Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2024

Accounting Policies [Abstract]

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, 2024, 2023 and 2022 are as follows (in thousands):

	Year Ended December 31,
	2024		2023		2022
Insurance	$	1,998,722	$	1,933,440	$	1,808,633
Government	842,552		852,789		781,975
Patient pay	419,701		413,948		379,987
Net revenue	$	3,260,975	$	3,200,177	$	2,970,595

The composition of net revenue by segment for the years ended December 31, 2024, 2023 and 2022 are as follows (in thousands):

	Year Ended December 31,
	2024		2023		2022
Net sales revenue:
Sleep Health	$	992,332	$	947,103	$	831,071
Respiratory Health	32,688		45,219		33,444
Diabetes Health	598,446		647,431		670,988
Wellness at Home	467,305		491,549		480,177
Total net sales revenue	$	2,090,771	$	2,131,302	$	2,015,680
Net revenue from fixed monthly equipment reimbursements:
Sleep Health	$	327,729	$	344,611	$	272,705
Respiratory Health	558,529		569,344		520,697
Diabetes Health	9,704		12,608		16,103
Wellness at Home	144,095		142,312		145,410
Total net revenue from fixed monthly equipment reimbursements	$	1,040,057	$	1,068,875	$	954,915
Net revenue from capitated revenue arrangements:
Sleep Health	$	29,152	$	—	$	—
Respiratory Health	59,933		—		—
Diabetes Health	6,260		—		—
Wellness at Home	34,802		—		—
Total net revenue from capitated revenue arrangements	$	130,147	$	—	$	—
Total net revenue
Sleep Health	$	1,349,213	$	1,291,714	$	1,103,776
Respiratory Health	651,150		614,563		554,141
Diabetes Health	614,410		660,039		687,091
Wellness at Home	646,202		633,861		625,587
Total net revenue	$	3,260,975	$	3,200,177	$	2,970,595

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, 2024				December 31, 2023
	Carrying Value		Fair Value		Carrying Value		Fair Value
Secured term loan	$	547,281	$	547,281	$	717,679	$	717,679
Senior unsecured notes	1,433,890		1,318,820		1,430,303		1,140,821
	$	1,981,171	$	1,866,101	$	2,147,982	$	1,858,500

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 to 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, 2024, 2023 and 2022 consisted of the following (in thousands):

	Year Ended December 31,
	2024		2023		2022
Cost of products and supplies	$	1,288,162	$	1,310,213	$	1,202,895
Salaries, labor and benefits	730,597		716,531		703,720
Patient equipment depreciation	320,289		325,696		286,288
Rent and occupancy	71,874		68,375		65,979
Other operating expenses	168,960		155,295		131,598
Total	$	2,579,882	$	2,576,110	$	2,390,480

Certain amounts previously reported within these categories of Cost of net revenue have been reclassified to General and administrative expenses in order to conform to the current year presentation. See Note 2(d), Reclassifications, for additional discussion of such reclassification.