CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Cash flows from operating activities:
Net income	$ 74,704	$ 134,682
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization, including patient equipment depreciation	248,835	180,827
Equity-based compensation	16,784	21,394
Change in fair value of warrant liability	(17,145)	(57,359)
Change in fair value of contingent consideration common shares liability		(34,050)
Reduction in the carrying amount of operating lease right-of-use assets	16,924	23,832
Deferred income tax expense	18,058	11,666
Change in fair value of interest rate swaps, net of reclassification adjustment	(2,202)	(2,185)
Amortization of deferred financing costs	3,926	4,069
Write-off of deferred financing costs		4,054
Loss on extinguishment of debt from prepayment penalty		16,135
Other	(2,023)	(1,614)
Changes in operating assets and liabilities, net of effects from acquisitions:
Accounts receivable	2,357	(25,046)
Inventory	(3,992)	3,626
Prepaid and other assets	4,211	(137)
Operating lease obligations	(16,794)	(23,292)
Operating liabilities	(66,696)	(81,852)
Net cash provided by operating activities	276,947	174,750
Cash flows from investing activities:
Payments for business acquisitions, net of cash acquired	(16,134)	(1,417,946)
Purchases of equipment and other fixed assets	(248,511)	(139,686)
Payments for cost method investments	(731)	(875)
Net cash used in investing activities	(265,376)	(1,558,507)
Cash flows from financing activities:
Proceeds from borrowings on long-term debt and lines of credit		1,165,000
Repayments on long-term debt and lines of credit	(15,000)	(822,271)
Repayments of finance lease obligations	(14,219)	(31,043)
Payments for shares purchased under share repurchase program	(13,992)
Proceeds from the exercise of stock options	1,388	12,140
Proceeds received in connection with employee stock purchase plan	1,616	1,016
Proceeds from the issuance of senior unsecured notes		1,100,000
Proceeds from the issuance of Class A Common Stock		278,850
Payments for equity issuance costs		(13,832)
Payments for debt financing costs		(29,185)
Payments for tax withholdings from restricted stock vesting and stock option exercises	(2,690)	(810)
Payments of contingent consideration and deferred purchase price from acquisitions	(5,563)	(22,211)
Distributions to noncontrolling interests	(2,000)	(1,070)
Payments for debt prepayment penalties		(16,135)
Net cash (used in) provided by financing activities	(50,460)	1,620,449
Net (decrease) increase in cash and cash equivalents	(38,889)	236,692
Cash and cash equivalents at beginning of period	149,627	99,962
Cash and cash equivalents at end of period	110,738	336,654
Supplemental disclosures:
Cash paid for interest	97,389	67,409
Cash paid for income taxes	10,490	13,799
Noncash investing and financing activities:
Equipment acquired under finance lease obligations	1,335	22,902
Unpaid equipment and other fixed asset purchases at end of period	50,864	12,688
Assets subject to operating lease obligations	5,411	11,340
Operating lease obligations	(5,411)	(11,340)
Equity consideration issued in connection with acquisitions		1,261,200
Contingent purchase price in connection with acquisitions		2,000
Deferred purchase price in connection with acquisitions	$ 422	$ 1,162