Subsequent Events

3 Months Ended

Mar. 31, 2023

Subsequent Events [Abstract]

Subsequent Events

Subsequent events

Launch of Mozarc Medical

On May 25, 2022, the Company entered into an agreement with Medtronic, Inc. and one of its subsidiaries (collectively, Medtronic) to form a new, independent kidney care-focused medical device company (Mozarc Medical) via a deconsolidating partial interest sale from Medtronic to the Company, which closed effective April 1, 2023. At the closing, the Company made a cash payment to Medtronic of $44,651, subject to certain customary post-closing adjustments, and contributed certain other non-cash assets to Mozarc Medical. Additionally, at close, the Company and Medtronic each contributed $224,415 in cash to launch Mozarc Medical. Pursuant to its agreement with Medtronic, the Company has also agreed to pay Medtronic additional consideration of up to $300,000 if certain regulatory and commercial milestones are achieved between 2024 and 2028.

Forward Interest Rate Cap Agreements

On April 21, 2023, the Company entered into several forward interest rate cap agreements with an aggregate notional amount of $1,000,000 that have the economic effect of capping the Company's exposure to Secured Overnight Financing Rate (SOFR) variable interest rate changes on specific portions of the Company's floating rate debt (2023 cap agreements). These

2023 cap agreements are designated as cash flow hedges and, as a result, changes in their fair values will be reported in other comprehensive income. These 2023 cap agreements do not contain credit-risk contingent features, and become effective on June 28, 2024 and June 30, 2024 and expire on December 31, 2025.

Second and Third Amendments to Credit Agreement

On April 3, 2023, the Company entered into the Second Amendment (the Second Amendment) to the Credit Agreement. The Second Amendment modifies the Credit Agreement to, among other things, transition the interest pricing on Term Loan B-1 from LIBOR+1.75% to a forward-looking term rate based on SOFR (Term SOFR) +1.75% and an additional credit spread adjustment (CSA), as well as to update the successor interest rate provisions in the Credit Agreement with respect to Term Loan B-1.

On April 28, 2023 (“Effective Date”), the Company entered into the Third Amendment (the Third Amendment) to the Credit Agreement. The Third Amendment modifies the Credit Agreement to, among other things, refinance its Term Loan A and revolving line of credit with a secured Term Loan A-1 facility in the aggregate principal amount of $1,250,000 and a secured revolving line of credit in the aggregate principal amount of up to $1,500,000. The facilities bear interest at a rate equal to one-month Term SOFR plus an interest rate percentage (initially 2.00%) and an additional CSA. The Credit Agreement, as amended, continues to include customary affirmative and negative covenants and events of default for financings of this type.

The Term Loan A-1 facility amortizes on a quarterly basis beginning September 30, 2023 at a rate of (i) 2.5% per annum during the first year following the Effective Date of the Third Amendment, (ii) 5.0% per annum during the second, third and fourth years following the Effective Date of the Third Amendment and (iii) 7.5% per annum during the fifth year following the Effective Date of the Third Amendment, with the balance due on April 28, 2028. The new secured revolving line of credit has a five-year term.