Hanger (HNGR) 10-Q 8 Aug 22 2022 Q2 Quarterly report Financial data

Cover

Cover - shares	6 Months Ended
	Jun. 30, 2022	Aug. 03, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2022
Document Transition Report	false
Entity File Number	1-10670
Entity Registrant Name	HANGER, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	84-0904275
Entity Address, Address Line One	10910 Domain Drive
Entity Address, Address Line Two	Suite 300
Entity Address, City or Town	Austin
Entity Address, State or Province	TX
Entity Address, Postal Zip Code	78758
City Area Code	512
Local Phone Number	777-3800
Title of 12(b) Security	Common Stock, par value $0.01 per share
Trading Symbol	HNGR
Security Exchange Name	NYSE
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		39,123,266
Entity Central Index Key	0000722723
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q2
Amendment Flag	false

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 24,380	$ 61,692
Accounts receivable, net	150,898	152,058
Inventories	88,018	87,462
Income taxes receivable	0	581
Other current assets	19,614	16,536
Total current assets	282,910	318,329
Non-current assets:
Property, plant, and equipment, net	81,015	82,434
Goodwill	377,164	363,554
Other intangible assets, net	25,147	25,892
Deferred income taxes	43,069	45,494
Operating lease right-of-use assets	139,009	144,491
Other assets	18,552	17,945
Total assets	966,866	998,139
Current liabilities:
Current portion of long-term debt	15,636	14,938
Accounts payable	67,651	63,565
Accrued expenses and other current liabilities	56,151	60,399
Accrued compensation related costs	56,795	54,465
Current portion of operating lease liabilities	34,326	33,438
Total current liabilities	230,559	226,805
Long-term liabilities:
Long-term debt, less current portion	465,022	502,307
Operating lease liabilities	117,230	124,016
Other liabilities	28,847	34,840
Total liabilities	841,658	887,968
Commitments and contingencies (Note P)
Shareholders’ equity:
Common stock, $0.01 par value; 60,000,000 shares authorized; 39,276,679 shares issued and 39,133,858 shares outstanding at 2022, and 38,891,438 shares issued and 38,748,617 shares outstanding at 2021	393	389
Additional paid-in capital	376,717	373,644
Accumulated other comprehensive loss	(1,330)	(11,150)
Accumulated deficit	(249,876)	(252,016)
Treasury stock, at cost; 142,821 shares at both 2022 and 2021	(696)	(696)
Total shareholders’ equity	125,208	110,171
Total liabilities and shareholders’ equity	$ 966,866	$ 998,139

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Jun. 30, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock authorized (in shares)	60,000,000	60,000,000
Common stock issued (in shares)	39,276,679	38,891,438
Common stock outstanding (in shares)	39,133,858	38,748,617
Treasury stock (in shares)	142,821	142,821

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Income Statement [Abstract]
Net revenues	$ 312,033	$ 280,819	$ 573,320	$ 518,289
Material costs	98,433	89,271	184,025	164,441
Personnel costs	110,275	97,549	211,950	187,429
Other operating costs	38,970	32,788	75,138	64,286
General and administrative expenses	35,444	33,110	67,886	64,013
Depreciation and amortization	8,124	8,007	16,079	16,005
Income from operations	20,787	20,094	18,242	22,115
Interest expense, net	7,524	7,152	14,909	14,492
Non-service defined benefit plan expense	160	167	320	334
Income before income taxes	13,103	12,775	3,013	7,289
Provision for income taxes	2,986	2,616	873	460
Net income	$ 10,117	$ 10,159	$ 2,140	$ 6,829
Basic and diluted per common share data:
Basic income per share (in dollars per share)	$ 0.26	$ 0.26	$ 0.05	$ 0.18
Weighted average shares used to compute basic income per share (in shares)	39,089,865	38,647,042	38,946,937	38,458,733
Diluted income per share (in dollars per share)	$ 0.26	$ 0.26	$ 0.05	$ 0.17
Weighted average shares used to compute diluted income per share (in shares)	39,250,735	39,208,155	39,293,775	39,216,725

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Statement of Comprehensive Income [Abstract]
Net income	$ 10,117	$ 10,159	$ 2,140	$ 6,829
Other comprehensive income:
Unrealized gain on cash flow hedges, net of tax provision of $942, $388, $3,001, and $1,184, respectively	2,866	1,225	9,762	3,737
Unrealized gain on defined benefit plan, net of tax provision of $15, $19, $63, and $38, respectively	46	60	58	120
Total other comprehensive income	2,912	1,285	9,820	3,857
Comprehensive income	$ 13,029	$ 11,444	$ 11,960	$ 10,686

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Statement of Comprehensive Income [Abstract]
Unrealized gain on cash flow hedges tax	$ 942	$ 388	$ 3,001	$ 1,184
Unrealized gain on defined benefit plan tax	$ 15	$ 19	$ 63	$ 38

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CHANGES IN SHAREHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Loss	Accumulated Deficit	Treasury Stock
Beginning balance at Dec. 31, 2020	$ 50,977	$ 383	$ 365,503	$ (20,215)	$ (293,998)	$ (696)
Beginning balance (in shares) at Dec. 31, 2020		38,179,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(3,330)				(3,330)
Share-based compensation expense	3,179		3,179
Issuance in connection with the exercise of stock options	366		366
Issuance in connection with the exercise of stock options (in shares)		29,000
Issuance of common stock upon vesting of restricted stock units	0	$ 4	(4)
Issuance of common stock upon vesting of restricted stock units (in shares)		365,000
Effect of shares withheld to cover taxes	(4,520)		(4,520)
Total other comprehensive income	2,572			2,572
Ending balance at Mar. 31, 2021	49,244	$ 387	364,524	(17,643)	(297,328)	(696)
Ending balance (in shares) at Mar. 31, 2021		38,573,000
Beginning balance at Dec. 31, 2020	50,977	$ 383	365,503	(20,215)	(293,998)	(696)
Beginning balance (in shares) at Dec. 31, 2020		38,179,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	6,829
Total other comprehensive income	3,857
Ending balance at Jun. 30, 2021	63,892	$ 389	367,726	(16,358)	(287,169)	(696)
Ending balance (in shares) at Jun. 30, 2021		38,722,000
Beginning balance at Mar. 31, 2021	49,244	$ 387	364,524	(17,643)	(297,328)	(696)
Beginning balance (in shares) at Mar. 31, 2021		38,573,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	10,159				10,159
Share-based compensation expense	3,239		3,239
Issuance in connection with the exercise of stock options	5	$ 1	4
Issuance in connection with the exercise of stock options (in shares)		80,000
Issuance of common stock upon vesting of restricted stock units	0	$ 1	(1)
Issuance of common stock upon vesting of restricted stock units (in shares)		69,000
Effect of shares withheld to cover taxes	(40)		(40)
Total other comprehensive income	1,285			1,285
Ending balance at Jun. 30, 2021	63,892	$ 389	367,726	(16,358)	(287,169)	(696)
Ending balance (in shares) at Jun. 30, 2021		38,722,000
Beginning balance at Dec. 31, 2021	$ 110,171	$ 389	373,644	(11,150)	(252,016)	(696)
Beginning balance (in shares) at Dec. 31, 2021	38,748,617	38,749,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	$ (7,977)				(7,977)
Share-based compensation expense	2,903		2,903
Issuance of common stock upon vesting of restricted stock units	0	$ 3	(3)
Issuance of common stock upon vesting of restricted stock units (in shares)		324,000
Effect of shares withheld to cover taxes	(3,452)		(3,452)
Total other comprehensive income	6,908			6,908
Ending balance at Mar. 31, 2022	108,553	$ 392	373,092	(4,242)	(259,993)	(696)
Ending balance (in shares) at Mar. 31, 2022		39,073,000
Beginning balance at Dec. 31, 2021	$ 110,171	$ 389	373,644	(11,150)	(252,016)	(696)
Beginning balance (in shares) at Dec. 31, 2021	38,748,617	38,749,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	$ 2,140
Total other comprehensive income	9,820
Ending balance at Jun. 30, 2022	$ 125,208	$ 393	376,717	(1,330)	(249,876)	(696)
Ending balance (in shares) at Jun. 30, 2022	39,133,858	39,134,000
Beginning balance at Mar. 31, 2022	$ 108,553	$ 392	373,092	(4,242)	(259,993)	(696)
Beginning balance (in shares) at Mar. 31, 2022		39,073,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	10,117				10,117
Share-based compensation expense	3,601		3,601
Issuance in connection with the exercise of stock options	51		51
Issuance in connection with the exercise of stock options (in shares)		9,000
Issuance of common stock upon vesting of restricted stock units	0	$ 1	(1)
Issuance of common stock upon vesting of restricted stock units (in shares)		52,000
Effect of shares withheld to cover taxes	(26)		(26)
Total other comprehensive income	2,912			2,912
Ending balance at Jun. 30, 2022	$ 125,208	$ 393	$ 376,717	$ (1,330)	$ (249,876)	$ (696)
Ending balance (in shares) at Jun. 30, 2022	39,133,858	39,134,000

CONDENSED CONSOLIDATED STATEM_5

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021
Cash flows provided by (used in) operating activities:
Net income	$ 2,140	$ 6,829
Adjustments to reconcile net income to net cash provided by (used in) operating activities:
Depreciation and amortization	16,079	16,005
Benefit from doubtful accounts	(68)	(292)
Share-based compensation expense	6,504	6,418
Deferred income taxes	(734)	232
Amortization of debt discounts and issuance costs	1,044	948
Gain on sale and disposal of fixed assets	(863)	(718)
Changes in operating assets and liabilities, net of acquisitions:
Accounts receivable, net	1,262	5,363
Inventories	309	(5,899)
Other current assets and other assets	(2,197)	(6,202)
Income taxes	584	57
Accounts payable	4,597	(6,577)
Accrued expenses and other current liabilities	1,606	(2,765)
Accrued compensation related costs	2,284	(21,412)
Other liabilities	(1,186)	(522)
Operating lease liabilities, net of amortization of right-of-use assets	(416)	(780)
Changes in operating assets and liabilities:	6,843	(38,737)
Net cash provided by (used in) operating activities	30,945	(9,315)
Cash flows used in investing activities:
Purchase of property, plant, and equipment	(10,596)	(13,339)
Acquisitions, net of cash acquired	(12,490)	(35,349)
Purchase of therapeutic program equipment leased to third parties under operating leases	(1,358)	(870)
Proceeds from sale of property, plant, and equipment	1,392	1,332
Net cash used in investing activities	(23,052)	(48,226)
Cash flows used in financing activities:
Payment of employee taxes on share-based compensation	(3,478)	(4,560)
Payment on Seller Notes	(5,000)	(2,265)
Repayment of term loan	(36,263)	(2,525)
Payments of financing lease obligations	(515)	(529)
Payments under vendor financing arrangements	0	(1,375)
Proceeds from the exercise of options	51	371
Net cash used in financing activities	(45,205)	(10,883)
Decrease in cash and cash equivalents	(37,312)	(68,424)
Cash and cash equivalents at beginning of period	61,692	144,602
Cash and cash equivalents at end of period	24,380	76,178
Non-cash financing and investing activities:
Purchase of property, plant, and equipment in accounts payable at period end	2,732	3,349
Seller Notes and other non-cash consideration related to acquisitions	4,002	10,057
Right-of-use assets obtained in exchange for finance lease obligations	$ 223	$ 95

Organization and Summary of Sig

Organization and Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2022
Organization and Summary of Significant Accounting Policies
Organization and Summary of Significant Accounting Policies	Organization and Summary of Significant Accounting Policies Description of Business Hanger, Inc. (“we,” “our,” or “us”) is a leading national provider of products and services that assist in enhancing or restoring the physical capabilities of patients with disabilities or injuries. We provide orthotic and prosthetic (“O&P”) services, distribute O&P devices and components, manage O&P networks, and provide therapeutic solutions to patients and businesses in acute, post-acute, and clinic settings. We operate through two segments, Patient Care and Products & Services. Basis of Presentation The accompanying interim unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X, and, therefore, do not include all of the information and footnotes required by GAAP for complete financial statements. These financial statements should be read in conjunction with the audited consolidated financial statements in our Annual Report on Form 10-K for the year ended December 31, 2021 (the “2021 Form 10-K”), as previously filed with the Securities and Exchange Commission (the “SEC”). In our opinion, the information contained herein reflects all adjustments necessary for a fair statement of our results of operations, financial position, and cash flows. All such adjustments are of a normal, recurring nature. The results of operations for the interim periods are not necessarily indicative of those to be expected for the full year. A detailed description of our significant accounting policies and management judgments is contained in our 2021 Form 10-K. Reclassifications We have reclassified certain amounts in the prior year condensed consolidated financial statements to be consistent with the current year presentation. These relate to immaterial classifications within expense line items in the condensed consolidated statements of operations. Recent Developments Regarding COVID-19 We are subject to risks and uncertainties as a result of the outbreak of the novel coronavirus (“COVID-19”) pandemic (“COVID-19 pandemic”). The extent and duration of the impact of the COVID-19 pandemic on our operations and financial condition remain uncertain and difficult to predict. As a result of the COVID-19 pandemic, we believe that our patients are continuing to defer visits to our O&P clinics, as well as elective surgical procedures, both of which impact our business volumes through decreased patient encounters and physician referrals. While the emerging variants of the COVID-19 virus continue to contribute to employee absences and our use of temporary labor, we believe the overall adverse impact of the COVID-19 pandemic on our business volumes has diminished and stabilized over time. The United States government has responded with fiscal policy measures intended to support the healthcare industry and economy as a whole, including the passage of the Coronavirus Aid, Relief and Economic Security Act (the “CARES Act”) in March 2020. CARES Act The CARES Act established the Public Health and Social Services Emergency Fund, also referred to as the Cares Act Provider Relief Fund, which set aside $203.5 billion to be administered through grants and other mechanisms to hospitals, public entities, not-for-profit entities and Medicare- and Medicaid- enrolled suppliers and institutional providers. The purpose of these funds is to reimburse providers for lost revenue and health-care related expenses that are attributable to the COVID-19 pandemic. In April 2020, the U.S. Department of Health and Human Services (“HHS”) began making payments to healthcare providers from the $203.5 billion appropriation. These are grants, rather than loans, to healthcare providers, and will not need to be repaid. During the full year of 2021, we recognized a total benefit of $1.1 million in our consolidated statement of operations within Other operating costs in our Patient Care segment for the grant proceeds we received under the CARES Act (“Grants”) from HHS. We accounted for the proceeds from the Grants by analogy to International Accounting Standard (“IAS 20”), Accounting for Government Grants and Disclosure of Government Assistance and its principles surrounding the recognition of grants related to income. We recognize income related to grants on a systematic and rational basis when it becomes probable that we have complied with the terms and conditions of the grant and in the period in which the corresponding costs or income related to the grant are recognized. We are using the Grants for their intended purpose, and are compliant to the reporting requirements set by the terms and conditions of the grant. Recent Accounting Pronouncements, Not Yet Adopted In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting . This ASU, effective beginning on March 12, 2020, provides optional expedients and exceptions for applying GAAP to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criteria are met. The amendments in this update apply only to contracts, hedging relationships, and other transactions that reference London Interbank Offered Rate (“LIBOR”) or another reference rate expected to be discontinued because of reference rate reform. The expedients and exceptions provided by the amendments do not apply to contract modifications made and hedging relationships entered into or evaluated after December 31, 2022, except for hedging relationships existing as of December 31, 2022, that an entity has elected certain optional expedients for and that are retained through the end of the hedging relationship. We are currently evaluating the effects that the adoption of this guidance, and related clarifying standards, will have on our condensed consolidated financial statements and the related disclosures.

Earnings Per Share

Earnings Per Share	6 Months Ended
	Jun. 30, 2022
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share Basic earnings per share is computed using the weighted average number of common shares outstanding during the period. Diluted earnings per share is computed using the weighted average number of common shares outstanding during the period plus any potentially dilutive common shares, such as stock options, restricted stock units, and performance-based units calculated using the treasury stock method. Total anti-dilutive shares excluded from the diluted earnings per share computation were 213,957 and 100,387 for the three and six months ended June 30, 2022 and 2,721 and 1,302 for the three and six months ended June 30, 2021. Our Credit Agreement (as defined below) restricts the payment of dividends or other distributions to our shareholders by us or any of our subsidiaries. See Note K - “Debt and Other Obligations” within these condensed consolidated financial statements. The reconciliation of the numerators and denominators used to calculate basic and diluted net income per share are as follows: For the Three Months Ended For the Six Months Ended (in thousands except share and per share amounts) 2022 2021 2022 2021 Net income $ 10,117 $ 10,159 $ 2,140 $ 6,829 Weighted average shares outstanding - basic 39,089,865 38,647,042 38,946,937 38,458,733 Effect of potentially dilutive restricted stock units and options 160,870 561,113 346,838 757,992 Weighted average shares outstanding - diluted 39,250,735 39,208,155 39,293,775 39,216,725 Basic income per share $ 0.26 $ 0.26 $ 0.05 $ 0.18 Diluted income per share $ 0.26 $ 0.26 $ 0.05 $ 0.17

Revenue Recognition

Revenue Recognition	6 Months Ended
	Jun. 30, 2022
Revenue from Contract with Customer [Abstract]
Revenue Recognition	Revenue Recognition Patient Care Segment Revenue in our Patient Care segment is primarily derived from contracts with third party payors for the provision of O&P devices and is recognized upon the transfer of control of promised products or services to the patient at the time the patient receives the device. At, or subsequent to delivery, we issue an invoice to the third party payor, which primarily consists of commercial insurance companies, Medicare, Medicaid, the U.S. Department of Veterans Affairs (the “VA”), or private or patient pay (“Private Pay”) individuals. We recognize revenue for the amounts we expect to receive from payors based on expected contractual reimbursement rates, which are net of estimated contractual discounts and implicit price concessions. These revenue amounts are further revised as claims are adjudicated, which may result in additional disallowances. The following table disaggregates revenue from contracts with customers in our Patient Care segment for the three and six months ended June 30, 2022 and 2021: For the Three Months Ended For the Six Months Ended (in thousands) 2022 2021 2022 2021 Patient Care Segment Medicare $ 83,013 $ 74,248 $ 148,867 $ 131,583 Medicaid 49,334 43,688 88,606 77,736 Commercial insurance / managed care (excluding Medicare and Medicaid managed care) 88,801 79,769 166,144 149,432 VA 25,393 21,633 46,442 41,397 Private Pay 19,129 17,449 35,429 32,321 Total $ 265,670 $ 236,787 $ 485,488 $ 432,469 The impact to revenue related to prior period performance obligations was not material for the three and six months ended June 30, 2022 or 2021. Products & Services Segment Revenue in our Products & Services segment is derived from the distribution of O&P components and from therapeutic solutions which includes the leasing and sale of rehabilitation equipment and ancillary consumable supplies combined with equipment maintenance, education, and training. The following table disaggregates revenue from contracts with customers in our Products & Services segment for the three and six months ended June 30, 2022 and 2021: For the Three Months Ended For the Six Months Ended (in thousands) 2022 2021 2022 2021 Products & Services Segment Distribution services, net of intersegment revenue eliminations $ 35,978 $ 33,275 $ 67,368 $ 63,935 Therapeutic solutions 10,385 10,757 20,464 21,885 Total $ 46,363 $ 44,032 $ 87,832 $ 85,820

Accounts Receivable, Net

Accounts Receivable, Net	6 Months Ended
	Jun. 30, 2022
Accounts Receivable, after Allowance for Credit Loss [Abstract]
Accounts Receivable, Net	Accounts Receivable, Net Accounts receivable, net represents outstanding amounts we expect to collect from the transfer of our products and services. Principally, these amounts are comprised of receivables from Medicare, Medicaid, and commercial insurance plans. Our accounts receivable represent amounts outstanding from our gross charges, net of contractual discounts, sales returns, and other implicit price concessions including estimates for payor disallowances and patient non-payments. We are exposed to credit losses primarily through our accounts receivable. These receivables are short in nature because their due date varies between due upon receipt of invoice and 90 days. We assess our receivables, divide them into similar risk pools, and monitor our ongoing credit exposure through active review of our aging buckets. Our activities include timely account reconciliations, dispute resolution, and payment confirmations. We also employ collection agencies and legal counsel to pursue recovery of defaulted receivables. Our expected loss methodology is developed using historical liquidation rates, current and future economic and market conditions, and a review of the current status of our patients and customers’ trade accounts receivable balances. We also group our receivables into similar risk pools to better measure the risks for each pool. After evaluating the risk for each pool, we have determined that additional credit loss risk is immaterial for the Patient Care segment. For the Products & Services segment, an allowance for doubtful accounts is recorded, which is deducted from gross accounts receivable to arrive at “Accounts receivable, net.” As of June 30, 2022, we have considered the current and future economic and market conditions resulting in a decrease to the allowance for doubtful accounts by approximately $0.1 million since December 31, 2021. Accounts receivable, net as of June 30, 2022 and December 31, 2021 is comprised of the following: As of June 30, 2022 As of December 31, 2021 (in thousands) Patient Care Products & Services Consolidated Patient Care Products & Services Consolidated Gross charges before estimates for implicit price concessions $ 167,017 $ 23,527 $ 190,544 $ 173,115 $ 21,459 $ 194,574 Less estimates for implicit price concessions: Payor disallowances (30,863) — (30,863) (33,007) — (33,007) Patient non-payments (6,835) — (6,835) (7,500) — (7,500) Accounts receivable, gross 129,319 23,527 152,846 132,608 21,459 154,067 Allowance for doubtful accounts — (1,948) (1,948) — (2,009) (2,009) Accounts receivable, net $ 129,319 $ 21,579 $ 150,898 $ 132,608 $ 19,450 $ 152,058

Inventories

Inventories	6 Months Ended
	Jun. 30, 2022
Inventory Disclosure [Abstract]
Inventories	Inventories Our inventories are comprised of the following: As of June 30, As of December 31, (in thousands) 2022 2021 Raw materials $ 23,850 $ 22,759 Work in process 20,772 15,807 Finished goods 43,396 48,896 Total inventories $ 88,018 $ 87,462

Acquisitions

Acquisitions	6 Months Ended
	Jun. 30, 2022
Business Combination and Asset Acquisition [Abstract]
Acquisitions	Acquisitions 2022 Acquisition Activity During 2022, we completed the following acquisitions of O&P clinics with the intention of expanding the geographic footprint of our patient care offerings through the acquisitions of these high quality O&P providers. None of the acquisitions were individually material to our financial position, results of operations, or cash flows. • In the first quarter of 2022, we completed the acquisition of all the outstanding equity interests of an O&P business for total consideration of $5.0 million, of which $4.0 million was cash consideration, net of cash acquired, and $1.0 million was issued in the form of notes to shareholders at fair value. • In the second quarter of 2022, we completed the acquisitions of all the outstanding equity interests of two O&P businesses for total consideration of $11.7 million, of which $8.5 million was cash consideration, net of cash acquired, and $3.2 million was issued in the form of notes to shareholders at fair value. We accounted for these transactions under the acquisition method of accounting and have reported the results of operations of each acquisition as of the respective dates of the acquisitions. We based the estimated fair values of intangible assets on an income approach utilizing the excess earnings method for customer relationships. The income approach utilizes management’s estimates of future operating results and cash flows using a weighted average cost of capital that reflects market participant assumptions. Other significant judgments used in the valuation of tangible assets acquired in the acquisitions include estimated selling price of inventory and estimated replacement cost for acquired property, plant, and equipment. For all other assets acquired and liabilities assumed, the fair value reflects the carrying value of the asset or liability due to their short maturity. We recorded the excess of the fair value of the consideration transferred in the acquisitions over the fair value of net assets acquired as goodwill. The goodwill reflects our expectations of favorable future growth opportunities, anticipated synergies through the scale of our O&P operations, and the assembled workforce. We expect that substantially all of the goodwill, which has been assigned to our Patient Care reporting unit, will not be deductible for federal income tax purposes. Acquisition-related costs associated with Hanger’s acquisition of O&P businesses are included in general and administrative expenses in our condensed consolidated statements of operations. Total acquisition-related costs incurred during the three and six months ended June 30, 2022 were $0.3 million and $0.6 million, respectively, which includes those costs for transactions that are in progress or were not completed during the respective period. Acquisition-related costs incurred for the acquisitions completed during the three and six months ended June 30, 2022 were $0.2 million and $0.3 million, respectively. We have not presented pro forma combined results for these acquisitions because the impact on previously reported statements of operations would not have been material individually or in the aggregate. Purchase Price Allocation We have performed a preliminary valuation analysis of the fair market value of the assets acquired and liabilities assumed in the acquisitions. The final purchase price allocations will be determined when we have completed and fully reviewed the detailed valuations which could differ materially from the preliminary allocations. The final allocations may include changes in allocations of acquired intangible assets as well as goodwill and other changes to assets and liabilities, including deferred taxes. The estimated useful lives of acquired intangible assets are also preliminary. The aggregate purchase price of these acquisitions was allocated on a preliminary basis as follows: (in thousands) Cash paid, net of cash acquired $ 12,490 Issuance of Seller Notes at fair value 4,195 Additional consideration 36 Aggregate purchase price 16,721 Accounts receivable 697 Inventories 865 Customer relationships (Weighted average useful life of 5.0 years) 2,270 Non-compete agreements (Weighted average useful life of 5.0 years) 243 Other assets and liabilities, net (418) Net assets acquired 3,657 Goodwill $ 13,064 Right-of-use assets and lease liabilities related to operating leases recognized in connection with the acquisitions completed for the six months ended June 30, 2022 were $0.7 million. During the third quarter of 2022 to date, we completed the acquisitions of two O&P businesses for a total purchase price of $8.1 million. Total consideration transferred for these acquisitions is comprised of $6.3 million in cash consideration and $1.8 million in the form of notes to shareholders at fair value. Due to the proximity in time of these transactions to the filing of this Form 10-Q, it is not practicable to provide a preliminary purchase price allocation of the fair value of the assets purchased and liabilities assumed in the acquisitions. Acquisition-related expenses related to these transactions were not material. 2021 Acquisition Activity During 2021, we completed the following acquisitions of O&P clinics with the intention of expanding the geographic footprint of our patient care offerings through the acquisition of these high quality O&P providers. None of the acquisitions were individually material to our financial position, results of operations, or cash flows. • In the first quarter of 2021, we completed the acquisitions of all the outstanding equity interests of three O&P businesses and the assets of one O&P business for total consideration of $24.2 million, of which $19.2 million was cash consideration, net of cash acquired, $4.0 million was issued in the form of notes to shareholders at fair value, and $1.0 million in additional consideration. • In the second quarter of 2021, we completed the acquisitions of all the outstanding equity interests of two O&P businesses for total consideration of $21.0 million, of which $16.0 million was cash consideration, net of cash acquired, $4.9 million was issued in the form of notes to shareholders at fair value, and $0.1 million in additional consideration. • In the third quarter of 2021, we completed the acquisitions of all the outstanding equity interests of three O&P businesses and the assets of one O&P business for total consideration of $6.2 million, of which $3.9 million was cash consideration, net of cash acquired, $1.5 million was issued in the form of notes to shareholders at fair value, and $0.8 million in additional consideration. • In the fourth quarter of 2021, we completed the acquisitions of all the outstanding equity interests of eight O&P businesses for total consideration of $53.1 million, of which $40.8 million was cash consideration, net of cash acquired, and $12.3 million was issued in the form of notes to shareholders at fair value. Acquisition-related costs are included in general and administrative expenses in our condensed consolidated statements of operations. Total acquisition-related costs incurred during the year ended December 31, 2021 were $2.1 million, which includes those costs for transactions that were in progress or were not completed during the respective period. Acquisition-related costs incurred for the acquisitions completed during the year ended December 31, 2021 were $1.6 million. The aggregate purchase price of these acquisitions was allocated on a preliminary basis as follows: (in thousands) Cash paid, net of cash acquired $ 79,927 Issuance of Seller Notes at fair value 22,706 Additional consideration, net 1,925 Aggregate purchase price 104,558 Accounts receivable 6,569 Inventories 4,683 Customer relationships (Weighted average useful life of 5.0 years) 11,745 Non-compete agreements (Weighted average useful life of 5.0 years) 558 Other assets and liabilities, net (5,121) Net assets acquired 18,434 Goodwill $ 86,124 Right-of-use assets and lease liabilities related to operating leases recognized in connection with acquisitions completed for the year ended December 31, 2021 were $8.9 million.

Goodwill and Other Intangible A

Goodwill and Other Intangible Assets	6 Months Ended
	Jun. 30, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Other Intangible Assets	Goodwill and Other Intangible Assets We assess goodwill and indefinite-lived intangible assets for impairment annually as of October 1st, and between annual tests if an event occurs, or circumstances change, that would more-likely-than-not reduce the fair value of a reporting unit below its carrying value. The following table summarizes the activity in goodwill of the Patient Care operating segment for the period indicated: For the Three Months Ended June 30, 2022 (in thousands) Goodwill, Gross Accumulated Impairment Goodwill, Net As of December 31, 2021 $ 792,222 $ (428,668) $ 363,554 Additions from acquisitions 13,064 — 13,064 Measurement period adjustments (1) 546 — 546 As of June 30, 2022 $ 805,832 $ (428,668) $ 377,164 (1) Measurement period adjustments primarily relate to 2021 acquisitions of approximately $0.5 million and are primarily attributable to adjustments to the preliminary allocations of acquired assets. The balances related to intangible assets as of June 30, 2022 are as follows: As of June 30, 2022 (in thousands) Gross Carrying Amount Accumulated Amortization Accumulated Impairment Net Carrying Amount Customer lists $ 30,894 $ (12,799) $ — $ 18,095 Trade name 255 (214) — 41 Patents and other intangibles 9,818 (6,924) — 2,894 Definite-lived intangible assets 40,967 (19,937) — 21,030 Indefinite-lived trade name 9,070 — (4,953) 4,117 Total other intangible assets $ 50,037 $ (19,937) $ (4,953) $ 25,147 Amortization expense related to other intangible assets was approximately $1.7 million and $3.3 million for the three and six months ended June 30, 2022, respectively, and $1.2 million and $2.2 million for the three and six months ended June 30, 2021, respectively.

Other Current Assets and Other

Other Current Assets and Other Assets	6 Months Ended
	Jun. 30, 2022
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Other Current Assets and Other Assets	Other Current Assets and Other Assets Other current assets consist of the following: As of June 30, As of December 31, (in thousands) 2022 2021 Non-trade receivables $ 6,582 $ 7,725 Prepaid maintenance 5,658 4,553 Prepaid insurance 1,706 510 Other prepaid assets 5,668 3,748 Total other current assets $ 19,614 $ 16,536 Other assets consist of the following: As of June 30, As of December 31, (in thousands) 2022 2021 Implementation costs for cloud computing arrangements $ 6,213 $ 6,459 Cash surrender value of company-owned life insurance 3,945 4,471 Finance lease right-of-use assets 2,563 2,732 Deposits 2,240 2,178 Non-trade receivables 1,565 1,172 Other 2,026 933 Total other assets $ 18,552 $ 17,945

Accrued Expenses and Other Curr

Accrued Expenses and Other Current Liabilities and Other Liabilities	6 Months Ended
	Jun. 30, 2022
Payables and Accruals [Abstract]
Accrued Expenses and Other Current Liabilities and Other Liabilities	Accrued Expenses and Other Current Liabilities and Other Liabilities Accrued expenses and other current liabilities consist of: As of June 30, As of December 31, (in thousands) 2022 2021 Patient prepayments, deposits, and refunds payable $ 29,236 $ 26,475 Insurance and self-insurance accruals 9,857 8,943 Accrued sales taxes and other taxes 8,272 7,803 Accrued professional fees 1,400 750 Accrued interest payable 774 707 Derivative liability — 6,425 Other current liabilities 6,612 9,296 Total $ 56,151 $ 60,399 Other liabilities consist of: As of June 30, As of December 31, (in thousands) 2022 2021 Supplemental executive retirement plan obligations $ 18,980 $ 20,779 Long-term insurance accruals 7,599 7,112 Derivative liability — 4,664 Other 2,268 2,285 Total $ 28,847 $ 34,840

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2022
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes We recorded a provision for income taxes of $3.0 million and $0.9 million for the three and six months ended June 30, 2022, respectively. The effective tax rate was 22.8% and 29.0% for the three and six months ended June 30, 2022, respectively. We recorded a provision for income taxes of $2.6 million and $0.5 million for the three and six months ended June 30, 2021, respectively. The effective tax rate was 20.5% and 6.3% for the three and six months ended June 30, 2021, respectively. The increase in the effective tax rate for the three months ended June 30, 2022 compared with the three months ended June 30, 2021 is primarily attributable to a windfall from share-based compensation for the three months ended June 30, 2021 compared to a shortfall from share-based compensation for the three months ended June 30, 2022. Our effective tax rate for the three months ended June 30, 2022 is similar to the federal statutory tax rate of 21%, but the difference consists primarily of research and development credits offset by non-deductible expenses and shortfall from share-based compensation. Our effective tax rate for the three months ended June 30, 2021 differed from the federal statutory tax rate of 21% primarily due to research and development credits, non-deductible expenses, and windfall from share-based compensation. For the year ending December 31, 2022, we estimate a research and development tax credit of $2.7 million, net of tax reserves. We record the tax benefit, net of tax reserves, as a deferred tax asset. For the year ended December 31, 2021, we recognized research and development tax credits of $4.3 million, net of tax reserves.

Debt and Other Obligations

Debt and Other Obligations	6 Months Ended
	Jun. 30, 2022
Debt Disclosure [Abstract]
Debt and Other Obligations	Debt and Other Obligations Debt consists of the following: As of June 30, As of December 31, (in thousands) 2022 2021 Debt: Term Loan B $ 449,800 $ 486,063 Seller Notes 28,885 29,812 Deferred payment obligation 4,000 4,000 Finance lease liabilities and other 3,112 3,344 Total debt before unamortized discount and debt issuance costs 485,797 523,219 Unamortized discount and debt issuance costs, net (5,139) (5,974) Total debt $ 480,658 $ 517,245 Current portion of long-term debt: Term Loan B $ 5,050 $ 5,050 Seller Notes 9,672 8,969 Finance lease liabilities and other 914 919 Total current portion of long-term debt 15,636 14,938 Long-term debt $ 465,022 $ 502,307 Credit Agreement and Term B Borrowings As of June 30, 2022, we have a Senior Credit Facility (the “Credit Agreement”) which provides for (i) a Term Loan B facility with $449.8 million outstanding which is due in quarterly principal installments with all remaining outstanding principal due at maturity in March 2025 and (ii) a revolving credit facility with an availability of $135.0 million which matures on November 23, 2026 (subject to a springing maturity if the term loans outstanding under the Credit Agreement are not repaid prior to the date that is 91 days prior to the stated maturity thereof). In June 2022, in addition to our normal quarterly principal payment of $1.3 million, we made an additional prepayment of $33.7 million, for total repayments of $35.0 million under the Credit Agreement. Availability under the revolving credit facility is reduced by outstanding letters of credit, which were $5.2 million as of June 30, 2022, resulting in approximately $129.8 million in available borrowing capacity. Our obligations under the Credit Agreement are currently guaranteed by our material domestic subsidiaries and will from time to time be guaranteed by, subject in each case to certain exceptions, any domestic subsidiaries that may become material in the future. Subject to certain exceptions, the Credit Agreement is secured by first-priority perfected liens and security interests in substantially all of our personal property and each subsidiary guarantor. Borrowings under the Credit Agreement bear interest at a variable rate equal to (i) LIBOR plus a specified margin, subject to a LIBOR interest rate floor of 0.00% per annum, or (ii) the base rate (which is the highest of (a) Bank of America, N.A.’s prime rate, (b) the federal funds rate plus 0.50% or (c) the sum of 1% plus one-month LIBOR) plus a specified margin. For the three months ended June 30, 2022, the weighted average interest rate on outstanding borrowings under our Term Loan B facility was approximately 4.2%. We have entered into interest rate swap agreements to hedge certain of our interest rate exposures, as more fully disclosed in Note M - “Derivative Financial Instruments.” We must also pay (i) an unused commitment fee ranging from 0.375% to 0.500% per annum of the average daily unused portion of the aggregate revolving credit commitments under the Credit Agreement, and (ii) a per annum fee equal to (a) for each performance standby letter of credit outstanding under the Credit Agreement with respect to nonfinancial contractual obligations, 50% of the applicable margin over LIBOR under the revolving credit facility in effect from time to time multiplied by the daily amount available to be drawn under such letter of credit, and (b) for each other letter of credit outstanding under the Credit Agreement, the applicable margin over LIBOR under the revolving credit facility in effect from time to time multiplied by the daily amount available to be drawn for such letter of credit. The Credit Agreement and its amendments contain various restrictions and covenants, including: (i) requirements that we maintain certain financial ratios at prescribed levels, (ii) a prohibition on payment of dividends and other distributions and (iii) restrictions on our ability and certain of our subsidiaries to consolidate or merge, create liens, incur additional indebtedness, dispose of assets, or consummate acquisitions outside the healthcare industry. The Credit Agreement includes the following financial covenants applicable for so long as any revolving loans and/or revolving commitments remain outstanding under the Credit Agreement: (i) a maximum consolidated first lien net leverage ratio (“Net Leverage Ratio”) (defined as, with certain adjustments and exclusions, the ratio of consolidated first-lien indebtedness to consolidated net income before interest, taxes, depreciation, amortization, non-cash charges and certain other items (“EBITDA”) for the most recently ended period of four fiscal quarters for which financial statements are available) shall be up to (a) 5.00 to 1.00 for the fiscal quarters ending June 30, 2022, and September 30, 2022 and (b) 4.75 to 1.00 for the fiscal quarter ending December 31, 2022 and the last day of each fiscal quarter thereafter, (ii) permit, at our election and up to three times during the term of the Credit Agreement, the maximum allowable leverage ratio for covenant purposes to be temporarily increased by an additional 0.50 to 1.00 for four consecutive fiscal quarters in connection with certain material acquisitions, and (iii) a minimum interest coverage ratio (defined as, with certain adjustments, the ratio of our EBITDA to consolidated interest expense to the extent paid or payable in cash) of 2.75 to 1.00 as of the last day of any fiscal quarter. The Credit Agreement also contains customary events of default. If an event of default under the Credit Agreement occurs and is continuing, then the lenders may declare any outstanding obligations under the Credit Agreement to be immediately due and payable; provided, however, that the occurrence of an event of default as a result of a breach of a financial covenant under the Credit Agreement does not constitute a default or event of default with respect to any term facility under the Credit Agreement unless and until the required revolving lenders shall have terminated their revolving commitments and declared all amounts outstanding under the revolving credit facility to be due and payable. In addition, if we or any subsidiary guarantor becomes the subject of voluntary or involuntary proceedings under any bankruptcy, insolvency, or similar law, then any outstanding obligations under the Credit Agreement will automatically become immediately due and payable. Loans outstanding under the Credit Agreement will bear interest at a rate of 2.00% per annum in excess of the otherwise applicable rate (i) upon acceleration of such loans, (ii) while a payment event of default exists or (iii) upon the lenders’ request, during the continuance of any other event of default. We were in compliance with all covenants at June 30, 2022. Seller Notes and the Deferred Payment Obligation We typically issue subordinated promissory notes (“Seller Notes”) as a part of the consideration transferred when making acquisitions. The Seller Notes are unsecured and are presented net of unamortized discount of $0.8 million and $0.9 million as of June 30, 2022 and December 31, 2021, respectively. We measure these instruments at their estimated fair values as of the respective acquisition dates. The stated interest rates on these instruments range from 2.50% to 3.00%. Principal and interest are payable in quarterly or annual installments and mature through May 2027.

Fair Value Measurements

Fair Value Measurements	6 Months Ended
	Jun. 30, 2022
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements Financial Instruments The carrying value of our outstanding term loan as of June 30, 2022 (excluding unamortized discounts and debt issuance costs of $4.3 million) was $449.8 million compared to its fair value of $432.9 million. The carrying value of our outstanding term loan as of December 31, 2021 (excluding unamortized discounts and debt issuance costs of $5.1 million) was $486.1 million compared to its fair value of $484.8 million. Our estimates of fair value are based on a discounted cash flow model and an indicative quote using unobservable inputs, primarily, our risk-adjusted credit spread, which represents a Level 3 measurement. We have interest rate swap agreements designated as cash flow hedges which are measured at fair value based on inputs other than quoted market prices that are observable, which represents a Level 2 measurement. See Note K - “Debt and Other Obligations” and Note M - “Derivative Financial Instruments” for further information.

Derivative Financial Instrument

Derivative Financial Instruments	6 Months Ended
	Jun. 30, 2022
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Financial Instruments	Derivative Financial Instruments Cash Flow Hedges of Interest Rate Risk In March 2018, we entered into interest rate swap agreements with notional values of $325.0 million at inception, which reduces $12.5 million annually until the swaps mature on March 6, 2024. As of June 30, 2022 and December 31, 2021, our swaps had a notional value outstanding of $275.0 million and $287.5 million, respectively. Change in Net Loss on Cash Flow Hedges Included in Accumulated Other Comprehensive Loss The following table presents the activity of cash flow hedges included in accumulated other comprehensive loss for the three months ended June 30, 2022 and 2021, respectively: (in thousands) Cash Flow Hedges Balance as of March 31, 2022 $ (1,608) Unrealized gain recognized in other comprehensive income before reclassifications, net of tax 1,481 Reclassification to interest expense, net of tax 1,385 Balance as of June 30, 2022 $ 1,258 Balance as of March 31, 2021 $ (14,259) Unrealized loss recognized in other comprehensive loss before reclassifications, net of tax (712) Reclassification to interest expense, net of tax 1,937 Balance as of June 30, 2021 $ (13,034) The following table presents the activity of cash flow hedges included in accumulated other comprehensive loss for the six months ended June 30, 2022 and 2021, respectively: (in thousands) Cash Flow Hedges Balance as of December 31, 2021 $ (8,504) Unrealized gain recognized in other comprehensive income, net of tax 6,501 Reclassification to interest expense, net 3,261 Balance as of June 30, 2022 $ 1,258 Balance as of December 31, 2020 $ (16,771) Unrealized loss recognized in other comprehensive loss, net of tax (183) Reclassification to interest expense, net 3,920 Balance as of June 30, 2021 $ (13,034) The following table presents the fair value of derivative assets and liabilities within the condensed consolidated balance sheets as of June 30, 2022 and December 31, 2021: As of June 30, 2022 As of December 31, 2021 (in thousands) Assets Liabilities Assets Liabilities Derivatives designated as cash flow hedging instruments: Other current assets $ 922 $ — $ — $ — Other assets 751 — — — Accrued expenses and other current liabilities — — — 6,425 Other liabilities — — — 4,664

Share-Based Compensation

Share-Based Compensation	6 Months Ended
	Jun. 30, 2022
Share-based Payment Arrangement [Abstract]
Share-Based Compensation	Share-Based Compensation On May 19, 2022, the shareholders approved the Hanger, Inc. 2022 Omnibus Incentive Plan (the “2022 Plan”). The 2022 Plan authorizes the issuance of (a) up to 1,960,000 shares of Common Stock, plus (b) 402,974 shares available for issuance under the Hanger, Inc. 2019 Omnibus Incentive Plan (the “2019 Plan”). Upon approval of the 2022 Plan, the 2019 Plan was no longer available for future awards. As of June 30, 2022, there were 1,519,125 unvested restricted stock awards outstanding. This was comprised of 1,127,637 employee service-based awards with a weighted average grant date fair value of $20.64 per share and 391,488 employee performance-based awards with a weighted average grant date fair value of $20.58 per share. As of June 30, 2022, there were 253,908 outstanding options exercisable with a weighted average exercise price of $12.77 and average remaining contractual term of 4.9 years. We recognized approximately $3.6 million and $6.5 million of share-based compensation expense for the three and six months ended June 30, 2022, respectively, and a total of approximately $3.2 million and $6.4 million of share-based compensation expense for the three and six months ended June 30, 2021, respectively. Share-based compensation expense, net of forfeitures, relates to restricted stock units, performance-based restricted stock units, and stock options.

Supplemental Executive Retireme

Supplemental Executive Retirement Plans	6 Months Ended
	Jun. 30, 2022
Retirement Benefits [Abstract]
Supplemental Executive Retirement Plans	Supplemental Executive Retirement Plans Defined Benefit Supplemental Executive Retirement Plan Effective January 2004, we implemented an unfunded noncontributory defined benefit plan (“DB SERP”) for certain senior executives. The DB SERP, which we administer, calls for fifteen annual payments upon retirement with the payment amount based on years of service and final average salary. Benefit costs and liability balances are calculated based on certain assumptions including benefits earned, discount rates, interest costs, mortality rates, and other factors. Actual results that differ from the assumptions are accumulated and amortized over future periods, affecting the recorded obligation and expense in future periods. We believe the assumptions used are appropriate; however, changes in assumptions or differences in actual experience may affect our benefit obligation and future expenses. The change in net benefit cost and obligation during the three and six months ended June 30, 2022 and 2021 is as follows: Change in Benefit Obligation: (in thousands) 2022 2021 Benefit obligation as of March 31 $ 16,273 $ 18,079 Service cost 116 123 Interest cost 100 88 Payments (12) (12) Benefit obligation as of June 30 $ 16,477 $ 18,278 Benefit obligation as of December 31, 2021 and 2020, respectively $ 17,935 $ 19,746 Service cost 232 246 Interest cost 199 175 Payments (1,889) (1,889) Benefit obligation as of June 30 $ 16,477 $ 18,278 Amounts Recognized in the Condensed Consolidated Balance Sheets: As of June 30, As of December 31, (in thousands) 2022 2021 Current accrued expenses and other current liabilities $ 1,913 $ 1,913 Non-current other liabilities 14,564 16,022 Total accrued liabilities $ 16,477 $ 17,935 Defined Contribution Supplemental Executive Retirement Plan In 2013, we established a defined contribution plan (“DC SERP”) that covers certain of our senior executives. Each participant is given a notional account to manage his or her annual distributions and allocate the funds among various investment options (e.g., mutual funds). These accounts are tracking accounts only for the purpose of calculating the participant’s benefit. The participant does not have ownership of the underlying mutual funds. When a participant initiates or changes the allocation of his or her notional account, we will generally make an allocation of our investments to match those chosen by the participant. While the allocation of our sub accounts is generally intended to mirror the participant’s account records (i.e., the distributions and gains or losses on those funds), the employee does not have legal ownership of any funds until payout upon retirement. The underlying investments are owned by the insurance company with which we own an insurance policy. As of June 30, 2022 and December 31, 2021, the estimated accumulated benefit obligation is $4.5 million and $4.8 million, of which $4.2 million and $4.1 million is funded and $0.3 million and $0.6 million is unfunded at June 30, 2022 and December 31, 2021, respectively. In connection with the DC SERP benefit obligation, we maintain a company-owned life insurance policy (“COLI”). The carrying value of the COLI is measured at its cash surrender value and is presented within “Other assets” in our condensed consolidated balance sheets. See Note H - “Other Current Assets and Other Assets” for additional information.

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2022
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Guarantees and Indemnification In the ordinary course of our business, we may enter into service agreements with service providers in which we agree to indemnify or limit the service provider against certain losses and liabilities arising from the service provider’s performance of the agreement. We have reviewed our existing contracts containing indemnification or clauses of guarantees and do not believe that our liability under such agreements is material. Other Matters From time to time we are subject to legal proceedings and claims which arise in the ordinary course of our business, and are also subject to additional payments under business purchase agreements. In the opinion of management, the amount of ultimate liability, if any, with respect to these actions will not have a materially adverse effect on our consolidated financial position, liquidity or results of operations. We operate in a highly regulated industry and receive regulatory agency inquiries from time to time in the ordinary course of our business, including inquiries relating to our billing activities. No assurance can be given that any discrepancies identified during a regulatory review will not have a material adverse effect on our consolidated financial statements.

Segment and Related Information

Segment and Related Information	6 Months Ended
	Jun. 30, 2022
Segment Reporting [Abstract]
Segment and Related Information	Segment and Related Information We have identified two operating segments and both performance evaluation and resource allocation decisions are determined based on each segment’s income from operations. The operating segments are described further below. Patient Care - This segment is primarily comprised of Hanger Clinic, which specializes in comprehensive, outcomes-based design, fabrication, and delivery of custom O&P devices. We also provide payor network contracting services to other O&P providers through this segment. The principal reimbursement sources for our services are: • Commercial private payors and other non-governmental organizations, which consist of individuals, rehabilitation providers, commercial insurance companies, health management organizations (“HMOs”), preferred provider organizations (“PPOs”), hospitals, vocational rehabilitation centers, workers’ compensation programs, third party administrators, and similar sources; • Medicare, a federally funded health insurance program providing health insurance coverage for persons aged 65 or older and certain persons with disabilities; • Medicaid, a health insurance program jointly funded by federal and state governments providing health insurance coverage for certain persons requiring financial assistance, regardless of age, which may supplement Medicare benefits for persons aged 65 or older requiring financial assistance; and • the VA. Products & Services - This segment is comprised of our distribution services and therapeutic solutions businesses. As a leading provider of O&P products in the United States, we engage in the distribution of a broad catalog of branded and private label O&P devices, products, and components to independent O&P providers nationwide. The other business in our Products & Services segment is our therapeutic solutions business, which develops specialized rehabilitation technologies and provides evidence-based clinical programs for post-acute rehabilitation to patients. Corporate & Other - This consists of corporate overhead and includes unallocated expense such as personnel costs, professional fees, and corporate offices expenses. The accounting policies of the segments are the same as those described in Note A - “Organization and Summary of Significant Accounting Policies” in our 2021 Form 10-K. Intersegment revenue primarily relates to sales of O&P components from the Products & Services segment to the Patient Care segment. The sales are priced at the cost of the related materials plus overhead. Summarized financial information concerning our reportable segments is shown in the following tables. Total assets for each of the segments has not materially changed from December 31, 2021. Patient Care Products & Services For the Three Months Ended For the Three Months Ended (in thousands) 2022 2021 2022 2021 Net revenues Third party $ 265,670 $ 236,787 $ 46,363 $ 44,032 Intersegments — — 63,433 54,900 Total net revenues 265,670 236,787 109,796 98,932 Material costs Third party suppliers 71,623 62,631 26,810 26,640 Intersegments 10,462 9,086 52,971 45,814 Total material costs 82,085 71,717 79,781 72,454 Personnel expenses 93,838 83,198 16,437 14,351 Other expenses 44,426 37,445 6,871 6,763 Depreciation & amortization 4,783 4,787 2,179 1,963 Segment income from operations $ 40,538 $ 39,640 $ 4,528 $ 3,401 Patient Care Products & Services For the Six Months Ended For the Six Months Ended (in thousands) 2022 2021 2022 2021 Net revenues Third party $ 485,488 $ 432,469 $ 87,832 $ 85,820 Intersegments — — 118,108 101,905 Total net revenues 485,488 432,469 205,940 187,725 Material costs Third party suppliers 131,541 114,290 52,484 50,151 Intersegments 21,520 17,349 96,588 84,556 Total material costs 153,061 131,639 149,072 134,707 Personnel expenses 180,247 158,952 31,703 28,477 Other expenses 85,122 73,586 13,928 12,566 Depreciation & amortization 9,527 9,602 4,202 3,898 Segment income from operations $ 57,531 $ 58,690 $ 7,035 $ 8,077 A reconciliation of the total of the reportable segments’ income from operations to consolidated net income is as follows: For the Three Months Ended For the Six Months Ended (in thousands) 2022 2021 2022 2021 Income from operations Patient Care $ 40,538 $ 39,640 $ 57,531 $ 58,690 Products & Services 4,528 3,401 7,035 8,077 Corporate & other (24,279) (22,947) (46,324) (44,652) Income from operations 20,787 20,094 18,242 22,115 Interest expense, net 7,524 7,152 14,909 14,492 Non-service defined benefit plan expense 160 167 320 334 Income before income taxes 13,103 12,775 3,013 7,289 Provision for income taxes 2,986 2,616 873 460 Net income $ 10,117 $ 10,159 $ 2,140 $ 6,829 A reconciliation of the reportable segments’ net revenues to consolidated net revenues is as follows: For the Three Months Ended For the Six Months Ended (in thousands) 2022 2021 2022 2021 Net revenues Patient Care $ 265,670 $ 236,787 $ 485,488 $ 432,469 Products & Services 109,796 98,932 205,940 187,725 Corporate & other — — — — Consolidating adjustments (63,433) (54,900) (118,108) (101,905) Consolidated net revenues $ 312,033 $ 280,819 $ 573,320 $ 518,289 A reconciliation of the reportable segments’ material costs to consolidated material costs is as follows: For the Three Months Ended For the Six Months Ended (in thousands) 2022 2021 2022 2021 Material costs Patient Care $ 82,085 $ 71,717 $ 153,061 $ 131,639 Products & Services 79,781 72,454 149,072 134,707 Corporate & other — — — — Consolidating adjustments (63,433) (54,900) (118,108) (101,905) Consolidated material costs $ 98,433 $ 89,271 $ 184,025 $ 164,441

Subsequent Events

Subsequent Events	6 Months Ended
	Jun. 30, 2022
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events On July 21, 2022, the Company entered into an Agreement and Plan of Merger (the “Merger Agreement”) with Hero Parent, Inc., a Delaware corporation (“Parent”), and Hero Merger Sub, Inc., a Delaware corporation and a wholly owned subsidiary of Parent (“Merger Sub”). Parent and Merger Sub are indirect subsidiaries of funds managed and advised by Patient Square Capital, a dedicated health care investment firm. The Merger Agreement provides, among other things and subject to the terms and conditions set forth therein, that Merger Sub will be merged with and into the Company, with the Company surviving as a wholly-owned subsidiary of Parent (the “Merger”). At the Effective Time (as defined in the Merger Agreement), by virtue of the Merger, each share of common stock of the Company issued and outstanding immediately prior to the Effective will be converted automatically into the right to receive $18.75 per share in cash. After the Merger, Hanger ’s common stock will no longer be traded on the New York Stock Exchange.

Organization and Summary of S_2

Organization and Summary of Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2022
Organization and Summary of Significant Accounting Policies
Basis of Presentation	Basis of Presentation The accompanying interim unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X, and, therefore, do not include all of the information and footnotes required by GAAP for complete financial statements. These financial statements should be read in conjunction with the audited consolidated financial statements in our Annual Report on Form 10-K for the year ended December 31, 2021 (the “2021 Form 10-K”), as previously filed with the Securities and Exchange Commission (the “SEC”). In our opinion, the information contained herein reflects all adjustments necessary for a fair statement of our results of operations, financial position, and cash flows. All such adjustments are of a normal, recurring nature. The results of operations for the interim periods are not necessarily indicative of those to be expected for the full year. A detailed description of our significant accounting policies and management judgments is contained in our 2021 Form 10-K.
Reclassifications	Reclassifications We have reclassified certain amounts in the prior year condensed consolidated financial statements to be consistent with the current year presentation. These relate to immaterial classifications within expense line items in the condensed consolidated statements of operations.
Recent Developments Regarding COVID-19	Recent Developments Regarding COVID-19 We are subject to risks and uncertainties as a result of the outbreak of the novel coronavirus (“COVID-19”) pandemic (“COVID-19 pandemic”). The extent and duration of the impact of the COVID-19 pandemic on our operations and financial condition remain uncertain and difficult to predict. As a result of the COVID-19 pandemic, we believe that our patients are continuing to defer visits to our O&P clinics, as well as elective surgical procedures, both of which impact our business volumes through decreased patient encounters and physician referrals. While the emerging variants of the COVID-19 virus continue to contribute to employee absences and our use of temporary labor, we believe the overall adverse impact of the COVID-19 pandemic on our business volumes has diminished and stabilized over time. The United States government has responded with fiscal policy measures intended to support the healthcare industry and economy as a whole, including the passage of the Coronavirus Aid, Relief and Economic Security Act (the “CARES Act”) in March 2020. CARES Act The CARES Act established the Public Health and Social Services Emergency Fund, also referred to as the Cares Act Provider Relief Fund, which set aside $203.5 billion to be administered through grants and other mechanisms to hospitals, public entities, not-for-profit entities and Medicare- and Medicaid- enrolled suppliers and institutional providers. The purpose of these funds is to reimburse providers for lost revenue and health-care related expenses that are attributable to the COVID-19 pandemic. In April 2020, the U.S. Department of Health and Human Services (“HHS”) began making payments to healthcare providers from the $203.5 billion appropriation. These are grants, rather than loans, to healthcare providers, and will not need to be repaid. During the full year of 2021, we recognized a total benefit of $1.1 million in our consolidated statement of operations within Other operating costs in our Patient Care segment for the grant proceeds we received under the CARES Act (“Grants”) from HHS. We accounted for the proceeds from the Grants by analogy to International Accounting Standard (“IAS 20”), Accounting for Government Grants and Disclosure of Government Assistance and its principles surrounding the recognition of grants related to income. We recognize income related to grants on a systematic and rational basis when it becomes probable that we have complied with the terms and conditions of the grant and in the period in which the corresponding costs or income related to the grant are recognized. We are using the Grants for their intended purpose, and are compliant to the reporting requirements set by the terms and conditions of the grant.
Recent Accounting Pronouncements, Not Yet Adopted	Recent Accounting Pronouncements, Not Yet Adopted In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting . This ASU, effective beginning on March 12, 2020, provides optional expedients and exceptions for applying GAAP to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criteria are met. The amendments in this update apply only to contracts, hedging relationships, and other transactions that reference London Interbank Offered Rate (“LIBOR”) or another reference rate expected to be discontinued because of reference rate reform. The expedients and exceptions provided by the amendments do not apply to contract modifications made and hedging relationships entered into or evaluated after December 31, 2022, except for hedging relationships existing as of December 31, 2022, that an entity has elected certain optional expedients for and that are retained through the end of the hedging relationship. We are currently evaluating the effects that the adoption of this guidance, and related clarifying standards, will have on our condensed consolidated financial statements and the related disclosures.
Revenue from Contract with Customer	Revenue in our Patient Care segment is primarily derived from contracts with third party payors for the provision of O&P devices and is recognized upon the transfer of control of promised products or services to the patient at the time the patient receives the device. At, or subsequent to delivery, we issue an invoice to the third party payor, which primarily consists of commercial insurance companies, Medicare, Medicaid, the U.S. Department of Veterans Affairs (the “VA”), or private or patient pay (“Private Pay”) individuals. We recognize revenue for the amounts we expect to receive from payors based on expected contractual reimbursement rates, which are net of estimated contractual discounts and implicit price concessions. These revenue amounts are further revised as claims are adjudicated, which may result in additional disallowances. Revenue in our Products & Services segment is derived from the distribution of O&P components and from therapeutic solutions which includes the leasing and sale of rehabilitation equipment and ancillary consumable supplies combined with equipment maintenance, education, and training.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	6 Months Ended
	Jun. 30, 2022
Earnings Per Share [Abstract]
Schedule of reconciliation of numerators and denominators used to calculate basic and diluted net income per share	The reconciliation of the numerators and denominators used to calculate basic and diluted net income per share are as follows: For the Three Months Ended For the Six Months Ended (in thousands except share and per share amounts) 2022 2021 2022 2021 Net income $ 10,117 $ 10,159 $ 2,140 $ 6,829 Weighted average shares outstanding - basic 39,089,865 38,647,042 38,946,937 38,458,733 Effect of potentially dilutive restricted stock units and options 160,870 561,113 346,838 757,992 Weighted average shares outstanding - diluted 39,250,735 39,208,155 39,293,775 39,216,725 Basic income per share $ 0.26 $ 0.26 $ 0.05 $ 0.18 Diluted income per share $ 0.26 $ 0.26 $ 0.05 $ 0.17

Revenue Recognition (Tables)

Revenue Recognition (Tables)	6 Months Ended
	Jun. 30, 2022
Revenue from Contract with Customer [Abstract]
Schedule of disaggregates of revenue from contracts with customers	The following table disaggregates revenue from contracts with customers in our Patient Care segment for the three and six months ended June 30, 2022 and 2021: For the Three Months Ended For the Six Months Ended (in thousands) 2022 2021 2022 2021 Patient Care Segment Medicare $ 83,013 $ 74,248 $ 148,867 $ 131,583 Medicaid 49,334 43,688 88,606 77,736 Commercial insurance / managed care (excluding Medicare and Medicaid managed care) 88,801 79,769 166,144 149,432 VA 25,393 21,633 46,442 41,397 Private Pay 19,129 17,449 35,429 32,321 Total $ 265,670 $ 236,787 $ 485,488 $ 432,469 The following table disaggregates revenue from contracts with customers in our Products & Services segment for the three and six months ended June 30, 2022 and 2021: For the Three Months Ended For the Six Months Ended (in thousands) 2022 2021 2022 2021 Products & Services Segment Distribution services, net of intersegment revenue eliminations $ 35,978 $ 33,275 $ 67,368 $ 63,935 Therapeutic solutions 10,385 10,757 20,464 21,885 Total $ 46,363 $ 44,032 $ 87,832 $ 85,820

Accounts Receivable, Net (Table

Accounts Receivable, Net (Tables)	6 Months Ended
	Jun. 30, 2022
Accounts Receivable, after Allowance for Credit Loss [Abstract]
Schedule of accounts receivable, net	Accounts receivable, net as of June 30, 2022 and December 31, 2021 is comprised of the following: As of June 30, 2022 As of December 31, 2021 (in thousands) Patient Care Products & Services Consolidated Patient Care Products & Services Consolidated Gross charges before estimates for implicit price concessions $ 167,017 $ 23,527 $ 190,544 $ 173,115 $ 21,459 $ 194,574 Less estimates for implicit price concessions: Payor disallowances (30,863) — (30,863) (33,007) — (33,007) Patient non-payments (6,835) — (6,835) (7,500) — (7,500) Accounts receivable, gross 129,319 23,527 152,846 132,608 21,459 154,067 Allowance for doubtful accounts — (1,948) (1,948) — (2,009) (2,009) Accounts receivable, net $ 129,319 $ 21,579 $ 150,898 $ 132,608 $ 19,450 $ 152,058

Inventories (Tables)

Inventories (Tables)	6 Months Ended
	Jun. 30, 2022
Inventory Disclosure [Abstract]
Schedule of inventories	Our inventories are comprised of the following: As of June 30, As of December 31, (in thousands) 2022 2021 Raw materials $ 23,850 $ 22,759 Work in process 20,772 15,807 Finished goods 43,396 48,896 Total inventories $ 88,018 $ 87,462

Acquisitions (Tables)

Acquisitions (Tables)	6 Months Ended
	Jun. 30, 2022
Business Combination and Asset Acquisition [Abstract]
Schedule of aggregate purchase price of acquisitions allocated on a preliminary basis	The aggregate purchase price of these acquisitions was allocated on a preliminary basis as follows: (in thousands) Cash paid, net of cash acquired $ 12,490 Issuance of Seller Notes at fair value 4,195 Additional consideration 36 Aggregate purchase price 16,721 Accounts receivable 697 Inventories 865 Customer relationships (Weighted average useful life of 5.0 years) 2,270 Non-compete agreements (Weighted average useful life of 5.0 years) 243 Other assets and liabilities, net (418) Net assets acquired 3,657 Goodwill $ 13,064 The aggregate purchase price of these acquisitions was allocated on a preliminary basis as follows: (in thousands) Cash paid, net of cash acquired $ 79,927 Issuance of Seller Notes at fair value 22,706 Additional consideration, net 1,925 Aggregate purchase price 104,558 Accounts receivable 6,569 Inventories 4,683 Customer relationships (Weighted average useful life of 5.0 years) 11,745 Non-compete agreements (Weighted average useful life of 5.0 years) 558 Other assets and liabilities, net (5,121) Net assets acquired 18,434 Goodwill $ 86,124

Goodwill and Other Intangible_2

Goodwill and Other Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of goodwill allocated to the Company's reportable segments	The following table summarizes the activity in goodwill of the Patient Care operating segment for the period indicated: For the Three Months Ended June 30, 2022 (in thousands) Goodwill, Gross Accumulated Impairment Goodwill, Net As of December 31, 2021 $ 792,222 $ (428,668) $ 363,554 Additions from acquisitions 13,064 — 13,064 Measurement period adjustments (1) 546 — 546 As of June 30, 2022 $ 805,832 $ (428,668) $ 377,164 (1) Measurement period adjustments primarily relate to 2021 acquisitions of approximately $0.5 million and are primarily attributable to adjustments to the preliminary allocations of acquired assets.
Schedule of balances related to indefinite-lived intangible assets	The balances related to intangible assets as of June 30, 2022 are as follows: As of June 30, 2022 (in thousands) Gross Carrying Amount Accumulated Amortization Accumulated Impairment Net Carrying Amount Customer lists $ 30,894 $ (12,799) $ — $ 18,095 Trade name 255 (214) — 41 Patents and other intangibles 9,818 (6,924) — 2,894 Definite-lived intangible assets 40,967 (19,937) — 21,030 Indefinite-lived trade name 9,070 — (4,953) 4,117 Total other intangible assets $ 50,037 $ (19,937) $ (4,953) $ 25,147

Other Current Assets and Othe_2

Other Current Assets and Other Assets (Tables)	6 Months Ended
	Jun. 30, 2022
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Schedule of other current assets	Other current assets consist of the following: As of June 30, As of December 31, (in thousands) 2022 2021 Non-trade receivables $ 6,582 $ 7,725 Prepaid maintenance 5,658 4,553 Prepaid insurance 1,706 510 Other prepaid assets 5,668 3,748 Total other current assets $ 19,614 $ 16,536
Schedule of other assets	Other assets consist of the following: As of June 30, As of December 31, (in thousands) 2022 2021 Implementation costs for cloud computing arrangements $ 6,213 $ 6,459 Cash surrender value of company-owned life insurance 3,945 4,471 Finance lease right-of-use assets 2,563 2,732 Deposits 2,240 2,178 Non-trade receivables 1,565 1,172 Other 2,026 933 Total other assets $ 18,552 $ 17,945

Accrued Expenses and Other Cu_2

Accrued Expenses and Other Current Liabilities and Other Liabilities (Tables)	6 Months Ended
	Jun. 30, 2022
Payables and Accruals [Abstract]
Schedule of accrued expenses and other current liabilities	Accrued expenses and other current liabilities consist of: As of June 30, As of December 31, (in thousands) 2022 2021 Patient prepayments, deposits, and refunds payable $ 29,236 $ 26,475 Insurance and self-insurance accruals 9,857 8,943 Accrued sales taxes and other taxes 8,272 7,803 Accrued professional fees 1,400 750 Accrued interest payable 774 707 Derivative liability — 6,425 Other current liabilities 6,612 9,296 Total $ 56,151 $ 60,399
Schedule of other liabilities	Other liabilities consist of: As of June 30, As of December 31, (in thousands) 2022 2021 Supplemental executive retirement plan obligations $ 18,980 $ 20,779 Long-term insurance accruals 7,599 7,112 Derivative liability — 4,664 Other 2,268 2,285 Total $ 28,847 $ 34,840

Debt and Other Obligations (Tab

Debt and Other Obligations (Tables)	6 Months Ended
	Jun. 30, 2022
Debt Disclosure [Abstract]
Schedule of debt	Debt consists of the following: As of June 30, As of December 31, (in thousands) 2022 2021 Debt: Term Loan B $ 449,800 $ 486,063 Seller Notes 28,885 29,812 Deferred payment obligation 4,000 4,000 Finance lease liabilities and other 3,112 3,344 Total debt before unamortized discount and debt issuance costs 485,797 523,219 Unamortized discount and debt issuance costs, net (5,139) (5,974) Total debt $ 480,658 $ 517,245 Current portion of long-term debt: Term Loan B $ 5,050 $ 5,050 Seller Notes 9,672 8,969 Finance lease liabilities and other 914 919 Total current portion of long-term debt 15,636 14,938 Long-term debt $ 465,022 $ 502,307

Derivative Financial Instrume_2

Derivative Financial Instruments (Tables)	6 Months Ended
	Jun. 30, 2022
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of activity of cash flow hedges included in accumulated other comprehensive loss	The following table presents the activity of cash flow hedges included in accumulated other comprehensive loss for the three months ended June 30, 2022 and 2021, respectively: (in thousands) Cash Flow Hedges Balance as of March 31, 2022 $ (1,608) Unrealized gain recognized in other comprehensive income before reclassifications, net of tax 1,481 Reclassification to interest expense, net of tax 1,385 Balance as of June 30, 2022 $ 1,258 Balance as of March 31, 2021 $ (14,259) Unrealized loss recognized in other comprehensive loss before reclassifications, net of tax (712) Reclassification to interest expense, net of tax 1,937 Balance as of June 30, 2021 $ (13,034) The following table presents the activity of cash flow hedges included in accumulated other comprehensive loss for the six months ended June 30, 2022 and 2021, respectively: (in thousands) Cash Flow Hedges Balance as of December 31, 2021 $ (8,504) Unrealized gain recognized in other comprehensive income, net of tax 6,501 Reclassification to interest expense, net 3,261 Balance as of June 30, 2022 $ 1,258 Balance as of December 31, 2020 $ (16,771) Unrealized loss recognized in other comprehensive loss, net of tax (183) Reclassification to interest expense, net 3,920 Balance as of June 30, 2021 $ (13,034)
Schedule of fair value of derivative assets and liabilities within the consolidated balance sheets	The following table presents the fair value of derivative assets and liabilities within the condensed consolidated balance sheets as of June 30, 2022 and December 31, 2021: As of June 30, 2022 As of December 31, 2021 (in thousands) Assets Liabilities Assets Liabilities Derivatives designated as cash flow hedging instruments: Other current assets $ 922 $ — $ — $ — Other assets 751 — — — Accrued expenses and other current liabilities — — — 6,425 Other liabilities — — — 4,664

Supplemental Executive Retire_2

Supplemental Executive Retirement Plans (Tables)	6 Months Ended
	Jun. 30, 2022
Retirement Benefits [Abstract]
Schedule of Change in Benefit Obligation	The change in net benefit cost and obligation during the three and six months ended June 30, 2022 and 2021 is as follows: Change in Benefit Obligation: (in thousands) 2022 2021 Benefit obligation as of March 31 $ 16,273 $ 18,079 Service cost 116 123 Interest cost 100 88 Payments (12) (12) Benefit obligation as of June 30 $ 16,477 $ 18,278 Benefit obligation as of December 31, 2021 and 2020, respectively $ 17,935 $ 19,746 Service cost 232 246 Interest cost 199 175 Payments (1,889) (1,889) Benefit obligation as of June 30 $ 16,477 $ 18,278
Schedule of Amounts Recognized in the Consolidated Balance Sheets	Amounts Recognized in the Condensed Consolidated Balance Sheets: As of June 30, As of December 31, (in thousands) 2022 2021 Current accrued expenses and other current liabilities $ 1,913 $ 1,913 Non-current other liabilities 14,564 16,022 Total accrued liabilities $ 16,477 $ 17,935

Segment and Related Informati_2

Segment and Related Information (Tables)	6 Months Ended
	Jun. 30, 2022
Segment Reporting [Abstract]
Summary of financial information concerning the Company's reporting segments	Summarized financial information concerning our reportable segments is shown in the following tables. Total assets for each of the segments has not materially changed from December 31, 2021. Patient Care Products & Services For the Three Months Ended For the Three Months Ended (in thousands) 2022 2021 2022 2021 Net revenues Third party $ 265,670 $ 236,787 $ 46,363 $ 44,032 Intersegments — — 63,433 54,900 Total net revenues 265,670 236,787 109,796 98,932 Material costs Third party suppliers 71,623 62,631 26,810 26,640 Intersegments 10,462 9,086 52,971 45,814 Total material costs 82,085 71,717 79,781 72,454 Personnel expenses 93,838 83,198 16,437 14,351 Other expenses 44,426 37,445 6,871 6,763 Depreciation & amortization 4,783 4,787 2,179 1,963 Segment income from operations $ 40,538 $ 39,640 $ 4,528 $ 3,401 Patient Care Products & Services For the Six Months Ended For the Six Months Ended (in thousands) 2022 2021 2022 2021 Net revenues Third party $ 485,488 $ 432,469 $ 87,832 $ 85,820 Intersegments — — 118,108 101,905 Total net revenues 485,488 432,469 205,940 187,725 Material costs Third party suppliers 131,541 114,290 52,484 50,151 Intersegments 21,520 17,349 96,588 84,556 Total material costs 153,061 131,639 149,072 134,707 Personnel expenses 180,247 158,952 31,703 28,477 Other expenses 85,122 73,586 13,928 12,566 Depreciation & amortization 9,527 9,602 4,202 3,898 Segment income from operations $ 57,531 $ 58,690 $ 7,035 $ 8,077
Schedule of reconciliation of reportable segments	A reconciliation of the total of the reportable segments’ income from operations to consolidated net income is as follows: For the Three Months Ended For the Six Months Ended (in thousands) 2022 2021 2022 2021 Income from operations Patient Care $ 40,538 $ 39,640 $ 57,531 $ 58,690 Products & Services 4,528 3,401 7,035 8,077 Corporate & other (24,279) (22,947) (46,324) (44,652) Income from operations 20,787 20,094 18,242 22,115 Interest expense, net 7,524 7,152 14,909 14,492 Non-service defined benefit plan expense 160 167 320 334 Income before income taxes 13,103 12,775 3,013 7,289 Provision for income taxes 2,986 2,616 873 460 Net income $ 10,117 $ 10,159 $ 2,140 $ 6,829 A reconciliation of the reportable segments’ net revenues to consolidated net revenues is as follows: For the Three Months Ended For the Six Months Ended (in thousands) 2022 2021 2022 2021 Net revenues Patient Care $ 265,670 $ 236,787 $ 485,488 $ 432,469 Products & Services 109,796 98,932 205,940 187,725 Corporate & other — — — — Consolidating adjustments (63,433) (54,900) (118,108) (101,905) Consolidated net revenues $ 312,033 $ 280,819 $ 573,320 $ 518,289 A reconciliation of the reportable segments’ material costs to consolidated material costs is as follows: For the Three Months Ended For the Six Months Ended (in thousands) 2022 2021 2022 2021 Material costs Patient Care $ 82,085 $ 71,717 $ 153,061 $ 131,639 Products & Services 79,781 72,454 149,072 134,707 Corporate & other — — — — Consolidating adjustments (63,433) (54,900) (118,108) (101,905) Consolidated material costs $ 98,433 $ 89,271 $ 184,025 $ 164,441

Organization and Summary of S_3

Organization and Summary of Significant Accounting Policies (Details) $ in Millions	6 Months Ended	12 Months Ended
	Jun. 30, 2022 USD ($) segment	Dec. 31, 2021 USD ($)
Organization and Summary of Significant Accounting Policies
Number of operating segments | segment	2
Proceeds received from grant		$ 1.1
Deferred payroll taxes under CARES Act	$ 5.9

Earnings Per Share - Narrative

Earnings Per Share - Narrative (Details) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Earnings Per Share [Abstract]
Total anti-dilutive shares (in shares)	213,957	2,721	100,387	1,302

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of reconciliation of numerators and denominators used to calculate basic and diluted net income per share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2021	Mar. 31, 2021	Jun. 30, 2022	Jun. 30, 2021
Earnings Per Share [Abstract]
Net income	$ 10,117	$ (7,977)	$ 10,159	$ (3,330)	$ 2,140	$ 6,829
Weighted average shares outstanding - basic (in shares)	39,089,865		38,647,042		38,946,937	38,458,733
Effect of potentially dilutive restricted stock units and options (in shares)	160,870		561,113		346,838	757,992
Weighted average shares outstanding - diluted (in shares)	39,250,735		39,208,155		39,293,775	39,216,725
Basic income per share (in dollars per share)	$ 0.26		$ 0.26		$ 0.05	$ 0.18
Diluted income per share (in dollars per share)	$ 0.26		$ 0.26		$ 0.05	$ 0.17

Revenue Recognition (Details)

Revenue Recognition (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Revenue Recognition
Net revenues	$ 312,033	$ 280,819	$ 573,320	$ 518,289
Patient Care
Revenue Recognition
Net revenues	265,670	236,787	485,488	432,469
Patient Care | Operating Segments
Revenue Recognition
Net revenues	265,670	236,787	485,488	432,469
Patient Care | Medicare | Operating Segments
Revenue Recognition
Net revenues	83,013	74,248	148,867	131,583
Patient Care | Medicaid | Operating Segments
Revenue Recognition
Net revenues	49,334	43,688	88,606	77,736
Patient Care | Commercial insurance / managed care (excluding Medicare and Medicaid managed care) | Operating Segments
Revenue Recognition
Net revenues	88,801	79,769	166,144	149,432
Patient Care | VA | Operating Segments
Revenue Recognition
Net revenues	25,393	21,633	46,442	41,397
Patient Care | Private Pay | Operating Segments
Revenue Recognition
Net revenues	19,129	17,449	35,429	32,321
Products & Services
Revenue Recognition
Net revenues	109,796	98,932	205,940	187,725
Products & Services | Operating Segments
Revenue Recognition
Net revenues	46,363	44,032	87,832	85,820
Products & Services | Distribution services, net of intersegment revenue eliminations | Operating Segments
Revenue Recognition
Net revenues	35,978	33,275	67,368	63,935
Products & Services | Therapeutic solutions | Operating Segments
Revenue Recognition
Net revenues	$ 10,385	$ 10,757	$ 20,464	$ 21,885

Accounts Receivable, Net - Narr

Accounts Receivable, Net - Narrative (Details) $ in Millions	6 Months Ended
	Jun. 30, 2022 USD ($)
Accounts Receivable, after Allowance for Credit Loss [Abstract]
Decrease in allowance for doubtful accounts	$ 0.1

Accounts Receivable, Net - Sche

Accounts Receivable, Net - Schedule of accounts receivable, net (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Accounts Receivable, net
Gross charges before estimates for implicit price concessions	$ 190,544	$ 194,574
Less estimates for implicit price concessions:
Payor disallowances	(30,863)	(33,007)
Patient non-payments	(6,835)	(7,500)
Accounts receivable, gross	152,846	154,067
Allowance for doubtful accounts	(1,948)	(2,009)
Accounts receivable, net	150,898	152,058
Patient Care
Accounts Receivable, net
Gross charges before estimates for implicit price concessions	167,017	173,115
Less estimates for implicit price concessions:
Payor disallowances	(30,863)	(33,007)
Patient non-payments	(6,835)	(7,500)
Accounts receivable, gross	129,319	132,608
Allowance for doubtful accounts	0	0
Accounts receivable, net	129,319	132,608
Products & Services
Accounts Receivable, net
Gross charges before estimates for implicit price concessions	23,527	21,459
Less estimates for implicit price concessions:
Payor disallowances	0	0
Patient non-payments	0	0
Accounts receivable, gross	23,527	21,459
Allowance for doubtful accounts	(1,948)	(2,009)
Accounts receivable, net	$ 21,579	$ 19,450

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Inventories
Raw materials	$ 23,850	$ 22,759
Work in process	20,772	15,807
Finished goods	43,396	48,896
Total inventories	$ 88,018	$ 87,462

Acquisitions - Narrative (Detai

Acquisitions - Narrative (Details) $ in Thousands	3 Months Ended							6 Months Ended	12 Months Ended
	Sep. 30, 2022 USD ($) business	Jun. 30, 2022 USD ($) business	Mar. 31, 2022 USD ($)	Dec. 31, 2021 USD ($) business	Sep. 30, 2021 USD ($) business	Jun. 30, 2021 USD ($) business	Mar. 31, 2021 USD ($) business	Jun. 30, 2022 USD ($)	Dec. 31, 2021 USD ($)
Acquisitions
Acquisition-related costs		$ 200						$ 300	$ 2,100
General and Administrative Expense
Acquisitions
Acquisition-related costs		300						600
2022 Acquisitions
Acquisitions
Aggregate purchase price		11,700	$ 5,000					16,721
Consideration paid in cash		8,500	4,000
Issuance of Seller Notes at fair value		$ 3,200	$ 1,000					4,195
Number of businesses acquired | business		2
Operating right-of-use assets		$ 700						700
Operating lease liabilities		$ 700						$ 700
2022 Acquisitions | Subsequent Event
Acquisitions
Aggregate purchase price	$ 8,100
Consideration paid in cash	$ 6,300
Number of businesses acquired | business	2
Additional consideration, net	$ 1,800
2021 Acquisitions
Acquisitions
Aggregate purchase price				$ 53,100	$ 6,200	$ 21,000	$ 24,200		104,558
Consideration paid in cash				40,800	3,900	16,000	19,200
Issuance of Seller Notes at fair value				$ 12,300	$ 1,500	$ 4,900	$ 4,000		22,706
Number of businesses acquired | business				8	3	2	3
Acquisition-related costs									1,600
Operating right-of-use assets				$ 8,900					8,900
Operating lease liabilities				$ 8,900					8,900
Additional consideration, net					$ 800	$ 100	$ 1,000		$ 1,925
Number of business' assets acquired | business					1		1

Acquisitions - Schedule of aggr

Acquisitions - Schedule of aggregate purchase price of acquisitions allocated on a preliminary basis (Details) - USD ($) $ in Thousands	3 Months Ended						6 Months Ended		12 Months Ended
	Jun. 30, 2022	Mar. 31, 2022	Dec. 31, 2021	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2021
Acquisitions
Cash paid, net of cash acquired							$ 12,490	$ 35,349
2022 Acquisitions
Acquisitions
Cash paid, net of cash acquired							12,490
Issuance of Seller Notes at fair value	$ 3,200	$ 1,000					4,195
Additional consideration							36
Aggregate purchase price	11,700	$ 5,000					16,721
Accounts receivable	697						697
Inventories	865						865
Other assets and liabilities, net	(418)						(418)
Net assets acquired	3,657						3,657
Goodwill							13,064
2022 Acquisitions | Customer relationships
Acquisitions
Other intangible assets, net	2,270						$ 2,270
Weighted average useful life of intangible assets							5 years
2022 Acquisitions | Non-compete agreements
Acquisitions
Other intangible assets, net	$ 243						$ 243
Weighted average useful life of intangible assets							5 years
2021 Acquisitions
Acquisitions
Cash paid, net of cash acquired									$ 79,927
Issuance of Seller Notes at fair value			$ 12,300	$ 1,500	$ 4,900	$ 4,000			22,706
Additional consideration, net				800	100	1,000			1,925
Aggregate purchase price			53,100	$ 6,200	$ 21,000	$ 24,200			104,558
Accounts receivable			6,569						6,569
Inventories			4,683						4,683
Other assets and liabilities, net			(5,121)						(5,121)
Net assets acquired			18,434						18,434
Goodwill									86,124
2021 Acquisitions | Customer relationships
Acquisitions
Other intangible assets, net			11,745						$ 11,745
Weighted average useful life of intangible assets									5 years
2021 Acquisitions | Non-compete agreements
Acquisitions
Other intangible assets, net			$ 558						$ 558
Weighted average useful life of intangible assets									5 years

Goodwill and Other Intangible_3

Goodwill and Other Intangible Assets - Goodwill (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2022	Dec. 31, 2021
Goodwill allocated
Goodwill, Net as of beginning of the year	$ 363,554
Goodwill, Net as of end of the year	377,164	$ 363,554
2021 Acquisitions
Goodwill allocated
Additions from acquisitions		86,124
Measurement period adjustments related to acquisitions	500
Patient Care
Goodwill allocated
Goodwill, Gross as of beginning of the period	792,222
Accumulated Impairment as of beginning of the period	(428,668)
Goodwill, Net as of beginning of the year	363,554
Additions from acquisitions	13,064
Measurement period adjustments	546
Goodwill, Gross as of end of the period	805,832	792,222
Accumulated Impairment as of end of the period	(428,668)	(428,668)
Goodwill, Net as of end of the year	$ 377,164	$ 363,554

Goodwill and Other Intangible_4

Goodwill and Other Intangible Assets - Intangible Assets (Details) $ in Thousands	Jun. 30, 2022 USD ($)
GOODWILL AND OTHER INTANGIBLE ASSETS
Definite-lived, Gross Carrying Amount	$ 40,967
Definite-lived, Accumulated Amortization	(19,937)
Definite-lived, Net Carrying Amount	21,030
Total other intangible assets, Gross Carrying Amount	50,037
Total other intangible assets, Accumulated Amortization	(19,937)
Accumulated Impairment	(4,953)
Total other intangible assets, Net Carrying Amount	25,147
Trade name
GOODWILL AND OTHER INTANGIBLE ASSETS
Indefinite lived, Gross Carrying Amount	9,070
Indefinite lived, Accumulated Impairment	(4,953)
Indefinite lived, Net Carrying Amount	4,117
Customer lists
GOODWILL AND OTHER INTANGIBLE ASSETS
Definite-lived, Gross Carrying Amount	30,894
Definite-lived, Accumulated Amortization	(12,799)
Definite-lived, Net Carrying Amount	18,095
Trade name
GOODWILL AND OTHER INTANGIBLE ASSETS
Definite-lived, Gross Carrying Amount	255
Definite-lived, Accumulated Amortization	(214)
Definite-lived, Net Carrying Amount	41
Patents and other intangibles
GOODWILL AND OTHER INTANGIBLE ASSETS
Definite-lived, Gross Carrying Amount	9,818
Definite-lived, Accumulated Amortization	(6,924)
Definite-lived, Net Carrying Amount	$ 2,894

Goodwill and Other Intangible_5

Goodwill and Other Intangible Assets - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense	$ 1.7	$ 1.2	$ 3.3	$ 2.2

Other Current Assets and Othe_3

Other Current Assets and Other Assets - Other current assets (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Non-trade receivables	$ 6,582	$ 7,725
Prepaid maintenance	5,658	4,553
Prepaid insurance	1,706	510
Other prepaid assets	5,668	3,748
Total other current assets	$ 19,614	$ 16,536

Other Current Assets and Othe_4

Other Current Assets and Other Assets - Other assets (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Implementation costs for cloud computing arrangements	$ 6,213	$ 6,459
Cash surrender value of company-owned life insurance	3,945	4,471
Finance lease right-of-use assets	2,563	2,732
Deposits	2,240	2,178
Non-trade receivables	1,565	1,172
Other	2,026	933
Total other assets	$ 18,552	$ 17,945

Accrued Expenses and Other Cu_3

Accrued Expenses and Other Current Liabilities and Other Liabilities - Accrued expenses and other current liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Payables and Accruals [Abstract]
Patient prepayments, deposits, and refunds payable	$ 29,236	$ 26,475
Insurance and self-insurance accruals	9,857	8,943
Accrued sales taxes and other taxes	8,272	7,803
Accrued professional fees	1,400	750
Accrued interest payable	774	707
Derivative liability	0	6,425
Other current liabilities	6,612	9,296
Total	$ 56,151	$ 60,399

Accrued Expenses and Other Cu_4

Accrued Expenses and Other Current Liabilities and Other Liabilities - Other liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Payables and Accruals [Abstract]
Supplemental executive retirement plan obligations	$ 18,980	$ 20,779
Long-term insurance accruals	7,599	7,112
Derivative liability	0	4,664
Other	2,268	2,285
Total	$ 28,847	$ 34,840

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2022	Dec. 31, 2021
Income Tax Contingency [Line Items]
Provision for income taxes	$ 2,986	$ 2,616	$ 873	$ 460
Effective tax rate (as a percent)	22.80%	20.50%	29%	6.30%
Recognition of tax benefits, current year						$ 4,300
Forecast
Income Tax Contingency [Line Items]
Recognition of tax benefits, current year					$ 2,700

Debt and Other Obligations (Det

Debt and Other Obligations (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Debt and Other Obligations
Total debt before unamortized discount and debt issuance costs	$ 485,797	$ 523,219
Unamortized discount and debt issuance costs, net	(5,139)	(5,974)
Total debt	480,658	517,245
Total current portion of long-term debt	15,636	14,938
Long-term debt	465,022	502,307
Term Loan B
Debt and Other Obligations
Total debt before unamortized discount and debt issuance costs	449,800	486,063
Unamortized discount and debt issuance costs, net	(4,300)	(5,100)
Total current portion of long-term debt	5,050	5,050
Seller Notes
Debt and Other Obligations
Total debt before unamortized discount and debt issuance costs	28,885	29,812
Total current portion of long-term debt	9,672	8,969
Deferred payment obligation
Debt and Other Obligations
Total debt before unamortized discount and debt issuance costs	4,000	4,000
Finance lease liabilities and other
Debt and Other Obligations
Total debt before unamortized discount and debt issuance costs	3,112	3,344
Total current portion of long-term debt	$ 914	$ 919

Debt and Other Obligations - Na

Debt and Other Obligations - Narrative (Details)	1 Months Ended	6 Months Ended
	Jun. 30, 2022 USD ($)	Jun. 30, 2022 USD ($) qtr increase_in_ratio	Mar. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Debt and Other Obligations
Outstanding amount of debt	$ 485,797,000	$ 485,797,000		$ 523,219,000
Term Loan B
Debt and Other Obligations
Outstanding amount of debt	449,800,000	449,800,000		486,063,000
Seller Notes
Debt and Other Obligations
Outstanding amount of debt	28,885,000	28,885,000		29,812,000
Unamortized discount	$ 800,000	$ 800,000		900,000
Seller Notes | Minimum
Debt and Other Obligations
Stated interest rates (as a percent)	2.50%	2.50%
Seller Notes | Maximum
Debt and Other Obligations
Stated interest rates (as a percent)	3%	3%
Deferred payment obligation
Debt and Other Obligations
Outstanding amount of debt	$ 4,000,000	$ 4,000,000		4,000,000
Unamortized discount	$ 400,000	$ 400,000		$ 400,000
Stated interest rates (as a percent)	3%	3%
Annual installment payment period		3 years
Credit Agreement | Loans Payable
Debt and Other Obligations
Weighted average interest rate	4.20%	4.20%
Revolving Credit Facility | Credit Agreement
Debt and Other Obligations
Outstanding amount of debt			$ 129,800,000
Maximum borrowing capacity	$ 135,000,000	$ 135,000,000
Principal payment	1,300,000
Periodic payment	33,700,000
Total repayments	35,000,000
Letters of credit outstanding amount	$ 5,200,000	$ 5,200,000
Increase in margin (as a percent)		50%
Number of increases in maximum leverage ratio | increase_in_ratio		3
Increase (decrease) in maximum allowable leverage ratio		50%
Number of consecutive fiscal quarters | qtr		4
Interest rate in excess of applicable rate upon acceleration and default (as a percent)		2%
Revolving Credit Facility | Credit Agreement | Fiscal Quarters Ended June 30, 2022 and September 30, 2022 [Member]
Debt and Other Obligations
Consolidated leverage ratio		500%
Revolving Credit Facility | Credit Agreement | Fiscal Quarters Ended December 31, 2022
Debt and Other Obligations
Consolidated leverage ratio		475%
Revolving Credit Facility | Credit Agreement | Last day of any fiscal quarter
Debt and Other Obligations
Consolidated leverage ratio		275%
Revolving Credit Facility | Credit Agreement | London Interbank Offered Rate (LIBOR)
Debt and Other Obligations
Interest rate margin (as a percent)		1%
Revolving Credit Facility | Credit Agreement | Fed Funds Effective Rate Overnight Index Swap Rate
Debt and Other Obligations
Interest rate margin (as a percent)		0.50%
Revolving Credit Facility | Credit Agreement | Minimum
Debt and Other Obligations
Unused commitment fee (as a percent)		0.375%
Revolving Credit Facility | Credit Agreement | Minimum | London Interbank Offered Rate (LIBOR)
Debt and Other Obligations
Interest rate margin (as a percent)		0%
Revolving Credit Facility | Credit Agreement | Maximum
Debt and Other Obligations
Unused commitment fee (as a percent)		0.50%

Debt and Other Obligations - Se

Debt and Other Obligations - Seller notes and the deferred payment obligation (Details) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2022	Dec. 31, 2021
Seller Notes
Debt and Other Obligations
Unamortized discount	$ 0.8	$ 0.9
Seller Notes | Minimum
Debt and Other Obligations
Stated interest rates (as a percent)	2.50%
Seller Notes | Maximum
Debt and Other Obligations
Stated interest rates (as a percent)	3%
Deferred payment obligation
Debt and Other Obligations
Unamortized discount	$ 0.4	$ 0.4
Stated interest rates (as a percent)	3%
Annual installment payment period	3 years

Fair Value Measurements (Detail

Fair Value Measurements (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
FAIR VALUE MEASUREMENTS
Unamortized discount and debt issuance costs, net	$ 5,139	$ 5,974
Total debt before unamortized discount and debt issuance costs	485,797	523,219
Term Loan B
FAIR VALUE MEASUREMENTS
Unamortized discount and debt issuance costs, net	4,300	5,100
Total debt before unamortized discount and debt issuance costs	449,800	486,063
Term Loan B | Fair Value, Recurring | Fair Value, Inputs, Level 3 | Estimate of Fair Value Measurement
FAIR VALUE MEASUREMENTS
Debt	432,900	484,800
Seller Notes
FAIR VALUE MEASUREMENTS
Total debt before unamortized discount and debt issuance costs	28,885	29,812
Seller Notes | Fair Value, Inputs, Level 3 | Reported Value Measurement
FAIR VALUE MEASUREMENTS
Unamortized discount and debt issuance costs, net	800	900
Outstanding amount	$ 32,100	$ 32,900

Derivative Financial Instrume_3

Derivative Financial Instruments - Cash flow hedge (Details) - Interest Rate Swap - Cash Flow Hedging - USD ($) $ in Millions	Jun. 30, 2022	Dec. 31, 2021	Mar. 31, 2018
DERIVATIVE FINANCIAL INSTRUMENTS
Notional amount of derivative instrument	$ 275	$ 287.5	$ 325
Annual reduction in notional amount of derivative			$ 12.5

Derivative Financial Instrume_4

Derivative Financial Instruments - Changes in net loss on cash flow hedges included in accumulated other comprehensive income (loss) (Details) - Interest Rate Swap - Cash Flow Hedging - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Changes in Net Gain or Loss on Cash Flow Hedges Included in Accumulated Other Comprehensive Income (Loss)
Balance at the beginning of the period	$ (1,608)	$ (14,259)	$ (8,504)	$ (16,771)
Unrealized gain (loss) recognized in other comprehensive income (loss), net of tax	1,481	(712)	6,501	(183)
Reclassification to interest expense, net of tax	1,385	1,937	3,261	3,920
Balance at the end of the period	$ 1,258	$ (13,034)	$ 1,258	$ (13,034)

Derivative Financial Instrume_5

Derivative Financial Instruments - Fair value of derivative assets and liabilities (Details) - Cash Flow Hedging - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Other current assets
Derivatives designated as cash flow hedging instruments:
Assets	$ 922	$ 0
Liabilities	0	0
Other assets
Derivatives designated as cash flow hedging instruments:
Assets	751	0
Liabilities	0	0
Accrued expenses and other current liabilities
Derivatives designated as cash flow hedging instruments:
Assets	0	0
Liabilities	0	6,425
Other liabilities
Derivatives designated as cash flow hedging instruments:
Assets	0	0
Liabilities	$ 0	$ 4,664

Share-Based Compensation (Detai

Share-Based Compensation (Details) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	May 19, 2022
Share Based Compensation
Options outstanding and exercisable (in share)	253,908		253,908
Weighted average exercise price of options exercisable (in dollars per share)	$ 12.77		$ 12.77
Average remaining contractual term of options exercisable			4 years 10 months 24 days
Stock-based compensation expense	$ 3.6	$ 3.2	$ 6.5	$ 6.4
2022 Omnibus Incentive Plan
Share Based Compensation
Shares of common stock authorized for issuance under the share-based compensation plan (in shares)					1,960,000
2019 Omnibus Incentive Plan
Share Based Compensation
Available for issuance (in shares)					402,974
Restricted Stock
Share Based Compensation
Shares outstanding (in shares)	1,519,125		1,519,125
Employee Service Based Awards
Share Based Compensation
Shares outstanding (in shares)	1,127,637		1,127,637
Weighted average grant date fair value (in dollars per share)	$ 20.64		$ 20.64
Performance-Based Stock Awards
Share Based Compensation
Shares outstanding (in shares)	391,488		391,488
Weighted average grant date fair value (in dollars per share)	$ 20.58		$ 20.58

Supplemental Executive Retire_3

Supplemental Executive Retirement Plans - Plan details and change in benefit obligation (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022 USD ($)	Jun. 30, 2021 USD ($)	Jun. 30, 2022 USD ($) payment	Jun. 30, 2021 USD ($)	Dec. 31, 2021 USD ($)
Retirement Benefits [Abstract]
Number of annual payments | payment			15
Change in Benefit Obligation
Benefit obligation at the beginning of the period	$ 16,273	$ 18,079	$ 17,935	$ 19,746
Service cost	116	123	232	246
Interest cost	100	88	199	175
Payments	(12)	(12)	(1,889)	(1,889)
Benefit obligation at the end of the period	16,477	$ 18,278	16,477	$ 18,278
Amounts Recognized in the Condensed Consolidated Balance Sheets:
Current accrued expenses and other current liabilities	1,913		1,913		$ 1,913
Non-current other liabilities	14,564		14,564		16,022
Total accrued liabilities	$ 16,477		$ 16,477		$ 17,935

Supplemental Executive Retire_4

Supplemental Executive Retirement Plans - DC SERP (Details) - USD ($) $ in Millions	Jun. 30, 2022	Dec. 31, 2021
Retirement Benefits [Abstract]
Estimated accumulated benefit obligation	$ 4.5	$ 4.8
Funded estimated accumulated benefit obligation	4.2	4.1
Unfunded estimated accumulated benefit obligation	$ 0.3	$ 0.6

Segment and Related Informati_3

Segment and Related Information - Narrative (Details)	6 Months Ended
	Jun. 30, 2022 segment
Segment Reporting [Abstract]
Number of operating segments	2

Segment and Related Informati_4

Segment and Related Information - Financial information (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Net revenue
Net revenues	$ 312,033	$ 280,819	$ 573,320	$ 518,289
Material costs	98,433	89,271	184,025	164,441
Personnel expenses	110,275	97,549	211,950	187,429
Depreciation & amortization	8,124	8,007	16,079	16,005
Income from operations	20,787	20,094	18,242	22,115
Patient Care
Net revenue
Net revenues	265,670	236,787	485,488	432,469
Material costs	82,085	71,717	153,061	131,639
Personnel expenses	93,838	83,198	180,247	158,952
Other expenses	44,426	37,445	85,122	73,586
Depreciation & amortization	4,783	4,787	9,527	9,602
Income from operations	40,538	39,640	57,531	58,690
Patient Care | Operating Segments
Net revenue
Net revenues	265,670	236,787	485,488	432,469
Material costs	71,623	62,631	131,541	114,290
Income from operations	40,538	39,640	57,531	58,690
Patient Care | Intersegment Eliminations
Net revenue
Net revenues	0	0	0	0
Material costs	10,462	9,086	21,520	17,349
Products & Services
Net revenue
Net revenues	109,796	98,932	205,940	187,725
Material costs	79,781	72,454	149,072	134,707
Personnel expenses	16,437	14,351	31,703	28,477
Other expenses	6,871	6,763	13,928	12,566
Depreciation & amortization	2,179	1,963	4,202	3,898
Income from operations	4,528	3,401	7,035	8,077
Products & Services | Operating Segments
Net revenue
Net revenues	46,363	44,032	87,832	85,820
Material costs	26,810	26,640	52,484	50,151
Income from operations	4,528	3,401	7,035	8,077
Products & Services | Intersegment Eliminations
Net revenue
Net revenues	63,433	54,900	118,108	101,905
Material costs	$ 52,971	$ 45,814	$ 96,588	$ 84,556

Segment and Related Informati_5

Segment and Related Information - Reconciliation of the reportable segments (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2021	Mar. 31, 2021	Jun. 30, 2022	Jun. 30, 2021
Segment and Related Information
Income from operations	$ 20,787		$ 20,094		$ 18,242	$ 22,115
Interest expense, net	7,524		7,152		14,909	14,492
Non-service defined benefit plan expense	160		167		320	334
Income before income taxes	13,103		12,775		3,013	7,289
Provision for income taxes	2,986		2,616		873	460
Net income	10,117	$ (7,977)	10,159	$ (3,330)	2,140	6,829
Consolidated net revenues	312,033		280,819		573,320	518,289
Consolidated material costs	98,433		89,271		184,025	164,441
Corporate & other
Segment and Related Information
Income from operations	(24,279)		(22,947)		(46,324)	(44,652)
Consolidated net revenues	0		0		0	0
Consolidating adjustments
Segment and Related Information
Consolidated net revenues	(63,433)		(54,900)		(118,108)	(101,905)
Patient Care
Segment and Related Information
Income from operations	40,538		39,640		57,531	58,690
Consolidated net revenues	265,670		236,787		485,488	432,469
Consolidated material costs	82,085		71,717		153,061	131,639
Patient Care | Operating Segments
Segment and Related Information
Income from operations	40,538		39,640		57,531	58,690
Consolidated net revenues	265,670		236,787		485,488	432,469
Consolidated material costs	71,623		62,631		131,541	114,290
Products & Services
Segment and Related Information
Income from operations	4,528		3,401		7,035	8,077
Consolidated net revenues	109,796		98,932		205,940	187,725
Consolidated material costs	79,781		72,454		149,072	134,707
Products & Services | Operating Segments
Segment and Related Information
Income from operations	4,528		3,401		7,035	8,077
Consolidated net revenues	46,363		44,032		87,832	85,820
Consolidated material costs	$ 26,810		$ 26,640		$ 52,484	$ 50,151

Subsequent Events (Details)

Subsequent Events (Details)	Jul. 21, 2022 $ / shares
Subsequent Event | Merger Agreement
Subsequent Events
Business acquisition, share price (in dollars per share)	$ 18.75