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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, 2022
OR
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)
_______________________________________________________
Virginia54-1701843
(State or other jurisdiction of
incorporation or organization)
(I.R.S. Employer
Identification No.)
9120 Lockwood BoulevardMechanicsvilleVirginia23116
(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 (804723-7000
    Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, $2 par value per shareOMINew 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 filerAccelerated 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 27, 2022 was 76,234,454 shares.



Owens & Minor, Inc. and Subsidiaries
Index
 
Page
Item 1.
Item 2.
Item 3.
Item 4.
Item 1.
Item 1A.
Item 2.
Item 5.
Item 6.
2


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)2022202120222021
Net revenue$2,497,401 $2,502,175 $7,404,368 $7,318,169 
Cost of goods sold1,984,122 2,173,336 5,985,136 6,146,511 
Gross margin513,279 328,839 1,419,232 1,171,658 
Distribution, selling and administrative expenses445,259 262,457 1,177,812 849,255 
Acquisition-related and exit and realignment charges8,898 6,380 50,048 20,967 
Other operating income, net(1,125)(2,873)(5,020)(5,016)
Operating income60,247 62,875 196,392 306,452 
Interest expense, net39,869 11,572 87,727 36,784 
Loss on extinguishment of debt   40,433 
Other expense, net783 799 2,347 2,397 
Income before income taxes19,595 50,504 106,318 226,838 
Income tax provision7,098 6,375 25,937 47,224 
Net income$12,497 $44,129 $80,381 $179,614 
Net income per common share:
Basic$0.17 $0.60 $1.08 $2.47 
Diluted$0.16 $0.58 $1.05 $2.38 
See accompanying notes to consolidated financial statements.
3

Owens & Minor, Inc. and Subsidiaries
Consolidated Statements of Comprehensive Income
(unaudited)
 
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2022202120222021
Net income$12,497 $44,129 $80,381 $179,614 
Other comprehensive income (loss) net of tax:
Currency translation adjustments(19,986)(12,014)(39,604)(26,724)
Change in unrecognized net periodic pension costs288 395 774 552 
Change in gains and losses on derivative instruments9,167  11,931 20,044 
Total other comprehensive (loss), net of tax(10,531)(11,619)(26,899)(6,128)
Comprehensive income$1,966 $32,510 $53,482 $173,486 
    
See accompanying notes to consolidated financial statements.
4

Owens & Minor, Inc. and Subsidiaries
Consolidated Balance Sheets
(unaudited)
 
September 30,December 31,
(in thousands, except per share data)20222021
Assets
Current assets
Cash and cash equivalents$76,770 $55,712 
Accounts receivable, net of allowances of $11,016 and $18,003
751,970 681,564 
Merchandise inventories1,508,443 1,495,972 
Other current assets104,734 88,564 
Total current assets2,441,917 2,321,812 
Property and equipment, net of accumulated depreciation of $414,920 and $334,500
575,799 317,235 
Operating lease assets275,833 194,006 
Goodwill1,631,336 390,185 
Intangible assets, net464,077 209,745 
Other assets, net149,620 103,568 
Total assets$5,538,582 $3,536,551 
Liabilities and equity
Current liabilities
Accounts payable$1,156,230 $1,001,959 
Accrued payroll and related liabilities106,618 115,858 
Other current liabilities339,526 226,204 
Total current liabilities1,602,374 1,344,021 
Long-term debt, excluding current portion2,547,059 947,540 
Operating lease liabilities, excluding current portion215,022 162,241 
Deferred income taxes83,473 35,310 
Other liabilities123,817 108,938 
Total liabilities4,571,745 2,598,050 
Commitments and contingencies
Equity
Common stock, par value $2 per share; authorized - 200,000 shares; issued and outstanding - 76,217 shares and 75,433 shares
152,434 150,865 
Paid-in capital413,894 440,608 
Retained earnings467,999 387,619 
Accumulated other comprehensive loss(67,490)(40,591)
Total equity966,837 938,501 
Total liabilities and equity$5,538,582 $3,536,551 
See accompanying notes to consolidated financial statements.
5

    Owens & Minor, Inc. and Subsidiaries
Consolidated Statements of Cash Flows
(unaudited)
Nine Months Ended September 30,
(in thousands)20222021
Operating activities:
Net income$80,381 $179,614 
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization155,438 68,142 
Share-based compensation expense15,765 19,078 
Loss on extinguishment of debt
 40,433 
Provision for losses on accounts receivable5,289 19,270 
Deferred income tax expense (benefit)2,991 (18,286)
Changes in operating lease right-of-use assets and lease liabilities922 1,190 
Gain on sale and dispositions of property and equipment (17,002) 
Changes in operating assets and liabilities:
Accounts receivable7,417 (84,381)
Merchandise inventories(6,823)(284,188)
Accounts payable30,424 120,821 
Net change in other assets and liabilities(45,423)(8,341)
Other, net8,666 20,484 
Cash provided by operating activities238,045 73,836 
Investing activities:
Acquisition, net of cash acquired(1,684,607) 
Additions to property and equipment(109,275)(26,446)
Additions to computer software(5,873)(6,179)
Proceeds from sale of property and equipment29,720 41 
Other, net(1,670) 
Cash used for investing activities(1,771,705)(32,584)
Financing activities:
Proceeds from issuance of debt1,691,000 574,900 
Borrowings (repayments) under revolving credit facility, net and accounts receivable securitization program30,000 (90,900)
Repayments of debt(3,000)(553,140)
Borrowings under amended accounts receivable securitization program697,700  
Repayments under amended accounts receivable securitization program(770,700) 
Financing costs paid(42,602)(13,912)
Cash dividends paid (548)
Payment for termination of interest rate swaps
 (15,434)
Other, net(41,813)(18,188)
Cash provided by (used for) financing activities1,560,585 (117,222)
Effect of exchange rate changes on cash, cash equivalents and restricted cash(5,752)(2,454)
Net increase (decrease) in cash, cash equivalents and restricted cash21,173 (78,424)
Cash, cash equivalents and restricted cash at beginning of period72,035 134,506 
Cash, cash equivalents and restricted cash at end of period$93,208 $56,082 
Supplemental disclosure of cash flow information:
Income taxes paid, net of refunds$33,568 $83,606 
Interest paid$61,889 $32,035 
Noncash investing activity:
Unpaid purchases of property and equipment and software at end of period$63,158 $ 
See accompanying notes to consolidated financial statements.
6

Owens & Minor, Inc. and Subsidiaries
Consolidated Statements of Changes in Equity
(unaudited)
 
(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, 202175,433 $150,865 $440,608 $387,619 $(40,591)$938,501 
Net income39,279 39,279 
Other comprehensive loss(598)(598)
Share-based compensation expense, exercises and other653 1,307 (30,867)(29,560)
Balance, March 31, 202276,086 152,172 409,741 426,898 (41,189)947,622 
Net income28,604 28,604 
Other comprehensive loss(15,770)(15,770)
Share-based compensation expense, exercises and other85 171 (1,968)(1,797)
Balance, June 30, 202276,171 152,343 407,773 455,502 (56,959)958,659 
Net income12,497 12,497 
Other comprehensive loss(10,531)(10,531)
Share-based compensation expense, exercises and other46 91 6,121 6,212 
Balance, September 30, 202276,217 $152,434 $413,894 $467,999 $(67,490)$966,837 
Balance, December 31, 202073,472 $146,944 $436,597 $167,022 $(38,509)$712,054 
Net income69,589 69,589 
Other comprehensive income7,903 7,903 
Dividends declared ($0.0025 per share)
(434)(434)
Share-based compensation expense, exercises and other1,628 3,256 (6,107)(2,851)
Balance, March 31, 202175,100 150,200 430,490 236,177 (30,606)786,261 
Net income65,896 65,896 
Other comprehensive loss(2,412)(2,412)
Dividends declared ($0.0025 per share)
(187)(187)
Share-based compensation expense, exercises and other295 591 (2,130)(1,539)
Balance, June 30, 202175,395 150,791 428,360 301,886 (33,018)848,019 
Net income44,129 44,129 
Other comprehensive loss(11,619)(11,619)
Dividends declared ($0.0025 per share)
(183)(183)
Share-based compensation expense, exercises and other34 67 6,592 6,659 
Balance, September 30, 202175,429 $150,858 $434,952 $345,832 $(44,637)$887,005 
See accompanying notes to consolidated financial statements.
7

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 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 results of operations for interim periods are not necessarily indicative of the results expected for the full year.
Our business has two 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 have reported financial results using this two segment structure and have recast our 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 North America, 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, 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 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.
September 30, 2022December 31, 2021
Cash and cash equivalents$76,770 $55,712 
Restricted cash included in Other assets, net16,438 16,323 
Total cash, cash equivalents, and restricted cash$93,208 $72,035 

Property and Equipment, net
Property and equipment are stated at cost less accumulated depreciation. Depreciation and amortization expense for financial reporting purposes is computed on a straight-line method over the estimated useful lives of the assets or, for capital leases and leasehold improvements, over the term of the lease, if shorter. In general, the estimated useful lives for computing depreciation and amortization are three to 15 years for machinery and equipment, five to 40 years for buildings, one to 10 years for patient equipment, and up to 15 years for leasehold and land improvements. Straight-line and accelerated methods of depreciation are used for income tax purposes. Normal maintenance and repairs are expensed as incurred, and renovations and
8


betterments are capitalized. We suspend depreciation and amortization on assets that are held for sale. In addition, we record capital-related government grants earned as reductions to the cost of property and equipment; and associated unpaid liabilities and grant proceeds receivable are considered non-cash changes in such balances for purposes of preparation of our consolidated statements of cash flows. Patient equipment consists of medical equipment rented to patients on a month-to-month basis. Patient equipment depreciation is classified in our consolidated statements of operations within cost of goods sold as the equipment is rented to patients as part of our primary operations within the Patient Direct segment.
Revenue Recognition
Our revenue is primarily generated from sales contracts with customers. Under most of our distribution and product sales arrangements, our performance obligations are limited to delivery of products to a customer upon receipt of a purchase order. For these arrangements, we recognize revenue at the point in time when shipment is completed, as control passes to the customer upon product receipt.
Revenue for activity-based fees and other services is recognized over time as activities are performed. Depending on the specific contractual provisions and nature of the performance obligation, revenue from services may be recognized on a straight-line basis over the term of the service, on a proportional performance model, based on level of effort, or when final deliverables have been provided.
Our contracts sometimes allow for forms of variable consideration including rebates, discounts, performance guarantees, and implicit price concessions. In these cases, we estimate the amount of consideration to which we will be entitled in exchange for transferring the product or service to the customer. Rebates and customer discounts are estimated based on contractual terms or historical experience and we maintain an accrual for rebates or discounts that have been earned but are unpaid. When we have implicit price concessions, we determine the variable consideration under the expected value method as part of determining the sales transaction price using historical reimbursement experience, historical sales returns, and other operating trends.
In most cases, we record revenue gross, as we are the primary obligor. When we act as an agent in a sales arrangement and do not bear a significant portion of inventory risks, primarily for our outsourced logistics business, we record revenue net of product cost. Sales taxes collected from customers and remitted to governmental authorities are excluded from revenues.
Within our Patient Direct segment, revenues are recognized under fee-for-service arrangements for equipment we rent to patients and sales of equipment, supplies and other items we sell to patients. Revenue that is generated from equipment that we rent to patients is primarily recognized over the noncancelable rental period, typically one month, and commences on delivery of the equipment to the patients. Revenues are recorded at amounts estimated to be received under reimbursement arrangements with third-party payors, including private insurers, prepaid health plans, Medicare, Medicaid and patients. Rental revenue, less estimated adjustments, is recognized as earned on a straight-line basis over the noncancellable lease term. We recorded $148 million and $299 million in revenue related to equipment we rent to patients for the three and nine months ended September 30, 2022. Equipment rental revenue was not material in the prior year.

Note 2—Fair Value
The carrying amounts of cash and cash equivalents, accounts receivable, 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 our derivative contracts is 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.

Note 3—Acquisition
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, 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 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.
The following table presents the preliminary estimated fair value of the assets acquired and liabilities assumed recognized as of the Acquisition Date. The fair value and useful lives of tangible and intangible assets acquired have been
9


estimated based on various valuation methods, including the income and cost approach, using several significant unobservable inputs including, but not limited to projected cash flows and a discount rate. These inputs are considered Level 3 inputs. The allocation of purchase price to assets and liabilities acquired is not yet complete, as valuations of tangible and intangible assets and liabilities are still in process. The updated preliminary purchase price allocation resulted in an approximate $8.3 million reduction in intangible amortization expense during the three months ended September 30, 2022 that would have been recognized in previous periods if the adjustment to provisional amounts were recognized as of the Acquisition Date. This reduction resulted from a reallocation of intangible assets value to those with longer useful lives as compared to the purchase price allocation originally estimated as of the Acquisition Date.
Preliminary Fair Value Originally Estimated as of Acquisition Date(1)
Differences Between Prior and the Current Periods Preliminary Fair Value EstimatePreliminary Fair Value Currently Estimated as of Acquisition Date
Assets acquired:
Current assets$142,136 $(1,968)$140,168 
Goodwill1,267,079 (17,601)1,249,478 
Intangible assets295,466 17,334 312,800 
Other non-current assets371,320 (11,149)360,171 
Total assets$2,076,001 $(13,384)$2,062,617 
Liabilities assumed:
Current liabilities$241,266 $5,012 $246,278 
Noncurrent liabilities150,128 (18,396)131,732 
Total liabilities391,394 (13,384)378,010 
Fair value of net assets acquired, net of cash$1,684,607 $ $1,684,607 

(1) As previously reported in our first quarter 2022 Form 10-Q.
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 relationships, including payor and capitated relationships, and trade names over their estimated weighted average useful lives of one to 15 years.
Goodwill of $1.2 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. Approximately $32 million of the goodwill 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 and nine months ended September 30, 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.
Three Months Ended September 30,Nine Months Ended September 30,
2022202120222021
Net revenue$2,497,401 $2,789,372 $7,681,481 $8,166,919 
Net income (loss)$12,497 $66,935 $(39,696)$227,540 
Pro forma net loss of $39.7 million for the nine months ended September 30, 2022 includes pro forma adjustments for interest expense of $20.8 million and amortization of intangible assets of $10.9 million, which reflects the updated preliminary purchase price allocation. 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. Revenue and net income of Apria since the Acquisition Date for the three months ended September 30, 2022 included in the consolidated statement of operations were $310 million and $0.7 million, respectively. Revenue and net loss of Apria since the Acquisition Date included in the consolidated statement of operations for the nine months ended September 30, 2022 were $620 million and $38.4 million, respectively.

10


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, 2022:
Products & Healthcare ServicesPatient DirectConsolidated
Carrying amount of goodwill, December 31, 2021$106,280 $283,905 $390,185 
Acquisitions(532)1,249,478 1,248,946 
Currency translation adjustments(7,795) (7,795)
Carrying amount of goodwill, September 30, 2022$97,953 $1,533,383 $1,631,336 

Intangible assets subject to amortization at September 30, 2022 and December 31, 2021 were as follows:

September 30, 2022December 31, 2021
Customer
Relationships
TradenamesOther
Intangibles
Customer
Relationships
TradenamesOther
Intangibles
Gross intangible assets$434,582 $202,000 $79,062 $275,526 $90,000 $43,189 
Accumulated amortization(182,741)(45,203)(23,623)(146,168)(33,242)(19,560)
Net intangible assets$251,841 $156,797 $55,439 $129,358 $56,758 $23,629 
Weighted average useful life12 years10 years7 years10 years11 years8 years

At September 30, 2022 and December 31, 2021, $142 million and $164 million in net intangible assets were held in the Products & Healthcare Services segment and $322 million and $45.7 million were held in the Patient Direct segment. Amortization expense for intangible assets was $14.3 million and $10.0 million for the three months ended September 30, 2022 and 2021 and $55.5 million and $30.1 million for the nine months ended September 30, 2022 and 2021. At September 30, 2022, customer relationships, tradenames, and other intangibles include preliminary estimated fair values of assets acquired as part of the Apria Acquisition.
Based on the current carrying value of intangible assets subject to amortization, estimated amortization expense is approximately $22 million for the remainder of 2022, $82 million for 2023, $65 million for 2024, $55 million for 2025, $54 million for 2026 and $47 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 realignment which include leadership reorganization costs, certain professional fees, 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, 2022 and 2021 were as follows:
Three Months Ended
 September 30,
Nine Months Ended
September 30,
2022202120222021
Products & Healthcare Services$1,983 $5,091 $4,396 $18,933 
Patient Direct 1,289 483 2,034 
Total exit and realignment charges$1,983 $6,380 $4,879 $20,967 
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The following table summarizes the activity related to exit and realignment cost accruals through September 30, 2022 and 2021:
Total
Accrued exit and realignment costs, December 31, 2021$8,306 
Provision for exit and realignment activities:
Severance811 
Other871 
Cash payments(6,903)
Accrued exit and realignment costs, March 31, 20223,085
Provision for exit and realignment activities:
Severance246 
Other968 
Cash payments(3,477)
Accrued exit and realignment costs, June 30, 2022822
Provision for exit and realignment activities:
Other1,251 
Cash payments(1,693)
Accrued exit and realignment costs, September 30, 2022$380 
Accrued exit and realignment costs, December 31, 2020$3,146 
Provision for exit and realignment activities:
Information system restructuring costs1,029 
Lease obligations347 
Other781 
Cash payments(2,915)
Accrued exit and realignment costs, March 31, 20212,388
Provision for exit and realignment activities:
Information system restructuring costs1,611 
Lease obligations(126)
Other989 
Cash payments(2,302)
Accrued exit and realignment costs, June 30, 20212,560
Provision for exit and realignment activities:
Information system restructuring costs1,506 
Lease obligations107 
Other3,142 
Cash payments(4,199)
Accrued exit and realignment costs, September 30, 2021$3,116 
In addition to the exit and realignment accruals in the preceding table, we also incurred $0.7 million of costs that were expensed as incurred for the three and nine months ended September 30, 2022, which related to an increase in reserves associated with certain retained assets of Fusion5. We incurred $1.6 million and $11.6 million of costs that were expensed as incurred for the three and nine months ended September 30, 2021, which 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.
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Acquisition-related charges within acquisition-related and exit and realignment charges presented in our consolidated statements of operations were $6.9 million and $45.2 million for the three and nine months ended September 30, 2022, which consisted primarily of costs related to the Apria Acquisition. There were no 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, 2021.
We do not expect material additional costs in 2022 for activities that were initiated through September 30, 2022.

Note 6—Debt

Debt consists of the following:
September 30, 2022December 31, 2021
Carrying
Amount
Estimated
Fair Value
Carrying
Amount
Estimated
Fair Value
Receivables securitization program$153,823 $157,000 $197,026 $200,000 
4.375% Senior Notes, due December 2024
245,436 239,179 245,086 263,263 
Term Loan A490,278 500,000   
4.500% Senior Notes, due March 2029
492,469 394,855 491,656 515,225 
Term Loan B577,062 585,806   
6.625% Senior Notes, due April 2030
584,934 526,968   
Finance leases and other17,777 17,777 15,809 15,809 
Total debt2,561,779 2,421,585 949,577 994,297 
Less current maturities(14,720)(14,720)(2,037)(2,037)
Long-term debt$2,547,059 $2,406,865 $947,540 $992,260 

We have $246 million, excluding deferred financing costs and third party fees, of 4.375% senior notes due in December 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 March 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 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 29, 2022, we completed the sale of $600 million in aggregate principal amount of our 6.625% senior notes due in April 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 Indenture dated March 29, 2022 (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 are effectively subordinated to any of our secured indebtedness, including indebtedness under our credit agreements.
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On March 29, 2022, we entered into a term loan credit agreement with an administrative agent and collateral agent and a syndicate of financial institutions, as lenders (the Credit Agreement) that provides for two new credit facilities (i) a $500 million 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 the 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 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 (i) increased the aggregate revolving credit commitments under the Revolving Credit Agreement by $150 million, to an aggregate amount of $450 million and (ii) replaced 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 September 30, 2022, we had no borrowings and letters of credit of $27.9 million under our Revolving Credit Agreement. At December 31, 2021, we had no borrowings and letters of credit of $9.4 million outstanding under our Revolving Credit Agreement. At September 30, 2022 and December 31, 2021, we had $422 million and $291 million available for borrowing under our Revolving Credit Agreement. We also had letters of credit and bank guarantees, which were issued outside of the Revolving Credit Agreement for $2.3 million and $2.2 million as of September 30, 2022 and December 31, 2021, which supports certain leased facilities as well as other normal business activities in the United States and Europe.
On March 29, 2022, we entered into a Security Agreement Supplement pursuant to which the Security and Pledge Agreement (the Security Agreement), dated March 10, 2021 was supplemented to grant collateral on behalf of the holders of the 2024 Notes, and the parties secured under the 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 Grantors (as defined in the Security Agreement) in the Grantors’ present and future subsidiaries, subject to certain customary exceptions, and (b) all present and future personal property and assets of the Grantors, subject to certain exceptions.
On March 29, 2022, we entered into an amendment to our accounts receivable securitization program (the Receivables Financing Agreement). Pursuant to the amended Receivables 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 Financing Agreement is based on a spread over a benchmark SOFR rate (as described in the Fourth Amendment to the Receivables Financing Agreement). Under the Receivables 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 Financing Agreement matures in March 2025.
The Revolving Credit Agreement, Term Loan A, Term Loan B, Receivables Financing Agreement, 2024 Notes, 2029 Unsecured Notes, and 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 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, 2022.
As of September 30, 2022, scheduled future principal payments of debt, excluding finance leases and other, were $1.5 million in 2022, $15.4 million in 2023, $274 million in 2024, of which $254 million is due in December 2024, $197 million in 2025, $43.5 million in 2026, $403 million in 2027, $6.0 million in 2028, $1.1 billion in 2029, and $600 million in 2030. Current maturities at September 30, 2022 include $6.3 million in principal payments on our Term Loan A, $6.0 million in principal payments on our Term Loan B and $2.5 million in current portion of finance leases.

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Note 7—Retirement Plans

We have a frozen noncontributory, unfunded retirement plan for certain retirees in the United States (U.S. Retirement Plan). As of September 30, 2022 and December 31, 2021, the accumulated benefit obligation of the U.S. Retirement Plan was $48.3 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, 2022 and 2021 were as follows:
Three Months Ended
 September 30,
Nine Months Ended
 September 30,
2022202120222021
Service cost$603 $693 $1,853 $2,106 
Interest cost516 443 1,559 1,337 
Recognized net actuarial loss267 353 801 1,060 
Net periodic benefit cost$1,386 $1,489 $4,213 $4,503 


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 pay interest on our Credit Agreement which fluctuates based on changes in our benchmark interest rates. In order to mitigate the risk of 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 interest rate swaps were designated as cash flow hedges. Cash flows related to the interest rate swap agreement are included in interest expense.
We determine the fair value of our foreign currency derivatives and interest rate swaps 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. 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.
The following table summarizes the terms and fair value of our outstanding derivative financial instruments as of September 30, 2022:
Derivative AssetsDerivative Liabilities
Notional AmountMaturity DateClassificationFair ValueClassificationFair Value
Cash flow hedges
Interest rate swaps$400,000 March 2027Other assets, net$16,123 Other liabilities$ 
Economic (non-designated) hedges
Foreign currency contracts$54,062 October 2022Other current assets$97 Other current liabilities$273 
In March 2021, we terminated the remaining $300 million in notional value of interest rate swaps concurrent with the debt financing transaction. The remaining balance of the fair value adjustments of $25.1 million, which related to these
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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 months ended September 30, 2021.
The following table summarizes the terms and fair value of our outstanding derivative financial instruments as of December 31, 2021:
Derivative AssetsDerivative Liabilities
Notional AmountMaturity DateClassificationFair ValueClassificationFair Value
Economic (non-designated) hedges
Foreign currency contracts$9,700 January 2022Other current assets$81 Other current liabilities$ 

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, 2022:
Amount of Gain Recognized in Other Comprehensive Income (Loss)Location of Loss Reclassified from Accumulated Other Comprehensive Loss into IncomeTotal Amount of Expense Line Items Presented in the Consolidated Statement of Operations in Which the Effects are RecordedAmount of Loss Reclassified from Accumulated Other Comprehensive Loss into Income
Three months ended September 30, 2022Nine months ended September 30, 2022Three months ended September 30, 2022Nine months ended September 30, 2022Three months ended September 30, 2022Nine months ended September 30, 2022
Interest rate swaps$12,153 $14,197 Interest expense, net$39,869 $87,727 $(234)$(1,926)
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, 2021:
Amount of Gain Recognized in Other Comprehensive Income (Loss)Location of Loss Reclassified from Accumulated Other Comprehensive Loss into IncomeTotal Amount of Expense Line Items Presented in the Consolidated Statement of Operations in Which the Effects are RecordedAmount of Loss Reclassified from Accumulated Other Comprehensive Loss into Income
Three months ended September 30, 2021Nine months ended September 30, 2021Three months ended September 30, 2021Nine months ended September 30, 2021Three months ended September 30, 2021Nine months ended September 30, 2021
Interest rate swaps$ $2,426