Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2023

Schedule of composition of net revenues by payor type and core service lines

The composition of net revenue by payor type for the years ended December 31, 2023, 2022 and 2021 are as follows (in thousands):


	Year Ended December 31,
	2023		2022		2021
Insurance	$	1,933,440	$	1,808,633	$	1,499,154
Government	852,789		781,975		685,513
Patient pay	413,948		379,987		269,868
Net revenue	$	3,200,177	$	2,970,595	$	2,454,535

The composition of net revenue by core product lines for the years ended December 31, 2023, 2022 and 2021 are as follows (in thousands):


	Year Ended December 31,
	2023		2022		2021
Net sales revenue:
Sleep	$	897,119	$	794,021	$	654,130
Diabetes	647,431		670,988		528,082
Supplies to the home	192,475		179,326		167,830
Respiratory	32,370		34,342		31,016
HME	110,197		118,542		113,805
Other	251,710		218,461		144,543
Total net sales revenue	$	2,131,302	$	2,015,680	$	1,639,406

Net revenue from fixed monthly equipment reimbursements:
Sleep	$	344,049	$	272,705	$	237,252
Diabetes	12,608		16,103		13,123
Respiratory	566,450		520,697		427,270
HME	96,328		102,256		95,936
Other	49,440		43,154		41,548
Total net revenue from fixed monthly equipment reimbursements	$	1,068,875	$	954,915	$	815,129

Total net revenue:
Sleep	$	1,241,168	$	1,066,726	$	891,382
Diabetes	660,039		687,091		541,205
Supplies to the home	192,475		179,326		167,830
Respiratory	598,820		555,039		458,286
HME	206,525		220,798		209,741
Other	301,150		261,615		186,091
Total net revenue	$	3,200,177	$	2,970,595	$	2,454,535

Schedule of carrying amounts and estimated fair values of debt

The table below shows the carrying amounts and estimated fair values, net of unamortized deferred financing costs, of the Company’s long-term debt arrangements (in thousands):


	December 31, 2023				December 31, 2022
	Carrying Value		Fair Value		Carrying Value		Fair Value
Secured term loan	$	717,679	$	717,679	$	761,547	$	761,547
Senior unsecured notes	1,430,303		1,140,821		1,426,720		1,227,574
	$	2,147,982	$	1,858,500	$	2,188,267	$	1,989,121

Summary of useful lives of property and equipment for purposes of computing depreciation

The useful lives of property and equipment for purposes of computing depreciation are:


Patient medical equipment			13 months ‑ 5 years
Computers and Software			5 ‑ 10 years
Vehicles			5 years
Other			2 ‑ 10 years

Schedule of useful lives of intangible assets acquired

The following table summarizes the useful lives of the Company’s identifiable intangible assets:


Tradenames			5 - 10 years
Payor contracts			10 years
Developed technology			5 years

Summary of cost of net revenue

Cost of net revenue for the years ended December 31, 2023, 2022 and 2021 consisted of the following (in thousands):


	Year Ended December 31,
	2023		2022		2021
Cost of products and supplies	$	1,305,219	$	1,199,481	$	955,813
Salaries, labor and benefits	785,876		777,306		602,969
Patient equipment depreciation	325,696		286,288		194,958
Other operating expenses	236,039		225,719		206,599
Rent and occupancy	67,783		64,375		48,586
Total	$	2,720,613	$	2,553,169	$	2,008,925