UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 20549

________________________________________________

FORM 10-Q

________________________________________________


☒			QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended ~~September 30, 2021~~March 31, 2022


☐			TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from to

Commission file number 1-9810

Owens & Minor, Inc.

(Exact name of Registrant as specified in its charter)


Virginia			54-1701843
(State or other jurisdiction of incorporation or organization)			(I.R.S. Employer Identification No.)

9120 Lockwood Boulevard	Mechanicsville	Virginia	23116
(Address of principal executive offices)			(Zip Code)

Post Office Box 27626, Richmond, Virginia			23261-7626
(Mailing address of principal executive offices)			(Zip Code)

Registrant’s telephone number, including area code (804) 723-7000

Securities registered pursuant to Section 12(b) of the Act:

Title of each class

Trading Symbol(s)

Name of each exchange on which registered

Common Stock, $2 par value per share

OMI

New York Stock Exchange

Indicate by check mark whether the Registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the Registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files). Yes ☒ No ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “larger accelerated filer”, “accelerated filer”, “smaller reporting company” and "emerging growth company" in Rule 12b-2 of the Exchange Act.


Large accelerated filer	☐☒	Accelerated filer	☒☐
Non-accelerated filer	☐ (Do not check if a smaller reporting company)	Smaller reporting company	☐
Emerging growth company	☐
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.			☐

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No ☒

The number of shares of Owens & Minor, Inc.’s common stock outstanding as of ~~October 31, 2021,~~April 28, 2022 was ~~75,455,760~~76,109,259 shares.

Table of Contents

Owens & Minor, Inc. and Subsidiaries

Index


Part I. Financial Information		Page

Item 1.	Financial Statements	3
	Consolidated Statements of Operations—Three ~~and~~ ~~Nine~~ Months Ended ~~September~~March ~~30, 2021~~3 1 , 202 2 and ~~2020~~202 1	3
	Consolidated Statements of Comprehensive Income ~~(Loss)—Three and~~ ~~Nine~~—Three Months Ended ~~September~~ ~~30,~~March 31, 2022 and 2021 ~~and 2020~~	4
	Consolidated Balance Sheets—~~September~~March ~~30, 2021~~3 1 , 202 2 and December 31, ~~2020~~202 1	5
	Consolidated Statements of Cash Flows—~~Nine~~Th ree Months Ended ~~September~~March ~~30, 2021~~3 1 , 202 2 and ~~2020~~202 1	6
	Consolidated Statements of Changes in Equity—Three ~~and~~ ~~Nine~~Months Ended ~~September~~ ~~30,~~March 31, 2022 and 2021 ~~and 2020~~	7
	Notes to Consolidated Financial Statements	8
Item 2.	Management’s Discussion and Analysis of Financial Condition and Results of Operations	20
Item 3.	Quantitative and Qualitative Disclosures About Market Risk	2928
Item 4.	Controls and Procedures	3029
Part II. Other Information

Item 1.	Legal Proceedings	30
Item 1A.	Risk Factors	30
Item 2.	Unregistered Sales of Equity Securities, Use of Proceeds and Issuer Purchases of Equity Securities	3233
Item 6.	Exhibits	3234

Table of Contents

Part I. Financial Information

Item 1. Financial Statements

Owens & Minor, Inc. and Subsidiaries

Consolidated Statements of Operations

(unaudited)

Three Months Ended
September 30, Nine Months Ended
September 30,
(in thousands, except per share data) 2021 2020 2021 2020
Net revenue $ 2,502,175 $ 2,187,928 $ 7,318,169 $ 6,118,340
Cost of goods sold 2,173,336 1,843,589 6,146,511 5,236,035
Gross margin 328,839 344,339 1,171,658 882,305
Distribution, selling and administrative expenses 262,457 262,538 849,255 758,320
Acquisition-related and exit and realignment charges 6,380 6,382 20,967 18,500
Other operating income, net (2,873) (134) (5,016) (3,020)
Operating income 62,875 75,553 306,452 108,505
Interest expense, net 11,572 20,975 36,784 65,923
Loss on extinguishment of debt — 308 40,433 2,580
Other expense (income), net 799 785 2,397 (1,193)
Income from continuing operations before income taxes 50,504 53,485 226,838 41,195
Income tax provision 6,375 7,404 47,224 3,863
Income from continuing operations, net of tax 44,129 46,081 179,614 37,332
Loss from discontinued operations, net of tax — — — (58,203)
Net income (loss) $ 44,129 $ 46,081 $ 179,614 $ (20,871)
Basic income (loss) per common share:
Income from continuing operations $ 0.60 $ 0.76 $ 2.47 $ 0.61
Loss from discontinued operations — — — (0.95)
Net income (loss) $ 0.60 $ 0.76 $ 2.47 $ (0.34)
Diluted income (loss) per common share:
Income from continuing operations $ 0.58 $ 0.76 $ 2.38 $ 0.61
Loss from discontinued operations — — — (0.95)
Net income (loss) $ 0.58 $ 0.76 $ 2.38 $ (0.34)


	Three Months Ended March 31,
(in thousands, except per share data)	2022		2021
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	—		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	$	0.53	$	0.98
Diluted	$	0.52	$	0.98

See accompanying notes to consolidated financial statements.

Table of Contents

Owens & Minor, Inc. and Subsidiaries

Consolidated Statements of Comprehensive Income ~~(Loss)~~

(unaudited)


		Three Months Ended September 30,				Nine Months Ended September 30,					Three Months Ended March 31,
(in thousands)	(in thousands)	2021		2020		2021		2020		(in thousands)	2022		2021
Net income (loss)		$	44,129	$	46,081	$	179,614	$	(20,871)
Other comprehensive income (loss), net of tax:
Net income										Net income	$	39,279	$	69,589
Other comprehensive (loss) income, net of tax:										Other comprehensive (loss) income, net of tax:
Currency translation adjustments	Currency translation adjustments	(12,014)		5,173		(26,724)		7,003		Currency translation adjustments	(787)		(12,262)
Change in unrecognized net periodic pension costs	Change in unrecognized net periodic pension costs	395		167		552		932		Change in unrecognized net periodic pension costs	189		121
Change in gains and losses on derivative instruments	Change in gains and losses on derivative instruments	—		1,681		20,044		(9,792)		Change in gains and losses on derivative instruments	—		20,044
Total other comprehensive income (loss), net of tax		(11,619)		7,021		(6,128)		(1,857)
Comprehensive income (loss)		$	32,510	$	53,102	$	173,486	$	(22,728)
Total other comprehensive (loss) income, net of tax										Total other comprehensive (loss) income, net of tax	(598)		7,903
Comprehensive income										Comprehensive income	$	38,681	$	77,492

See accompanying notes to consolidated financial statements.

Table of Contents

Owens & Minor, Inc. and Subsidiaries

Consolidated Balance Sheets

(unaudited)


		September 30,		December 31,			March 31,		December 31,
(in thousands, except per share data)	(in thousands, except per share data)	2021		2020		(in thousands, except per share data)	2022		2021
Assets	Assets					Assets
Current assets	Current assets					Current assets
Cash and cash equivalents	Cash and cash equivalents	$	39,759	$	83,058	Cash and cash equivalents	$	211,298	$	55,712
Accounts receivable, net of allowances of $19,273 and $19,087		759,744		700,792
Accounts receivable, net of allowances of $20,714 and $18,003						Accounts receivable, net of allowances of $20,714 and $18,003	775,779		681,564
Merchandise inventories	Merchandise inventories	1,514,387		1,233,751		Merchandise inventories	1,447,383		1,495,972
Other current assets	Other current assets	84,335		118,264		Other current assets	118,889		88,564
Total current assets	Total current assets	2,398,225		2,135,865		Total current assets	2,553,349		2,321,812
Property and equipment, net of accumulated depreciation of $320,389 and $284,126		308,463		315,662
Property and equipment, net of accumulated depreciation of $344,569 and $334,500						Property and equipment, net of accumulated depreciation of $344,569 and $334,500	586,668		317,235
Operating lease assets	Operating lease assets	184,554		144,755		Operating lease assets	278,205		194,006
Goodwill	Goodwill	386,693		394,086		Goodwill	1,657,159		390,185
Intangible assets, net	Intangible assets, net	209,789		243,351		Intangible assets, net	494,888		209,745
Other assets, net	Other assets, net	96,395		101,920		Other assets, net	137,700		103,568
Total assets	Total assets	$	3,584,119	$	3,335,639	Total assets	$	5,707,969	$	3,536,551
Liabilities and equity	Liabilities and equity					Liabilities and equity
Current liabilities	Current liabilities					Current liabilities
Accounts payable	Accounts payable	$	1,118,753	$	1,000,186	Accounts payable	$	1,115,400	$	1,001,959
Accrued payroll and related liabilities	Accrued payroll and related liabilities	100,171		109,447		Accrued payroll and related liabilities	95,995		115,858
Other current liabilities	Other current liabilities	206,094		236,094		Other current liabilities	442,900		226,204
Total current liabilities	Total current liabilities	1,425,018		1,345,727		Total current liabilities	1,654,295		1,344,021
Long-term debt, excluding current portion	Long-term debt, excluding current portion	959,485		986,018		Long-term debt, excluding current portion	2,635,314		947,540
Operating lease liabilities, excluding current portion	Operating lease liabilities, excluding current portion	154,009		119,932		Operating lease liabilities, excluding current portion	221,612		162,241
Deferred income taxes	Deferred income taxes	37,093		50,641		Deferred income taxes	110,319		35,310
Other liabilities	Other liabilities	121,509		121,267		Other liabilities	138,807		108,938
Total liabilities	Total liabilities	2,697,114		2,623,585		Total liabilities	4,760,347		2,598,050
Commitments and contingencies	Commitments and contingencies	0		0		Commitments and contingencies	0		0
Equity	Equity					Equity
Common stock, par value $2 per share; authorized - 200,000 shares; issued and outstanding - 75,429 shares and 73,472 shares		150,858		146,944
Common stock, par value $2 per share; authorized - 200,000 shares; issued and outstanding - 76,086 shares and 75,433 shares						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	Paid-in capital	434,952		436,597		Paid-in capital	409,741		440,608
Retained earnings	Retained earnings	345,832		167,022		Retained earnings	426,898		387,619
Accumulated other comprehensive loss	Accumulated other comprehensive loss	(44,637)		(38,509)		Accumulated other comprehensive loss	(41,189)		(40,591)
Total equity	Total equity	887,005		712,054		Total equity	947,622		938,501
Total liabilities and equity	Total liabilities and equity	$	3,584,119	$	3,335,639	Total liabilities and equity	$	5,707,969	$	3,536,551

See accompanying notes to consolidated financial statements.

Table of Contents

Owens & Minor, Inc. and Subsidiaries

Consolidated Statements of Cash Flows

(unaudited)


		Nine Months Ended September 30,					Three Months Ended March 31,
(in thousands)	(in thousands)	2021		2020		(in thousands)	2022		2021
Operating activities:	Operating activities:					Operating activities:
Net income (loss)		$	179,614	$	(20,871)
Adjustments to reconcile net income (loss) to cash provided by operating activities:
Net income						Net income	$	39,279	$	69,589
Adjustments to reconcile net income to cash provided by operating activities:						Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization	Depreciation and amortization	68,142		69,494		Depreciation and amortization	24,125		22,900
Share-based compensation expense	Share-based compensation expense	19,078		15,275		Share-based compensation expense	5,403		5,182
Loss on divestiture		—		65,472
Loss on extinguishment of debt	Loss on extinguishment of debt	40,433		2,580		Loss on extinguishment of debt	—		40,433
Provision for losses on accounts receivable	Provision for losses on accounts receivable	19,270		9,583		Provision for losses on accounts receivable	5,628		8,462
Deferred income tax (benefit) expense		(18,286)		25,017
Deferred income tax benefit						Deferred income tax benefit	(69)		(5,865)
Changes in operating lease right-of-use assets and lease liabilities	Changes in operating lease right-of-use assets and lease liabilities	1,190		(1,328)		Changes in operating lease right-of-use assets and lease liabilities	(462)		448
Changes in operating assets and liabilities:	Changes in operating assets and liabilities:					Changes in operating assets and liabilities:
Accounts receivable	Accounts receivable	(84,381)		(20,173)		Accounts receivable	(12,919)		(45,919)
Merchandise inventories	Merchandise inventories	(284,188)		52,605		Merchandise inventories	58,098		(89,393)
Accounts payable	Accounts payable	120,821		136,156		Accounts payable	(6,967)		18,742
Net change in other assets and liabilities	Net change in other assets and liabilities	(8,341)		(69,117)		Net change in other assets and liabilities	(33,165)		(1,666)
Other, net	Other, net	20,484		3,503		Other, net	748		2,510
Cash provided by operating activities	Cash provided by operating activities	73,836		268,196		Cash provided by operating activities	79,699		25,423
Investing activities:	Investing activities:					Investing activities:
Proceeds from divestiture		—		133,000
Acquisition, net of cash acquired						Acquisition, net of cash acquired	(1,576,278)		—
Additions to property and equipment	Additions to property and equipment	(26,446)		(21,678)		Additions to property and equipment	(9,609)		(5,048)
Additions to computer software	Additions to computer software	(6,179)		(4,702)		Additions to computer software	(1,352)		(1,575)
Proceeds from sale of property and equipment		41		178
Proceeds from cash surrender value of life insurance policies		—		6,032
Cash (used for) provided by investing activities		(32,584)		112,830
Other, net						Other, net	3		4
Cash used for investing activities						Cash used for investing activities	(1,587,236)		(6,619)
Financing activities:	Financing activities:					Financing activities:
Proceeds from issuance of debt	Proceeds from issuance of debt	574,900		150,000		Proceeds from issuance of debt	1,691,000		500,000
Repayments under revolving credit facility, net		(90,900)		(107,900)
Borrowings (repayments) under revolving credit facility, net and accounts receivable securitization program						Borrowings (repayments) under revolving credit facility, net and accounts receivable securitization program	41,700		(21,600)
Repayments of debt	Repayments of debt	(553,140)		(270,399)		Repayments of debt	—		(523,140)
Financing costs paid	Financing costs paid	(13,912)		(10,367)		Financing costs paid	(33,744)		(11,700)
Cash dividends paid	Cash dividends paid	(548)		(467)		Cash dividends paid	—		(181)
Payment for termination of interest rate swaps	Payment for termination of interest rate swaps	(15,434)		—		Payment for termination of interest rate swaps	—		(15,434)
Other, net	Other, net	(18,188)		(5,822)		Other, net	(34,762)		(8,339)
Cash used for financing activities		(117,222)		(244,955)
Effect of exchange rate changes on cash and cash equivalents		(2,454)		6,721
Net (decrease) increase in cash, cash equivalents and restricted cash		(78,424)		142,792
Cash provided by (used for) financing activities						Cash provided by (used for) financing activities	1,664,194		(80,394)
Effect of exchange rate changes on cash, cash equivalents and restricted cash						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						Net increase (decrease) in cash, cash equivalents and restricted cash	155,988		(63,729)
Cash, cash equivalents and restricted cash at beginning of period	Cash, cash equivalents and restricted cash at beginning of period	134,506		84,687		Cash, cash equivalents and restricted cash at beginning of period	72,035		134,506
Cash, cash equivalents and restricted cash at end of period	Cash, cash equivalents and restricted cash at end of period	$	56,082	$	227,479	Cash, cash equivalents and restricted cash at end of period	$	228,023	$	70,777
Supplemental disclosure of cash flow information:	Supplemental disclosure of cash flow information:					Supplemental disclosure of cash flow information:
Income taxes paid (received), net of refunds		$	83,606	$	(1,892)
Income taxes paid, net of refunds						Income taxes paid, net of refunds	$	4,478	$	898
Interest paid	Interest paid	$	32,035	$	61,271	Interest paid	$	12,626	$	10,255

See accompanying notes to consolidated financial statements.

Table of Contents

Owens & Minor, Inc. and Subsidiaries

Consolidated Statements of Changes in Equity

(unaudited)


(in thousands, except per share data)	(in thousands, except per share data)	Common Shares Outstanding	Common Stock ($2 par value )		Paid-In Capital		Retained Earnings		Accumulated Other Comprehensive Loss		Total Equity		(in thousands, except per share data)	Common Shares Outstanding	Common Stock ($2 par value )		Paid-In Capital		Retained Earnings		Accumulated Other Comprehensive Loss		Total Equity
Balance, December 31, 2021													Balance, December 31, 2021	75,433	$	150,865	$	440,608	$	387,619	$	(40,591)	$	938,501
Net income													Net income						39,279				39,279
Other comprehensive loss													Other comprehensive loss								(598)		(598)
Share-based compensation expense, exercises and other													Share-based compensation expense, exercises and other	653	1,307		(30,867)						(29,560)
Balance, March 31, 2022													Balance, March 31, 2022	76,086	$	152,172	$	409,741	$	426,898	$	(41,189)	$	947,622

Balance, December 31, 2020	Balance, December 31, 2020	73,472	$	146,944	$	436,597	$	167,022	$	(38,509)	$	712,054	Balance, December 31, 2020	73,472	$	146,944	$	436,597	$	167,022	$	(38,509)	$	712,054
Net income	Net income						69,589				69,589		Net income						69,589				69,589
Other comprehensive income	Other comprehensive income								7,903		7,903		Other comprehensive income								7,903		7,903
Dividends declared ($0.0025 per share)	Dividends declared ($0.0025 per share)						(434)				(434)		Dividends declared ($0.0025 per share)						(434)				(434)
Share-based compensation expense, exercises and other	Share-based compensation expense, exercises and other	1,628	3,256		(6,107)						(2,851)		Share-based compensation expense, exercises and other	1,628	3,256		(6,107)						(2,851)
Balance, March 31, 2021	Balance, March 31, 2021	75,100	150,200		430,490		236,177		(30,606)		786,261		Balance, March 31, 2021	75,100	$	150,200	$	430,490	$	236,177	$	(30,606)	$	786,261
Net income							65,896				65,896
Other comprehensive loss									(2,412)		(2,412)
Dividends declared ($0.0025 per share)							(187)				(187)
Share-based compensation expense, exercises and other		295	591		(2,130)						(1,539)
Balance, June 30, 2021		75,395	150,791		428,360		301,886		(33,018)		848,019
Net income							44,129				44,129
Other comprehensive loss									(11,619)		(11,619)
Dividends declared ($0.0025 per share)							(183)				(183)
Share-based compensation expense, exercises and other		34	67		6,592						6,659
Balance, September 30, 2021		75,429	$	150,858	$	434,952	$	345,832	$	(44,637)	$	887,005

Balance, December 31, 2019		62,843	$	125,686	$	251,401	$	137,774	$	(52,707)	$	462,154
Net loss							(11,324)				(11,324)
Other comprehensive loss									(39,405)		(39,405)
Dividends declared ($0.0025 per share)							(127)				(127)
Share-based compensation expense, exercises and other		42	84		4,956						5,040
Balance, March 31, 2020		62,885	125,770		256,357		126,323		(92,112)		416,338
Net loss							(55,627)				(55,627)
Other comprehensive income									30,527		30,527
Dividends declared ($0.0025 per share)							(156)				(156)
Share-based compensation expense, exercises and other		852	1,704		2,376						4,080
Balance, June 30, 2020		63,737	127,474		258,733		70,540		(61,585)		395,162
Net income							46,081				46,081
Other comprehensive income									7,021		7,021
Dividends declared ($0.0025 per share)							(156)				(156)
Share-based compensation expense, exercises and other		(21)	(42)		3,269						3,227
Balance, September 30, 2020		63,716	$	127,432	$	262,002	$	116,465	$	(54,564)	$	451,335

See accompanying notes to consolidated financial statements.

Table of Contents

Owens & Minor, Inc. and Subsidiaries

Notes to Consolidated Financial Statements

(unaudited)

(in thousands, except per share data, unless otherwise indicated)

Note 1—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 ~~our)~~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 ~~Movianto business~~represented a component that met accounting requirements to be classified as discontinued operations for the nine months ended September 30, 2020. In accordance with GAAP, the results of operations of the Movianto business are presented as discontinued operations through June 18, 2020 (the Divestiture Date) and, as such, have been excluded from continuing operations for the nine months ended September 30, 2020. With the exception of Note 3, the Notes to Consolidated Financial Statements reflect the continuing operations of Owens & Minor, Inc. and its subsidiaries. See Note 3 for additional information regarding discontinued operations. 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 2 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 2 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 ~~September 30,~~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.~~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.

September 30, 2021 December 31, 2020
Cash and cash equivalents $ 39,759 $ 83,058
Restricted cash included in Other current assets — 35,126
Restricted cash included in Other assets, net 16,323 16,322
Total cash, cash equivalents, and restricted cash $ 56,082 $ 134,506

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Note 2—Fair Value

The carrying amounts of cash and cash equivalents, accounts receivable, ~~and~~ 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 ~~foreign currency~~our derivative contracts isare 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.

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Note 3—~~Discontinued Operations~~

Acquisition

On ~~June 18, 2020,~~March 29, 2022 (the Acquisition Date), we completed the ~~divestiture~~acquisition of ~~our European logistics business, Movianto (the Divestiture),~~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 ~~well as certain support functions~~of March 31, 2022 that was paid in ~~our Dublin office,~~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 ~~Walden Group SAS (the Buyer)~~receive $37.50 in cash. Apria is a leading provider of integrated home healthcare equipment and EHDH (as Buyer’s guarantor) for cash consideration of $133 million. We concluded that the Movianto business met the criteria for discontinued operations through the Divestiture Date, as the intention to sell represented a strategic shift and the criteria for held-for-sale were met. Movianto was previously reportedrelated services in the ~~Global Solutions~~United States. This business is reported as part of the Patient Direct segment.

Accordingly, the results of operations from the Movianto business are reported in the accompanying consolidated statements of operations as Loss from discontinued operations, net of tax for the three and nine months ended September 30, 2020.

The following table ~~summarizes~~presents the ~~financial results~~preliminary estimated fair value of ~~our discontinued operations for~~ the ~~three~~assets acquired and ~~nine months ended September 30, 2020:~~

~~Three Months Ended September 30, 2020~~

~~Nine Months Ended September 30, 2020~~

~~Net revenue~~

—

~~226,759~~

~~Cost of goods sold~~

—

~~53,923~~

~~Gross margin~~

—

~~172,836~~

~~Distribution, selling, and administrative expenses~~

—

~~157,512~~

~~Loss on divestiture~~

—

~~65,472~~

~~Acquisition-related and exit and realignment charges~~

—

~~4,825~~

~~Other operating income, net~~

—

~~(388)~~

~~Operating loss~~

—

~~(54,585)~~

~~Interest expense, net~~

—

~~3,144~~

~~Loss from discontinued operations before income taxes~~

—

~~(57,729)~~

~~Income tax provision from discontinued operations~~

—

~~474~~

~~Loss from discontinued operations, net of tax~~

—

~~(58,203)~~

~~We suspended depreciation~~liabilities assumed recognized as of the Acquisition Date. The fair value and ~~amortization on~~useful lives of tangible and intangible assets ~~that are held-for-sale, including right-of-use assets recorded in accordance with ASU No. 2016-02, for the nine months ended September 30, 2020.~~

~~No revenue or expense~~acquired have been ~~recorded in discontinued operations related~~estimated based on a review of publicly available data for transactions involving companies deemed comparable to the ~~disposal group subsequent~~Company. The allocation of purchase price to ~~the Divestiture Date.~~

We have entered into transition services agreements with a subsidiary of the Buyer, pursuant to which we and a subsidiary of the Buyer will provide to each other various transitional services. Certain transition service arrangement costs and reimbursements were recorded during the three and nine months ended September 30, 2021 and 2020 and were immaterial for the periods presented. These arrangements were substantially completed as of September 30, 2021.

~~We had no~~ assets and liabilities acquired is not yet complete, as valuations of ~~the discontinued Movianto business reflected on the consolidated balance sheets at September 30, 2021~~tangible and ~~December 31, 2020.~~

~~The following table provides operating~~intangible assets and ~~investing cash flow information for our discontinued operations:~~

liabilities are still in process.


	~~Nine Months Ended September 30, 2020~~Preliminary Fair Value Currently Estimated as of Acquisition Date
~~Operating Activities:~~Assets acquired:
~~Loss on divestiture~~Current assets	$	~~65,472~~142,136
~~Investing Activities:~~Goodwill	1,267,079
~~Capital expenditures~~Intangible assets	~~3,027~~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 to 15 years.

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. NaNne 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.

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	Three Months Ended March 31,
	2022		2021
Net revenue	$	2,684,065	$	2,601,808
Net (loss) income	$	(90,182)	$	74,133

Pro forma net loss of $90.2 million for the three months ended March 31, 2022 includes pro forma adjustments for interest expense of $20.8 million and amortization of intangible assets of $20.3 million. The Pro forma net loss also includes $39.4 million in seller transaction expenses and stock compensation expense associated with $108 million owed to the holders of Apria stock awards in connection with the Apria Acquisition. The amount of revenue and net income of Apria since the Acquisition Date included in the consolidated statement of operations for the three months ended March 31, 2022 have not been separately disclosed, as the effects were not material to our consolidated financial statements.

Note 4—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 ~~September 30, 2021:~~March 31, 2022:

Global Solutions Global Products Consolidated
Carrying amount of goodwill, December 31, 2020 $ 283,905 $ 110,181 $ 394,086
Currency translation adjustments — (7,393) (7,393)
Carrying amount of goodwill, September 30, 2021 $ 283,905 $ 102,788 $ 386,693


	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 ~~September 30, 2021~~March 31, 2022 and December 31, ~~2020~~2021 were as follows:


		September 30, 2021						December 31, 2020							March 31, 2022							December 31, 2021
		Customer Relationships		Tradenames		Other Intangibles		Customer Relationships		Tradenames		Other Intangibles				Customer Relationships		Tradenames		Other Intangibles			Customer Relationships		Tradenames		Other Intangibles
Gross intangible assets	Gross intangible assets	$	265,527	$	90,000	$	43,313	$	270,505	$	90,000	$	43,245	Gross intangible assets		$	275,429	$	156,937	$	271,761		$	275,526	$	90,000	$	43,189
Accumulated amortization	Accumulated amortization	(139,632)		(31,152)		(18,267)		(121,209)		(24,881)		(14,309)		Accumulated amortization		(152,465)		(35,351)		(21,423)			(146,168)		(33,242)		(19,560)
Net intangible assets	Net intangible assets	$	125,895	$	58,848	$	25,046	$	149,296	$	65,119	$	28,936	Net intangible assets		$	122,964	$	121,586	$	250,338		$	129,358	$	56,758	$	23,629
Weighted average useful life	Weighted average useful life	10 years		11 years		8 years		10 years		11 years		8 years		Weighted average useful life		10 years		11 years		5 years			10 years		11 years		8 years

At ~~September 30,~~March 31, 2022 and December 31, 2021, ~~$51.1~~$158 million and $164 million in net intangible assets were held in the ~~Global Solutions~~Products & Healthcare Services segment and ~~$159~~$337 million and $45.7 million were held in the ~~Global Products~~Patient Direct segment. Amortization expense for intangible assets was ~~$10.0~~$10.3 million and ~~$10.2~~$10.0 million for the three months ended ~~September 30, 2021~~March 31, 2022 and ~~2020,~~2021. At March 31, 2022, other intangibles includes preliminary estimated fair values of payor relationships, customer list and ~~$30.1 million and $31.5 million for~~other intangible assets acquired as part of the ~~nine months ended September 30, 2021 and 2020.~~Apria Acquisition.

Based on the current carrying value of intangible assets subject to amortization, estimated amortization expense is approximately ~~$10~~$96 million for the remainder of ~~2021, $39 million for~~ 2022, ~~$39~~$126 million for 2023, ~~$34~~$67 million for 2024, ~~$28~~$42 million for 2025, ~~and $27~~$41 million for ~~2026.~~2026 and $38 million for 2027.

Note 5—Exit and Realignment Costs

We 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

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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 ~~and nine~~ months ended ~~September 30,~~March 31, 2022 and 2021 ~~and 2020~~ were as follows:

Three Months Ended
September 30, Nine Months Ended September 30,
2021 2020 2021 2020
Global Solutions segment $ 5,352 $ 2,714 $ 16,166 $ 6,255
Global Products segment 1,028 2,877 4,801 3,364
Total exit and realignment charges $ 6,380 $ 5,591 $ 20,967 $ 9,619

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	Three Months Ended March 31,
	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 ~~September 30, 2021~~March 31, 2022 and ~~2020:~~

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~~
~~Provision for exit and realignment activities:~~
~~Information system restructuring costs~~	~~1,611~~
~~Lease obligations~~	~~(126)~~
~~Other~~	~~989~~
~~Cash payments~~	~~(2,302)~~
~~Accrued exit and realignment costs, June 30, 2021~~	~~2,560~~
~~Provision for exit and realignment activities:~~
~~Information system restructuring costs~~	~~1,506~~
~~Lease obligations~~	~~107~~
~~Other~~	~~3,142~~
~~Cash payments~~	~~(4,199)~~
~~Accrued exit and realignment costs, September 30, 2021~~	$	~~3,116~~

~~Accrued exit and realignment costs, December 31, 2019~~	$	~~8,162~~
~~Provision for exit and realignment activities:~~
~~Severance~~	~~1,391~~
~~Information system restructuring costs~~	~~183~~
~~Lease obligations~~	~~202~~
~~Other~~	53
~~Cash payments~~	~~(5,799)~~
~~Accrued exit and realignment costs, March 31, 2020~~	~~4,192~~
~~Provision for exit and realignment activities:~~
~~Severance~~	~~809~~
~~Information system restructuring costs~~	~~671~~
~~Lease obligations~~	~~219~~
~~Other~~	~~501~~
~~Cash payments~~	~~(2,072)~~
~~Accrued exit and realignment costs, June 30, 2020~~	~~4,320~~
~~Provision for exit and realignment activities:~~
~~Severance~~	~~1,950~~
~~Information system restructuring costs~~	77
~~Lease obligations~~	~~848~~
~~Other~~	~~2,716~~
~~Cash payments~~	~~(7,083)~~
~~Accrued exit and realignment costs, September 30, 2020~~	$	~~2,828~~2,388

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In addition to the exit and realignment accruals in the preceding table, we also incurred ~~$1.6 million and $11.6~~$3.8 million of costs that were expensed as incurred for the three ~~and nine~~ months ended ~~September 30,~~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 ~~includes $1.5 million and $9.6 million~~ of ~~wind-down~~ costs related to ~~Fusion5 for~~ the ~~three and nine months ended September 30, 2021.~~

Apria acquisition. There were no0 acquisition-related charges included within acquisition-related and exit and realignment charges presented in our consolidated statements of operations for the three ~~and nine~~ months ended ~~September 30,~~March 31, 2021. Acquisition-related charges within acquisition-related and exit and realignment charges presented in our consolidated statements of operations were $0.8 million and $8.9 million for the three and nine months ended September 30, 2020, which consisted primarily of transition costs for the Halyard acquisition.

We ~~may incur~~expect material additional ~~charges~~costs in ~~2021~~2022 for ~~wind-down costs related to Fusion5.~~activities that were initiated through March 31, 2022.

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Note 6—Debt

Debt consists of the following:


		September 30, 2021				December 31, 2020					March 31, 2022				December 31, 2021
		Carrying Amount		Estimated Fair Value		Carrying Amount		Estimated Fair Value			Carrying Amount		Estimated Fair Value		Carrying Amount		Estimated Fair Value
Term Loan A-2		$	—	$	—	$	33,865	$	34,390
Term Loan B		—		—		477,525		486,614
Receivables Securitization Program	Receivables Securitization Program	196,683		200,000		152,929		155,100		Receivables Securitization Program	$	226,169	$	230,000	$	197,026	$	200,000
4.375% Senior Notes, due December 2024	4.375% Senior Notes, due December 2024	245,011		261,329		244,780		253,241		4.375% Senior Notes, due December 2024	245,286		250,068		245,086		263,263
Revolver	Revolver	12,300		12,300		103,200		103,200		Revolver	11,700		11,700		—		—
Term Loan A										Term Loan A	489,848		500,000		—		—
4.500% Senior Notes, due March 2029	4.500% Senior Notes, due March 2029	491,430		507,075		—		—		4.500% Senior Notes, due March 2029	491,887		478,415		491,656		515,225
Term Loan B										Term Loan B	579,080		589,878		—		—
6.625% Senior Notes, due March 2030										6.625% Senior Notes, due March 2030	583,930		617,484		—		—
Finance leases and other	Finance leases and other	15,677		15,677		13,668		13,668		Finance leases and other	15,615		15,615		15,809		15,809
Total debt	Total debt	961,101		996,381		1,025,967		1,046,213		Total debt	2,643,515		2,693,160		949,577		994,297
Less current maturities	Less current maturities	(1,616)		(1,616)		(39,949)		(40,453)		Less current maturities	(8,201)		(8,100)		(2,037)		(2,037)
Long-term debt	Long-term debt	$	959,485	$	994,765	$	986,018	$	1,005,760	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 used a portion of the net proceeds from the Notes Offering to repay our Term B Loan and borrowings under our revolving credit facility. In connection with these repayments, we recorded $15.3 million in write-offs of deferred financing costs and third party fees within loss on extinguishment of debt for the nine months ended September 30, 2021. No write-offs of deferred financing costs and third party fees were recorded for the three months ended September 30, 2021. 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 ~~10, 2021,~~29, 2022, we ~~terminated~~completed the sale of $600 million in aggregate principal amount of our ~~then existing~~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 ~~agreement and all obligations thereunder were repaid.~~ agreements.

On ~~that same date,~~March 29, 2022, we entered into a ~~new~~term loan credit agreement with ~~Bank of America, N.A.~~an administrative agent and collateral agent and a syndicate of financial institutions, as lenders (the Credit Agreement) ~~with~~that provides for 2 new credit facilities (i) a ~~$300~~$500 million ~~revolving credit facility.~~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 ~~our revolving credit facility~~the Term Loan A is based on ~~a spread over a benchmark rate (as described~~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 ~~the Credit Agreement). The Credit Agreement matures in March 2026.~~

At September 30, 2021 and December 31, 2020, we had borrowings of $12.3 million and $103 million and letters of credit of $9.4 million and $13.9 million outstanding under our revolving credit facilities. At September 30, 2021 and Decembermore favorable

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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, ~~2020,~~2022, we had ~~$278~~borrowings of $11.7 million and ~~$283~~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, ~~outstanding~~which were issued outside of the Revolving Credit Facility for ~~$2.2~~$2.1 million and ~~$1.6~~$2.2 million as of ~~September 30, 2021~~March 31, 2022 and December 31, ~~2020,~~2021, which supports certain leased facilities as well as other normal business activities in the United States and Europe. ~~These letters of credit and guarantees were issued outside of the revolving credit facility.~~

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 Agreement~~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 ~~10, 2021,~~29, 2022, we entered into an amendment to our accounts receivable securitization program (the Receivables ~~Securitization Program)~~Financing Agreement). Pursuant to the amended Receivables ~~Securitization Program,~~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 ~~Securitization Program~~Financing Agreement is based on a spread over a benchmark SOFR rate (as described in the ~~Third~~Fourth Amendment to the Receivables Financing Agreement). Under the Receivables ~~Securitization Program,~~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 ~~Securitization Program~~Financing Agreement matures in March ~~2024.~~2025.

The Revolving Credit Agreement, Term Loan A, Term Loan B, Receivables ~~Securitization Program,~~Financing Agreement, 2024 Notes, 2029 Unsecured Notes, and ~~2029~~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 Agreement~~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 ~~September 30, 2021.~~March 31, 2022.

As of ~~September 30, 2021,~~March 31, 2022, scheduled future principal payments of debt, excluding finance leases and other, were ~~$446~~$4.5 million in 2022, $15.4 million in 2023, $274 million in 2024, ~~$12.3~~$270 million in 2025, $43.5 million due in 2026, ~~and $500~~$415 million in ~~2029.~~2027, $6.0 million due in 2028, $1.1 billion in 2029, and $600 million in 2030. Current maturities at ~~September 30, 2021~~March 31, 2022 include ~~$1.6~~$6.0 million in principal payments on our Term Loan B and $2.2 million in current portion of finance leases.

Note 7—Retirement Plans

We have a frozen noncontributory, unfunded retirement plan for certain retirees in the United ~~States.~~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 covering substantially all of their respective teammates.

The components of net periodic benefit cost for the three ~~and nine~~ months ended ~~September 30,~~March 31, 2022 and 2021 ~~and 2020~~ were as follows:


		Three Months Ended September 30,				Nine Months Ended September 30,					Three Months Ended March 31,
		2021		2020		2021		2020			2022		2021
Service cost	Service cost	$	693	$	362	$	2,106	$	1,073	Service cost	$	633	$	704
Interest cost	Interest cost	443		498		1,337		1,488		Interest cost	523		446
Recognized net actuarial loss	Recognized net actuarial loss	353		214		1,060		642		Recognized net actuarial loss	267		353
Net periodic benefit cost	Net periodic benefit cost	$	1,489	$	1,074	$	4,503	$	3,203	Net periodic benefit cost	$	1,423	$	1,503

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Note 8—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.

~~Table~~In April 2022, in order to mitigate the risk of ~~Contents~~

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 ~~September 30, 2021:~~March 31, 2022:

Derivative Assets

Derivative Liabilities

Derivative Assets

Derivative Liabilities

Notional Amount

Maturity Date

Classification

Fair Value

Classification

Fair Value

Notional Amount

Maturity Date

Classification

Fair Value

Classification

Fair Value

Economic (non-designated) hedges

Foreign currency contracts

14,400

October 2021

Other current assets

Other current liabilities

—

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. ~~In September 2020, we terminated $150 million in notional value of interest rate swaps.~~ 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 ~~nine~~three months ended ~~September 30,~~March 31, 2021.

The following table summarizes the terms and fair value of our outstanding derivative financial instruments as of December 31, ~~2020:~~2021:

Derivative Assets

Derivative Liabilities

Derivative Assets

Derivative Liabilities

Notional Amount

Maturity Date

Classification

Fair Value

Classification

Fair Value

Notional Amount

Maturity Date

Classification

Fair Value

Classification

Fair Value

Cash flow hedges

Interest rate swaps

300,000

May 2022 and May 2025

Other assets, net

—

Other liabilities

17,872

Economic (non-designated) hedges

Foreign currency contracts

30,300

January 2021

Other current assets

151

Other current liabilities

—

Foreign currency contracts

9,700

January 2022

Other current assets

Other current liabilities

—

The following table summarizes the effect of cash flow hedge accounting on our consolidated statements of operations for the three ~~and nine~~ months ended ~~September 30,~~March 31, 2021:

Amount of Gain Recognized in Other Comprehensive Income (Loss) 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
Three Months Ended September 30, 2021 Nine Months Ended September 30, 2021 Three Months Ended September 30, 2021 Nine Months Ended September 30, 2021 Three Months Ended September 30, 2021 Nine Months Ended September 30, 2021
Interest rate swaps $ — $ 2,426 Loss on extinguishment of debt $ — $ (40,433) $ — $ (25,518)


	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 ~~periods~~period presented.

~~The following table summarizes the effect of cash flow hedge accounting on our consolidated statements of operations for the three and nine months ended September 30, 2020:~~

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Amount of Loss Recognized in Other Comprehensive Income (Loss) 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
Three Months Ended September 30, 2020 Nine Months Ended September 30, 2020 Three Months Ended September 30, 2020 Nine Months Ended September 30, 2020 Three Months Ended September 30, 2020 Nine Months Ended September 30, 2020
Interest rate swaps $ (515) $ (19,913) Interest expense, net $ (20,975) $ (65,923) $ (3,028) $ (6,889)

~~The amount of ineffectiveness associated with these contracts was immaterial for the periods presented.~~

For the three ~~and nine~~ months ended ~~September 30,~~March 31, 2022 and 2021, we recognized losses of ~~$0.9~~$0.1 million and ~~$2.5 million associated with our economic (non-designated) foreign currency contracts. For the three and nine months ended September 30, 2020 we recognized losses of $0.9 million and $2.3~~$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.

Note 9—Leases

The components of lease expense were as follows:


		Three Months Ended March 31,
	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, 2022		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.

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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

Note 10—Income Taxes

The effective tax rate was ~~12.6% and 20.8%~~18.6% for the three ~~and nine~~ months ended ~~September 30, 2021,~~March 31 2022, compared to ~~13.8% and 9.4%~~24.4% in the same ~~periods~~quarter of ~~2020.~~2021. The change in these rates resulted primarily from an income tax benefit recorded in the first quarter of 2020 associated with the Coronavirus Aid, Relief, and Economic Security (CARES) Act and in the third quarter of 2021 associated with the 2017 Tax Cuts and Jobs Act, 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.~~stock recorded in the first quarter of 2022. The liability for unrecognized tax benefits was ~~$23.0~~$21.6 million at ~~September 30, 2021~~March 31, 2022 and ~~$20.8~~$21.4 million at December 31, ~~2020.~~2021. Included in the liability at ~~September 30, 2021~~March 31, 2022 and December 31, ~~2020~~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 ~~Services~~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,

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interest, and any potential penalties could have a material adverse impact on our financial position, results of operations or cash flows.

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Note ~~10—~~11—Net Income ~~(Loss)~~ per Common Share

The following summarizes the calculation of net income ~~(loss)~~ per common share attributable to common shareholders for the three ~~and nine~~ months ended ~~September 30, 2021~~March 31, 2022 and ~~2020:~~2021:

Three Months Ended
September 30, Nine Months Ended
September 30,
(in thousands, except per share data) 2021 2020 2021 2020
Income from continuing operations, net of tax $ 44,129 $ 46,081 $ 179,614 $ 37,332
Loss from discontinued operations, net of tax — — — (58,203)
Net income (loss) $ 44,129 $ 46,081 $ 179,614 $ (20,871)
Weighted average shares outstanding - basic 73,215 60,786 72,649 60,983
Dilutive shares 2,743 137 2,754 —
Weighted average shares outstanding - diluted 75,958 60,923 75,403 60,983
Basic income (loss) per common share:
Income from continuing operations $ 0.60 $ 0.76 $ 2.47 $ 0.61
Loss from discontinued operations — — — (0.95)
Net income (loss) $ 0.60 $ 0.76 $ 2.47 $ (0.34)
Diluted income (loss) per common share:
Income from continuing operations $ 0.58 $ 0.76 $ 2.38 $ 0.61
Loss from discontinued operations — — — (0.95)
Net income (loss) $ 0.58 $ 0.76 $ 2.38 $ (0.34)


	Three Months Ended March 31,
(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

Note ~~11—~~12—Shareholders' Equity

In 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 ~~September 30, 2021,~~March 31, 2022, no shares were issued and $50.0 million of common stock remained available under the at-the-market equity financing program.

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Note ~~12—~~13—Accumulated Other Comprehensive Loss

The following table shows the changes in accumulated other comprehensive loss by component for the three ~~and nine~~ months ended ~~September 30, 2021~~March 31, 2022 and ~~2020:~~2021:


	Retirement Plans		Currency Translation Adjustments		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)

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Retirement Plans Currency
Translation
Adjustments Derivatives Total
Accumulated other comprehensive loss, June 30, 2021 $ (18,290) $ (14,728) $ — $ (33,018)
Other comprehensive loss before reclassifications — (12,014) — (12,014)
Income tax — — — —
Other comprehensive loss before reclassifications, net of tax — (12,014) — (12,014)
Amounts reclassified from accumulated other comprehensive loss 500 — — 500
Income tax (105) — — (105)
Amounts reclassified from accumulated other comprehensive loss, net of tax 395 — — 395
Other comprehensive income (loss) 395 (12,014) — (11,619)
Accumulated other comprehensive loss, September 30, 2021 $ (17,895) $ (26,742) $ — $ (44,637)

Retirement Plans Currency Translation Adjustments Derivatives Total
Accumulated other comprehensive loss, June 30, 2020 $ (13,926) $ (23,471) $ (24,188) $ (61,585)
Other comprehensive income (loss) before reclassifications — 5,173 (516) 4,657
Income tax — — 40 40
Other comprehensive income (loss) before reclassifications, net of tax — 5,173 (476) 4,697
Amounts reclassified from accumulated other comprehensive loss 214 — 3,028 3,242
Income tax (47) — (871) (918)
Amounts reclassified from accumulated other comprehensive loss, net of tax 167 — 2,157 2,324
Other comprehensive income 167 5,173 1,681 7,021
Accumulated other comprehensive loss, September 30, 2020 $ (13,759) $ (18,298) $ (22,507) $ (54,564)

Retirement Plans Currency
Translation
Adjustments Derivatives Total
Accumulated other comprehensive loss, December 31, 2020 $ (18,447) $ (18) $ (20,044) $ (38,509)
Other comprehensive (loss) income before reclassifications — (26,724) 2,426 (24,298)
Income tax — — (611) (611)
Other comprehensive (loss) income before reclassifications, net of tax — (26,724) 1,815 (24,909)
Amounts reclassified from accumulated other comprehensive loss 704 — 25,518 26,222
Income tax (152) — (7,289) (7,441)
Amounts reclassified from accumulated other comprehensive loss, net of tax 552 — 18,229 18,781
Other comprehensive income (loss) 552 (26,724) 20,044 (6,128)
Accumulated other comprehensive loss, September 30, 2021 $ (17,895) $ (26,742) $ — $ (44,637)

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Retirement Plans Currency Translation Adjustments Derivatives Total
Accumulated other comprehensive loss, December 31, 2019 $ (14,691) $ (25,301) $ (12,715) $ (52,707)
Other comprehensive loss before reclassifications — (8,577) (19,913) (28,490)
Income tax — — 5,113 5,113
Other comprehensive loss before reclassifications, net of tax — (8,577) (14,800) (23,377)
Amounts reclassified from accumulated other comprehensive loss 1,067 15,580 6,889 23,536
Income tax (135) — (1,881) (2,016)
Amounts reclassified from accumulated other comprehensive loss, net of tax 932 15,580 5,008 21,520
Other comprehensive income (loss) 932 7,003 (9,792) (1,857)
Accumulated other comprehensive loss, September 30, 2020 $ (13,759) $ (18,298) $ (22,507) $ (54,564)


	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)

We include amounts reclassified out of accumulated other comprehensive loss related to defined benefit pension plans as a component of net periodic pension cost recorded in Other expense, ~~(income),~~ net.

Note ~~13—~~14—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 2 segments: ~~Global Solutions~~Products & Healthcare Services and ~~Global Products.~~Patient Direct. The ~~Global Solutions~~Products & Healthcare Services segment includes our United States distribution ~~businesses~~business (Medical ~~Distribution and Patient Direct)~~Distribution), outsourced logistics and value-added services ~~business.~~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. ~~We believe all inter-segment sales are at prices that approximate market.~~

The following tables present financial information by segment:

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Three Months Ended
September 30, Nine Months Ended
September 30,
2021 2020 2021 2020
Net revenue:
Segment net revenue
Global Solutions $ 2,022,919 $ 1,865,182 $ 5,850,007 $ 5,261,415
Global Products 679,067 473,797 2,026,385 1,235,391
Total segment net revenue 2,701,986 2,338,979 7,876,392 6,496,806
Inter-segment revenue
Global Products (199,811) (151,051) (558,223) (378,466)
Total inter-segment revenue (199,811) (151,051) (558,223) (378,466)
Consolidated net revenue $ 2,502,175 $ 2,187,928 $ 7,318,169 $ 6,118,340
Operating income:
Global Solutions $ 20,366 $ 10,972 $ 47,729 $ 8,522
Global Products 51,327 89,923 310,242 160,268
Inter-segment eliminations 7,587 (8,718) (475) (10,322)
Intangible amortization (10,025) (10,242) (30,077) (31,463)
Acquisition-related and exit and realignment charges (6,380) (6,382) (20,967) (18,500)
Consolidated operating income $ 62,875 $ 75,553 $ 306,452 $ 108,505
Depreciation and amortization:
Global Solutions $ 9,951 $ 9,572 $ 29,678 $ 31,273
Global Products 12,691 11,118 38,464 38,221
Consolidated depreciation and amortization $ 22,642 $ 20,690 $ 68,142 $ 69,494
Capital expenditures:
Global Solutions $ 5,752 $ 3,582 $ 14,776 $ 7,545
Global Products 8,192 10,656 17,849 15,808
Discontinued operations — — — 3,027
Consolidated capital expenditures $ 13,944 $ 14,238 $ 32,625 $ 26,380


	Three Months Ended March 31,
	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


		September 30, 2021		December 31, 2020			March 31, 2022		December 31, 2021
Total assets:	Total assets:					Total assets:
Global Solutions		$	2,135,865	$	2,117,372
Global Products		1,408,495		1,135,209
Products & Healthcare Services						Products & Healthcare Services	$	2,960,748	$	3,012,303
Patient Direct						Patient Direct	2,535,923		468,536
Segment assets	Segment assets	3,544,360		3,252,581		Segment assets	5,496,671		3,480,839
Cash and cash equivalents	Cash and cash equivalents	39,759		83,058		Cash and cash equivalents	211,298		55,712
Consolidated total assets	Consolidated total assets	$	3,584,119	$	3,335,639	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

Note 15—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

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Three Months Ended September 30, Nine Months Ended September 30,
2021 2020 2021 2020
Net revenue:
United States $ 2,380,794 $ 2,101,074 $ 6,900,222 $ 5,872,143
International 121,381 86,854 417,947 246,197
Consolidated net revenue $ 2,502,175 $ 2,187,928 $ 7,318,169 $ 6,118,340

~~Note 14—Recent Accounting Pronouncements~~

Inbeginning after December ~~2019,~~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. ~~2019-12, Simplifying~~2019-05, Financial Instruments - Credit Losses (Topic 326) Targeted Transition Relief. These ASUs do not change the ~~Accounting for Income Taxes, which simplifies the accounting for income taxes, eliminates certain exceptions within ASC 740, Income Taxes, and clarifies certain aspects~~core principle of the ~~current~~ guidance in ASU No. 2016-13. Instead these amendments are intended to ~~promote consistency among reporting entities. Most amendments~~clarify and improve operability of certain topics included within the ~~standard are required to be applied on a prospective basis, while certain amendments must be applied on a retrospective or modified retrospective basis. We adopted~~credit losses standard. These ASUs will have the same effective date and transition requirements as ASU No. ~~2019-12 effective beginning January 1, 2021. Its adoption did not have a material impact on our consolidated financial statements.~~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 ~~current~~material debt agreements ~~contemplate~~no longer reference LIBOR as a benchmark rate. The transition ~~from LIBOR to another benchmark rate in the event that LIBOR ceases to exist. We do~~did not ~~expect the transition to~~ 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.

~~There~~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 ~~no further changes in~~issued. We adopted ASU 2021-08 prospectively, effective beginning January 1, 2022. Its adoption did not have a material impact on our ~~significant~~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 ~~policies from those contained in~~model by analogy. We adopted ASU No. 2021-10 effective beginning January 1, 2022. Its adoption did not have a material impact on our ~~Annual Report on Form 10-K for the year ended December 31, 2020.~~consolidated financial statements.

Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following discussion and analysis describes results of operations and material changes in the financial condition of Owens & Minor, Inc. and its subsidiaries since December 31, ~~2020.~~2021. Trends of a material nature are discussed to the extent known and considered relevant. This discussion should be read in conjunction with the consolidated financial statements, related notes thereto, and management’s discussion and analysis of financial condition and results of operations included in our Annual Report on Form 10-K for the year ended December 31, ~~2020.~~2021.

Overview

Owens & Minor, Inc., along with its subsidiaries, (we, us, or our) is a leading global healthcare solutions company. ~~On June 18, 2020 (the Divestiture Date),~~To better reflect how we ~~completed the divestiture of our European logistics business, Movianto (the Divestiture),~~go to market as well as certain ~~support functions in~~changes to the leadership team, organizational structure, budgeting and financial reporting processes, we have organized our ~~Dublin, Ireland office, to Walden Group SAS (the Buyer)~~business into two distinct segments: Products & Healthcare Services and ~~EHDH (as Buyer’s guarantor) for cash consideration of $133 million. The Divestiture~~Patient Direct. Products & Healthcare Services provides ~~us with a greater ability to focus on~~distribution, outsourced logistics and ~~invest in our differentiated products,~~value-added services, and ~~U.S. distribution businesses.~~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.

As a result of the Divestiture, the results of operations from our Movianto business are reported as “Loss from discontinued operations, net of tax” for the three and nine months ended September 30, 2020. See Note 3, “Discontinued Operations,” of the Notes to Consolidated Financial Statements for further information. Unless otherwise indicated, the following information relates to continuing operations.

Income from continuing operations per diluted share was $0.58 and $2.38 for the three and nine months ended September 30, 2021 as compared to $0.76 and $0.61 for the three and nine months ended September 30, 2020. Global Solutions segment operating income was $20.4 million and $47.7 million for the three and nine months ended September 30, 2021, compared to $11.0 million and $8.5 million for the three and nine months ended September 30, 2020. These increases were a

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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. 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.

Net income per diluted share was $0.52 for the three months ended March 31, 2022 as compared to $0.98 for the three months ended March 31, 2021. Products & Healthcare Services segment operating income was $89.1 million for the three months ended March 31, 2022, compared to $150.4 million for the three months ended March 31, 2021. The decrease was primarily the result of the timing of glove price changes, accelerating inflationary pressures, including commodities, transportation, and labor, partially offset by leveraging our fixed costs, and operating efficiencies. Patient Direct segment operating income was $15.8 million for the three months ended March 31, 2022, compared to $12.3 million for the three months ended March 31, 2021. The increase was primarily the result of strong revenue growth, leveraging our fixed costs, and operating efficiencies. Global Products segment operating income was $51.3 million and $310 million for the three and nine months ended September 30, 2021, compared to $89.9 million and $160 million for the three and nine months ended September 30, 2020. The decrease for the three months ended September 30, 2021 was primarily the result of the timing of glove cost pass-through, accelerating inflationary pressures, including commodities, transportation, and labor,efficiencies, partially offset by revenue growth. The increase for the nine months ended September 30, 2021 was a result of higher personal protective equipment (PPE) sales, favorable timing of cost pass-through on gloves, productivity initiatives, favorable product mix, and improved fixed cost leverage, partially offset by higher commodity prices and rising transportation costs, compared to the prior year.accelerating inflationary pressures.

COVID-19 Update

We are closely monitoring the impact of the 2019 novel coronavirus (COVID-19), including ~~the related Delta variant,~~recent variants, on all aspects of our business, including how it impacts our customers, teammates, suppliers, vendors and distribution channels. We have taken actions to protect our teammates while maintaining business continuity as we respond to the needs from this global pandemic. We will continue to actively monitor the situation and may take further actions that alter our business operations as may be required by federal, state or local authorities or that we determine are in the best interests of our teammates, customers, suppliers and shareholders.

Revenue for the nine months ended September 30, 2021 of $7.3 billion continues to be impacted by COVID-19 and includes the effective response to the ongoing recovery of elective procedures, higher sales of PPE, and pass-through of elevated glove costs.Operating income for the nine months ended September 30, 2021 also benefited from improved productivity and increased manufacturing output related to PPE, favorable product mix and operating efficiencies. In 2020, we expanded our PPE production operations and have taken measures to increase and improve our production such as retooling existing equipment, installing and optimizing new production lines and ramping up our new non-woven fabric machinery. We expect that we will continue servicing our customers' needs related to the heightened demand for our PPE as a result of various factors, including the implementation of new regulations and healthcare protocols calling for increased use of PPE, healthcare professional preference for medical grade PPE, stockpile PPE demand and the creation of new channels for PPE demand in healthcare, non-healthcare and international markets.

In March 2020, under the Defense Production Act (DPA), we were awarded a contract with the U.S. Department of Health and Human Services to produce N-95 respirator masks in an effort to replenish the Strategic National Stockpile. In April 2020, also under the DPA, the U.S. Department of Defense initiated a technology investment agreement with us involving up to $30.0 million of anticipated funding of assets to expand capacity to supply N-95 respirator masks. Through September 30, 2021, substantially all of the anticipated funding had been expended and reimbursed in accordance with this arrangement.

We are unable to predict the timing of the pandemic and the full impact that COVID-19 will have on our future operating results, financial position and cash flows due to numerous variables and continued uncertainties. Travel, transportation, and business operation restrictions arising from virus containment efforts of governments around the world have continued to impact our operations in certain locations, including within Asia. Essential activity exceptions from these restrictions have allowed us to continue to operate but virus containment efforts have resulted in additional direct costs from supply chain challenges. Although we have experienced growth in sales volumes for certain of our products (such as ~~PPE)~~personal protective equipment (PPE)) during the COVID-19 pandemic, as well as improved productivity and manufacturing output, there can be no assurance that such growth rates, increased sales volumes or other improvements will be maintained during or following the COVID-19 pandemic.

~~Results~~Philips Respironics Recall

In June 2021, one of ~~Operations~~Apria's suppliers, Philips Respironics, announced a voluntary recall (Recall) for continuous and non-continuous ventilators (certain CPAP, BiLevel positive airway pressure and ventilator devices) related to polyurethane foam used in those devices. The Food and Drug Administration (FDA) has since identified this as a Class I recall, the most serious category of recall. Because we distribute these products and provide related home respiratory services and, in part, due to the substantial number of impacted devices, we will likely devote substantial time and resources to coordinating recall-related activity and to supporting our home healthcare patients’ needs. This Recall may cause us to incur significant costs, some or all of which may not be recoverable from the product manufacturer. The Recall may also materially negatively affect our revenues and results of operations as a result of patients not using their impacted devices, current shortages in the availability of both replacement devices for impacted patients and new devices for new patients, patient hesitancy to use respiratory devices generally or other reasons.

We are closely monitoring the impact of the Recall on our business and the uncertainty surrounding the availability and supply of CPAP and ventilators due to the Recall. There is an equipment shortage in the industry and the Recall or other supply chain disruptions may have a future material adverse effect on our financial condition or results of operations, cash flows and liquidity.

~~Net revenue.~~

Three Months Ended
September 30, Change
(Dollars in thousands) 2021 2020 $ %
Global Solutions $ 2,022,919 $ 1,865,182 $ 157,737 8.5 %
Global Products 679,067 473,797 205,270 43.3 %
Inter-segment (199,811) (151,051) (48,760) (32.3) %
Net revenue $ 2,502,175 $ 2,187,928 $ 314,247 14.4 %

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Nine Months Ended
September 30, Change
(Dollars in thousands) 2021 2020 $ %
Global Solutions $ 5,850,007 $ 5,261,415 $ 588,592 11.2 %
Global Products 2,026,385 1,235,391 790,994 64.0 %
Inter-segment (558,223) (378,466) (179,757) (47.5) %
Net revenue $ 7,318,169 $ 6,118,340 $ 1,199,829 19.6 %
Results of Operations

Net revenue.


	Three Months Ended March 31,				Change
(Dollars in thousands)	2022		2021		$		%
Products & Healthcare Services	$	2,134,041	$	2,109,445	$	24,596	1.2	%
Patient Direct	272,911		217,089		55,822		25.7	%
Net revenue	$	2,406,952	$	2,326,534	$	80,418	3.5	%

The ~~change~~increase in net revenue in our Patient Direct segment for the three ~~and nine~~ months ended September 30, 2021 reflected our market share gains, the effective response to the ongoing recovery of elective procedures, higher sales of surgical & infection prevention (S&IP) products, pass-through of elevated glove costs, as well asMarch 31, 2022 was driven by continued strong performance in our ~~Patient Direct business.~~Byram business and the acquisition of Apria on March 29, 2022. The increase in net revenue in our Products & Healthcare Services segment for the three months ended March 31, 2022 reflected market share gains and growth with existing customers, along with an additional sales day, partially offset by a decline in PPE sales. Foreign currency translation had ~~a favorable~~an unfavorable impact on net revenue of ~~$1.8 million and $23.5~~$8.5 million for the three ~~and nine~~ months ended ~~September 30, 2021~~March 31, 2022 as compared to the prior year.

Cost of goods sold.

Three Months Ended
September 30, Change
(Dollars in thousands) 2021 2020 $ %
Cost of goods sold $ 2,173,336 $ 1,843,589 $ 329,747 17.9 %


		Nine Months Ended September 30,				Change					Three Months Ended March 31,				Change
(Dollars in thousands)	(Dollars in thousands)	2021		2020		$		%		(Dollars in thousands)	2022		2021		$		%
Cost of goods sold	Cost of goods sold	$	6,146,511	$	5,236,035	$	910,476	17.4	%	Cost of goods sold	$	2,033,504	$	1,883,783	$	149,721	7.9	%

Cost of goods sold includes the cost of the product (net of supplier incentives and cash discounts) and all costs incurred for shipments of products from manufacturers to our distribution centers for all customer arrangements where we are the primary obligor and bear risk of general and physical inventory loss. These are sometimes referred to as distribution contracts. Cost of goods sold also includes direct and certain indirect labor, material and overhead costs associated with our ~~Global~~ Products & Healthcare Services segment. There is no cost of goods sold associated with our fee-for-service arrangements. Cost of goods sold compared to prior year reflects changes in sales activity, including sales mix, and accelerating inflationary pressures.

Gross margin.

Three Months Ended
September 30, Change
(Dollars in thousands) 2021 2020 $ %
Gross margin $ 328,839 $ 344,339 $ (15,500) (4.5) %
As a % of net revenue 13.14 % 15.74 %


		Nine Months Ended September 30,						Change					Three Months Ended March 31,						Change
(Dollars in thousands)	(Dollars in thousands)	2021			2020			$		%		(Dollars in thousands)	2022			2021			$		%
Gross margin	Gross margin	$	1,171,658		$	882,305		$	289,353	32.8	%	Gross margin	$	373,448		$	442,751		$	(69,303)	(15.7)	%
As a % of net revenue	As a % of net revenue	16.01		%	14.42		%					As a % of net revenue	15.52		%	19.03		%

Gross margin decrease in the three months ended ~~September 30, 2021~~March 31, 2022 was driven by the timing of glove cost pass-through and accelerating inflationary pressures, partially offset by revenue growth. Gross margin increase in the nine months ended September 30, 2021 was driven by revenue growth, market dynamics including timing of glove price and cost changes ~~an overall improved~~in the prior year, accelerating inflationary pressures and sales mix, ~~and operating efficiencies,~~ partially offset by ~~accelerating inflationary pressures.~~revenue growth. Foreign

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currency translation had an unfavorable impact on gross margin of ~~$6.2 million and $0.8~~$4.0 million for the three ~~and nine~~ months ended ~~September 30, 2021~~March 31, 2022 as compared to the prior year.

Operating expenses.


		Three Months Ended September 30,						Change					Three Months Ended March 31,						Change
(Dollars in thousands)	(Dollars in thousands)	2021			2020			$		%		(Dollars in thousands)	2022			2021			$		%
Distribution, selling and administrative expenses	Distribution, selling and administrative expenses	$	262,457		$	262,538		$	(81)	—	%	Distribution, selling and administrative expenses	$	279,740		$	292,701		$	(12,961)	(4.4)	%
As a % of net revenue	As a % of net revenue	10.49		%	12.00		%					As a % of net revenue	11.62		%	12.58		%
Acquisition-related and exit and realignment charges	Acquisition-related and exit and realignment charges	$	6,380		$	6,382		$	(2)	—	%	Acquisition-related and exit and realignment charges	$	33,548		$	5,963		$	27,585	462.6	%
Other operating income, net	Other operating income, net	$	(2,873)		$	(134)		$	(2,739)	(2,044.0)	%	Other operating income, net	$	(899)		$	(2,605)		$	1,706	65.5	%

Nine Months Ended
September 30, Change
(Dollars in thousands) 2021 2020 $ %
Distribution, selling and administrative expenses $ 849,255 $ 758,320 $ 90,935 12.0 %
As a % of net revenue 11.60 % 12.39 %
Acquisition-related and exit and realignment charges $ 20,967 $ 18,500 $ 2,467 13.3 %
Other operating income, net $ (5,016) $ (3,020) $ (1,996) (66.1) %

Distribution, selling and administrative (DS&A) expenses include labor and warehousing costs associated with our distribution and outsourced logistics services and all costs associated with our fee-for-service arrangements. Shipping and handling costs are primarily included in DS&A expenses and include costs to store, move, and prepare products for shipment,

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as well as costs to deliver products to customers. Overall DS&A expenses were affected by ~~revenue growth,~~ changes in accrued incentive compensation, teammate benefits, charitable contributions, and operational efficiencies, partially offset by higher volume to support revenue growth and accelerating inflationary pressures ~~and operational efficiencies~~ for the three ~~and nine~~ months ended ~~September 30, 2021. In addition, overall DS&A expenses were affected by charitable contributions for the nine months ended September 30, 2021.~~March 31, 2022. DS&A expenses also included an ~~unfavorable~~favorable impact for foreign currency translation of ~~$0.1 million and $2.3~~$0.9 million for the three ~~and nine~~ months ended ~~September 30, 2021.~~March 31, 2022.

Acquisition-related ~~and exit and realignment~~ charges ~~presented in our consolidated statements of operations of $6.4 million and $21.0~~were $31.9 million for the three ~~and nine~~ months ended ~~September 30, 2021~~March 31, 2022 as compared to no acquisition-related charges for the three months ended March 31, 2021. Acquisition-related costs in 2022 consisted primarily of ~~wind-down costs related to Fusion5, leadership reorganization costs, IT restructuring charges, and other~~ costs related to the reorganization of the U.S. operations. Acquisition-related charges within acquisition-related and exit and realignment charges presented in our consolidated statements of operations were $0.8 million and $8.9 million for the three and nine months ended September 30, 2020, which consisted primarily of transition costs for the HalyardApria acquisition. Exit and realignment charges were ~~$5.6 million and $9.6~~$1.7 million for the three ~~and nine~~ months ended ~~September 30, 2020 and~~March 31, 2022, which consisted primarily of severance ~~from reduction~~and other charges associated with the reorganization of our segments. Exit and realignment charges were $6.0 million for the three months ended March 31, 2021, which consisted primarily of an increase in ~~force, post divestiture costs related to the Movianto business,~~reserves associated with certain retained assets of Fusion5, IT restructuring charges and other costs related to the reorganization of the U.S. commercial, operations and executive teams.

The change in other operating income, net for the three ~~and nine~~ months ended ~~September 30, 2021~~March 31, 2022 includes the impact of ~~higher~~foreign currency transaction losses, as compared to foreign currency transaction gains ~~as compared to~~for the ~~prior year.~~three months ended March 31, 2021.

Interest expense, net.

Three Months Ended
September 30, Change
(Dollars in thousands) 2021 2020 $ %
Interest expense, net $ 11,572 $ 20,975 $ (9,403) (44.8) %
Effective interest rate 4.17 % 5.64 %


	Three Months Ended March 31,						Change
(Dollars in thousands)	2022			2021			$		%
Interest expense, net	$	12,019		$	13,672		$	(1,653)	(12.1)	%
Effective interest rate	4.65		%	5.45		%

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Nine Months Ended
September 30, Change
(Dollars in thousands) 2021 2020 $ %
Interest expense, net $ 36,784 $ 65,923 $ (29,139) (44.2) %
Effective interest rate 4.72 % 6.35 %

Interest expense, net and the effective interest rate for the three ~~and~~ ~~nine~~months ended ~~September 30, 2021~~March 31, 2022 decreased primarily due to ~~a reduction of debt and~~ lower interest ~~rates.~~rates, partially offset by the increase in debt associated with the Apria Acquisition on March 29, 2022. See Note 6 in Notes to Consolidated Financial Statements.

Loss on extinguishment of debt.

Three Months Ended
September 30, Change
(Dollars in thousands) 2021 2020 $ %
Loss on extinguishment of debt $ — $ 308 $ (308) (100.0) %


		Nine Months Ended September 30,				Change					Three Months Ended March 31,				Change
(Dollars in thousands)	(Dollars in thousands)	2021		2020		$		%		(Dollars in thousands)	2022		2021		$		%
Loss on extinguishment of debt	Loss on extinguishment of debt	$	40,433	$	2,580	$	37,853	1,467.2	%	Loss on extinguishment of debt	$	—	$	40,433	$	(40,433)	(100.0)	%

Loss on extinguishment of debt for the ~~nine~~three months ended ~~September 30,~~March 31, 2021 includes the write-off of deferred financing costs and third party fees associated with the debt financing in March 2021 of $15.3 million and amounts reclassified from accumulated other comprehensive loss as a result of the termination of our interest rate swaps of $25.1 million. ~~Loss on extinguishment of debt for the three and~~ ~~nine~~ ~~months ended September 30, 2020~~ ~~primarily includes the write-off of deferred financing costs and third party fees, offset by the gain on extinguishment of debt related to the partial repurchase of our 2021 and 2024 Notes.~~

Other expense, ~~(income),~~ net.

Three Months Ended
September 30, Change
(Dollars in thousands) 2021 2020 $ %
Other expense (income), net $ 799 $ 785 $ 14 1.8 %


		Nine Months Ended September 30,				Change					Three Months Ended March 31,				Change
(Dollars in thousands)	(Dollars in thousands)	2021		2020		$		%		(Dollars in thousands)	2022		2021		$		%
Other expense (income), net		$	2,397	$	(1,193)	$	3,590	300.9	%
Other expense, net										Other expense, net	$	783	$	569	$	214	37.6	%

Other expense, ~~(income),~~ net for the three ~~and nine~~ months ended ~~September 30,~~March 31, 2022 and 2021 ~~and 2020~~ represents interest cost and net actuarial losses related to our retirement plans.~~Other expense (income), net for the~~ ~~nine months ended September 30, 2020 includes a gain from the surrender of company-owned life insurance policies.~~

Income taxes.


		Three Months Ended September 30,						Change					Three Months Ended March 31,						Change
(Dollars in thousands)	(Dollars in thousands)	2021			2020			$		%		(Dollars in thousands)	2022			2021			$		%
Income tax provision	Income tax provision	$	6,375		$	7,404		$	(1,029)	(13.9)	%	Income tax provision	$	8,978		$	22,429		$	(13,451)	(60.0)	%
Effective tax rate	Effective tax rate	12.6		%	13.8		%					Effective tax rate	18.6		%	24.4		%

2423

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Nine Months Ended
September 30, Change
(Dollars in thousands) 2021 2020 $ %
Income tax provision $ 47,224 $ 3,863 $ 43,361 1,122.5 %
Effective tax rate 20.8 % 9.4 %

The change in the effective tax rate for the three ~~and nine~~ months ended ~~September 30, 2021~~March 31, 2022 compared to the same ~~periods~~period in ~~2020~~2021 resulted primarily from an income tax benefit recorded in the first quarter of 2020 associated with the Coronavirus Aid, Relief, and Economic Security (CARES) Act and in the third quarter of 2021 associated with the 2017 Tax Cuts and Jobs Act, 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.~~stock recorded in the first quarter of 2022.

Financial Condition, Liquidity and Capital Resources

Financial condition. We monitor operating working capital through days sales outstanding (DSO) and merchandise inventory days. We estimate a hypothetical increase (decrease) in DSO of one day would result in a decrease (increase) in our cash balances, an increase (decrease) in borrowings against our revolving credit facility or ~~Receivables Securitization Program,~~receivables securitization program, or a combination thereof of approximately $27 million.

The majority of our cash and cash equivalents are held in cash depository accounts with major banks in the United States, Europe, and Asia. Changes in our working capital can vary in the normal course of business based upon the timing of inventory purchases, collections of accounts receivable, and payments to suppliers.


		September 30, 2021		December 31, 2020				Change							March 31, 2022				December 31, 2021		Change
(Dollars in thousands)	(Dollars in thousands)					$				%		(Dollars in thousands)					$				%
Cash and cash equivalents	Cash and cash equivalents	$	39,759			$	83,058			$	(43,299)			(52.1)			%	Cash and cash equivalents	$	211,298	$	55,712	$	155,586		279.3	%
Accounts receivable, net of allowances	Accounts receivable, net of allowances	$	759,744	$	700,792			$	58,952			8.4	%	Accounts receivable, net of allowances	$	775,779			$	681,564	$	94,215	13.8		%
Consolidated DSO (1)	Consolidated DSO (1)	27.3		26.0										Consolidated DSO (1)	24.9				24.6
Merchandise inventories	Merchandise inventories	$	1,514,387	$	1,233,751			$	280,636			22.7	%	Merchandise inventories	$	1,447,383			$	1,495,972	$	(48,589)	(3.2)		%
Inventory days (2)	Inventory days (2)	64.1		57.8										Inventory days (2)	63.7				64.7
Accounts payable	Accounts payable	$	1,118,753	$	1,000,186			$	118,567			11.9	%	Accounts payable	$	1,115,400			$	1,001,959	$	113,441	11.3		%

(1) Based on period end accounts receivable and net revenue for the quarters ended ~~September 30, 2021~~March 31, 2022 and December 31, ~~2020~~2021, excluding the impact of the Apria Acquisition.

(2) Based on period end merchandise inventories and cost of goods sold for the quarters ended ~~September 30, 2021~~March 31, 2022 and December 31, ~~2020~~

2021, excluding the impact of the Apria Acquisition.

Liquidity and capital expenditures. The following table summarizes our consolidated statements of cash flows for the ~~nine~~three months ended ~~September 30, 2021~~March 31, 2022 and ~~2020, which relates to continuing operations and discontinued operations:~~2021:


(Dollars in thousands)	(Dollars in thousands)	2021		2020		(Dollars in thousands)	2022		2021
Net cash provided by (used for):	Net cash provided by (used for):					Net cash provided by (used for):
Operating activities	Operating activities	$	73,836	$	268,196	Operating activities	$	79,699	$	25,423
Investing activities	Investing activities	(32,584)		112,830		Investing activities	(1,587,236)		(6,619)
Financing activities	Financing activities	(117,222)		(244,955)		Financing activities	1,664,194		(80,394)
Effect of exchange rate changes	Effect of exchange rate changes	(2,454)		6,721		Effect of exchange rate changes	(669)		(2,139)
Net (decrease) increase in cash, cash equivalents and restricted cash		$	(78,424)	$	142,792
Net increase (decrease) in cash, cash equivalents and restricted cash						Net increase (decrease) in cash, cash equivalents and restricted cash	$	155,988	$	(63,729)

Cash provided by operating activities in the first ~~nine~~three months of ~~2021~~2022 and ~~2020~~2021 reflected ~~fluctuations in~~cash generated by net income along with changes in working capital.

Cash used for investing activities in the first ~~nine~~three months of ~~2021~~2022 included cash paid for the acquisition of Apria of $1.6 billion and ~~2020~~capital expenditures of $11.0 million for our strategic and operational efficiency initiatives associated with property and equipment and capitalized software. Cash used for investing activities in the first three months of 2021 included capital expenditures of ~~$32.6 million and $26.4~~$6.6 million for our strategic and operational efficiency initiatives associated with property and equipment, investments for increased manufacturing capacity in the Americas, and capitalized software. Cash provided by investing activities in the first nine months of 2020 included cash consideration received of $133 million from the sale of Movianto and proceeds of $6.0 million from the surrender of company-owned life insurance policies.

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Cash used for financing activities in the first ~~nine~~three months of ~~2021~~2022 included ~~dividend payments of $0.5 million and net repayments of $90.9 million~~borrowings under our revolving credit facility, net and accounts receivable securitization program of $41.7 million compared to ~~$0.5 million and $108~~net repayments of $21.6 million for the same period of ~~2020.~~2021. We also had proceeds from borrowings of ~~$575~~$1.7 billion related to the 2030 Unsecured Notes, Term Loan A, and Term Loan B for the first three months of 2022, compared to $500 million related to the 2029 Unsecured Notes ~~and Accounts Receivable Securitization Program~~ for the first ~~nine~~three months of ~~2021, compared to $150 million related to the Accounts Receivable Securitization Program for the first nine months of 2020.~~2021. ~~Financing activities also included repayments of $553 million for the first nine months of 2021 on our term loans, 2021 and 2024 Notes, and~~ ~~Accounts Receivable Securitization Program,~~ ~~compared~~ ~~to $270 million~~ ~~in the same period of~~ ~~2020~~ ~~on our term loans and 2021 and 2024 Notes. We used $83.3 million of cash to repurchase~~ ~~$87.9 million~~ ~~aggregate principal amount of the 2021 and 2024 Notes during the first~~ ~~nine~~ ~~months of 2020.~~ We also paid ~~$13.9~~$33.7 million in financing costs in the first ~~nine~~three months of ~~2021~~2022, as compared to ~~$10.4~~$11.7 million ~~in financing costs~~ for the same period of ~~2020.~~ 2021. Payments for taxes related to the vesting of restricted stock awards were $35.7 million and $8.0 million for the first three months of 2022 and 2021, which are included in Other, net. Financing activities in the first three months of 2021 included repayments of $523 million on our previous Term Loan A-2 and previous Term Loan B. In addition, we paid $15.4 million to terminate the remaining $300 million in notional value of interest rate swaps during the first ~~nine~~three months of 2021. ~~Payments for taxes related to the vesting~~

Table of ~~restricted stock awards were $19.3 million and $3.6~~Contents~~million for the first nine months of 2021 and 2020, which are included in Other, net.~~

Capital ~~resources~~.resources. Our sources of liquidity include cash and cash equivalents, a revolving credit facility ~~under our Credit Agreement~~ with ~~Bank of America, N.A, as~~ an administrative ~~agent~~ and collateral agent and a syndicate of financial institutions, as lenders (the Revolving Credit Agreement), and ~~the Receivables Securitization Program.~~a receivables securitization program. The Revolving Credit Agreement provides a revolving borrowing capacity of ~~$300~~$450 million. We have $1.1 billion in outstanding term loans under a term loan credit agreement (the Credit Agreement). The interest rate on our revolving credit facility is based on a spread over a benchmark rate (as described in the Revolving Credit Agreement). The Revolving Credit Agreement matures in March 2026. The interest rate on the Term Loan A facility (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 facility (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.

At ~~September 30, 2021~~March 31, 2022 and December 31, ~~2020,~~2021, we had borrowings of ~~$12.3~~$11.7 million and ~~$103 million,~~letters of credit of $28.0 million. At December 31, 2021, we had no borrowings and letters of credit of $9.4 million ~~and $13.9 million~~ outstanding under our credit agreements. At ~~September 30, 2021~~March 31, 2022 and December 31, ~~2020,~~2021, we had ~~$278~~$410 million and ~~$283~~$291 million, available for borrowing. We also had letters of credit and bank guarantees, ~~outstanding~~which were issued outside of the Revolving Credit Facility for ~~$2.2~~$2.1 million and ~~$1.6~~$2.2 million as of ~~September 30, 2021~~March 31, 2022 and December 31, ~~2020,~~2021, which supports certain leased facilities as well as other normal business activities in the United States and Europe. ~~These letters of credit and guarantees were issued outside of the revolving credit facility.~~

On March ~~10, 2021,~~29, 2022, we entered into an amendment to our accounts receivable securitization program (the Receivables ~~Securitization Program)~~Financing Agreement). Pursuant to the amended Receivables ~~Securitization Program,~~Financing Agreement, the aggregate principal amount of the loans made by the Lenders (as defined) will not exceed~~$450~~ $450 million outstanding at any time. The interest rate under the Receivables ~~Securitization Program~~Financing Agreement is based on a spread over a benchmark SOFR rate (as described in the ~~Third~~Fourth Amendment to the Receivables Financing Agreement). Under the Receivables ~~Securitization Program,~~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 ~~Securitization Program~~Financing Agreement matures in March ~~2024.~~2025.

In 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 ~~September 30, 2021~~March 31, 2022 no shares were issued and $50.0 million of common stock remained available under the at-the-market equity financing program.

We regularly evaluate market conditions, our liquidity profile and various financing alternatives to enhance our capital structure. From time to time, we may enter into transactions to repay, repurchase or redeem our outstanding indebtedness (including by means of open market purchases, privately negotiated repurchases, tender or exchange offers and/or repayments or redemptions pursuant to the debt’s terms). Our ability to consummate any such transaction will depend on prevailing market conditions, our liquidity requirements, contractual restrictions and other factors. We cannot provide any assurance as to if or when we will consummate any such transactions or the terms of any such transaction.

The third quarter dividend of $0.0025 per share was paid in September 2021. The payment of future dividends remains within the discretion of the Board of Directors and will depend upon our results of operations, financial condition, capital requirements, current and future limitations under our Credit Agreement and other factors.

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We believe available financing sources, including cash generated by operating activities and borrowings under the Revolving Credit Agreement and Receivables ~~Securitization Program,~~Financing Agreement, will be sufficient to fund our working capital needs, capital expenditures, long-term strategic growth, payments under long-term debt and lease arrangements, ~~payments of quarterly cash dividends,~~ debt repurchases and other cash requirements. While we believe that we will have the ability to meet our financing needs in the foreseeable future, changes in economic conditions may impact (i) the ability of financial institutions to meet their contractual commitments to us, (ii) the ability of our customers and suppliers to meet their obligations to us or (iii) our cost of borrowing.

We earn a portion of our operating income in foreign jurisdictions outside the United States. Our cash and cash equivalents held by our foreign subsidiaries totaled ~~$28.7~~$51.1 million and ~~$72.0~~$26.9 million at ~~September 30, 2021~~March 31, 2022 and December 31, ~~2020.~~2021. We continue to remain permanently reinvested in our foreign subsidiaries, with the exception of a subsidiary in Thailand. We

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have no specific plans to indefinitely reinvest the unremitted earnings of our foreign subsidiary located in Thailand as of ~~September 30, 2021.~~March 31, 2022. As such, we have recorded withholding tax liabilities that would be incurred upon future distribution to the U.S. There are no unrecognized deferred taxes as there is no outside basis difference unrelated to unremitted earnings for Thailand. We will continue to evaluate our foreign earnings repatriation policy in ~~2021~~2022 for all our foreign subsidiaries.

Guarantor and Collateral Group Summarized Financial Information

We are providing the following information in compliance with Rule 13-01, “Financial Disclosures about Guarantors and Issuers of Guaranteed Securities” and Rule 13-02 of Regulation S-X, of with respect to our 2024 Notes. See Note 6 of the accompanying consolidated financial statements for additional information regarding the terms of the 2024 Notes.

The following tables present summarized financial information for Owens & Minor, Inc. and the guarantors of Owens & Minor, Inc.’s 2024 Notes (together, "the Guarantor Group"), on a combined basis with intercompany balances and transactions between entities in the Guarantor Group eliminated. The guarantor subsidiaries are 100% owned by Owens & Minor, Inc. Separate financial statements of the guarantor subsidiaries are not presented because the guarantees by our guarantor subsidiaries are full and unconditional, as well as joint and several.

Summarized financial information of the Guarantor Group is as follows:


Summarized Consolidated Statement of Operations - Guarantor Group	~~Nine~~Three Months Ended ~~September 30, 2021~~March 31, 2022
(Dollars in thousands)
Net revenue(1)	$	~~7,197,318~~2,320,785
Gross margin	~~1,086,054~~326,742
Operating income	~~265,888~~
~~Income from continuing operations, net of tax~~	~~158,735~~31,159
Net income	~~158,735~~20,742

(1)Includes ~~$297~~$62 million in sales to non-guarantor subsidiaries for the ~~nine~~three months ended ~~September 30, 2021.~~March 31, 2022.


Summarized Consolidated Balance Sheets - Guarantor Group	Summarized Consolidated Balance Sheets - Guarantor Group	September 30, 2021		December 31, 2020		Summarized Consolidated Balance Sheets - Guarantor Group	March 31, 2022		December 31, 2021
(Dollars in thousands)	(Dollars in thousands)					(Dollars in thousands)
Total current assets	Total current assets	$	1,428,986	$	1,559,248	Total current assets	$	1,660,658	$	1,449,917
Total assets	Total assets	2,950,802		2,943,125		Total assets	4,939,206		2,807,581
Current liabilities	Current liabilities	1,456,508		1,374,800		Current liabilities	1,700,027		1,399,499
Total liabilities	Total liabilities	2,500,939		2,465,894		Total liabilities	4,542,949		2,422,542

The following tables present summarized financial information for Owens & Minor, Inc. and the subsidiaries of Owens & Minor, Inc.’s 2024 Notes pledged that constitute a substantial portion of collateral (together, "the Collateral Group"), on a combined basis with intercompany balances and transactions between entities in the Collateral Group eliminated. The pledged subsidiaries are 100% owned by Owens & Minor, Inc. No trading market for the subsidiaries included in the Collateral Group exists.

Summarized financial information of the Collateral Group is as follows:

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Summarized Consolidated Balance Sheets - Collateral Group	Summarized Consolidated Balance Sheets - Collateral Group	September 30, 2021		December 31, 2020		Summarized Consolidated Balance Sheets - Collateral Group	March 31, 2022		December 31, 2021
(Dollars in thousands)	(Dollars in thousands)					(Dollars in thousands)
Total current assets	Total current assets	$	1,517,670	$	1,651,460	Total current assets	$	1,753,371	$	1,514,724
Total assets	Total assets	2,703,556		2,851,226		Total assets	4,907,983		2,729,455
Current liabilities	Current liabilities	1,422,746		1,356,024		Current liabilities	1,650,855		1,341,691
Total liabilities	Total liabilities	2,498,158		2,480,953		Total liabilities	4,530,738		2,398,694

The results of operations of the Collateral Group are not materially different from the corresponding amounts presented in our consolidated statements of operations.

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Recent Accounting Pronouncements

For a discussion of recent accounting pronouncements, see our Annual Report on Form 10-K for the year ended December 31, ~~2020~~2021 and Note 1415 in the Notes to Consolidated Financial Statements, included in this Quarterly Report on Form 10-Q for the period ended on ~~September 30, 2021.~~March 31, 2022.

Forward-looking Statements

Certain statements in this discussion constitute “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. Although we believe our expectations with respect to the forward-looking statements are based upon reasonable assumptions within the bounds of our knowledge of our business and operations, all forward-looking statements involve risks and uncertainties and, as a result, actual results could differ materially from those projected, anticipated or implied by these statements. Such forward-looking statements involve known and unknown risks, including, but not limited to:

•our ability to achieve revenue and operating income goals may be affected by: COVID-19 related factors, risks and challenges, including among others, the length of time that the pandemic continues, and any worsening of the pandemic, including through any new variant strains of the underlying virus, or future pandemics, related governmental responses, the effectiveness, availability, and public acceptance of vaccines, a decrease in revenue ultimately resulting in less cash flow, longer duration in receivables collection, the need to expedite payments to important suppliers may grow, shifts in demand away from certain products we manufacture and distribute, reduced workforces which may be caused by, but not limited to, the temporary inability of the workforce to work due to illness, quarantine, or government vaccine and other mandates, temporary production and distribution center and office closures due to reduced workforces or government vaccine and other mandates, availability of raw materials, potential resulting labor negotiations or disputes, changes in the types and numbers of businesses that compete with us, including non-traditional competitors, and the aggressiveness of that competition, impacts of the pandemic or future pandemics on other third parties with whom we conduct business, the healthcare industry, and the broader business environment, and trends in elective surgeries and other healthcare spending not directly associated with COVID-19;

•competitive pressures in the marketplace, including intense pricing pressure;

•our ability to retain existing and attract new customers in a market characterized by consolidation among significant ~~customer consolidation~~customers, health insurers and/or other industry participants, and intense cost-containment initiatives;

•our dependence on sales to certain customers or the loss or material reduction in purchases by key customers;

•our dependence on distribution of product of certain suppliers;

•our ability to successfully identify, manage or integrate acquisitions;

•our ability to successfully manage our international operations, including risks associated with changes in international trade regulations, foreign currency volatility, changes in regulatory conditions, deteriorating economic conditions, adverse tax consequences, and other risks of operating in international markets;

•the risk that problems may arise in successfully integrating the businesses of Apria and the Company, which may result in the combined company not operating as effectively and efficiently as expected and the risk that the combined company may be unable to achieve the anticipated synergies or cost savings, or it may take longer than expected to achieve those synergies;

•the effect of our acquisition of Apria and any developments relating thereto on our relationships with customers, suppliers and other third parties, as well as our operating results and business;

•uncertainties related to and our ability to adapt to changes in government regulations, including healthcare laws and regulations;

•risks arising from possible violations of legal, regulatory or licensing requirements of the markets in which we operate;

•uncertainties related to general economic, regulatory and business conditions;

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•our ability to successfully implement our strategic initiatives;

•the availability of and modifications to existing supplier funding programs and our ability to meet the terms to qualify for certain of these programs;

•the effect of price volatility in the commodities markets, including fuel price fluctuations, on our operating costs and supplier product prices;

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•our ability to adapt to changes in product pricing and other terms of purchase by suppliers of product;

•the ability of customers and suppliers to meet financial commitments due to us;

•changes in manufacturer preferences between direct sales and wholesale distribution;

•changing trends in customer profiles and ordering patterns and our ability to meet customer demand for additional value-added services;

•our ability to manage operating expenses and improve operational efficiencies in response to changing customer profiles;

•our ability to meet performance targets specified by customer contracts under contractual commitments;

•availability of and our ability to access special inventory buying opportunities;

•the ability of business partners and financial institutions to perform their contractual responsibilities;

•our ability to continue to obtain financing, obtain financing at reasonable rates and to manage financing costs and interest rate risk, and our ability to refinance, extend or repay our substantial indebtedness;

•the risk that information systems are interrupted or damaged or fail for any extended period of time, that new information systems are not successfully implemented or integrated, or that there is a data security breach in our information systems;

•we depend on reimbursements by payors, which could lead to delays and uncertainties in the reimbursement process;

•the home healthcare industry is highly competitive and fragmented, with limited barriers to entry which may make it susceptible to vertical integration by manufacturers, payors, providers (such as hospital systems) or disruptive new entrants;

•the risk that a decline in business volume or profitability could result in an impairment of goodwill or other long-lived assets;

•our ability to timely or adequately respond to technological advances in the medical supply ~~industry;~~and home healthcare industries and/or product and therapy innovations may make the services we currently provide obsolete or less competitive;

•our failure to adequately insure against losses, including from substantial claims and litigation, could have an adverse impact on our operations, financial condition, or prospects;

•recalls of any of our products, either voluntarily or at the direction of the Food and Drug Administration or another governmental authority, or safety risks or the discovery of serious safety issues with our products;

•our capitation arrangements may prove unprofitable if actual utilization rates exceed our assumptions;

•reductions in Medicare, Medicaid and commercial payor reimbursement rates could have a material adverse effect on our results of operations and financial condition;

•the costs associated with and outcome of outstanding and any future litigation, including product and professional liability claims;

•adverse changes in U.S. and foreign tax laws and the outcome of outstanding tax contingencies and legislative and tax proposals;

•our ability to successfully implement the expense reduction and productivity and efficiency initiatives;

•our ability to continue to comply with the terms and conditions of ~~Byram Healthcare’s~~Apria’s Corporate Integrity Agreement; and

•other factors detailed from time to time in the reports we file with the SEC, including those described in “Item 1A. Risk Factors” of our Annual Report on Form 10-K for the year ended December 31, ~~2020, our Form 10-Q for the three months ended March 31, 2021, and our Form 10-Q for the three and six months ended June 30,~~ 2021.

We undertake no obligation to update or revise any forward-looking statements, except as required by applicable law.

Item 3. Quantitative and Qualitative Disclosures About Market Risk

We are subject to price risk for our raw materials, the most significant of which relates to the cost of polypropylene and nitrile used in the manufacturing processes of our ~~Global~~ Products & Healthcare Services segment. Prices of the commodities

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underlying these raw materials are volatile and have fluctuated significantly in recent years and in the future may contribute to fluctuations in our results of operations. The ability to hedge these commodity prices is limited.

We are exposed to risks of changes in shipping and freight costs, including container and other third party fees associated with the transportation of our products. Shipping and freight costs have fluctuated significantly in recent years and in the future may contribute to changes in our results of operations.

In the normal course of business, we are exposed to foreign currency translation and transaction risks. Our business transactions outside of the United States are denominated in the euro, Malaysian ringgit, Mexican peso, Thai baht and other currencies. We may use foreign currency forwards, swaps and options, where possible, to manage our risk related to certain foreign currency fluctuations.

We are exposed to market risk from changes in interest rates related to our borrowing under our Revolving Credit Agreement and Receivables ~~Securitization Program. We had~~Financing Agreement. Excluding deferred financing costs and third party fees, ~~$12.3~~we had $500 million in borrowings under our Term Loan A, $600 million in borrowings under our Term Loan B, $11.7 million in borrowings under our revolving credit facility, ~~$197~~$230 million in

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borrowings under our Receivables ~~Securitization Program~~Financing Agreement and ~~$9.4~~$28.0 million in letters of credit under the Revolving Credit Agreement at ~~September 30, 2021. We~~March 31, 2022. After considering the effects of an interest rate swap agreement entered into during April 2022, we estimate an increase in interest rates of 100 basis points would result in a potential reduction in future pre-tax earnings of approximately ~~$2.2~~$9.4 million per year based on our borrowings outstanding at ~~September 30, 2021.~~March 31, 2022.

Due to the nature and pricing of our ~~Global Solutions~~Products & Healthcare Services segment distribution services, we are exposed to potential volatility in fuel prices. Our strategies for helping to mitigate our exposure to changing domestic fuel prices have included using trucks with improved fuel efficiency. We benchmark our domestic diesel fuel purchase prices against the U.S. Weekly Retail On-Highway Diesel Prices (benchmark) as quoted by the U.S. Energy Information Administration. The benchmark averaged ~~$3.16~~$4.30 and ~~$2.58~~$2.91 per gallon in the first ~~nine~~three months of ~~2021~~2022 and ~~2020.~~2021. Based on our fuel consumption in the first ~~nine~~three months of ~~2021,~~2022, we estimate that every 10 cents per gallon increase in the benchmark would directly reduce our ~~Global Solutions~~Products & Healthcare Services segment operating income by approximately $0.2 million on an annualized basis.We are also indirectly exposed to increased shipping and freight costs, including container and other third party fees associated with the transportation of our products due to changes in fuel prices. Changes in fuel prices have contributed to significant shipping and freight costs in recent years and in the future may contribute to changes in our results of operations.

Item 4. Controls and Procedures

We carried out an evaluation, with the participation of management, including our principal executive officer and principal financial officer, of the effectiveness of our disclosure controls and procedures (pursuant to Rule 13a-15(e) under the Securities Exchange Act of 1934, as amended) as of the end of the period covered by this report. Based upon that evaluation, the principal executive officer and principal financial officer concluded that our disclosure controls and procedures were effective as of ~~September 30, 2021.~~March 31, 2022. There was no change in our internal control over financial reporting that occurred during the period of this report that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting. In connection with the Apria Acquisition, we are currently evaluating the acquired processes, information technology systems and other components of internal controls over financial reporting as part of our integration activities which may result in periodic changes. Such changes will be disclosed as required by applicable SEC guidance.

SEC guidance permits the exclusion of an evaluation of the effectiveness of a registrant's disclosure controls and procedures as they relate to the internal control over financial reporting for an acquired business during the first year following such acquisition. In the first quarter of 2022, we acquired Apria, Inc. This acquisition represented $2.1 billion of total assets and $11.0 million of revenues as of and for the three months ended March 31, 2022. Management's evaluation and conclusion as to the effectiveness of the design and operation of the Company's disclosure controls and procedures as of and for the period covered by this report excludes any evaluation of the internal control over financial reporting of Apria, Inc.

Part II. Other Information

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Item 1. Legal Proceedings

Certain legal proceedings pending against us are described in our Annual Report on Form 10-K for the year ended December 31, ~~2020.~~2021. Through ~~September 30, 2021,~~March 31, 2022, there have been no material developments in any legal proceedings reported in such Annual Report.

Item 1A. Risk Factors

The following description of risk factors updates and supplements risk factors associated with our business previously disclosed in our Annual Report on Form 10-K for the year ended December 31, ~~2020, our Form 10-Q for the three months ended March 31, 2021, and our Form 10-Q for the three and six months ended June 30,~~ 2021. These risk factors are in addition to those mentioned in other parts of this report and are not all of the risks that we face. We could also be affected by risks that we currently are not aware of or that we currently do not consider material to our business.

We face increasing competition, accelerating pricing pressure and changes in technology.

The medical/surgical supply distribution industry in the United States is highly competitive and characterized by pricing and margin pressure for our business. We compete with other national distributors and a number of regional and local distributors, as well as customer self-distribution models and, to a lesser extent, certain outsourced logistics companies. Competitive factors within the medical/surgical supply distribution industry include market pricing, the relative bargaining power of provider networks and group purchasing organizations (GPO), total delivered product cost, product availability, the ability to fill and invoice orders accurately, delivery time, range of services provided, efficient product sourcing, inventory management, information technology, electronic commerce capabilities, and the ability to meet customer-specific requirements. Our success is dependent on the ability to compete on the above factors, while managing internal costs and expenses.

The home healthcare industry is also intensely competitive and highly fragmented. There are a large number of providers, including hospital systems, physician specialists and sleep labs, industrial gas manufacturers, home healthcare agencies and health maintenance organizations. There are also relatively few barriers to entry in local home healthcare markets. Hospitals and health systems are routinely looking to provide coverage and better control of post-acute healthcare services, including home healthcare services of the types we provide. In addition, pharmacy benefit managers, such as CVS Health Corporation, are beginning to compete with us in the home healthcare market. Large technology companies, such as Amazon.com, Inc. and Alphabet Inc., have disrupted other supply businesses and, in the case of Amazon.com, Inc. and their new pharmacy offerings, entered the healthcare market or publicly stated their interest in doing so. In the event such companies enter the home healthcare market, we may experience a loss of referrals or revenue.

Some of our competitors may now or in the future have greater financial or marketing resources than we do, or have more effective sales and marketing activities, which may increase pricing pressure and limit our ability to maintain or increase our market share. In addition, in certain markets, competitors may have more effective sales and marketing activities or other products and services that are or perceived to be superior to our own.

It is also possible that major changes in available technology, payor benefit or coverage policies related to those changes, or the preferences of customers, patients and referral sources, may cause our current product offerings to become less competitive or obsolete, and it will be necessary for us to adapt to those changes. Such unanticipated changes could cause us to incur increased capital expenditures and strategies and could have a material adverse effect on our business, results of operations, financial condition and cash flows.

Changing conditions in the United States healthcare industry may impact our results of operations.

A large percentage of our revenue is derived in the United States. We, along with our customers and suppliers, are subject to ~~risks related~~extensive federal and state regulations relating to ~~public health crises or future outbreaks of health crises or other adverse public health developments such~~healthcare as well as the ~~global pandemic associated with~~policies and practices of the ~~2019 novel coronavirus (COVID-19).~~

Asprivate healthcare insurance industry. In recent years, there have been a ~~global healthcare solutions company, we are impacted by public health crises such as the global pandemic associated with COVID-19. The outbreak has significantly increased uncertainty~~number of government and ~~unpredictability of global economic conditions and the demand for and supply of raw materials and finished goods required for our operations. In addition, public and~~ private ~~sector policies and~~ initiatives to reduce healthcare costs and government spending. These changes have included an increased reliance on managed care; consolidation of competitors, suppliers and customers; a shift in healthcare provider venues from acute care settings to clinics, physician offices and home care; and the ~~transmission~~development of ~~COVID-19, such as the imposition of travel restrictions, the adoption of remote working~~larger, more sophisticated purchasing groups. National and ~~vaccination mandates, have impacted or may~~regional insurers and managed care organizations are regularly attempting to seek reductions in the ~~future impact our operations. In these challenging and dynamic circumstances,~~prices we continue to work to protect our teammates and the public, maintain business continuity and sustain our operations, including ensuring the safety and protection of the people who work in our production and distribution centers across the world, many of whom support the manufacturing and delivery of products that are critical in response to the global pandemic. We may restrict the operations of our production and distribution centers if we deem it necessary or if recommended or mandated by governmental authorities which would have an adverse impact on us. There is a risk that revenues will decrease ultimately resulting in less cash flow, we may see longer duration in receivables collection, and the need to expedite payments to important suppliers may grow. COVID-19 has impacted and may further impact our supply chains relative to global demandcharge for our ~~facial protection, nitrile gloves, and protective apparel products. COVID-19 has also affected and may further affect the ability of suppliers and vendors to provide~~ products and services to ~~us or~~them and their members, including through direct contracts with healthcare providers, increased oversight and greater enrollment of patients in managed care programs and preferred provider organizations. We have faced, and expect to ~~do so at acceptable quality levels or prices. Some of these factors could increase the demand~~continue to face, pricing pressures due to reductions in provider reimbursement for our products ~~while others could decrease demand or make it more difficult for us~~and services. In addition, in recent years, the healthcare industry in the United States has experienced and continues to ~~serve customers. For example,~~experience significant consolidation in response to cost containment legislation and general market pressures to reduce costs. This consolidation of our customers, health insurers and suppliers generally gives them greater bargaining power to reduce the ~~significant~~pricing available to them. All of these changes place additional financial pressure on healthcare provider customers, who in turn seek to reduce the costs and pricing of products and services provided by us. We expect the healthcare industry to continue to change significantly and these potential changes, which may include a reduction in ~~elective surgical procedures, which began mid-March~~government support of ~~2020, resulted~~healthcare services, adverse changes in legislation or regulations, and further reductions in healthcare reimbursement practices, could have a material ~~negative impact~~adverse effect on our ~~revenue for 2020. Any worsening~~business, results of ~~the COVID-19 pandemic or future outbreaks could result in similar reductions in elective surgical procedures or otherwise~~operations and financial condition.

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~~reduce demand~~We have concentration in and dependence on certain healthcare provider customers and Group Purchasing Organizations. New Group Purchasing Organizations or provider networks and an expansion of the multi-tiered costing structure may place us at a competitive disadvantage.

In 2021, although no single customer accounted for 5% of our consolidated net revenue on a pro forma basis for our ~~products,~~acquisition of Apria, our top ten customers in the United States represented approximately 18% of our consolidated net revenue on a pro forma basis for our acquisition of Apria. In addition, in 2021, approximately 63% of our consolidated net revenue on a pro forma basis for our acquisition of Apria was from sales to member hospitals under contract with our largest GPOs: Vizient, Premier and HPG. We could lose a significant healthcare provider customer or GPO relationship if an existing contract expires without being replaced or is terminated by the customer or GPO prior to its expiration. Although the termination of our relationship with a given GPO would not necessarily result in the loss of the member hospitals as customers, any such termination of ~~which~~a GPO relationship, or a significant individual healthcare provider customer relationship, could have a material ~~negative impact~~adverse effect on our ~~revenues~~results of operations and ~~profit~~financial condition.

The medical products industry is subject to a multi-tiered costing structure, which can vary by manufacturer and/or product. Under this structure, certain institutions can obtain more favorable prices for ~~future periods.~~

medical products than we are able to obtain. The multi-tiered costing structure continues to expand as many large integrated healthcare providers and others with significant purchasing power, such as GPOs, demand more favorable pricing terms. Additionally, the formation of provider networks and GPOs may shift purchasing decisions to entities or persons with whom we do not have a historical relationship. This may threaten our ability to compete effectively, which could in turn negatively impact our financial results. Although we ~~have experienced significant growth in sales volumes for certain~~are seeking to obtain similar terms from manufacturers to obtain access to lower prices demanded by GPO contracts or other contracts, and to develop relationships with provider networks and new GPOs, we cannot assure you that such terms will be obtained or contracts will be executed.

The reliance of our home healthcare business on relatively few vendors for the majority of its patient equipment and supplies and which are to be imposed on certain manufacturers of such items could adversely affect our ability to operate this business.

We currently rely on a relatively small number of vendors to provide us with the majority of our patient equipment and supplies for our home healthcare business. From time to time, we also enter into certain exclusive arrangements with a given vendor for the provision of patient equipment and supplies. Further, some of our supply agreements contain pricing scales that depend on meeting certain order volumes. Our inability to procure certain equipment and supplies, including as a result of failure to maintain and renew certain agreements and access arrangements, could have a materially adverse effect on our results of operations. We often use vendors selectively for quality and cost reasons. Significant price increases, or disruptions in the ability to obtain such equipment and supplies from existing vendors, may force us to increase our prices (which we may be unable to do) or reduce our margins and could force us to use alternative vendors. Any change in the existing vendors we use could cause delays in the delivery of products ~~(such as PPE) during~~and possible losses in revenue, which could adversely affect our results of operations. In addition, alternative vendors may not be available, or may not provide their products and services at similar or favorable prices. If we cannot obtain the ~~COVID-19 pandemic, as well as improved productivity~~patient equipment and ~~manufacturing output, there can be no assurance that such growth rates, increased sales volumes~~supplies we currently use, or ~~other improvements will be maintained during~~alternatives at similar or ~~following the COVID-19 pandemic. We may also see a decline in such growth rates and sales volumes when the impact of the pandemic subsides and the healthcare system returns~~favorable prices, our ability to ~~a more normalized state. In particular, demand for~~provide such products may ~~also decline as government-sponsored COVID-19 response stimulus, relief~~be severely impacted, which could have an adverse effect on our business, financial condition, results of operations, cash flow, capital resources and ~~production initiatives, such as those under~~liquidity.

We are subject to stringent regulatory and licensing requirements, and we have been, are and could become the ~~Defense Production Act (DPA)~~subject of federal and state investigations and compliance reviews.

We are required to comply with extensive and complex laws and regulations at the ~~Coronavirus Aid, Relief~~federal, state and ~~Economic Security (CARES) Act, expire. An accelerated shift of demand away from certain of our products and services could also adversely impact our revenues and profit margins.~~

Furthermore, COVID-19 has impacted and may further impact the broader economies of affected countries, including negatively impacting economic growth, the proper functioning of financial and capital markets, foreign currency exchange rates, and interest rates. For example, the continued spread of COVID-19 has led to disruption and volatility in the global capital markets, which increases the cost of capital and adversely impacts access to capital. Due to the speed with which the situation is developing and the uncertainty of its duration, any future outbreaks, similar pandemics, the timing of recovery, travel restrictions, business closures or business disruptions, a recession, depression or other sustained adverse market event resulting from the spread of the COVID-19 and the effectiveness of actions takenlocal government levels in the United States and other countries where we operate. We, and certain of our employees, also are required to ~~contain~~hold permits and ~~treat~~licenses and to comply with the ~~disease,~~operational and security standards of various governmental bodies and agencies. Any failure to comply with these laws and regulations or any failure to maintain the necessary permits, licenses or approvals, or to comply with the required standards, could disrupt our operations and/or adversely affect our results of operations and financial condition.

Among the U.S. healthcare related laws that we are ~~not able at this time~~subject to ~~predict~~include the ~~extent~~Anti-kickback Statute, the Stark Law, the False Claims Act and similar state laws relating to fraud, waste and abuse. The requirements of these laws are complex and subject to varying interpretations, and it is possible that regulatory authorities could challenge our policies and practices. If we fail to comply with these laws, we could be subject to federal or state government investigations or qui tam actions (false claims cases initiated by private parties purporting to act on behalf of federal or state governments), which ~~the COVID-19 pandemic,~~could result in civil or ~~any future outbreaks or similar pandemics, may have a material effect on our financial or operational results. However, the following adverse risks exist:~~

•Actions by the United States government or other foreign government could affect our business. These actions include purchasing products that we make or sell, imposing new product standards or allowing the use of alternative products, instituting regulatory requirements to purchase only locally manufactured products, exercising control over manufacturing or distribution operations, including use of the DPA, taking trade actionscriminal sanctions, including the ~~imposition~~loss of licenses or ~~removal of tariffs or import / export controls, subsidizing~~ the ~~supply of products, imposition of vaccine mandates or other actions;~~

•~~Quarantine decisions by public or private entities may influence our~~ ability to ~~operate or our ability to ship or receive products. For example, if shipping companies cease or reduce land or sea freight channels, raw material~~participate in Medicare, Medicaid and ~~finished good deliveries may be slowed or stopped;~~

•~~Our customers may change their payment patterns or lose their ability to pay invoices, which could have a material adverse impact on our cash flow;~~

•Our suppliers may increase pricing or impose new purchasing requirements, such as minimum purchase quantities or pay-in-advance payment terms, which could have a material adverse impact on our cash flow;

•~~Raw materials or finished goods that we require for our operations may not be available, or pricing for such items may increase beyond the willingness of our customers to pay;~~

•~~New competitors may enter our market, including both small~~other federal and ~~large scale manufacturers;~~

•COVID-19 illness among our workers in manufacturing or distribution operations could impact our operations or compel the closure of one or more facilities for an unknown period of time. Labor relations in our facilities related to COVID-19 could also negatively impact our operations;

•~~We may invest in additional manufacturing capacity for which demand slows in the future, which could have a material adverse impact on our cash flow;~~state healthcare programs. Such sanctions and

•Technology infrastructure failures could materially inhibit our operations that currently include a substantial portion of remote work. For example, voice or data line failures resulting from natural, manmade or cyber-attack could impair our ability to operate.

We have incurred additional costs to ensure we meet the needs of our customers, including increasing our workforce in order to produce or distribute certain essential products for our customers, providing personal protective equipment to our workforce, incremental shipping and transportation costs, incremental technology costs, and additional cleaning costs throughout our facilities. We expect to continue to incur additional costs, which may be significant as we continue to implement operational changes in response to this pandemic, any future outbreaks or similar pandemics. Further, our management is focused on mitigating COVID-19, which has required and will continue to require, a large investment of time and resources across our enterprise and will delay other value added services and strategic initiatives. Additionally, some of our teammates are currently working remotely. An extended period of remote work arrangements, and any worsening of the COVID-19 pandemic, or future outbreaks, could strain our business continuity plans, introduce operational risk, including but not limited to cybersecurity risks, and impair our ability to manage our business. If we do not respond appropriately to the pandemic, any future outbreaks or similar pandemics, or if customers do not perceive our response to be adequate for the United States or our international markets, we could suffer damage to our reputation and our brands, which damages could adversely affect our ~~business.~~results of operations and financial condition.

Our global operations are also subject to risks of violation of laws, including those that prohibit improper payments to and bribery of government officials and other individuals and organizations. These laws include the U.S. Foreign Corrupt Practices Act, the U.K. Bribery Act and other similar laws and regulations in foreign jurisdictions, any violation of which could result in substantial liability and a loss of reputation in the marketplace. Failure to comply with these laws also could subject us to civil and criminal penalties that could adversely affect our business and results of operations.

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Our Patient Direct business is a Medicare-certified supplier and participates in state Medicaid programs. Failure to comply with applicable standards and regulations could result in civil or criminal sanctions, including the loss of our ability to participate in Medicare, Medicaid and other federal and state healthcare programs.

We collect, handle and maintain patient-identifiable health information and other sensitive personal and financial information, which are subject to federal, state and foreign laws that regulate the use and disclosure of such information. Regulations currently in place continue to evolve, and new laws in this area could further restrict our ability to collect, handle and maintain personal or patient information, or could require us to incur additional compliance costs, either of which could have an adverse impact on our results of operations. Violations of federal (such as the Health Insurance Portability and Accountability Act of 1996, as amended, or HIPAA), state or foreign laws (such as the European Union’s General Data Protection Regulation, as amended, or GDPR) concerning privacy and data protection could subject us to civil or criminal penalties, breach of contract claims, costs for remediation and harm to our reputation.

Our operations, including our billing practices and our arrangements with healthcare providers, are also subject to extensive federal and state laws and audits, inquiries and investigations from government agencies. For example, in connection with the settlement agreements resolving the investigation conducted by the U.S. Attorney's Office for the Southern District of New York regarding civil investigative demands, Apria was required to enter into a five-year Corporate Integrity Agreement (CIA) with the Office of Inspector General for the U.S. Department of Health and Human Services. The CIA provides that Apria will, among other things, impose certain oversight obligations on its board of directors, provide certain management certifications, and continue or implement, as applicable certain compliance training and education. The CIA also requires Apria to engage independent third parties to review compliance with the CIA, as well as certain reporting, certification, record retention and notification requirements. Failure to comply with the obligations under the CIA could have material consequences for Apria including monetary penalties or exclusion from participation in federal healthcare programs. Applicable laws may be directed at payments for the products and services we provide, conduct of our operations, preventing fraud and abuse, and billing and reimbursement from government programs such as Medicare and Medicaid and from commercial payors. These laws may have related rules and regulations that are subject to interpretation and may not provide definitive guidance as to their application to our operations, including our arrangements with hospitals, physicians, and other healthcare providers.

Federal and state governments have contracted with private entities to audit and recover revenue resulting from payments made in excess of those permitted by federal and state benefit program rules. These entities include, but are not limited to, Recovery Audit Contractors that are responsible for auditing Medicare claims, Unified Program Integrity Contractors that are responsible for the identification of suspected fraud through medical record review and Medicaid Integrity Contractors, that are responsible for auditing Medicaid claims. We believe audits, inquiries, and investigations from these contractors and others will occur from time to time in the ordinary course of our business. We also may be subject to increased audits from commercial payors and pursuant to federal, civil, and criminal statutes that relate to our billings to commercial payors. Our efforts to be responsive to these audits, inquiries, and investigations may result in substantial costs and divert management’s time and attention away from the operation of our business. Moreover, an adverse outcome with respect to any audit, inquiry or investigation may result in damage to our reputation, or in fines, penalties or other sanctions imposed on us. Such pending or future audits, inquiries, or investigations, or the public disclosure of such matters, could have a material adverse effect on our business, financial condition, results of operations, cash flow, capital resources and liquidity.

Federal and state laws are broadly worded and may be interpreted or applied by prosecutorial, regulatory, or judicial authorities in ways that we cannot predict. Additionally, in many instances, there are only limited publicly available guidelines and methodologies for determining errors with certain audits. As a result, there can be a significant lack of clarity regarding required documentation and audit methodology. The clarity and completeness of each patient medical file, some of which is the work product of physicians not employed by us, is essential to successfully challenging any payment denials.

Accordingly, our arrangements and business practices may be the subject of government scrutiny or be found to violate applicable laws. If federal or state government officials challenge our operations or arrangements with third parties that we have structured based upon our interpretation of these laws, rules, and regulations, such a challenge could potentially disrupt our business operations and we may incur substantial defense costs, even if we successfully defend our interpretation of these laws, rules, and regulations. If the government or third parties successfully challenge our interpretation, such a challenge may have a material adverse effect on our business, financial condition, results of operations, cash flow, capital resources and liquidity.

Our failure to comply with regulatory requirements or receive regulatory clearances or approvals for our medical gas facilities, products or operations could adversely affect our business.

We have a number of medical gas facilities in several states. These facilities are subject to federal and state regulatory requirements. Our medical gas facilities and operations are subject to extensive regulation by the FDA and other federal and state authorities. The FDA regulates medical gases, including medical oxygen, pursuant to its authority under the FFDCA. Among other requirements, the FDA’s cGMP regulations impose certain quality control, documentation, and recordkeeping requirements on the receipt, processing, and distribution of medical gas. Further, in each state where we operate medical gas facilities, we are subject to regulation under state health and safety laws, which vary from state to state. The FDA and state authorities conduct periodic, unannounced inspections at medical gas facilities to assess compliance with the cGMP and other regulations. We expend significant time, money, and resources in an effort to achieve substantial compliance with the cGMP

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regulations and other federal and state law requirements at each of our medical gas facilities. There can be no assurance, however, that these efforts will be successful and that our medical gas facilities will achieve and maintain compliance with federal and state laws and regulations. Our failure to achieve and maintain regulatory compliance at our medical gas facilities could result in enforcement action, including warning letters, fines, product recalls or seizures, temporary or permanent injunctions, or suspensions in operations at one or more locations, as well as civil or criminal penalties, all of which could materially harm our business, financial condition, results of operations, cash flow, capital resources, and liquidity.

The medical gas products we manufacture and distribute and certain other products we distribute are subject to extensive regulation by the FDA and other federal and state governing authorities. Compliance with FDA, state, and other requirements regarding production, safety, quality, manufacturing, distribution and marketing is costly and time-consuming, and while we seek to be in full compliance, instances of non-compliance could arise from time to time. We cannot be assured that any of our medical gases will be certified by the FDA. We have applied for, and received, designated gas certifications for our medical gas products. We may not be successful in receiving certification in the future. Other potential product manufacturing-related risks include difficulties or delays in product manufacturing, sales, or marketing, which could affect future results through regulatory actions, shutdowns, approval delays, withdrawals, recalls, penalties, supply disruptions or shortages, reputational harm, product liability, and/or unanticipated costs.

Failure to comply with applicable regulatory requirements could result in administrative enforcement action by the FDA or state agencies, which may include any of the following: adverse publicity; warning or untitled letters; fines; injunctions; consent decrees; civil money penalties; recalls; termination of distribution or seizure of our products; operating restrictions or partial suspension or total shutdown of production; delays in the introduction of products into the market; withdrawals or suspensions of current medical gas certifications or drug approvals, resulting in prohibitions on sales of our products; and criminal prosecution. There is also a risk that we may not adequately implement sustainable processes and procedures to maintain regulatory compliance and to address future regulatory agency findings, should they occur. The FDA may change its policies, adopt additional regulations or revise existing regulations, each of which could prevent or delay certification of our medical gases, or could impact our ability to market a device that was previously certified or cleared by the FDA. Any of ~~COVID-19~~these sanctions could result in higher than anticipated costs or lower than anticipated sales and have a material adverse effect on our business, financial condition, results of operations, cash flow, capital resources and liquidity.

Our operations involve the storage, transportation and provision of compressed and liquid oxygen, which carries an inherent risk of rupture or other accidents with the potential to cause substantial loss.

Our operations are subject to the many hazards inherent in the storage, transportation and provision of medical gas products and compressed and liquid oxygen, including ruptures, leaks and fires. These risks could result in substantial losses due to personal injury or loss of life, severe damage to and destruction of property and equipment and pollution or other environmental damage and may ~~also exacerbate~~result in curtailment or suspension of our related operations. If a significant accident or event occurs, it could adversely affect our business, financial position and results of operations. Additionally, corrective action plans, fines or other sanctions may be levied by government regulators who oversee the storage, transportation and provision of hazardous materials such as compressed or liquid oxygen.

Our capitation arrangements may prove unprofitable if actual utilization rates exceed our assumptions.

From time to time, we enter into capitation arrangements with commercial payors pursuant to which they agree to pay us a set amount (on a per member per month basis for a defined patient population) without regard to the actual services provided. We negotiate the contractual rates in these arrangements with payors based on assumptions regarding average expected utilization of services. If actual utilization rates exceed our assumptions, the profitability of such arrangements may be diminished. Moreover, we may be obligated to perform under such capitation arrangements even if the contractual reimbursement rates are insufficient to cover our costs based on actual levels of utilization.

Our acquisition of Apria has increased our exposure to risks ~~discussed~~relating to the home healthcare industry.

In 2021, our Patient Direct segment contributed approximately 10% of our consolidated net revenue. On a pro forma basis for the Apria Acquisition, our Patient Direct business would have represented approximately 19% of our consolidated net revenue in ~~Item~~2021. Accordingly, our exposure to risks relating to the home healthcare industry, including those risks previously disclosed in “Item 1A. Risk ~~Factors in~~Factors” of our Annual Report on Form 10-K ~~any~~for the year ended December 31, 2021, has materially increased following our acquisition of ~~which could have a material effect on us. This situation is changing rapidly and additional impacts may arise that we are not aware of currently.~~Apria.

Item 2. Unregistered Sales of Equity Securities, Use of Proceeds and Issuer Purchases of Equity Securities

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Item 6. Exhibits

(a)Exhibits


2.1						Agreement and Plan of Merger, dated as of January 7, 2022, by and among Owens & Minor, Inc., StoneOak Merger Sub Inc. and Apria, Inc. (incorporated by reference to Exhibit 2.1 to Current Report on Form 8-K filed with the SEC on January 10, 2022, File No. 001-09810).

3.1						Amended and Restated Bylaws of the Company effective April 29, ~~2021~~2022 (incorporated herein by reference to the Company’s Current Report on Form 8-K, Exhibit 3.1, dated ~~May 3, 2021)~~April 29, 2022)

4.1						Indenture dated March ~~10, 2021,~~29, 2022 by and among ~~Owens & Minor, Inc.,~~the Company, the guarantors named therein and Regions Bank, as ~~Trustee~~trustee (incorporated herein by reference to the Company’s Current Report on Form 8-K, Exhibit 4.1, dated March ~~11, 2021)~~29, 2022)

4.2						Form of Global Note for the ~~4.500%~~6.625% Senior Notes due ~~2029 (included as Exhibit A to Exhibit 4.1 hereto)~~2030 (incorporated herein by reference to the Company’s Current Report on Form 8-K, Exhibit 4.2, dated March ~~11, 2021)~~29, 2022)

4.3						~~Sixth~~Seventh Supplemental Indenture dated as of March ~~10, 2021,~~29, 2022, by and among ~~Owens & Minor, Inc.,~~the Company, the guarantors ~~signatory thereto~~named therein and U.S. Bank National Association, as trustee (incorporated herein by reference to the Company’s Current Report on Form 8-K, Exhibit 4.3, dated March ~~11, 2021).~~29, 2022)

4.4						First Supplemental Indenture dated as of March 29, 2022, by and among the Company, the guarantors named therein and Regions Bank, as trustee, to the Indenture dated as of March 10, 2021 (incorporated herein by reference to the Company’s Current Report on Form 8-K, Exhibit 4.4, dated March 29, 2022)

4.5						First Supplemental Indenture dated as of March 29, 2022, by and among the Company, the guarantors named therein and Regions Bank, as trustee, to the Indenture dated of March 29, 2022 (incorporated herein by reference to the Company’s Current Report on Form 8-K, Exhibit 4.5, dated March 29, 2022)

10.1						Form of Restricted Stock Agreement ~~of Resignation, Appointment, and Acceptance,~~(incorporated herein by reference to the Company’s Current Report on Form 8-K, Exhibit 10.1, dated ~~as September 10, 2021, by and among Owens & Minor, Inc., U.S. Bank National Association, as Prior Trustee, and Regions Bank, as Successor Trustee~~March 1, 2022)**

10.2						Form of ~~Owens & Minor, Inc.~~ Restricted Stock Unit Award Agreement ~~under~~(incorporated herein by reference to the ~~Company's 2018 Stock Incentive Plan~~Company’s Current Report on Form 8-K, Exhibit 10.2, dated March 1, 2022)**

10.3						Form of ~~Owens & Minor, Inc. Restricted~~2022 Performance Stock Unit Award Agreement ~~under~~(incorporated herein by reference to the ~~Company's~~Company’s Current Report on Form 8-K, Exhibit 10.3, dated March 1, 2022)**

10.4						Credit Agreement dated as of March 29, 2022, by and among the Company, certain subsidiaries of the Company party thereto, as borrowers, JPMorgan Chase Bank, N.A., as an administrative agent and collateral agent, and a syndicate of financial institutions, as lenders (incorporated herein by reference to the Company’s Current Report on Form 8-K, Exhibit 10.1, dated March 29, 2022)**

10.5						Fourth Amendment to Receivables Financing Agreement, dated as of March 29, 2022, by and among O&M Funding LLC, as borrower, Owens & Minor Medical, Inc., as initial servicer, the lenders party thereto, and PNC Bank, National Association, as administrative agent (incorporated herein by reference to the Company’s Current Report on Form 8-K, Exhibit 10.2, dated March 29, 2022)**

10.6						Joinder to Credit Agreement, Amendment No. 2 to Credit Agreement, Amendment No. 1 to Security Agreement and Amendment No. 1 to Guaranty, dated as of March 29, 2022, by and among the Company and certain subsidiaries of the Company, as borrowers, the guarantors and lenders thereto and Bank of America, N.A., as administrative agent and collateral agent, L/C issuer and swing line lender - filed herewith

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10.7						Amendment No. 3 t o the Owens & Minor, Inc. 2018 Stock Incentive Plan - filed herewith **

22.1						List of Guarantor Subsidiaries ~~(incorporated herein by reference to our Annual Report on Form 10-K, Exhibit 22.1, for the year ended December 31, 2020)~~

22.2						List of Subsidiaries Pledged as Collateral

31.1						Certification of Chief Executive Officer pursuant to Rule 13a-14(a) under the Securities Exchange Act of 1934, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

31.2						Certification of Chief Financial Officer pursuant to Rule 13a-14(a) under the Securities Exchange Act of 1934, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

32.1						Certification of Chief Executive Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.

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32.2

Certification of Chief Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.

101.INS

Inline XBRL Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.

101.SCH

Inline XBRL Taxonomy Extension Schema Document

101.CAL

Inline XBRL Taxonomy Extension Calculation Linkbase Document

101.DEF

Inline XBRL Taxonomy Definition Linkbase Document

101.LAB

Inline XBRL Taxonomy Extension Label Linkbase Document

101.PRE

Inline XBRL Taxonomy Extension Presentation Linkbase Document

104

Cover Page Interactive Data File (formatted as inline ~~XBRL~~iXBRL and contained in Exhibit 101)

* Certain exhibits and schedules have been omitted pursuant to Item 601(b)(2) of Regulation S-K. We hereby undertake to furnish copies of such omitted materials supplementally upon request by the SEC.

** Management contract or compensatory plan or arrangement

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SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.


		Owens & Minor, Inc.
		(Registrant)

Date:	~~November~~May 3, ~~2021~~2022	/s/ Edward A. Pesicka
		Edward A. Pesicka
		President, Chief Executive Officer & Director

Date:	~~November~~May 3, ~~2021~~2022	/s/ Andrew G. Long
		Andrew G. Long
		Executive Vice President & Chief Financial Officer

3436


	Three Months Ended September 30,				Nine Months Ended September 30,
	2021		2020		2021		2020
Net revenue:
United States	$	2,380,794	$	2,101,074	$	6,900,222	$	5,872,143
International	121,381		86,854		417,947		246,197
Consolidated net revenue	$	2,502,175	$	2,187,928	$	7,318,169	$	6,118,340