Owens & Minor (OMI) 10-Q 3 May 22 2022 Q1 Quarterly report Financial data

Cover page

Cover page - shares	3 Months Ended
	Mar. 31, 2022	Apr. 28, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2022
Document Transition Report	false
Entity File Number	1-9810
Entity Registrant Name	Owens & Minor, Inc.
Entity Incorporation, State or Country Code	VA
Entity Tax Identification Number	54-1701843
Entity Address, Address Line One	9120 Lockwood Boulevard
Entity Address, City or Town	Mechanicsville
Entity Address, State or Province	VA
Entity Address, Postal Zip Code	23116
City Area Code	804
Local Phone Number	723-7000
Title of 12(b) Security	Common Stock, $2 par value per share
Trading Symbol	OMI
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Smaller Reporting Entity	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		76,109,259
Entity Central Index Key	0000075252
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q1
Amendment Flag	false

Consolidated Statements of Oper

Consolidated Statements of Operations - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Income Statement [Abstract]
Net revenue	$ 2,406,952	$ 2,326,534
Cost of goods sold	2,033,504	1,883,783
Gross margin	373,448	442,751
Distribution, selling and administrative expenses	279,740	292,701
Acquisition-related and exit and realignment charges	33,548	5,963
Other operating income, net	(899)	(2,605)
Operating income	61,059	146,692
Interest expense, net	12,019	13,672
Loss on extinguishment of debt	0	40,433
Other expense, net	783	569
Income before income taxes	48,257	92,018
Income tax provision	8,978	22,429
Net income	$ 39,279	$ 69,589
Net income per common share:
Basic (in usd per share)	$ 0.53	$ 0.98
Diluted (in usd per share)	$ 0.52	$ 0.98

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Statement of Comprehensive Income [Abstract]
Net income	$ 39,279	$ 69,589
Other comprehensive (loss) income, net of tax:
Currency translation adjustments	(787)	(12,262)
Change in unrecognized net periodic pension costs	189	121
Change in gains and losses on derivative instruments	0	20,044
Total other comprehensive (loss) income, net of tax	(598)	7,903
Comprehensive income	$ 38,681	$ 77,492

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Current assets
Cash and cash equivalents	$ 211,298	$ 55,712
Accounts receivable, net of allowances of $20,714 and $18,003	775,779	681,564
Merchandise inventories	1,447,383	1,495,972
Other current assets	118,889	88,564
Total current assets	2,553,349	2,321,812
Property and equipment, net of accumulated depreciation of $344,569 and $334,500	586,668	317,235
Operating lease assets	278,205	194,006
Goodwill	1,657,159	390,185
Intangible assets, net	494,888	209,745
Other assets, net	137,700	103,568
Total assets	5,707,969	3,536,551
Current liabilities
Accounts payable	1,115,400	1,001,959
Accrued payroll and related liabilities	95,995	115,858
Other current liabilities	442,900	226,204
Total current liabilities	1,654,295	1,344,021
Long-term debt, excluding current portion	2,635,314	947,540
Operating lease liabilities, excluding current portion	221,612	162,241
Deferred income taxes	110,319	35,310
Other liabilities	138,807	108,938
Total liabilities	4,760,347	2,598,050
Commitments and contingencies
Equity
Common stock, par value $2 per share; authorized - 200,000 shares; issued and outstanding - 76,086 shares and 75,433 shares	152,172	150,865
Paid-in capital	409,741	440,608
Retained earnings	426,898	387,619
Accumulated other comprehensive loss	(41,189)	(40,591)
Total equity	947,622	938,501
Total liabilities and equity	$ 5,707,969	$ 3,536,551

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($) shares in Thousands, $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Accounts receivable, allowances	$ 20,714	$ 18,003
Property and equipment, accumulated depreciation	$ 344,569	$ 334,500
Common stock, par value (in usd per share)	$ 2	$ 2
Common stock, authorized (shares)	200,000	200,000
Common stock, issued (shares)	76,086	75,433
Common stock, outstanding (shares)	76,086	75,433

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Operating activities:
Net income	$ 39,279	$ 69,589
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization	24,125	22,900
Share-based compensation expense	5,403	5,182
Loss on extinguishment of debt	0	40,433
Provision for losses on accounts receivable	5,628	8,462
Deferred income tax benefit	(69)	(5,865)
Changes in operating lease right-of-use assets and lease liabilities	(462)	448
Changes in operating assets and liabilities:
Accounts receivable	(12,919)	(45,919)
Merchandise inventories	58,098	(89,393)
Accounts payable	(6,967)	18,742
Net change in other assets and liabilities	(33,165)	(1,666)
Other, net	748	2,510
Cash provided by operating activities	79,699	25,423
Investing activities:
Acquisition, net of cash acquired	(1,576,278)	0
Additions to property and equipment	(9,609)	(5,048)
Additions to computer software	(1,352)	(1,575)
Other, net	3	4
Cash used for investing activities	(1,587,236)	(6,619)
Financing activities:
Proceeds from issuance of debt	1,691,000	500,000
Borrowings (repayments) under revolving credit facility, net and accounts receivable securitization program	41,700	(21,600)
Repayments of debt	0	(523,140)
Financing costs paid	(33,744)	(11,700)
Cash dividends paid	0	(181)
Payment for termination of interest rate swaps	0	(15,434)
Other, net	(34,762)	(8,339)
Cash provided by (used for) financing activities	1,664,194	(80,394)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(669)	(2,139)
Net increase (decrease) in cash, cash equivalents and restricted cash	155,988	(63,729)
Cash, cash equivalents and restricted cash at beginning of period	72,035	134,506
Cash, cash equivalents and restricted cash at end of period	228,023	70,777
Supplemental disclosure of cash flow information:
Income taxes paid, net of refunds	4,478	898
Interest paid	$ 12,626	$ 10,255

Consolidated Statements of Chan

Consolidated Statements of Changes in Equity - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Paid-In Capital	Retained Earnings	Accumulated Other Comprehensive Loss
Beginning Balance (in shares) at Dec. 31, 2020		73,472
Beginning Balance at Dec. 31, 2020	$ 712,054	$ 146,944	$ 436,597	$ 167,022	$ (38,509)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	69,589			69,589
Other comprehensive income (loss)	7,903				7,903
Dividends declared	(434)			(434)
Share-based compensation expense, exercises and other (in shares)		1,628
Share-based compensation expense, exercises and other	(2,851)	$ 3,256	(6,107)
Ending Balance (in shares) at Mar. 31, 2021		75,100
Ending Balance at Mar. 31, 2021	$ 786,261	$ 150,200	430,490	236,177	(30,606)
Beginning Balance (in shares) at Dec. 31, 2021	75,433	75,433
Beginning Balance at Dec. 31, 2021	$ 938,501	$ 150,865	440,608	387,619	(40,591)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	39,279			39,279
Other comprehensive income (loss)	(598)				(598)
Share-based compensation expense, exercises and other (in shares)		653
Share-based compensation expense, exercises and other	$ (29,560)	$ 1,307	(30,867)
Ending Balance (in shares) at Mar. 31, 2022	76,086	76,086
Ending Balance at Mar. 31, 2022	$ 947,622	$ 152,172	$ 409,741	$ 426,898	$ (41,189)

Consolidated Statements of Ch_2

Consolidated Statements of Changes in Equity (Parenthetical)	3 Months Ended
	Mar. 31, 2021$ / shares
Statement of Stockholders' Equity [Abstract]
Dividends declared, per share (in usd per share)	$ 0.0025

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2022
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies Basis of Presentation The accompanying unaudited consolidated financial statements include the accounts of Owens & Minor, Inc. and the subsidiaries it controls (we, us, our or the Company) and contain all adjustments (which are comprised only of normal recurring accruals and use of estimates) necessary to conform with U.S. generally accepted accounting principles (GAAP). All significant intercompany accounts and transactions have been eliminated. The results of operations for interim periods are not necessarily indicative of the results expected for the full year. To better reflect how we go to market as well as certain changes to the leadership team, organizational structure, budgeting and financial reporting processes which drive changes to segment reporting, we have organized our business into two distinct segments: Products & Healthcare Services and Patient Direct. Products & Healthcare Services provides distribution, outsourced logistics and value-added services, and manufactures and sources medical surgical products through our production and kitting operations. Patient Direct expands our business along the continuum of care through delivery of disposable medical supplies sold directly to patients and home health agencies and is a leading provider of integrated home healthcare equipment and related services in the United States. Beginning with the quarter ended March 31, 2022, we now report financial results using this two segment structure and have recast prior year segment results on the same basis. On March 29, 2022, we completed the acquisition of 100% of Apria, Inc. pursuant to the Agreement and Plan of Merger dated January 7, 2022, in exchange for approximately $1.7 billion, net of cash acquired. Refer to Note 3 for additional details. Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation. Use of Estimates The preparation of consolidated financial statements in conformity with GAAP requires us to make assumptions and estimates that affect reported amounts and related disclosures. Actual results may differ from these estimates. Cash, Cash Equivalents and Restricted Cash Cash, cash equivalents and restricted cash includes cash and marketable securities with an original maturity or maturity at acquisition of three months or less. Cash, cash equivalents and restricted cash are stated at cost. Nearly all of our cash, cash equivalents and restricted cash are held in cash depository accounts in major banks in the United States, Europe, and Asia. Cash that is held by a major bank and has restrictions on its availability to us is classified as restricted cash. Restricted cash included in Other assets, net as of March 31, 2022 and December 31, 2021 primarily represents cash held in an escrow account as required by the Centers for Medicare & Medicaid Services (CMS) in conjunction with the Bundled Payments for Care Improvement (BPCI) initiatives related to wind-down costs of Fusion5. The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the accompanying consolidated balance sheets that sum to the total of those same amounts presented in the accompanying consolidated statements of cash flows. March 31, 2022 December 31, 2021 Cash and cash equivalents $ 211,298 $ 55,712 Restricted cash included in Other assets, net 16,725 16,323 Total cash, cash equivalents, and restricted cash $ 228,023 $ 72,035 Patient Equipment Patient equipment, which is included within property and equipment, net, is stated at cost less depreciation and reserves for non-recoverable and obsolete patient equipment. Patient equipment consists of medical equipment rented to patients on a month-to-month basis. Patient equipment is generally placed for rent; however, it could also be sold to customers. Once the rented equipment is returned to us, the patient equipment is assessed and repaired as necessary. Patient equipment is typically leased to subsequent patients if its condition is suitable.

Fair Value

Fair Value	3 Months Ended
	Mar. 31, 2022
Fair Value Disclosures [Abstract]
Fair Value	Fair ValueThe carrying amounts of cash and cash equivalents, accounts receivable, accounts payable, and accrued payroll and related liabilities reported in the consolidated balance sheets approximate fair value due to the short-term nature of these instruments. The carrying amount of restricted cash also approximates fair value due to its nature. The fair value of debt is estimated based on quoted market prices or dealer quotes for the identical liability when traded as an asset in an active market (Level 1) or, if quoted market prices or dealer quotes are not available, on the borrowing rates currently available for loans with similar terms, credit ratings, and average remaining maturities (Level 2). See Note 6 for the fair value of debt. The fair value of our derivative contracts are determined based on the present value of expected future cash flows considering the risks involved, including non-performance risk, and using discount rates appropriate for the respective maturities. Observable Level 2 inputs are used to determine the present value of expected future cash flows. See Note 8 for the fair value of derivatives.

Acquisition

Acquisition	3 Months Ended
	Mar. 31, 2022
Business Combination and Asset Acquisition [Abstract]
Acquisition	Acquisition On March 29, 2022 (the Acquisition Date), we completed the acquisition of 100% of Apria, Inc. (Apria) pursuant to the Agreement and Plan of Merger (Apria Acquisition) dated January 7, 2022, in exchange for approximately $1.7 billion, including $108 million owed to holders of Apria stock awards as of March 31, 2022 that was paid in April 2022, net of $144 million of cash acquired. The purchase was funded with a combination of debt and cash on hand. At the time of the Apria Acquisition, each share of Apria’s common stock was converted into the right to receive $37.50 in cash. Apria is a leading provider of integrated home healthcare equipment and related services in the United States. This business is reported as part of the Patient Direct segment. The following table presents the preliminary estimated fair value of the assets acquired and liabilities assumed recognized as of the Acquisition Date. The fair value and useful lives of tangible and intangible assets acquired have been estimated based on a review of publicly available data for transactions involving companies deemed comparable to the Company. The allocation of purchase price to assets and liabilities acquired is not yet complete, as valuations of tangible and intangible assets and liabilities are still in process. Preliminary Fair Value Currently Estimated as of Acquisition Date Assets acquired: Current assets $ 142,136 Goodwill 1,267,079 Intangible assets 295,466 Other non-current assets 371,320 Total assets 2,076,001 Liabilities assumed: Current liabilities 241,266 Noncurrent liabilities 150,128 Total liabilities 391,394 Fair value of net assets acquired, net of cash $ 1,684,607 Current assets acquired includes $89.3 million in fair value of receivables, which reflects the approximate amount contractually owed. We are amortizing the preliminary fair value of acquired intangible assets, primarily customer contracts, trade names and payor and capitated relationships, over their estimated weighted average useful lives of two Goodwill of $1.3 billion, which we assigned to our Patient Direct segment, consists largely of expected opportunities to expand into new markets and further develop a presence in the home healthcare business. None of the goodwill recognized is expected to be deductible for income tax purposes. The following table provides pro forma results of net revenue and net (loss) income for the three months ended March 31, 2022 and 2021 as if Apria was acquired on January 1, 2021. The pro forma results below are not necessarily indicative of the results that would have been if the acquisition had occurred on the dates indicated, nor are the pro forma results indicative of results which may occur in the future. Three Months Ended March 31, 2022 2021 Net revenue $ 2,684,065 $ 2,601,808 Net (loss) income $ (90,182) $ 74,133

Goodwill and Intangible Assets

Goodwill and Intangible Assets	3 Months Ended
	Mar. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Goodwill and Intangible Assets In connection with our new segment structure, which began in the first quarter of 2022, goodwill is now reported as part of Products & Healthcare Services or Patient Direct. There was no change to our underlying reporting units as part of that segment change and therefore no reallocation of goodwill. The following table summarizes the goodwill balances by segment and the changes in the carrying amount of goodwill through March 31, 2022: Products & Healthcare Services Patient Direct Consolidated Carrying amount of goodwill, December 31, 2021 $ 106,280 $ 283,905 $ 390,185 Acquisition — 1,267,079 1,267,079 Currency translation adjustments (105) — (105) Carrying amount of goodwill, March 31, 2022 $ 106,175 $ 1,550,984 $ 1,657,159 Intangible assets subject to amortization at March 31, 2022 and December 31, 2021 were as follows: March 31, 2022 December 31, 2021 Customer Tradenames Other Customer Tradenames Other Gross intangible assets $ 275,429 $ 156,937 $ 271,761 $ 275,526 $ 90,000 $ 43,189 Accumulated amortization (152,465) (35,351) (21,423) (146,168) (33,242) (19,560) Net intangible assets $ 122,964 $ 121,586 $ 250,338 $ 129,358 $ 56,758 $ 23,629 Weighted average useful life 10 years 11 years 5 years 10 years 11 years 8 years At March 31, 2022 and December 31, 2021, $158 million and $164 million in net intangible assets were held in the Products & Healthcare Services segment and $337 million and $45.7 million were held in the Patient Direct segment. Amortization expense for intangible assets was $10.3 million and $10.0 million for the three months ended March 31, 2022 and 2021. At March 31, 2022, other intangibles includes preliminary estimated fair values of payor relationships, customer list and other intangible assets acquired as part of the Apria Acquisition. Based on the current carrying value of intangible assets subject to amortization, estimated amortization expense is approximately $96 million for the remainder of 2022, $126 million for 2023, $67 million for 2024, $42 million for 2025, $41 million for 2026 and $38 million for 2027.

Exit and Realignment Costs

Exit and Realignment Costs	3 Months Ended
	Mar. 31, 2022
Restructuring and Related Activities [Abstract]
Exit and Realignment Costs	Exit and Realignment CostsWe periodically incur exit and realignment and other charges associated with optimizing our operations which includes the consolidation of certain distribution and outsourced logistics centers, administrative offices and warehouses, our client engagement center and IT restructuring charges. These charges also include costs associated with our strategic organizational realignment which include leadership reorganization costs, certain professional fees, and costs to streamline administrative functions and processes and divestiture related costs. Exit and realignment charges by segment for the three months ended March 31, 2022 and 2021 were as follows: Three Months Ended 2022 2021 Products & Healthcare Services $ 1,199 $ 5,963 Patient Direct 483 — Total exit and realignment charges $ 1,682 $ 5,963 The following table summarizes the activity related to exit and realignment cost accruals through March 31, 2022 and 2021: Total Accrued exit and realignment costs, December 31, 2021 $ 8,306 Provision for exit and realignment activities: Severance 811 Other 871 Cash payments (6,903) Accrued exit and realignment costs, March 31, 2022 $ 3,085 Accrued exit and realignment costs, December 31, 2020 $ 3,146 Provision for exit and realignment activities: Information system restructuring costs 1,029 Lease obligations 347 Other 781 Cash payments (2,915) Accrued exit and realignment costs, March 31, 2021 $ 2,388 In addition to the exit and realignment accruals in the preceding table, we also incurred $3.8 million of costs that were expensed as incurred for the three months ended March 31, 2021, including $3.2 million related to an increase in reserves associated with certain retained assets of Fusion5, $0.5 million in impairment charges related to our client engagement center, and $0.1 million in other asset charges. Acquisition-related charges within acquisition-related and exit and realignment charges presented in our consolidated statements of operations were $31.9 million for the three months ended March 31, 2022, which consisted primarily of costs related to the Apria acquisition. There were no acquisition-related charges included within acquisition-related and exit and realignment charges presented in our consolidated statements of operations for the three months ended March 31, 2021.

Debt

Debt	3 Months Ended
	Mar. 31, 2022
Debt Disclosure [Abstract]
Debt	Debt Debt consists of the following: March 31, 2022 December 31, 2021 Carrying Estimated Carrying Estimated Receivables Securitization Program $ 226,169 $ 230,000 $ 197,026 $ 200,000 4.375% Senior Notes, due December 2024 245,286 250,068 245,086 263,263 Revolver 11,700 11,700 — — Term Loan A 489,848 500,000 — — 4.500% Senior Notes, due March 2029 491,887 478,415 491,656 515,225 Term Loan B 579,080 589,878 — — 6.625% Senior Notes, due March 2030 583,930 617,484 — — Finance leases and other 15,615 15,615 15,809 15,809 Total debt 2,643,515 2,693,160 949,577 994,297 Less current maturities (8,201) (8,100) (2,037) (2,037) Long-term debt $ 2,635,314 $ 2,685,060 $ 947,540 $ 992,260 We have $246 million, excluding deferred financing costs and third party fees, of 4.375% senior notes due in 2024 (the 2024 Notes), with interest payable semi-annually. The 2024 Notes were sold at 99.6% of the principal amount with an effective yield of 4.422%. We have the option to redeem the 2024 Notes in part or in whole prior to maturity at a redemption price equal to the greater of 100% of the principal amount or the present value of the remaining scheduled payments discounted at the applicable Benchmark Treasury Rate (as defined) plus 30 basis points. In March 2021, we issued $500 million, excluding deferred financing costs and third party fees, of 4.500% senior unsecured notes due in 2029 (the 2029 Unsecured Notes), with interest payable semi-annually (the Notes Offering). The 2029 Unsecured Notes were sold at 100% of the principal amount with an effective yield of 4.500%. We may redeem all or part of the 2029 Unsecured Notes prior to March 31, 2024, at a price equal to 100% of the principal amount of the 2029 Unsecured Notes redeemed, plus accrued and unpaid interest, if any, to, but not including, the redemption date, plus a “make-whole” premium, as described in the Indenture dated March 10, 2021 (the Indenture). On or after March 31, 2024, we may redeem all or part of the 2029 Unsecured Notes at the applicable redemption prices described in the Indenture, plus accrued and unpaid interest, if any, to, but not including, the redemption date. We may also redeem up to 40% of the aggregate principal amount of the 2029 Unsecured Notes at any time prior to March 31, 2024, at a redemption price equal to 104.5% with an amount equal to or less than the net cash proceeds from certain equity offerings, plus accrued and unpaid interest, if any, to, but excluding, the redemption date. On March 29, 2022, we completed the sale of $600 million in aggregate principal amount of our 6.625% senior notes due 2030 (the 2030 Unsecured Notes), with interest payable semi-annually. The 2030 Unsecured Notes were sold at 100% of the principal amount with an effective yield of 6.625%. We may redeem all or part of the 2030 Unsecured Notes, prior to April 1, 2025, at a price equal to 100% of the principal amount of the 2030 Unsecured Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date, plus a “make-whole” premium, as described in the New Indenture. From and after April 1, 2025, we may redeem all or part of the 2030 Unsecured Notes at the applicable redemption prices described in the New Indenture, plus accrued and unpaid interest, if any, to, but excluding, the redemption date. We may also redeem up to 40% of the aggregate principal amount of 2030 Unsecured Notes at any time prior to April 1, 2025, at a redemption price equal to 106.625% with an amount equal to or less than the net cash proceeds from certain equity offerings, plus accrued and unpaid interest, if any, to, but excluding, the redemption date. The 2029 Unsecured Notes and 2030 Unsecured Notes will be effectively subordinated to any of our secured indebtedness, including indebtedness under the credit agreements. On March 29, 2022, we entered into a term loan credit agreement with an administrative agent and collateral agent and a syndicate of financial institutions, as lenders (the Credit Agreement) that provides for two new credit facilities (i) a $500 million Term Loan A facility (the Term Loan A), and (ii) a $600 million Term Loan B facility (the Term Loan B). The interest rate on the Term Loan A is based on either the Term SOFR or the Base Rate plus an Applicable Rate which varies depending on the current Debt Ratings or Total Leverage Ratio, determined as to whichever shall result in more favorable pricing to the Borrowers (each as defined in the Credit Agreement). The interest rate on the Term Loan B is based on either the Term SOFR or the Base Rate plus an Applicable Rate. The Term Loan A will mature in March 2027 and the Term Loan B will mature in March 2029. On March 29, 2022, we entered into an amendment to our revolving credit agreement, dated as of March 10, 2021 with an administrative agent and collateral agent and a syndicate of financial institutions, as lenders (Revolving Credit Agreement). The amendment will (i) increase the aggregate revolving credit commitments under the Revolving Credit Agreement by $150 million, to an aggregate amount of $450 million and (ii) replace the Eurocurrency Rate with the Adjusted Term SOFR Rate (each as defined in the Revolving Credit Agreement). The Revolving Credit Agreement matures in March 2027. At March 31, 2022, we had borrowings of $11.7 million and letters of credit of $28.0 million under our revolving credit facility. At December 31, 2021, we had no borrowings and letters of credit of $9.4 million outstanding under our revolving credit facilities. At March 31, 2022 and December 31, 2021, we had $410 million and $291 million available for borrowing. We also had letters of credit and bank guarantees, which were issued outside of the Revolving Credit Facility for $2.1 million and $2.2 million as of March 31, 2022 and December 31, 2021, which supports certain leased facilities as well as other normal business activities in the United States and Europe. We entered into a Security and Pledge Agreement (the Security Agreement), dated March 10, 2021 and amended March 29, 2022, pursuant to which we granted collateral on behalf of the holders of the 2024 Notes, and the parties secured under the credit agreements (the Secured Parties) including first priority liens and security interests in (a) all present and future shares of capital stock owned by the Credit Parties (as defined) in the Credit Parties’ present and future subsidiaries, subject to certain customary exceptions, and (b) all present and future personal property and assets of the Credit Parties, subject to certain exceptions. On March 29, 2022, we entered into an amendment to our accounts receivable securitization program (the Receivables Financing Agreement). Pursuant to the amended Receivables Financing Agreement, the aggregate principal amount of the loans made by the Lenders (as defined) will not exceed $450 million outstanding at any time. The interest rate under the Receivables Financing Agreement is based on a spread over a benchmark SOFR rate (as described in the Fourth Amendment to the Receivables Financing Agreement). Under the Receivables Financing Agreement, certain of our subsidiaries sell substantially all of their accounts receivable balances to our wholly owned special purpose entity, O&M Funding LLC. The Receivables Financing Agreement matures in March 2025. The Revolving Credit Agreement, Term Loan A, Term Loan B, Receivables Financing Agreement, 2024 Notes, 2029 Unsecured Notes, and 2030 Unsecured Notes contain cross-default provisions which could result in the acceleration of payments due in the event of default of any of the related agreements. The terms of the credit agreements also require us to maintain ratios for leverage and interest coverage, including on a pro forma basis in the event of an acquisition or divestiture. We were in compliance with our debt covenants at March 31, 2022. As of March 31, 2022, scheduled future principal payments of debt, excluding finance leases and other, were $4.5 million in 2022, $15.4 million in 2023, $274 million in 2024, $270 million in 2025, $43.5 million due in 2026, $415 million in 2027, $6.0 million due in 2028, $1.1 billion in 2029, and $600 million in 2030. Current maturities at March 31, 2022 include $6.0 million in principal payments on our Term Loan B and $2.2 million in current portion of finance leases.

Retirement Plans

Retirement Plans	3 Months Ended
	Mar. 31, 2022
Retirement Benefits [Abstract]
Retirement Plans	Retirement Plans We have a frozen noncontributory, unfunded retirement plan for certain retirees in the United States (U.S. Retirement Plan). As of March 31, 2022 and December 31, 2021, the accumulated benefit obligation of the U.S. Retirement Plan was $49.6 million and $50.2 million. Certain of our foreign subsidiaries also have defined benefit pension plans The components of net periodic benefit cost for the three months ended March 31, 2022 and 2021 were as follows: Three Months Ended 2022 2021 Service cost $ 633 $ 704 Interest cost 523 446 Recognized net actuarial loss 267 353 Net periodic benefit cost $ 1,423 $ 1,503

Derivatives

Derivatives	3 Months Ended
	Mar. 31, 2022
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivatives	Derivatives We are directly and indirectly affected by changes in foreign currency, which may adversely impact our financial performance and are referred to as “market risks.” When deemed appropriate, we use derivatives as a risk management tool to mitigate the potential impact of certain market risks. We do not enter into derivative financial instruments for trading purposes. We enter into foreign currency contracts to manage our foreign exchange exposure related to certain balance sheet items that do not meet the requirements for hedge accounting. These derivative instruments are adjusted to fair value at the end of each period through earnings. The gain or loss recorded on these instruments is substantially offset by the remeasurement adjustment on the foreign currency denominated asset or liability. We determine the fair value of our foreign currency derivatives based on observable market-based inputs or unobservable inputs that are corroborated by market data. We do not view the fair value of our derivatives in isolation, but rather in relation to the fair values or cash flows of the underlying exposure. All derivatives are carried at fair value in our consolidated balance sheets in other current assets and other current liabilities. We consider the risk of counterparty default to be minimal. We report cash flows from our hedging instruments in the same cash flow statement category as the hedged items. In April 2022, in order to mitigate the risk of increases in benchmark rates, we entered into an interest rate swap agreement whereby we agree to exchange with the counterparty, at specified intervals, the difference between fixed and variable amounts calculated by reference to the notional amount. The following table summarizes the terms and fair value of our outstanding derivative financial instruments as of March 31, 2022: Derivative Assets Derivative Liabilities Notional Amount Maturity Date Classification Fair Value Classification Fair Value Economic (non-designated) hedges Foreign currency contracts $ 20,000 April 2022 Other current assets $ 127 Other current liabilities $ — In March 2021, we terminated the remaining $300 million in notional value of interest rate swaps concurrent with the debt financing transaction. The remaining balance of the fair value adjustments of $25.1 million, which related to these terminated interest rate swaps, within Accumulated other comprehensive loss was reclassified to Loss on extinguishment of debt within our consolidated statements of operations for the three months ended March 31, 2021. The following table summarizes the terms and fair value of our outstanding derivative financial instruments as of December 31, 2021: Derivative Assets Derivative Liabilities Notional Amount Maturity Date Classification Fair Value Classification Fair Value Economic (non-designated) hedges Foreign currency contracts $ 9,700 January 2022 Other current assets $ 81 Other current liabilities $ — The following table summarizes the effect of cash flow hedge accounting on our consolidated statements of operations for the three months ended March 31, 2021: Amount of Gain Recognized in Other Comprehensive Income Location of Loss Reclassified from Accumulated Other Comprehensive Loss into Income Total Amount of Expense Line Items Presented in the Consolidated Statement of Operations in Which the Effects are Recorded Amount of Loss Reclassified from Accumulated Other Comprehensive Loss into Income Interest rate swaps $ 2,426 Loss on extinguishment of debt $ (40,433) $ (25,518) The amount of ineffectiveness associated with these contracts was immaterial for the period presented. For the three months ended March 31, 2022 and 2021, we recognized losses of $0.1 million and $1.0 million associated with our economic (non-designated) foreign currency contracts. We recorded the change in fair value of derivative instruments and the remeasurement adjustment of the foreign currency denominated asset or liability in other operating income, net for our foreign exchange contracts.

Leases

Leases	3 Months Ended
	Mar. 31, 2022
Leases [Abstract]
Leases	Leases The components of lease expense were as follows: Three Months Ended Classification 2022 2021 Operating lease cost DS&A Expenses $ 16,100 $ 14,086 Finance lease cost: Amortization of lease assets DS&A Expenses 331 239 Interest on lease liabilities Interest expense, net 307 307 Total finance lease cost 638 546 Short-term lease cost DS&A Expenses 116 259 Variable lease cost DS&A Expenses 4,729 4,317 Total lease cost $ 21,583 $ 19,208 Variable lease cost consists primarily of taxes, insurance, and common area or other maintenance costs for our leased facilities which are paid as incurred. Supplemental balance sheet information is as follows: Classification March 31, December 31, 2021 Assets: Operating lease assets Operating lease assets $ 278,205 $ 194,006 Finance lease assets Property and equipment, net 8,728 8,896 Total lease assets $ 286,933 $ 202,902 Liabilities: Current Operating Other current liabilities $ 67,388 $ 41,817 Finance Other current liabilities 2,202 2,037 Noncurrent Operating Operating lease liabilities, excluding current portion 221,612 162,241 Finance Long-term debt, excluding current portion 11,116 11,314 Total lease liabilities $ 302,318 $ 217,409 The gross value recorded under finance leases was $20.7 million and $20.6 million with associated accumulated amortization of $12.0 million and $11.7 million as of March 31, 2022 and December 31, 2021. Operating lease assets include $69.1 million in right-of-use assets and $70.3 million of operating lease liabilities acquired as a result of the Apria Acquisition, as of March 31, 2022. Other information related to leases was as follows: Three Months Ended March 31, 2022 2021 Supplemental cash flow information Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating and finance leases $ 15,965 $ 13,848 Financing cash flows from finance leases $ 397 $ 234 Right-of-use assets obtained in exchange for new operating and finance lease liabilities $ 27,300 $ 23,986 Weighted average remaining lease term (years) Operating leases 4.6 5.4 Finance leases 6.2 7.7 Weighted average discount rate Operating leases 7.0% 8.8% Finance leases 10.7% 12.2% Maturities of lease liabilities as of March 31, 2022 were as follows: Operating Leases Finance Leases Total 2022 $ 69,487 $ 2,094 $ 71,581 2023 83,056 2,750 85,806 2024 69,605 2,697 72,302 2025 49,727 2,631 52,358 2026 33,658 2,248 35,906 Thereafter 44,571 4,538 49,109 Total lease payments 350,104 16,958 367,062 Less: Interest (61,104) (3,640) (64,744) Present value of lease liabilities $ 289,000 $ 13,318 $ 302,318
Leases	Leases The components of lease expense were as follows: Three Months Ended Classification 2022 2021 Operating lease cost DS&A Expenses $ 16,100 $ 14,086 Finance lease cost: Amortization of lease assets DS&A Expenses 331 239 Interest on lease liabilities Interest expense, net 307 307 Total finance lease cost 638 546 Short-term lease cost DS&A Expenses 116 259 Variable lease cost DS&A Expenses 4,729 4,317 Total lease cost $ 21,583 $ 19,208 Variable lease cost consists primarily of taxes, insurance, and common area or other maintenance costs for our leased facilities which are paid as incurred. Supplemental balance sheet information is as follows: Classification March 31, December 31, 2021 Assets: Operating lease assets Operating lease assets $ 278,205 $ 194,006 Finance lease assets Property and equipment, net 8,728 8,896 Total lease assets $ 286,933 $ 202,902 Liabilities: Current Operating Other current liabilities $ 67,388 $ 41,817 Finance Other current liabilities 2,202 2,037 Noncurrent Operating Operating lease liabilities, excluding current portion 221,612 162,241 Finance Long-term debt, excluding current portion 11,116 11,314 Total lease liabilities $ 302,318 $ 217,409 The gross value recorded under finance leases was $20.7 million and $20.6 million with associated accumulated amortization of $12.0 million and $11.7 million as of March 31, 2022 and December 31, 2021. Operating lease assets include $69.1 million in right-of-use assets and $70.3 million of operating lease liabilities acquired as a result of the Apria Acquisition, as of March 31, 2022. Other information related to leases was as follows: Three Months Ended March 31, 2022 2021 Supplemental cash flow information Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating and finance leases $ 15,965 $ 13,848 Financing cash flows from finance leases $ 397 $ 234 Right-of-use assets obtained in exchange for new operating and finance lease liabilities $ 27,300 $ 23,986 Weighted average remaining lease term (years) Operating leases 4.6 5.4 Finance leases 6.2 7.7 Weighted average discount rate Operating leases 7.0% 8.8% Finance leases 10.7% 12.2% Maturities of lease liabilities as of March 31, 2022 were as follows: Operating Leases Finance Leases Total 2022 $ 69,487 $ 2,094 $ 71,581 2023 83,056 2,750 85,806 2024 69,605 2,697 72,302 2025 49,727 2,631 52,358 2026 33,658 2,248 35,906 Thereafter 44,571 4,538 49,109 Total lease payments 350,104 16,958 367,062 Less: Interest (61,104) (3,640) (64,744) Present value of lease liabilities $ 289,000 $ 13,318 $ 302,318

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2022
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The effective tax rate was 18.6% for the three months ended March 31 2022, compared to 24.4% in the same quarter of 2021. The change in these rates resulted primarily from the mixture of income and losses in jurisdictions in which we operate and the incremental income tax benefit associated with the vesting of restricted stock recorded in the first quarter of 2022. The liability for unrecognized tax benefits was $21.6 million at March 31, 2022 and $21.4 million at December 31, 2021. Included in the liability at March 31, 2022 and December 31, 2021 were $2.7 million of tax positions for which ultimate deductibility is highly certain but for which there is uncertainty about the timing of such deductibility. On August 26, 2020, we received a Notice of Proposed Adjustment (NOPA) from the Internal Revenue Service (IRS) regarding our 2015 and 2016 consolidated income tax returns. On June 30, 2021, we received a NOPA from the IRS regarding our 2017 and 2018 consolidated income tax returns. Within the NOPAs, the IRS has asserted that our taxable income for the aforementioned years should be higher based on their assessment of the appropriate amount of taxable income that we should report in the United States in connection with our sourcing of products by our foreign subsidiaries for sale in the United States by our domestic subsidiaries. Our amount of taxable income in the United States is based on our transfer pricing methodology, which has been consistently applied through the current date. We strongly disagree with the IRS position and will pursue all available administrative and judicial remedies, including those available under the U.S. - Ireland Income Tax Treaty to alleviate double taxation. We regularly assess the likelihood of adverse outcomes resulting from examinations such as this to determine the adequacy of our tax reserves. We believe that we have adequately reserved for this matter and that the final adjudication of this matter will not have a material impact on our consolidated financial position, results of operations or cash flows. However, the ultimate outcome of disputes of this nature is uncertain, and if the IRS were to prevail on its assertions, the additional tax,

Net Income per Common Share

Net Income per Common Share	3 Months Ended
	Mar. 31, 2022
Earnings Per Share [Abstract]
Net Income per Common Share	Net Income per Common Share The following summarizes the calculation of net income per common share attributable to common shareholders for the three months ended March 31, 2022 and 2021: Three Months Ended (in thousands, except per share data) 2022 2021 Net income $ 39,279 $ 69,589 Weighted average shares outstanding - basic 73,643 70,834 Dilutive shares 2,376 104 Weighted average shares outstanding - diluted 76,019 70,938 Net income per common share: Basic $ 0.53 $ 0.98 Diluted $ 0.52 $ 0.98

Shareholders' Equity

Shareholders' Equity	3 Months Ended
	Mar. 31, 2022
Equity [Abstract]
Shareholders' Equity	Shareholders' EquityIn May 2020, we entered into an equity distribution agreement, pursuant to which we may offer and sell, from time to time, shares of our common stock having an aggregate offering price of up to $50.0 million. We intend to use the net proceeds from the sale of our securities offered by this program for the repayment of indebtedness and/or for general corporate and working capital purposes. As of March 31, 2022, no shares were issued and $50.0 million of common stock remained available under the at-the-market equity financing program.

Accumulated Other Comprehensive

Accumulated Other Comprehensive Loss	3 Months Ended
	Mar. 31, 2022
Equity [Abstract]
Accumulated Other Comprehensive Loss	Accumulated Other Comprehensive Loss The following table shows the changes in accumulated other comprehensive loss by component for the three months ended March 31, 2022 and 2021: Retirement Plans Currency Derivatives Total Accumulated other comprehensive loss, December 31, 2021 $ (14,597) $ (25,994) $ — $ (40,591) Other comprehensive loss before reclassifications — (787) — (787) Income tax — — — — Other comprehensive loss before reclassifications, net of tax — (787) — (787) Amounts reclassified from accumulated other comprehensive loss 249 — — 249 Income tax (60) — — (60) Amounts reclassified from accumulated other comprehensive loss, net of tax 189 — — 189 Other comprehensive income (loss) 189 (787) — (598) Accumulated other comprehensive loss, March 31, 2022 $ (14,408) $ (26,781) $ — $ (41,189) Retirement Plans Currency Translation Adjustments Derivatives Total Accumulated other comprehensive loss, December 31, 2020 $ (18,447) $ (18) $ (20,044) $ (38,509) Other comprehensive income (loss) before reclassifications — (12,262) 2,426 (9,836) Income tax — — (611) (611) Other comprehensive income (loss) before reclassifications, net of tax — (12,262) 1,815 (10,447) Amounts reclassified from accumulated other comprehensive loss 156 — 25,518 25,674 Income tax (35) — (7,289) (7,324) Amounts reclassified from accumulated other comprehensive loss, net of tax 121 — 18,229 18,350 Other comprehensive income (loss) 121 (12,262) 20,044 7,903 Accumulated other comprehensive loss, March 31, 2021 $ (18,326) $ (12,280) $ — $ (30,606)

Segment Information

Segment Information	3 Months Ended
	Mar. 31, 2022
Segment Reporting [Abstract]
Segment Information	Segment Information We periodically evaluate our application of accounting guidance for reportable segments and disclose information about reportable segments based on the way management organizes the enterprise for making operating decisions and assessing performance. We report our business under two segments: Products & Healthcare Services and Patient Direct. The Products & Healthcare Services segment includes our United States distribution business (Medical Distribution), outsourced logistics and value-added services business, and Global Products which manufactures and sources medical surgical products through our production and kitting operations. The Patient Direct segment includes our home healthcare businesses (Byram and Apria). We evaluate the performance of our segments based on their operating income excluding intangible amortization and acquisition-related and exit and realignment charges that, either as a result of their nature or size, would not be expected to occur as part of our normal business operations on a regular basis. Segment assets exclude inter-segment account balances as we believe their inclusion would be misleading and not meaningful. The following tables present financial information by segment: Three Months Ended 2022 2021 Net revenue: Products & Healthcare Services $ 2,134,041 $ 2,109,445 Patient Direct 272,911 217,089 Consolidated net revenue $ 2,406,952 $ 2,326,534 Operating income: Products & Healthcare Services $ 89,083 $ 150,418 Patient Direct 15,793 12,263 Intangible amortization (10,269) (10,026) Acquisition-related and exit and realignment charges (33,548) (5,963) Consolidated operating income $ 61,059 $ 146,692 Depreciation and amortization: Products & Healthcare Services $ 18,994 $ 19,160 Patient Direct 5,131 3,740 Consolidated depreciation and amortization $ 24,125 $ 22,900 Capital expenditures: Products & Healthcare Services $ 10,643 $ 6,464 Patient Direct 318 159 Consolidated capital expenditures $ 10,961 $ 6,623 March 31, 2022 December 31, 2021 Total assets: Products & Healthcare Services $ 2,960,748 $ 3,012,303 Patient Direct 2,535,923 468,536 Segment assets 5,496,671 3,480,839 Cash and cash equivalents 211,298 55,712 Consolidated total assets $ 5,707,969 $ 3,536,551 The following table presents net revenue by geographic area, which were attributed based on the location from which we ship products or provide services. Three Months Ended March 31, 2022 2021 Net revenue: United States $ 2,262,019 $ 2,182,755 International 144,933 143,779 Consolidated net revenue $ 2,406,952 $ 2,326,534

Recent Accounting Pronouncement

Recent Accounting Pronouncements	3 Months Ended
	Mar. 31, 2022
Accounting Policies [Abstract]
Recent Accounting Pronouncements	Recent Accounting PronouncementsOn June 16, 2016, the FASB issued ASU No. 2016-13 Financial Instruments - Credit Losses, Measurement of Credit Losses on Financial Instruments, which changes the way entities measure credit losses for most financial assets and certain other instruments that are not measured at fair value through net earnings. This standard will be effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. Early adoption is permitted. We are still evaluating the impact the adoption of ASU No. 2016-13 will have on our consolidated financial statements and related disclosures; however, we do not expect this to have a material impact. Subsequent to the issuance of ASU No. 2016-13, the FASB issued ASU 2018-19, Codification Improvements to Topic 326, Financial Instruments - Credit Losses and ASU No. 2019-05, Financial Instruments - Credit Losses (Topic 326) Targeted Transition Relief. These ASUs do not change the core principle of the guidance in ASU No. 2016-13. Instead these amendments are intended to clarify and improve operability of certain topics included within the credit losses standard. These ASUs will have the same effective date and transition requirements as ASU No. 2016-13. 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, which 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 apply only to contracts, hedging relationships, and other transactions that reference LIBOR or another reference rate expected to be discontinued because of reference rate reform. The amendments are effective for all entities as of March 12, 2020 through December 31, 2022. Our material debt agreements no longer reference LIBOR as a benchmark rate. The transition did not have a material impact on our consolidated financial statements. In October 2020, the FASB issued ASU No. 2020-10, Codification Improvements, to improve consistency by amending the FASB Accounting Standards Codification (the Codification) to include all disclosure guidance in the appropriate disclosure sections. This ASU also clarifies application of various provisions in the Codification by amending and adding new headings, cross referencing to other guidance, and refining or correcting terminology. The amendments in this ASU do not change GAAP and, therefore, are not expected to result in a significant change in practice. We adopted ASU No. 2020-10 effective beginning January 1, 2021. Its adoption did not have a material impact on our consolidated financial statements. In October 2021, the FASB issued ASU No. 2021-08, Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers. ASU 2021-08 requires the company acquiring contract assets and contract liabilities obtained in a business combination to recognize and measure them in accordance with ASC 606, Revenue from Contracts with Customers. At the acquisition date, the company acquiring the business should record related revenue, as if it had originated the contract. Before the update such amounts were recognized by the acquiring company at fair value. The amendments in this ASU are effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. Early adoption is permitted, including in interim periods, for any financial statements that have not yet been issued. We adopted ASU 2021-08 prospectively, effective beginning January 1, 2022. Its adoption did not have a material impact on our consolidated financial statements. In November 2021, the FASB issued ASU 2021-10, Government Assistance (Topic 832): Disclosures by Business Entities about Government Assistance, which requires certain annual disclosures about transactions with a government that are accounted for by applying a grant or contribution accounting model by analogy. We adopted ASU No. 2021-10 effective beginning January 1, 2022. Its adoption did not have a material impact on our consolidated financial statements.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2022
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying unaudited consolidated financial statements include the accounts of Owens & Minor, Inc. and the subsidiaries it controls (we, us, our or the Company) and contain all adjustments (which are comprised only of normal recurring accruals and use of estimates) necessary to conform with U.S. generally accepted accounting principles (GAAP). All significant intercompany accounts and transactions have been eliminated. The results of operations for interim periods are not necessarily indicative of the results expected for the full year. To better reflect how we go to market as well as certain changes to the leadership team, organizational structure, budgeting and financial reporting processes which drive changes to segment reporting, we have organized our business into two distinct segments: Products & Healthcare Services and Patient Direct. Products & Healthcare Services provides distribution, outsourced logistics and value-added services, and manufactures and sources medical surgical products through our production and kitting operations. Patient Direct expands our business along the continuum of care through delivery of disposable medical supplies sold directly to patients and home health agencies and is a leading provider of integrated home healthcare equipment and related services in the United States. Beginning with the quarter ended March 31, 2022, we now report financial results using this two segment structure and have recast prior year segment results on the same basis.
Reclassifications	Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation.
Use of Estimates	Use of Estimates The preparation of consolidated financial statements in conformity with GAAP requires us to make assumptions and estimates that affect reported amounts and related disclosures. Actual results may differ from these estimates.
Cash, Cash Equivalents and Restricted Cash	Cash, Cash Equivalents and Restricted CashCash, cash equivalents and restricted cash includes cash and marketable securities with an original maturity or maturity at acquisition of three months or less. Cash, cash equivalents and restricted cash are stated at cost. Nearly all of our cash, cash equivalents and restricted cash are held in cash depository accounts in major banks in the United States, Europe, and Asia. Cash that is held by a major bank and has restrictions on its availability to us is classified as restricted cash. Restricted cash included in Other assets, net as of March 31, 2022 and December 31, 2021 primarily represents cash held in an escrow account as required by the Centers for Medicare & Medicaid Services (CMS) in conjunction with the Bundled Payments for Care Improvement (BPCI) initiatives related to wind-down costs of Fusion5.
Patient Equipment	Patient Equipment Patient equipment, which is included within property and equipment, net, is stated at cost less depreciation and reserves for non-recoverable and obsolete patient equipment. Patient equipment consists of medical equipment rented to patients on a month-to-month basis. Patient equipment is generally placed for rent; however, it could also be sold to customers. Once the rented equipment is returned to us, the patient equipment is assessed and repaired as necessary. Patient equipment is typically leased to subsequent patients if its condition is suitable.
Fair Value	The carrying amounts of cash and cash equivalents, accounts receivable, accounts payable, and accrued payroll and related liabilities reported in the consolidated balance sheets approximate fair value due to the short-term nature of these instruments. The carrying amount of restricted cash also approximates fair value due to its nature. The fair value of debt is estimated based on quoted market prices or dealer quotes for the identical liability when traded as an asset in an active market (Level 1) or, if quoted market prices or dealer quotes are not available, on the borrowing rates currently available for loans with similar terms, credit ratings, and average remaining maturities (Level 2). See Note 6 for the fair value of debt. The fair value of our derivative contracts are determined based on the present value of expected future cash flows considering the risks involved, including non-performance risk, and using discount rates appropriate for the respective maturities. Observable Level 2 inputs are used to determine the present value of expected future cash flows. See Note 8 for the fair value of derivatives.
Segment Information	We periodically evaluate our application of accounting guidance for reportable segments and disclose information about reportable segments based on the way management organizes the enterprise for making operating decisions and assessing performance. We report our business under two segments: Products & Healthcare Services and Patient Direct. The Products & Healthcare Services segment includes our United States distribution business (Medical Distribution), outsourced logistics and value-added services business, and Global Products which manufactures and sources medical surgical products through our production and kitting operations. The Patient Direct segment includes our home healthcare businesses (Byram and Apria). We evaluate the performance of our segments based on their operating income excluding intangible amortization and acquisition-related and exit and realignment charges that, either as a result of their nature or size, would not be expected to occur as part of our normal business operations on a regular basis. Segment assets exclude inter-segment account balances as we believe their inclusion would be misleading and not meaningful.
Recent Accounting Pronouncements	On June 16, 2016, the FASB issued ASU No. 2016-13 Financial Instruments - Credit Losses, Measurement of Credit Losses on Financial Instruments, which changes the way entities measure credit losses for most financial assets and certain other instruments that are not measured at fair value through net earnings. This standard will be effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. Early adoption is permitted. We are still evaluating the impact the adoption of ASU No. 2016-13 will have on our consolidated financial statements and related disclosures; however, we do not expect this to have a material impact. Subsequent to the issuance of ASU No. 2016-13, the FASB issued ASU 2018-19, Codification Improvements to Topic 326, Financial Instruments - Credit Losses and ASU No. 2019-05, Financial Instruments - Credit Losses (Topic 326) Targeted Transition Relief. These ASUs do not change the core principle of the guidance in ASU No. 2016-13. Instead these amendments are intended to clarify and improve operability of certain topics included within the credit losses standard. These ASUs will have the same effective date and transition requirements as ASU No. 2016-13. 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, which 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 apply only to contracts, hedging relationships, and other transactions that reference LIBOR or another reference rate expected to be discontinued because of reference rate reform. The amendments are effective for all entities as of March 12, 2020 through December 31, 2022. Our material debt agreements no longer reference LIBOR as a benchmark rate. The transition did not have a material impact on our consolidated financial statements. In October 2020, the FASB issued ASU No. 2020-10, Codification Improvements, to improve consistency by amending the FASB Accounting Standards Codification (the Codification) to include all disclosure guidance in the appropriate disclosure sections. This ASU also clarifies application of various provisions in the Codification by amending and adding new headings, cross referencing to other guidance, and refining or correcting terminology. The amendments in this ASU do not change GAAP and, therefore, are not expected to result in a significant change in practice. We adopted ASU No. 2020-10 effective beginning January 1, 2021. Its adoption did not have a material impact on our consolidated financial statements. In October 2021, the FASB issued ASU No. 2021-08, Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers. ASU 2021-08 requires the company acquiring contract assets and contract liabilities obtained in a business combination to recognize and measure them in accordance with ASC 606, Revenue from Contracts with Customers. At the acquisition date, the company acquiring the business should record related revenue, as if it had originated the contract. Before the update such amounts were recognized by the acquiring company at fair value. The amendments in this ASU are effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. Early adoption is permitted, including in interim periods, for any financial statements that have not yet been issued. We adopted ASU 2021-08 prospectively, effective beginning January 1, 2022. Its adoption did not have a material impact on our consolidated financial statements. In November 2021, the FASB issued ASU 2021-10, Government Assistance (Topic 832): Disclosures by Business Entities about Government Assistance, which requires certain annual disclosures about transactions with a government that are accounted for by applying a grant or contribution accounting model by analogy. We adopted ASU No. 2021-10 effective beginning January 1, 2022. Its adoption did not have a material impact on our consolidated financial statements.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2022
Accounting Policies [Abstract]
Schedule of Cash and Cash Equivalents	The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the accompanying consolidated balance sheets that sum to the total of those same amounts presented in the accompanying consolidated statements of cash flows. March 31, 2022 December 31, 2021 Cash and cash equivalents $ 211,298 $ 55,712 Restricted cash included in Other assets, net 16,725 16,323 Total cash, cash equivalents, and restricted cash $ 228,023 $ 72,035
Schedule of Restrictions on Cash and Cash Equivalents	The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the accompanying consolidated balance sheets that sum to the total of those same amounts presented in the accompanying consolidated statements of cash flows. March 31, 2022 December 31, 2021 Cash and cash equivalents $ 211,298 $ 55,712 Restricted cash included in Other assets, net 16,725 16,323 Total cash, cash equivalents, and restricted cash $ 228,023 $ 72,035

Acquisition (Tables)

Acquisition (Tables)	3 Months Ended
	Mar. 31, 2022
Business Combination and Asset Acquisition [Abstract]
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The following table presents the preliminary estimated fair value of the assets acquired and liabilities assumed recognized as of the Acquisition Date. The fair value and useful lives of tangible and intangible assets acquired have been estimated based on a review of publicly available data for transactions involving companies deemed comparable to the Company. The allocation of purchase price to assets and liabilities acquired is not yet complete, as valuations of tangible and intangible assets and liabilities are still in process. Preliminary Fair Value Currently Estimated as of Acquisition Date Assets acquired: Current assets $ 142,136 Goodwill 1,267,079 Intangible assets 295,466 Other non-current assets 371,320 Total assets 2,076,001 Liabilities assumed: Current liabilities 241,266 Noncurrent liabilities 150,128 Total liabilities 391,394 Fair value of net assets acquired, net of cash $ 1,684,607
Schedule of Pro Forma	The following table provides pro forma results of net revenue and net (loss) income for the three months ended March 31, 2022 and 2021 as if Apria was acquired on January 1, 2021. The pro forma results below are not necessarily indicative of the results that would have been if the acquisition had occurred on the dates indicated, nor are the pro forma results indicative of results which may occur in the future. Three Months Ended March 31, 2022 2021 Net revenue $ 2,684,065 $ 2,601,808 Net (loss) income $ (90,182) $ 74,133

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	3 Months Ended
	Mar. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Changes in Carrying Amount of Goodwill	The following table summarizes the goodwill balances by segment and the changes in the carrying amount of goodwill through March 31, 2022: Products & Healthcare Services Patient Direct Consolidated Carrying amount of goodwill, December 31, 2021 $ 106,280 $ 283,905 $ 390,185 Acquisition — 1,267,079 1,267,079 Currency translation adjustments (105) — (105) Carrying amount of goodwill, March 31, 2022 $ 106,175 $ 1,550,984 $ 1,657,159
Schedule of Intangible Assets	Intangible assets subject to amortization at March 31, 2022 and December 31, 2021 were as follows: March 31, 2022 December 31, 2021 Customer Tradenames Other Customer Tradenames Other Gross intangible assets $ 275,429 $ 156,937 $ 271,761 $ 275,526 $ 90,000 $ 43,189 Accumulated amortization (152,465) (35,351) (21,423) (146,168) (33,242) (19,560) Net intangible assets $ 122,964 $ 121,586 $ 250,338 $ 129,358 $ 56,758 $ 23,629 Weighted average useful life 10 years 11 years 5 years 10 years 11 years 8 years

Exit and Realignment Costs (Tab

Exit and Realignment Costs (Tables)	3 Months Ended
	Mar. 31, 2022
Restructuring and Related Activities [Abstract]
Schedule of Exit And Realignment Charges By Segment	Exit and realignment charges by segment for the three months ended March 31, 2022 and 2021 were as follows: Three Months Ended 2022 2021 Products & Healthcare Services $ 1,199 $ 5,963 Patient Direct 483 — Total exit and realignment charges $ 1,682 $ 5,963
Schedule Of Restructuring And Related Costs Accrual Activity	The following table summarizes the activity related to exit and realignment cost accruals through March 31, 2022 and 2021: Total Accrued exit and realignment costs, December 31, 2021 $ 8,306 Provision for exit and realignment activities: Severance 811 Other 871 Cash payments (6,903) Accrued exit and realignment costs, March 31, 2022 $ 3,085 Accrued exit and realignment costs, December 31, 2020 $ 3,146 Provision for exit and realignment activities: Information system restructuring costs 1,029 Lease obligations 347 Other 781 Cash payments (2,915) Accrued exit and realignment costs, March 31, 2021 $ 2,388

Debt (Tables)

Debt (Tables)	3 Months Ended
	Mar. 31, 2022
Debt Disclosure [Abstract]
Schedule Of Debt	Debt consists of the following: March 31, 2022 December 31, 2021 Carrying Estimated Carrying Estimated Receivables Securitization Program $ 226,169 $ 230,000 $ 197,026 $ 200,000 4.375% Senior Notes, due December 2024 245,286 250,068 245,086 263,263 Revolver 11,700 11,700 — — Term Loan A 489,848 500,000 — — 4.500% Senior Notes, due March 2029 491,887 478,415 491,656 515,225 Term Loan B 579,080 589,878 — — 6.625% Senior Notes, due March 2030 583,930 617,484 — — Finance leases and other 15,615 15,615 15,809 15,809 Total debt 2,643,515 2,693,160 949,577 994,297 Less current maturities (8,201) (8,100) (2,037) (2,037) Long-term debt $ 2,635,314 $ 2,685,060 $ 947,540 $ 992,260

Retirement Plans (Tables)

Retirement Plans (Tables)	3 Months Ended
	Mar. 31, 2022
Retirement Benefits [Abstract]
Schedule of Components of Net Periodic Benefit Cost For Domestic Retirement Plan	The components of net periodic benefit cost for the three months ended March 31, 2022 and 2021 were as follows: Three Months Ended 2022 2021 Service cost $ 633 $ 704 Interest cost 523 446 Recognized net actuarial loss 267 353 Net periodic benefit cost $ 1,423 $ 1,503

Derivatives (Tables)

Derivatives (Tables)	3 Months Ended
	Mar. 31, 2022
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule Of Derivative Instruments	The following table summarizes the terms and fair value of our outstanding derivative financial instruments as of March 31, 2022: Derivative Assets Derivative Liabilities Notional Amount Maturity Date Classification Fair Value Classification Fair Value Economic (non-designated) hedges Foreign currency contracts $ 20,000 April 2022 Other current assets $ 127 Other current liabilities $ — The following table summarizes the terms and fair value of our outstanding derivative financial instruments as of December 31, 2021: Derivative Assets Derivative Liabilities Notional Amount Maturity Date Classification Fair Value Classification Fair Value Economic (non-designated) hedges Foreign currency contracts $ 9,700 January 2022 Other current assets $ 81 Other current liabilities $ —
Schedule Of Cash Flow Hedges Included In Accumulated Other Comprehensive Income (Loss)	The following table summarizes the effect of cash flow hedge accounting on our consolidated statements of operations for the three months ended March 31, 2021: Amount of Gain Recognized in Other Comprehensive Income Location of Loss Reclassified from Accumulated Other Comprehensive Loss into Income Total Amount of Expense Line Items Presented in the Consolidated Statement of Operations in Which the Effects are Recorded Amount of Loss Reclassified from Accumulated Other Comprehensive Loss into Income Interest rate swaps $ 2,426 Loss on extinguishment of debt $ (40,433) $ (25,518) The amount of ineffectiveness associated with these contracts was immaterial for the period presented.

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2022
Leases [Abstract]
Schedule of Components of Lease Expense	The components of lease expense were as follows: Three Months Ended Classification 2022 2021 Operating lease cost DS&A Expenses $ 16,100 $ 14,086 Finance lease cost: Amortization of lease assets DS&A Expenses 331 239 Interest on lease liabilities Interest expense, net 307 307 Total finance lease cost 638 546 Short-term lease cost DS&A Expenses 116 259 Variable lease cost DS&A Expenses 4,729 4,317 Total lease cost $ 21,583 $ 19,208 Other information related to leases was as follows: Three Months Ended March 31, 2022 2021 Supplemental cash flow information Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating and finance leases $ 15,965 $ 13,848 Financing cash flows from finance leases $ 397 $ 234 Right-of-use assets obtained in exchange for new operating and finance lease liabilities $ 27,300 $ 23,986 Weighted average remaining lease term (years) Operating leases 4.6 5.4 Finance leases 6.2 7.7 Weighted average discount rate Operating leases 7.0% 8.8% Finance leases 10.7% 12.2%
Schedule of Supplemental Balance Sheet Information	Supplemental balance sheet information is as follows: Classification March 31, December 31, 2021 Assets: Operating lease assets Operating lease assets $ 278,205 $ 194,006 Finance lease assets Property and equipment, net 8,728 8,896 Total lease assets $ 286,933 $ 202,902 Liabilities: Current Operating Other current liabilities $ 67,388 $ 41,817 Finance Other current liabilities 2,202 2,037 Noncurrent Operating Operating lease liabilities, excluding current portion 221,612 162,241 Finance Long-term debt, excluding current portion 11,116 11,314 Total lease liabilities $ 302,318 $ 217,409
Schedule of Maturities of Finance Lease Liabilities	Maturities of lease liabilities as of March 31, 2022 were as follows: Operating Leases Finance Leases Total 2022 $ 69,487 $ 2,094 $ 71,581 2023 83,056 2,750 85,806 2024 69,605 2,697 72,302 2025 49,727 2,631 52,358 2026 33,658 2,248 35,906 Thereafter 44,571 4,538 49,109 Total lease payments 350,104 16,958 367,062 Less: Interest (61,104) (3,640) (64,744) Present value of lease liabilities $ 289,000 $ 13,318 $ 302,318
Schedule of Maturities of Operating Lease Liabilities	Maturities of lease liabilities as of March 31, 2022 were as follows: Operating Leases Finance Leases Total 2022 $ 69,487 $ 2,094 $ 71,581 2023 83,056 2,750 85,806 2024 69,605 2,697 72,302 2025 49,727 2,631 52,358 2026 33,658 2,248 35,906 Thereafter 44,571 4,538 49,109 Total lease payments 350,104 16,958 367,062 Less: Interest (61,104) (3,640) (64,744) Present value of lease liabilities $ 289,000 $ 13,318 $ 302,318

Net Income per Common Share (Ta

Net Income per Common Share (Tables)	3 Months Ended
	Mar. 31, 2022
Earnings Per Share [Abstract]
Summary Of Calculation Of Net Income Income Per Common Share	The following summarizes the calculation of net income per common share attributable to common shareholders for the three months ended March 31, 2022 and 2021: Three Months Ended (in thousands, except per share data) 2022 2021 Net income $ 39,279 $ 69,589 Weighted average shares outstanding - basic 73,643 70,834 Dilutive shares 2,376 104 Weighted average shares outstanding - diluted 76,019 70,938 Net income per common share: Basic $ 0.53 $ 0.98 Diluted $ 0.52 $ 0.98

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive Loss (Tables)	3 Months Ended
	Mar. 31, 2022
Equity [Abstract]
Changes In Accumulated Other Comprehensive Loss By Component	The following table shows the changes in accumulated other comprehensive loss by component for the three months ended March 31, 2022 and 2021: Retirement Plans Currency Derivatives Total Accumulated other comprehensive loss, December 31, 2021 $ (14,597) $ (25,994) $ — $ (40,591) Other comprehensive loss before reclassifications — (787) — (787) Income tax — — — — Other comprehensive loss before reclassifications, net of tax — (787) — (787) Amounts reclassified from accumulated other comprehensive loss 249 — — 249 Income tax (60) — — (60) Amounts reclassified from accumulated other comprehensive loss, net of tax 189 — — 189 Other comprehensive income (loss) 189 (787) — (598) Accumulated other comprehensive loss, March 31, 2022 $ (14,408) $ (26,781) $ — $ (41,189) Retirement Plans Currency Translation Adjustments Derivatives Total Accumulated other comprehensive loss, December 31, 2020 $ (18,447) $ (18) $ (20,044) $ (38,509) Other comprehensive income (loss) before reclassifications — (12,262) 2,426 (9,836) Income tax — — (611) (611) Other comprehensive income (loss) before reclassifications, net of tax — (12,262) 1,815 (10,447) Amounts reclassified from accumulated other comprehensive loss 156 — 25,518 25,674 Income tax (35) — (7,289) (7,324) Amounts reclassified from accumulated other comprehensive loss, net of tax 121 — 18,229 18,350 Other comprehensive income (loss) 121 (12,262) 20,044 7,903 Accumulated other comprehensive loss, March 31, 2021 $ (18,326) $ (12,280) $ — $ (30,606)

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2022
Segment Reporting [Abstract]
Financial Information By Segment	The following tables present financial information by segment: Three Months Ended 2022 2021 Net revenue: Products & Healthcare Services $ 2,134,041 $ 2,109,445 Patient Direct 272,911 217,089 Consolidated net revenue $ 2,406,952 $ 2,326,534 Operating income: Products & Healthcare Services $ 89,083 $ 150,418 Patient Direct 15,793 12,263 Intangible amortization (10,269) (10,026) Acquisition-related and exit and realignment charges (33,548) (5,963) Consolidated operating income $ 61,059 $ 146,692 Depreciation and amortization: Products & Healthcare Services $ 18,994 $ 19,160 Patient Direct 5,131 3,740 Consolidated depreciation and amortization $ 24,125 $ 22,900 Capital expenditures: Products & Healthcare Services $ 10,643 $ 6,464 Patient Direct 318 159 Consolidated capital expenditures $ 10,961 $ 6,623
Consolidated Total Assets	March 31, 2022 December 31, 2021 Total assets: Products & Healthcare Services $ 2,960,748 $ 3,012,303 Patient Direct 2,535,923 468,536 Segment assets 5,496,671 3,480,839 Cash and cash equivalents 211,298 55,712 Consolidated total assets $ 5,707,969 $ 3,536,551
Schedule Of Revenue From External Customers And Long-lived Assets, By Geographical	The following table presents net revenue by geographic area, which were attributed based on the location from which we ship products or provide services. Three Months Ended March 31, 2022 2021 Net revenue: United States $ 2,262,019 $ 2,182,755 International 144,933 143,779 Consolidated net revenue $ 2,406,952 $ 2,326,534

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Narrative (Details) $ in Billions	Mar. 29, 2022USD ($)	Mar. 31, 2022segment	Mar. 31, 2022numberOfSegment
Summary Of Significant Accounting Policies [Line Items]
Number of distinct segments | segment		2
Number of reportable segments		2	2
Apria, Inc
Summary Of Significant Accounting Policies [Line Items]
Percentage of business acquired	100.00%
Business combination consideration transferred | $	$ 1.7

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Schedule of Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021	Mar. 31, 2021	Dec. 31, 2020
Accounting Policies [Abstract]
Cash and cash equivalents	$ 211,298	$ 55,712
Restricted cash included in Other assets, net	16,725	16,323
Total cash, cash equivalents, and restricted cash	$ 228,023	$ 72,035	$ 70,777	$ 134,506

Acquisition - Narrative (Detail

Acquisition - Narrative (Details) - USD ($)	Mar. 29, 2022	Apr. 30, 2022	Mar. 31, 2022	Mar. 31, 2021
Business Acquisition [Line Items]
Fair value receivables	$ 89,300,000
Acquisition			$ 1,267,079,000
Goodwill expected tax deductible amount	$ 0
Apria, Inc
Business Acquisition [Line Items]
Share price (usd per share)	$ 37.50
Acquisition debt			108,000,000
Apria, Inc | Subsequent Event
Business Acquisition [Line Items]
Payment of stock award consideration		$ 108,000,000
Minimum | Primarily Customer Contracts, A Trade Name And Payor And Capitated Relationships
Business Acquisition [Line Items]
Estimated weighted average useful lives	2 years
Maximum | Primarily Customer Contracts, A Trade Name And Payor And Capitated Relationships
Business Acquisition [Line Items]
Estimated weighted average useful lives	15 years
Apria, Inc
Business Acquisition [Line Items]
Percentage of business acquired	100.00%
Business combination consideration transferred	$ 1,700,000,000
Cash acquired from acquisition	144,000,000
Acquisition	$ 1,300,000,000
Pro forma net loss			90,182,000	$ (74,133,000)
Pro forma, adjustments for interest expense			20,800,000
Pro forma, amortization of intangible assets			20,300,000
Seller transaction and stock compensation expense			$ 39,400,000

Acquisition - Estimated Fair Va

Acquisition - Estimated Fair Value of The Assets Acquired and Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Mar. 29, 2022	Dec. 31, 2021
Assets acquired:
Goodwill	$ 1,657,159		$ 390,185
Apria, Inc
Assets acquired:
Current assets		$ 142,136
Goodwill		1,267,079
Intangible assets		295,466
Other non-current assets		371,320
Total assets		2,076,001
Liabilities assumed:
Current liabilities		241,266
Noncurrent liabilities		150,128
Total liabilities		391,394
Fair value of net assets acquired, net of cash		$ 1,684,607

Acquisition - Pro Forma (Detail

Acquisition - Pro Forma (Details) - Apria, Inc - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Business Acquisition, Pro Forma Information, Nonrecurring Adjustment [Line Items]
Net revenue	$ 2,684,065	$ 2,601,808
Net (loss) income	$ (90,182)	$ 74,133

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Changes in Carrying Amount of Goodwill (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2022USD ($)
Goodwill [Roll Forward]
Carrying amount of goodwill, December 31, 2021	$ 390,185
Acquisition	1,267,079
Currency translation adjustments	(105)
Carrying amount of goodwill, March 31, 2022	1,657,159
Patient Direct
Goodwill [Roll Forward]
Carrying amount of goodwill, December 31, 2021	106,280
Acquisition	0
Currency translation adjustments	(105)
Carrying amount of goodwill, March 31, 2022	106,175
Products & Healthcare Services
Goodwill [Roll Forward]
Carrying amount of goodwill, December 31, 2021	283,905
Acquisition	1,267,079
Currency translation adjustments	0
Carrying amount of goodwill, March 31, 2022	$ 1,550,984

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Intangible Assets Subject to Amortization (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2021
Finite-Lived Intangible Assets [Line Items]
Net intangible assets	$ 494,888	$ 209,745
Customer Relationships
Finite-Lived Intangible Assets [Line Items]
Gross intangible assets	275,429	275,526
Accumulated amortization	(152,465)	(146,168)
Net intangible assets	$ 122,964	$ 129,358
Weighted average useful life (in years)	10 years	10 years
Tradenames
Finite-Lived Intangible Assets [Line Items]
Gross intangible assets	$ 156,937	$ 90,000
Accumulated amortization	(35,351)	(33,242)
Net intangible assets	$ 121,586	$ 56,758
Weighted average useful life (in years)	11 years	11 years
Other Intangibles
Finite-Lived Intangible Assets [Line Items]
Gross intangible assets	$ 271,761	$ 43,189
Accumulated amortization	(21,423)	(19,560)
Net intangible assets	$ 250,338	$ 23,629
Weighted average useful life (in years)	5 years	8 years

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Finite-Lived Intangible Assets [Line Items]
Intangible assets, net	$ 494,888		$ 209,745
Amortization expense for intangible assets	10,300	$ 10,000
Estimated amortization expense for the remainder of 2022	96,000
Estimated amortization expense for 2023	126,000
Estimated amortization expense for 2024	67,000
Estimated amortization expense for 2025	42,000
Estimated amortization expense for 2026	41,000
Estimated amortization expense for 2027	38,000
Products & Healthcare Services
Finite-Lived Intangible Assets [Line Items]
Intangible assets, net	158,000		164,000
Patient Direct
Finite-Lived Intangible Assets [Line Items]
Intangible assets, net	$ 337,000		$ 45,700

Exit and Realignment Costs - Ex

Exit and Realignment Costs - Exit and realignment charges by segment (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Restructuring Cost and Reserve [Line Items]
Exit and realignment charges	$ 1,682	$ 5,963
Products & Healthcare Services
Restructuring Cost and Reserve [Line Items]
Exit and realignment charges	1,199	5,963
Patient Direct
Restructuring Cost and Reserve [Line Items]
Exit and realignment charges	$ 483	$ 0

Exit and Realignment Costs - Ac

Exit and Realignment Costs - Accrual for Exit and Realignment Costs (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Restructuring Reserve [Roll Forward]
Accrued exit and realignment costs, beginning of period	$ 8,306	$ 3,146
Cash payments	(6,903)	(2,915)
Accrued exit and realignment costs, end of period	3,085	2,388
Severance
Restructuring Reserve [Roll Forward]
Provision for exit and realignment activities:	811
Other
Restructuring Reserve [Roll Forward]
Provision for exit and realignment activities:	$ 871	781
Information system restructuring costs
Restructuring Reserve [Roll Forward]
Provision for exit and realignment activities:		1,029
Lease obligations
Restructuring Reserve [Roll Forward]
Provision for exit and realignment activities:		$ 347

Exit and Realignment Costs - Na

Exit and Realignment Costs - Narrative (Details) - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Restructuring Cost and Reserve [Line Items]
Incurred cost		$ 3,800,000
Reserves associated with certain retained assets	$ 5,628,000	8,462,000
Operating lease impairment loss	500,000
Other asset charges	100,000
Acquisition-related and exit and realignment charges	33,548,000	5,963,000
Acquisition Related, Exit and Realignment Charges
Restructuring Cost and Reserve [Line Items]
Acquisition-related and exit and realignment charges	$ 31,900,000	0
Fusion5
Restructuring Cost and Reserve [Line Items]
Reserves associated with certain retained assets		$ 3,200,000

Debt - Schedule of Debt (Detail

Debt - Schedule of Debt (Details) - USD ($)	Mar. 31, 2022	Mar. 29, 2022	Dec. 31, 2021	Mar. 31, 2021
Debt Instrument [Line Items]
Finance leases and other	$ 13,318,000
Long-term debt	$ 2,635,314,000		$ 947,540,000
Senior Notes | 4.375% Senior Notes, due December 2024
Debt Instrument [Line Items]
Interest rate of debt	4.375%
Senior Notes | 4.500% Senior Notes, due March 2029
Debt Instrument [Line Items]
Interest rate of debt	4.50%			4.50%
Senior Notes | 6.625% Senior Notes, due March 2030
Debt Instrument [Line Items]
Interest rate of debt	6.625%	6.625%
Revolver | Revolver
Debt Instrument [Line Items]
Long-term debt	$ 11,700,000		0
Carrying Amount
Debt Instrument [Line Items]
Total debt	2,643,515,000		949,577,000
Less current maturities	(8,201,000)		(2,037,000)
Long-term debt	2,635,314,000		947,540,000
Carrying Amount | Finance leases and other
Debt Instrument [Line Items]
Finance leases and other	15,615,000		15,809,000
Carrying Amount | Receivables Securitization Program
Debt Instrument [Line Items]
Long-term debt	226,169,000		197,026,000
Carrying Amount | Senior Notes | 4.375% Senior Notes, due December 2024
Debt Instrument [Line Items]
Long-term debt	245,286,000		245,086,000
Carrying Amount | Senior Notes | 4.500% Senior Notes, due March 2029
Debt Instrument [Line Items]
Long-term debt	491,887,000		491,656,000
Carrying Amount | Senior Notes | 6.625% Senior Notes, due March 2030
Debt Instrument [Line Items]
Long-term debt	583,930,000		0
Carrying Amount | Revolver | Revolver
Debt Instrument [Line Items]
Long-term debt	11,700,000		0
Carrying Amount | Secured Debt | Term Loan A
Debt Instrument [Line Items]
Long-term debt	489,848,000		0
Carrying Amount | Secured Debt | Term Loan B
Debt Instrument [Line Items]
Long-term debt	579,080,000		0
Estimated Fair Value
Debt Instrument [Line Items]
Total debt	2,693,160,000		994,297,000
Less current maturities	(8,100,000)		(2,037,000)
Long-term debt	2,685,060,000		992,260,000
Estimated Fair Value | Finance leases and other
Debt Instrument [Line Items]
Finance leases and other	15,615,000		15,809,000
Estimated Fair Value | Receivables Securitization Program
Debt Instrument [Line Items]
Long-term debt	230,000,000		200,000,000
Estimated Fair Value | Senior Notes | 4.375% Senior Notes, due December 2024
Debt Instrument [Line Items]
Long-term debt	250,068,000		263,263,000
Estimated Fair Value | Senior Notes | 4.500% Senior Notes, due March 2029
Debt Instrument [Line Items]
Long-term debt	478,415,000		515,225,000
Estimated Fair Value | Senior Notes | 6.625% Senior Notes, due March 2030
Debt Instrument [Line Items]
Long-term debt	617,484,000		0
Estimated Fair Value | Revolver | Revolver
Debt Instrument [Line Items]
Long-term debt	11,700,000		0
Estimated Fair Value | Secured Debt | Term Loan A
Debt Instrument [Line Items]
Long-term debt	500,000,000		0
Estimated Fair Value | Secured Debt | Term Loan B
Debt Instrument [Line Items]
Long-term debt	$ 589,878,000		$ 0

Debt - Narrative (Details)

Debt - Narrative (Details) $ in Thousands	Mar. 29, 2022USD ($)creditFacility	Mar. 31, 2021USD ($)	Mar. 31, 2022USD ($)	Dec. 31, 2021USD ($)
Debt Instrument [Line Items]
Number of credit facilities | creditFacility	2
Short-term finance leases			$ 2,202	$ 2,037
Revolver
Debt Instrument [Line Items]
Face amount	$ 450,000
Maximum borrowing capacity	150,000
Letter of Credit
Debt Instrument [Line Items]
Letters of credit outstanding, amount			2,100	2,200
Revolver
Debt Instrument [Line Items]
Remaining borrowing capacity			410,000	291,000
Long-term debt, maturities, repayments of principal in 2022			4,500
Long-term debt, maturities, repayments of principal in 2023			15,400
Long-term debt, maturities, repayments of principal in 2024			274,000
Long-term debt, maturities, repayments of principal in 2025			270,000
Long-term debt, maturities, repayments of principal in 2026			43,500
Long-term debt, maturities, repayments of principal in 2027			415,000
Long-term debt, maturities, repayments of principal in 2028			6,000
Long-term debt, maturities, repayments of principal in 2029			1,100,000
Long-term debt, maturities, repayments of principal in 2030			600,000
Revolver | Letter of Credit
Debt Instrument [Line Items]
Letters of credit outstanding, amount			28,000	$ 9,400
4.375% Senior Notes, due December 2024 | Senior Notes
Debt Instrument [Line Items]
Face amount			$ 246,000
Interest rate of debt			4.375%
Debt issued, percent of par			99.60%
Effective yield percentage			4.422%
Senior notes redemption price, percentage			100.00%
Rate of interest discounted			0.30%
4.500% Senior Notes, due March 2029 | Senior Notes
Debt Instrument [Line Items]
Face amount		$ 500,000
Interest rate of debt		4.50%	4.50%
Debt issued, percent of par		100.00%
Effective yield percentage		4.50%
Senior notes redemption price, percentage			100.00%
4.500% Senior Notes, due March 2029 | Senior Notes | Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Senior notes redemption price, percentage			104.50%
Redemption price, percentage of principal amount redeemed			40.00%
6.625% Senior Notes, due March 2030 | Senior Notes
Debt Instrument [Line Items]
Face amount	$ 600,000
Interest rate of debt	6.625%		6.625%
Debt issued, percent of par	100.00%
Effective yield percentage	6.625%
Senior notes redemption price, percentage			100.00%
6.625% Senior Notes, due March 2030 | Senior Notes | Debt Instrument, Redemption, Period One
Debt Instrument [Line Items]
Senior notes redemption price, percentage			106.625%
Redemption price, percentage of principal amount redeemed			40.00%
Term Loan A
Debt Instrument [Line Items]
Face amount	$ 500,000
Term Loan B
Debt Instrument [Line Items]
Face amount	600,000
Long-term debt, maturities, repayments of principal in 2022			$ 6,000
Maximum | Receivables Securitization Program
Debt Instrument [Line Items]
Face amount	$ 450,000

Retirement Plans - Components o

Retirement Plans - Components of Net Periodic Benefit Cost - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Dec. 31, 2021
Retirement Benefits [Abstract]
Accumulated benefit obligation	$ 49.6	$ 50.2
Defined benefit plan, type [extensible enumeration]	Pension Plan [Member]

Retirement Plans - Components_2

Retirement Plans - Components of Net Periodic Benefit Cost (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Retirement Benefits [Abstract]
Service cost	$ 633	$ 704
Interest cost	523	446
Recognized net actuarial loss	267	353
Net periodic benefit cost	$ 1,423	$ 1,503

Derivatives - Summary of the te

Derivatives - Summary of the terms and fair value of our outstanding derivative financial instruments (Details) - Economic (non-designated) hedges - Foreign currency contracts - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Derivative [Line Items]
Notional Amount	$ 20,000	$ 9,700
Other current assets
Derivative [Line Items]
Derivative Asset, fair value	127	81
Other current liabilities
Derivative [Line Items]
Derivative liabilities, fair value	$ 0	$ 0

Derivatives - Narrative (Detail

Derivatives - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Designated as Hedging Instrument | Interest rate swaps
Derivative [Line Items]
Derivative, terminated notional value		$ 300
Designated as Hedging Instrument | Interest rate swaps | Loss on extinguishment of debt
Derivative [Line Items]
Derivative, terminated notional value	$ 25.1
Economic (non-designated) hedges | Foreign currency contracts
Derivative [Line Items]
Loss on derivative not designed as hedging instrument	$ 0.1	$ 1

Derivatives - Summary of the ef

Derivatives - Summary of the effect of cash flow hedge (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Derivative Instruments, Gain (Loss) [Line Items]
Loss on extinguishment of debt	$ 0	$ (40,433)
Interest rate swaps
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain Recognized in Other Comprehensive Income		2,426
Loss on extinguishment of debt | Interest rate swaps | Reclassification out of Accumulated Other Comprehensive Income
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Loss Reclassified from Accumulated Other Comprehensive Loss into Income		$ (25,518)

Leases - Components of Lease Ex

Leases - Components of Lease Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Finance lease cost:
Interest on lease liabilities	$ 307	$ 307
Total finance lease cost	638	546
Total lease cost	21,583	19,208
DS&A Expenses
Lessee, Lease, Description [Line Items]
Operating lease cost	16,100	14,086
Finance lease cost:
Amortization of lease assets	331	239
Short-term lease cost	116	259
Variable lease cost	$ 4,729	$ 4,317

Leases - Supplemental Balance S

Leases - Supplemental Balance Sheet Information (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Operating lease assets	$ 278,205	$ 194,006
Finance lease assets	8,728	8,896
Total lease assets	286,933	202,902
Current operating lease liabilities	67,388	41,817
Current finance lease liabilities	2,202	2,037
Noncurrent operating lease liabilities	221,612	162,241
Noncurrent finance lease liabilities	11,116	11,314
Total lease liabilities	$ 302,318	$ 217,409
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Property, Plant, and Equipment and Finance Lease Right-of-Use Asset, after Accumulated Depreciation and Amortization	Property, Plant, and Equipment and Finance Lease Right-of-Use Asset, after Accumulated Depreciation and Amortization
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Other Liabilities, Current	Other Liabilities, Current
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Other Liabilities, Current	Other Liabilities, Current
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Long-term debt, excluding current portion	Long-term debt, excluding current portion

Leases - Narrative (Details)

Leases - Narrative (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Lessee, Lease, Description [Line Items]
Finance leases, gross	$ 20,700	$ 20,600
Finance leases, accumulated depreciation	12,000	11,700
Operating lease assets	278,205	$ 194,006
Present value of lease liabilities	289,000
Apria, Inc
Lessee, Lease, Description [Line Items]
Operating lease assets	69,100
Present value of lease liabilities	$ 70,300

Leases - Supplemental cash flow

Leases - Supplemental cash flow information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating and finance leases	$ 15,965	$ 13,848
Financing cash flows from finance leases	397	234
Right-of-use assets obtained in exchange for new operating and finance lease liabilities	$ 27,300	$ 23,986
Weighted average remaining lease term (years)
Operating leases	4 years 7 months 6 days	5 years 4 months 24 days
Finance leases	6 years 2 months 12 days	7 years 8 months 12 days
Weighted average discount rate
Operating leases	7.00%	8.80%
Finance leases	10.70%	12.20%

Leases - Maturities of lease li

Leases - Maturities of lease liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Operating Leases
2022	$ 69,487
2023	83,056
2024	69,605
2025	49,727
2026	33,658
Thereafter	44,571
Total lease payments	350,104
Less: Interest	(61,104)
Present value of lease liabilities	289,000
Finance Leases
2022	2,094
2023	2,750
2024	2,697
2025	2,631
2026	2,248
Thereafter	4,538
Total lease payments	16,958
Less: Interest	(3,640)
Finance leases and other	13,318
Total
2022	71,581
2023	85,806
2024	72,302
2025	52,358
2026	35,906
Thereafter	49,109
Total lease payments	367,062
Less: Interest	(64,744)
Total lease liabilities	$ 302,318	$ 217,409

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Effective income tax rate	18.60%	24.40%
Liability for unrecognized tax benefit	$ 21.6		$ 21.4
Unrecognized tax benefit highly certain	$ 2.7		$ 2.7

Net Income per Common Share - S

Net Income per Common Share - Summary of Calculation of Net Income Per Common Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Earnings Per Share [Abstract]
Net income	$ 39,279	$ 69,589
Weighted average number of shares outstanding, basic (in shares)	73,643	70,834
Diluted shares (in shares)	2,376	104
Weighted average number of shares outstanding, diluted (in shares)	76,019	70,938
Net income per common share:
Basic (in usd per share)	$ 0.53	$ 0.98
Diluted (in usd per share)	$ 0.52	$ 0.98

Shareholders' Equity - Narrativ

Shareholders' Equity - Narrative (Details) - Equity Distribution Agreement - USD ($)	1 Months Ended	3 Months Ended
	May 31, 2020	Mar. 31, 2022
Class of Stock [Line Items]
Number of shares issued in transaction (in shares)		0
Aggregate offering price, remaining available amount		$ 50,000,000
Common Stock
Class of Stock [Line Items]
Aggregate offering price	$ 50,000,000

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive Loss - Changes in Accumulated Loss by Component (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Accumulated Other Comprehensive Income (Loss), Net of Tax [Roll Forward]
Beginning Balance	$ 938,501	$ 712,054
Other comprehensive loss before reclassifications	(787)	(9,836)
Income tax	0	(611)
Other comprehensive loss before reclassifications, net of tax	(787)	(10,447)
Amounts reclassified from accumulated other comprehensive loss	249	25,674
Income tax	(60)	(7,324)
Amounts reclassified from accumulated other comprehensive loss, net of tax	189	18,350
Total other comprehensive (loss) income, net of tax	(598)	7,903
Ending Balance	947,622	786,261
Retirement Plans
Accumulated Other Comprehensive Income (Loss), Net of Tax [Roll Forward]
Beginning Balance	(14,597)	(18,447)
Other comprehensive loss before reclassifications	0	0
Income tax	0	0
Other comprehensive loss before reclassifications, net of tax	0	0
Amounts reclassified from accumulated other comprehensive loss	249	156
Income tax	(60)	(35)
Amounts reclassified from accumulated other comprehensive loss, net of tax	189	121
Total other comprehensive (loss) income, net of tax	189	121
Ending Balance	(14,408)	(18,326)
Currency Translation Adjustments
Accumulated Other Comprehensive Income (Loss), Net of Tax [Roll Forward]
Beginning Balance	(25,994)	(18)
Other comprehensive loss before reclassifications	(787)	(12,262)
Income tax	0	0
Other comprehensive loss before reclassifications, net of tax	(787)	(12,262)
Amounts reclassified from accumulated other comprehensive loss	0	0
Income tax	0	0
Amounts reclassified from accumulated other comprehensive loss, net of tax	0	0
Total other comprehensive (loss) income, net of tax	(787)	(12,262)
Ending Balance	(26,781)	(12,280)
Derivatives
Accumulated Other Comprehensive Income (Loss), Net of Tax [Roll Forward]
Beginning Balance	0	(20,044)
Other comprehensive loss before reclassifications	0	2,426
Income tax	0	(611)
Other comprehensive loss before reclassifications, net of tax	0	1,815
Amounts reclassified from accumulated other comprehensive loss	0	25,518
Income tax	0	(7,289)
Amounts reclassified from accumulated other comprehensive loss, net of tax	0	18,229
Total other comprehensive (loss) income, net of tax	0	20,044
Ending Balance	0	0
Accumulated Other Comprehensive Loss
Accumulated Other Comprehensive Income (Loss), Net of Tax [Roll Forward]
Beginning Balance	(40,591)	(38,509)
Ending Balance	$ (41,189)	$ (30,606)

Segment Information - Financial

Segment Information - Financial Information by Segment (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2022USD ($)	Mar. 31, 2022segment	Mar. 31, 2022numberOfSegment	Mar. 31, 2021USD ($)
Segment Reporting [Abstract]
Number of reportable segments		2	2
Segment Reporting, Revenue Reconciling Item [Line Items]
Net revenue	$ 2,406,952			$ 2,326,534
Operating income:	61,059			146,692
Intangible amortization	(10,300)			(10,000)
Acquisition-related and exit and realignment charges	(33,548)			(5,963)
Depreciation and amortization	24,125			22,900
Consolidated capital expenditures	10,961			6,623
Operating Segments
Segment Reporting, Revenue Reconciling Item [Line Items]
Net revenue	2,406,952			2,326,534
Operating Segments | Products & Healthcare Services
Segment Reporting, Revenue Reconciling Item [Line Items]
Net revenue	2,134,041			2,109,445
Operating income:	89,083			150,418
Depreciation and amortization	18,994			19,160
Consolidated capital expenditures	10,643			6,464
Operating Segments | Patient Direct
Segment Reporting, Revenue Reconciling Item [Line Items]
Net revenue	272,911			217,089
Operating income:	15,793			12,263
Depreciation and amortization	5,131			3,740
Consolidated capital expenditures	318			159
Segment Reconciling Items
Segment Reporting, Revenue Reconciling Item [Line Items]
Intangible amortization	(10,269)			(10,026)
Acquisition-related and exit and realignment charges	$ (33,548)			$ (5,963)

Segment Information - Consolida

Segment Information - Consolidated Total Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Segment Reporting, Asset Reconciling Item [Line Items]
Assets	$ 5,707,969	$ 3,536,551
Cash and cash equivalents	211,298	55,712
Operating Segments
Segment Reporting, Asset Reconciling Item [Line Items]
Assets	5,496,671	$ 3,480,839
Operating Segments | Products & Healthcare Services
Segment Reporting, Asset Reconciling Item [Line Items]
Assets	2,960,748
Operating Segments | Patient Direct
Segment Reporting, Asset Reconciling Item [Line Items]
Assets	$ 2,535,923

Segment Information - Net reven

Segment Information - Net revenue by geographic area (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Segment Reporting Information [Line Items]
Net revenue	$ 2,406,952	$ 2,326,534
United States
Segment Reporting Information [Line Items]
Net revenue	2,262,019	2,182,755
International
Segment Reporting Information [Line Items]
Net revenue	$ 144,933	$ 143,779