquisition since the respective acquisition dates for the acquisitions described above were immaterial for the three and six months ended June 30, 2023. |
Equipment and Other Fixed Asset
Equipment and Other Fixed Assets | 6 Months Ended |
Jun. 30, 2024 | |
Property, Plant and Equipment [Abstract] | |
Equipment and Other Fixed Assets | Equipment and Other Fixed Assets Equipment and other fixed assets as of June 30, 2024 and December 31, 2023 are as follows (in thousands): June 30, December 31, Patient medical equipment $ 811,940 $ 791,349 Computers and software 91,053 85,509 Delivery vehicles 35,062 35,021 Other 22,079 20,203 Gross carrying value 960,134 932,082 Less accumulated depreciation (463,998) (436,981) Equipment and other fixed assets, net $ 496,136 $ 495,101 For the three months ended June 30, 2024 and 2023, the Company recorded depreciation expense of $85.6 million and $89.3 million, respectively. For the six months ended June 30, 2024 and 2023, the Company recorded depreciation expense of $172.9 million and $173.1 million, respectively. |
Goodwill and Identifiable Intan
Goodwill and Identifiable Intangible Assets | 6 Months Ended |
Jun. 30, 2024 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Goodwill and Identifiable Intangible Assets | Goodwill and Identifiable Intangible Assets Goodwill is an asset representing the future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized . The change in the carrying amount of goodwill for the six months ended June 30, 2024 was as follows (in thousands): Gross carrying Balance at December 31, 2023 $ 2,724,958 Goodwill impairment (13,078) Balance at June 30, 2024 $ 2,711,880 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. The Company did not identify any triggering events indicating a possible impairment of goodwill at June 30, 2024. The non-cash goodwill impairment charge included in the table above relates to a definitive agreement for the disposition of certain immaterial custom rehab technology assets which was signed subsequent to June 30, 2024, and is expected to close in the third quarter of 2024. Identifiable intangibl e assets that are separable and have determinable useful lives are valued separa tely and amortized over the period which reflects the pattern in which the economic benefits of the assets are expected to be consumed. Identifiable intangible assets consisted of the following at June 30, 2024 and December 31, 2023 (in thousands): June 30, 2024 Weighted-Average Tradenames, net of accumulated amortization of $44,723 $ 68,077 6.2 Payor contracts, net of accumulated amortization of $32,316 49,684 6.1 Developed technology, net of accumulated amortization of $5,040 1,260 1.0 Identifiable intangible assets, net $ 119,021 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 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 $5.6 million and $11.1 million for the three and six months ended June 30, 2024, respectively, and was $10.0 million and $20.0 million for the three and six months ended June 30, 2023, respectively. Future amortization expense related to identifiable intangible assets is estimated to be as follows (in thousands): Twelve months ending June 30, 2025 $ 22,217 2026 20,119 2027 18,384 2028 17,936 2029 17,936 Thereafter 22,429 Total $ 119,021 The Company did not recognize any impairment charges related to identifiable intangible assets during the six months ended June 30, 2024 and 2023. |
Fair Value of Assets and Liabil
Fair Value of Assets and Liabilities | 6 Months Ended |
Jun. 30, 2024 | |
Fair Value Disclosures [Abstract] | |
Fair Value of Assets and Liabilities | Fair Value of Assets and Liabilities FASB ASC Topic 820, Fair Value Measurements and Disclosures ("ASC 820"), creates a single definition of fair value, establishes a framework for measuring fair value in U.S. GAAP and expands disclosures about fair value measurements. Assets and liabilities adjusted to fair value in the balance sheet are categorized based upon the level of judgment associated with the inputs used to measure their fair value. Level inputs, as defined by ASC 820, are as follows: Level input Input Definition Level 1 Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. Level 2 Inputs, other than quoted prices included in Level 1 that are observable for the asset or liability through corroboration with market data at the measurement date. Level 3 Unobservable inputs that reflect management’s best estimate of what market participants would use in pricing the asset or liability at the measurement date. The following table presents the valuation of the Company’s financial assets and liabilities as of June 30, 2024 and December 31, 2023 measured at fair value on a recurring basis. The fair value estimates presented herein are based on information available to management as of June 30, 2024 and December 31, 2023. These estimates are not necessarily indicative of the amounts the Company could ultimately realize. (in thousands) Level 1 Level 2 Level 3 June 30, 2024 Assets Interest rate swap agreements-short term $ — $ 4,889 $ — Interest rate swap agreements-long term — 1,635 — Total assets measured at fair value $ — $ 6,524 $ — Liabilities Warrant liability — — 4,464 Total liabilities measured at fair value $ — $ — $ 4,464 (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 Interest Rate Swaps The Company uses interest rate swap agreements to manage interest rate risk by converting a portion of its variable rate borrowings to a fixed rate and recognizes these derivative instruments as either assets or liabilities in the accompanying consolidated balance sheets at fair value. The valuation of these derivative instruments is determined using widely accepted valuation techniques, including discounted cash flow analysis on the expected cash flows of each derivative. This analysis reflects the contractual terms of the derivatives, including the period to maturity, and uses observable market-based inputs, including interest rate curves and implied volatilities. The fair value of the Company’s interest rate swaps are determined using the market standard methodology of netting the discounted future fixed cash payments and the discounted expected variable cash payments receipts. The variable cash receipts are based on an expectation of future interest rates (forward curves) derived from observable market interest rate curves. To comply with the provisions of FASB ASC Topic 820, Fair Value Measurement , the Company incorporates credit valuation adjustments to appropriately reflect both its own nonperformance risk and the respective counterparty’s nonperformance risk in the fair value measurements. In adjusting the fair value of its derivative contracts for the effect of nonperformance risk, the Company has considered the impact of netting and any applicable credit enhancements, such as collateral postings, thresholds, mutual puts and guarantees. Although the Company has determined that the majority of the inputs used to value its derivatives fall within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with the Company’s derivatives utilize Level 3 inputs, such as estimates of current credit spreads to evaluate the likelihood of default by the Company and the respective counterparties. The Company has determined that the significance of the impact of the credit valuation adjustments made to its derivative contracts, which determination was based on the fair value of each individual contract, was not significant to the overall valuation. As a result, all of the Company’s derivatives held as of June 30, 2024 and December 31, 2023 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, contingent consideration liabilities of $6.9 million was included in other current liabilities in the accompanying consolidated balance sheets. There were no contingent consideration liabilities as of June 30, 2024. A reconciliation of the Company’s contingent consideration liabilities related to acquisitions for the six months ended June 30, 2024 and 2023 is as follows (in thousands): Six Months Ended June 30, 2024 Beginning Balance Payments Ending Balance Contingent consideration - Level 3 liabilities $ 6,850 $ (6,850) $ — Six Months Ended June 30, 2023 Contingent consideration - Level 3 liabilities $ 7,500 $ — $ 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 10 , Stockholders' Equity , for additional discussion of the warrant liability and the material assumptions leveraged for the pricing model . Non-Financial Assets Measured at Fair Value on a Non-Recurring Basis During the six months ended June 30, 2024 and 2023, there were no fair value measurements on a non-recurring basis for the Company’s non-financial assets. |
Derivative Instruments and Hedg
Derivative Instruments and Hedging Activities | 6 Months Ended |
Jun. 30, 2024 | |
Derivative Instruments and Hedging Activities Disclosure [Abstract] | |
Derivative Instruments and Hedging Activities | Derivative Instruments and Hedging Activities The Company records all derivatives on its consolidated balance sheet at fair value. As of June 30, 2024, 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"). The notional amount associated with the Company's interest rate swap agreements that were outstanding as of June 30, 2024 was $250 million and have a maturity date in January 2026. The Company has designated its swaps as effective cash flow hedges of interest rate risk. Accordingly, changes in the fair value of the interest rate swaps are recorded as a component of accumulated other comprehensive income within stockholders’ equity and subsequently reclassified into interest expense in the same period during which the hedged transaction affects earnings. The table below presents the fair value of the Company’s derivatives related to its interest rate swap agreements, which are designated as hedging instruments, as well as their classification in the consolidated balance sheets at June 30, 2024 and December 31, 2023 (in thousands): June 30, 2024 December 31, 2023 Balance Sheet Location Asset Prepaid and other current assets $ 4,889 $ 4,482 Other assets 1,635 986 Total $ 6,524 $ 5,468 During the three months ended June 30, 2024 and 2023, as a result of the effect of cash flow hedge accounting, the Company recognized a loss, net of tax, of $0.3 million, and a gain, net of tax, of $2.8 million, respectively, in other comprehensive income. In addition, during the three months ended June 30, 2023, $0.4 million was reclassified from other comprehensive income June 30, 2024. During the six months ended June 30, 2024 and 2023, as a result of the effect of cash flow hedge accounting, the Company recognized a gain, net of tax, of $0.9 million and $0.6 million, respectively, in other comprehensive income. In addition, during the six months ended June 30, 2024 other comprehensive income |
Accounts Payable and Accrued Ex
Accounts Payable and Accrued Expenses | 6 Months Ended |
Jun. 30, 2024 | |
Accounts Payable and Accrued Liabilities, Current [Abstract] | |
Accounts Payable and Accrued Expenses | Accounts Payable and Accrued Expenses Accounts payable and accrued expenses as of June 30, 2024 and December 31, 2023 consisted of the following (in thousands): June 30, December 31, Accounts payable $ 279,562 $ 211,504 Employee-related accruals 38,502 47,462 Accrued interest 29,151 29,327 Litigation settlement 10,685 57,340 Other 88,660 46,361 Total $ 446,560 $ 391,994 As previously disclosed, in February 2024, the Company learned that a cyber security threat actor had gained access to some of the information technology systems of Change Healthcare, a subsidiary of UnitedHealth Group, with which one of the Company’s third-party software providers interfaces in connection with the Company’s claims processing activity. UnitedHealth Group isolated the impacted systems upon learning of this threat and Change Healthcare suspended its claims processing activity with the Company’s software provider. During the six months ended June 30, 2024, t he Company participated in the Optum Temporary Funding Assistance Program which was designed to provide short-term cash flow relief to providers impacted by the disruption in Change Healthcare’s services. As of June 30, 2024 |
Debt
Debt | 6 Months Ended |
Jun. 30, 2024 | |
Debt Disclosure [Abstract] | |
Debt | Debt The following is a summary of long term-debt as of June 30, 2024 and December 31, 2023 (in thousands): June 30, December 31, Secured term loan $ 650,000 $ 720,000 Senior unsecured notes 1,450,000 1,450,000 Unamortized deferred financing fees (19,549) (22,018) 2,080,451 2,147,982 Current portion (40,000) (53,368) Long-term portion $ 2,040,451 $ 2,094,614 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. At the option of the Company, amounts borrowed under the 2021 Credit Agreement bear interest at variable rates based upon either the Base Rate (as defined), payable quarterly, or Term SOFR (as defined), payable monthly or quarterly. Interest periods for loans based on Term SOFR are available for one or three months at the option of the Company. Borrowings using Base Rate accrue interest at a per annum rate equal to the sum of (a) the Base Rate determined on each day (subject to a zero percent floor), plus an Applicable Margin (as defined) ranging from 0.50% to 2.25% per annum determined based on the Consolidated Senior Secured Leverage Ratio (as defined) of the Company. Borrowings using Term SOFR accrue interest at a per annum rate equal to the sum of (a) Term SOFR for the applicable interest period (subject to a zero percent floor), plus (b) a Term SOFR adjustment of 0.10%, plus (c) an Applicable Margin (as defined) ranging from 1.50% to 3.25% per annum determined based on the Consolidated Senior Secured Leverage Ratio of the Company. 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 actual daily undrawn portion of the 2021 Revolver depending upon the Consolidated Senior Secured Leverage Ratio of the Company. 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. The Company was in compliance with the applicable covenants in the 2021 Credit Agreement as of June 30, 2024. 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 proceeds thereof are not reinvested, unpermitted debt transactions, and from annual Excess Cash Flow (as defined) if certain leverage tests are not met. Secured Term Loan The outstanding borrowing under the 2021 Term Loan requires quarterly principal repayments of $10.0 million through December 31, 2025, and the unpaid principal balance is due at maturity in January 2026. As a result of the calculation of excess cash flow as of December 31, 2023, the Company was required to make a mandatory prepayment of $13.4 million on the 2021 Term Loan, which was paid in March 2024. In addition, the Company made voluntary repayments on the 2021 Term Loan totaling $36.6 million during the six months ended June 30, 2024. At June 30, 2024 and December 31, 2023, there was $650.0 million and $720.0 million, respectively, outstanding under the 2021 Term Loan. The per annum interest rate under the 2021 Term Loan was 7.43% at June 30, 2024. Revolving Credit Facility During the six months ended June 30, 2024, the Company borrowed $75.0 million under the 2021 Revolver which was repaid during that period. At June 30, 2024, there was $21.6 million outstanding under letters of credit. During the six months ended June 30, 2023, the Company borrowed $50.0 million under the 2021 Revolver which was repaid during that period. 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 June 30, 2024, 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 $346.4 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 AdaptHealth’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. AdaptHealth 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, AdaptHealth 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, AdaptHealth 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 AdaptHealth’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%, and (iii) February 1, 2026 and thereafter is 100.000% in each case together with accrued and unpaid interest. AdaptHealth 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, AdaptHealth 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, AdaptHealth 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 AdaptHealth’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. AdaptHealth 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, AdaptHealth 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, AdaptHealth may be required to make an offer to purchase the 6.125% Senior Notes upon the sale of certain assets or upon specific kinds of changes of control. |
Stockholders' Equity
Stockholders' Equity | 6 Months Ended |
Jun. 30, 2024 | |
Equity [Abstract] | |
Stockholders' Equity | Stockholders' Equity Under the Company's Third Amended and Restated Certificate of Incorporation, there are 300,000,000 shares of authorized Common Stock and 5,000,000 shares of authorized Preferred Stock. Holders of Common Stock are entitled to one vote for each share. The shares of Preferred Stock shall be issued with such designations, voting and other rights and preferences as may be determined from time to time by the Company’s board of directors. Treasury Stock In May 2022, the Company’s board of directors authorized a share repurchase program for up to $200.0 million of the Company’s Common Stock, 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 six months ended June 30, 2023, the Company purchased 631,953 shares of the Company’s Common Stock for $9.2 million under the Share Repurchase Program, which is reflected in Treasury Stock in the accompanying consolidated statements of stockholders’ equity. Subsequent to June 30, 2024, as discussed in Note 14, Commitments and Contingencies , the Company issued 1 million shares from its Treasury Stock in connection with a litigation settlement. Warrants As of June 30, 2024, the Company had 3,871,557 warrants outstanding, which have an expiration date of November 20, 2024. Each warrant is exercisable into one share of Common Stock at a price of $11.50 per share. The exercise price and number of shares of Common Stock issuable upon exercise of the warrants may be adjusted in certain circumstances including in the event of a share dividend, or recapitalization, reorganization, merger or consolidation. However, the warrants will not be adjusted for the issuance of Common Stock at a price below its exercise price. There were no warrants exercised during the six months ended June 30, 2024 and 2023. The Company classifies its warrants as a liability in its consolidated balance sheets because of certain terms included in the corresponding warrant agreement. The estimated fair value of the warrants is recorded as a liability, with such fair value reclassified to stockholders’ equity upon the exercise of such warrants. Prior to exercise, the change in the estimated fair value of such warrants each period is recognized as a non-cash charge or gain in the Company’s consolidated statements of operations. A reconciliation of the changes in the warrant liability during the six months ended June 30, 2024 and 2023 was as follows (in thousands): Estimated fair value of warrant liability at December 31, 2023 $ 4,021 Change in estimated fair value of the warrant liability 443 Estimated fair value of warrant liability at June 30, 2024 $ 4,464 Estimated fair value of warrant liability at December 31, 2022 $ 38,503 Change in estimated fair value of the warrant liability (22,726) Estimated fair value of warrant liability at June 30, 2023 $ 15,777 The warrant liability is classified as a current liability as of June 30, 2024 and December 31, 2023 in the accompanying consolidated balance sheets since the expiration date of the warrants is less than one year as of such dates. 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. On June 20, 2024, the stockholders of the Company approved an amendment and restatement of the 2019 Plan to increase the number of shares of Common Stock of the Company reserved under the 2019 Plan by 8,350,000 shares, to permit the grant of up to 18,350,000 shares of Common Stock, subject to certain adjustments and limitations. At June 30, 2024, 6,678,373 shares of the Company’s Common Stock were available for issuance under the 2019 Plan. Stock Options There were no stock options granted during the six months ended June 30, 2024 and 2023. The following table provides the activity regarding the Company’s outstanding stock options during the six months ended June 30, 2024 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, 2023 2,219 $ 3.75 $ 19.36 5.1 Years Expired (735) $ 4.58 $ 23.38 Outstanding, June 30, 2024 1,484 $ 3.34 $ 17.38 4.8 Years The following table provides the activity for all outstanding stock options during the six months ended June 30, 2024 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Outstanding, December 31, 2023 3,409 $ 14.90 4.9 Years Exercised (177) $ 3.08 Expired (735) $ 23.38 Outstanding, June 30, 2024 2,497 $ 13.24 4.7 Years During the six months ended June 30, 2024, 176,623 stock options were exercised resulting in $0.5 million of cash proceeds received by the Company and the issuance of 176,623 shares of the Company’s Common Stock. During the six months ended June 30, 2023, 559,071 stock options were exercised on a cashless basis resulting in the issuance of 213,852 shares of the Company's Common Stock. Restricted Stock During the six months ended June 30, 2024, the Company granted the following shares of restricted stock: • 1,398,395 shares of restricted stock to various employees which vest ratably over the two • 52,326 shares of restricted stock to an employee which primarily vest on the two-month anniversary following the applicable vesting commencement dates. The grant-date fair value of these awards was $0.5 million • 122,663 shares of restricted stock to the Company's non-employee directors which vest approximately one year following the grant date. The grant-date fair value of these awards was $1.2 million. • 1,047,291 shares of performance-vested restricted stock units ("Performance RSUs") to certain employees of the Company which will vest on the three-year period following the vesting commencement dates 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 dates. The grant-date fair value of these awards, using a Monte-Carlo simulation analysis, was $19.2 million. The payout of shares on the vesting dates are as follows based on the Company’s Relative TSR versus the Peer Group (for performance between the stated goals noted below, straight-line interpolation will be applied): • Less than 25 th Percentile – No payout • Greater than or equal to 25 th Percentile – 50% of Performance RSUs • Equal to 50 th Percentile – 100% of Performance RSUs • Greater than or equal to 75 th Percentile – 200% of Performance RSUs Activity related to the Company’s non-vested restricted stock grants for the six months ended June 30, 2024 is presented below (in thousands, except per share data): Number of Shares of Weighted-Average Grant Date Non-vested balance, December 31, 2023 2,068 $ 19.16 Granted 2,621 $ 12.41 Vested (636) $ 33.27 Forfeited (47) $ 36.48 Non-vested balance, June 30, 2024 4,006 $ 14.93 Equity-Based Compensation Expense The Company recorded equity-based compensation expense of $5.2 million during the three months ended June 30, 2024, of which $4.4 million and $0.8 million is included in general and administrative expenses and cost of net revenue, respectively, in the accompanying consolidated statements of operations. The Company recognized equity-based compensation expense of $6.8 million during the three months ended June 30, 2023, of which $7.7 million is included in general and administrative expenses in the accompanying consolidated statements of operations. The equity-based compensation expense recognized during the three months ended June 30, 2023 includes a net reduction to expense of $0.9 million included in cost of net revenue in the accompanying consolidated statements of operations. As a result of the change in the probability assessment of the vesting of certain unvested shares of restricted stock in which vesting was based on the achievement of a performance condition, during the three months ended June 30, 2023, the Company reversed $2.2 million of previously recognized equity-based compensation expense related to performance conditions no longer deemed probable, which reduced cost of net revenue in the accompanying consolidated statements of operations in that period. The Company recognized equity-based compensation expense of $9.8 million during the six months ended June 30, 2024 , of which $8.0 million and $1.8 million is included in general and administrative expenses and cost of net revenue, respectively, in the accompanying consolidated statements of operations. The Company recognized equity-based compensation expense of $12.8 million during the six months ended June 30, 2023 , of which $12.3 million and $0.5 million is included in general and administrative expenses and cost of net revenue, respectively, in the accompanying consolidated statements of operations. At June 30, 2024, there was $42.0 million of unrecognized compensation expense related to equity-based compensation awards, which is expected to be recognized over a weighted-average period of 2.2 years. As previously disclosed, by mutual agreement with the Company, effective June 30, 2023, Stephen Griggs resigned as Chief Executive Officer of the Company. In connection with Mr. Griggs’ separation, the Company accelerated the vesting of 78,130 unvested stock options and 143,739 unvested shares of restricted stock which were subject to time-based vesting conditions only. In addition, the Company modified the vesting conditions for 159,555 shares of Performance RSU's to allow for vesting based on the achievement of the applicable Relative TSR, but no longer requires continuous employment through the applicable vesting date. In connection with the accelerated vesting and modification, the Company recognized $4.0 million of equity-based compensation expense, which is included in general and administrative expenses in the accompanying consolidated statements of operations for the three and six m onths ended June 30, 2023 . |
Earnings Per Share
Earnings Per Share | 6 Months Ended |
Jun. 30, 2024 | |
Earnings Per Share [Abstract] | |
Earnings Per Share | Earnings Per Share Earnings Per Share ("EPS") is computed by dividing net income by the weighted average number of common shares outstanding during the period on a basic and diluted basis. The Company computes diluted net income per share using the more dilutive of the treasury stock method and the two-class method after giving effect to all potential dilutive Common Stock. The Company’s potentially dilutive securities include potential common shares related to outstanding warrants, unvested restricted stock, outstanding stock options and outstanding preferred stock. See Note 10, Stockholders' Equity , for additional discussion of these potential dilutive securities. Diluted net income per share considers the impact of potentially dilutive securities except when the potential common shares have an antidilutive effect. The Company’s outstanding preferred stock are considered participating securities, thus requiring the two-class method of computing diluted net income per share. Computation of diluted net income per share under the two-class method excludes from the numerator any dividends paid or owed on participating securities and any undistributed earnings considered to be attributable to participating securities. The related participating securities are similarly excluded from the denominator. Computations of basic and diluted net income per share were as follows (in thousands, except per share data): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Numerator Net income attributable to AdaptHealth Corp. $ 19,435 $ 13,977 $ 17,301 $ 29,684 Less: Earnings allocated to participating securities (1) 1,656 1,182 1,475 2,508 Net income for basic EPS $ 17,779 $ 12,795 $ 15,826 $ 27,176 Change in fair value of warrant liability (2) — — — (22,726) Net income for diluted EPS $ 17,779 $ 12,795 $ 15,826 $ 4,450 Denominator (1) (2) Basic weighted-average common shares outstanding 133,218 134,295 133,066 134,409 Add: Warrants (2) — — — 857 Add: Stock options 298 833 235 1,552 Add: Unvested restricted stock 2,513 1,105 2,397 1,182 Diluted weighted-average common shares outstanding 136,029 136,233 135,698 138,000 Basic net income per share $ 0.13 $ 0.10 $ 0.12 $ 0.20 Diluted net income per share $ 0.13 $ 0.09 $ 0.12 $ 0.03 (1) The Company’s preferred stock are considered participating securities. Computation of EPS under the two-class method excludes from the numerator any dividends paid or owed on participating securities and any undistributed earnings considered to be attributable to participating securities. The related participating securities are similarly excluded from the denominator. (2) For the six months ended June 30, 2023, the impact to earnings from the change in fair value of the Company’s warrant liability is excluded from the numerator, and the corresponding security is included in the denominator, for purposes of computing diluted net income per share. This adjustment is included as the effect of the numerator and denominator adjustment for this derivative instrument is dilutive as a result of the non-cash gain recorded for the change in fair value of this instrument during the period. For the six months ended June 30, 2024 and the three months ended June 30, 2024 and 2023, this adjustment is excluded from the computation of diluted net income per share under the treasury stock method since its inclusion would have been anti-dilutive. The table below provides the weighted-average number of potential common shares associated with outstanding securities not included in the Company’s computation of diluted net income per share for the three and six months ended June 30, 2024 and 2023 because to do so would be antidilutive (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Preferred Stock 12,406 12,406 12,406 12,406 Warrants 3,872 — 3,872 — Stock options 2,200 2,219 2,263 468 Unvested restricted stock 1,431 — 1,547 — Total 19,909 14,625 20,088 12,874 |
Leases
Leases | 6 Months Ended |
Jun. 30, 2024 | |
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 ("ROU") 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 lease costs and expenses and sublease income for the three and six months ended June 30, 2024 and 2023 (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. Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Operating lease costs $ 10,391 $ 10,598 $ 21,395 $ 21,072 Finance lease costs: Amortization of ROU assets $ 2,538 $ 2,477 $ 4,793 $ 3,007 Interest on lease liabilities $ 551 $ — $ 1,058 $ — Other lease costs and income: Variable leases costs (1) $ 6,195 $ 4,538 $ 12,067 $ 10,559 Sublease income $ 257 $ 409 $ 537 $ 787 (1) Amounts represent variable costs incurred that were not included in the initial measurement of the lease liability such as common area maintenance and utilities costs associated with leased real estate. The following table provides the weighted average remaining lease terms and weighted average discount rates for the Company’s leases as of June 30, 2024 and December 31, 2023: June 30, 2024 December 31, 2023 Weighted average remaining lease term, weighted based on lease liability balances: Operating leases 5.2 years 5.6 years Finance leases 3.4 years 3.6 years Weighted average discount rate, weighted based on remaining balance of lease payments: Operating leases 4.7 % 4.4 % Finance leases 6.8 % 6.7 % The following table provides the undiscounted amount of future cash flows related to the Company’s operating and finance leases, as well as a reconciliation of such undiscounted cash flows to the amounts included in the Company’s lease liabilities as of June 30, 2024 (in thousands): Operating Leases Finance Leases 2024 $ 18,180 $ 6,896 2025 31,854 13,177 2026 23,396 11,973 2027 15,392 8,335 2028 12,027 1,451 Thereafter 24,776 156 Total future undiscounted lease payments $ 125,625 $ 41,988 Less: amount representing interest (14,591) (4,468) Present value of future lease payments (lease liability) $ 111,034 $ 37,520 The following table provides certain cash flow and supplemental non-cash information related to the Company’s lease liabilities for the six months ended June 30, 2024 and 2023, respectively (in thousands): Six Months Ended June 30, Cash paid for amounts included in the measurement of lease liabilities: 2024 2023 Operating cash payments for operating leases $ 21,432 $ 20,847 Financing cash payments for finance leases $ 4,890 $ 3,679 Lease liabilities arising from obtaining right-of-use assets: Operating leases $ 15,967 $ 5,112 Finance leases $ 10,895 $ 12,203 |
Income Taxes
Income Taxes | 6 Months Ended |
Jun. 30, 2024 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | Income Taxes The Company is subject to U.S. federal, state, and local income taxes. For the three months ended June 30, 2024 and 2023, the Company recorded income tax expense of $7.2 million and $5.4 million, respectively. For the six months ended June 30, 2024 and 2023, the Company recorded income tax expense of $13.9 million and $3.7 million, respectively. For the six months ended June 30, 2024, the Company recognized a $1.0 million income tax benefit, and corresponding increase to net deferred tax assets, related to non-cash goodwill impairment charges totaling $13.1 million. See Note 5, Goodwill and Identifiable Intangible Assets , for additional details. As of June 30, 2024 and December 31, 2023, the Company had an unrecognized tax benefit of $5.2 million and $6.6 million, respectively. Tax Receivable Agreement AdaptHealth Corp. is party to a Tax Receivable Agreement ("TRA") with certain current and former members of AdaptHealth Holdings LLC, a Delaware limited liability company ("AdaptHealth Holdings"). The TRA provides for the payment by AdaptHealth Corp. of 85% of the tax savings, if any, that AdaptHealth Corp. realizes (or is deemed to realize in certain circumstances) as a result of (i) certain 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. At June 30, 2024, the Company's liability relating to the TRA was $290.2 million, of which $24.3 million and $265.9 million is included in other current liabilities and other long-term liabilities, respectively, in the accompanying consolidated balance sheets. 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. |
Commitments and Contingencies
Commitments and Contingencies | 6 Months Ended |
Jun. 30, 2024 | |
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 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 alleged 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 sought 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, the defendants entered into a stipulation and agreement of settlement with the Lead Plaintiffs (the “Securities Settlement”). On March 5, 2024, the court granted preliminary approval of the settlement. On July 10, 2024, the court entered a judgment approving the class action settlement. The judgment certified the putative class for settlement purpose, found that the settlement is fair, reasonable, and adequate in all respects, and subject to certain exclusions and limitations, releases claims on behalf of the settlement class that were asserted or could have been asserted in the Consolidated Class Action against the defendants. Subject to any appeals, the judgment will become final under the Securities Settlement within 30 days of entry. The Company’s portion of the settlement consists of (i) $32.2 million of cash from the Company’s insurance carriers; (ii) $17.8 million of cash from the Company; (iii) 1 million shares of the Company’s Common Stock (the “Settlement Shares”), which had a fair value of $7.3 million recognized at December 31, 2023; and (iv) the implementation of certain corporate governance reforms. All of the aforementioned cash consideration has been paid consistent with the Securities Settlement during the six months ended June 30, 2024. For the six months ended June 30, 2024, the Company recognized a pre-tax expense of $2.4 million for the change in fair value of the Settlement Shares, which is included in other loss, net in the accompanying consolidated statements of operations. As of June 30, 2024, the Company recorded a liability of $9.7 million relating to the Settlement Shares; such liability is included in accounts payable and accrued expenses in the accompanying consolidated balance sheet s. In July 2024, the Company issued the Settlement Shares from available Treasury Stock. In connection with the issuance, in the third quarter of 2024, the Company expects to eliminate the $9.7 million liability through a reduction to Treasury Stock and Additional paid-in capital of $17.7 million and $8.0 million, respectively. On March 7, 2024, the Company entered into a settlement agreement 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. If the Securities Settlement becomes final, the insurance 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 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 (the “Derivative Plaintiff”), 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. On April 23, 2024, defendants entered into a stipulation and agreement of settlement with the Derivative Plaintiff. In exchange for full releases, the proposed settlement consists of (i) $0.9 million in attorneys’ fees and expenses, which will be funded with cash from the Company; and (ii) the implementation of corporate governance reforms separate from those negotiated in Securities Settlement. For the six months ended June 30, 2024, the Company recorded a pre-tax expense of $0.9 million associated with the settlement, which is included in other loss, net in the accompanying consolidated statements of operations. As of June 30, 2024, the Company recorded a liability of $0.9 million relating to the settlement; such liability is included in accounts payable and accrued expenses in the accompanying consolidated balance sheets. On June 25, 2024, the court granted preliminary approval of the settlement, and set the final approval hearing for November 13, 2024. 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 will be released from the claims that were asserted or could have been asserted in the Derivative 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 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. 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 May 14, 2024, Lead Plaintiffs filed a consolidated complaint against the Company and certain of its current and former officers and directors, and certain underwriters, on behalf of shareholders that purchased or otherwise acquired the Company’s stock between August 4, 2020 and November 7, 2023 (as to the complaint the “Allegheny County Consolidated Complaint”; as to the action, the “Allegheny County Consolidated Class Action”). The Allegheny County Consolidated 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 (i) the Company’s billing practices with respect to its diabetes business, and (ii) the Company’s compliance programs and integration with respect to acquired companies. The Allegheny County Consolidated Complaint seeks unspecified damages. On July 23, 2024, the defendants filed a motion to dismiss the Allegheny County Consolidated Complaint. Plaintiffs’ opposition brief is due to be filed on October 1, 2024; and defendants’ reply brief is due to be filed on November 15, 2024. 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. On March 20, 2024, a putative shareholder of the Company, Weiding Wu, filed a shareholder derivative complaint related to the allegations in the Allegheny County Complaint, and 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 “Wu Derivative Complaint”; as to the action, the “Wu Derivative Action”). The Wu Derivative Complaint alleges, among other things, that the defendants breached their fiduciary duties and 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 Wu Derivative Complaint also alleges claims for unjust enrichment, waste of corporate assets, abuse of control, and gross mismanagement. The Derivative Complaint seeks, among other things, an award of money damages. On July 25, 2024, the parties to the Wu Derivative Action stipulated to stay the Wu Derivative Action pending final resolution of the Allegheny County Consolidated Class Action. On July 26, 2024, the court so-ordered the parties’ stipulation. The Company intends to vigorously defend against the allegations contained in the Wu Derivative Complaint, but there can be no assurance that the defense will be successful. |
Related Party Transactions
Related Party Transactions | 6 Months Ended |
Jun. 30, 2024 | |
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 $3.6 million and $2.7 million for the three months ended June 30, 2024 and 2023, respectively, and $7.1 million and $5.0 million for the six months ended June 30, 2024 and 2023, respectively. The Company accounts for this investment under the cost method of accounting based on its level of equity ownership. As of June 30, 2024 and December 31, 2023, 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 approximately 1.0% of the Company’s consolidated net revenue during the three and six months ended June 30, 2024 and 2023 . As of June 30, 2024 and December 31, 2023, the Company had an immaterial outstanding accounts receivable balance from this third-party payor. A director of the Company is an employee of a beneficial owner of more than 5% of the Company’s Common Stock as of June 30, 2024. 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. Payments to this vendor were $27.8 million and $9.4 million for the three months ended June 30, 2024 and 2023, respectively, and $28.2 million and $20.6 million , for the six months ended June 30, 2024 and 2023, respectively. |
Subsequent Events
Subsequent Events | 6 Months Ended |
Jun. 30, 2024 | |
Subsequent Events [Abstract] | |
Subsequent Events | Subsequent Events The Company evaluated subsequent events for the period from June 30, 2024 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. |
General Information (Policies)
General Information (Policies) | 6 Months Ended |
Jun. 30, 2024 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Basis of Presentation | Basis of Presentation The interim consolidated financial statements of the Company have been prepared in accordance with accounting principles generally accepted in the United States of America ("U.S. GAAP"). In the opinion of management, the interim consolidated financial statements include all necessary adjustments for a fair presentation of the financial position and results of operations for the periods presented. |
Basis of Consolidation | Basis of Consolidation The accompanying interim consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation. |
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. |
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. |
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, a nd/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. |
Long-Lived Assets | Long-Lived Assets The Company’s long-lived assets, such as equipment and other fixed assets, operating lease right-of-use assets, finance lease right-of-use assets and definite-lived identifiable intangible assets, are assessed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to estimated undiscounted future cash flows expected to be generated by the asset. If the carrying amount of an asset exceeds its estimated undiscounted future cash flows, an impairment charge is recognized by the amount by which the carrying amount of the asset exceeds the fair value of the asset. Definite-lived identifiable intangible assets consist of tradenames, payor contracts, contractual rental agreements and developed technology. These assets are amortized using the straight-line method over their estimated useful lives, which reflects the pattern in which the economic benefits of the assets are expected to be consumed. In addition to consideration of impairment upon the events or changes in circumstances described above, management regularly evaluates the remaining useful lives of its long-lived assets. The following table summarizes the useful lives of the Company’s identifiable intangible assets: Tradenames 5 to 10 years Payor contracts 10 years Developed technology 5 years |
Equity-based Compensation | Equity-based Compensation The Company accounts for its equity-based compensation in accordance with Financial Accounting Standards Board ("FASB") Accounting Standards Codification ("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 10, Stockholders’ Equity , for additional information regarding the Company’s equity-based compensation expense. |
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 Chief Executive Officer, who currently 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. |
Accounting for Leases | Accounting for Leases The Company accounts for its leases in accordance with FASB ASC 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. 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 12, Leases, for additional information. |
Recently Issued Accounting Pronouncements Not Yet Adopted | Recently Issued Accounting Pronouncements Not Yet Adopted In March 2024, the FASB issued Accounting Standards update "ASU" No. 2024-02, Codification Improvements-Amendments to Remove References to the Concepts Statements , which removes various references to concepts statements from the FASB Accounting Standards Codification. This ASU is effective for the Company beginning in the first quarter of fiscal year 2026, with early adoption permitted. The Company does not expect that the new guidance will have a material impact on its consolidated financial statements, and intends to adopt the guidance when it becomes effective in the first quarter of fiscal year 2026. In March 2024, the FASB issued ASU No. 2024-01, Compensation-Stock Compensation ("Topic 718") , which provides illustrative guidance to help entities determine whether profits interest and similar awards should be accounted for as share-based payment arrangements within the scope of ASC 718. ASU 2024-01 is effective for annual periods beginning after December 15, 2024, and interim periods within those annual periods. The Company is currently evaluating the impact that this standard will have on its consolidated financial statements and related disclosures. 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 statements and related 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. In March 2024, the SEC issued its final climate disclosure rule, which requires registrants to provide climate-related disclosures in their annual reports and registration statements. The new disclosure requirements will be effective for the Company beginning with its annual report for the year ending December 31, 2025. In April 2024, the SEC stayed its final climate rule to allow for a judicial review of pending legal challenges. The Company is currently evaluating the impact these rules will have on its consolidated financial statements and related disclosures and will monitor the litigation progress relating to these rules for possible impacts on the disclosure requirements under the rules. |
General Information (Tables)
General Information (Tables) | 6 Months Ended |
Jun. 30, 2024 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Schedule of useful lives of acquired intangible assets | The following table summarizes the useful lives of the Company’s identifiable intangible assets: Tradenames 5 to 10 years Payor contracts 10 years Developed technology 5 years |
Revenue Recognition and Accou_2
Revenue Recognition and Accounts Receivable (Tables) | 6 Months Ended |
Jun. 30, 2024 | |
Revenue from Contract with Customer [Abstract] | |
Schedule of composition of net revenues by payor type and core service lines | The composition of net revenue by payor type for the three and six months ended June 30, 2024 and 2023 are as follows (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Insurance $ 487,787 $ 474,828 $ 971,152 $ 911,612 Government 210,946 209,662 409,344 398,509 Patient pay 107,242 108,796 217,976 227,791 Net revenue $ 805,975 $ 793,286 $ 1,598,472 $ 1,537,912 The composition of net revenue by core product lines for the three and six months ended June 30, 2024 and 2023 are as follows (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Net sales revenue: Sleep $ 233,361 $ 215,849 $ 458,887 $ 429,306 Diabetes 147,261 165,021 294,240 307,565 Supplies to the home 44,265 48,323 88,913 94,878 Respiratory 7,871 8,191 15,575 16,120 HME 25,963 27,237 51,585 55,800 Other 57,684 57,012 113,345 110,219 Total net sales revenue $ 516,405 $ 521,633 $ 1,022,545 $ 1,013,888 Net revenue from fixed monthly equipment reimbursements: Sleep $ 82,053 $ 86,783 $ 162,743 $ 167,705 Diabetes 2,382 3,886 4,661 7,717 Respiratory 138,899 145,889 276,131 280,612 HME 23,355 23,974 45,921 46,315 Other 11,637 11,121 23,208 21,675 Total net revenue from fixed monthly equipment reimbursements $ 258,326 $ 271,653 $ 512,664 $ 524,024 Net revenue from capitated revenue arrangements: Sleep $ 6,976 $ — $ 14,028 $ — Diabetes 1,546 $ — 3,144 — Supplies to the home 3,080 $ — 6,290 — Respiratory 14,456 $ — 29,582 — HME 3,712 $ — 7,210 — Other 1,474 $ — 3,009 — Total net revenue from capitated revenue arrangements $ 31,244 $ — $ 63,263 $ — Total net revenue: Sleep $ 322,390 $ 302,632 $ 635,658 $ 597,011 Diabetes 151,189 168,907 302,045 315,282 Supplies to the home 47,345 48,323 95,203 94,878 Respiratory 161,226 154,080 321,288 296,732 HME 53,030 51,211 104,716 102,115 Other 70,795 68,133 139,562 131,894 Total net revenue $ 805,975 $ 793,286 $ 1,598,472 $ 1,537,912 |
Acquisitions (Tables)
Acquisitions (Tables) | 6 Months Ended |
Jun. 30, 2024 | |
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract] | |
Summary of consideration | The following table summarizes the consideration paid at closing for all acquisitions during the six months ended June 30, 2023 (in thousands): Cash $ 18,173 Deferred payments 50 Total $ 18,223 |
Summary of estimated fair values of the net assets acquired | Based upon management’s evaluation, the consideration paid for all acquisitions during the six months ended June 30, 2023 was allocated as follows during the period (in thousands): Cash $ 268 Accounts receivable 1,798 Inventory 1,001 Prepaid and other current assets 10 Equipment and other fixed assets 9,863 Operating lease right-of-use assets 5,506 Finance lease right-of-use assets 200 Goodwill 6,796 Accounts payable and accrued expenses (667) Other current liabilities (846) Operating lease liabilities (5,506) Finance lease liabilities (200) Net assets acquired $ 18,223 |
Equipment and Other Fixed Ass_2
Equipment and Other Fixed Assets (Tables) | 6 Months Ended |
Jun. 30, 2024 | |
Property, Plant and Equipment [Abstract] | |
Schedule of equipment and other fixed assets | Equipment and other fixed assets as of June 30, 2024 and December 31, 2023 are as follows (in thousands): June 30, December 31, Patient medical equipment $ 811,940 $ 791,349 Computers and software 91,053 85,509 Delivery vehicles 35,062 35,021 Other 22,079 20,203 Gross carrying value 960,134 932,082 Less accumulated depreciation (463,998) (436,981) Equipment and other fixed assets, net $ 496,136 $ 495,101 |
Goodwill and Identifiable Int_2
Goodwill and Identifiable Intangible Assets (Tables) | 6 Months Ended |
Jun. 30, 2024 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Schedule of change in the carrying amount of goodwill | The change in the carrying amount of goodwill for the six months ended June 30, 2024 was as follows (in thousands): Gross carrying Balance at December 31, 2023 $ 2,724,958 Goodwill impairment (13,078) Balance at June 30, 2024 $ 2,711,880 |
Schedule of identifiable intangible assets | Identifiable intangible assets consisted of the following at June 30, 2024 and December 31, 2023 (in thousands): June 30, 2024 Weighted-Average Tradenames, net of accumulated amortization of $44,723 $ 68,077 6.2 Payor contracts, net of accumulated amortization of $32,316 49,684 6.1 Developed technology, net of accumulated amortization of $5,040 1,260 1.0 Identifiable intangible assets, net $ 119,021 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 |
Schedule of future amortization expense related to identifiable intangible assets | Future amortization expense related to identifiable intangible assets is estimated to be as follows (in thousands): Twelve months ending June 30, 2025 $ 22,217 2026 20,119 2027 18,384 2028 17,936 2029 17,936 Thereafter 22,429 Total $ 119,021 |
Fair Value of Assets and Liab_2
Fair Value of Assets and Liabilities (Tables) | 6 Months Ended |
Jun. 30, 2024 | |
Fair Value Disclosures [Abstract] | |
Summary of financial assets and liabilities measured at fair value on a recurring basis | The following table presents the valuation of the Company’s financial assets and liabilities as of June 30, 2024 and December 31, 2023 measured at fair value on a recurring basis. The fair value estimates presented herein are based on information available to management as of June 30, 2024 and December 31, 2023. These estimates are not necessarily indicative of the amounts the Company could ultimately realize. (in thousands) Level 1 Level 2 Level 3 June 30, 2024 Assets Interest rate swap agreements-short term $ — $ 4,889 $ — Interest rate swap agreements-long term — 1,635 — Total assets measured at fair value $ — $ 6,524 $ — Liabilities Warrant liability — — 4,464 Total liabilities measured at fair value $ — $ — $ 4,464 (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 |
Reconciliation of contingent consideration liabilities | A reconciliation of the Company’s contingent consideration liabilities related to acquisitions for the six months ended June 30, 2024 and 2023 is as follows (in thousands): Six Months Ended June 30, 2024 Beginning Balance Payments Ending Balance Contingent consideration - Level 3 liabilities $ 6,850 $ (6,850) $ — Six Months Ended June 30, 2023 Contingent consideration - Level 3 liabilities $ 7,500 $ — $ 7,500 |
Derivative Instruments and He_2
Derivative Instruments and Hedging Activities (Tables) | 6 Months Ended |
Jun. 30, 2024 | |
Derivative Instruments and Hedging Activities Disclosure [Abstract] | |
Summary of fair value of derivative financial instruments as well as their classification on the consolidated balance sheets | The table below presents the fair value of the Company’s derivatives related to its interest rate swap agreements, which are designated as hedging instruments, as well as their classification in the consolidated balance sheets at June 30, 2024 and December 31, 2023 (in thousands): June 30, 2024 December 31, 2023 Balance Sheet Location Asset Prepaid and other current assets $ 4,889 $ 4,482 Other assets 1,635 986 Total $ 6,524 $ 5,468 |
Accounts Payable and Accrued _2
Accounts Payable and Accrued Expenses (Tables) | 6 Months Ended |
Jun. 30, 2024 | |
Accounts Payable and Accrued Liabilities, Current [Abstract] | |
Schedule of components accounts payable and accrued expenses | Accounts payable and accrued expenses as of June 30, 2024 and December 31, 2023 consisted of the following (in thousands): June 30, December 31, Accounts payable $ 279,562 $ 211,504 Employee-related accruals 38,502 47,462 Accrued interest 29,151 29,327 Litigation settlement 10,685 57,340 Other 88,660 46,361 Total $ 446,560 $ 391,994 |
Debt (Tables)
Debt (Tables) | 6 Months Ended |
Jun. 30, 2024 | |
Debt Disclosure [Abstract] | |
Schedule of summary of long term debt | The following is a summary of long term-debt as of June 30, 2024 and December 31, 2023 (in thousands): June 30, December 31, Secured term loan $ 650,000 $ 720,000 Senior unsecured notes 1,450,000 1,450,000 Unamortized deferred financing fees (19,549) (22,018) 2,080,451 2,147,982 Current portion (40,000) (53,368) Long-term portion $ 2,040,451 $ 2,094,614 |
Stockholders' Equity (Tables)
Stockholders' Equity (Tables) | 6 Months Ended |
Jun. 30, 2024 | |
Equity [Abstract] | |
Schedule of changes in warrant liability | A reconciliation of the changes in the warrant liability during the six months ended June 30, 2024 and 2023 was as follows (in thousands): Estimated fair value of warrant liability at December 31, 2023 $ 4,021 Change in estimated fair value of the warrant liability 443 Estimated fair value of warrant liability at June 30, 2024 $ 4,464 Estimated fair value of warrant liability at December 31, 2022 $ 38,503 Change in estimated fair value of the warrant liability (22,726) Estimated fair value of warrant liability at June 30, 2023 $ 15,777 |
Schedule of stock option activity | The following table provides the activity regarding the Company’s outstanding stock options during the six months ended June 30, 2024 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, 2023 2,219 $ 3.75 $ 19.36 5.1 Years Expired (735) $ 4.58 $ 23.38 Outstanding, June 30, 2024 1,484 $ 3.34 $ 17.38 4.8 Years The following table provides the activity for all outstanding stock options during the six months ended June 30, 2024 (in thousands, except per share data): Number of Weighted-Average Weighted-Average Outstanding, December 31, 2023 3,409 $ 14.90 4.9 Years Exercised (177) $ 3.08 Expired (735) $ 23.38 Outstanding, June 30, 2024 2,497 $ 13.24 4.7 Years |
Schedule of restricted stock activity | Activity related to the Company’s non-vested restricted stock grants for the six months ended June 30, 2024 is presented below (in thousands, except per share data): Number of Shares of Weighted-Average Grant Date Non-vested balance, December 31, 2023 2,068 $ 19.16 Granted 2,621 $ 12.41 Vested (636) $ 33.27 Forfeited (47) $ 36.48 Non-vested balance, June 30, 2024 4,006 $ 14.93 |
Earnings Per Share (Tables)
Earnings Per Share (Tables) | 6 Months Ended |
Jun. 30, 2024 | |
Earnings Per Share [Abstract] | |
Schedule of calculation of basic and diluted earnings (loss) per share | Computations of basic and diluted net income per share were as follows (in thousands, except per share data): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Numerator Net income attributable to AdaptHealth Corp. $ 19,435 $ 13,977 $ 17,301 $ 29,684 Less: Earnings allocated to participating securities (1) 1,656 1,182 1,475 2,508 Net income for basic EPS $ 17,779 $ 12,795 $ 15,826 $ 27,176 Change in fair value of warrant liability (2) — — — (22,726) Net income for diluted EPS $ 17,779 $ 12,795 $ 15,826 $ 4,450 Denominator (1) (2) Basic weighted-average common shares outstanding 133,218 134,295 133,066 134,409 Add: Warrants (2) — — — 857 Add: Stock options 298 833 235 1,552 Add: Unvested restricted stock 2,513 1,105 2,397 1,182 Diluted weighted-average common shares outstanding 136,029 136,233 135,698 138,000 Basic net income per share $ 0.13 $ 0.10 $ 0.12 $ 0.20 Diluted net income per share $ 0.13 $ 0.09 $ 0.12 $ 0.03 (1) The Company’s preferred stock are considered participating securities. Computation of EPS under the two-class method excludes from the numerator any dividends paid or owed on participating securities and any undistributed earnings considered to be attributable to participating securities. The related participating securities are similarly excluded from the denominator. (2) For the six months ended June 30, 2023, the impact to earnings from the change in fair value of the Company’s warrant liability is excluded from the numerator, and the corresponding security is included in the denominator, for purposes of computing diluted net income per share. This adjustment is included as the effect of the numerator and denominator adjustment for this derivative instrument is dilutive as a result of the non-cash gain recorded for the change in fair value of this instrument during the period. For the six months ended June 30, 2024 and the three months ended June 30, 2024 and 2023, this adjustment is excluded from the computation of diluted net income per share under the treasury stock method since its inclusion would have been anti-dilutive. |
Schedule of antidilutive securities excluded from computation of earnings per share | The table below provides the weighted-average number of potential common shares associated with outstanding securities not included in the Company’s computation of diluted net income per share for the three and six months ended June 30, 2024 and 2023 because to do so would be antidilutive (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Preferred Stock 12,406 12,406 12,406 12,406 Warrants 3,872 — 3,872 — Stock options 2,200 2,219 2,263 468 Unvested restricted stock 1,431 — 1,547 — Total 19,909 14,625 20,088 12,874 |
Leases (Tables)
Leases (Tables) | 6 Months Ended |
Jun. 30, 2024 | |
Leases [Abstract] | |
Lease costs and sublease income | The following table presents information about lease costs and expenses and sublease income for the three and six months ended June 30, 2024 and 2023 (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. Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Operating lease costs $ 10,391 $ 10,598 $ 21,395 $ 21,072 Finance lease costs: Amortization of ROU assets $ 2,538 $ 2,477 $ 4,793 $ 3,007 Interest on lease liabilities $ 551 $ — $ 1,058 $ — Other lease costs and income: Variable leases costs (1) $ 6,195 $ 4,538 $ 12,067 $ 10,559 Sublease income $ 257 $ 409 $ 537 $ 787 (1) Amounts represent variable costs incurred that were not included in the initial measurement of the lease liability such as common area maintenance and utilities costs associated with leased real estate. |
Weighted average remaining lease terms and weighted average discount rates | The following table provides the weighted average remaining lease terms and weighted average discount rates for the Company’s leases as of June 30, 2024 and December 31, 2023: June 30, 2024 December 31, 2023 Weighted average remaining lease term, weighted based on lease liability balances: Operating leases 5.2 years 5.6 years Finance leases 3.4 years 3.6 years Weighted average discount rate, weighted based on remaining balance of lease payments: Operating leases 4.7 % 4.4 % Finance leases 6.8 % 6.7 % |
Schedule of operating lease liability maturity | The following table provides the undiscounted amount of future cash flows related to the Company’s operating and finance leases, as well as a reconciliation of such undiscounted cash flows to the amounts included in the Company’s lease liabilities as of June 30, 2024 (in thousands): Operating Leases Finance Leases 2024 $ 18,180 $ 6,896 2025 31,854 13,177 2026 23,396 11,973 2027 15,392 8,335 2028 12,027 1,451 Thereafter 24,776 156 Total future undiscounted lease payments $ 125,625 $ 41,988 Less: amount representing interest (14,591) (4,468) Present value of future lease payments (lease liability) $ 111,034 $ 37,520 |
Schedule of finance lease liability maturity | The following table provides the undiscounted amount of future cash flows related to the Company’s operating and finance leases, as well as a reconciliation of such undiscounted cash flows to the amounts included in the Company’s lease liabilities as of June 30, 2024 (in thousands): Operating Leases Finance Leases 2024 $ 18,180 $ 6,896 2025 31,854 13,177 2026 23,396 11,973 2027 15,392 8,335 2028 12,027 1,451 Thereafter 24,776 156 Total future undiscounted lease payments $ 125,625 $ 41,988 Less: amount representing interest (14,591) (4,468) Present value of future lease payments (lease liability) $ 111,034 $ 37,520 |
Cash flow and supplemental non-cash information related to our lease liabilities | The following table provides certain cash flow and supplemental non-cash information related to the Company’s lease liabilities for the six months ended June 30, 2024 and 2023, respectively (in thousands): Six Months Ended June 30, Cash paid for amounts included in the measurement of lease liabilities: 2024 2023 Operating cash payments for operating leases $ 21,432 $ 20,847 Financing cash payments for finance leases $ 4,890 $ 3,679 Lease liabilities arising from obtaining right-of-use assets: Operating leases $ 15,967 $ 5,112 Finance leases $ 10,895 $ 12,203 |
General Information - Useful Li
General Information - Useful Lives Of Identifiable Intangible Assets (Details) | Jun. 30, 2024 |
Payor contracts | |
Property, Plant and Equipment [Line Items] | |
Useful lives of identifiable intangible assets (in years) | 10 years |
Developed technology | |
Property, Plant and Equipment [Line Items] | |
Useful lives of identifiable intangible assets (in years) | 5 years |
Minimum | Tradenames | |
Property, Plant and Equipment [Line Items] | |
Useful lives of identifiable intangible assets (in years) | 5 years |
Maximum | Tradenames | |
Property, Plant and Equipment [Line Items] | |
Useful lives of identifiable intangible assets (in years) | 10 years |
General Information - Narrative
General Information - Narrative (Details) | 6 Months Ended | |
Jun. 30, 2024 USD ($) segment | Jun. 30, 2023 USD ($) | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | ||
Impairment of long-lived assets | $ | $ 0 | $ 0 |
Number of segments, operating | 1 | |
Number of segments, reportable | 1 |
Revenue Recognition and Accou_3
Revenue Recognition and Accounts Receivable - Composition of Net Revenue (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2024 | Jun. 30, 2023 | Jun. 30, 2024 | Jun. 30, 2023 | |
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | $ 805,975 | $ 793,286 | $ 1,598,472 | $ 1,537,912 |
Transferred at Point in Time | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 516,405 | 521,633 | 1,022,545 | 1,013,888 |
Transferred Over Time, Non-Capitated Arrangement | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 258,326 | 271,653 | 512,664 | 524,024 |
Transferred Over Time, Capitated Arrangement | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 31,244 | 0 | 63,263 | 0 |
Sleep | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 322,390 | 302,632 | 635,658 | 597,011 |
Sleep | Transferred at Point in Time | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 233,361 | 215,849 | 458,887 | 429,306 |
Sleep | Transferred Over Time, Non-Capitated Arrangement | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 82,053 | 86,783 | 162,743 | 167,705 |
Sleep | Transferred Over Time, Capitated Arrangement | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 6,976 | 0 | 14,028 | 0 |
Diabetes | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 151,189 | 168,907 | 302,045 | 315,282 |
Diabetes | Transferred at Point in Time | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 147,261 | 165,021 | 294,240 | 307,565 |
Diabetes | Transferred Over Time, Non-Capitated Arrangement | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 2,382 | 3,886 | 4,661 | 7,717 |
Diabetes | Transferred Over Time, Capitated Arrangement | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 1,546 | 0 | 3,144 | 0 |
Supplies to the home | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 47,345 | 48,323 | 95,203 | 94,878 |
Supplies to the home | Transferred at Point in Time | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 44,265 | 48,323 | 88,913 | 94,878 |
Supplies to the home | Transferred Over Time, Capitated Arrangement | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 3,080 | 0 | 6,290 | 0 |
Respiratory | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 161,226 | 154,080 | 321,288 | 296,732 |
Respiratory | Transferred at Point in Time | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 7,871 | 8,191 | 15,575 | 16,120 |
Respiratory | Transferred Over Time, Non-Capitated Arrangement | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 138,899 | 145,889 | 276,131 | 280,612 |
Respiratory | Transferred Over Time, Capitated Arrangement | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 14,456 | 0 | 29,582 | 0 |
HME | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 53,030 | 51,211 | 104,716 | 102,115 |
HME | Transferred at Point in Time | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 25,963 | 27,237 | 51,585 | 55,800 |
HME | Transferred Over Time, Non-Capitated Arrangement | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 23,355 | 23,974 | 45,921 | 46,315 |
HME | Transferred Over Time, Capitated Arrangement | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 3,712 | 0 | 7,210 | 0 |
Other | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 70,795 | 68,133 | 139,562 | 131,894 |
Other | Transferred at Point in Time | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 57,684 | 57,012 | 113,345 | 110,219 |
Other | Transferred Over Time, Non-Capitated Arrangement | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 11,637 | 11,121 | 23,208 | 21,675 |
Other | Transferred Over Time, Capitated Arrangement | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 1,474 | 0 | 3,009 | 0 |
Insurance | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 487,787 | 474,828 | 971,152 | 911,612 |
Government | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | 210,946 | 209,662 | 409,344 | 398,509 |
Patient pay | ||||
Disaggregation of Revenue [Line Items] | ||||
Total net revenue | $ 107,242 | $ 108,796 | $ 217,976 | $ 227,791 |
Revenue Recognition and Accou_4
Revenue Recognition and Accounts Receivable - Narrative (Details) - USD ($) $ in Millions | Jun. 30, 2024 | Dec. 31, 2023 |
Revenue from Contract with Customer [Abstract] | ||
Unbilled revenue | $ 40.2 | $ 68.4 |
Acquisitions - Narrative (Detai
Acquisitions - Narrative (Details) - Home Medical Equipment Provider Acquired In 2023 | 6 Months Ended |
Jun. 30, 2023 provider | |
Business Acquisition [Line Items] | |
Percentage of interest acquired | 100% |
Number of home medical equipment providers acquired | 3 |
Acquisitions - Consideration Pa
Acquisitions - Consideration Paid (Details) - Significant Acquisitions In 2023 $ in Thousands | 6 Months Ended |
Jun. 30, 2023 USD ($) | |
Business Acquisition [Line Items] | |
Cash | $ 18,173 |
Deferred payments | 50 |
Total | $ 18,223 |
Acquisitions - Net Assets Acqui
Acquisitions - Net Assets Acquired (Details) - USD ($) $ in Thousands | Jun. 30, 2024 | Dec. 31, 2023 | Jun. 30, 2023 |
Business Acquisition [Line Items] | |||
Goodwill | $ 2,711,880 | $ 2,724,958 | |
Significant Acquisitions In 2023 | |||
Business Acquisition [Line Items] | |||
Cash | $ 268 | ||
Accounts receivable | 1,798 | ||
Inventory | 1,001 | ||
Prepaid and other current assets | 10 | ||
Equipment and other fixed assets | 9,863 | ||
Operating lease right-of-use assets | 5,506 | ||
Finance lease right-of-use assets | 200 | ||
Goodwill | 6,796 | ||
Accounts payable and accrued expenses | (667) | ||
Other current liabilities | (846) | ||
Operating lease liabilities | (5,506) | ||
Finance lease liabilities | (200) | ||
Net assets acquired | $ 18,223 |
Equipment and Other Fixed Ass_3
Equipment and Other Fixed Assets (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | |||
Jun. 30, 2024 | Jun. 30, 2023 | Jun. 30, 2024 | Jun. 30, 2023 | Dec. 31, 2023 | |
Property, Plant and Equipment [Line Items] | |||||
Gross carrying value | $ 960,134 | $ 960,134 | $ 932,082 | ||
Less accumulated depreciation | (463,998) | (463,998) | (436,981) | ||
Equipment and other fixed assets, net | 496,136 | 496,136 | 495,101 | ||
Depreciation expense | 85,600 | $ 89,300 | 172,900 | $ 173,100 | |
Patient medical equipment | |||||
Property, Plant and Equipment [Line Items] | |||||
Gross carrying value | 811,940 | 811,940 | 791,349 | ||
Computers and software | |||||
Property, Plant and Equipment [Line Items] | |||||
Gross carrying value | 91,053 | 91,053 | 85,509 | ||
Delivery vehicles | |||||
Property, Plant and Equipment [Line Items] | |||||
Gross carrying value | 35,062 | 35,062 | 35,021 | ||
Other | |||||
Property, Plant and Equipment [Line Items] | |||||
Gross carrying value | $ 22,079 | $ 22,079 | $ 20,203 |
Goodwill and Identifiable Int_3
Goodwill and Identifiable Intangible Assets - Change in Goodwill (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2024 | Jun. 30, 2023 | Jun. 30, 2024 | Jun. 30, 2023 | |
Goodwill [Roll Forward] | ||||
Beginning balance | $ 2,724,958 | |||
Goodwill impairment | $ (6,548) | $ 0 | (13,078) | $ 0 |
Ending balance | $ 2,711,880 | $ 2,711,880 |
Goodwill and Identifiable Int_4
Goodwill and Identifiable Intangible Assets - Intangible Assets (Details) - USD ($) $ in Thousands | Jun. 30, 2024 | Dec. 31, 2023 |
Finite-Lived Intangible Assets [Line Items] | ||
Total | $ 119,021 | $ 130,160 |
Tradenames | ||
Finite-Lived Intangible Assets [Line Items] | ||
Accumulated amortization | 44,723 | 38,314 |
Total | $ 68,077 | $ 74,486 |
Weighted-Average Remaining Life (Years) | 6 years 2 months 12 days | 6 years 7 months 6 days |
Payor contracts | ||
Finite-Lived Intangible Assets [Line Items] | ||
Accumulated amortization | $ 32,316 | $ 28,216 |
Total | $ 49,684 | $ 53,784 |
Weighted-Average Remaining Life (Years) | 6 years 1 month 6 days | 6 years 7 months 6 days |
Developed technology | ||
Finite-Lived Intangible Assets [Line Items] | ||
Accumulated amortization | $ 5,040 | $ 4,410 |
Total | $ 1,260 | $ 1,890 |
Weighted-Average Remaining Life (Years) | 1 year | 1 year 6 months |
Goodwill and Identifiable Int_5
Goodwill and Identifiable Intangible Assets - Narrative (Details) - USD ($) | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2024 | Jun. 30, 2023 | Jun. 30, 2024 | Jun. 30, 2023 | |
Goodwill and Intangible Assets Disclosure [Abstract] | ||||
Amortization of intangible assets | $ 5,600,000 | $ 10,000,000 | $ 11,100,000 | $ 20,000,000 |
Impairment charges | $ 0 | $ 0 |
Goodwill and Identifiable Int_6
Goodwill and Identifiable Intangible Assets - Future Amortization Expense of Identified Intangible Assets (Details) - USD ($) $ in Thousands | Jun. 30, 2024 | Dec. 31, 2023 |
Goodwill and Intangible Assets Disclosure [Abstract] | ||
2025 | $ 22,217 | |
2026 | 20,119 | |
2027 | 18,384 | |
2028 | 17,936 | |
2029 | 17,936 | |
Thereafter | 22,429 | |
Total | $ 119,021 | $ 130,160 |
Fair Value of Assets and Liab_3
Fair Value of Assets and Liabilities - Valuation of Financial Assets and Liabilities (Details) - Fair Value, Recurring - USD ($) $ in Thousands | Jun. 30, 2024 | Dec. 31, 2023 |
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 | |
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 | 6,524 | 5,468 |
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 | |
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 | 4,889 | 4,482 |
Level 2 | Interest rate swap agreements-long term | ||
Assets | ||
Total assets measured at fair value | 1,635 | 986 |
Level 3 | ||
Assets | ||
Total assets measured at fair value | 0 | 0 |
Liabilities | ||
Total liabilities measured at fair value | 4,464 | 10,871 |
Level 3 | Acquisition-related contingent consideration-short term | ||
Liabilities | ||
Total liabilities measured at fair value | 6,850 | |
Level 3 | Warrant liability | ||
Liabilities | ||
Total liabilities measured at fair value | 4,464 | 4,021 |
Level 3 | Interest rate swap agreements-short term | ||
Assets | ||
Total assets measured at fair value | 0 | 0 |
Level 3 | Interest rate swap agreements-long term | ||
Assets | ||
Total assets measured at fair value | $ 0 | $ 0 |
Fair Value of Assets and Liab_4
Fair Value of Assets and Liabilities - Narrative (Details) - USD ($) $ in Millions | Jun. 30, 2024 | Dec. 31, 2023 |
Fair Value Disclosures [Abstract] | ||
Contingent consideration liability | $ 0 | $ 6.9 |
Fair Value of Assets and Liab_5
Fair Value of Assets and Liabilities - Contingent Consideration Rollforward (Details) - Contingent Consideration Liabilities - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2024 | Jun. 30, 2023 | |
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward] | ||
Beginning Balance | $ 6,850 | $ 7,500 |
Payments | (6,850) | 0 |
Ending Balance | $ 0 | $ 7,500 |
Derivative Instruments and He_3
Derivative Instruments and Hedging Activities - Narrative (Details) - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2024 | Jun. 30, 2023 | Jun. 30, 2024 | Jun. 30, 2023 | |
Derivative [Line Items] | ||||
Amount reclassified from other comprehensive income | $ 0.4 | $ 0.4 | $ 1 | |
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 | ||
Cash Flow Hedging | ||||
Derivative [Line Items] | ||||
Gain (loss) on derivative, net | $ (0.3) | $ 2.8 | 0.9 | $ 0.6 |
Interest Rate Swap | Designated as Hedging Instrument | ||||
Derivative [Line Items] | ||||
Notional amount | $ 250 | $ 250 |
Derivative Instruments and He_4
Derivative Instruments and Hedging Activities - Financial Instruments (Details) - Designated as Hedging Instrument - USD ($) $ in Thousands | Jun. 30, 2024 | Dec. 31, 2023 |
Derivative Instruments and Hedging Activities Disclosures [Line Items] | ||
Asset | $ 6,524 | $ 5,468 |
Interest Rate Swap | Prepaid and other current assets | ||
Derivative Instruments and Hedging Activities Disclosures [Line Items] | ||
Asset | 4,889 | 4,482 |
Interest Rate Swap | Other assets | ||
Derivative Instruments and Hedging Activities Disclosures [Line Items] | ||
Asset | $ 1,635 | $ 986 |
Accounts Payable and Accrued _3
Accounts Payable and Accrued Expenses (Details) - USD ($) $ in Thousands | Jun. 30, 2024 | Dec. 31, 2023 |
Accounts Payable And Accrued Liabilities, Current [Line Items] | ||
Accounts payable | $ 279,562 | $ 211,504 |
Employee-related accruals | 38,502 | 47,462 |
Accrued interest | 29,151 | 29,327 |
Litigation settlement | 10,685 | 57,340 |
Other | 88,660 | 46,361 |
Total | 446,560 | $ 391,994 |
Change Healthcare | ||
Accounts Payable And Accrued Liabilities, Current [Line Items] | ||
Other | $ 39,600 |
Debt - Summary of Long-Term Deb
Debt - Summary of Long-Term Debt (Details) - USD ($) $ in Thousands | Jun. 30, 2024 | Dec. 31, 2023 |
Debt Instrument [Line Items] | ||
Unamortized deferred financing fees | $ (19,549) | $ (22,018) |
Net long-term debt | 2,080,451 | 2,147,982 |
Current portion | (40,000) | (53,368) |
Long-term portion | 2,040,451 | 2,094,614 |
Secured term loan | ||
Debt Instrument [Line Items] | ||
Gross long-term debt | 650,000 | 720,000 |
Senior unsecured notes | ||
Debt Instrument [Line Items] | ||
Gross long-term debt | $ 1,450,000 | $ 1,450,000 |
Debt - Narrative (Details)
Debt - Narrative (Details) - USD ($) $ in Thousands | 1 Months Ended | 6 Months Ended | ||||
Aug. 31, 2021 | Jan. 31, 2021 | Jul. 31, 2020 | Jun. 30, 2024 | Jun. 30, 2023 | Dec. 31, 2023 | |
Debt Instrument [Line Items] | ||||||
Repayment of loan | $ 145,000 | $ 65,000 | ||||
Borrowings on lines of credit | 75,000 | 50,000 | ||||
Secured term loan | ||||||
Debt Instrument [Line Items] | ||||||
Borrowing capacity | $ 800,000 | |||||
Quarterly principal repayments | 10,000 | |||||
Mandatory prepayment | $ 13,400 | |||||
Repayment of loan | 36,600 | |||||
Debt balance outstanding | $ 650,000 | 720,000 | ||||
Credit facility interest rate | 7.43% | |||||
Revolving Credit Loans 2021 | ||||||
Debt Instrument [Line Items] | ||||||
Borrowing capacity | 450,000 | |||||
Borrowings on lines of credit | $ 75,000 | $ 50,000 | ||||
Remaining maximum borrowings available | 346,400 | |||||
Letter Of Credit 2021 | ||||||
Debt Instrument [Line Items] | ||||||
Borrowing capacity | $ 55,000 | |||||
Credit Agreement 2021 | Minimum | ||||||
Debt Instrument [Line Items] | ||||||
Commitment fee (as a percent) | 0.25% | |||||
Credit Agreement 2021 | Maximum | ||||||
Debt Instrument [Line Items] | ||||||
Commitment fee (as a percent) | 0.50% | |||||
Credit Agreement 2021 | Base Rate | Minimum | ||||||
Debt Instrument [Line Items] | ||||||
Rate margin (as a percent) | 0.50% | |||||
Credit Agreement 2021 | Base Rate | Maximum | ||||||
Debt Instrument [Line Items] | ||||||
Rate margin (as a percent) | 2.25% | |||||
Credit Agreement 2021 | Term SOFR Adjustment | ||||||
Debt Instrument [Line Items] | ||||||
Rate margin (as a percent) | 0.10% | |||||
Credit Agreement 2021 | Secured Overnight Financing Rate (SOFR) | Minimum | ||||||
Debt Instrument [Line Items] | ||||||
Rate margin (as a percent) | 1.50% | |||||
Credit Agreement 2021 | Secured Overnight Financing Rate (SOFR) | Maximum | ||||||
Debt Instrument [Line Items] | ||||||
Rate margin (as a percent) | 3.25% | |||||
Revolver Letter Of Credit Sublimit Maturing July 2025 | ||||||
Debt Instrument [Line Items] | ||||||
Debt balance outstanding | 21,600 | |||||
Senior Unsecured Notes 5.125 Per Cent Due 2030 | ||||||
Debt Instrument [Line Items] | ||||||
Face amount | $ 600,000 | |||||
Debt interest rate | 5.125% | |||||
Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period Two | ||||||
Debt Instrument [Line Items] | ||||||
Redemption price, as percent of principal | 102.563% | |||||
Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period Three | ||||||
Debt Instrument [Line Items] | ||||||
Redemption price, as percent of principal | 101.281% | |||||
Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period Four | ||||||
Debt Instrument [Line Items] | ||||||
Redemption price, as percent of principal | 100% | |||||
Senior Unsecured Notes 5.125 Per Cent Due 2030 | Debt Instrument, Redemption, Period One | ||||||
Debt Instrument [Line Items] | ||||||
Redemption price, as percent of principal | 100% | |||||
Percentage of original principal that may be redeemed | 40% | |||||
Redemption price, as percent of principal, proceeds from equity offerings | 105.125% | |||||
Senior unsecured notes | ||||||
Debt Instrument [Line Items] | ||||||
Debt balance outstanding | $ 1,450,000 | $ 1,450,000 | ||||
Face amount | $ 500,000 | |||||
Debt interest rate | 4.625% | |||||
Percentage of original principal that may be redeemed | 40% | |||||
Redemption price, as percent of principal, proceeds from equity offerings | 104.625% | |||||
Senior unsecured notes | Debt Instrument, Redemption, Period Two | ||||||
Debt Instrument [Line Items] | ||||||
Redemption price, as percent of principal | 102.313% | |||||
Senior unsecured notes | Debt Instrument, Redemption, Period Three | ||||||
Debt Instrument [Line Items] | ||||||
Redemption price, as percent of principal | 101.156% | |||||
Senior unsecured notes | Debt Instrument, Redemption, Period Four | ||||||
Debt Instrument [Line Items] | ||||||
Redemption price, as percent of principal | 100% | |||||
Senior unsecured notes | Debt Instrument, Redemption, Period One | ||||||
Debt Instrument [Line Items] | ||||||
Redemption price, as percent of principal | 100% | |||||
Senior Notes 6.125 Percent Due 2028 | ||||||
Debt Instrument [Line Items] | ||||||
Face amount | $ 350,000 | |||||
Debt interest rate | 6.125% | |||||
Percentage of original principal that may be redeemed | 40% | |||||
Redemption price, as percent of principal, proceeds from equity offerings | 106.125% | |||||
Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Two | ||||||
Debt Instrument [Line Items] | ||||||
Redemption price, as percent of principal | 103.063% | |||||
Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Three | ||||||
Debt Instrument [Line Items] | ||||||
Redemption price, as percent of principal | 102.042% | |||||
Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Four | ||||||
Debt Instrument [Line Items] | ||||||
Redemption price, as percent of principal | 101.021% | |||||
Senior Notes 6.125 Percent Due 2028 | Debt Instrument, Redemption, Period Five | ||||||
Debt Instrument [Line Items] | ||||||
Redemption price, as percent of principal | 100% |
Stockholders' Equity - Narrativ
Stockholders' Equity - Narrative (Details) $ / shares in Units, $ in Thousands | 1 Months Ended | 3 Months Ended | 6 Months Ended | ||||||||
Jun. 30, 2023 shares | Aug. 06, 2024 shares | Jun. 30, 2024 USD ($) $ / shares shares | Mar. 31, 2024 USD ($) | Jun. 30, 2023 USD ($) | Mar. 31, 2023 USD ($) | Jun. 30, 2024 USD ($) vote $ / shares shares | Jun. 30, 2023 USD ($) shares | Jun. 20, 2024 shares | Dec. 31, 2023 shares | May 31, 2022 USD ($) | |
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Common stock shares authorized (in shares) | 300,000,000 | 300,000,000 | 300,000,000 | ||||||||
Preferred stock, shares authorized (in shares) | 5,000,000 | 5,000,000 | 5,000,000 | ||||||||
Number of votes per share | vote | 1 | ||||||||||
Amount of cash authorized for stock repurchase program | $ | $ 200,000 | ||||||||||
Number of shares purchased under repurchase program (in shares) | 631,953 | ||||||||||
Value of shares repurchase | $ | $ 9,224 | $ 9,200 | |||||||||
Warrants outstanding (in shares) | 3,871,557 | 3,871,557 | |||||||||
Common stock for each warrant exercised (in shares) | 1 | 1 | |||||||||
Exercise price (in dollars per share) | $ / shares | $ 11.50 | $ 11.50 | |||||||||
Warrants exercised in cashless transaction, number exercised (in shares) | 0 | 0 | |||||||||
Granted (in shares) | 0 | 0 | |||||||||
Number of shares issued for options exercised on a cash basis (in shares) | 176,623 | ||||||||||
Exercise of stock options | $ | $ 545 | $ 500 | |||||||||
Options exercised in cashless basis (in shares) | 559,071 | ||||||||||
Options exercised cashless basis (in shares) | 213,852 | ||||||||||
Equity-based compensation expense | $ | $ 5,200 | $ 6,800 | 9,800 | $ 12,800 | |||||||
Unrecognized compensation expense | $ | 42,000 | $ 42,000 | |||||||||
Recognition period (in years) | 2 years 2 months 12 days | ||||||||||
Treasury Stock | Subsequent Event | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Shares issued (in shares) | 1,000,000 | ||||||||||
Performance Percentage Less Than 25% | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Performance payout percentage | 0% | ||||||||||
Performance Percentage Greater Than or Equal to 25% | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Performance payout percentage | 50% | ||||||||||
Performance Percentage Equal to 50% | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Performance payout percentage | 100% | ||||||||||
Performance Percentage Greater Than or Equal to 75% | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Performance payout percentage | 200% | ||||||||||
General and Administrative Expense | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Equity-based compensation expense | $ | 4,400 | 7,700 | $ 8,000 | 12,300 | |||||||
Cost of Sales | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Equity-based compensation expense | $ | $ 800 | 900 | $ 1,800 | 500 | |||||||
Unvested restricted stock | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Granted (in shares) | 2,621,000 | ||||||||||
Performance Based Restricted Stock Unit | Cost of Sales | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Equity-based compensation expense | $ | (2,200) | ||||||||||
Various Employees | Unvested restricted stock | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Granted (in shares) | 1,398,395 | ||||||||||
Grant date fair value | $ | $ 11,600 | ||||||||||
Various Employees | Unvested restricted stock | Minimum | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Vesting period (in years) | 2 years | ||||||||||
Various Employees | Unvested restricted stock | Maximum | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Vesting period (in years) | 3 years | ||||||||||
Employee | Unvested restricted stock | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Granted (in shares) | 52,326 | ||||||||||
Vesting period (in years) | 2 months | ||||||||||
Grant date fair value | $ | $ 500 | ||||||||||
Non-Employee Directors | Unvested restricted stock | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Granted (in shares) | 122,663 | ||||||||||
Vesting period (in years) | 1 year | ||||||||||
Grant date fair value | $ | $ 1,200 | ||||||||||
Certain Employees | Performance Based Restricted Stock Unit | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Granted (in shares) | 1,047,291 | ||||||||||
Vesting period (in years) | 3 years | ||||||||||
Grant date fair value | $ | $ 19,200 | ||||||||||
Term of relative total shareholder return v. defined peer group (in years) | 3 years | ||||||||||
Prior CEO | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Equity-based compensation expense | $ | $ 4,000 | $ 4,000 | |||||||||
Prior CEO | Unvested restricted stock | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Accelerated vesting (in shares) | 143,739 | ||||||||||
Prior CEO | Stock options | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Accelerated vesting (in shares) | 78,130 | ||||||||||
Prior CEO | Performance Shares | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Increase in shares (in shares) | 159,555 | ||||||||||
2019 Incentive Plan | |||||||||||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | |||||||||||
Shares authorized for issuance (in shares) | 18,350,000 | ||||||||||
Stock available for issuance (in shares) | 6,678,373 | 6,678,373 | 8,350,000 |
Stockholders' Equity - Warrants
Stockholders' Equity - Warrants (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2024 | Jun. 30, 2023 | Jun. 30, 2024 | Jun. 30, 2023 | |
Warrant [Roll Forward] | ||||
Estimated fair value of warrant liability, beginning | $ 4,021 | $ 38,503 | ||
Change in estimated fair value of the warrant liability | $ (7,010) | $ (812) | 443 | (22,726) |
Estimated fair value of warrant liability, ending | $ 4,464 | $ 15,777 | $ 4,464 | $ 15,777 |
Stockholders' Equity - Stock Op
Stockholders' Equity - Stock Option Activity (Details) - $ / shares shares in Thousands | 6 Months Ended | 12 Months Ended |
Jun. 30, 2024 | Dec. 31, 2023 | |
Number of Options | ||
Outstanding at beginning of period (in shares) | 3,409 | |
Exercised (in shares) | (177) | |
Expired (in shares) | (735) | |
Outstanding at end of period (in shares) | 2,497 | 3,409 |
Weighted-Average Exercise Price per Share | ||
Outstanding at beginning of period (in dollars per share) | $ 14.90 | |
Exercised (in dollars per share) | 3.08 | |
Expired (in dollars per share) | 23.38 | |
Outstanding at end of period (in dollars per share) | $ 13.24 | $ 14.90 |
Weighted-Average Remaining Contractual Term | ||
Weighted average remaining contractual term (in years) | 4 years 8 months 12 days | 4 years 10 months 24 days |
2019 Incentive Plan | ||
Number of Options | ||
Outstanding at beginning of period (in shares) | 2,219 | |
Expired (in shares) | (735) | |
Outstanding at end of period (in shares) | 1,484 | 2,219 |
Weighted-Average Grant Date Fair Value per Share | ||
Outstanding at beginning of period (in dollars per share) | $ 3.75 | |
Expired (in dollars per share) | 4.58 | |
Outstanding at end of period (in dollars per share) | 3.34 | $ 3.75 |
Weighted-Average Exercise Price per Share | ||
Outstanding at beginning of period (in dollars per share) | 19.36 | |
Expired (in dollars per share) | 23.38 | |
Outstanding at end of period (in dollars per share) | $ 17.38 | $ 19.36 |
Weighted-Average Remaining Contractual Term | ||
Weighted average remaining contractual term (in years) | 4 years 9 months 18 days | 5 years 1 month 6 days |
Stockholders' Equity - Restrict
Stockholders' Equity - Restricted Stock (Details) - Unvested restricted stock shares in Thousands | 6 Months Ended |
Jun. 30, 2024 $ / shares shares | |
Number of Shares of Restricted Stock | |
Non-vested balance at beginning of period (in shares) | shares | 2,068 |
Granted (in shares) | shares | 2,621 |
Vested (in shares) | shares | (636) |
Forfeited (in shares) | shares | (47) |
Non-vested balance at end of period (in shares) | shares | 4,006 |
Weighted-Average Grant Date Fair Value per Share | |
Non-vested, grant date fair value at beginning of period (in dollars per share) | $ / shares | $ 19.16 |
Granted (in dollars per share) | $ / shares | 12.41 |
Vested (in dollars per share) | $ / shares | 33.27 |
Forfeited (in dollars per share) | $ / shares | 36.48 |
Non-vested, grant date fair value at end of period (in dollars per share) | $ / shares | $ 14.93 |
Earnings Per Share - Basic and
Earnings Per Share - Basic and Diluted Earnings Income per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2024 | Jun. 30, 2023 | Jun. 30, 2024 | Jun. 30, 2023 | |
Numerator | ||||
Net income attributable to AdaptHealth Corp. | $ 19,435 | $ 13,977 | $ 17,301 | $ 29,684 |
Less: Earnings allocated to participating securities | 1,656 | 1,182 | 1,475 | 2,508 |
Net income for basic EPS | 17,779 | 12,795 | 15,826 | 27,176 |
Change in fair value of warrant liability | (7,010) | (812) | 443 | (22,726) |
Net income for diluted EPS | $ 17,779 | $ 12,795 | $ 15,826 | $ 4,450 |
Denominator | ||||
Basic weighted-average common shares outstanding (in shares) | 133,218 | 134,295 | 133,066 | 134,409 |
Add: Warrants (in shares) | 0 | 0 | 0 | 857 |
Diluted weighted-average common shares outstanding (in shares) | 136,029 | 136,233 | 135,698 | 138,000 |
Basic net income per share (in dollars per share) | $ 0.13 | $ 0.10 | $ 0.12 | $ 0.20 |
Diluted net income per share (in dollars per share) | $ 0.13 | $ 0.09 | $ 0.12 | $ 0.03 |
Stock options | ||||
Denominator | ||||
Add: Stock options (in shares) | 298 | 833 | 235 | 1,552 |
Unvested restricted stock | ||||
Denominator | ||||
Add: Unvested restricted stock (in shares) | 2,513 | 1,105 | 2,397 | 1,182 |
Earnings Per Share - Antidiluti
Earnings Per Share - Antidilutive Securities (Details) - shares shares in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2024 | Jun. 30, 2023 | Jun. 30, 2024 | Jun. 30, 2023 | |
Antidilutive Securities Excluded from Computation of Earnings Per Share | ||||
Antidilutive securities excluded (in shares) | 19,909 | 14,625 | 20,088 | 12,874 |
Preferred Stock | ||||
Antidilutive Securities Excluded from Computation of Earnings Per Share | ||||
Antidilutive securities excluded (in shares) | 12,406 | 12,406 | 12,406 | 12,406 |
Warrants | ||||
Antidilutive Securities Excluded from Computation of Earnings Per Share | ||||
Antidilutive securities excluded (in shares) | 3,872 | 0 | 3,872 | 0 |
Stock options | ||||
Antidilutive Securities Excluded from Computation of Earnings Per Share | ||||
Antidilutive securities excluded (in shares) | 2,200 | 2,219 | 2,263 | 468 |
Unvested restricted stock | ||||
Antidilutive Securities Excluded from Computation of Earnings Per Share | ||||
Antidilutive securities excluded (in shares) | 1,431 | 0 | 1,547 | 0 |
Leases - Lease Costs and Sublea
Leases - Lease Costs and Sublease Income (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2024 | Jun. 30, 2023 | Jun. 30, 2024 | Jun. 30, 2023 | |
Leases [Abstract] | ||||
Operating lease costs | $ 10,391 | $ 10,598 | $ 21,395 | $ 21,072 |
Finance lease costs: | ||||
Amortization of ROU assets | 2,538 | 2,477 | 4,793 | 3,007 |
Interest on lease liabilities | 551 | 0 | 1,058 | 0 |
Other lease costs and income: | ||||
Variable leases costs | 6,195 | 4,538 | 12,067 | 10,559 |
Sublease income | $ 257 | $ 409 | $ 537 | $ 787 |
Leases - Weighted Average Remai
Leases - Weighted Average Remaining Lease Terms and Discount Rates (Details) | Jun. 30, 2024 | Dec. 31, 2023 |
Weighted average remaining lease term, weighted based on lease liability balances: | ||
Operating leases (in years) | 5 years 2 months 12 days | 5 years 7 months 6 days |
Finance leases (in years) | 3 years 4 months 24 days | 3 years 7 months 6 days |
Weighted average discount rate, weighted based on remaining balance of lease payments: | ||
Operating leases | 4.70% | 4.40% |
Finance leases | 6.80% | 6.70% |
Leases - Lease Maturity (Detail
Leases - Lease Maturity (Details) $ in Thousands | Jun. 30, 2024 USD ($) |
Operating Leases | |
2024 | $ 18,180 |
2025 | 31,854 |
2026 | 23,396 |
2027 | 15,392 |
2028 | 12,027 |
Thereafter | 24,776 |
Total future undiscounted lease payments | 125,625 |
Less: amount representing interest | (14,591) |
Present value of future lease payments (lease liability) | 111,034 |
Finance Leases | |
2024 | 6,896 |
2025 | 13,177 |
2026 | 11,973 |
2027 | 8,335 |
2028 | 1,451 |
Thereafter | 156 |
Total future undiscounted lease payments | 41,988 |
Less: amount representing interest | (4,468) |
Present value of future lease payments (lease liability) | $ 37,520 |
Leases - Cash Flow and Suppleme
Leases - Cash Flow and Supplemental Non-Cash Information (Details) - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2024 | Jun. 30, 2023 | |
Cash paid for amounts included in the measurement of lease liabilities: | ||
Operating cash payments for operating leases | $ 21,432 | $ 20,847 |
Financing cash payments for finance leases | 4,890 | 3,679 |
Lease liabilities arising from obtaining right-of-use assets: | ||
Operating leases | 15,967 | 5,112 |
Finance leases | $ 10,895 | $ 12,203 |
Income Taxes (Details)
Income Taxes (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | |||
Jun. 30, 2024 | Jun. 30, 2023 | Jun. 30, 2024 | Jun. 30, 2023 | Dec. 31, 2023 | |
Income Taxes | |||||
Income tax expense | $ 7,248 | $ 5,399 | $ 13,858 | $ 3,685 | |
Increase in income tax benefit | 1,000 | ||||
Goodwill impairment | 6,548 | $ 0 | 13,078 | $ 0 | |
Unrecognized tax benefits | 5,200 | $ 5,200 | $ 6,600 | ||
Payout percentage | 85% | ||||
Liability related to TRA | 290,200 | $ 290,200 | 291,600 | ||
Other Current Liabilities | |||||
Income Taxes | |||||
Liability related to TRA | 24,300 | 24,300 | 1,500 | ||
Other Noncurrent Liabilities | |||||
Income Taxes | |||||
Liability related to TRA | $ 265,900 | $ 265,900 | $ 290,100 |
Commitments and Contingencies (
Commitments and Contingencies (Details) - USD ($) $ in Thousands, shares in Millions | 6 Months Ended | 12 Months Ended | ||||
Apr. 23, 2024 | Feb. 26, 2024 | Jun. 30, 2024 | Dec. 31, 2023 | Sep. 30, 2024 | Nov. 08, 2021 | |
Loss Contingencies [Line Items] | ||||||
Litigation settlement | $ 10,685 | $ 57,340 | ||||
Pending Litigation | ||||||
Loss Contingencies [Line Items] | ||||||
Receivable from insurance carriers | $ 32,200 | |||||
Payment on legal proceeding | $ 17,800 | |||||
Settlement shares (in shares) | 1 | |||||
Fair value of settlement shares | $ 7,300 | |||||
Pre-tax expense | 2,400 | |||||
Litigation settlement | 9,700 | |||||
Director and officer coverage limits available | $ 35,000 | |||||
Pending Litigation | Forecast | ||||||
Loss Contingencies [Line Items] | ||||||
Reclassification from liabilities to stockholders' equity | $ 9,700 | |||||
Pending Litigation | Additional paid-in capital | Forecast | ||||||
Loss Contingencies [Line Items] | ||||||
Reclassification from liabilities to stockholders' equity | 8,000 | |||||
Pending Litigation | Treasury Stock | Forecast | ||||||
Loss Contingencies [Line Items] | ||||||
Reclassification from liabilities to stockholders' equity | $ 17,700 | |||||
Pending Litigation | Derivative Plaintiff | ||||||
Loss Contingencies [Line Items] | ||||||
Pre-tax expense | $ 900 | 900 | ||||
Litigation settlement | $ 900 |
Related Party Transactions (Det
Related Party Transactions (Details) $ in Millions | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2024 USD ($) | Jun. 30, 2023 USD ($) | Jun. 30, 2024 USD ($) executive | Jun. 30, 2023 USD ($) | |
Vendor Two | ||||
Related Party Transactions | ||||
Number of executives | executive | 1 | |||
Ownership interest, as a percent | 1% | |||
Expenses, related party | $ 3.6 | $ 2.7 | $ 7.1 | $ 5 |
Third-Party Payor | Maximum | ||||
Related Party Transactions | ||||
Net revenue related party | 1% | 1% | ||
Vendor Three | ||||
Related Party Transactions | ||||
Ownership interest, as a percent | 5% | |||
Expenses, related party | $ 27.8 | $ 9.4 | $ 28.2 | $ 20.6 |